Whether you are a new or “seasoned” parent, you have lots of questions about your newborn – how she looks, how to care for him, what “stuff” you need. At Women & Infants, we have all the educational resources you need to care for the newest addition to your family.
Call the Warm Line at 1-800-711-7011
We provide new parents with a toll-free telephone support system. Staffed by experienced nurses/lactation consultants, offers helpful information regarding new babies, breastfeeding, and postpartum issues.
Bathing your baby is an experience many parents treasure. It's a great time to bond, distraction-free, as your tiny new family member enjoys the sensation of warm water on their skin. Yet this common parenting ritual often comes with questions about when and how to do it well. Here are some bathing tips:
All babies cry. It’s their way of telling you they need something. Your baby may cry for four to six hours over a 24-hour period. Responding to your baby’s needs will help to develop trust between you and your baby. To soothe your crying baby, find a calm quiet place and try:
If nothing seems to be working, call your baby’s pediatric care provider or the Warm Line at 1 (800) 711-7011 to speak with a nurse.
Coping with a baby’s crying can be very frustrating. If you’re feeling overly tense or angry and you think you may shake or hit your baby, lay them in a safe place such as the crib and walk away for a short break. Call a friend or a family member and try to get help taking care of your baby. Do not allow yourself or anyone else to shake the baby. An injury caused by shaking a baby is called Shaken Baby Syndrome. Shaking can cause blindness, brain damage, cerebral palsy, or even death. Never shake, hit, throw, slam, or jerk your baby. Anything that causes the baby’s head to flop back and forth or hit a surface can cause damage. Crying is communication.
Expect to change six to 10 diapers each day. You may find you need to change your baby when he or she wakes, after feeding, and/or just before you put him or her down to sleep. Change soiled diapers as soon as possible.
To gently clean the diaper area:
If your baby appears to have sensitive skin, apply a thin layer of fragrance-free Zinc oxide or petrolatum ointment at diaper changes. Be sure to wash your hands after every diaper change.
Diaper rash happens even with the best of care. If your baby gets a diaper rash, you can:
If your baby’s diaper rash does not go away or becomes worse, call the baby’s health care provider or the Warm Line at 1 (800) 711-7011 for additional advice.
Your baby can see right after birth. Babies can focus up to eight inches in front of themselves. By one month, they can see clearly up to three feet. At four months, distance vision is fully developed and babies can follow moving objects with their eyes.
At birth, babies prefer human faces and, as they grow, they will respond to facial expressions.
The best way to prevent spreading germs to your baby is by washing your hands often and thoroughly. Wash your hands before and after you care for your baby, especially before feedings and after diaper changes.
Avoid having visitors who have symptoms of a cold or the flu. Be sure to wash your baby's toys and pacifiers regularly in hot, soapy water or on the top shelf of the dishwasher.
Making your home safe for your baby helps prevent accidents. The following safety tips are recommended:
You will need a variety of things to take care of your baby. The following are some of the key items you should have:
Your baby should be securely fastened in a car seat every time he or she rides in a vehicle. The American Academy of Pediatrics (AAP) recommends:
At this time car seat installation services at Women & Infants are temporarily suspended. Staff will provide each family with resources to help them properly install their car seat prior to discharge.
DO NOT USE a car seat if:
When choosing a crib for your baby, make sure it meets current safety standards as recommended by the American Academy of Pediatrics:
For the first few weeks of a baby’s life, some parents prefer to use a bassinet or cradle because it’s portable and allows the baby to sleep in their bedroom. But keep in mind that babies grow fast and a cradle that’s sturdy enough for a 1-month-old may be outgrown by the next month.
Infants should sleep in the parents’ room, close to the parents’ bed but on a separate surface (room sharing). The infant’s crib, portable crib, play yard or bassinet should be placed in the parent’s bedroom for at least 6 months but preferably a year.
Source: The American of Pediatrics, www.aap.org
Strollers are a great way to travel with your baby. They allow the baby to nap comfortably while you get some fresh air and exercise. When choosing a stroller, look at the price, convenience, and practical features such as protection from the sun. A model that reclines flat for infants is helpful, so they can sleep and have comfortable head support.
A newborn baby may sleep 12 to 18 hours a day. Newborns usually sleep in naps with short wake times. It is normal for a baby to wake up two to three times during the night. When first born, babies often have their day and night reversed. It takes at least three to six weeks before you can begin to see your baby’s sleep pattern. Most babies will not sleep through the night until they are at least 12 pounds or three months of age.
On the first night you bring your baby home, don’t be surprised if he or she is more vocal and wakeful through the night. This is normal. Follow your baby’s cues and feed frequently. This is a transition period and will take some time and patience before you all adjust. During this time:
Babies need short periods of tummy time, too. Tummy time should always be supervised and is a good way to help your baby develop normal muscle strength in the neck and chest. Tummy time also helps prevent your baby from developing flat spots on the head.
The ABCs of safe sleep
Source: The American of Pediatrics, www.aap.org
B (On their backs)
C (In a crib)
Many first-time parents have never seen a newborn baby the first day after birth and may be surprised about the normal newborn appearance.
A blue/gray skin color is normal in the first few minutes after birth. The skin color changes to pink after the baby starts to cry. It is normal for a baby's hands and feet to appear slightly blue one or two days after birth. Call your baby's health care provider if you notice a blue or gray coloring anywhere on your baby's skin after you leave the hospital. African American and Hispanic babies may have lighter skin than their parents at birth. The skin color darkens in a few days.
Your baby may have a creamy yellowish-white coating called vernix on his or her skin at birth. This protects the baby before birth and will wash off after the first few baths.
Lanugo is a fine, downy hair on the face, shoulders, and back of some babies. It will fall off in the first few weeks.
Milia are tiny white bumps or yellow spots across the top of the baby's nose or skin. These are caused by skin gland secretions and disappear in the first two to three weeks of life.
Swelling or puffiness, also called edema, is normal on the baby's head, face, and eyes. It usually goes away in a few days. Swelling of the breasts is also common in both male and female babies, due to mother's hormones that are passed to the baby before birth. In addition, you may notice a few drops of milk leaking from your baby's breast. This, too, is normal and usually only lasts about one week.
Many newborns develop a yellowish tinge to their skin in the first few days of life. This is jaundice and is caused by a normal breakdown of old red blood cells resulting in an increased amount of bilirubin. As the bilirubin levels rise above normal, this yellowish tinge will appear first on the face, then on the chest and abdomen, and finally on the legs. Bilirubin levels in term infants usually reach their highest between days three and four. For late pre-term infants, bilirubin levels will reach their highest between days five and seven. If you are concerned that your baby is jaundiced, especially if the yellowish tinge reaches the level of the belly button, you should call the baby's health care provider. A blood test may be ordered to determine if treatment is needed.
At birth, your baby's head may appear long and/or misshapen. This is called molding and enabled the baby to fit through the birth canal. Molding is normal, and your baby's head will become round in a few days. If you had an internal monitor during labor, you may see a scab on the baby's head. This heals in a few days. If forceps or vacuum extraction were used during delivery, there may be a small amount of redness and bruising.
All babies have two soft spots, or fontanelles, on their head. These are the areas where the immature bones of the skull are still growing together. The larger opening is on the top of the head and will remain soft until after the baby's first birthday. It is normal to see it moving up and down as your baby feeds or cries. A smaller fontanelle is at the back of the head and will close by four months of age. It is okay to touch these areas gently. If either of the soft spots looks sunken or bulging, call your baby's health care provider.
It is not unusual to see swelling of the genitals (sexual organs) in newborns after birth. This is due to the mother's hormones passed to the baby before birth.
In girls, the labia or lips around the vagina may appear swollen or enlarged and will return to normal in a few days. Sometimes a drop of blood or pink tint may appear on the diaper. This is normal. A clear mucous discharge from the vagina is also normal.
In boys, the penis and scrotum may appear swollen or enlarged and will return to normal in a few days.
In the hospital, your baby will have the following screenings, as required by the Rhode Island Department of Health:
Circumcision is a surgical procedure in which the skin covering the end of the penis is removed. Circumcision is usually performed by a doctor in the first few days of life. An infant must be stable and healthy to safely be circumcised. Scientific studies show some medical benefits of circumcision. However, these benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised. Parents may want their sons circumcised for religious, social, and cultural reasons. Since circumcision is not essential to a child's health, parents should choose what is best for their child by looking at the benefits and risks.
Many parents choose to have their sons circumcised because "all the other men in the family were circumcised" or because they do not want their sons to feel "different." Others feel that circumcision is unnecessary and choose not to have it done. Some groups, such as followers of the Jewish and Islamic faiths, practice circumcision for religious and cultural reasons. Since circumcision may be more risky if done later in life, parents may want to decide before or soon after their son is born if they want their son circumcised.
As noted above, research studies suggest that there may be some medical benefits to circumcision. These include the following:
Just as there are reasons parents may choose circumcision, there are reasons why parents may choose NOT to have their son circumcised:
Almost all uncircumcised boys can be taught proper hygiene that can lower their chances of getting an infection, cancer of the penis, and sexually-transmitted diseases.
When done without pain medicine, circumcision is painful. There are pain medicines available that are safe and effective. The American Academy of Pediatrics recommends that they be used to reduce pain from circumcision. Local anesthetics can be injected into the penis to lower pain and stress in infants. Talk to your pediatrician/obstetrician about which pain medicine is best for your son. Problems with using pain medicine are rare and usually not serious.
After the circumcision, the tip of the penis may seem raw or yellowish. There will be a gauze dressing, and it should be changed with each diapering to reduce the risk of the penis becoming infected. A medicated ointment should be used to keep the gauze dressing from sticking. It takes about seven to 10 days for the penis to fully heal after circumcision.
Problems after a circumcision are very rare. However, call your pediatrician right away if:
It is normal to have a little yellow discharge or coating around the head of the penis, but this should not last longer than a week. See your pediatrician if you notice any signs of infection such as redness, swelling, or foul-smelling drainage.
If you choose not to have your son circumcised, talk to your pediatrician about how to keep your son's penis clean. The foreskin usually does not fully retract for several years and should never be forced. The uncircumcised penis is easy to keep clean by gently washing the genital area while bathing. You do not need to do any special cleansing, such as with cotton swabs or antiseptics.
Later, when the foreskin fully retracts, boys should be taught how to wash underneath the foreskin every day. Teach your son to clean his foreskin by:
Source: The American of Pediatrics, www.aap.org
It is best to use a digital thermometer to check your baby's temperature. A “normal" temperature varies with the child's age, activity, and time of day. A fever usually is a temperature of 100.4 degrees Fahrenheit or higher.
Rectal temperatures are the most accurate. A rectal temperature reading is taken in your baby’s bottom. A normal rectal temperature is 97.7 to 99.7 degrees. Call the baby’s health care provider if your baby’s rectal temperature is less than 97.5 degrees or greater than 100.4 degrees. Be sure to mention if you took the temperature rectally or under the arm.
Put petroleum ointment at the end of the thermometer bulb.
Lay your baby on his/her belly or side on a firm surface.
Hold your baby still and gently insert the thermometer one-half inch into the rectum until the digital thermometer displays a reading.
Axillary temperatures are the least accurate, but you can use this method to screen a child of any age. An axillary temperature is taken under the arm. A normal reading is 97.7 to 99.5 degrees. Call your baby’s health care provider when he or she has a fever of 100.4 degrees Fahrenheit or higher. Be sure to mention if you took the temperature rectally or under the arm.
Take your baby's shirt off.
Hold the thermometer at a 45-degree angle and place the bulb in the baby’s armpit.
Hold your baby’s arm snugly against his or her side until the digital thermometer displays a reading.
It is normal to be concerned about your baby's health. When newborns are sick, they don't always give you a lot of signs. Because you are just getting to know your baby, it may be difficult to notice a change in behavior. Trust your instincts. If you think your baby is sick, call his or her health care provider. Although usually harmless, call your baby's health care provider if the baby has any of the following symptoms:
The umbilical cord is clamped immediately after birth. The clamp is removed before the baby goes home from the hospital. The cord stump should fall off in seven to 14 days. When it falls off, a small amount of blood or wetness is normal. At home, you should:
Most people have heard about jaundice; when the baby's skin is yellow, but may not understand why it happens or what to do about it.
When babies are born, they have a lot of red blood cells. These extra red blood cells break down into bilirubin (pronounced billy-ru-ben). A newborn baby's liver is not mature enough to get rid of this bilirubin so it builds up in the baby's body and causes the skin and the whites of the eyes to turn yellow. If the bilirubin level gets too high, it can hurt your baby's nervous system.
Finding out that your baby has jaundice can be scary but it is very common, and most times does not cause any problems. Ask your doctor or nurse if you have any questions or concerns about jaundice in your baby. You can also call the Warm Line at 1-800-711-7011. The Warm Line is staffed by registered nurses who will answer questions you may have about your baby. The Warm Line is open Monday thru Friday, from 9 a.m. to 9 p.m., and from 9 a.m. to 5 p.m. on Saturday and Sunday.
There are two types of jaundice. Normal jaundice happens in about half of all full-term babies and in about 80 percent of babies born early (before 37 weeks). Jaundice may last longer in babies born early.
Pathologic jaundice is caused by an illness or other medical problem like an infection. Sometimes the baby's blood type is different from the mother's and that causes problems such as jaundice. Other causes can be liver or intestinal problems or being born too early.
Jaundice usually starts to show on about day two or three of life. Bilirubin levels reach the highest level at about day three or four in a term baby. The levels in a late pre-term baby (born at 35 to 37 weeks) will peak between day five and seven. Jaundice usually disappears in about one week but can last longer in babies who are born early.
The yellow is first seen in the eyes and face, and then it spreads down the body. If the baby is yellow just in the face, it is okay. If the baby is yellow to the belly button or you cannot wake the baby for a feeding, call the baby's doctor or the Warm Line (1-800-711-7011).
In natural lighting, press on the baby's skin with your fingertip. When you raise your finger, the skin should be white. If it is yellow, your baby is jaundiced to that point. In babies whose skin color is darker, you need to watch the white of their eyes and the palms of their hands for the yellow color.
A small bit of blood will be taken from your baby's heel and tested to see how much bilirubin is in the blood.
The bilirubin collects in the baby's stool. When the baby has a bowel movement, the bilirubin goes out. If the baby doesn't have a bowel movement, the bilirubin goes back into the body and levels get higher. So we want babies to have bowel movements. It is very important to feed them. They do not need water. Water will make them urinate, but not have a stool. They need calories (food) to make them move their bowels.
If you are breastfeeding, make sure you feed the baby eight to 12 times in 24 hours. If you are bottle-feeding, feed the baby six to eight times in 24 hours.
Treatment may include:
If a breastfed baby is jaundiced, it is often because he or she is not nursing enough and not having a stool. Breastfeeding on cue day and night may help prevent jaundice. Breast milk is a natural laxative and feeding your baby frequently will help remove the jaundice. Sometimes a breastfed baby can become jaundiced when he or she is two or three weeks old. This may be due to something in the breast milk that prevents the bilirubin from being removed. Treatment is not usually needed. If there are no other causes for the jaundice, continue breastfeeding. It may take as long as three months for the levels to return to normal.
When the weather permits, it is fine for you and your baby to enjoy the fresh air. Because a baby's skin is tender, however, avoid direct sun exposure during his or her first year.
If your baby gets sunburned, call his or her health care provider. A mild burn for an adult could be serious for your baby. Babies can burn even on overcast days.