Dr. Benjamin Ho: Part 2: Basic Medical Expectations & Sleep

Dr. Benjamin Ho, Medical Director of Texas Children’s Pediatrics Concierge Medicine program

Expert advice for new parents from Dr. Benjamin Ho, Medical Director of Texas Children’s Pediatrics Concierge Medicine program. Part 2 of 3-part article series. Part 2: Basic Medical Expectations & Sleep

Basic Medical Expectations

Growth

One of the most important reasons for frequent visits is to track the growth of your baby.  Babies normally follow the same guidelines and my most common advice about this is that it does not necessarily matter where the babies fall on their growth curve and there is generally no need to worry if they are trending consistently on the curve.           

Weight - All newborns lose weight in the first few days of life but should not lose more than 8-10%.  They should gain about one ounce per day and the weight should double at around 4 months and triple by one year of age.

Height – Babies should grow about one inch a month for the first few months and half an inch per month from 6-12 months.  By one year of age, the height should increase by 50% from birth.

Head size – In general, a baby’s head grows one inch in circumference in the first 6 months and then a quarter inch from 6-12 months

Development

When I was in medical school, I remember being fascinated to learn that most babies meet specific developmental milestones at certain times.  Just like a baby’s growth, it is also fundamental to track these basic milestones as well.  However, please keep in mind that these milestones are just averages and it does not necessarily mean there is anything wrong if your baby does not meet any specific milestones at certain times. 

One Month – Although not much seems to happen in the beginning, you will notice your baby will be able to lift their head briefly, smile and coos. 

Four Months – Things definitely get more interesting as babies start to roll over, grab and reach for things and hold their head more steadily.  I remember this was also the first time that I heard my baby’s first laugh, and this is an exquisite memory that you will never forget.

Six Months – This was my favorite time during infancy when you can start noticing a little more personality.  They may start to sit up with support, transfer objects from hand to hand and sleep through the night.  I also recommend that you start childproofing the house now since they will be mobile very soon.

Nine Months – I remember jokingly saying to my family that my son at 9 months was finally acting like a real human being.  It will be extremely exciting to see your baby start crawling and standing, waving and clapping, and saying nonspecific “mama” and “dada”.

One Year – It is time to celebrate as you reach their first birthday.  Babies usually start walking, saying 1-2 words and pincer grasping. 

Feeding

In the first year of life, breastmilk and formula will be the main source of nutrition for your baby.  Babies are usually fed every 2-3 hours around the clock.  My general advice to parents is to let the baby be your guide.  They will know when they are hungry and know when they are full so follow their feeding cues.  Babies normally nurse 20-30 minutes on one or both breasts and will continue to be more efficient as they grow older.  As for formula, you can expect babies to drink 2-3 ounces every 2-3 hours for the first month, 4-6 ounces every 3-4 hours from 1-3 months and 6-8 ounces every 3-4 hours afterwards.  I also typically recommend starting solid foods, like fruits and vegetables, at 4-6 months and all other foods, including meats, shellfish, and peanut butter to babies at 6 months and up.  Please remember that this is only a broad overview and discuss with your pediatrician to address any specific concerns.

Sleep

Doesn’t it sound ironic that babies sleep so much in the beginning, but new parents are always tired from a lack of sleep?  The reason for this is that even though they sleep a lot, their sleep is fragmented, and they do not sleep more than 3-4 hours straight at a time.  The first few months are incredibly hard since babies eat every 2-3 hours around the clock.  Thankfully, this phase will pass as they commonly begin to sleep more at night around 4-6 months.  I regularly begin to advise parents to sleep train their babies around this time.  Again, your pediatrician will be the best source of information about the best way to approach this.  Please keep in mind that no matter how exhausted you are from the dearth of sleep, remember that like most things in life, it is just a stage and will pass in time. 

Learn more about Dr. Benjamin Ho and Concierge Medicine at Texas Children’s Pediatrics.

Check back in for the Part 3 of Dr. Ho’s series, where he discusses Essential Medical Baby Supplies & Taking Care Of Yourself.