Skin Care and Bathing:
Sponge bathe the baby until the cord has fallen off and the umbilicus is dry. Dabbing the cord with Isopropyl (rubbing alcohol) may help this process but is not necessary. As the cord separates you may see some spotting of blood and the base may look wet and a slimy yellow gray in color. This is part of the cord separation process and this is okay. Call our office if you notice any redness or red streaking, discharge or foul smell from the cord. After the umbilical cord is gone you may tub bathe every 1 or 2 days using any mild non-perfumed soap. Shampoo the scalp no more than twice a week; do not use baby oil on the skin or scalp. A little A&D or Vaseline ointment on the healing circumcision will prevent irritation. Rashes on the face are usually very common and resolve on their own. Rashes in the diaper area usually respond to frequent diaper changes, leaving the diaper off to air dry, and using creams such as Desitin, A&D, Balmex or other over the counter diaper creams.
Bowel Habits and Constipation:
Because babies have bowel movements lying on their backs and because they do not have fully developed abdominal muscles they may cry in order to force the stool out. While this is distressing to watch, it is a quite normal patter as long as stool is passed and there is no change in appetite. Normal stools are usually seedy or mustard like in consistency. Formula fed children produce more formed stools. Frequency may vary from several times daily to once every three or four days (in older infants). When the lack of bowel movements causes poor feeding or extreme discomfort, intervention may be needed for constipation. This may involve dietary supplements or other maneuvers for relief. Please call us if you have any questions.
Many babies develop a yellow discoloration to their skin or eyes; this is called jaundice. It is generally not serious, but if you notice it once you get your baby home please call our office. Often it is noticed on the third to fourth day of life but may occur later. Occasionally a baby may require a little help to clear the jaundice.
A normal temperature in a newborn under 2 months of age is somewhat different that a normal temperature in an older child. A temperature varying from 98.6 by more than 2 degrees above of below (i.e.. 96.6 to 100.4) may be a sign of infection in a child under 8 weeks of age and should be promptly evaluated. We recommend checking temperatures in newborns rectally when your child feels warm or shows signs of illness. The American Academy of Pediatrics recommends using a digital thermometer when taking an infants temperature. Infrared thermometers (Thermoscan and other brands) are not recommended for taking a newborns temperature. They may be inaccurate by several degrees in a newborns narrow ear canal. We also do not recommend temporal skin scanning thermometers in this age group as well. Since babies respond quickly to environmental temperature, temperatures should not be taken shortly after your baby has been tightly bundled or exposed to cold.
Circumcision & Umbilical Care:
Circumcision site may normally weep some whitish drainage. Circumcision sites should be clean and rinsed with warm water, mild soap can be used, it is unnecessary to clean vigorously. Persistent bleeding swelling or progressive redness should be evaluated in our office. Application of vaseline ointments will be used after the circumcision is completed and with initial diaper changes. Hands on care will be done while you are in the nursery. An umbilical cord will stay attached to the skin surface for up to several weeks. Keep the cord dry and it will fall off by itself in 2 to 4 weeks. It is normal for the umbilicus to have a small discharge, which may contain a small amount of blood as the cord is separating. If this should persist after separation please call our office. If there is a delay in cord separation beyond 4 weeks, please call our office.
A room temperature of 70 – 72 degrees and light, loose fitting clothing are best. Do not keep the baby too warm. A useful rule is if you are comfortable then the baby is comfortable. A heated home in the winter may become extremely dry. A vaporizer (cool mist) or humidifier adds added moisture to the air if the baby is congested. The baby may go outside if the weather permits but please avoid crowds, lengthy trips, exposure to malls or anyone who is sick especially during the first 2 – 3 months of age. Avoid direct sunlight exposure especially during the summer months because your baby is very sensitive.
Our office recommends that parents take a CPR course, which is available through the American Red Cross and learn how to take a temperature. For more safety tips go to: www.safekids.org, which is found on our website’s medical information section.
A properly installed car seat for the baby is an absolute necessity. State laws requires the use of appropriate car seats which must be anchored to the vehicle facing rearward and the infant must be strapped into the seat. For more information refer to our website’s medical information section.
If there are any older children at home please remember that the arrival of a new baby can be very stressful for them. It may be hard for a child to share the time and attention that they were used to receiving from their parents. They may feel jealous of the new baby and angry with you. To help ease the strain, try to involve the older child as much as possible in the care of the baby. Our office recommends that you bring your older siblings in for the baby’s check-ups and include them in the participation of the check-up. Remember if you can include the older child they will not have to fight for your attention by misbehaving. When visitors come ask them to spend some time initially with the older child. It can hurt the older child’s feelings to be passed by and at this point the baby won’t care. Remember that all children are special, develop differently and have different personalities. Try to avoid comparisons throughout your child’s years they tend hurt one of your children’s feelings. Do not be alarmed if your older child regresses when the new baby comes home. There is no harm in indulging them while at the same time giving them praise and attention for more mature behavior. Remember your child will tend to repeat behavior that gets the most attention so don’t make too big of a fuss over their baby ways.
Sleep & Sleeping Positions:
Newborns sleep a lot during the first month of life. Your child may sleep anywhere from 12 to 20 hours per day with an average of 16 hours per day. The duration of this sleep is variable with anywhere from 15 minutes to 5 or 6 hours. Most newborns awaken 1 to 3 times during the night in the first 3 months of life, and the majority of infants can be expected to sleep through the night by 4 to 6 months of age. Many parents assume that these night time awakening are related to their infants need to eat; however infants awaken several times during the night because they have an immature sleeping pattern. Two general patterns exist, REM sleep, which is an active sleep pattern, where babies display a lot of movement. Infants may go through this pattern 2 to 4 times per night, resulting in a nighttime awakening at the end of each REM sleep pattern. Newborns have this pattern during 50% of their sleeping time (adults around 25%). No wonder babies wake up so much at night. This pattern decreases by age 3 to 4 months. Non-REM sleep, or quiet sleep patter, in which there is less movement and a regular breathing patter and a deeper sleep in which is seems to be very difficult to awaken your baby.
The American Academy of Pediatrics recommends placing healthy infants on their backs when putting them to sleep. Recent studies have shown decreasing risks of SIDS (Sudden Infant Death Syndrome) when infants sleep on their backs rather than their stomachs. Side sleeping is not as safe as back sleeping and is not advised. There are times when infants need to be place on their stomachs (ex: infant with air-way abnormality) and you will be instructed to do so. Overall the actual risks for SIDS is extremely low. Finally the use of a pacifier and running a fan in the room has been found to reduce the risk of SIDS.
Here are some things that could come in handy in the future:
- Bulb suction syringe
- Digital thermometer
- Cool mist vaporizer
- Diaper creams (A&D, Balmes, Desitin)
- Room monitor such as Safety 1st.
- Car seat
- Wash linens and clothing with Dreft Detergent
- Activated carbon water filter, which remove most pesticides and industrial pollutants from the water.
We recommend the following; they are easy to use and economical:
By using these filters you will help our environment by decreasing the use of plastic containers and reducing the possible exposure of your families toy of EDC’s (Endocrine Disruptive Compounds, which you will hear more about in the future)