Well Child Care, 2 Weeks

YOUR TWO-WEEK-OLD:

  • Will sleep a total of 15 to 18 hours a day, waking to feed or for diaper changes. Your baby does not know the difference between night and day.

  • Has weak neck muscles and needs support to hold his or her head up.

  • May be able to lift their chin for a few seconds when lying on their tummy.

  • Grasps object placed in their hand.

  • Can follow some moving objects with their eyes. They can see best 7 to 9 inches (8 cm to 18 cm) away.

  • Enjoys looking at smiling faces and bright colors (red, black, white).

  • May turn towards calm, soothing voices. Newborn babies enjoy gentle rocking movement to soothe them.

  • Tells you what his or her needs are by crying. May cry up to 2 or 3 hours a day.

  • Will startle to loud noises or sudden movement.

  • Only needs breast milk or infant formula to eat. Feed the baby when he or she is hungry. Formula-fed babies need 2 to 3 ounces (60 ml to 89 ml) every 2 to 3 hours. Breastfed babies need to feed about 10 minutes on each breast, usually every 2 hours.

  • Will wake during the night to feed.

  • Needs to be burped halfway through feeding and then at the end of feeding.

  • Should not get any water, juice, or solid foods.

SKIN/BATHING

  • The baby's cord should be dry and fall off by about 10 to 14 days. Keep the belly button clean and dry.

  • A white or blood-tinged discharge from the female baby's vagina is common.

  • If your baby boy is not circumcised, do not try to pull the foreskin back. Clean with warm water and a small amount of soap.

  • If your baby boy has been circumcised, clean the tip of the penis with warm water. Apply petroleum jelly to the tip of the penis until bleeding and oozing has stopped. A yellow crusting of the circumcised penis is normal in the first week.

  • Babies should get a brief sponge bath until the cord falls off. When the cord comes off, the baby can be placed in an infant bath tub. Babies do not need a bath every day, but if they seem to enjoy bathing, this is fine. Do not apply talcum powder due to the chance of choking. You can apply a mild lubricating lotion or cream after bathing.

  • The two week old should have 6 to 8 wet diapers a day, and at least one bowel movement "poop" a day, usually after every feeding. It is normal for babies to appear to grunt or strain or develop a red face as they pass their bowel movement.

  • To prevent diaper rash, change diapers frequently when they become wet or soiled. Over-the-counter diaper creams and ointments may be used if the diaper area becomes mildly irritated. Avoid diaper wipes that contain alcohol or irritating substances.

  • Clean the outer ear with a wash cloth. Never insert cotton swabs into the baby's ear canal.

  • Clean the baby's scalp with mild shampoo every 1 to 2 days. Gently scrub the scalp all over, using a wash cloth or a soft bristled brush. This gentle scrubbing can prevent the development of cradle cap. Cradle cap is thick, dry, scaly skin on the scalp.

IMMUNIZATIONS

  • The newborn should have received the first dose of Hepatitis B vaccine prior to discharge from the hospital.

  • If the baby's mother has Hepatitis B, the baby should have been given an injection of Hepatitis B immune globulin in addition to the first dose of Hepatitis B vaccine. In this situation, the baby will need another dose of Hepatitis B vaccine at 1 month of age, and a third dose by 6 months of age. Remind the baby's caregiver about this important situation.

TESTING

  • The baby should have a hearing test (screen) performed in the hospital. If the baby did not pass the hearing screen, a follow-up appointment should be provided for another hearing test.

  • All babies should have blood drawn for the newborn metabolic screening. This is sometimes called the state infant screen or the "PKU" test, before leaving the hospital. This test is required by state law and checks for many serious conditions. Depending upon the baby's age at the time of discharge from the hospital or birthing center and the state in which you live, a second metabolic screen may be required. Check with the baby's caregiver about whether your baby needs another screen. This testing is very important to detect medical problems or conditions as early as possible and may save the baby's life.

NUTRITION AND ORAL HEALTH

  • Breastfeeding is the preferred feeding method for babies at this age and is recommended for at least 12 months, with exclusive breastfeeding (no additional formula, water, juice, or solids) for about 6 months. Alternatively, iron-fortified infant formula may be provided if the baby is not being exclusively breastfed.

  • Most 1 month olds feed every 2 to 3 hours during the day and night.

  • Babies who take less than 16 ounces (473 ml) of formula per day require a vitamin D supplement.

  • Babies less than 6 months of age should not be given juice.

  • The baby receives adequate water from breast milk or formula, so no additional water is recommended.

  • Babies receive adequate nutrition from breast milk or infant formula and should not receive solids until about 6 months. Babies who have solids introduced at less than 6 months are more likely to develop food allergies.

  • Clean the baby's gums with a soft cloth or piece of gauze 1 or 2 times a day.

  • Toothpaste is not necessary.

  • Provide fluoride supplements if the family water supply does not contain fluoride.

DEVELOPMENT

  • Read books daily to your child. Allow the child to touch, mouth, and point to objects. Choose books with interesting pictures, colors, and textures.

  • Recite nursery rhymes and sing songs with your child.

SLEEP

  • Place babies to sleep on their back to reduce the chance of SIDS, or crib death.

  • Pacifiers may be introduced at 1 month to reduce the risk of SIDS.

  • Do not place the baby in a bed with pillows, loose comforters or blankets, or stuffed toys.

  • Most children take at least 2 to 3 naps per day, sleeping about 18 hours per day.

  • Place babies to sleep when drowsy, but not completely asleep, so the baby can learn to self soothe.

  • Encourage children to sleep in their own sleep space. Do not allow the baby to share a bed with other children or with adults who smoke, have used alcohol or drugs, or are obese. Never place babies on water beds, couches, or bean bags, which can conform to the baby's face.

PARENTING TIPS

  • Newborn babies cannot be spoiled. They need frequent holding, cuddling, and interaction to develop social skills and attachment to their parents and caregivers. Talk to your baby regularly.

  • Follow package directions to mix formula. Formula should be kept refrigerated after mixing. Once the baby drinks from the bottle and finishes the feeding, throw away any remaining formula.

  • Warming of refrigerated formula may be accomplished by placing the bottle in a container of warm water. Never heat the baby's bottle in the microwave because this can burn the baby's mouth.

  • Dress your baby how you would dress (sweater in cool weather, short sleeves in warm weather). Overdressing can cause overheating and fussiness. If you are not sure if your baby is too hot or cold, feel his or her neck, not hands and feet.

  • Use mild skin care products on your baby. Avoid products with smells or color because they may irritate the baby's sensitive skin. Use a mild baby detergent on the baby's clothes and avoid fabric softener.

  • Always call your caregiver if your child shows any signs of illness or has a fever (temperature higher than 100.4° F (38° C) taken rectally). It is not necessary to take the temperature unless the baby is acting ill. Rectal thermometers are the most reliable for newborns. Ear thermometers do not give accurate readings until the baby is about 6 months old.

  • Do not treat your baby with over-the-counter medications without calling your caregiver.

SAFETY

  • Set your home water heater at 120° F (49° C).

  • Provide a cigarette-free and drug-free environment for your child.

  • Do not leave your baby alone. Do not leave your baby with young children or pets.

  • Do not leave your baby alone on any high surfaces such as a changing table or sofa.

  • Do not use a hand-me-down or antique crib. The crib should be placed away from a heater or air vent. Make sure the crib meets safety standards and should have slats no more than 2 and 3/8 inches (6 cm) apart.

  • Always place babies to sleep on their back. "Back to Sleep" reduces the chance of SIDS, or crib death.

  • Do not place the baby in a bed with pillows, loose comforters or blankets, or stuffed toys.

  • Babies are safest when sleeping in their own sleep space. A bassinet or crib placed beside the parent bed allows easy access to the baby at night.

  • Never place babies to sleep on water beds, couches, or bean bags, which can cover the baby's face so the baby cannot breathe. Also, do not place pillows, stuffed animals, large blankets or plastic sheets in the crib for the same reason.

  • The child should always be placed in an appropriate infant safety seat in the backseat of the vehicle. The child should face backward until at least 1 year old and weighs over 20 lbs/9.1 kgs.

  • Make sure the infant seat is secured in the car correctly. Your local fire department can help you if needed.

  • Never feed or let a fussy baby out of a safety seat while the car is moving. If your baby needs a break or needs to eat, stop the car and feed or calm him or her.

  • Never leave your baby in the car alone.

  • Use car window shades to help protect your baby's skin and eyes.

  • Make sure your home has smoke detectors and remember to change the batteries regularly!

  • Always provide direct supervision of your baby at all times, including bath time. Do not expect older children to supervise the baby.

  • Babies should not be left in the sunlight and should be protected from the sun by covering them with clothing, hats, and umbrellas.

  • Learn CPR so that you know what to do if your baby starts choking or stops breathing. Call your local Emergency Services (at the non-emergency number) to find CPR lessons.

  • If your baby becomes very yellow (jaundiced), call your baby's caregiver right away.

  • If the baby stops breathing, turns blue, or is unresponsive, call your local Emergency Services (911 in US).

WHAT IS NEXT?

Your next visit will be when your baby is 1 month old. Your caregiver may recommend an earlier visit if your baby is jaundiced or is having any feeding problems.