General Care

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Your baby is unique. As parents, the people most closely involved, you will come to know your baby best. Trust yourself. Most new parents are unsure of their parenting skills. These worries will soon disappear with experience. You will see that you can provide the proper nutrition and the love, warmth, and attention your baby needs. My staff and I are here to answer your questions and address your concerns as you build your confidence.

All babies sneeze, yawn, burp, have hiccups, pass gas, cough, cry and get fussy. These are normal behaviors. Sneezing is the only way that babies can clear their nose of lint, dust, and mucus. Hiccups are common little muscle spasms, but not painful. Crying is a baby’s way of saying, “I’m tired,” “I’m wet,” “I want to be held,” “I’m too hot,” “I’m hungry.” Gradually, you will learn what your baby means when she cries.

Because a baby’s immunity is not very good in the first few months of life, it is a good idea to make an effort to minimize exposure to infection. This can be best done by not exposing your baby or anyone you know who has a contagious disease (including a cold or a flu virus), restricting visitors to select a group of special family and friends, and asking that everyone who is going to touch the baby to wash his hands thoroughly with soap and water or an alcohol-based handwashing solution. Other friends and relatives can visit you and the baby later.

Care of Navel and Circumcision
The umbilical cord remnant usually falls off within a few weeks. To keep the area clean, swab the umbilical cord (navel) each time you change your baby’s diaper. Soak a cotton-tipped swab in rubbing alcohol and gently wipe the tip and base of the cord area. Your baby may squirm because the alcohol is cool, but you are not hurting him. It can take several weeks for the cord stump to fall off. Continue this care for a week after it does.

Call me if you notice redness of the skin around the cord or a strong odor or pus-like discharge from the cord itself. Except for the diaper area, which you will clean after each diaper change, your baby does not get very dirty. Until the umbilical stump has fallen off, only a sponge bath is recommended.

If your son was circumcised, clean the area with a cotton ball and warm water at each diaper change. Apply petroleum jelly or the antibiotic ointment I have recommended with each diaper change to prevent the surface of the penis from sticking to the diaper. If the Plastibell® method was used, the ring should fall off by the eighth day. Call me if it does not. Whatever method, call me if there is swelling, bleeding, or an unusual discharge or odor. If your son was not circumcised, the penis can be gently cleaned daily. You should not pull back the foreskin to clean under it.

Your Baby’s Safety
The kinds of injuries a baby may experience change with age, so you need to consider and adjust your safety efforts continuously. No one can protect a baby from all hazards; but there is a lot you can do, starting the day your baby comes home from the hospital.

Car Safety
Always use a government-approved, rear-facing car safety seat in the back seat of your car. In an accident, a baby held in a passenger’s arms can strike parts of the inside of the car or be thrown from it. Make sure that there is NO air bag protecting the seat where your baby is placed. Ask me for information to help you buy, rent, or borrow an approved car safety seat.

Be sure your dashboard and back seat shelf are free of all objects that could fly off if you hit the brakes suddenly. Never leave your baby alone in a vehicle. Keep the vehicle at a comfortable temperature and well ventilated. On hot days, check the car seat surface before placing your baby in the seat. Cover a leather or plastic seat with a towel to avoid burning the baby. On cold days, bring an extra blanket to cover your baby.

Diapers
Wet diapers and frequent feedings are signs that your baby is getting enough to drink. Sometimes it is difficult to determine if a diaper is wet. A tissue liner inside the diaper can help slow wetness. It is common, during the first 4 to 5 days after birth, to find a pink-colored stain in your baby’s wet diapers. This results from normal crystals in the urine and is not a problem.

Preventing Diaper Rash
Change your baby’s diaper frequently. Let her bottom air-dry as long as possible at each diaper change. You may use a zinc oxide cream or petroleum jelly to protect the skin. Do not use powder.

Changing Your Son’s Diaper
If your son is circumcised, gently rinse the area at each diaper change. It is important to keep the area as clean as possible. The gauze wrap on the penis will usually fall off within 24 hours following circumcision. Until the circumcision is healed, I recommend applying petroleum jelly or an antibiotic ointment to prevent the penis from sticking to the diaper.

Changing Your Daughter’s Diaper
Using a wet cloth, wipe from front to back. Gently clean between all creases of skin. A little blood-tinged mucus from her vagina is normal at first. If this condition continues, becomes more frequent or heavier, call me.

Regular Visits to Our Office
There is a recommended schedule of “well baby” visits to which you should bring your baby. These visits will give me a chance to check on your baby’s growth and development, to talk with you about the care of your baby, and to offer guidance as your baby grows. Immunizations against a wide variety of important childhood illnesses are generally driven at these well-baby visits.

During these visits, my staff and I will also discuss with you my recommendations for handling many common childhood illnesses and problems. When you need to call our office about an illness your child may have, please prepare for the call by doing the following:

  • Write down what seems to be wrong
  • Take a temperature reading
  • Have the names and amounts of medicines you are giving your baby
  • Have a pencil and paper in hand to note my instructions
  • Have a pharmacy phone number available in case a prescription will be needed

Please call during office hours when you need advice about non-urgent problems. My professional staff or I will be happy to give you guidance and answer your questions. Keep paper and pencil near your phone to write down any instructions we may give. If an emergency occurs, call me immediately or call 911 or go to the emergency room for what happens to be a serious problem. When I am out of town or otherwise unavailable, I will arrange for another doctor to be available for you.

Crib, Bassinet, Carriage, Playpen, Changing Table
The crib for your baby must have slats or bars no more than 2-3/8 inches apart, no unsafe design features, and a snug-fitting mattress. To avoid blocking your baby’s breathing, do not have pillows, large, fluffy toys, blankets, or loose plastic sheeting in the crib, bassinet, carriage or playpen.

Cover the mattress with a waterproof cover, quilted pad, and well-fitting, soft baby sheet. Healthy infants should be placed on their back when put to sleep. Always be with your baby while he is on a flat surface above the floor unprotected by side rails, to avoid injury from falls. Keep one hand on your baby while he is on the changing table.

Supervision
As your baby grows, keep small objects such as buttons, pins, and toys with small parts out of the baby’s reach so he cannot pick them up and swallow them. If you offer a pacifier, use only a commercially made one that meets safety standards and doesn’t have a long cord that could wrap around his neck and cause choking. 

Never leave your baby alone with a person you don’t know. Never let any stranger take your baby from you, no matter what the excuse. Don’t leave your baby alone with a pet, no matter how “friendly” the pet has been. Don’t leave your baby alone with any young child.

Bowel Movements
Bowel movements of newborn babies vary considerably in size, color, consistency and frequency. A baby may have several bowel movements daily, or none for a few days. Frequent bowel movements in a breastfed newborn are a good indication that he is getting enough breast milk. 

Stools may be yellow, brown, or green – firm, loose, or pasty. Your baby’s first stools are black-green, tarry and sticky. They are called meconium. By day 2 or 3, the stool will probably become brown to green and seedy. A breastfed baby’s stools are generally yellow, loose, and seedy once past the meconium stage. The stools of a bottle-fed baby may be yellow, green, or brown and may be loose to well-formed.

Change your baby’s diaper as soon as possible after each bowel movement or wetting. Clean the diaper area and wipe it gently with a cotton washcloth or a non-sensitizing diaper wipe.

Your Sleeping Baby
Newborns do not have the same sleep patterns as adults. Regular sleep patterns develop as your baby gets older. Newborns usually sleep 16-18 hours a day. They sleep 2-3 hours, wake up, eat, and go to sleep again. They often seem to have no real pattern and no regard for whether it’s day or night. At about 6 weeks old, their sleep and wake pattern begins to become established. By 16 weeks, many will have settled into a regular schedule.

When putting your baby to bed, the American Academy of Pediatrics recommends that healthy infants sleep on their backs to reduce the risk of SIDS (sudden infant death syndrome). SIDS is a term used to describe the sudden death of babies in their sleep for no known reason.

Six Steps to Reduce the Risk of SIDS

  1. Put your baby on his back to sleep in an appropriate, safe infant crib with a firm mattress.
  2. Do not put your baby to sleep in a bed shared with any other person (including yourself), on a couch, sofa, waterbed or any soft mattress.
  3. Do not let him sleep on soft things like cushions, pillows, blankets, sheepskins or foam pads. Keep your baby’s crib free of extra fluffy blankets and stuffed animals.
  4. Smoking during pregnancy has been associated with a higher risk of SIDS. Do not smoke near your baby. Do not let others smoke near your baby.
  5. Do not let your baby get too hot. Dress him in as much or as little as you would wear. Do not wrap your baby in lots of blankets or clothes. If your baby is sweating, has damp hair, or is developing a heat rash, he may be too hot.
  6. If possible, breastfeed your baby. Breastfeeding has been shown to be healthier for your baby and reduce the risk of SIDS.