Newborn Baby Care
Hello, as a stay at home mother of six children I would like to take this opportunity to share what I have learned with you all. I have covered all the basics I think you will need for the first few months of life. Below is a list of the topics I have covered. Please remember this just my experience; please do not substitute what I say for your health care provider’s suggestions.
Swaddling
Comforting baby
Carrying your baby
Bathing
Nail trimming
Sleep Positions
Family Bed
Diaper Changes
Dressing Baby
Breast Feeding
Bottle Feeding
Swaddling
Newborn babies have many adjustments to make when they first leave the security of mom. With the bright lights, loud noises, and people touching them, it can be very overwhelming to them. Swaddling is the best way to keep a new baby feeling safe and secure. When a newborn is swaddled their arms and legs are secure against them as they are use to, they are in a more familiar environment which allows them to take in new sensations within their comfort zone.
Swaddling a newborn sounds much harder than it is. It just takes practice. Using a baby doll to practice is always a good idea.
Place baby with his/her head toward the corner of the receiving blanket
Take one side of the blanket and bring it across the baby tucking the end under baby
Bring up the bottom of the blanket and tuck it into the top of the blanket that you had just draped across baby
Bring the last side across baby and tuck under baby, all done!
The more you practice the tighter you will be able to get this and the more your baby will like it.
Comforting Baby
As baby adjusts to life on the outside he/she may have times where they are just fussy. Here are some ideas on what to try.
Swaddling - Covered above
Swinging - placing baby in a baby swing works wonders for the baby that loves constant motion.
Shh’ing - Hold baby tight to your chest and making a shh’ing sound over and over it sounds like the womb to baby.
Bounce Seats - Those lovely bouncing seats with the vibrating motion.
Carrying Baby - Place baby in a baby sling and wear your baby as you move around. They love the closeness; they can hear your heartbeat, feel your warmth and smell you. Baby slings, as opposed to front pack carriers, allow you to carry baby in many different positions. They also grow with your baby from newborn until toddler-hood, keeping you from having to get multiple items to help carry baby in.
Bathing
Bathing a newborn is slippery work, but nothing besides a greased pig is as hard to hold onto than a wet, soapy newborn. Finding the right bath tub for you is the first step. How do you wish to wash baby? If you want to bathe baby in the tub or over the sink, then one of the folding tubs works well, but do not use these if you wish to bathe on the changing table or any other surface you want to keep dry; they leak. If you want to bathe at the table, get a solid tub. The bath slings are good for newborn care while umbilical cord is still on but not needed after that. Considering umbilical cords usually fall off in a couple of weeks, sponge bathing is the better option and more cost effective.
To bathe a newborn, first get everything ready. Set up tub and fill with water. Have the baby’s wash cloth wet and full of the soap you’re going to use (only a dab is needed). Have within easy reach a shampoo bottle (opened), a cup for rinsing off baby, and a towel laid out and ready to receive baby. Place your naked bundle into the tub. I have found that wearing a bath mitt (the kind where your hand goes inside) is the easiest way to hang on to baby. Start at the top and work your way down. Work quickly as babies get cold very fast. Using your wash cloth you had ready, wash the face (avoid eyes) and get behind the ears. Next, move to the neck. Try to lift the rolls to clean everything (placing your other hand behind the neck can help you expose the front of the neck to get it really clean). Move onto chest, arms, hands (get in between the fingers), down to the belly, legs, and feet (get between the toes). Lean baby forward and get the back. Lastly, get the buns and crotch area. Rinse out the wash cloth and with it still dripping wet, get the hair/head wet. Use the shampoo and use the wet wash cloth to rinse off the head. With the cup you have at hand, rinse baby of all suds, making sure you have one cup full for the back as you lift him/her out of the tub. Place baby on waiting towel and wrap up tight, drying head/hair first.
Nail Trimming
Babies nails are very sharp and can be quite long even at birth. You may need to trim them even before you leave the hospital. There are a few different ways to trim a newborn’s nails. It just depends on what you are comfortable with. You can bite them, use clippers or use curved scissors. The best time to trim nails is when your little one is asleep, so he/she doesn’t pull or get startled at the wrong moment.
Biting : Bitting of the nail is the easiest and some say safest because you are not going to accidentally clip the skin. If you were a nail bitter as a child, you know how to do this. Just get the nail started and you can peel the rest of it off. When you have done all the nails, touch them and if you find any rough spots use a baby nail file to smooth out any rough edges.
Clippers : To use clippers make sure you have baby clippers. Do not try to use adult clippers. Clip the baby’s nails the same as you would your own - straight across, making sure you do not get too close to the skin. File any rough edges.
Curved scissors: With the scissors you can follow the natural curve of the skin below the nail and also reduce the rough edges you get at the end of your trimming session. Simply start at one edge and clip as you go. Always make sure to keep clear of the skin
Sleep Positions
We have all heard that babies must now be put to sleep on their backs. This reduces the chance of SIDS. The facts cannot be ignored. Unfortunately not all babies like to sleep this way and this creates problems for parents that want to do what’s best for baby and need baby to sleep. The first thing to try to keep them on their back is swaddling. Some babies do not like the back position because it has them laying in a position that is uncomfortable and unfamiliar to them. If you swaddle your baby tight, they feel more secure and are more likely to sleep on their back. If that still does not work for your baby, luckily we now have options. If baby will not sleep on their back, you can put them on their side which also reduces the chance of SIDS more than belly sleeping. You can get them and keep them on their sides a couple of different ways.
Start with two receiving blankets. Lay one blanket on top of the other and then roll into a tight sausage. Tuck the blankets against the side of the crib or basinet and lay baby against it, slightly tipped toward their back. Roll one more blanket the same way and place it in front of baby. Tuck it in close to baby, making sure the top edge does not go above the baby’s nipple line. This should keep baby from falling forward into the belly position.
The other option is to buy one of the side lying positioners you can find everywhere these days. These do the same job as the receiving blankets but allow you to place baby in the middle of the crib or bassinet and keeps you from having to roll and re-roll the receiving blankets again and again.
If you decide on the side lying positioner, keep in mind that baby will not use it for long and they are all essentially equal. In any position you try (except belly), remember that newborns will sleep better if they are swaddled, especially for the first month or so.
One problem that does arrive from the "back to sleep" campaign is that babies are now developing flat skulls. To avoid this problem with your baby, have them sleep in a different position each time you put them down. Just rotate right side, left side, back, and so on. While baby is awake and alert, lay them on their belly while you are there to play with them. Placing infants on their tummies for tummy time for a few minutes a few times each day helps develop neck strength, muscle tone and also lets them get comfortable being on their belly like they will have to be to learn how to crawl later on.
Family Bed
Having baby sleep with you in the family bed is a wonderful way for both mom and dad to bond with baby. The family bed also makes the middle of the night feedings easier on all. If you are breast feeding, you simply attach baby in the side lying position and when baby is done you can both go right back to sleep. No getting up to get baby or having to get up once baby is feed. If you are bottle feeding and have one of the bottle warmers, you simply warm the bottle, feed baby and go right back to bed with all the same ease and convenience talked about in the breast-feeding section.
Of course with the family bed come different responsibilities. You need to make sure your mattress is firm, that your pillows can’t cover baby (if you have queen or king-sized pillows exchange them for twin size), your blankets stay clear of baby, and that you or your partner are not such heavy sleepers that you will not wake if you roll on baby. A good way to avoid any of these is the co-sleeper bed. There are two kinds. One attaches to the side of your main bed and the other can be placed in your bed and comes with firm sides that keep baby in his/her place and you in yours. If either parent is on medication that makes them sleep heavy or has been drinking, the family bed is not a good idea.
Diaper Changes
Welcome to the world of parenting! Nothing says baby is here like having to change dirty pants. Diapers are an unavoidable part of having a baby but also something you will be able to enjoy after time. Yes, I said enjoy. Diapering time is one of the few times during the day when it is just you and baby.
As with all things concerning baby on a table, you need all your supplies at hand, and stay close to baby. You will need a clean diaper, wipes, alcohol swabs, Vaseline and gauze (for circumcised little boys only), your diaper pail, and for your little boys a pre-fold diaper is a really good idea.
Remove the baby’s soiled diaper and place out of baby’s reach
Wipe the little one’s bottom making sure with little girls that you wipe from front to back, never back to front. Even little ones can get bladder infections.
With little boys, if he is circumcised, wipe the head of the penis first and then down the shaft to the base and wipe the rest of the bottom.
If uncircumcised, never fully retract the foreskin (it can take a year or longer for the opening at the base of the foreskin to be large enough to safely expose the head of the penis). If you wish you can retract the foreskin just a bit to run clean water on it, but never force it. Uncircumcised boys can be more prone to bladder infections then circumcised boys but only for the first year. According to some studies, and not according to others.
Finish wiping the rest of the bottom.
Once baby is clean (if you have a little boy this is when you’d want to put a pre-fold diaper/burp rag over the penis to prevent getting a shower).
If the umbilical cord has not fallen off use your alcohol swab and wipe from the base to the top going round and round.
For the circumcised boys put a little Vaseline on the head of the penis and wrap with a small piece of gauze to keep the head of the penis from sticking to the diaper. Place the new diaper under baby, fasten in place and you are ready to go (For a couple of hours at least).
Dressing baby
Dressing baby is one of the perks of having babies. You get to put them in all these cute clothes and they don’t tell you they don’t like it. You’ll get that pleasure in a few years. The best gauge of how to dress baby is mom. In my experience baby is best off dressed just as mom is with the exception of needing a little hat and maybe a blanket depending on the time of year. If mom is good in a pair of shorts and a sleeveless top then dress baby just as light. If mom’s cold and dressed in head to toe fleece then dress baby the same. Babies temperature regulators are not fully functional yet so we must do it for them, covering or uncovering as needed to keep them comfy. Babies can over heat just as easily as they can get cold so keep that in mind as you pack for your outing. Maybe pack both sets of clothes so you can mix and match to get them just right wherever you are going. As your baby gets a bit older, he/she will let you how they need to be dressed. If baby is sweating, you have too many layers on them. If their arms and legs are pulling in, try a blanket or warmer clothes.
Breast feeding
Breast milk is the best food for your baby. Just ask pediatricians and other medical professionals, all of whom will say the healthiest way to feed an infant is to nurse him. The health benefits are so great, in fact, that the American Academy of Pediatrics recommends breastfeeding for at least the first year of a baby's life (exclusively for the first six months), and longer if both you and your child are willing.
Breast milk is a complete food source. It contains all the nutrients your baby needs — at least 400 of them — including hormones and disease-fighting compounds absent in formula. Remarkably, its nutritional makeup even adjusts to your baby's needs as he grows and develops. And apart from the brain-building, infection-fighting benefits of mother's milk, which no formula can duplicate, nursing helps build a special bond between you and your baby. When you nurse, your child thrives on the skin-to-skin contact, the cuddling, and the holding. You will, too.
Breast feeding is a wonderful, exciting, bonding and loving way to feed your baby. Yet in the beginning it can be stressful to some new moms. Like all things, when it comes to a newborn, both mom and baby need to learn how to interact with each other. This extends to breast feeding. It is a natural way to feed baby, yet as you have never fed anyone this way your baby has also never fed this way so both need to adjust. It takes time and patience. While you are in the hospital take full advantage of the help available from lactation consultants, nurses, or even your doctor when you see them. Have a nurse there each time you go to latch baby on if it helps you. Once you are home, contact your local chapter of La Le Leche League. Better yet attend a meeting before you deliver. Most hospitals offer lactation help lines and make sure you have the phone number before you leave. If you have delivered at home, talk with your midwife or Doula for ideas. They should both be there to help with this transition.
Sore Nipples: Nipple soreness is one of the main reasons women stop nursing early. To avoid soreness, make sure you get all the help you can at the start of day one. Make sure baby opens his/her mouth wide before you put them to breast. Baby should take the nipple and as much of the areola as possible. If using the cradle hold, look to see that baby’s ear, shoulder and hip are in a strait line, that baby is held tight to your body belly to belly. You should be able to see the baby swallow or at least the little ear moving to let you know he/she is drinking. If using the football hold (great for the C-section moms) you will have baby’s head in your hands and be looking at his/her cute little face. As above, make sure baby takes the nipple and as much areola as possible. Baby’s side should be tucked in close to yours with their body supported by a pillow. This position is great for eye contact while feeding. Baby can see you with both eyes and you can actually see them drinking. For the C-section mom, this allows you to feed your baby without any pressure on your sore belly.
Lanolin is a wonderful product to use to avoid sore nipples. After each feeding, if you are sore or not, put a little lanolin on per the instructions on the tube. It helps keep the areola and nipple supple and intact, preventing the soreness from starting. An ounce of prevention is worth more then a pound of cure when it comes to sore nipples.
Engorgement: An over full breast will happen to most new moms. You wake in the middle of the night or morning to find two hard rocks on your chest where your breasts use to be. This can happen in the first few days when your milk supply comes in and even later on when your baby starts skipping feeding and sleeping longer at night. In the early days if your areola is also very hard, it will be very difficult for baby to latch on. You will need to relieve some of the pressure so baby can latch on and help you out. You can hand express, pump, or, if your husband is willing, he can latch on to help out.
To hand express you simply place your thumb on top of the breast above the nipple (about where your baby’s lip would rest) and the fingers below (same as where baby’s mouth would be) push in, slightly squeeze down and pull out. It will take a few tries to get it right and to get the milk flowing. Placing a warm compress on the breast a few minutes before you begin helps. Also, a hot shower can produce let down and relieve pressure. If you need quicker relief than you can hand express, your husband is a very useful tool. Sit in a comfy position and have hubby latch on like baby would. His mouth is bigger so he should be able to take all the areola. A minute or two of suckling is more than likely all you will need to soften the breast enough for baby to latch on and finish what hubby has started. Hubby is also very useful if you get a clogged duct, have him latch on with his nose toward the full duct and suckle until you feel the duct release. Baby can also do this in the same way. Husbands can just eat more if needed to clear the problem.
Pumps: There are so many different kinds. Before you buy a pump, think about how you will need to use it. If you are returning to work, get a top of the line double electric. It is your best bet. Most come with car adapters so you can pump in the car if your work place has no where you can pump. If you are going to use the pump for less frequent storage, maybe pumping a bottle a day, and to relieve engorgement, a mini electric single pump is all you need. Lastly, if you think you will need it only to relieve engorgement and maybe the occasional bottle, a manual pump will work well.
Bottle feeding
Before you first use new bottles, nipples, and rings, you should sterilize them by submerging them in a pot of boiling water for at least five minutes. Then allow them to air dry on a clean towel. After that, a good cleaning in hot, soapy water, or a cycle through the dishwasher is sufficient. (You can find some handy bottle gear, such as dishwasher baskets for nipples, rings, and bottle caps, and special bottle drying racks, at most baby supply stores.) If you have well water, repeated sterilization of the bottles may be best.
Though many parents do sterilize the water used to mix formula, especially in the newborn months, you don't need to unless your pediatrician recommends it due to your local water supply. If you use well water, you will likely be told to sterilize it or use bottled water for mixing formula. If you do choose to boil the water you use to mix formula, save yourself time by preparing enough in the morning for the whole day.
There's no health reason to feed baby warmed milk but your baby may prefer it. When you're ready to feed your baby, you can warm a bottle in a pan of hot--not boiling--water, or by running it under the tap; you can also buy a bottle warmer designed for this purpose.
If your baby is accustomed to drinking bottles at room temperature or slightly cold, you save yourself the time and hassle of preheating bottles, especially when she's crying to be fed — right now. This is especially convenient in the middle of the night.
Never use a microwave to heat a bottle of breast milk or formula. Since a microwave oven heats unevenly, it can create hot pockets, leading to burns and cause a breakdown of the nutrients.
Like so much with babies, you'll need to listen and observe. If you hear a lot of noisy sucking sounds while she drinks, she may be taking in too much air. To help your baby swallow less air, hold her at a 45-degree angle. Also take care to tilt the bottle so that the nipple and neck are always filled with formula.
Never prop a bottle. Besides not providing you or the baby with time for bonding and snuggling, it can cause the baby to choke. Bottle feeding, like breastfeeding, can be a wonderful time for nurturing your baby by holding her close.
Written by Christine Bradt 2004
