Why are my newborn’s hands and feet cold? This is caused by the newborn’s body’s attempts to control his or her temperature. When newborns are chilled, they will pull blood from their hands and feet to keep their head and body warm. When they do this their hands and feet will become cool and blue. This is a normal process and is nothing to be concerned about.

What does the Apgar score mean? The Apgar score is a scoring system developed to evaluate the newborn’s transition from in the womb to life outside the womb. The scoring is done at one and five minutes after birth.

The newborn receives either zero, one or two points for each of the following five criteria: heart rate, respiratory effort, muscle tone, response to stimulation, and skin color. The higher the score, the more quickly the child has adapted to the outside environment. A score of eight to ten indicates the best possible adaptation.

In what position should my newborn sleep? The American Academy of Pediatrics (AAP) recommends that all healthy infants sleep on their backs the first six months of life. Studies have shown sleeping on the back reduces the risk of Sudden Infant Death Syndrome (SIDS).

SIDS is the sudden unexplained death of a healthy infant. Thousands of babies die each year from SIDS. Typically, a baby dies from SIDS while sleeping.

What is breast hypertrophy? Breast hypertrophy occurs when a newborn infant has small lumps of tissue under the nipples. This is caused by hormonal changes in the mother in preparation to breast feed during pregnancy. These hormones are transported across the placenta to the fetus causing breast tissue in the infant to be stimulated and enlarge.

What is witches’ milk? This is milk from the newborn’s breast buds. It is not uncommon and usually the milk can be expressed with a little gentle pressure. It is related to maternal hormones stimulating the newborn breast to produce milk. The ability of the baby's breasts to respond in this fashion is a mark of baby born at (or near) full-term. It resolves without treatment is about one to two weeks.

What is colic? Colic is unexplained crying (not due to pain or hunger). The bouts of crying usually last one to two hours and the child acts normally between bouts. A child with colic usually stops crying when held, rocked or experiencing motion. Colic begins before two weeks of age and usually stops by three months of age.

What qualifies as constipation is an infant? Constipation occurs when an infant is having great pain and difficulty passing his stools, and the stools are firm. Infrequent passing of stools is not considered a sign of constipation in infants.

What is Erb’s palsy? Erb’s palsy is a birth injury to the shoulder and arm. During birth, the nerves controlling the arm and hand are over-stretched, causing swelling of the nerve roots. This causes a temporary paralysis of the arm and hand on one side and usually resolves itself over one to two days. Rarely, physical therapy or surgery is necessary to help the newborn return function to his arm.

What are Epstein pearls and are they worth anything? These are tiny cysts found on the roof of the newborn’s mouth. They contain trapped mucus membrane skin cells. They occur only in the newborn and are very common, seen in approximately 80 percent of newborns. On the gums, they sometimes resemble emerging teeth. The condition is harmless. They will go away in two to three weeks.

What is erythema toxicum? Erythema toxicum is a blotchy red rash found on newborn usually by the first or second day of life. Some of the spots can have a raised center pimple surrounded by a flare of red. Erythema toxicum can occur in half of all newborns. The rash generally resolves on its own by the fifth or sixth day of life. It is not dangerous or contagious.

What is a fontanel? The fontanel is the baby’s “soft spot.” It is found just above a baby’s forehead in the middle. It represents the meeting point of several of a baby’s bony skull plates. As the skull calcifies and the separation between the bony plates disappears, the soft spot also disappears. This occurs around 18 months of age. There is also a posterior soft spot located midline in the skull on the back of the head. This is usually much smaller and harder to find. It also closes earlier.

What is a baby’s soft spot? The soft spot is found just above a baby’s forehead in the middle. It represents the meeting point of several of a baby’s bony skull plates. As the skull calcifies and the separation between the bony plates disappears, the soft spot also disappears. This occurs around 18 months of age. There is also a posterior soft spot located midline in the skull on the back of the head. This is usually much smaller and harder to find. It also closes earlier.

What is lanugo? Lanugo is downy fine hair found on the shoulders of newborns. Usually, most of this hair is shed during the seventh or eighth month of pregnancy. Sometimes it is still present for a few months after birth, especially in babies born early. No treatment is necessary.

What are milia? Milia is a normal newborn rash found on the nose and face. Multiple tiny white “pimple-like” lesions make up the rash. They will go away in first few weeks of life.

What is vernix? This is a white “cream cheese-like” substance that covers the skin of newborns. It is mainly comprised of an oily material secreted by the glands of the skin prior to birth. A baby born prematurely will have more vernix then a full term infant. It may contain certain proteins that have antibacterial activity.

What is meconium? Meconium is the first stool material of a newborn. It is usually dark green to black in color and will take two to three days to pass.

What is an Rh factor incompatibility? Everyone has different blood types (A, B, AB or O). There is an additional blood typing system called Rh factor, which is a protein found on the red cells in our blood. If you carry this protein you are Rh positive and if you do not carry this protein you are Rh negative.

A pregnant mother who is Rh negative with a father who is Rh positive could have a baby who is Rh positive. During the first pregnancy, this is not a problem. However, when the baby is being delivered, the mother’s and baby’s blood may mix. If this happens, the mother’s immune system will recognize the Rh protein as foreign and produce antibodies against this Rh protein. With future pregnancies (if the future baby is Rh positive) the reaction from the antibodies in the mother’s blood may attack the red cells in the baby’s blood making the newborn anemic and jaundiced. There are shots the pregnant mother can get called Rhogam, which prevents the mother’s immune system from producing the antibodies against the Rh factor.

When a baby is small for gestational age (SGA), what does that mean? Newborns who are smaller than normal (less than 2.5 kilograms or 5 ½ pounds) are considered small for gestational age (SGA). Many things can cause SGA newborns including multiple birth, placenta problems, maternal infection, poor prenatal care or drug abuse.

When a baby is large for gestational age (LGA), what does that mean? Newborns who are larger than normal (greater than four kilograms or almost nine pounds) are considered large for gestational age. This can happen with mothers who are diabetic or obese.

What is SIDS? SIDS (Sudden Infant Death) is a sudden unexplained death of an infant under one year of age. It is the leading cause of death in infants one month to one year of age. It is unpredictable and can cause 2,500 deaths a year in otherwise normal infants. It is also called crib death.

Risk factors include:

• Age between two and four months
• Cold weather
• Being an African-American infant (two times more likely) or Native American infant (three times as likely).
• Being a boy
• Smoking, drinking, or drug use during pregnancy
• Poor prenatal care
• Prematurity or low birth-weight
• Mothers younger than 20
• Smoke exposure following birth
• Overheating from excessive sleepwear and bedding
• Stomach sleeping

When is the peak time for SIDS? Most SIDS cases occur between the ages of two and four months. Ninety percent of SIDS infants die before six months of age.

What is known to prevent SIDS? Many things can be done to prevent SIDS. Back sleeping is the single most important thing a parent can do to prevent SIDS. Other recommendations are:

• No smoking
• Avoiding covering an infant’s head
• Avoiding using soft, loose bedding
• Not overdressing your infant
• Breast-feeding

My baby has a bone sticking out of the middle of his chest. Should I worry? This bone is called the xyphoid process. This is a normal bony prominence visible on thinner infants. As adults we still have this bone. It’s a little harder to see, however, when you have additional padding.

What are normal sleep requirements for babies?

Source: Solve Your Child's Sleep Problems, Richard Ferber, Simon & Schuster, 1985