Caring for Your Baby

You’re home from the hospital. So now what do you do? It’s 3:00 in the afternoon, and you’re still in your pajamas. You haven’t cooked a meal in weeks and don’t plan on it anytime soon. And you’re not sure if it’s day or night. As crazy as it all seems, just know that all of this is absolutely normal. Once you settle into a feeding and sleeping routine with baby, things will be much easier. Household tasks will fall into place as well. It just takes time, and of course, patience. Following are some tips that will hopefully make the first few months with baby less stressful and more enjoyable:

• Visitors & Crowds
  During the first few weeks of your baby’s life, it’s important that he or she is not exposed to harmful germs, especially those that young children can have. We encourage you to limit the number of people who handle your baby during this time so that his/her immune system has time to build up resistance to any infections.
  
• Baby’s Weight
  Newborns typically lose weight the first few days after birth. This should not concern you. They will soon begin to gain weight and should be back to their birth weight by day ten. The general rule is that by six months they should double their birth weight and by one year, triple it.
  
• Umbilical Cord
  While in the hospital, a nurse will go over instructions for caring for your baby’s umbilical cord. Within one to four weeks, the cord should fall off by itself. It’s important that you don’t try to pull it off or cut it off prematurely. Keep the diaper rolled below the cord until it falls off and the area heals. After it falls off, you may notice a little discharge, sometimes with a little blood. This is normal. However, if you notice continued oozing, a foul odor, surrounding redness or fever, have your child examined by a healthcare provider. Until the cord falls off, you will want to give your baby sponge baths (refer to sponge bath section for tips).
  
• Sleeping Patterns
  Most babies are not capable of sleeping through the night, so go ahead and plan on some sleepless nights for you and baby. Generally, babies will wake up every 2-3 hours because they are hungry. Some will drift immediately back off to sleep after feeding, and others will be more alert. Every baby is different and will establish their own pattern of sleep. We recommend that you plan your rest periods around baby’s.
  
  During the first week or two of life, baby will sleep a lot. In fact, at times it may be hard to keep him/her awake at all. Don’t worry. This will change. As baby gets older, he/she will become more alert. By 4-8 weeks of age, you will notice that baby may start sleeping through one or both of the nighttime feedings, allowing you more sleep. Feeding your baby solid foods will not make him/her sleep longer, so wait to introduce these until around 5-6 months. The key is to be patient and for you to rest when your baby is resting. We promise that there will be a day when you both sleep through the night.
  
• Sleeping Positions & SIDS
  
  Recent studies have shown that there is a higher incidence of Sudden Infant Death Syndrome (SIDS) in infants who sleep on their stomachs. We recommend that healthy babies be put on their back when sleeping. Some infants who have malformations or other conditions may need to be placed on their stomach, so be sure and consult with a healthcare provider. Also, restrain from using a “wedge” or other devise designed to help your baby maintain a sleep position. Many of these sleep aids have not been tested for safety and none have been proven to reduce SIDS.
  

  Other sleep recommendations for preventing SIDS include: Make sure baby’s mattress is firm and in a crib approved for safety. Remove all soft pillows, comforters and sheepskins, and do not let baby sleep on other soft surfaces such as waterbeds, sofas or feather beds. Pillows, fluffy toys, comforters, blankets, quilts, etc. can cover you baby’s airways while sleeping. Remove all such items from the crib. Keep baby’s room at a comfortable temperature and dress him/her in as little or as much clothing as you are comfortable in while sleeping. Baby can overheat if overdressed. Make sure that your baby’s face and head are uncovered during sleep. Do not let him/her sleep in clothing that has a hood or is loose around the face. A blanket is not necessary to keep your baby comfortable if he/she is dressed in appropriate sleepwear. If you must use a blanket make sure it only comes up to baby’s waist and is tucked into the sides of the mattress to prevent shifting. Smoking before and after birth can be unsafe to your baby. Ask others around you not to smoke as well. Sleeping in the same bed with your baby can be unsafe. There have been cases where infants have suffocated because an adult rolled over on them in the night. Smoking and alcohol use is also dangerous and can impair your arousal should baby need you. If you want your newborn nearby, try putting the crib next to your bed where you can have close contact, but also ensure safety.

• Tummy Time
  While you should not let your baby sleep on his/her tummy, it is ok to have supervised “tummy time” while baby is awake. Putting your baby on his tummy promotes good shoulder and muscle development and helps to avoid flat spots on the back of the head.
  
• Immunizations & Illness
  Your baby will need to see a doctor for routine immunizations and well visits. During these visits your baby’s weight and growth will be monitored to ensure proper development. This is also the perfect time to discuss with the doctor any concerns you have about feeding, cord care, excessive crying, fevers and vomiting. If you are not sure what is normal behavior in your baby, call the doctor’s office. Most have a nurse that will consult with you over the phone.
  
  Immunizations are shots or vaccinations that protect your child against diseases that can be prevented. Your child can begin receiving them as early as birth. Your baby’s doctor will provide you with a schedule of immunizations and a record of all shots given. It’s important that you keep your baby’s immunization record in a safe place, as your child will need it to enter school and even college.
  
• Taking Baby’s Temperature
  A baby’s temperature can be taken under the arm. Ear thermometers are not as accurate until your baby’s ears get bigger. Be sure and ask your healthcare provider which method of temperature taking they would recommend. A thermometer is a must in any nursery, and your baby’s temperature will be important in determining if he/she needs medical treatment.
  
• Bowel Movements
  As long as your baby is eating normally and doesn’t have any sign of illness, you need not worry about his/her bowel function. It’s normal for their stool to change in number, color and consistency from day to day. Some babies may have as many as 6-8 a day, while your baby may only have one every other day. Also, breastfeeding babies will have different bowel movements than formula-fed babies. For breastfeeding babies, stool is usually more runny, mustard yellow colored and seedy in consistency. Formula-fed babies will have stools that are less runny and more tan in color. Both may have stools that are anywhere from green to gray to brown.
  
  Your baby may grunt and turn red during bowel movements. This is normal and is not a sign of constipation. However, harder, pebble-like stools can be constipation. Diarrhea in babies is usually frequent and associated with excess water. If either continues for more than one day or you notice blood in the stool, contact a healthcare provider.
  
• Teething
  All babies react differently to teething. Some have trouble eating and are very fussy. Others may just drool a lot. Topical creams and teething toys are helpful, but if irritability and crying persists, see your healthcare provider.
  
• Diaper Rash
  Changing your baby’s diaper frequently, especially after he/she wets or has a bowel movement, is the best way to prevent diaper rash. If there is a rash, wash your baby’s bottom with warm water and apply a diaper rash cream or petroleum jelly. If the rash gets worse and begins to bleed, see a doctor.
  
• Skin Care
  Because a baby’s skin is very sensitive, you may notice blotchiness, redness or rashes that are usually completely harmless. Some babies even get what is called “baby acne” that mimics the teenage kind and is caused by the mother’s hormones. Dry and peeling skin are also common, especially on baby’s hands, feet and scalp. Lotions and creams are not recommended for dry skin because it slows down the shedding of dead skin. In fact, lotions and powders should be avoided the first two weeks. Check with a healthcare provider to find out what products they would recommend.
  
• Sponge Baths
  Bath time can be a very special time for parents and baby to bond. It’s also the perfect time to check for any skin irritations and to see how the umbilical cord is healing. Find an area of the house that is safe and not drafty to ensure that baby does not get chilled. Always make sure that all bath supplies are within reach and never leave your baby unattended. And most importantly, enjoy this time with your child.
  

  Here are some other helpful tips for sponge bathing: Lay baby on a towel on a flat surface and undress him/her. Be sure and cover up areas you are not washing with a blanket so baby doesn’t get cold. Pick a time to bathe that does not follow a feeding. Baby is likely to spit up if bathing takes place too soon after eating. Begin washing at the eyes. Take a corner of a washcloth that is moist with warm water and lightly move it from the inner part of the eye to the outer part. Repeat with the other eye using a different corner of the washcloth. Wash the baby’s face with clean warm water using a washcloth or your hand. Then wash around baby’s nose and ears. NEVER use a swab in your baby’s nose or ears. This could cause severe damage including a ruptured eardrum. When washing the baby’s body make sure you get into every fold and crevice. Wash around the umbilical cord with clean, warm water. If baby has a dirty diaper, then use a clean part of the diaper to wipe away any stool on baby’s bottom. Then use a washcloth with warm water to clean the area thoroughly. When washing the genitals, always use clean water. With little girls, wash front to back as not to cause infection in the bladder. Girls may have a lot of discharge which is completely normal. Boys who have been circumcised should be cleaned with clean, warm water until the penis is healed. If your son was not circumcised, lightly wash the penis with warm, soapy water. There is no need to force the foreskin back. Ask your healthcare provider if you have any questions. While washing baby’s hair, we recommend you wrap your baby in a towel and hold him/her in the football carrying position. Using clean water, slowly pour some over baby’s hair. Take a dab of baby shampoo and gently work it into the hair being sure to stimulate the entire scalp, including the soft spots. Cradle cap, which is a scaly patch on the head, can occur if baby’s scalp is not stimulated for proper circulation. If cradle cap does appear, talk with a healthcare professional.

• Fingernails
  Many new parents are scared to cut baby’s fingernails in fear they may hurt him/her. If you cut them while baby is sleeping, chances are he/she will not even notice. You should not cut baby’s fingernails during the first two weeks. You may have received little mitts to put over the hands to prevent scratching himself/herself. After two weeks, use only a pair of baby scissors or baby clippers.
  
• Circumcision
  Circumcision of your son is a very personal decision for you that will most likely be based on religion, cultural factors, whether or not the father is circumcised, or hygiene issues. The procedure involves removing the foreskin that surrounds the head of the penis. Your healthcare provider will explain to you the different techniques for circumcision and care following the procedure, as well as will have you sign a consent form. Your provider will determine the best time to perform the circumcision on your baby whether it is during your hospital stay or a few days after you are discharged.
  
  For the first few days, you will need to apply petroleum jelly to the circumcised area with each diaper change. The penis may appear red and have yellowish crusty spots. Do not try to wipe off the yellow areas. This is normal and is part of the healing process. If you notice any excessive oozing, bleeding or swelling, contact your healthcare provider. If you choose not to have your son circumcised, be sure and ask about proper care.
  
• Jaundice
  Jaundice, or yellowing of the skin and eyes, is very common in newborns. It is caused by a chemical in the body called bilirubin and is not dangerous unless its level gets too high.
  
  Bilirubin is produced by the liver, and although your baby was born with a fully developed liver, it takes time for it to function efficiently. The extra bilirubin in the liver is transferred to the blood and stored in the skin until the liver can break it down. Thus, the skin’s yellow appearance. Jaundice may last up to one week and will usually clear up without any medical treatment.
  
  It is important that you pay close attention to your baby’s coloring and contact a doctor if the yellowing gets worse. Your baby’s healthcare provider should monitor your baby’s bilirubin level and make treatment recommendations. You may need to make several doctor or lab visits during this time, so that bilirubin levels can be monitored. There are a variety of treatment options depending on the severity of the jaundice. Many babies are treated with phototherapy, also called a bililite that lowers the bilirubin buildup with exposure to a special fluorescent light.
  
• Car Seats
  You must have your infant in a car seat at all times when riding in the car. It’s not only safer, it’s the law. Make sure the seat you have says “dynamically or crash tested,” and that it meets the requirements of Federal Vehicle Safety Standard 213. Car seats should be placed in the middle of the back seat and should face the rear until the baby weighs 20 pounds and is one year old. Never put a baby in a front seat where there is an airbag. It is also important to make sure your baby’s car seat is installed properly and that it is an appropriate seat for the weight of your child. View more information on car seats.
  
• Safety Tips
  You can never be too cautious with your newborn. And never too precautious with a toddler. If this is your first child, you’ll be amazed at the many items and products around your home that are dangerous for children. We don’t want you to be worried, but we do want you to be safe. And most of all, we want you to enjoy watching your precious little one grow and develop.
  
  Here are a few helpful safety tips that could make a big difference in preventing accidents and causing harm.
  • Never leave your baby unattended, especially when lying on a bed, table or other surface. · Never leave an infant or child unattended in a car, not even for a second.
  • Keep small and loose objects away from babies. Buttons, peanuts, candy, beads or anything small that can be swallowed is harmful.
  • Keep plastic wrap and plastic bags (garbage, grocery, garment) out of reach to prevent suffocation.
  • Remove sharp items from reach, including scissors, knives, etc. Put safely away in tight containers.
  • Childproof wall sockets, doorknobs and cabinets with cleaning products. Babies are very curious.
  • Make sure all stairs have a gate to prevent baby from crawling up or falling down. Also, if you have a pool, make sure there is a fence around the pool with a gate that is securely locked.
  • When baby is old enough, choose a highchair that is sturdy and will not tip over.
  • Never leave baby alone at bath time, and be sure the water is not too hot.
  • Remove any strings, ribbons, blankets, pacifiers and fluffy animals from crib and surrounding area.
  • Make sure baby’s room has good airflow and that the temperature is not too hot or too cold.
  • Never hold your baby when cooking or holding hot pans or dishes. · If you must smoke, do not smoke around your baby or hold baby while smoking. Not only can baby get burned, the smoke is harmful to their lungs.
  • Ask a healthcare provider to recommend a sunscreen and the appropriate age to begin using it.
  • Always keep car windows and doors locked that are closest to baby.
  • Make sure guns are locked up and out of reach.
  • Never shake your baby. Major trauma even death can result.