Newborn Care
Having a baby is a wonderful and exciting experience. But those early weeks and months can also be an overwhelming time filled with many questions. To help you on your journey, we've created the guide below with helpful facts on newborn care. Remember, if you have questions or concerns, please call us. We are always here to assist you.
Urine
When your newborn baby is feeding well, you will see six to eight wet diapers per day. If insufficient fluid is being taken in or excessive fluid is being lost (due to vomiting, diarrhea or fever), your child will urinate less frequently. If this is the case, please call us. Strong smelling urine may be normal, but foul smelling or red or dark-colored urine should be evaluated.
Bowel Movements
Your baby's first bowel movements are called meconium. Meconium looks black, like tar, and sticks to the skin. After your baby begins to digest his feedings, bowel movements turn dark brownish-green and are less sticky. After that, the color varies from bright yellow to green.
Breastfed babies continue to have frequent bowel movements (often with each feeding) for weeks. This may eventually change to one each day or even one every week. Stools that are soft and mushy, smooth and pasty, seedy, formed, or even stools with occasional color changes, from yellow to orange to pea-soup-green, are normal. Frequent watery, bloody or hard stools causing discomfort should be evaluated.
Bowel movements are a relatively monumental task for a baby: straining, grunting, turning red and crying can be expected and are not necessarily signs of constipation.
Diapers
Simply put, whatever type of diaper you're comfortable with, we're comfortable with. Just be sure your baby is comfortable. If using cloth diapers and laundering them at home, it is advisable to rinse them in cold water, soak them in detergent with bleach, then wash them in detergent with hot water.
The Navel
Most umbilical cords fall off between 10 and 21 days of life. Check your baby's cord each time you do a diaper change. If it is clean and dry, just let it be. If there is a moist discharge or soiling from urine, you may wipe it clean with an alcohol swab. A foul-smelling umbilical cord or redness or tenderness of the skin on the abdomen around the base of the belly button are reasons to call us. Until the cord falls off, give your baby sponge baths rather than tub baths.
Bathing
When you give your baby any type of bath, remember:
- Check the water temperature first with your elbow or wrist; hot water feels like lukewarm water when you use your hand to test the water.
- Set hot water thermostats to 120 degrees or less. It takes 10 minutes in 120-degree water to produce a third-degree (full-thickness) burn, but it takes only one second in 160-degree water to do the same!
- Never turn your back on or leave your baby unattended for even one second.
- Use only a small amount of mild soap that is fragrance-free and hypoallergenic.
- Applying a fragrance-free, hypoallergenic moisturizer after a bath helps to prevent dry skin.
- For girls, always clean the vaginal area from front to back.
- Limit bathing time to less than 10 minutes to avoid drying out your baby's skin.
Circumcision
Circumcisions are usually done by your obstetrician and are usually performed the day before your discharge from the hospital. If the circumcision is done with a plastic ring, the area should be kept clean until the ring falls off. Those done without a ring often look red and swollen for the first few days. Use a quarter-sized dollop of Vaseline or A&D ointment on a gauze pad to cover the tip of the penis at each diaper change until it is healed—this prevents skin adhesions and irritation from the diaper. Often, a yellowish tissue appears on the third or fourth day of healing: this is normal healing tissue, so do not attempt to wipe it away.
Studies have shown that safe pain medications given to your baby prior to his circumcision greatly decrease the pain associated with the procedure. Please feel free to discuss this topic further with us or your obstetrician.
Vaginal Discharge
A mucousy, white or even blood-tinged discharge is normal in response to maternal hormones in your baby's body. This will disappear on its own after a few weeks.
Clothes/Outdoor Wear
Whether inside or outside, dress your baby as you would dress yourself, adding an additional layer of clothing—such as a light blanket—in the first few weeks of life. When weather permits it and your baby is appropriately dressed, outdoor time is great for both new babies and their families.
It is generally good practice to wash all baby clothes before wearing. If your family or baby has a history of sensitive skin, eczema or atopic dermatitis, we recommend using a fragrance-free, hypoallergenic laundry detergent.
Hiccups & Sneezing
Babies yawn, sneeze and hiccup. These are normal baby reflexes in response to excitement and stimulation. Sneezing does not necessarily indicate illness unless it's accompanied by a sudden increase in nasal congestion, fever or cough. Hiccups are more common around feeding time and may occasionally cause a baby to spit up all or part of a feeding.
Sleeping
The recommended sleeping position is on the back, not on the stomach. (Tummy time is great for exercise and stimulation when both you and your baby are awake and alert.) Try to put your newborn down for most naps and bedtimes drowsy but awake. This will encourage good sleep habits.
Babies should sleep away from the direct flow of fans and air conditioners. Babies do not need pillows, quilts, bumpers, comforters or toys inside their crib. A firm crib mattress covered by a sheet is the safest bedding. Consider dressing your child in a flame-resistant sleeper.
Crying
No need to tell you: babies cry. Most babies have fussy periods, often in the late afternoon or early evening. It is often difficult to stop this fussing, which may last as long as two hours or more. Check to make sure that your baby is not hungry, soiled, hot, cold, in need of a change of position or wanting to be held. Always try to comfort your baby. Fussiness, as well as irregularities in feeding and napping schedules, is particularly common in the first few weeks of life and in new surroundings. This usually resolves anywhere from a few days to three or four months of age. Remember:
- You will not spoil your baby by holding or rocking them during the newborn period.
- Persistent crying, irritability or other concerns you may have about your baby's well-being warrant a phone call.
When To Call Us
Call us if something is bothering you about your baby. If your concern is not addressed here and it is not an emergency, the best time to call is during routine office hours. It would be impossible to describe all possible emergencies, but here are a few important points:
- Temperature: A temperature that is either too high or too low can be a sign of illness in your infant. In the first three months of life, please call immediately about a rectal temperature above 100.4 degrees or below 97 degrees.
- Activity: Your child's level of activity is just as important as their temperature. A baby (four months of age or less) who misses two or more routine feedings, who is very irritable, or is difficult to awaken, may be sick with or without fever. Please call if your child is excessively irritable or lethargic.
- Vomiting/diarrhea: Occasional spitting up or loose stools often cause no problems, but an infant with multiple episodes of vomiting and/or diarrhea can become dehydrated if they are getting insufficient amounts of the proper fluids. Please call us if your child is experiencing any of these signs of dehydration:
- Infrequent urination (less than every six to eight hours).
- A dry-looking mouth or no tears with crying.
- A sunken appearance to the eyes.
- Excessive lethargy or irritability.
Please call our team today at (203) 288-4288 to schedule a wellness visit for your child or to ask any questions.