Caring For Your New Baby

Bath Time
While the umbilical cord is still attached, we recommend sponge bathing (twice a week or as needed). The cord usually takes one to three weeks to fall off. Wait two days after the cord has fallen off and bathe in a small plastic tub with non-drying soap such as Dove or Johnson’s Neutrogena. Place a soft towel inside the tub to keep your baby from slipping and sliding. Never leave your baby alone in the tub. Bath time is a wonderful time between you and your baby. Have plenty of time, relax and focus on keeping your baby comfortable. Keep the room warm, sing or talk to your baby during the bath.

Skin Care

Even babies produce body oils to keep their skin soft. Powders, ointments or creams are not necessary. Avoid talcum powder to avoid risk of chemical pneumonia if your baby inhales some into their lungs. If your baby has dry skin, use lotions such as Johnson and Johnson baby lotion, Vaseline Intensive Care Lotion, Eucerin or Aquaphor. Use petroleum jelly for deep cracks around the ankles.

Head

Many baby's heads do not appear round after birth. The molding that occurs during delivery usually resolves within the first few days, resulting in a rounded head. Use a mild shampoo to wash the hair. Do not be afraid to touch or wash the area over the soft spot. A strong membrane protects this area and you cannot hurt your child by touching it.

Cradle cap is a collection of yellow greasy scales on the scalp, which occurs in infancy. Use regular baby shampoo and lather up the hair and leave it on for five minutes. Gently use a soft clean toothbrush to remove the scales on the scalp. Another suggestion is to massage mineral oil or baby oil into the scalp before washing with a mild dandruff shampoo. A washcloth or soft baby brush will help remove the scales.

Nails

Nails are soft, flexible and grow quickly during the newborn period. Trim or file nails while your baby is sleeping. After a bath the nails are soft. To prevent ingrown toenails, cut the nail bed straight across. Remember, infants learn about their environment and the world by feeling, hearing, seeing, smelling and tasting.

Umbilical Cord Care

Apply alcohol to the base of the cord with a Q-tip or cotton ball after every diaper change. Then clean the stump that is exposed to the air. Some babies fuss due to the coolness of the alcohol. The cord falls off in about 7 to 21 days. Like a scab, you may notice a few drops of blood. Until your baby’s umbilical cord stump falls off, fold-down the diaper to leave the area open to air. The application of alcohol should continue a few more days to complete the drying process. A foul odor, redness, or a thick yellow discharge from the cord may indicate infection. Call us if any of these are present.

Genitalia

As in older girls, clean baby girls by wiping front to back. This prevents stool from entering the urinary tract and leading to an infection. Mothers pass hormones to their babies, causing some infant girls to have a bloody or clear vaginal discharge in the first week of life. This discharge could last up to three days.

Uncircumcised boys do not need to have their foreskin retracted for cleaning. Clean only the outside of the foreskin. For newborn circumcised boys, apply Vaseline where the penis is going to touch on the diaper. The circumcisions is initially red and tender and should then turn a golden color, and start scabbing over and be completely healed in about four to five days.

Some boys are circumcised using a “Plastibel” ring. Do not pull it off. The ring should fall off by 14 days. Gently clean the area with water three times a day. Follow the instructions given to you by your obstetrician.

Rashes and Birthmarks

Diaper Rash

A baby’s skin is sensitive and tender, and the diaper area is warm, moist and dark and a perfect place for a rash. Frequent diaper changes, leaving the diaper off for a few minutes open to air, and cutting off the elastic around the leg of the diaper will help clear most rashes. Some rashes will persist. Try applying A&D Ointment, Vaseline or Desitin to the rash. Call us if the rash is not much better in three days of using the diaper creams.

Milia
Milia are tiny white bumps that occur on the faces of 40% of newborn babies. The nose and cheeks are most often involved, but can also be seen on the forehead and chin. Although they look like pimples, they are not infected. They are blocked-off skin pores and will open up and disappear by one to two months of age. No ointments or creams should be applied to them. Washing them is the best way to make them disappear. Use mild baby soap and a washcloth. Gentle scrubbing will break them up.

Baby Acne
Around two to four weeks of age, small red bumps appear on the cheeks and face, some may spread to the scalp, chest and back. This occurs due to the transference of maternal hormones. It usually resolves spontaneously and can last until four to six months of age. Areas may appear red with crying or after sleeping. They cause the baby no discomfort. You can use mild soap to wash the areas. This will not speed up the disappearance of the rash. No treatment is necessary.

Heat Rash (Miliaria)
Fine, pinpoint, pink bumps may appear on the neck, chest and upper back if your baby is too warm or overdressed. This is also called prickly heat. Your baby is comfortable dressed in the same or just one more layer than you are. Let your baby’s face tell you what to do. If your baby’s cheeks are too red, remove a layer of clothing. Feel your baby’s chest or back. Since hands and feet are often naturally cool, they are not a good indicator of your baby’s comfort level.

Stork Bites
(Pink Birthmarks or Nevus Flammeus)
This is the most common birthmark of newborns. It is a flat red or pink often an irregular shaped spot on the forehead, back of the neck, eyelids or bridge of the nose. This birthmark is a collection of blood vessels that lie close to the skin. They usually disappear by one to two years of age. Most birthmarks on the nape of the neck clear, some can persist into adult life. Blood vessel birthmarks that are raised or increasing in size are called Strawberry Hemangiomas.

Mongolian Spots
Mongolian spots are bluish-green or bluish-gray flat birthmarks found in more than 90% of Native American, Asian, Hispanic, and black babies. They occur most commonly over the back and buttocks or can be present on any part of the body. They vary greatly in size and shape. Most fade away by two to three years of age, although a small amount may persist into adult life.

Strawberry Hemangiomas

Bright red-raised birthmarks develop after the birth of the baby during the first two months of age. They are more frequent on fair skinned babies and may be located anywhere on the body. You see them on the head and in many cases on the face. They grow rapidly during the first year then slowly shrinks down. Most will resolve in early childhood. Leave them alone.

Outdoors and Visitors
When the weather is pleasant it is all right to take your baby outside. Be prepared with food, extra diapers, baby wipes and extra clothing. Avoid direct sunlight during the first year. Protect the baby from the sun using a hat with a brim and clothing. Do not use sunscreens on infants under six months of age.

Limit visitors during the first few weeks. Be sure everyone around your baby has not been exposed to someone coming down with an illness. Wash hands before touching the baby, and remember increased holding and handling can over-stimulate your baby and lead to fussiness.

General Care

Smoking
Give your baby the best! Provide your baby with a smoke-free environment. Do not let anyone smoke around your baby. If one person smokes in the house, it is like your child actively smoking 30 to 40 cigarettes a year. Exposure to cigarette smoke lowers your child’s resistance and causes them to have more frequent illnesses such as: colds, bronchiolitis and ear infections.

Encourage your friend or family member to live longer and stay healthier by not smoking. Encourage them to see their physician and help them quit the habit. If it is absolutely necessary, smoke outside, change your clothes, wash your hands and rinse your mouth before you come near the newborn baby. Never allow anyone to hold the baby with a lit cigarette. Never take the baby in a smoky car.

Safety
Most accidents are preventable. Always have the baby strapped in correctly and have it correctly attached in the car. Even at an early age, baby’s squirm, wriggle and move. Never leave your baby where they can roll and fall. Be on a constant watch for things around the house that could be dangerous. As your baby grows and becomes more mobile watch out for things that can be put in the mouth. Remember, your baby is totally dependent on adults to look after their safety.

Illness
It concerns us when an infant is ill. Call us if you notice any of the following:

Poor feeding two or three times in a row
More than three consecutive episodes of vomiting (spitting up 1-2 tablespoons can be normal)
Increased crying, irritability, unable to console, decreased muscle tone
Rectal temperature over 101ºF or less than 97ºF
Poor color, blue around the lips
You feel that something just does not seem right

Useful Items

Diaper cream (Desitin, Vaseline, A&D Ointment)
Ear syringe to use as nasal aspirator
Normal saline nose drops
Digital thermometer
Acetaminophen (Tylenol) infant drops—call before giving in an infant less than two months of age
Pediatrician’s, pharmacy’s telephone number

Poison Control: 1 (800) 222-1222

Suggested Reading

General Infant Care

Infants and Mothers, by T. Berry Brazelton, MD
The First Twelve Months, by Frank Caplan
Between Doctor and Child, by T. Berry Brazelton, MD
Baby and Child Care, by Benjamin Spock, MD
Touchpoints, by T. Berry Brazelton, MD
Your Child’s Health: A Pediatric Guide for Parents, by Barton Schmitt, MD
Your Baby and Child from Birth to Age Five, by Penelope Leach
What To Expect the First Year of Life, by Eisenberg, Murkoff and Hathaway

We look forward to seeing you in the office.
Congratulations again.
Enjoy your new baby!

Adapted from B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.

Provided as a service to medicine by Wyeth Pediatrics,

Makers of SMA* and Nursoy* infant formulas

*Registered Trademark