Well baby care in the first weeks of life
Well baby visits are an essential component of newborn care. According to the Rourke Baby Record, newborns should be assessed by their primary care practitioner within the first week of life, at two weeks of age, and at one month of age. The Rourke is an evidence-based set of guidelines for well baby and child care checkups recommended by the Canadian Paediatric Society, the Canadian College of Family Physicians and the Dietitians of Canada. Due to the importance of these well baby checkups and the numerous infants within Hastings and Prince Edward Counties not having a primary care provider, Quinte Health is currently providing the 72-hour well baby checkup for unattached infants only. Those who have a primary care provider should continue to be seen by their primary care provider for all well baby checkups. These visits provide an opportunity to monitor the infant’s early growth patterns and to prevent unnecessary feeding challenges.
For a breastfed baby, the newborn well baby checkups provide an excellent opportunity to assess whether breastfeeding is going well. If not recognized early, breastfeeding challenges can persist and impact milk production, maternal confidence, infant growth, and breastfeeding duration. Recognizing breastfeeding challenges early and connecting families with additional lactation support is important in helping them achieve their breastfeeding goals. Babies who are breastfeeding well will:
- stop losing weight by 72 hours of age and begin gaining,
- regain their birth weight by 10-14 days of age,
- gain approximately one oz (30 g) per day in the first three months of life,
- be passing three or more yellow stools per day in the first few weeks of life.
When weighing babies, it is recommended that WHO Growth Charts for Canada are used and the baby is weighed naked. Weighing naked and recording the weight in grams will facilitate accurate comparison with the birth weight.
If you assess a breastfed newborn that is not stooling at least three times daily in the first few weeks of life, is gaining weight slowly or is falling off their growth curve, please refer the family to South East Health Unit for a thorough breastfeeding assessment and feeding plan by a public health nurse. Any other breastfeeding concerns such as nipple pain, latching difficulties or concerns about milk production may also be referred.
To refer a family for a breastfeeding consultation, please complete the online referral form, or fax in the referral form to 613-966-4363. Please include the reason for the breastfeeding consultation referral in the additional comments section (e.g., breastfeeding baby not gaining well, last known weight etc.).
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