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Newborn Care


Having a new baby is an exciting time and may also be a time of nervousness for the parents. Here we will try to answer the most frequently asked questions of new parents. We realize that not all your questions may be answered here, and we hope that you will ask them of us at your next office visit.

Each infant is different. While it is tempting to compare your baby to others, remember that there are many parts of growth and development that are normal but may not occur in every child.

Infant behavior is variable, especially in the newborn period. While some infants are quite active and loud, others are quiet and sleep for long stretches of time. Though early sleep patterns are variable, many newborns sleep about 15 hours a day, in a random wake and sleep pattern. Some normal infants sleep as little as 8 of the 24 hours in a day. Some infants are active and energetic while other normal babies are relaxed and quiet.

You will find that many relatives, friends and other "experts" all ready to offer advice. Though mostly well intended, it can be confusing or just opposite to your common sense. We are aware of this and we welcome the opportunity to help you sort through this advice and help you in your personal decisions regarding your child.

Examine your baby carefully from head to toe. If there is anything at all that concerns you about your child, please call our attention to it so that we can address your concern.

Routine office visits are recommended to allow for the assessment of the health of children, to administer preventive immunizations, to screen for illness or growth abnormalities, to discuss injury prevention and discuss any concerns about child rearing.

As soon as you and your baby are dismissed from the hospital, you will be in charge of his care. The following items are some suggestions and comments concerning the general care of infants. We hope that you find them helpful and hope that you will note your additional concerns so that we may discuss them with you during our routine visits.

It is very common for newborns to have dry, flaking skin, especially at the ankles and wrists. The dry skin doesn't seem to bother the babies, but you may use baby lotion if you wish. Frequent bathing may make the skin drier, so you only need to bathe your baby once every other day for the first month. We recommend any of the baby soaps or washes that are available. Until the umbilical cord falls off and the belly button heals, it is best to give sponge baths. Once the belly button heals, then you may bathe your baby in a tub of water.

Diaper rashes are very common in infants, especially on the buttocks. Diaper rash creams such as Desiten, A& D, and Dr Smith's Ointment are all useful. If your baby has a rash that doesn't respond to these products after a few days, please contact us, as this may be a sign of a yeast diaper rash.

Babies in the first three months often develop a red bumpy rash on the face and chest. This is called milia, and usually does not need to be treated. It is due to a combination of heat, humidity and the sensitive skin some infants have.

Your baby will be comfortable in the same environment that you are. Generally, temperatures between 74 and 78 degrees is best.

We suggest that you wash all new clothing to remove starch and sizing put there in the manufacturing of the clothing. The type of laundry detergent doesn't matter. If your infant appears to be sensitive to laundry detergent, rinsing the clothes a second time in the washing machine will remove any residual detergent.

Some infants have more ear wax than others. This hardly ever interferes with hearing. You may clean the ear wax you see with a washcloth, but do not use cotton swabs to clean out the wax; these usually push the wax in further instead.

Infant shampoo is available which does not sting the eyes. Cradle cap, an oily, flaky material on the scalp, may be removed with gentle brushing or a fingertip massage. If the scale is tough to remove by ordinary shampooing, try rubbing in a small amount of light mineral oil into the scaly area before the shampoo.

Breast fed infants usually begin with a bowel movement at each feeding which is a soft, unformed stool containing "curds" and yellow in color. Later, as the intestine matures, the breast fed infant will often have a decrease in the number of stools produced. Breast babies are nearly never truly constipated with hard dry stools. Hard, dry or very thick stools produced by formula fed infants may be treated by using solid or liquid glycerin rectal suppositories. Your doctor may advise you to add sugar water, Karo (corn) syrup or apple juice to your baby's diet.

Many babies in the first 2 months of life cry as they are having perfectly normal bowel movements. They should settle down after the bowel movement is completed.

Boys: if your child is circumcised, the circumcision site needs good cleansing with mild soap and water just as the rest of the skin does. The plastic bells used in some circumcisions are usually fall off in 7-9 days. Circumcisions are not expected to bleed, become tender, excessively red, swollen, or to develop pus or a foul odor. A yellow or white scab does appear in normal healing. If he is not circumcised, you do not need to do anything special to the foreskin while he is an infant.
Girls: When cleaning after bowel movements, using mild soap and water or diaper wipes and clean from the front moving toward the bottom. Wiping in the other direction may lead to urine infections. Girls usually have a clear mucus discharge from the vagina which can be cleaned gently. This mucus may be blood-tinged normally in the first 3 months of life, especially in breast fed girls. You may notice a white material inside the labia; this is normal and does not need to be cleaned out.

UMBILICUS (Belly button)
The umbilicus is treated with a purple dye at the hospital and there is usually little problem in dealing with the cord. Gently clean the cord with rubbing alcohol 3 to 4 times a day, using a cotton ball or cotton swab, and be sure to get under the cord when possible. Your baby may fuss at the coolness of the alcohol, but the alcohol does not sting or burn since the cord has no nerve endings. Cleaning more than 4 times a day will result in the cord staying on longer than normal. There is no harm in getting the cord wet with soap and water during bathing. Most cords fall off during the second or third week of life, and you may normally see a few drops of blood or some oozy yellow material as it's about to fall off. However, red skin around the umbilical cord is a sign of infection, and you should call us if you see this.

After birth, babies have to get used to the dust and other particles in the air. Your baby may sound "snorty" and sneeze a lot, especially in the first days after birth. This is normal, and not a sign of allergies or a head cold. It is necessary to clear the nose only when the congestion is a problem for the child while eating or sleeping. You can clear the nose by salt water (saline) nose drops followed by gentle suction, using the rubber suction syringe provided at the hospital.

Finger and toenails can be clipped using a fingernail clipper being careful not to cut the ends of the fingers and toes. Shorter nails are easier to clean. The nails can be cleaned with a soft brush to remove dirt and debris from under the nail tips.

Usually, the breast milk or formula provides all the water your infant needs. But in hot weather, or if the baby is constipated, extra water may be given. In the first three months of life, tap water should be boiled; after 3 months, you no longer need to boil it.

The average rectal temperature in babies as in adults is 99.6 degrees. This temperature is just an average, though, and the body's temperature can vary up or down one whole degree in a day's time. There is no need to measure an infant's temperature unless you suspect fever. In infants, the rectal temperature is the best temperature to take at home. If your baby has a rectal temperature of 100.1 degrees or more, please call us. While the fever will not hurt your baby, fever in a small infant may be the only sign of a serious infection and we will want to examine your baby.