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New Baby Care
Call your pediatrician whenever your baby doesn't seem to be him or herself. That is, the baby doesn't ‘look right’ or act normally to you. Indications of a problem may be:
- Has a fever greater than 100 degrees rectally or axillary (under arm).
- Has diarrhea-frequent, watery, foul-smelling stools or bloody or mucous stools.
- Vomits forcefully after more than one feeding.
- Cries excessively or is sleeping more than usual.
- Has not urinated within eight hours of the circumcision. Still has the plastibell (plastic ring on penis) more than eight days after the circumcision. (Note: Some circumcisions are not done using a plastic ring.)
- Has increasing jaundice (yellow color to the skin) and, at the same time, may be sleeping more, eating less and having fewer wet and soiled diapers.
Bulb Syringe
During your hospital stay, a bulb syringe will be given to you to take home. This is for suctioning your baby's mouth and nose when spitting up mucus, old milk or formula and is handy for your baby's wet burp, stuffy nose, or choking. The proper method for suctioning a baby's mouth is to turn the head to the side, squeeze the bulb to expel the air, place the syringe tip inside the mouth along the cheek, release the bulb to draw fluid and expel mucus from the bulb after removing from the baby's mouth. Always clear the mouth before clearing the nose to reduce the baby's chance of inhaling mouth mucus. Repeat as needed.
Cleansing the Bulb Syringe
You should wash the bulb syringe in hot, soapy water at least once a week. To clean the syringe, simply fill it with soapy water and then rinse it thoroughly with plain water. Then sterilize by filling the bulb with clear water, placing it in a pan of boiling water and boiling it for three to five minutes.
Umbilical Cord (Belly Button) Care
The umbilical cord stump usually dries and falls off during the first or second week of life. It is helpful to apply rubbing alcohol on a cotton ball to the base of the umbilical cord three to four times daily-it's easiest to do this with each diaper change. Wipe the stump from top to bottom and clean well around the base where the stump meets the skin. Be sure to gently lift the cord so that the alcohol reaches the area where the cord is attached to the navel. Some blood spotting from the cord is common three to four days before and after the cord falls off. Continue to gently cleanse the area with alcohol until the site has healed. After the cord falls off, use an alcohol-dipped cotton ball to clean the belly button until healed.
SOME REMINDERS:
- Do sponge, not tub, baths until the cord falls off and the area heals completely.
- Position baby on its side until the area heals and looks like a normal belly button.
- Inspect the cord when cleaning for signs of infection. Any foul odors, redness, active bleeding or drainage should be reported to your pediatrician immediately.
- A diaper should never cover the cord or waterproof pants.
- The cord's bluish color is caused by dye to promote drying. This dye also helps prevent infection.
Voidings/Passing of Urine
Usually, the first voiding or passing of urine is seen within 24 hours of birth. Notify your physician if you fail to notice a wet diaper during the first day of life. If you breastfeed, once your milk is in and the baby is nursing regularly, six to eight or more good, wet diapers a day means your baby is getting enough to eat. Once the bottle-fed infant is taking regular feedings, most newborns will void with each feeding and usually more often the first month. The urine should be pale in color. If you notice orange-colored areas on the diaper, representing concentrated urine, the baby needs more fluids.
Stages of Stools
MECONIUM - dark green or black tarry stools passed on the first day.
TRANSITIONAL - the next stools seen once the baby has been feeding-may be looser in consistency and greenish in color.
STOOLS OF BREASTFED BABIES - are loose, watery, yellow stools with cottage cheese type particles. By the end of the first week your baby will be stooling frequently - perhaps with every feeding or three to 10 times a day.
STOOLS OF FORMULA FED BABIES - are less frequent and more formed than breastfed stools. You will usually see one to three greenish-yellowish, pasty stools. Learn what's normal for your baby. Stooling patterns and frequencies vary for every baby. Some breast and formula-fed babies normally have one large stool every three to four days. Call your pediatrician if your baby is having diarrhea or difficulty passing stools.
Diaper Rash
A common problem among babies is diaper rash. It is an area of small pimples with accompanying redness and sometimes even bleeding. The ammonia produced from urine when it lays against the baby's skin causes this. To prevent diaper rash:
- Change diapers promptly after baby wets or stools.
- Clean urine and stool off of the baby's skin well.
- Some doctors recommend petroleum jelly (Vaseline) as a barrier to wetness.
To treat diaper rash when it happens:
- Do not use plastic pants because this does not promote drying.
- Avoid powders.
- Use a product, which you can purchase over the counter (such as ‘Desitin,’ A&D ointment or for occasional use, hydrocortisone cream). Be sure to clean these off when changing diapers and reapply.
Jaundice
Jaundice is a yellow coloration of the skin caused by the deposit of excess bilirubin in the blood. Bilirubin is a pigment released when red blood cells break down. New babies are born with more red blood cells than they need, but their livers are not mature enough to eliminate all the bilirubin released. That's why many two- to three-day-old babies develop a normal form of jaundice that disappears within a couple of weeks. Bilirubin is normally excreted through the baby's stools. Offering more fluids and calories through frequent feedings can prevent mild jaundice from progressing. There are other causes of jaundice such as Rh and blood type incompatibilities or infection. Sometimes, babies require phototherapy (exposure to fluorescent lights) to help promote bilirubin excretion and control the jaundice. If your baby requires phototherapy, your physicians and nurses will discuss the treatment plan with you individually.