Welcome to the practice of Drs. Paul E. Gaffuri and Kenneth J. Kroopnick. We are pleased that you have entrusted us to care for your child.

• Office hours are 8:30-4:30 . We break for lunch between 12:30 and 1:30 . Please call as early as possible to schedule urgent visits.

• Weekend hours are for urgent visits and are made by arrangement in the morning. Please call early (preferably before 9 a.m. ) if your child is ill and might need to be seen. Some weekends, sick children will be seen at Giombetti and Brady Pediatrics, 208 Delaware Avenue .

• 24 hour phone coverage is available. You may call 478-9423 at any time . After hours, please limit these calls to urgent matters. Scheduling and routine calls should be made during normal business hours. After hours phone numbers are as follows:

• Monday through Thursday, 4:30 until 11:00 , p.m., 244-1864 . This is our answering service. They will page us with your urgent call and we or our covering doctors will call you back.

• Monday through Thursday, 11:00 , p.m. until 8:30 , a.m., please call Nightcare at 800-418-9066.

• Friday, 4:30, p.m. until Saturday 7:30 , a.m., please call Nightcare at 800-418-9066.

• Saturday and Sunday, 7:30 until 12:00, please call our main number, 478-9423. On weekends we share coverage with Giombetti and Brady Pediatrics (439-5611). Instructions will be given on which number to call.

• Please note that while Giombetti & Brady Pediatrics participates with almost all the insurance companies we participate with, there are a few exceptions-check your insurance handbook.

• Saturday and Sunday, after 12:00 p.m., please call Nightcare at 800- 418-9066. We reopen at 8:30 Monday morning.

• At all times you may call our main number for this information.

Feeding in the first few weeks

Nurse your baby about 10 minutes on the first breast and as long as he or she wants on the second. Breast feeding should take about 30 minutes at each feeding initially. If you are formula feeding, newborns usually take about 1 ounce per feeding at first and increase to as much as 3 ounces by 1 week.

A baby is doing well:

• Has soft or loose bowel movements
• 1 to 2 large or several small bowel movements for the first 2 to 3 days.
• After the first 2 to 3 days, 2 or more bowel movements in 24 hours.
• Has pale, light colored urine with almost no smell
• In the first 3 days, 1 to 2 wet diapers per day (occasional brick red staining is normal)
• 6 wet diapers as the milk supply increases (usually by the third day). This is easier to notice in cloth diapers, you can put a tissue in the diaper if you are not sure.
• Is feeding well at least 8 to 12 times in 24 hours.
• Listen for swallowing or a quiet "caw" sound.
• Is back to birth weight at about 2 weeks of age

Get help if any of these signs listed above are not present, or if:

• Your baby is very sleepy and hard to wake for feedings
• Your nipples are sore and do not start to get better
• You have fever, chills, flu symptoms or a red painful area on your breast.
• The baby has a deep yellow or orange color.

Skin Care

• Change diapers frequently
• Increase air exposure
• Rinse skin with warm water
• Most babies do not need a barrier cream routinely. You can use petroleum jelly or a commercial barrier cream as needed.
• If your baby has a yeast infection (bright red and not responding to warm water washing and a barrier cream) you may use clotrimazole cream (sold for athlete's foot) twice a day. If the rash is not improving after a few days call the office during regular hours.

Umbilical Cord

Try to keep the cord dry. Air exposure helps with the drying and separation. Try to keep the diaper off of the cord. Usually the cord will separate off by two weeks of age. A small amount of bleeding from the cord site as it scabs over is normal.

Circumcision

Keep the area clean and dry. It should heal in about a week. If there are any signs of infection (increased redness, swelling or drainage) call our office.

Bringing the baby out

Only close relatives or friends should visit in the first month. Good hand washing or (even more effective) an alcohol gel should be used. During the first two months crowded areas should be avoided (shopping malls, church, etc.). Walks outside are encouraged.

The first appointment

Your baby's first appointment is within one week of discharge. Call earlier if there are concerns regarding feedings or anything else. The baby's next physicals are at the following ages: one month, two months, four months, six months, nine months and one year.

Thank you, again for choosing us as your child's pediatricians. We look forward to caring for your child. Congratulations.

Paul E. Gaffuri, M.D. & Kenneth J. Kroopnick, M.D.