Concerns for My 5-Week-Old Baby: Vaccination and Feeding Issues

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My baby is currently five weeks old! He was born at thirty-five weeks and three days without the use of oxygen, as he was born in a clinic.
There was no specific ophthalmological examination conducted.
The pediatrician at the postpartum care center mentioned that there are many sources of hospital infections and suggested that I take him to a large hospital for vaccinations and follow-up examinations when he is two months old.
I'm concerned if that will be too late.
What should I do? Since returning from the postpartum care center, my baby often doesn't finish 100cc of breast milk, and his milk intake has decreased! When feeding, he has a wheezing sound while breathing, which is different from the previous nasal congestion sounds! His bowel movements have increased (the consistency seems to have less moisture, but it's not like goat stool)! Is there a connection? I'm feeling overwhelmed as a new mom.

Yin Yin, 0~9 year old female. Ask Date: 2004/11/01

Dr. Lin Wenxian reply Pediatrics

Dr.
Lin Wen-Hsien, the head of the Pediatrics Department at Tainan Hospital under the Ministry of Health and Welfare, responded to DEAR Yinyin's mother: The ophthalmic examination suggested by the physician at the postpartum care center likely refers to checking for retinopathy of prematurity (ROP).
This type of retinal condition primarily occurs due to the immaturity of the retinal blood vessels in premature infants, leading to abnormal proliferation of retinal blood vessels after birth, which can pull and detach the retina.
If treatment is missed, it may result in blindness.
However, such severe outcomes are mostly seen in infants born at very low gestational ages, with low birth weights, and who require prolonged and high-concentration oxygen therapy.
Your child was born at 35 weeks and 3 days gestation and did not require oxygen; generally, the risk of developing this condition is quite low.
In fact, even the retinal screening at four weeks of age may not be necessary.
If you are still very concerned, you can make an appointment at a medical center's ophthalmology clinic for follow-up on retinopathy of prematurity.
For infants in the first few months, their airways are much smaller than those of adults, so even a small amount of secretions can cause noisy breathing.
If there are no other abnormalities and the frequency is not excessive, this can be considered normal, and parents need not worry too much.
However, if there are signs of decreased activity, poor feeding, or even fever, then a visit to the pediatrician is necessary.
Regarding concerns about feeding and bowel movements, it is important to note that the frequency and consistency of an infant's stools can vary widely.
It is acceptable for an infant to have a bowel movement once every couple of days or several times a day, and the stool can be slightly soft or firm.
It is typically not until the child is two or three years old that their bowel habits will resemble those of adults.
For more information, you can refer to the following websites:
http://www.tmn.idv.tw/pinging/QA/gi/gi026.htm
http://www.tmn.idv.tw/pinging/QA/gi/gi016.htm
http://health.yam.com/article.asp?channelid=62&serial=8745
http://www.vghtpe.gov.tw/~peds/ped/incuba.htm
Tainan Hospital wishes you good health and all the best!

Reply Date: 2004/11/01

More Info

Dear New Mom,
Congratulations on your new baby! It’s completely normal to have concerns, especially as a first-time parent. Let’s address your questions regarding vaccinations, feeding issues, and your baby’s overall health.

Vaccination Concerns:
Your pediatrician's advice to wait until your baby is two months old to receive vaccinations at a larger hospital is quite standard. The recommended vaccination schedule typically begins at two months of age, which includes important vaccines such as the DTaP (diphtheria, tetanus, and pertussis), IPV (polio), Hib (Haemophilus influenzae type b), PCV (pneumococcal conjugate vaccine), and RV (rotavirus vaccine). Starting vaccinations at two months is not considered too late; in fact, it is the norm. It’s essential to ensure that your baby receives these vaccinations on schedule to protect against various infectious diseases. If you have any specific concerns about the timing or types of vaccines, don’t hesitate to discuss them with your pediatrician during your visit.

Feeding Issues:
Regarding your baby's feeding habits, it’s common for newborns to have fluctuating feeding patterns. At five weeks old, your baby may still be adjusting to breastfeeding. If your baby is consistently not finishing 100cc of breast milk, it might be due to several factors, including growth spurts, changes in appetite, or even the comfort of being fed. Babies often go through phases where they may eat less or more, and this can be perfectly normal.

The wheezing sound you mentioned during feeding could indicate a few things. It might be related to nasal congestion or a slight respiratory issue. If your baby is experiencing nasal congestion, it can affect their feeding and cause them to make unusual sounds while sucking. It’s important to monitor this closely. If the wheezing persists or is accompanied by other symptoms like coughing, difficulty breathing, or lethargy, I recommend consulting your pediatrician for a thorough evaluation.

Bowel Movements:
As for your baby’s bowel movements, it’s normal for newborns to have varying stool patterns. The fact that your baby’s stools are more frequent and less formed than before could be a result of their diet (primarily breast milk) and their developing digestive system. Breastfed babies can have a wide range of stool consistency and frequency. As long as the stools are not hard or dry (which would indicate constipation), and your baby is not showing signs of distress, this is typically not a cause for concern.

General Recommendations:
1. Keep Track of Feeding: Monitor your baby’s feeding patterns and try to establish a routine. If your baby seems hungry, offer the breast more frequently, even if they don’t finish the previous feeding.

2. Nasal Congestion Relief: If you suspect nasal congestion, you can use saline drops and a bulb syringe to help clear your baby’s nasal passages before feeding. This can make feeding more comfortable for them.

3. Consult Your Pediatrician: If you have ongoing concerns about your baby’s feeding, breathing sounds, or bowel movements, it’s always best to consult your pediatrician. They can provide personalized advice and reassurance based on your baby’s specific situation.

4. Stay Informed: Keep an eye on your baby’s growth and development. Regular check-ups with your pediatrician will help ensure that your baby is on track and receiving the necessary vaccinations and care.

Remember, parenting is a learning process, and it’s okay to seek help and advice when you need it. Your pediatrician is there to support you and your baby’s health journey. Wishing you and your little one all the best!
Warm regards,
Doctor Q&A Teams

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