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Newborn Care

• Umbilical Cord & Navel

The umbilical cord is nothing more than a remnant of unnecessary flesh that has no nerve or blood supply. Your baby can not feel you touch the cord, and of course, it does not hurt him/her to do so.

The cord usually falls off in about a week, but some babies may keep theirs closer to a month. To promote drying and lessen the chance of infection, the cord should never be covered by bands and you should try to keep the diaper folded out and down below the navel.

Apply rubbing alcohol to the cord, and its base, with a Q-tip at each diaper change. Don't be afraid to move the folds of the navel to wipe hard-to-reach spots.  When the cord drops off there will frequently be a little bleeding, which is normal.  Clean the blood away with some alcohol and a Q-tip until it is healed. If the cord or the surrounding belly becomes red or has a foul odor or drainage, notify our office promptly.

• Circumcision

If you desire to have this procedure performed, it can be done by your obstetrician.  For the first 2-4 days you will need to apply a gauze with Vaseline, petroleum jelly or A&D ointment to the raw areas on your baby's penis. This will prevent the tip of the penis from sticking to the diaper until it has healed. If any areas appear significantly inflamed, Neosporin ointment may be used. A small whitish area or scab is normal during the first week and it will disappear during the healing process.  However if your baby has a discharge, bleeding, severe inflammation or fever, you need to call us or bring him to the office.

• Vaginal Care

Because of the influence of maternal hormones, infant vaginas often have a white creamy discharge which can be cleaned away with wet cotton balls. At times a scant amount of vaginal bleeding may occur as these estrogens wear off. This should be mentioned to us at the first checkup so we can check for any other problems.

• Bowel Movements

Most babies move their bowels by the time they are 48 hours old, but thereafter there is no set schedule. Some infants seem to have a stool after every feeding while others “go” only once every few days, and may switch patterns frequently. Initially, the stool may be green-black and sticky but soon becomes the more normal seedymustard like stools of normal babies. Please refrain from using laxatives, enemas, or suppositories to promote bowel movements. Call us if you think something is not normal, particularly if your infant's stool is watery or you detect mucus or blood in it.

• Nasal Congestion & Sneezing

Newborn babies sneeze a lot and may sound congested because they do not know how to blow their noses. Since they need to breathe through the nose while eating, you may want to place a few drops of saline solution in each nostril and gently suction, after a few minutes, it out with a bulb syringe before each feeding.  The saline drops can be purchased ready-made or prepared at home from one teaspoon salt in one pint of warm water (prepared fresh daily).

• Skin Care

The newborn skin is very sensitive and can react to almost any materials it comes in contact with, including “baby” soaps, oils and powders, as well as clothing, dry air and moisture. Be very cautious about anything that comes in contact with your baby's skin.

• Baths

Because babies sweat quite a bit, they should be bathed every day. Although if you forget or are too tired, it's all right to skip a day. Use a mild soap like dove and plain lukewarm water. Baby soaps can be used as well but some babies may be sensitive to the fragrance and develop a rash.

Until the umbilical stump has fallen off you will need to sponge bathe your baby.  Place the baby on a towel or baby bath sponge inside the baby bathtub. Gently bathe your baby with a sponge or washcloth. Avoid too much soap, the more you use, the harder it is to get off. Don't forget the scalp and hair (if your bay has any!).  You may use a baby shampoo or the same soap you are using to bathe your baby.  You may pour water over your baby's head and bottom but be careful to avoid getting the eyes or the umbilical stump wet.

When cleaning the eyes, use a washcloth with nothing but water and gently wipe from the corner of the nose to the outside. When cleaning the nose and ears, clean only what you can see. Do not stick a cotton tip in an area when you cannot see. You may use the bulb syringe to suction your baby's nose at the end. If you get the umbilical cord wet accidentally, gently pat it dry and clean it with alcohol.

Once the umbilical cord has fallen off, you can get the area wet.

Note: Gather everything you need before you start the bathing process:

• tub with warm water

• soap

• towel or bath sponge 

• shampoo

• washcloth 

• towel

Never leave your baby unattended while you get something.

• Diaper rash

Almost all babies will get a diaper rash from time to time. Often it is caused by the moisture in the urine and stool irritating the skin, and will usually resolve quickly if the skin is allowed to dry out by removing the diaper for periods of time. Applying a good soothing ointment such as A&D or Desitin protects the skin from further irritation.

Diaper rashes may also be caused by yeast that normally live in infant's stools and this may require prescription medication before it resolves. If the rash doesn't clear with Desitin or Balmex, it could possibly be yeast. Please call us during regular office hours for advice.

• Crying

While crying is inevitable in all babies, it is also what seems to concern new parents more than any other problem. Some infants only cry briefly and are easily consoled while others (including yours) cry louder and longer than any other infant. There are many good suggestions for dealing with crying including gently rocking your baby, swaddling snugly in blankets, burping, using a pacifier, taking him/her out for a stroller ride, etc. If your infant continues to cry despite all the measures, call the office and we'll try to advise you.

• Sleeping

Most newborns will sleep 14-16 hours a day, and this should leave plenty of time for the parents to get adequate rest as well as carry on life's other functions. Do not expect your baby to sleep through the night for many weeks, and be prepared to catch naps yourself during the day so you don't tire out. Early on, establish routines for bedtime and avoid letting your baby sleep in the bed with you (even if the baby sleeps, you won't). Recently, it has been determined that sleeping on the back reduces the chance of crib death, and your child should be put to bed that way, until he/she learns to roll over. Babies who are put into their cribs awake, learn to put themselves to sleep, and sleep through the night earlier than those who are allowed to fall asleep in the parents' arms. Establish a bedtime quiet routine of your choosing, but stop just short of your baby falling asleep. Your baby may fuss for a short while, but will eventually teach him/herself how to fall off to sleep.

• Fever

A fever of 100.4 or more taken rectally in an infant less than 3 months of age may be a cause for concern, and our office should be notified immediately.

In an older infant, rectal temperatures of 102 to 104 degrees are common in ordinary childhood illnesses and are not a reason for great concern. Most of the time fever tells us that some type of infection has started. In many cases, the fever is gone in a day or so. This is usually a short-lived viral infection. Most high fevers seem to occur at night.

We do not recommend the use of ear thermometers.

• Fever is a temperature greater than 100.4 degrees rectally, 99.5 degrees axillary.

• Accurate reporting of symptoms and signs is more important than the child's temperature.

• Dosage of acetaminophen may be administered every 4 to 6 hours; avoid aspirin.

• Sponging head and neck with warm water (not alcohol) helps to reduce fever by evaporative cooling. Dress the child in light comfortable clothes.

• Treat fevers calmly.

• Allow febrile children to sleep without being awakened for medication or taking temperature.

• Another anti-fever medication, ibuprofen, may be used if the child is taking fluids well. It is given every 6-8 hours.

 

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