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In this episode of the Mother of Boys Survival Guide Podcast, hosts Cheryl Bohn and Suzy Shaw discuss the overwhelming journey of motherhood, particularly focusing on the challenges faced by first-time moms. Joined by pediatrician Dr. Barnaby Starr, they explore essential topics such as newborn care, feeding, sleep patterns, recognizing illness, and preparing siblings for a new baby. The conversation emphasizes the importance of trusting maternal instincts and seeking professional advice when needed, while also providing practical tips for navigating the early stages of parenting.
Dr. Barnaby Starr is a highly respected pediatrician based in Baltimore, known for his decades of dedicated service to children’s health and well-being. With extensive experience in pediatric medicine, he has earned a reputation for his compassionate care, deep medical expertise, and commitment to community health initiatives. Dr. Starr has worked closely with families to address a wide range of childhood health concerns, from routine checkups to complex medical conditions. Beyond his clinical practice, he has been actively involved in public health advocacy, striving to improve healthcare access for underserved communities. His passion for pediatric care and his unwavering dedication to his patients have made him a trusted figure in the Baltimore medical community.
After retiring from his practice in 2024, Dr. Starr turned his energy and passion to writing a book for young adults. Switch Hitter: A Tennis Novel is a compelling sports fiction story that blends the excitement of tennis with themes of perseverance and personal growth. The novel follows a young athlete navigating the challenges of competition, self-discovery, and the pressures of the game. With his deep understanding of both medicine and sports, Dr. Starr brings authenticity and insight to the world of competitive tennis in a way that is insightful for young adults.
The information provided in this podcast is for general informational purposes only and does not constitute professional advice. Consult with a qualified professional for specific guidance.
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Cheryl Bohn: Thanks for tuning in to the Mothers of Boys Survival Guide Podcast, where you’ll hear tested advice from our experts and our mothers of boys, or as we call you, the MOB, to offer insight and recommendations on raising boys.
I’m Cheryl Bond, and I’m here with Suzy Shaw, my good friend, TV producer, and author of Mothers of Boys Survival Guide. Hey, Suz.
Suzy Shaw: Hi, Cheryl.
Cheryl Bohn: Well, one thing we know as moms is that you need to keep your sense of humor raising kids.
Suzy Shaw: True.
Cheryl Bohn: And you need a really good support group surrounding you. We can be really hard on ourselves as moms, and it’s important to share our stories and advice.
Suzy Shaw: Cheryl, that’s one of the big reasons why I wrote the book. One of the tips I share in the book is what I call the “give job,” and it’s important to discuss with your partner whose schedule is going to change or “give” when there are sudden schedule disruptions like a sick child, and you can certainly count on disruptions happening.
Cheryl Bohn: Oh, yeah.
Suzy Shaw: When my boys were ill, we were lucky enough to have one of the top docs in Baltimore as our pediatrician, and he is with us today.
Cheryl Bohn: Yes. Joining us is Dr. Barnaby Starr. Dr. Starr has over 42 years of experience as a pediatrician in the Baltimore area, and he’s recently retired. He’s here to offer some practical tips to help moms navigate the magical but tiring journey of caring for their infants. So thank you so much for being here, Dr. Starr. Your name exudes confidence.
Dr. Barnaby Starr: Confidence is key.
Cheryl Bohn: So you have literally seen thousands of babies and parents throughout your career. Are there any common concerns you would hear from first-time parents across the board?
Dr. Barnaby Starr: Absolutely. Almost every parent comes in with the misconception that the newborn is a blank slate immunologically, on which the environment could wreak all kinds of havoc, and that they have to constantly be on the lookout because of this fragile, non-immune creature, and it really isn’t true.
I would say the mantra in my practice was to trust Mother Nature, and what Mother Nature does is, yes, the baby, when the baby’s born, doesn’t have its own immune system yet, but it’s borrowing immunity from the mother, and the vast majority of immunity that the baby is born with comes through the placenta during the last trimester. So the only baby that’s going to miss out on this is the very early premature baby. So if you have a baby within four weeks of your due date or beyond that, this baby is strengthened by the mother’s memory for all the immune experience that she’s had her whole life, and that passes through the placenta into the baby and then gets supplemented in the first several weeks of breastfeeding with antibodies that are in the colostrum. Even if you choose not to breastfeed, the vast majority of immunity in the baby has gotten into the baby through the placenta. So you have to trust Mother Nature. She knows what she’s doing.
The second most common fear that I think new parents have is that if something is going awry, how will they recognize it? Because the baby is not yet very communicative. Well, Mother Nature is very smart, and she wants the symptoms of illness to be recognizable by all people, not just pediatricians, or only pediatricians’ children who survive. So the cues of an illness in a newborn are going to be behavioral, a sudden change in the sleep-wake cycle, refusing to eat, or seeming to have trouble with their breathing. Very dramatic things that anyone would be able to recognize.
Cheryl Bohn: Yeah. So really paying attention to what does seem normal for that baby’s behavior and noticing anything that might change.
Dr. Barnaby Starr: Absolutely. The cues of an illness in the neonatal period, which we should consider to be about six to eight weeks, the cues are behavioral. The child is not acting the way they’ve been acting. That’s a time to maybe pick up the phone, and call the pediatrician. And I always told Suzy, as I told all my patients, if you’re really worrying about something, pick up the phone and call. The majority of the time, I won’t be worried, and I’ll be able to reassure you. And if I am worried, that’s when we need to see the baby. Look at your pediatrician as your paid worrier.
Suzy Shaw: So Dr. Starr, when we brought our baby home, it was really very overwhelming. Do you have any advice for parents and moms with that transition?
Dr. Barnaby Starr: Well, I think the first one is not to worry that the baby’s not getting enough in the first couple of days of breastfeeding or even bottle feeding, because the babies really aren’t that eager to feed early on. And Mother Nature, once again, she knows what she’s doing.
What’s happening when you’re breastfeeding is the first couple of days, it’s actually colostrum, colostrum, which is very rich in antibodies and not very sweet and tasty to the baby. And Mother Nature didn’t want the milk in there with that, because the milk would stimulate the baby to digest, thereby breaking down those immune globulins.
If you’re bottle feeding, you’ll notice the baby takes two or three days to really get warmed up. And they tend to lose weight in those first couple of days because they’re born with extra water weight to get through that early neonatal period. So I think the principal thing not to worry about is, are they not getting enough?
The average baby takes two weeks to get back to its birth weight. They all lose weight the first three to five days.
Cheryl Bohn: Yeah. I know. I think we tend to just hyper-focus on every aspect of everything, staring at them, not taking our eyes off of them, analyzing how much food they’re getting. We like that you say you’re the one to call so that we don’t have to overanalyze everything.
Dr. Barnaby Starr: Absolutely. I mean, it takes a lot of experience to know what to ask you on the phone to make sure I’m not worried. People would often call off and say, I think my baby’s having trouble breathing. Well, what do you mean by that? “Well, it’s very noisy and congested.” Well, how’s the baby eating? “Great.” Well, then the baby’s not having trouble breathing. The baby’s just congested. And a simple intervention like saline saltwater nose drops might make the breathing through the nose a little easier.
But again, if the baby’s feeding well, doesn’t have a fever, and again, they can run warmer than we do, too. So when you put your hand on your baby, they often feel warmer than we’re used to, normal in that newborn period.
Cheryl Bohn: Right. Well, sleep is something that is huge and a big adjustment for new parents. Do you have any advice on trying to get good sleep patterns or get into a good routine for sleep?
Dr. Barnaby Starr: Absolutely. But you shouldn’t have too high an expectation at the beginning. Because in the beginning, the child is actually digesting and absorbing their own digestive nutrients for the first time after birth. During the pregnancy, they’ve basically been on an IV drip called the placenta. So they’ve had continuous nutrition through the bloodstream. Now, all of a sudden, they’re getting their nutrition through oral feeding. And you shouldn’t expect them to sleep more than four hours before getting a feed in that early neonatal period.
Cheryl Bohn: I mean, that sounds like that’s just something that you don’t, I, even having four kids, never really thought about that with food and sleeping and what was happening with the placenta.
Dr. Barnaby Starr: It takes about four to six weeks for the baby to start being able to keep their blood sugar up for longer periods. And so you shouldn’t have expectations that the baby should sleep through the night before that. And I really don’t think it’s realistic to expect the baby to consistently sleep through the night until around three to four months. Before that, you can count on them waking up at least once at night. And feed will often be all they need.
And then you start to notice around three months that they’re less aggressive and serious about feeding, and it might just be a comfort issue. And as far as really having expectations of getting continuous nights of sleep, again, I’d say three to four months.
Another very important thing about the newborn in that first six weeks is they’re learning how to handle all the stimuli of their own body. So they’re very focused on organizing all these new internal stimuli that come from digesting food, like we just talked about. And it isn’t until six to eight weeks that they have that constant input organized and can now focus on their outside world. And that’s why six to eight weeks is when you can start expecting them to really look at you and smile in response to your face, what we call the social smile. Six to eight weeks is realistic for that. Earlier than that, it’s more their effect is related to internal stimuli.
Suzy Shaw: So, Dr. Star, the, you know, one of the big concerns with new moms in breastfeeding, you know, what, what are the benefits and should there be any, do you have advice for, for women who are not going to breastfeed, they’re going to bottle feed?
Dr. Barnaby Starr: Absolutely. First of all, no guilt. You do whatever you feel most comfortable with because if you’re doing breastfeeding when you really don’t want to, it probably is not going to go very well. It takes a commitment.
Can a baby turn out very healthy who is not breastfeeding? Absolutely. As we talked about, most of the immune transfer is actually during the pregnancy and not after birth. If you want to breastfeed, then you really have to hang in there with it for at least two weeks before you make a decision that you don’t want to breastfeed because it does take a week for it to start getting more warmed up and more comfortable.
As far as… do I have any advice on routines, I would say get the baby used to it, and after five to ten minutes on one breast, try on the other one. And, I always found it was much better in terms of weight gain for the baby to get a smaller amount of time on two breasts than a large amount of time in a sleeping baby on one breast.
As far as specifics with the bottles, again, you have a lot of input from your family usually because they have experience with bottles. And, I also recommend letting the husband start doing bottle feeding quite early on so the baby gets used to feeding from both parents.
Cheryl Bohn: Yeah, that’s a great point. Well, you touched on this a little bit, but when your baby’s sick for the first time or you’re noticing things that you’re attributing to thinking it’s something where they could be sick, what do you tell your parents when to call you? When should they know if it’s a symptom of a sickness?
Dr. Barnaby Starr: Well, for example, one episode of vomiting in a baby that is within the first few weeks of life is extremely common because the sphincter at the top of the stomach that keeps things in our tummies, that is very weak due to the hormones that circulated in the mother right and around the time of delivering a baby, those hormones were meant to loosen these kind of muscles up so she could deliver the baby more easily. So the baby’s sphincter at the top of its stomach is going to cause it to be very easy for them to throw up if sudden changes in position. So one episode of vomiting would not be something to call your pediatrician about.
However, if all day long the baby’s not tolerating any of their feeds, that could be a reason. What you look for in that kind of case, is the stomach distended? Is the baby acting like they’re in pain? They have a different cry from normal? Those are things we might look for. And again, like we said earlier, consistently not being interested in feeding or once the baby’s six weeks old, not looking at you, not noticing the environment, turning the focus inward when we should be now at six weeks, focusing outward. Those are the things you look for.
Temperature-wise, as we talked about, they can run a slightly higher body temperature than we do. Up to 100.5 can be normal in a newborn. So you don’t want to get too crazy about constantly checking their temperature. But if you think they’re breathing faster than normal and not eating well, I recommend the old-fashioned rectal thermometer for an accurate body temperature. And if it’s 101 or more than that, you want to consult your physician.
Suzy Shaw: What about being babies that are colicky? You know, one of my babies was really colicky and it was difficult for everybody in the house.
Dr. Barnaby Starr: Colic, true colic is literally all throughout the day, day or night. And it’s supposed to look like their stomach is bothering them. And no one fully understands what causes colic, although the current theories are that the baby’s gut is sterile when the baby’s born. So that all the normal flora that inhabit our gut and help us with digestion, those take three or four months to come in and normalize. And in colic, there’s a theory that a higher proportion of gas-producing organisms got in there, and so they’re just uncomfortable all the time until miraculously, at three to four months, when the correct flora has established themselves, they go through digestion much easier.
So there are all kinds of things people try. There are drops that you can try and things like that. But the bottom line is, it’s not a serious illness, and they do grow out of it.
Cheryl Bohn: How do you determine or differentiate between a baby that’s colicky and a baby that’s just crying a lot? Well, the pediatrician may want to try changing formulas or changing something in your diet if you’re breastfeeding and experimenting with things like that because food intolerances can present like colic. It’s, colic really is a diagnosis of elimination, eliminating the correctable, the correctable reasons.
Suzy Shaw: So, you know, safety is always a top concern, and there’s a lot of technology that’s available these days to help, you know, comfort with cameras and keeping an eye on, on your baby and sleep patterns. Could you just talk for a moment about the things to be, like, actively concerned about? You know, maybe SIDS or other siblings or germs when they’re young, they’re very young?
Dr. Barnaby Starr: Yeah. Well, again, germs do get overblown, because we did used to live in caves, and the babies did fine in caves. So, germs tend to get overblown.
So, SIDS, especially if there’s a family history, SIDS is something to worry about. But, again, the back sleeping campaign has greatly reduced the incidence of SIDS, not totally eliminated it. But, again, some things that are diagnosed as SIDS are actually cardiac issues. Some can be respiratory issues. Some can even be neurologic issues, and they can all sometimes mistakenly be called SIDS when really something else is going on.
But, I would say, again, trust Mother Nature. I don’t think there’s any foolproof, new, high-tech something that’s going to keep moms from worrying, because it’s normal to be a little worried.
Cheryl Bohn: Well, I have a friend who’s having her second baby. So, she’s trying to prepare her two-year-old daughter for her little brother. And some days, the two-year-old is super excited about having a little brother, and then other days, the two-year-old says, no, you know, I don’t want a little brother. Do you have any advice on kind of how to address that emotional roller coaster with the other sibling that’s going to be impacted?
Dr. Barnaby Starr: Well, one of the reasons I went into pediatrics is children are honest. And what that represents is true ambivalence. And guess what? That older sibling is correct to be ambivalent about the arrival of someone who’s going to steal the stage, and they have really been the only one. So, reassurance that that child is still very important and will actually help teach the new child what to do and how to handle situations, and getting the older child involved right from the start, that can be a big help.
But also, not overreacting when the child is negative about the new sibling. And trying to say, it’s okay that you feel that way. It’s going to be a little hard. We are going to have to help each other. But that is true ambivalence. That’s the child that pets the new baby on the head three times and then clocks it. And that’s honest and normal. But in terms of seeing something really bad happen, I’ve never seen it.
Cherly Bohn: Yeah. Well, that’s great advice. So, obviously, I think picking the right pediatrician is key. It’s really a relationship that’s so important when you have your first, second, third, you’re building your family. What are some things that parents should consider when they’re picking the right pediatrician for them? What are some things that they should think about?
Dr. Barnaby Starr: Well, I think probably the most important single thing would be to get a sense of whether this person who’s a potential pediatrician for them seems to enjoy what they’re doing. Pediatrics is a field you have to go into for the right reasons. You love children. You love the experience of different ages because general pediatrics, you deal with zero to 18. And you want to find someone who’s not just walking through a routine but really seems to enjoy what they’re doing. That would be number one.
Number two, in this day and age, is find out what the call system is like. When something is going on and things tend to go on with our babies at night, who do you get on the phone when you call? Is it someone who really doesn’t know your child? Is it do they sign out to a call group that really is a separate entity from their practice? Or do you get one of two or three doctors so that over time they get to know you? I think that’s probably the most critical thing. It’s much easier to go into the office, have your exam. It’s much scarier when something’s going on at night and you get somebody who’s not really part of the practice.
Suzy Shaw: That’s really great advice. And it was one of the things that I appreciated the most about your practice is that it was a very small group of pediatricians that was calling us back when we need it.
Dr. Barnaby Starr: That is getting harder to find, Suzy. I got to tell you. But medicine itself is becoming a little less personal and a little more transactional and not really thrilled about that direction, which is why I’m enjoying my retirement.
Cheryl Bohn: Well, 42 years is a pretty solid amount of time in working in that field.
Suzy Shaw: So, Dr. Starr, we’re going to ask all of our guests this question. If you had, like, a motto or a mantra that you would recommend for young moms, you know, sort of like, but you’ve already shared this, it’s my job to worry. If you’re worried about something, contact the doctor. What would you say that mantra would be?
Dr. Barnaby Starr: I’d say my mantra is trust Mother Nature. She’s been doing this longer than any single expert in, whether it be nursing, hematology, any subspecialty. Mother Nature, she’s been having babies successfully grow up in all kinds of environments. And I would say, you know, trust Mother Nature.
Suzy Shaw: Including the cave. And in your retirement, Dr. Starr, you’ve written a book that I have read, and it’s just, you know, fabulous.
Dr. Barnaby Starr: That’s so nice of you to mention.
Suzy Shaw: Can you tell us a little bit about it?
Dr. Barnaby Starr: Yeah, it’s about a teenage girl who confronts a lot of the problems and a lot of the issues that teenagers in our society are confronting. She comes from a very difficult emotional background in that her father died when she was young. He was her only tennis coach, and she played in a very unorthodox style where she uses both forehands, lefty and righty, and has no backhand. And I use that to help teach teenagers that if you do things in an unorthodox manner, but you’re willing to put in the work, you can go very far. And she tries to become the first woman to win a major tennis tournament who plays with two forehands.
Cheryl Bohn: It was a great time together.
Dr. Barnaby Starr: That was great. It was.
Suzy Shaw: For those interested in Dr. Starr’s book, Switch Hitter: A Tennis Novel, please visit the mothersofboys.life website. We’ll post a link to the book and additional resources related to this podcast.
Cheryl Bohn: Thank you all for joining us today. Follow The MOB on Facebook, Instagram, YouTube, and your favorite podcast platform. Be kind to yourselves, moms, and have a great week.
Mothers of Boys Survival Guide is a production of Flame Digital Communications and author Suzy Shaw. This episode was edited by Adam Radtke. Our theme music is by Raphael Fierro-Valerio of Pond5. Join the mob online at mothersofboys.life. See you next week.
