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The Science of Immunity

sok_ribbon.pngWhen my first baby was born, we tucked him away for weeks before letting him out in public. My daughter, on the other hand, seemed to barely make it home from the hospital before she was being toted on preschool drop-offs and grocery store runs. I worried about her being outside so early, but the reality of life with two kids made it unavoidable.

So what are the best guidelines when it comes to taking your newborn out to meet the world? It’s a question a lot of new parents have in the early weeks and months. I spoke to pediatrician Yael Wapinski, who practices on Manhattan’s Upper East Side, to understand the when, where, and whys of new babies and public places.

When is it okay to take a newborn out in public? 

It’s okay to take your newborn in public (a store, park, playground, or doctor’s office) right away. How else would parents with a second, third or fourth child get by?

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That said, you should follow a few guidelines when you take your new baby out:

  • Avoid bringing baby out during busy times of the day. Try to do grocery shopping and pharmacy stops at mid-morning hours. Avoid the after-school rush in public places, which is usually after 3pm, so that you expose your baby to fewer people (and thus, fewer germs).
  • Schedule doctor visits wisely. If you’re bringing your newborn to the pediatrician’s office for well visits, weight checks, or jaundice concerns, remember this space isn’t ideal for little babies (many kids are there because they’re sick). Most offices accommodate by offering “sick” and “well” waiting areas to separate these populations, and others will even have special waiting areas for newborns. If you can, avoid busy times at the doctor’s: first thing in the morning when the office opens and the after-school rush (after 3:00 pm) will be when the most sick kids are there.
  • Be the most careful with a baby who is under two months old. There are several reasons for this, mostly having to do with a baby’s less-developed immune system and vulnerability in the face of a serious infection. This is also the point when most pediatricians give the first set of vaccines. Pediatricians have a separate response for dealing with a baby who has a fever if he is less than 6-8 weeks old versus a baby who is older than that (the former usually entails being sent to a hospital to be checked for any serious bacterial infection, whereas the latter might entail being checked in the doctor’s office). The two-month age is an important milestone.

What exactly is the risk of bringing a newborn out in public? 

The fear is that somebody who is sick will be in contact with the newborn. Newborns have relatively weak immune systems, so they’re more vulnerable. If a sick person sneezes or coughs near the baby, or touches him, this could be a potential source of infection. Adults are a little more careful about keeping their hands off a newborn (or at least should be, especially if they’re sick) whereas children are not — they often have no problem wiping their nose with their hand and then going to touch a newborn right on the mouth! The places that are riskier are simply where your baby is more likely to have contact with a sick person. A walk around the block or a park is not likely to involve close contact with people, but the odds of being in proximity to a sick person on an airplane, for example, are strong.

Is there a continuum when it comes to the most-to-least desirable places to take a newborn?

Absolutely. In general, open and airy places, such as a park, are better; the open air circulating is less likely to be contaminated with germs from somebody who is sick. Closed spaces are less ideal — especially if there are bound to be other kids there — such as a children’s museum. It’s also not generally recommended that babies travel in a closed space such as an airplane or train until they have had the first set of vaccines, because here you’re without an influx of fresh air for hours. Even though this air is sometimes run through a filter, there is still potential for breathing in germs from someone who is sitting a few rows away from you.

Are there benefits to taking a newborn outside (sunlight, fresh air)? In other words, are some parents too cautious about keeping their newborn inside?

Yes. Sunlight is one of the best sources for vitamin D. We are concerned with babies not getting enough vitamin D, as it can have long-lasting effects on bone structure and growth. This is why we recommend all breastfeeding mothers supplement with vitamin D, and why formula has vitamin D.

But one of the main benefits of going outside is the positive impact for mom! There is nothing more refreshing than going out for air and sun, and taking a walk is great exercise and can help the post-partum body move back into shape. Re-connecting with the outside world helps moms not feel isolated while they’re going through the difficult beginning weeks and months. I’ve seen mommy groups taking walks around a park; it’s a wonderful way to connect with others and let off steam while discussing the challenges of motherhood.

What are the best practices for parents bringing newborns out?

  • Keep your newborn tucked away. If there must be exposure to other people (a special family event, holiday, or religious ceremony), keep the baby in a bassinet, car seat, or stroller in the corner of the room (or another room, if possible) only to come out when necessary. People can admire your precious newborn from a distance all they want, but avoid having him passed around, because this increases the likelihood that he will get in the hands of one person who is sick.
  • Cover with a blanket. If you go out, keep the car seat or basinet covered with a blanket or plastic so that on the off chance someone nearby happens to sneeze, those droplets won’t fall onto his face.
  • Avoid letting children touch your newborn. If there is an older sibling, I usually teach that child how to sanitize first before touching and then ask them to hold the baby’s feet as much as they want, instead of going to his hands or face.
  • Indirect sunlight only. Babies should only get indirect sunlight, because their relative lack of melatonin makes them more susceptible to sunburn.

Keep these guidelines in mind, venture out in safe and smart ways and, most importantly, enjoy your outings with your brand new baby!

Moms on-the-go: Shop your baby travel gear, from strollers to slings!

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