-Submitted photo
Dr. Audrey Bush, medical director - inpatient pediatrics for Blank Children's Hospital, is pictured with her daughter, Avery. Among other tips for keeping newborns healthy, Bush recommends anyone within the baby's close circle receive a flu shot.

From the moment a child is born, there is often a great deal of excitement from family, friends and relatives to meet the new baby.

That often includes some kissing, hugging and some pinching of the cheeks.

But for the first few months of a child’s life, caution should be exercised when it comes to physical contact, according to Dr. Audrey Bush, medical director of inpatient pediatrics for Blank Children’s Hospital in Des Moines.

“One of the hard parts is people are so excited to meet this new family member, the new baby, but we really encourage parents as much as possible to limit crowds when they can,” said Bush who also provides care in Fort Dodge through UnityPoint Health’s partnership Blank Children’s Hospital.

During flu season and with viruses like COVID-19 still circulating, there has been a heightened level of concern for little ones.

“This time of year as we are working in newborn nursery or talking with families it’s become a more common question in the last 18 months with COVID and also this time of year for flu and all the viruses we see,” Bush said.

Illnesses that may not be such a big deal for adults are a big deal for infants.

“The first month of life or two months of life, we treat fever in babies like a really big deal,” Bush said. “The reason is because is where if you or I had a cold or one of these viruses, we would probably have mild cold symptoms and move on.

But for a little baby it could turn into something very serious. That fever could mean they have pneumonia. If they get a respiratory virus like the flu, it could turn into a big respiratory infection. It could be a much bigger deal for these tiny babies. A life threatening respiratory infection. Things that might be little bugs for us as adults or older people, it might be a much bigger deal for these tiny babies.”

In terms of a fever, Bush said a temperature 100.4 degrees Fahrenheit or higher is a fever.

“Easiest way is to take it right under the arm,” Bush said. “For those first two months or younger, if they have a fever we want them to be seen by their pediatrician. We want them seen by a provider if they have a fever younger than two months. And we don’t want parents to give them Tylenol before that. Bring them into us, get them seen and the provider can help them decide what’s best.”

Some signs that something is wrong could include irregular breathing.

“If they are breathing more than once a second or are so fussy that they can’t calm down or if they are so sleepy that they won’t wake up to do the normal things they do,” Bush said. “Those are all really important things that would concern us and make us want to have them seen by a doctor.”

When it comes to lessening the chances of an illness, Bush recommends proper hygiene and distance for anyone in the baby’s immediate circle.

“It really comes back to the basics,” Bush said. “Things like cover your mouth when you cough, washing hands really well. Those are some of the best suggestions. Definitely if anyone is sick, we would encourage them to wait until those symptoms are gone.”

Bush said most people tend to be understanding with a new baby in the picture.

“When you frame it as you just want to do the best thing for this adorable new family member, family members are responsive to that,” Bush said. “Asking people to stay away a little bit until they feel better is a big one.

Bush added, “I do feel like, we have all gotten used to the Zoom lifestyle in the 18 months, so I feel like families are more receptive to that when it’s necessary. I have a little baby (Avery) at home and my family was really receptive about giving us some space for a little while and letting baby get out of that first couple of months before coming to visit. So we did a lot of FaceTiming and that went really well.”

Flu shots are encouraged for anyone old enough (6 months or older) to have one.

“Anyone in that baby’s close circle should get a flu shot,” Bush said. “Anyone who will visit with the family. I think it’s a simple thing parents can ask anyone who wants to be around the baby to do. And I think again it’s one of those things where family members who may not ordinarily get the flu shot, when they want to see that new grandbaby or cute new relative that could be something to help seal the deal to encourage them to get the flu shot this year.”

Bush also recommends adults in the baby’s immediate circle to be up to date on the whooping cough vaccine.

Keeping little ones comfortable during winter

According to Bush, babies should be dressed in one more layer than what an adult feels comfortable in.

“Inside the house, our usual advice for little babies, whatever an adult is comfortable wearing plus another layer for the little baby,” Bush said. “If you are comfortable in a short sleeve T-shirt and sweatpants, then I would probably have them sleep for sure in a long sleeve outfit and a swaddle or sleep sack.”

In terms of providing a safe sleep environment, Bush said babies should be in a room with a comfortable temperature.

“Even in the winter we want them in a room with a comfortable temperature, somewhere in that 68-72 is a great range,” Bush said. “Always on their back to sleep and in a safe space that’s all their own. Nothing extra in there with them. No stuffed animals or pillows or blankets. they make swaddle sacks or sleep sacks or a thin blanket.”

When it comes to newer baby products like weighted blankets, Bush is hesitant to recommend those.

“Companies are putting out new fancy sleep products faster than they can issue recommendations on what’s safe or not,” she said. “Anything that can restrict the movement or keep the baby stuck in a position that’s not flat, or stuck where they can’t sort of naturally move is going to be something that we would steer away from.”

Car seats/coats

Fluffy coats can be a no-no for car seats, Bush said.

“It’s tempting to put older kids but especially little babies, it’s tempting to put them in those cute fluffy jackets to keep them warm,” Bush said. “Especially when it’s snowing. Those aren’t safe either. We want them to be in a layer where that car seat strap can still stay nice and secure against their body. You want to still fit those two finger widths under the strap like you normally would. Adding a big puffy winter coat can make the straps too loose, so then it’s not safe for the child anymore.”

Bush added, “You can put a blanket around them once they are strapped in to their car seat, not covering their face or their mouth at all.”

Empowered parents

As time goes on, babies and children become more resilient.

“The first month of life is when I would be most cautious and protective,” Bush said. “Up until two months when they get their first set of vaccines, we start to feel a little more comfortable and then with time their immune system grows stronger, their lungs grow stronger and bigger. So everything gets better with time.”

Bush said the ultimate goal is see the little ones grow up healthy.

“In general there’s a lot to be scared about but just enjoying your new child and celebrating that and feeling empowered as a parent to do what’s best for them is a great important thing to do,” Bush said. “That’s a really exciting thing to see them grow up healthy. That’s our goal is and we know that’s what parents’ goals are, too. We want to see them grow up strong and healthy.”