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By Dr. Jamie Hutton

Vitamin D is necessary for absorption of calcium and phosphorus. These minerals are necessary for strong bones, appropriate brain growth, and a good immune system. Infants, particularly breastfed infants, do not get enough vitamin D on their own. It is recommended that infants get 400 IU of vitamin D daily.

Many moms want to take extra vitamin D so the baby can get enough through breastmilk without having to give the baby a supplement. A mom would need to take 4,000–6,000 IU daily for enough to pass into the breastmilk for the infant. Formula contains vitamin D, but the infant would need to take 32 ounces daily to get enough vitamin D. We do create vitamin D when our skin is exposed to sunlight, but babies should not have that much direct exposure to sunlight to get the appropriate amount of vitamin D.

When the baby is taking fortified cow’s milk and food, around the 1-year age mark, the vitamin D supplement can be stopped.

The vitamin K shot, recommended for all newborns by the American Academy of Pediatrics (AAP) since 1961, is crucial for preventing Vitamin K Deficiency Bleeding (VKDB), a rare but potentially fatal or debilitating condition. Babies are born with low levels of vitamin K, which is essential for blood clotting, leaving them vulnerable to severe, uncontrollable bleeding, often in the brain.

Key reasons for the Vitamin K shot

• Preventing fatal bleeding (VKDB) — Without the shot, infants are 81 times more likely to develop severe, potentially fatal bleeding.
• Low Vitamin K levels at birth — Babies are born with very low levels of vitamin K because it does not cross the placenta easily.
• Insufficient Vitamin K in breast milk — While breast milk is best for babies, it does not contain enough vitamin K to prevent deficiency.
• Immature gut flora — Newborns lack the intestinal bacteria necessary to produce their own vitamin K.
• Unpredictable bleeding — VKDB can happen without warning, often after the baby has left the hospital, up to 6 months of age.
• Protection for circumcision — The shot is essential to prevent uncontrolled bleeding during male circumcision.

Why the shot (injection) is preferred

• Reliability — An intramuscular injection is the most effective and reliable way to ensure a newborn has enough vitamin K.
• Long-term protection — The shot is stored in the liver and released slowly over months, providing lasting protection until the baby starts eating solid foods.
• Oral alternatives are ineffective — Oral Vitamin K is not approved by the FDA for newborns in the US because it is less effective and requires multiple, strictly timed doses, which increases the risk of error.

Safety and myths

• Safety record — The vitamin K shot is considered safe and has been used for over 60 years.
• No link to cancer — Multiple studies have refuted a 1990s study that claimed a link between the vitamin K shot and childhood cancer.
• Side effects — The only known side effects are minor pain, bruising, or swelling at the injection site.
• Not a vaccine — Although given as a shot, it is a necessary nutrient, not a vaccine.

By Dr. Jamie Hutton

Why is my baby yellow? How do I make it go away? Is it going to hurt my baby? These are all common questions for new parents. Almost all newborns are jaundiced to some degree.

Jaundice is the buildup of bilirubin in the baby’s blood. Bilirubin comes from the breakdown of the baby’s red blood cells, which is normal after delivery. The newborn liver is immature and cannot excrete the bilirubin as fast as it is produced. The bilirubin causes a yellow discoloration of the skin and eyes.

When the baby is in the hospital after birth, they will be checked every 12–24 hours for jaundice, often by visual inspection or by measurement through the skin. If levels are high, blood will be drawn to check the exact level of bilirubin. The American Academy of Pediatrics has levels that are deemed low risk or high risk.

The biggest concern about high bilirubin levels is that they can be toxic to the brain and cause kernicterus, lasting brain damage that can cause uncontrolled movements, an upward gaze, and hearing loss. The good news is that jaundice can be treated and kernicterus can be prevented.

The best treatment is feeding. The more the baby eats, the more bowel movements they produce, which is how bilirubin is excreted. If levels become too high, the baby will be admitted to the hospital for light therapy. Light therapy uses special lamps that emit a blue-green spectrum, which changes the structure of the bilirubin and allows it to be excreted in the urine and stool.

In summary, jaundice is a yellowing of the baby’s skin that, at high enough levels, can cause brain damage. The level peaks at 3–5 days of life. Your pediatrician will look closely at your baby during the hospital follow-up visit and determine the degree of jaundice and whether levels need to be checked.

By Dr. Jamie Hutton

A newborn breastfed baby should have one wet diaper for each day of life, up to day four. After the fourth day of life, the baby should have at least four wet diapers per day.

Quantity of bowel movements is not as important as consistency.

For breastfed babies

• First two days of life — tarry black stool.
• Four to five days of life — brownish green → greenish yellow → seedy yellow.
• Once milk supply is established, BM usually stays a seedy yellow consistency for 6–8 weeks.
• Breastfed babies’ stool is usually loose and they can go for 7–10 days without having a BM.
• Some babies will have multiple BMs per day; others can go days without pooping. Both are acceptable.

For formula-fed babies

• First two days of life — tarry black stool.
• Four to five days of life — brownish green → greenish yellow → yellow (mustard color).
• Formula-fed babies are more prone to be constipated and may strain to poop.
• They will not have the “seedy” yellow consistency that a breastfed baby has.
• Stool tends to be more formed and have a “sticky” texture.

By Dr. Jamie Hutton

Some may say you are spoiling your baby if you hold them too much. The truth is the opposite: babies need to be held.

Studies show that kangaroo care, where the baby is in just a diaper and placed on mom or dad’s bare chest, regulates the baby’s heart rate, respiratory rate, and temperature. It is also important for brain development.

Your baby is completely dependent on you to take care of all of their needs. By holding and cuddling them, you are actually making them feel secure and creating a healthy bond. You cannot hold your baby too much.

Enjoy this time. It really does go by fast.

By Dr. Jamie Hutton

Neonatal acne is very common, and it is not harmful for the baby.

It is most common between 2 and 6 weeks of age. It looks like small superficial pustules, most often on the chin, forehead, and cheeks, and occasionally appears on the neck and upper body.

It typically gets better on its own and does not need any treatment. It also does not leave scars, as long as it isn’t picked at. Neonatal acne is thought to be caused by hormones, which even out in the first couple of weeks of life, and the pustules go away.