CARING FOR YOUR NEWBORN
Congratulations on the birth of your newborn infant! A new baby is fun and exciting. As you have prepared for this momentous occasion, you may have many questions and concerns about caring for your child. We hope this information will provide you with some basic information and advice in caring for your infant during the newborn period.
The American Academy of Pediatrics, as well as our practice, recommends breast-feeding as the optimal nourishment for your baby. Not only does human milk provide all the protein, sugar, fat and vitamins that your baby needs, it carries special benefits that formula cannot match. Research suggests that breast milk protects against certain diseases like upper respiratory infections, diarrhea/vomiting, allergies, and Sudden Infant Death Syndrome (SIDS). Furthermore, the mother benefits with quicker weight loss, a reduced risk of osteoporosis, ovarian cancer, and breast cancer in premenopausal women.
Breastfeeding can be difficult to get established, but once going, can be sustained for as long as the infant and mother team find enjoyable. Don’t be shy about asking for help while you and your baby learn this new skill. The doctors and nurses at the hospital as well as our office are available to assist you.
Positioning is everything. Make sure you are comfortable, then assist your baby in latching on in such a way that your nipple and much of the areola are pulled well into your baby’s mouth. Your baby will not choke on your nipple. It should feel like a tugging sensation. If your nipples are not sore, breastfeeding should not be painful. If it pinches or produces pain, break the suction, reposition and try again.
Breastfed infants should be fed on demand; for most infants this is 8-12 times per day. Some newborns can be sleepy and difficult to wake. If your baby is not demanding to be fed, wake her if 3-4 hours have passed.
The duration of each feed can vary. While some infants nurse for only 10 minutes on one breast, others may stay on for longer. You should not allow your baby to feed for longer than 20 minutes on each side at any given feeding; otherwise, your nipples may become sore. You will know that your baby is getting enough to eat if there are at least 3-4 wet diapers a day and at least 1-3 stools per day in the first 4 weeks of life.
Formula fed babies should also be fed on demand and allowed to eat as much volume as desired. You may find that your baby stools only once a day or every other day, this is quite normal.
The first bowel movements are meconium, a tarry greenish-black substance. They then will slowly transition to a golden yellow, sometimes loose and seedy. Some babies stool with each feed, others once every several days. Both can be normal. As a general rule, constipation is defined by difficulty in passing stools that appear hard and formed, not by the frequency or infrequency of stooling.
CARING FOR THE SKIN
Bathe the baby every other day. Daily baths are unnecessary and may dry out the skin. Wash the genital area after a bowel movement; washing is not necessary after urination. Clean the baby using a mild soap or other cleansing agent that is hypoallergenic and isn’t perfumed. Rinse the soap off thoroughly with clean water. Wash the hair with soap or baby shampoo. The baby is ready for a tub bath as soon as the umbilical stump detaches. All newborns have dry, cracking skin. Use an ointment or lotion that is hypoallergenic. We suggest petroleum jelly (Vaseline). Avoid baby powder since the infants tend to inhale the powder and give them pneumonia.
UMBILICAL STUMP CARE
Recommendations on caring for the umbilical cord have varied historically and are inconsistent. Most universally accepted options include using isopropyl alcohol swabs to cleanse the area, or simply do nothing at all. Either way, to hasten healing and prevent infection, keep the area dry and exposed to air. When putting on the diaper, fold it down in front below the navel. Avoid wetting the area until the cord falls off (especially tub baths). There may be a small amount of bleeding. The cord usually detaches by 2-4 weeks of age, through sometimes may take longer. Call us if the area around the navel turns red or appears painful to the baby. Avoid using povidone-iodine swabs for the cord.
Some infants develop jaundice in the first several days of life. The yellowing of the skin usually starts that the head and progresses down toward the toes. The yellow color is from bilrubin, the end product from the breakdown of red blood cells that is processed by the liver. Newborns often produce more bilirubin than their immature livers can handle. As a result jaundice occurs. In general, jaundice is a harmless normal process, however, circumstances do exist where treatment is required. Call us if your child appears to have jaundice below the navel, seems listless and difficult to arouse, or you are just not sure of the severity.
SPECIAL TOPICS FOR GIRLS
Girls have a little white discharge that comes from their vaginas in the first couple of months of life. It is very thick and sticky. It is not dirt. Wipe gently with a cotton ball soaked in warm water. Anything that doesn’t wipe away easily should be left alone. Girls can also have a bloody discharge from their vaginas. It is like a little period from all of her mothers’ hormones so don’t be alarmed if you see some blood in the diaper.
SPECIAL TOPICS FOR BOYS
If your son has been circumcised, wash the circumcision site with warm water and apply Vaseline with each diaper change. You may notice some redness around the circumcision site or some whitish/yellowish discharge that is normal and does not represent infection. Call our office if your son’s penis seems particularly tender, feels warm to the touch or appears to be oozing.
The foreskin in uncircumcised males usually doesn’t retract easily until several years of age. Never force the skin to retract.
Car Seats: Your infant should ride in a rear-facing seat until they are 2 years of age. The safest place in the car is in the middle of the back seat. It is dangerous to place your baby in a rear-facing car seat in the front if there is an airbag.
Sleeping Position: the current recommendation is to place your infant on his/her back when sleeping to reduce the risk of SIDS.
SIGNS OF ILLNESS
Call us immediately should your child have a fever (rectal temperature over 100.4), forceful vomiting, lack of stools or feeding difficulties, irritability or inability to console your child, or any injury to your infant. Mild congestion is almost a universal problem among newborns are usually doesn’t require treatment. Call if there is a persistent cough or breathing difficulty. If you are unsure, contact us and we will be happy to assist you.