Newborn Care
Watching your baby grow and develop can be an exciting and rewarding experience. There are, however, many common problems and questions that arise that can be upsetting and puzzling to new parents. There are many approaches to various problems, and these will vary from child to child. Remember that loving your child, common sense, and the ability to adapt to particular situations are the keystones to successful child rearing.
Crying
On average, newborn babies cry three hours a day. Babies cry because they may be hungry, cold, wet, or too warm. They just may need to suck, or be cuddled, or they simply may be expressing themselves. You cannot spoil an infant less than four months of age so do not be afraid to hold and comfort them. If your baby’s cry seems different, you cannot seem to comfort him/her, or the baby seems to be in pain, take a rectal temperature and call the pediatrician’s office.
Cord and Circumcision Care
The umbilical cord area may be kept clean by simply washing with water. If there is any redness of the skin around the cord, call your pediatrician’s office.
The circumcision should be cared for as instructed by the hospital. Tylenol should only be given in the hospital for pain control after circumcision. It should never be given to an infant less than two months of age once home. Please call the office immediately if your newborn seems excessively irritable, or has any temperature above 100.3° rectally in the first two months of life.
Skin Care
Many babies have normal rashes that include white dots over their noses and chins or small red splotches with a raised center that comes and goes over different parts of the body throughout the day. These require no special care and will go away on their own.
Heat rash is common in summer and winter and will occur over the neck, chest, upper back and in the creases. Avoid too warm a room or too heavy clothing, and treat by keeping the baby cool and dry.
Infant acne normally appears on the cheeks and nose as red and white bumps—it may be present at birth, but more typically appears after three weeks of age. It will go away on its own, so just continue to just use water to clean the baby’s face.
Diaper rash is very common and can best be avoided by changing the baby as soon as he/she urinates or has a bowel movement. Also, try to avoid using baby wipes in the first month of life—instead use water and a clean soft cloth (i.e. a wash cloth) to clean the diaper area. If your baby does develop a diaper rash apply a diaper cream like Desitin® or A&D ointment to help the skin heal.
Sterilization
It is not necessary to sterilize bottles or nipples if they are carefully washed and thoroughly rinsed. A dishwasher is quite satisfactory.
Sleeping
In the first months of life, and especially in the first few weeks of life, babies will spend a majority of their time sleeping, anywhere from 12 to 20 hours a day. Your baby should start to awaken for feedings by himself/herself after a few days of life. If your baby is running a fever or not awakening for feedings call the pediatrician’s office.
It is recommended that parents put their baby to sleep on his/her back, on a firm mattress, with no loose blankets, stuffed animals, or pillows. In the winter, it is better to put your infant in warm pajamas rather than using blankets to keep them warm. By following these recommendations and preventing exposure to second hand smoke, the chances of SIDS (Sudden Infant Death Syndrome) will decrease.
SIDS
Sudden Infant Death Syndrome (SIDS) is the sudden unexplained death of a baby less than one year. Though we don’t fully understand SIDS, we do know there are several things that can help prevent it.
First, your baby should always sleep on his/her back. Research has shown that back sleeping reduces the risk for SIDS significantly compared to the prone or sidelying positions. Although some babies may not like this position initially, nearly all will quickly adapt if given time. Other recent research suggests that using a pacifier for sleep may decrease the risk for SIDS as well.
Babies should be put to sleep with a pacifier for the first six to twelve months of life. It is wise to wait to introduce a pacifier in breastfed infants until breastfeeding is well established, but no later than one month. Pacifier use at times other than sleep should not be encouraged.
Spit Up
Almost all babies will spit up some, usually right after feeding and especially if not burped enough. A few teaspoons can appear to be several ounces when spread out on a cloth or the floor. The spit up does not bother most babies, and as long as the baby is gaining weight and is happy, it is nothing to worry about. If your baby seems to spit up frequently, try keeping him/her upright after a feeding for at least half an hour and try not to bounce him/her around too much. In addition, you can put the baby to sleep at a 45° angle by placing a wedge or layering a towel under the mattress (the baby should always sleep on a firm mattress).
If your baby’s spit up is very forceful, increasing in frequency or green in color they need to be seen as soon as possible by their doctor.
Bowel Movements
Most parents will be able to tell when their baby is having a bowel movement, because he/she will typically be a little fussy, turn red in the face, and may grunt and cry and draw up their legs. If the stool is soft, the baby is not constipated. All newborn babies pass gas, more than most parents expect.
Most breastfed babies will stool several times a day. The stools are usually a yellow mustard color with some seed-like material mixed in. In some breastfed babies, the stool may be a variety of colors and they may not stool every day. At around two months of age, stooling patterns may change to much less frequent and larger volume stools.