UNION HOSPITAL MATERNITY SERVICES

Caring For Your Baby: Basic Care

Skin Care
Oil produced by glands in your baby's skin keeps the skin smooth and soft. The natural oil helps keep the skin clean and prevents skin infections. Your baby's skin does not need lotion or oil. Bathing baby less often or not using soap may be helpful if baby's skin is dry, since soap and water tend to remove the skin's natural oils. You may use a very small amount of Vaseline for cracked and peeling skin on hands and feet.

Umbilical Cord
You should keep the cord dry. Fold the diaper away from the cord. Clean the cord with alcohol several times a day or at each diaper change. It will dry and fall off within 7-14 days. If you notice a foul odor, redness or thick yellow drainage, please call your doctor. After the cord has healed completely, you may begin to bathe your baby in a tub.

Diaper Area
Baby girls may have creamy or slightly blood tinged discharge from her vagina and the area may be puffy and swollen. This will disappear within the first two weeks. Baby boys often have a puffy or swollen scrotum. This swelling also disappears within the first two weeks. Both boys and girls may have swollen breast tissue and you may even see drops of liquid on the nipples. This is normal. All of these changes are caused by the hormones the baby got from the mother during pregnancy.

Circumcision
After a baby boy has been circumcised, your doctor may apply a Vaseline dressing to the penis for the first 24 hours. Your nurse will show you how to do this. The penis should be washed gently with a clean, warm soapy cloth the third day after the circumcision. Wash daily thereafter. Do not push the foreskin back. At your baby's checkup, your doctor will show you how to care for this area.

Uncircumcised Infant
It is not necessary to pull back any part of the skin on the penis in order to wash it. No special care is required. Just clean the external skin. As your baby gets older, ask your physician for advice on care of the penis.

Care of Your Daughter
To cleanse your baby girl's diaper area, gently separate the labia (large folds of skin, or the lips) and wipe the area lightly with downward strokes. Always wipe from front to back and use a clean area of cloth for each stroke. Rinse thoroughly to remove soap.

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Diaper Rash
Diaper rash is caused by bacteria or irritation. Changing diapers quickly after they become wet or dirty and cleansing the diaper area at the time of each diaper change will help prevent diaper rash. Let diaper area air dry when possible. A light dusting of corn starch powder may be helpful. You may have to apply a thin layer of over-the-counter medicine especially made for diaper rash. If the rash persists, you should call your baby's doctor.

Bathing the Baby
Bath time is a wonderful time to get to know your baby. Make this a quiet and unhurried time for both of you. Give your baby a sponge bath until the umbilical cord falls off. The room should be warm (75-80°F) and free from drafts. The supplies you use for your baby's bath should be used for baby only. If you use soap it should be mild and non-perfumed. Very little soap or no soap should be used since soap may cause baby's skin to dry out.

First, wash your baby's face, beginning with the eyes and using water only. Shampoo your baby's hair with each bath, using baby shampoo or a mild soap. Then wash the rest of the body with soap and water, ending with the diaper area. Baby lotions or oils are not necessary, as your baby produces a natural body oil.

Bulb Syringe
We have provided you with a bulb syringe in order to keep your baby's nose and mouth cleaned out. He cannot blow his own nose, so you need to use the bulb syringe to clean it for him. Before putting the tip in your baby's nose, depress the bulb syringe. Gently put it in your baby's nose or mouth. Release the bulb to provide suction. Squirt the mucous out on a tissue and repeat, if needed. Clean the syringe out in warm, soapy water and rinse well.

Nail Cutting
Your baby's nails are very soft. When trimming his nails, do so while he is asleep. Cut the nail straight across with either baby clippers or blunt-ended scissors. The skin grows up on the sides, so cutting the nail straight across will prevent you from cutting the skin. The sharp edges may be filed with an emery board or nail file.

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Temperature Taking
Babies sometimes get a fever. Fever is the way the baby's body fights an infection. If you think your baby is sick, you should call your doctor. Before you call, take the baby's temperature. A normal range for your baby is 97-99°F.

How to take your baby's temperature under the arm:

• If using a mercury thermometer, shake it until the mercury is below 97°F. If using a digital thermometer, push the on button.
• Make sure the tip of the thermometer is in the middle of the armpit and hold your baby's arms to his/her side.
• A mercury thermometer should be held in place for three minutes. A digital thermometer will beep when it is done taking the temperature.

If the temperature is over 100°F, call your doctor. When you report the temperature to the doctor, tell him the reading on the thermometer and how you took the temperature (under the arm).

Safe Sleep Practices:

• The crib slats should be no more then 2-3/8 inches apart.
• Use a firm mattress that fits the crib snugly.
• Use a tightly fitted sheet to cover the mattress. Couches, adult mattresses, futons, etc are not considered a firm surface.
• Keep all soft objects and loose bedding out of the crib (no pillows, sheepskin, quilts, fluffy blankets, stuffed toys, bumper pads, etc).
• Avoid overheating or over-bundling your baby.  Dress appropriately for the season.  Appropriately sized sleep sacks are optimal, thus avoiding blankets and other loose bedding.  If swaddling is needed for comfort, it is to be below the armpits (ask your health care provider to show you the proper technique).
• If a blanket is used, place baby’s feet at the foot of the crib.  Tuck the blanket under the crib mattress at the bottom and on both sides. The blanket should be no higher than the baby’s chest.
• Do not expose your baby to second hand smoke.  Clothing exposed to second hand smoke should be changed prior to handling your baby. Wash your hands before touching your baby.
• Keep your baby’s sleep area close to, but separate from, where the parents sleep. It is not safe to allow your baby to share a bed with anyone (parents, other children, pets, etc).
• Infants may be brought into bed for feeding or comforting but should be returned to their own crib when the parent is ready to return to sleep.
• Sleeping on a couch, recliner or armchair with your baby is not safe.
• The use of a pacifier is recommended throughout the first year of life when placing infants down to sleep unless refused by the parents.  For breastfed infants, avoid pacifier use until breastfeeding is firmly established (approximately 1 month). A pacifier should not be reinserted once the infant falls asleep. Pacifiers should not be coated in any sweet solution.
• Avoid commercial devices marketed to reduce the risk of SIDS, flat head syndrome and acid reflux (such as wedges, rolled blankets, etc).
• Provide Tummy Time when your baby is awake and someone is watching; hold your baby upright when he or she is not sleeping; change the direction that your baby lies in the crib from one week to the next; and avoid too much time in car seats, carriers, and bouncy seats.
• Please teach EVERYONE that cares for your infant (grandparents, babysitters, child care providers, etc) that your infant is to be placed on their back to sleep for every sleep during nap and nighttime for the first year. Side sleeping and stomach sleeping is no longer advised.  The risk of SIDS is 7 to 8 times higher among infants who normally sleep on their backs and then are placed on their stomachs to sleep.  The risk increases to as much as 18 times in a child care setting if baby normally sleeps on their back and is placed on their tummy to sleep by the nonparental caregiver.

American Academy of Pediatrics (AAP) Task Force on Sudden Infant Death Syndrome (2005)

Jaundice
Some babies develop a yellowish color to their skin and the whites of their eyes. This usually occurs 2 to 7 days after birth. Sometimes babies have extra red blood cells at birth. Their bodies break down the red blood cells, which releases part of their contents (bilirubin) into the skin. This causes the yellow tint.

A little jaundice is expected, but if it looks excessive, your doctor may order a blood test. If the results are high, your baby may be placed under special lights in the nursery.

When to Call the Doctor
Signs of illness that should be reported:

1. Temperature above 100°F (under the arm)
2. Frequent vomiting (not spitting up)
3. Refusing to eat several feedings in a row
4. Several loose, liquid bowel movements
5. Excessive crying
6. Weak and very sleepy
7. Any rash which will not go away
8. If your baby has had only one wet diaper or less in 24 hours

Have a pencil handy to write instructions. Explain when the problem began; how often it occurs; how much vomiting or diarrhea (be specific); temperature; and any changes in behavior.

Taken from CBE/Fall 1989.

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