Washington Pediatrics 	608 East 12th Street Washington NC 27889         
 				Telephone: (252) 946-4134


After Office Hours, Weekends or Holidays:
An answering service (946-2262) will take all calls.
You may be directed to call our Nurse Triage Phone Service during specific hours.
This service will put you in contact with trained nurses at UNC-Chapel Hill, who offer you mediecal advice.
If necessary, or if you would like to speak with the doctor further, the nurse will contact the doctor on call.
He/she will then return your call.

If an absolute emergency exists, take your child to the emergency room at the Beaufort County Hospital and ask the emergency room to call your pediatrician immediately.
Try not to use the emergency room for illness other than emergencies.
It is better for someone to see your child who is familiar with his or her particular problems.
Also, emergency rooms are more expensive than office visits. 
Please try to make appointments for your visits when possible.
It is our sincere desire to try and see appointments first and on time.

We are delighted to have your child as a patient. 
Since so many of our new patients are newborns, the following information may help you in the new born period.

Well Child Center
Opened in July 1998, the downstairs portion of our building now serves for Well Child Checkups - Age 3 and under.
Please park in the lot in the front and enter those doors downstairs. This is by appointment only.

Feeding
Breast feeding is the preferred method of feeding your baby.
There are a number of reasons for this, such as some protection against infection, safety, economy and superior nutritional value.
Probably, breast feeding's greatest advantage is the opportunity for a mother to come close to her baby and give her the maximum comfort and security.

Although breast feeding is encouraged, it is a decision that should be reserved for each individual mother. 
There are excellent formulas available, such as SIMILAC with Iron and ISOMIL - Soy with Iron, that provide satisfactory nourishment. 

Techniques of Breast Feeding
Almost all mothers can breast feed and are capable of producing milk of good quality and adequate amounts.
The baby will be brought to the mother as soon as the mother is ready to nurse (some mothers like to begin in the delivery room).

It is advisable to nurse frequently in the first few days of life. 
The chief stimulant that produces mother's milk is the infant suckling. 
If the mother feels capable, she should nurse as often as she wishes.

After your milk comes in, you may still find that your baby will nurse on an irregular schedule. 
The baby may nurse several times in a four hour period and then skip four to six hours. 
This is perfectly normal. Use your own judgment as to how frequently to feed. 
Often your baby will establish a schedule as convenient as one you try to devise for him or her.

Sore nipples are frequently present in the first few days of nursing. 
This invariably passes as soon as the baby has nursed for a few days. 
It is better to go on and nurse when nipples seem sore because the more you nurse, the sooner the soreness will stop.

Care of Breast
Use a good nursing brassiere. Wash your hands before nursing. 
Wash your breasts once a day during your regular bath. 
Excessive washing of breasts can cause nipples to dry out and crack. 
Ointments and oils applied to nipples are seldom necessary.

Extra Help
Karen Pryor has written and excellent paperback book: Nursing your baby. This is worth reading. 
Probably of more value is to seek advice of a friend or other mothers who are experienced in nursing. 
An experienced nursing mother has a great store of knowledge about the ins and outs of nursing. 
Our office nurses are trained to assists new mothers. Please call if you have concerns.

Bottle Feeding
There are several excellent types of milks and formulas available for your baby. 
It is suggested that you use one of about the same nature as breast milk which has vitamins and Iron added, such as SIMILAC and ISOMIL. 
This will be discussed when you are ready to leave the hospital. 
It is seldom necessary to boil water, bottles or nipples. 
Prepare your bottles and nipples just as you would wash dishes. 
Although it is perfectly all right to warm your baby's bottle, giving the baby a cold or room temperature bottle is acceptable.

Frequency of Feeding
Babies differ as to how often they need to be fed. 
At times you may have to feed two to three times in a four-hour period, and then the baby may skip four to six hours. 
Get to know your baby; allow him to set his own schedule. 
It usually will be as good as one you try to devise yourself.

Burping
Burp your baby after feeding or during feeding intervals if you like. 
Hold the infant onto your shoulder and pat gently for about a minute. 
If the baby doesn't burp, resume your feeding; or if finished feeding, put the baby down on his or her stomach and leave the baby alone.

Bathing
Wash your baby with mild soap and water just as you would wash yourself. 
It may be necessary when cleaning a baby's bottom after a stool to use cotton and water to remove excess stool. 
Lotions and oils are of no value to an infant's skin and may do more harm than good. 
Talcum powder at the time of diapering may be helpful. No special soap is needed.

Care of the Cord
Keep the cord clean and dry with a small amount of rubbing alcohol. 
Do not give the baby a bath until the cord falls off. The cord may bleed a little as it comes off.

Circumcision
This does not usually require particular care. 
Wash the area as you would the rest of his body with warm soap and water. 
You may need to dab some Vaseline on the tip of the penis for the first few days. 
When you return at age one or two weeks we will inspect this carefully to see if special care is needed.

Stools
A baby's bowel habits are very irregular. Some infants have stool after each feeding; some skip a day. 
Many babies strain and cry when they have a stool. 
These are usually normal within normal limits for a newborn. 
Unless the infant acts sick, there is no need to worry. 
Please call before trying to regulate bowels with suppositories or laxatives.

Diapers and Wetting
Babies wet about every five minutes. It is impossible to keep them dry. 
Most mothers change their babies at feeding time. 
Disposable or clothe diapers may be used according to the mother's preference. 
If cloth diapers are used, please wash in a non detergent soap such as IVORY Snow.

Sleeping
It is better for a baby to sleep in a room of its own. 
It is absolutely necessary that the baby sleep in its own crib or bassinette. 
An infant seat is a fine piece of equipment to acquire. It serves as an extra sleeping space. 
We also recommend that the baby sleep on its side for the first few months.

Safety Seat
The leading cause of death in children over one year old is accidents, primarily automobile accidents. 
Of children under the age of five years who die from automobile accidents, 91% could have been saved with proper restraining devices.
Proper use of such devices could have reduced the severity of injuries by 78%.

We feel it is extremely important for you to purchase your baby a car seat restraining device.

A very excellent and clearly worded pamphlet supplied by the Highway Safety Research Center will be given to you before you leave the Hospital. 
Car seats are required by law in North Carolina. 
Infants should NOT be placed in the front seat of your car if the vehicle is equipped with a passenger side Air Bag.

Crying
Oh, if we knew what to tell you to keep a baby from crying! 
One thing for sure; the least likely way to have a good baby is to poke something in his or her mouth every time the baby cries. 
Feed at regular intervals. Adding solid foods like cereal early does not cut down on crying!

Probably the most useful way to encourage your infant to settle down is to handle your baby the same way every time. 
The most characteristic feature of a newborn is that they can adjust, follow you. 
Almost all mothers handle their infants a little bit different. 
That's fine as long as you do the same thing all of the time. 
A starting point that might be helpful is to feed your baby, burp it, put it down on its stomach and let it alone for 15 minutes. 
If you handle your baby this way time and again, the baby will fall into a reasonable sleep habit.

One last piece of advice: if you are around your baby day in and day out, very soon you will be an expert. 
You will of course know more about the baby than anyone. Do the best you can. 
The overwhelming odds are that you will be doing the right thing.

Ask us for help! We will be happy to do anything we can. 
We invite you to call us. We will bring you back to the office in 1-2 weeks for your first checkup. 
This information is designed to help your early weeks with your new baby. 

You may find the American Academy of Pediatrics book, Caring for Your Baby and Young Child, Birth to Age 5, a ready source to answer your questions.

Fever
Fever is a symptom, not a disease. Your infant will not be hurt by fever. 
It is important however to contact our office if your newborn has a rectal temperature above 101°F. 
Older infants and children tolerate fever better than young infants. 
Please give them appropriate doses of acetaminophen (Tylenol, Panadol, Tempra) every four hours to help with the discomfort. 
The infant's appearance and behavior is more important than the height of the fever.

Immunizations
Your infant's first immunization will be given in the hospital, if you so desire. 
Hepatitis B is now preventable, and we strongly encourage parents to protect their children against serious diseases. 
The schedules for immunizations will be reviewed with your when you come in for your first appointment. 
These vaccinations are available at our office as well as the local health departments.