Newborn Care ALL THE LITTLE THINGS YOU FORGOT TO ASK… Umbilical Cord The umbilical cord stump will generally fall off in a week or 2. Please keep the area dry. You do not need to apply anything (i.e. alcohol) and please do not bathe the baby until it falls off. Keep the area as open to air as possible. When the stump falls off, it may be moist, bleed a bit, or have a yellow discharge. These things are all normal and will quickly dry-up. Please call your pediatrician if the area is very red or draining fluid regularly. Bathing A warm wet washcloth, every 2-3 days, is all you need until the cord falls off. Newborn’s skin is very dry and flaky. This is normal and will go away on its own. Plain Vaseline on any dry, cracked areas is safe to use. There is no need to use anything on the skin other than water and Vaseline. Nail Care Newborn’s nails grow very quickly, and your baby may have been born with very long, sharp nails. Using an emery board to file the nails, or very carefully using small nail clippers is safe. Eyes Sometimes, newborns have eye discharge or crustiness on and off for several weeks/ months. This is often due to a clogged tear duct. If the eyes are red and/or there are large amounts of discharge all day long, please call the pediatrician. It is normal for up to one year to have intermittent eye discharge/crustiness (without redness), especially after sleep. This can be gently wiped away with warm water on a clean washcloth. Vaginal Discharge Newborn girls can have a swollen vaginal area with thick, white, clear, or even bloody discharge after birth. This is due to hormones passed to the baby from mom and will resolve on its own (may last longer if breastfeeding). You may gently wipe any discharge away while changing the diaper. Breast Bumps Both newborn boys and girls may have swollen breast tissue for a few weeks. It is completely normal. Reflexes Most of your baby’s initial movements are reflexive. Things like rooting (looking for a something to suck, like a nipple), grasp, and sucking are automatic reflexes present after (and before!) birth. Another more dramatic one you will see if the Moro (“startle”) reflex. It may appear that the baby “jumps” or startles frequently with a loud noise, or for no reason at all. This generally peaks during the first month and disappears by 2 months. Hiccups & Sneezing Both occur frequently in the newborn period, are normal, and don’t require treatment. Sneezing does not mean the baby is getting sick or has allergies. The baby may sneeze or have the hiccups several times in a day. If your baby seems to be coughing, breathing rapidly, or making a grunting noise with each breath, please call your pediatrician Nasal Congestion Nasal congestion and mucus are very common and both completely normal for babies, and may occur intermittently during the first year of life. If the baby has just spit up, or had a “wet burp”, milk will often get stuck in the back of the nose causing congestion. The congestion may seem worse when they are lying flat on their backs during sleep, since gravity is not helping. You can use normal saline drops in the nose as needed, and a nasal aspirator if the child is so congested they cannot feed well, but please do this very gently because “digging” in the nose can actually cause more congestion. Otherwise, we recommend ignoring it. A cool mist humidifier is also worthwhile in the winter months. Another thing to try is NoseFrida http://www.fridababy.com/shop/nosefrida/. Please remember to NEVER put a baby to sleep on their stomach. Spitting up ALL BABIES SPIT UP. It is normal and expected, and can last for several months. If the spit-ups are very forceful, frequent, and/or the child seems very uncomfortable while spitting up, please call the pediatrician. Projectile vomiting across the room or vomit that is persistently brown, green, or yellow requires medical attention. Most babies are “happy spitters”-they spit up all over you and are smiling right afterwards. Burping and Gas You should try to burp at the end of the feeding or if the baby interrupts the feeding. Try for a couple of minutes. If you don’t get a good burp, don’t worry. Some babies are good burpers, some aren’t, and some are only good sometimes. Don’t worry. Crying All babies cry. There can be absolutely nothing wrong with them and they will still cry. Almost all babies will have a fussy period in the evening/late night hours. It is part of their normal neurologic development. Many parents blame gas on the fussiness, saying their baby has “colic”, however it is usually during these normal periods of crying that the baby swallows more air, and thereby has more gas. These fussy periods of crying usually improve by 3-4 months of age. Until then, how do we keep our sanity? Here are a few tricks… ● The probiotic, L. reuterii, by BioGaia, was shown to reduce crying time in colicky breastfed babies and may be helpful. ● Gripe water, an old time, natural remedy made from fennel seed, chamomile and ginger,may calm the baby and help with digestion, but is not regulated by the FDA. Consult your physician prior to giving if you have questions. ● Simethicone Gas Drops help gas bubbles become more manageable. Consult your physician prior to giving if you have any questions. ● “The Happiest Baby on the Block” book and DVD, by Dr. Harvey Karp, reveals valuable secrets on how to calm a fussy baby. ● Pacifiers, while not recommended in the first days of life while babies are learning to latch and suckle on mother’s breast, can be helpful to soothe a crying baby. Babies love to suck, so it may help calm them. There is evidence that pacifier use may decrease a baby’s risk of SIDS. It is NOT a good idea to tie the pacifier to a string around the baby’s neck or attach the string to their clothes. This is a strangling hazard and must be avoided. ● Hold them- Babies love to be held. YOU CANNOT SPOIL A BABY IN THE NEWBORN PERIOD. It is the baby’s instinct to want to be held constantly and will help calm the baby. Signs of Illness A baby cannot tell you if they are sick or something hurts. Trust your gut and look for the following signs: ● Appetite changes ● Personality changes A rectal temperature equal to or greater than 100.3 F. This MUST be done rectally for at least the first 6 months. You CANNOT assume the baby does or doesn’t have a fever by feeling the baby’s head. If your baby is less than 12 weeks old and has a rectal temperature of 100.3 or higher, please call your pediatrician right away--day or night. Sterilizing You DO NOT need to sterilize bottles! Just wash everything the way you do the dishes you eat off of-- soap and water-- or top shelf of dishwasher. Using the bags you stick in the microwave are also fine, but unnecessary. Temperature Keep the temperature in your home at what you would normally keep it. It is not necessary to make your house warmer for the baby. It is always better to be on the side of cooler than too warm. You can use fans (which have been shown to reduce the risk of SIDS), air conditioners, heating systems, etc- whatever is needed for the time of year. Additionally, most new parents tend to overdress their new babies. The same amount of clothing that you feel comfortable wearing is what your baby should wear. Put on as many layers as make sense, counting the blankets, and then touch the baby’s chest after being in that environment after 10-15 minutes. If the baby’s chest feels cold, put on a layer, if it feels sweaty, take off a layer. Never use the baby’s hands and feet as a guide to their temperature... they are always colder (and often bluish in color which is also normal). Going Outside/ Visitors On any day above freezing temperatures, please take the baby out for a walk! It is good for all of you to get the fresh air and exercise. Limit visitors as much as possible, especially those with illness. You want the number of people that are close to and touching the baby to be minimal due to risk of infection. Make sure everyone washes their hands well before touching the baby. Teach other children to only touch the baby’s feet rather than their hands or face. Use common sense with crowded areas (malls, restaurants, churches, etc). Remember that people LOVE to touch babies, and for the first few months you want to minimize this as much as possible. Car Seat Safety To obtain information on car seat safety, you may call the toll-free Department of Transportation Vehicle Safety Hotline: 1-800-424-9393. Your baby's safety is very important. Accidents are the leading cause of death and serious illness to children. Because of this, we make safety a primary concern. First, it is the law in Pennsylvania that you seat your child in a car safety seat. You may not even take your child home from the hospital without such a seat.