Basic Newborn Care

Newborn / Baby Care & Feeding

Guiding new parents through baby’s first year and beyond is a top priority at Advanced Pediatrics. The following newborn and baby care articles have been written by Advanced Pediatric Associates and Pediatric Web. Should you have any questions regarding the following care recommendations, please call our Nurse Line at 303-699-6200, Option 2.

Share This:

Basic Newborn Care

Babies are Babies! All Babies ...

SNEEZE, COUGH, AND MAY SOUND CONGESTED

Sneezing is how a baby cleans his or her nose of mucus, lint or milk curds. Coughing is often baby’s way of clearing his or her throat. Your newborn may also sound congested. This is not only because newborns primarily breathe through their noses until they are about 4 months of age, but also because the humidity in Colorado is so low. Using nasal saline drops and a cool mist humidifier may be beneficial (see Room Temperature and Humidity). 

HICCUP

Hiccups are little spasms of the diaphragm muscle. Having your baby latch onto your breast for a few minutes or giving a few sips of formula from a bottle may stop them. 

SPIT UP

Spitting up is very common with infants (some babies spit up after every feeding). This typically improves with age. Spitting up is different than vomiting (see How to Tell  if Your  Baby is Ill). Spitting up is not painful, does not cause crying, is smaller in amount, and is usually caused by poor closure of the valve at the upper end of the stomach and overfeeding. If you are concerned that your baby may be sick, or about the frequency or forcefulness of spitting up, please call our office.

Here are a few tips to help manage spit  up:

  • Feed baby in calm and quite environment, free from any interruptions, sudden noises or bright lights. 
  • If your baby spits up frequently, try giving smaller amounts per feeding. 
  • Hold baby in upright position when bottle feeding. Do not feed while baby is lying down. 
  • Burp baby 2 or 3 times during each feeding (every 3 – 5 minutes for bottle fed babies). Burp each time for less than a minute, even if no burp occurs. Babies don’t always need to burp. 
  • When bottle feeding, make sure hole in nipple is correct size.  If it is too large, the formula will flow too fast, and if it is too small your baby will get frustrated and gulp for air. To see if hole is correct size, invert bottle and then stop. A few drops should come out. 
  • Hold baby upright for 20 – 30 minutes after each feeding. Sometimes it is helpful to use a front-pack, backpack or swing for up to 60 minutes after feedings. 
  • Decrease time baby spends in sitting position (such as infant seats). After 6 months of age a jumpy seat is helpful. The newer ones are stable. 
  • Wait 2 – 2 ½ hours between feedings, but not so long that baby is frantically hungry.

ARE UNCOORDINATED

Except for sucking,  baby’s  actions  are  poorly  coordinated.  Arms and legs twitch, tremble and move without purpose.  Breathing  is often irregular and noisy. Babies respond to sudden movements or stimulation with jerky arm and leg movements and  crying. 

CRY

In most instances crying babies need to be held. They need someone with a soothing touch and voice. During the early months of life too much holding cannot spoil babies. It is, however, normal for a newborn to cry occasionally without reason. (Babies are often fussiest in the evening and crying generally peaks when baby is around 6 weeks old.) In fact, some babies cry in order to fall asleep. When your baby cries make sure that he or she is not hungry and is dry and comfortable (no sign of illness, pain or fever). Then if holding your baby does not console him or her, it is fine to let your baby cry for 10 to 15 minutes to see if he or she will fall asleep. 

Back to Top

Fussy Babies

While all babies cry, some cry more than others. One in five babies is fussy – difficult to comfort and may have trouble feeding and sleeping. For parents, caring for a fussy baby can be exhausting and frustrating.

If you have concerns about  your  baby’s  fussiness,  please call our Nurse Line and discuss your concerns with one of our registered nurses. No matter how tired and frustrated you may be, NEVER shake your baby. Shaking a baby can cause severe brain damage and other serious disorders – even death. If you find yourself overwhelmed by crying, put your baby in a safe place like a crib, close the door, and check back when you’re calm. For more information on calming a crying baby, see www.CalmACryingBaby.org and www.FussyBabyNetworkColorado.org

Back to Top

Bathing Baby and Skin Care

Clear water sponge baths should be given until the umbilical cord has fallen off and the navel is completely dry. Then you can tub- bathe your baby with water and a mild soap such as “Dove.” Avoid deodorant and highly scented soaps. Since Colorado has a dry climate, baths normally need to be given only every 2 to 3 days. Wash your baby’s hair once or twice a week with a mild baby shampoo. Do not use cotton swabs in ear canals. Normally, baby’s skin does not need any ointments or baby oil. If, however, your baby’s skin is dry or cracked, apply a white non-scented lotion, cream or ointment such as Aveeno, Aquaphor, Moisturel, Eucerin or Keri once or twice a day to damp skin.

Back to Top

Diapers and Diaper Care

Disposable diapers and cloth diapers are both fine for baby. If you choose cloth diapers, make sure the diaper is pre-rinsed and soaked in a vinegar solution or Diaperene. It is also important to do two rinses following washing to eliminate soap and ammonia residue, which are two of the causes of diaper rash. 

Your baby’s diaper should be changed whenever it gets wet or soiled. After removing the diaper, rinse baby’s bottom with a warm wet washcloth (or alcohol free baby-wipes). If your baby had a stool,  it is ideal to wash him or her in a tub of warm water using a mild soap to make sure that your baby is clean. 

Proper diaper care can prevent most diaper rashes. If your baby does get diaper rash, most respond to 3 days of warm water cleansing and air exposure. If you have tried this or the rash is bright red, your baby may have a yeast infection which can be treated with an over the counter anti-yeast cream such as Lotrimin three times a  day. Please call our office if rash doesn’t improve after  3  days of using anti-yeast cream, or if you notice pimples, pustules, yellow scabs, spreading redness or the rash is very raw or  bleeds.

Back to Top

Fingernails and Toenails

Trim your baby’s nails once a week after a bath when they are soft. Use clippers, baby scissors or a nail file. Round off the corners of the fingernails so that your baby won’t scratch himself or herself. Cut toenails straight across to prevent ingrown toenails. It is often easiest to trim fingernails and toenails while your baby is  asleep.

Back to Top

Umbilical Cord Care

Try to keep the cord dry. It may take from one to three weeks for the cord to fall off. If during this time you smell a foul odor or there is redness surrounding the cord, please call our office. There may be some oozing of fluid or blood that is harmless If so, you may clean the area with alcohol and a cotton ball twice daily for one day. If the area continues to ooze or is raw for more than 5 days, please call our office. Clear water can be used to clean the cord base once cord has fallen off. Do not give your baby a submersion bath until the umbilical cord has fallen off.

Back to Top

Circumcision and Male Genitalia

If your baby is uncircumcised you do not need to retract the foreskin of the penis any further than it does naturally. Retraction usually occurs gradually over the first four years of life. 

If your baby was circumcised using a plastibell (a small plastic ring encircling the end of the penis), you do not need to apply creams or Vaseline to the penis. Clean the area with warm water until the plastibell falls off, usually within 7 to 14 days. 

If your baby is circumcised without a plastibell, use Vaseline jelly on the tip of the penis for the first couple of days to keep it from sticking to your baby’s diaper. During the healing process it is normal to see yellowish patches over the head of the penis and tiny spots of blood on the diaper.

Back to Top

Female Genitalia

Baby girls sometimes have a bloody or mucous discharge from the vagina for the first week or two of life. This is normal. It is also normal to have a thick white substance in the inner labia. Some girls have a hymenal tag, an extra tag of skin in the vaginal area. This is also normal. When changing a diaper or bathing your baby,  clean  the entire labial folds and creases by wiping from front to back. It is not necessary to remove the thick substance.

Back to Top

Baby's Stools

Baby’s stools initially are sticky, dark greenish-black (meconium). After a few days the stools become yellow-green and seedy (transitional). Formula-fed babies stools become yellowish curdy to semi-solid about the third day. Breast-fed babies have mustardy, very liquid stools. The normal number of stools varies from one every feeding to one large, soft stool every second or third day.

Back to Top

Constipation

Many parents are concerned their baby is constipated when they turn red and appear to be straining while passing stool. This is very normal—as long as the stool is normal, your baby has an appetite and the stool is not hard. Constipation is hard, dried-out pellets of stools. Infrequent stools do not mean that a baby is constipated. If your baby has gone for longer than four to five days with no bowel movement (assuming all else is well), try taking your baby’s temperature rectally. This often stimulates a stool. If that stool is hard and dry or if this does not produce a stool, call our office. Breastfed babies may go 7 to 10 days without having a stool. 

Back to Top

Diarrhea

Diarrhea is a marked increase in both the amount of liquid in the stool and / or the frequency of the stools. A diarrhea stool appears to be mostly fluid that soaks into the diaper. Call our office if true diarrhea persists over several hours or if you see blood in the  stool.

Back to Top

Taking Temperature

Temperatures measured rectally are the most accurate. However an armpit temperature is the safest and may be helpful for screening. If the armpit temperature is above 99° F (37 2° C), check again with a rectal temperature. To take a rectal temperature, lubricate a clean rectal thermometer with petroleum jelly, then lay your baby stomach down on your lap. Gently slide the thermometer into the opening of the anus for about ½ inch (inserting until the silver tip disappears). Hold your baby still and leave the thermometer in 2 minutes with a glass thermometer, or about 20 seconds with a digital electronic thermometer (until it beeps). If the temperature is over 100 degrees (or less than 97.5 degrees), please call our  office.

Back to Top

Sleeping

Newborns normally sleep 14 to 17 hours per day. Babies generally do not have regular sleep cycles until they are around 6 months old. As babies get older they need less sleep and take more regular naps. Every baby is different, but the sleep chart below may give you a general idea for how much sleep your baby may need per day during the first 2 years of life.

Research shows that swaddling helps keep newborn  babies calm and asleep longer because swaddling mimics the coziness inside the womb. It is important that swaddling be snug around baby and not come loose – but not too tight. Only swaddle baby when it is time to sleep, because a swaddled baby will often sleep longer and not wake as easily. To reduce the risk of SIDS (sudden infant death syndrome), always put baby to sleep on his or her back. Stop swaddling baby by 2 months of age, or once baby starts trying to roll over.

Back to Top

Crib Safety

If possible, have your baby sleep in a standard-sized crib with a firm mattress. Since your baby will spend much of his or her time in the crib, make certain it is safe. Crib bars should be no more than 2 3/8 inches apart (If you are using an older crib, please make sure you check the distance between the crib bars). All cribs should be checked for loose or defective crib bars before using. The mattress should be the same size as the crib and should be waterproof. Bumper pads and wedges are unnecessary and can even pose a safety threat. Stuffed toys, pillows and other items should be removed from the crib, as they also pose a hazard to a sleeping baby. Co-sleeping (sharing sleep time in bed with your newborn) can also be dangerous, especially in households where there is smoking.

Back to Top

Clothing

Your baby will generally be comfortable in one more layer of clothing than you require at any particular time of year. Light loose-fitting cotton or synthetic fabrics are best. Avoid wool or silk fabrics and wash all new clothing and blankets before using them. 

Back to Top

Pacifiers

A pacifier can be useful for soothing babies. The shield should be at least 1½ inches in diameter and the pacifier should be one single piece. Recent studies have shown that babies who use pacifiers at naptime and bedtime throughout the first year of life may have a reduced risk of SIDS. 

Back to Top

Going Outdoors

You may take your newborn outdoors whenever the weather is pleasant. Babies born in the summer may be taken out after they are about a week old; you may want to wait awhile longer to take a newborn out in the winter. Make sure your baby’s head is covered— especially in the cold, wind, and sun. Avoid direct sun—babies sunburn easily and that can be very  dangerous.

Back to Top

Room Temperature & Humidity

Try to keep an even, comfortable temperature in the house. Ventilation is important in warm weather. A thermostat setting that is comfortable to you is acceptable as long as baby is wearing an extra layer of clothes and booties. When baby is sleeping, it is preferable to dress baby in sleeper warm enough for the room temperature, rather than covering baby with loose blankets. 

A cool mist humidifier is highly recommended for baby’s room. This is useful for dry winter months and for treatment of many respiratory illnesses. No additive fluid or medicine is advised. Steam humidifiers should be avoided because of the possibility of burns. It is important to wash the humidifier with vinegar and soapy water at least once a week to prevent a build-up of minerals and mold. Water in the humidifier should be changed daily. 

Back to Top

Visitors and Crowds

It is best to keep your baby inside, away from a lot of contacts, especially in the first two months of life. If your baby goes with you to crowded places during the first two months of life, a Snugli type carrier is ideal. These carriers keep your baby next to mom or dad and away from other people. 

Everyone wants to hold, feed and play with your new baby. Unfortunately, some of these people, especially other children, may have a cold or other infection. Your baby should not be passed around from person to person—you may have to be very firm about  this. Make sure that those who will be around your baby have been vaccinated against Pertussis (whooping cough) and the flu. Good hand washing is essential for anyone who will be touching or holding your baby.

Crowds of people are not healthy places for new babies. This includes supermarkets, churches, department stores, restaurants, and schools. Babies less than two months of age should not be taken to places where there is an increased risk of exposure to  germs.

When you need a babysitter, a supportive family member or a good friend is often the best solution. Try to avoid leaving your newborn at a place that has older toddler children because of the increased risk of exposure to germs. If your baby gets ill, he or she should always remain at home or in the care of immediate family.
 

Written by Advanced Pediatric Associates

Reviewed July 2015

 

Back to Top

Article provided by
Advanced Pediatric Associates

Disclaimer:  If you are not a patient of Advanced Pediatric Associates, we recommend that you consult with your own physician regarding health concerns. This information is provided as a guide to our patients, but in no way replaces the advice given by our staff. Occasionally, advice given by our providers or nurse line may vary slightly from that offered by Pediatric Web and its contributors. If you are unsure of any issue regarding your child's health, please call our Patient Care Line at (303) 699-6200. 

Back to Top