CLICK HERE TO SCHEDULE YOUR CLASSES AND SEASONAL VACCINES.

Newborn Information

Congratulations!

Having a baby is one of the most exciting times in your life. Nothing is more rewarding than the privilege of caring for this new life and providing an environment in which both you and your child will thrive and develop. Choosing the pediatrician that can best care for your child is an important decision. At Pediatric Associates of Austin, we share your joy and enthusiasm and look forward to the opportunity in partnering with you on the exciting journey of raising a child.

Newborn Newcomer's Class

At Pediatric Associates, we offer a complimentary Newborn Newcomer’s Class once a month. The one hour class is on the first Tuesday or Wednesday of every month beginning at 12:00pm. At the class, you’ll tour our office and learn about how the practice operates. At the end of the class, you’ll have a chance to meet our physicians and ask questions. Please call our office at 512-458-5323 to reserve a spot. You don’t have to be a new parent to attend. 

Upon Arrival

When your baby is born at an affiliated hospital, simply tell your obstetrician and the hospital staff that you have chosen Pediatric Associates of Austin as your child’s pediatrician. Our office will be notified of your baby’s birth by the hospital staff. Upon discharge, please contact our office about scheduling your baby’s first visit to our office.

What Our Newborns Parents are saying:

DECISIONS TO MAKE BEFORE THE BABY ARRIVES:

  • Breast versus Bottle Feeding
  • Circumcision
  • When to take off from work
  • When to return to work
  • Child Care
  • What type diapers to use
  • Hepatitis B

WHAT YOUR BABY NEEDS TO LEAVE THE HOSPITAL:

  • Car Seat (rear facing seat until baby weighs 20 pounds)
  • Outfit to wear home

THINGS YOUR BABY WILL NEED WHEN YOU FIRST GET HOME: 

  • Diapers Wipes (plain or pre-moistened)
  • Bassinet or crib
  • Cotton t-shirts
  • Receiving blankets
  • Bottles and nipples
  • Bottle and nipple cleaning brushes
  • Formula (only if bottle feeding)

THINGS NOT TO WORRY ABOUT: 

  • Eyes moving in different directions
  • Baby’s sneezing
  • Stools will be dark and tarry and will progress to a watery yellow
  • White or pink tinged vaginal discharge
  • Periodic breathing (fast-slow-fast) breathing pattern

BREAST FEEDING: 

It sometimes takes 2-4 days for the breast milk to start coming in. Don’t get discouraged. The nursing staff will help you with any problems. If the mother is on any medication please check with our office to see if it is compatible with breastfeeding.

PLEASE INFORM US OF ANY POTENTIAL PROBLEM OR CONCERN YOU MAY HAVE REGARDING YOUR BABY.

Hello exhausted new parents! Congratulations and welcome to the chaos of parenthood!

This is a handout about Triple Feeding, which is a temporary measure to try to increase mother’s milk supply while ensuring your baby is getting adequate calories and fluid. Feedings (i.e. this whole process) should occur at least every 2-2.5 hours during the day and at least every 3 hours overnight – and that’s from the start of one feeding to the start of the next.

There three components are as follows:

  1. Direct Breastfeeding (20-30 minutes total)
    • The first component is to have the infant feed directly at the breast.
    • Falling asleep at the breast is not unusual for a newborn – you’ll want to try to stimulate the infant to keep him/her active at the breast: try undressing, tickling the feet, tapping/rubbing the back. Skin to skin contact before and during the feeding, along with massaging the breasts during the feed also encourages the infant to stay active.
    • Do “switch nursing” – once the infant slows sucking on one breast, switch to the other side. This will often wake the infant; you can switch back and forth several times to keep them active at the breast.
    • If the baby will not latch after a few minutes or shuts down at the breast, move on to the next step 

Once the infant is no longer actively sucking, let the infant come off the breast. Non-nutritive sucking (i.e. using mom as a pacifier) does increase nipple stimulation and milk production but can be very time consuming. Limit the total duration of breastfeeding to 10-15 minutes per breast. Frequency of nipple stimulations is usually more important than duration for increasing milk supply.

  1. Supplementation (10-15 minutes total) 

If possible, hand baby to another care provider to supplement with expressed breast milk (if available), or formula, so that mother can do step #3. Usually offer 1-1.5 ounces (30-45 mL) but can vary.

  1. Pumping (5-15 minutes total) 
    • Pump for 5-15 minutes total, using a double electric breast pump (5 minutes if milk not in yet, 15 minutes if it is!) 
    • Enlist supportive family members to help clean pump parts and bottles! 
    • Remember, it is normal to express very small amounts of milk at this time. It’s about the stimulation, not the volume of milk. Any milk you can produce, can be used for a supplemental feed or stored for a rainy day. And, for most women, prolactin (milk-producing hormone) levels are highest in the morning, and decline as the day goes on, which means your supply decrease throughout the day; this is normal.


This is a general outline for triple feeding; your physician or lactation consultant/counselor can help recommend changes to better suit your personal needs. Every mother-infant pair is unique! We understand that this is exhausting; remember YOUR health and sanity matter too! 

Keep it up! You’re doing great!

When you see pictures of mothers feeding their babies, you are often met with the image of a sweet and calm bundled baby with a mother who is lovingly looking down. While this absolutely can be true, infant feeding can be a bit more challenging than the pictures show. I like to say that feeding your baby is going to be a journey. There will be some highs and some lows, but having support along the way is crucial.

My name is Erin Moore. I have been a pediatric nurse for over a decade and a nurse practitioner with PAA since 2019. I didn’t realize how much of a journey infant feeding could be until I had a baby of my own. We had so many beautiful moments, but there was also a lot of stress and anxiety when it came to navigating breastfeeding and eventually introducing formula. It inspired me to become a lactation counselor to better support parents on their infant feeding journey. My passion is educating new parents on all types of infant feeding, whether it is exclusive breastfeeding, exclusive formula feeding or a combination of both. 

Learning about infant feeding during pregnancy can help you feel more comfortable along your entire infant feeding journey, especially in those first few days of life where both you and your baby are “figuring it out”.

These are 3 tips to get infant feeding off to a good start:

  • Practice skin-to-skin immediately after delivery if possible

    • One of the best ways to start your feeding journey as smoothly as possible is to practice skin-to-skin as soon as your baby is born. There are many benefits for you and your baby and it can also help kickstart your breastfeeding journey. I encourage you to feed your baby within 1-2 hours after delivery, whether via a bottle or via the breast.

    • Remember, skin-to-skin is still beneficial if you are separated from your baby. Enlist the help of your family members or close friends. If your baby is unable to do skin-to-skin and you would like to breastfeed, I encourage you to practice hand expression or pumping colostrum on the same schedule your baby would eat – every 2 to 3 hours, a minimum of 8-10 times in a 24 hour period.

  • Have a flexible feeding plan and know your options

    • We all have an idea of how we would like infant feeding to go, but sometimes it doesn’t go the way we planned. I encourage parents to be flexible with their feeding plans *just in case* an unforeseen situation occurs. 

    • There are medical reasons babies may need supplementation in the first few days of life or even throughout the first year. I encourage families to become familiar with the process of requesting donor milk through a milk bank or learning about and choosing a formula before you need it. If needing to supplement, I highly recommend asking for support in building and maintaining your milk supply if your goal is to exclusively breastfeed.

  • Ask for support frequently

    • Remember…you do not have to figure out feeding on your own. I recommend asking for in-person lactation as much as possible throughout your hospital stay. They are stretched thin, but they SHOULD BE there for you when you need them. If you are planning on breastfeeding, have a lactation professional observe 2-3 feeding sessions and give you feedback on your latch. They can also teach you how to use your pump and to bottle feed.

    • The providers at PAA are here to help guide and advise you. I am also available for questions and in-person lactation visits throughout your baby’s entire first year and on. Remember, feeding support does not end after you leave the hospital. Check-ins are needed much more frequently than expected.

Know that our providers at PAA will be with you every step of your feeding journey and will do everything we can to support you in meeting your infant feeding goals.

If you are interested in learning more about newborn care and infant feeding, please click here to sign up for one of our monthly classes. 

Pediatric Associates Of Austin follows the immunization guidelines recommended by the American Academy of Pediatrics (AAP). For information about these vaccines and the diseases they protect against, please visit http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunization/Pages/vaccine-preventable-diseases-and-policy.aspx

For detailed informational sheets published by the Centers for Disease Control (CDC) please visit www.cdc.gov/vaccines/pubs/vis/

Our Vaccine Philosophy

Our practice believes that all children should receive the recommended vaccines according to the guidelines provided by the AAP and the CDC. Vaccines are safe and effective in preventing diseases and health complications in children and young adults. Regular vaccinations help children ward off infections, and are administered as one of the safest and best methods of disease prevention.

We are happy to discuss your concerns about vaccines at your child’s next visit.

Recommended Immunization Schedule

In 1975 the American Academy of Pediatrics (AAP) updated a 1971 policy by stating “there is no absolute medical indication for routine circumcision of the newborn.” This position was reiterated in 1983 by both the AAP and the American College of Obstetrics and Gynecology. After a recent rigorous review process that included an AAP task Force on Circumcision and many AAP committees, etc., the AAP has modified its position. Unfortunately, the statement of that position does not at this time clearly come down on either side of this issue of whether to circumcise a newborn male or not. “Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks. When circumcision is being considered, the benefits and risks should be explained to the parents and informed consent obtained.” Points of interest in the background material presented:

  • Preliminary date suggest that the incidence of urinary tract infection in male infants maybe reduced when circumcision is performed in the newborn period. Though one very large study in US Army hospitals reported a tenfold increase in these infections in uncircumcised as compared with circumcised males, the AAP has concerns about possible methodological flaws with the study and suggests that conclusions should not be definitely drawn at this time.
  • Cancer of the penis occurs almost exclusively in uncircumcised men. The decision not to circumcise a male infant must be accompanied by a lifetime commitment to genital hygiene to minimize the risk of developing penile cancer.
  • Evidence linking uncircumcised men to cancer of the cervix in their sexual partners and evidence regarding the relationship of circumcision to sexually transmitted diseases is conflicting and inconclusive.
  • Infants undergoing circumcision without anesthesia demonstrate responses suggesting that they are experiencing pain. Local anesthesia may reduce this response but adds an element of risk; information regarding its use has not been reported in large numbers of cases. More data from large controlled studies is required before local anesthesia can be advocated.
  • Though circumcision should not be performed in an unstable or sick infant, it is a rapid and generally safe procedure when performed by an experienced operator. The most common complications are local infection and bleeding.


Hopefully, there will be sufficient interest in this issue to result in the kind of studies required providing definitive answers. It is surprising and frustrating that with a surgical procedure so widely used for centuries, we continue to be lacking the data needed about its benefits and hazards.

A newborn is a baby less than 1 month old. Newborns generally eat, sleep, cry, need their diapers changed frequently and require lots of love. If a newborn is ill, the symptoms can be subtle. It is possible for a newborn to deteriorate quickly. Please call our office day or night for any of the following:

  • Your baby is two months or younger and develops a fever of 100 degrees
    or higher rectally.
  • Your newborn is less than one month of age with any sign of illness (e.g., bad cough, poor color, vomiting or diarrhea). Exception: mild nasal congestion or sneezing.
  • Your baby looks or acts very sick.
  • Your baby becomes lethargic (like a rag doll) and does not respond.
  • Constant crying for over three hours
  • Mouth and lips become bluish
  • Skin becomes grayish

If any of the above occurs or you have urgent questions or concerns call our office number (458-5323) day or night. If it is after hours you will hear a recording explaining how to reach the physician or nurse on call. Be prepared to give your baby’s name, age, medication, temperature, and any other relevant information when you are called back. If you do not hear back in a reasonable period of time always call again. There is a charge for all
after hour calls.

For routine questions you may call during our regular office hours. Our nursing staff is all R.N.s with pediatric experience and will be happy to discuss your concerns. The nurses “triage” the calls received and make every effort to call back promptly but will return the more urgent phone calls
with ill children first. It is reasonable to expect to receive a return call the same day, usually within a couple of hours, unless we are very busy. There is no charge for calling during regular office hours.

HEAD: Most babies, especially those delivered vaginally will look like little “cone heads” and they will often be bruised slightly around their head and face. These both improve dramatically in the first two days. 

FACE: Usually very puffy at first—remember, they have been under water for the past nine months. Because of this, their eyes will not open very wide for 1-2 days. EARS: Often bent in unusual positions for a few days.

NECK: Usually can’t find it until they are about 6 months. 

CHEST: Almost all babies will have some breast tissue directly under their nipples. This is of no concern, even boys. 

HANDS: Usually held in a fist – if not, they will usually close their fist if you stroke their palm.

CORD: May have a plastic clamp and is usually dyed purple. Underneath, it is yellow color. It is important to lift up the cord and clean it with alcohol at least 4 times a day. 

GENITALS: This is another area in which they tend to accumulate fluid and have lots of swelling. 

LEGS AND FEET: Often twisted and bent because of the cramped conditions, but if significant it may be worth mentioning to your doctor. 

SKIN: Many have Stork Bites, which are red patches on their forehead, eyelids or back of their neck. These fade away over the first year. Many darker skinned infants will have Mongolian Spots, which look like bruises over their lower back. These too will fade as the years pass. At 1-3 days of age, many infants will develop Erythema Toxicum, which looks like mosquito bites all over the body. This is a perfectly harmless rash, which resolves in a few days without treatment. Their faces get many harmless rashes, the most common of which is milia, which looks like a lot of tiny white bumps. 

THE MAIN THING TO REMEMBER IS THAT IF YOU ARE WORRIED ABOUT SOMETHING – ASK QUESTIONS!

Your newborn needs to have a sponge bath. Don’t give your baby a tub bath until the cord (navel), and a boy’s circumcision have healed. It isn’t necessary to bathe your baby every day, unless you really enjoy it. Clean the genital area at each diaper change, then sponge bathe the baby. Every other day is probably adequate in the summer and once or twice a week during winter months.

Get together everything you need before you start the bath. Do not leave your baby alone on the changing table, counter top or tub. Even a newborn baby can move more than you realize and could fall to the floor. Plan the bath in a warm area free of drafts so your baby doesn’t get too cold. Rather than get “goose pimples” if a newborn gets cold his skin will become mottled or splotchy in appearance.

Newborns frequently do not like the experience of the sponge bath and often cry vigorously. Don’t jump to the conclusion that you are doing anything wrong, or that you’re hurting the baby. Try putting a towel on the baby’s body then uncover only the part you’re sponging. Cover the wet part again. This may help keep your baby warmer, and perhaps less fussy. Baby probably will be less fussy if he isn’t really hungry or overfull from just being fed. 

Items you will need for a sponge bath: 

  • Basin or sink for water 
  • Mild soap 
  • Warm, draft-free area (bathroom, kitchen) 
  • Cotton Balls 
  • Something to wrap baby in (blanket or towel) 
  • Alcohol/Q-tips (cord care) 
  • Wash Cloth 
  • Clean change of clothes/diapers


Check the water temperature with your elbow or wrist:
The water should be about body temperature –neither too cool nor too warm. You can add warm water if needed.

Undress Baby: Leave the diaper on, as this will prevent wet surprises. Wrap the baby in a towel or blanket.

Eyes: Dip a fresh cotton ball in the warm water, squeeze out excess water. Wipe each eye from the inside corner (next to the nose) to the outside corner. Use a clean cotton ball for each eye.

Nose: Cleanse gently just inside the nostrils. Hold the baby’s head firmly. Don’t drop water inside the baby’s nose.

Ears: With a washcloth, gently wash around the outside of the baby’s ear and behind the ear. Don’t clean the baby’s ear canal and never put anything into the ear canal to clean it.

Face: With a soft washcloth, squeeze out excess water. Wash the baby’s face and pat dry to prevent chilling. Do not use soap on the face.

Hair: To shampoo your baby’s hair, hold your baby by placing your arm under the baby’s back and your hand behind the head. Tilt the head so water will run off the back of the head instead of down the face. Squeeze water from the washcloth over the baby’s scalp. With your free hand, wash the hair and scalp with mild baby shampoo or baby liquid soap using a circular motion. To rinse, squeeze plain water from the washcloth onto the head until all the suds are gone. Babies’ heads sweat easily so you may need to wash your baby’s hair daily to prevent cradle cap.

Body: Remove the diaper. Soap the rest of the body. Be careful not to get the unhealed navel or circumcision wet. Clean the folds of skin (thighs, groin) well. Squeeze plain water from the washcloth over the baby to rinse the soap off. Pat dry baby with a towel.

Cord: Lift cord and cleanse base with alcohol saturated Q-tip or cotton ball 

Expecting a baby? We would like to take a moment to provide you with some insurance information, which can sometimes be difficult to understand. We have devised the following checklist to guide you. Insurance is ultimately the parent’s responsibility but we are happy to help if you have questions.

  • Remember to call your insurance and enroll your newborn on your insurance plan. You have thirty days to comply, but we strongly recommend that you do this as soon as possible. Many parents call their insurance company before they are discharged from the hospital.
  • Most newborns are covered under the mother’s insurance policy for the first 30 days after the baby is born, as long as your baby has been added to moms policy. If your baby is going to be covered by two separate insurance policies, even if only for the first 30 days after birth, please contact both insurance companies so the coordination of benefits can be determined. This enables our insurance department to file to the correct insurance company as primary/secondary.
  • Inform the front desk of all last names (including mother’s maiden name) by which your newborn might be registered either at the hospital or insurance company.
  • Inform the front desk if your newborn is covered by more than one insurance policy. Determine the amount of any deductible or co-pay your insurance requires.
  • Check your well visit/immunization coverage of your policy.
  • Does your insurance require a primary care physician to get pre-authorizations for referrals to specialists? Do you have a list of specialists you must go to in order to receive benefits? If your child requires hospitalization after birth, we admit to Dell Children’s Hospital of Austin. Is Dell on your list of hospitals?
  • If a nebulizer or biliblanket is needed, we have those items available in our office

Disorders Included in the Texas Newborn Screening Panel
Bloodspot Testing Conducted at DSHS Laboratory

Amino Acid Disorders
Argininosuccinic Acidemia (ASA) 

Citrullinemia (CIT) 

Homocystinuria (HCY) 

Maple Syrup Urine Disease (MSUD) 

Phenylketonuria (PKU) 

Tyrosinemia Type I (TYR 1) 

Argininemia (ARG) 

Benign Hyperphenylalaninemia (H-PHE) 

Biopterin Defect in Cofactor Biosynthesis (BIOPT-BS) 

Biopterin Defect in Cofactor Regeneration (BIOPT-REG) 

Citrullinemia, Type II (CIT II) 

Hypermethioninemia (MET) 

Tyrosinemia, Type II (TYR II) 

Tyrosinemia, Type III (TYR III)

Fatty Acid Oxidation Disorders 

Carnitine Uptake Defect (CUD) 

Long-Chain Hydroxyacyl-CoA Dehydrogenase Deficiency (LCHAD) 

Medium Chain Acyl-CoA Dehydrogenase (MCAD) 

Trifunctional Protein Deficiency (TFP) 

Very-Long-Chain Acyl-Co A Dehydrogenase Deficiency (VLCAD) 

2,4 Dienoyl-CoA Reductase Deficiency (DE RED) 

3-Hydroxyacyl-Coenzyme A Dehydrogenase Deficiency (HADH) 

Carnitine Acylcarnitine Translocase Deficiency (CACT) 

Carnitine Palmitoyl Transferase I Deficiency (CPT1) 

Carnitine Palmitoyltransferase Type II Deficiency (CPTII) 

Glutaric Acidemia, Type II (GA2) 

Medium-Chain Ketoacyl-CoA Thiolase Deficiency (MCAT) 

Short-Chain Acyl-CoA Dehydrogenase Deficiency (SCAD)

Organic Acid Disorders 

3-Methylcrotonyl-CoA Carboxylase Deficiency (3MCC) 

3-Hydroxy-3methylglutaric Aciduria (HMG) 

Beta-Ketothiolase Deficiency (BKT) 

Glutaric Acidemia Type 1 (GA1) 

Isovaleric Acidemia (IVA) 

Methylmalonic Acidemia (MMA) (Cbl A and Cbl B forms) (Cbl A,B) 

Methylmalonic Acidemia (mutase deficiency form) (MUT) 

Multiple Carboxylase Deficiency (MCD) 

Propionic Acidemia (PROP) 

2 Methylbutyryl-CoA Dehydrogenase Deficiency (2MBG) 

2-Methyl-3-Hydroxybutyric Acidemia (2M3HBA) 

3-Methylglutaconic Aciduria (3MGA) 

Isobutyrylglycinuria (IBG) 

Methylmalonic Acidemia with Homocystinuria (Cbl C,D) 

Malonic Acidemia (MAL)

Endocrine Disorders 

Congenital Adrenal Hyperplasia (CAH) 

Congenital Hypothyroidism (CH) 

Hemoglobin Disorders 

Sickle Cell Anemia (Hb SS) 

Sickle Beta Zero Thalassemia (Hb S/Th) 

Sickle-Hemoglobin C Disease (Hb S/C) 

Various Hemoglobinopathies (Var Hb)

Other Disorders 

Biotinidase Deficiency (BIOT) 

Cystic Fibrosis (CF) 

Galactosemia (GALT) 

Severe Combined Immunodeficiency (SCID) 

Spinal Muscular Atrophy (SMA) 

X-Linked Adrenoleukodystrophy (X-ALD) 

T-Cell Related Lymphocyte Deficiencies

Point-of-Service Screening Conducted at Birthing Facility 

Critical Congenital Heart Disease (CCHD) 

Newborn Hearing Screening

If your child is seriously ill, please call us directly at