Caring for Your Infant
Babies are fascinating individuals; no two are alike. Their ability to adapt to the strange new world outside the womb is astonishing. So too will be your ability to adapt to the needs of your infant. Before long you will know baby better than anyone else. Trust your instincts.
Babies' needs are quite simple. They want to be loved and fed, and to be kept warm, dry and clean. Their comfort is your first interest. Babies' clothes should be comfortably loose. Avoid overdressing or bundling indoors. At comfortable room temperature (68-72º F), a diaper, shirt, cotton gown, and cotton receiving blanket are usually sufficient. The baby's room should have fresh air but should not be cold or drafty. Avoid a strong overhead light. In hot weather, adequate ventilation is important; air conditioners and fans are fine to use. During the cold weather season when heating your home, the air may become uncomfortably dry; a steam vaporizer should be used to moisturize the baby's breathing passages.
During the first two months of life, your baby must be protected from germs until his/her natural resistance has improved. Do your best to limit close contact with visitors during this time and avoid trips to crowded places such as the supermarket, church or synagogue, mall, swimming pool, indoor party, etc. Grandparents and siblings, however, must be allowed to cuddle. Direct sunlight is also undesirable since a baby's skin is very sensitive. Babies may go outside whenever you do as long as he/she is dressed properly and protected from direct sunlight and wind.
Babies Will Be Babies
What is normal?
Many behaviors which a baby exhibits normally may be of great concern to first time parents. They may include: sneezing, yawning, hiccoughing, jitteriness, chin quivering, startling easily, eye crossing and crying. Many are simply signs of the baby's immature nervous system and will disappear over the first few months of life. Hiccoughs are little spasms of the diaphragm or breathing muscle and do not bother the baby. Sneezing is the infant's way of clearing his/her nasal passages and does not mean the baby has a cold. Coughing clears the baby's throat, although a persistent cough is a cause for concern. Crying can mean many things from hunger or thirst to dirty diapers, boredom, or just "letting off steam." Crying does not necessarily mean the baby needs to be fed. All babies have a fussy period, usually in the late afternoon or evening (lengths of which may vary tremendously). Use this time to entertain and play with your baby.
Stool patterns are of great concern for parents (and grandparents) but hardly ever worry the doctors. They may normally vary in number from one per week to one after each feeding. The frequency of stooling is not a concern as long as the stool is soft and the baby has no difficulty passing it. Color is rarely important and varies widely. It is also normal for babies to grunt and strain when moving their bowels, often drawing their legs up to their belly. This does not indicate pain or constipation unless the stool is very firm and pellet-like. Remember, as a general rule, when it comes to stools, if it does not bother the baby, it should not bother the parent. If the baby is happy and growing, the stool pattern is fine.
It is important to pay attention to your baby's frequency of urination because this is an indication of how well your baby is feeding. In the first few days of life, you should see wet diapers increasing in both frequency and "heaviness." Typically, 6 to 8 wet diapers a day are a sign that your baby's feedings are well established. Contact your baby's doctor if you have concerns that your baby is not passing enough urine.
Feeding
Feeding is one of a baby's more pleasant experiences. Both of you should be comfortable and relaxed with the process. Whether breast or bottle feeding, hold your baby close to you. Feed in a quiet area. Babies are very sensitive to their surroundings and do not feed well when there are many distractions.
Feed your baby on demand, according to his/her schedule, usually when awakening from a sound sleep. Do not look at the clock to determine feeding times; you will learn very quickly that periods of sleep are precious moments which you should not disturb. In the early weeks, your baby will be much happier if left to his/her own urges.
The choice of breast versus bottle is an individual one. There is no right or wrong method of feeding. Whichever method you choose, it is important to feel comfortable with your decision. Do not let peer or family pressure sway you.
Baby Care Instructions
Care of the Navel
The umbilical cord stump usually falls off in 1-3 weeks, but sometimes it takes longer. A small amount of blood or mucus is common, especially after the stump falls off. If you observe this, you may wipe the area gently with a cotton ball dipped in rubbing alcohol at each diaper change.
Care of the Genitals
Girls: Separate the labial folds and gently wash the area with soap and a soft washcloth. A mucousy white or slightly bloody vaginal discharge is very common in the first few days of life, may continue for several weeks, and will stop by itself.
Boys: Circumcision is a social custom; it is not medically necessary. If your son has been circumcised, the penis may still be somewhat irritated at the time of discharge from the hospital. With each diaper change, wash the penis gently and apply Vaseline to the head of the penis to keep it from rubbing against the diaper. Applying Vaseline is no longer necessary after the area appears healed, usually 3-5 days. If your son has not been circumcised, simply wash the genital area with soap and water. It is not necessary or desirable to retract the foreskin of the penis when cleaning. This will occur naturally over time, usually by six years of age.
Skin Care
Until the navel heals, sponge bathe your baby with mild soap and water. Once the cord has fallen off, he/she can be bathed in a tub or basin. Use a mild soap on your baby's skin. Dove, Tone, or Caress soaps are fine. Bathe your baby only as necessary (once each day is plenty), as overbathing will dry your newborn's skin. Any moisturizing cream (Baby Lotion, Keri Lotion, Vaseline Intensive Care) can be used to soften the dry skin that babies usually develop in the first months. Baby wipes are acceptable for the diaper area but should be discontinued if a rash develops. Diaper ointments (e.g. Desitin, A&D, Balmex) or cornstarch powders (not talc) are also acceptable to use but are not necessary.
Jaundice
Some newborns may develop a yellow tinge to their skin and whites of their eyes. This typically occurs in the first two weeks. The medical word is "jaundice." Notify your baby's doctor if your infant is looking yellow.
Washing Baby's Clothes
Baby's skin is sensitive and fair. It tends to be irritated by detergents. Use Ivory Snow or Dreft to wash the baby's clothes and diapers. In general, a fabric softener added to the wash is better than one added to the dryer. If a skin rash develops, try eliminating the fabric softener altogether.
Fever
Any fever in the first 6-8 weeks of life is a problem. It is not necessary to check your child's temperature unless he/she feels warm or is not acting his/her usual self. Temperatures should be taken by gently inserting a rectal thermometer in to the baby's rectum for 2 minutes. This is the fastest and most accurate method for taking a baby's temperature. If the thermometer reads more than 100.4º F, the baby has a fever. If your child is less than three months of age, notify the doctor immediately.
Car Seat
A car seat is an essential item and required by state law. It does not have to be fancy or expensive; however, it must be certified as crash proof. Your infant must be safely secured in a rear-facing car seat every time he/she is in the car. Baby should be in the back seat, preferably in the middle, and should remain rear-facing until both 20 lbs and one year of age. Only at this point can babies be turned face-forward in a child car seat. If you have car seat questions, call 1-800-CAR-BELT for the American Academy of Pediatric's Answer Line.
Please, never hold your child in your arms or a bassinet while in the car. Of course, for your safety and as an example to your children, remember to wear your seatbelt.
Sleeping Position
Recent research has resulted in a significant change in recommendations for infant sleeping position. It is now strongly recommended that infants be put down to sleep on their backs or their sides, not their stomachs. The only exception is if your infant spits up frequently and your baby's doctor recommends otherwise.
Don't Forget About You!
As much as life with a new baby is wonderful and exhilarating, it may at times be overwhelming and exhausting. Take care of yourself. Rest when your baby sleeps. Ask for help from family and friends. If you do not like the way you are feeling, tell someone. Contact your health professional. For more information on post-partum depression, you can check out the website www.postpartumstress.com.