Baby Care: First Year

Lesson 2: Newborn Care: Getting a Good Start

Initial Bodily Needs and Basic Care

The following paragraphs contain instructions on meeting your baby's initial needs.

Cord Stump: The plastic clamp on your baby's umbilical cord stump is removed within twenty-four hours of her birth. Keep her cord stump dry, and fold her diaper below it. Avoid immersing her in water to bathe her. Sponge her clean instead until the stump falls off. It may be swollen and moist during the first few days, then it dries and shrivels over the next few days. The cord may smell slightly. The skin around the stump should look normal and not inflamed. The stump falls off within two weeks. It's normal to see a few drops of blood then.

Foreskin: An intact foreskin protects your baby's penis from irritation and infection caused by wet or soiled diapers. His foreskin is tight for the first year. During this time, normal bathing is all the care it needs. Do not forcibly retract your son's foreskin. By three years old, his foreskin should be fully retractable. During his baths, pull back his foreskin and gently clean out the secretions that accumulate under it. Teach him to clean himself this way.

Circumcision Site:

About Circumcision: The decision to circumcise is made for religious or cultural reasons or out of preference. Your baby is placed on a restraining board, his hands and feet are secured, and up to one-half of the skin of his penis is cut away. The use of a local anesthetic during the circumcision may not remove all of your baby's pain, but it helps. It heals within a week. As with any surgical procedure, occasional problems may occur such as bleeding, infection, or injury to the penis.

Follow your doctor's instructions on caring for your baby's circumcision site. Apply a protective lubricant over his circumcision site each time you change his diaper for the first few days. During the first week, his circumcision wound will go from swollen to yellow-scabbed. His penis should not be red or draining pus.

Feeding: A breastfed baby will nurse frequently from every twenty minutes to about every two hours. She will be hungry more often than a bottlefed baby because breast milk is more easily digested than formula. Make sure that she latches on correctly. Sit up or lie on your side. Turn her to face you, belly to belly. Tickle her cheek with your nipple. When her mouth is open, pull her toward your breast. Place as much of your breast in her mouth as possible. Your nipple should be deep inside her mouth to protect it from being sucked directly. It takes several weeks to learn to breastfeed, and a couple of months to become an expert. Don't give up. If you experience sore nipples or other problems, experiment with new positions, and contact a local La Leche League group or lactation consultant.

Whether breastfeeding or bottlefeeding with breast milk or formula, feed your baby when she signals that she is hungry, according to her own schedule. She is learning to trust you.

Burping: Your baby may need to be burped, or she may not. After feeding, place her on your shoulder or across your lap and pat or rub her back. She may spit up with her burp. If she doesn't burp within a couple of minutes and she seems content, she probably doesn't need to burp. If she falls asleep while feeding, it's not necessary to wake her to burp.

Diapering: Look at changing your baby's diaper as an opportunity for bonding. Focus on your baby, not the job, so she will look forward to the process. Talk to her and smile at her. Avoid showing distaste for the job, because your baby regards herself by what she sees on your face.

You have several choices when it comes to dealing with your baby's elimination: cloth diapers, disposables, or neither (called natural infant hygiene.) If you choose cloth diapers, you may use fitted or flat diapers, and home washing or diaper service. Cloth diaper covers with velcro straps have replaced pins and plastic pants. (See pages 81 and 82 in The Baby Book for instructions on folding a flat cloth diaper.) Parents who choose not to use diapers learn to read their babies' cues and take them to the appropriate place to eliminate. Many cultures practice this natural infant hygiene. (Visit natural-wisdom.com for more information on natural infant hygiene.)

Change diapers frequently. To determine if a disposable diaper is wet, squeeze the outside of the diaper. If you feel gel, the diaper is wet and needs to be changed. Even though disposable diapers absorb moisture away from your baby's skin, it is not sanitary to leave them on. Creams and ointments are not necessary for rashless bottoms.

While changing your baby's diaper on a changing table, never take both hands off her. She can fall off the table in an instant. Always use the safety strap, but don't rely on it. When using a public changing table, test the table's security before placing your baby on it.

As your baby gets older, she will squirm and wiggle while you change her diaper. Be creative in distracting her. Sing to her. Dangle a toy from your mouth. Make funny faces. If she squirms too much, change her on the floor where it's safest.

Dressing: In general, dress your baby in as much or as little clothing as you wear plus a layer such as a blanket. Cold hands and feet indicate her need for more warmth. Hot, sweaty skin indicates her need to be cooler. Her clothing should be breathable and well fitting so she can move freely. A baby who sleeps alone can wear a blanket sleeper, but one who sleeps with you should be dressed more lightly for bed to avoid becoming overheated by your body heat.

Bathing: Your baby needs to be bathed only about twice per week. Spot clean areas such as behind her ears and in crevices daily. Use soap only on oily or sweaty areas. Shampoo her hair only about once per week. Use mild baby soap and shampoo. Don't use oils or powders on your baby after her bath, because they can irritate her sensitive skin.

Until her cord falls off (and until your son's circumcision site heals), sponge-bathe your baby. You need soft washcloths, baby soap and shampoo, a clean towel, and a diaper. Wrap your baby in a blanket or towel. Uncover her head. Wet a washcloth with warm water. Gently wash her face, behind her ears, and in her neck crevices. Unless she is dirty, use only water. Wet her head with the washcloth and gently massage a small amount of baby shampoo into her hair. Rinse her scalp over the sink with running water. Blot her head dry and cover it to keep her warm. Uncover the rest of her body and gently wash her with the warm washcloth. Wash all her crevices. When cleaning around her vagina, always wash from front to back to avoid contamination from her anus. It is not necessary to wash away her normal, white vaginal discharge. Do not retract the foreskin of an uncircumcised boy's penis.

Finger and Toe Nails: Trim or file your baby's nails while she is asleep. Use a nail clipper designed for babies. Depress her finger pad away from her nail as you cut. If you are afraid to cut her nails, use a nail file. Her toenails won't grow as fast, but keep an eye on them.

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