January: Cervical Health Awareness month
Kangaroo-a-thon in the NICU– a friendly competition for NICU families to see who can do the most skin-to-skin!

February: Black History month
Safe Sleep Fair in the NICU– a walk-through learning experience to see exactly how your baby should sleep at home and exactly how not to let your baby sleep!

March: Ovarian Cancer Awareness and National Nutrition month
Dr. Seuss’s Birthday Read-a-thon in the NICU- a friendly competition for NICU families to see who can read the most to their babies!

April: National Donate Life Awareness
March of Dimes: March for Babies
UAMS NICU Reunion

May: National High Blood Pressure Education month
Mamies Poppy Plate Party

June: National Child Vision Awareness

July: Cord Blood Awareness month

August: World Breastfeeding Awareness
Kangaroo-a-thon in the NICU– a friendly competition for NICU families to see who can do the most skin-to-skin!

September: Safe Sleep Awareness and Newborn Screening Awareness
Safe Sleep Fair in the NICU– a walk-through learning experience to see exactly how your baby should sleep at home and exactly how not to let your baby sleep!

October: SIDS/SUID Awareness, Breast Cancer Awareness, and Perinatal Loss Awareness
UAMS Day of Remembrance
International Wave of Light Ceremony (October 15th)
Costume Photos in the NICU

November: Prematurity Awareness
Dr. Seuss’s Birthday Read-a-thon in the NICU- a friendly competition for NICU families to see who can read the most to their babies!

December: National Hand Washing Awareness
First Photos with Santa in the NICU

Is my baby’s poop normal?

Parents often worry that their baby is not pooping as they should. Constipation is a common problem in children of all ages. Every baby is different. Babies who are constipated typically have bowel movements (poops) that look hard or pellet-like, cry a lot while trying to poop, and sometimes don’t have as many poops as they used to. When checking to see if your baby poops enough, you should consider the following:

• The effort it takes for them to poop
• How often are they pooping?
• Texture (consistency)
• Color of their poop

Effort: How difficult is it for a baby to poop?

It is common for babies to strain during a poop. Sometimes their face will turn red. Young babies have a hard time coordinating all the muscles involved in pooping. Pooping can be a major event for a baby, and their face may show it! If a baby is really fussy or straining for more than 10 minutes to poop, they may be constipated.

Frequency: How often does a “normal” baby poop?

Some babies go several times a day, while others may skip a day or two between poops. Babies’ poop habits change as their digestive systems mature and their diets change.

Formula-fed babies usually have a bowel movement at least once most days, but may go 1 to 2 days between poops.

Breastfed babies usually poop more than formula-fed babies. After they are a few months old, they may still have poops after each feeding or they may go a few days between poops.

The frequency of bowel movements alone does not determine if a baby is constipated. You should consider what is normal for your baby. The frequency of poops along with the texture, color, size, and ease of passing stool are all important factors when determining if there is a problem.

Texture: What stool texture/consistency is “normal?”

There isn’t a “normal” consistency for poop. Each baby’s individual digestive system and current diet will affect the texture. In general:

• Formula-fed babies have soft, mushy stools.
• Breastfed babies or babies fed formulas that have prebiotics can have loose, seedy stools.
• Babies eating solid foods will have more solid stools.
• Hard, dry, pellet-like stools are a common sign of constipation.
• Watery stools lasting for 24 hours could be diarrhea, and you should contact your baby’s doctor.

Color: What colors of stool are “normal”?

A wide range of colors can be considered normal- from bright green to yellow to dark brown. Just like the texture of poop, the color of stool depends on a baby’s diet and their particular digestive system. When babies start eating solid foods, you might see purple in their poop after blueberries or red after beets.

If your baby has black, tarry, red-streaked, or white colored poop, call your baby’s doctor.

The American Academy of Pediatrics (AAP) suggests asking yourself the following questions:

• Is my baby really fussy?
• Is my baby spitting up more than usual?
• Is my baby having a lot more or fewer poops than before?
• Are my baby’s stools unusually hard, or do they have blood related to hard stools?
• Does my baby strain for more than 10 minutes without success?

If your baby shows these signs, they may be constipated. Call your baby’s doctor to report these signs and ask what you can do to help your baby.

What can parents do?

Just like constipated adults, your baby may need a change in physical activity or diet.

Physical activity

• Bicycling legs- Move your baby’s legs up and down as if they are riding a bicycle
• Squats- During bath time, hold your baby in a tub of warm water with his knees pulled up to his chest in a squatting position.
• Massage- Give your baby a tummy massage, moving your hands in a clockwise motion to help stool travel through their digestive system. Ask your baby’s doctor or physical therapist to show you this massage to make sure you are doing it correctly.

Diet changes

• If your baby is one month old, you can try giving them a little fruit juice to help soften their stool (one month after their due date if your baby was premature).
• Start by giving 1 ounce of prune, apple, or pear juice a day. The sugars in these fruit juices aren’t digested very well, so they draw fluid into the intestines and help loosen stool.
• Once your baby starts eating foods, offer them fruits like prunes, pears, plums, and apricots.

Your well-meaning family and friends may offer suggestions on how to help your baby poop. Some of the typical remedies include giving your baby Karo syrup, performing rectal stimulation, or giving glycerin suppositories or over-the-counter laxatives. Each of these remedies could be harmful to your baby.

DO NOT give your baby Karo syrup, glycerin suppositories, laxatives, or stimulate their rectum unless your doctor has instructed you to do so.

Always talk to your baby’s doctor FIRST before you do anything different with your infant.

Spitting up is common in healthy babies—almost all babies spit up now and then. Good news! Most babies outgrow it after only a few months. Only 1 percent of babies are still spitting up after their first birthday.

What is the difference between spitting up and vomiting?

Spitting up is the easy flow of a baby’s stomach contents through his or her mouth, possibly with a burp.

Vomiting occurs when the flow is forceful — shooting out inches rather than dribbling from the mouth.

Does my baby have reflux?

Reflux is short for gastroesophageal reflux or GER. Normally, a muscle (lower esophageal sphincter) between the esophagus and the stomach keeps stomach contents where they belong. Until this muscle has time to mature, spitting up might be an issue — especially if your baby is relatively full. Babies may spit up more if they are fed more volume than their stomach can hold.

How can you feed your baby if he had reflux?

If your baby had reflux in the NICU, the nurses may have shown you how to feed and position your baby to minimize spit-up. These tips may help:

• Hold your baby upright during feeding unless you have been instructed to feed your baby in a specific position to help them safely eat.
• Try smaller, more frequent feedings
• Burp your baby often, especially if you are feeding him with a bottle
• Keep your baby still and upright after feeding
• Keep a stack of cloth diapers or burp cloths handy. Use them to protect your clothes, your baby’s clothes and your furniture.

Will reflux cause problems for my baby?

Spitting up is messy, but it is normal during your baby’s early months. It rarely involves choking, coughing, or pain. As long as your baby seems comfortable, and is eating well and gaining weight, there is little cause for concern. Keep in mind it is easy to overestimate the amount your baby has spit up based on the size of a spit-up stain.

When should you call your baby’s health care provider?

• Your baby is not gaining weight
• Your baby arches his back or cries during feeding
• Your baby refuses to eat, or is very irritable after feeding
• The spit-up looks like something other than formula or breast milk (yellow or green color)
• There is a large amount of spit-up (more than 1 or 2 tablespoons)
• Your baby vomits with great force (projectile vomiting)
• Your baby has fewer wet diapers than normal
• Your baby seems very tired or lethargic
• The spit up or vomiting is new, or is accompanied by other new symptoms (fever, loose stools, fussiness)

Tummy Time

What are the benefits?

Improves motor development

Tummy time is a great way to build your baby’s neck, back, and core muscles. Building these muscles will help them reach developmental milestones such as rolling over, sitting up, and crawling.

Encourages play with hands

Giving your baby colorful toys during tummy time will encourage them to reach for and grab. This will help your baby develop their fine motor skills.

Prevents flatness on your baby’s head

Since your baby sleeps a lot and they are on their back a lot, it is important to keep changing the position of your baby to prevent these flat spots from occurring.

Increases visual stimulation

Giving your baby a chance to be on their tummy will give them a new view on the world to see and a different perspective from being on their backs.

When? You can start as soon as you get home! Starting out, your baby may become easily tired and upset by tummy time. This is completely normal! See below for helpful tips to make tummy time enjoyable.

How? You can begin your tummy time by placing your baby on your tummy while you lie on your back or sit reclined in a chair. If you are feeling sleepy, DO NOT do tummy time. Begin with short time intervals such as 3 to 5 minutes, twice a day. As your baby gets stronger, tummy time can gradually increase to about 40 to 60 minutes, multiple times a day. Pay attention to signs of tiredness. Some of these include irritability, resting head on surface, clenched fist or finger splaying, jerking arm/leg movements, and grunting. Make it fun! Spread out toys, lay on your tummy facing the baby, storytelling, place a mirror in front of your baby, place baby on different types of surfaces to experience different sensations, or play music.

What about in the NICU? You may do tummy time with your NICU baby once your baby’s nurse, doctor or Physical Therapist says it is okay. You and the baby must be alert (awake)! Tummy time can be done while you are holding the baby or in the baby’s crib.

Precautions

• Only do this when your baby is awake and alert. If your baby becomes drowsy, remember to place them on their back for sleeping.
• Always supervise your baby when doing tummy time.

Stimulating the breast often during the first days and weeks after
giving birth is a great way to get a good milk supply. Begin
nursing or expressing milk as soon after delivery as possible. To
get your body to make more milk you must remove the milk your
body has already made, so it is important to nurse or express milk
every two to three hours (8 to 12 times every 24 hours).

If you are feeding your baby at the breast:
Use your baby’s signals to guide breastfeeding. If your baby is waking up and moving, making sucking motions/sticking out the tongue, or nuzzling you (also called rooting) it is time to breastfeed. Your baby may want to eat
every hour or so, and most babies feed 8 to 12 times each day. In the early days and weeks after birth, a term baby should not go more than 4 hours without eating. Late preterm infants (those delivered at 34- 36 weeks) should eat more frequently (at least every 3 hours).
Some issues with milk supply are related to improper equipment, poor fit, or inefficient latch and suck.
Our lactation consultants are here to help you with these issues, both in the hospital and with follow-up appointments if needed.
If you are expressing your breast milk using your hands (hand expression) or a pump:
-Empty your breasts as often as your baby might eat (every 2-3 hours).
-Try to pump both sides at the same time using a hospital-grade electric pump.
-Have a calm, soothing routine when you pump:
Use a warm cloth to warm your breasts.
Sit in a comfortable chair with a table close at hand.
Have a drink nearby such as water or milk (pumping makes you thirsty).
Have your pump supplies within reach (extra bottles, washcloth for drips, and lids for bottles).
Play calm, soothing music in the background.
If possible, pump while you can see and hear your baby. If you are away from your baby, have his/her picture or a blanket or piece of clothing that he/she has worn recently. Seeing, hearing, and smelling your baby are very powerful ways to get your milk to “let-down.”
-Pump after you hold or feed your baby.
-Massage all areas of your breast before and during pumping to help the milk to move from the deeper breast tissue to the nipple where it exits the breast (also called “hands on pumping”).
-Have your partner massage your upper back and between your shoulder blades to help relax you and help the let-down reflex.

Herbs, Nutritional Supplements and Medications:
-A balanced diet is very important—your body needs fuel and building blocks to make milk.
-Continue to take prenatal vitamins or multivitamins while you are producing breast milk.
-A bowl of oatmeal each day may help maintain or increase your milk supply. Oatmeal is a healthy addition to your diet and will cause no harm to mom or baby.
-Before you begin taking a new medication or supplement, discuss the risks and benefits with your healthcare providers and a trained lactation specialist.
-Fenugreek may help increase your milk supply when taken as a part of a balanced diet that includes plenty of liquids. There is limited information about the safety of fenugreek, especially for moms of preterm babies, but there are very few warnings of it causing harm. Other things should be done before starting a supplement such as fenugreek.
– Herbal preparations such as “lactation tea” sometimes contain fenugreek, milk thistle and many other herbs. These products may contain herbs that decrease milk supply or can cause harm to babies.
-There are no prescription medications available in the United States that will increase milk supply.
Things that do not help your milk supply or may cause harm:
-Reglan may cause permanent side effects in you or your baby and is not recommended for increasing milk supply.
-Beer, hops, and brewer’s yeast do not improve milk supply. Multiple studies show decreased milk production in the hours after ingestion as well as poor feeding and increased drowsiness in babies.
-Over hydration: while dehydration will affect your milk supply, drinking too much water may be dangerous as well. “Drink to your thirst” means you should drink water or low-fat milk when you feel thirsty (on average 8-10 eight ounce glasses a day). So basically, drink a glass every time you feed or pump.
-Mint: peppermint and spearmint may decrease your milk supply.
-Too much caffeine will decrease your milk supply.
-Cold medications containing decongestants or anti-histamines usually cause temporary decrease in milk supply.
-Some birth control medications may affect your milk supply. Have a careful discussion with your healthcare provider about birth control options that will have little or no effect on your milk production. Breastfeeding alone is not considered effective birth control.

Every mother wants their baby to be healthy. But smoking while you are
pregnant or after the baby is born can be harmful.