Well-Baby Care

Building confidence in caring for baby comes as the reward of successfully meeting your baby's needs. There is a lot to learn, a few basics to master, and instincts that you will learn to trust. The first few weeks with your newborn may seem frozen in time like they have flown by, and as though you can't remember life before his arrival all at the same time. This is a time of getting to know one another that will last a lifetime. Within a few weeks, your dedication to listening to your baby and your intuition will make you an expert about your baby. The goal in caregiving is to keep your baby safe and comfortable and to use each experience to develop a bond that comes from the process of spending time close to one another.

Baby Safety

• Support baby's head and neck with your hand or arm under his neck
• Always buckle baby into rear-facing infant seat secured in the back seat
• Never shake a baby for any reason. Infants are susceptible to "shaken baby syndrome" serious injury or death can occur as a result of being shaken.
• Do not engage in physical or dangerous activities or cook with a baby in a carrier.
• Never leave an infant seat unattended on an elevated surface such as a table or countertop.
• Do not handle hot items (soup, coffee, etc) while holding the baby.
• Never leave baby unattended in carriers, swings, baby seats, stroller or items.
• Never leave the baby for any reason when near water.
• Place baby on back or side for sleep on a firm mattress without pillows, heavy blanket, or large stuffed toys.
• Never take your hands or eyes off baby while on changing table.

The American Academy of Pediatrics stand on newborn nutrition is that a baby should be solely breastfed for the first 6 months of life. A baby has a digestive system that is not fully developed until about 9 months to a year. A baby doesn't start to take food until they start cutting teeth and can swallow without spitting it out of its mouth or chokes. Babies sometimes need to burp during feeding in order to expel air swallowed. There are several positions used for burping: Upright- with head cradled on your shoulder and his bottom resting on your forearm sitting on your lap facing to either side, lay baby on the tummy, on your lap. Pat your baby's back gently for a few seconds while you steady him with another hand. See breastfeeding page.

Bathing the newborn may be an intimidating experience at first but can prove to be a favorite activity over time if you hang in there. Newborns will need to lose their umbilical cord stump before enjoying a tub bath. Sponge baths are an excellent introduction for both babies and parents.

Sponge Bath

• Gather all supplies before starting the bath- fill the basin with warm water.
• Undress baby and wrap him in the towel on padded surface exposing only the area you are working with at one time.
• Wet washcloth with warm water (no soap) Wipe eyes from the inside corner to outside corner and pat face dry.
• Wash baby's neck, face chest, arms, and legs with warm water and mild soap, rinse and pat dry.
• Lay baby on stomach and wash his neck back and legs, rinse and pat dry.
• Bundle baby in a towel and hold using one arm to support the head and neck. Cradle baby over the basin to shampoo, rinse and pat dry with a towel.
• Remove diaper and wash diaper area (no soap on the newly circumcised penis) Rinse with washcloth wiping front to back and pat dry.

Tub Baths

• Gather supplies before starting the water. Use a small towel or bath sponge to prevent slipping. Add just a few inches of warm water.
• Cradle baby and gently slide him into water supporting head with one hand or arm under the neck. Do not move the arm away while bathing.
• Start with eyes as with a sponge bath and work to the diaper area.
• Shampoo last and wrap in the dry towel immediately.

Umbilical Cord Care

• Your health care provider will typically advise you on cord care
• Keep the area around the umbilical cord stump clean and dry by wiping with a clean cotton swab. Use GoldenSeal™ salve for the cord. Fold the diaper so that it does not rub or irritate the stump. Wait for tub bathing until the cord falls off. Report signs of bleeding, redness, discharge, swelling or odor to the midwife.

Circumcision

Circumcision is the amputation of the newborn male penis. The foreskin of the penis is removed to expose the highly sensitive raw glands (head). This is an excruciatingly painful experience that comes with a long recovery time of sometimes over 6 months. Circumcision comes with many complications and needs to be considered a very invasive cosmetic surgery with no medical advantage. According to the American Academy of Pediatrics, circumcision is considered an unnecessary procedure and most do not do it any longer. Insurance companies are no longer covering for the surgery.

Sites to visit before circumcision:

www.nocirc.org or www.intact.org Also listen to my interview with Marilynn Milos on “Timely Topics in Childbirth” radio show achieves for more information.

Circumcision Care

Your doctor will discuss follow up care for circumcision after the procedure is completed. The most important fact to remember is that tub bathing will need to wait until the circumcision is healed and the umbilical cord stump has fallen off. Special instruction will also be given with regard to diaper changes.

Sleep

Sleep is a commodity when a newborn arrives. You can expect your newborn to sleep an average of 16 ½ hours per day at first with the need to feed every 2-3 hours. That number of hours decreases over the next few months and in a couple of months, he may settle into a pattern of daytime naps and four to six-hour stretches during the night…or not.

The atmosphere of comfort, bathing, and bedtime rituals such as soft music, lower lighting, and rocking promise to provide enjoyment for both baby and parents. These are the moments that memories are made of.

Growth and Development are subjects that cover chapters and books. Growth guidelines vary from baby to baby and if a baby is nursed or formula-fed they will need to be assessed accordingly. This will also be addressed during each visit with your care team. Babies are measured in percentiles of height and weight and are tracked to ensure that your baby is thriving. As parents, it is important to share any pertinent information. Issues that are significant about baby’s birth, postpartum, health and biological history need to be shared in your visits with the midwife, pediatrician, and dentist. Your child's growth will be monitored and development noted with each visit. Babies develop skills at different rates while falling into categories that allow them to be evaluated.

Call your health care provider, if you witness the following symptoms:

• Fever over 100 (degrees) F
• Difficulty breathing
• Repeated vomiting
• Persistent diarrhea
• Blood in urine or stool
• Disinterest in feeding/ baby is lethargic
• High pitched crying inconsolably
• Rash
• Yellow/ orange skin or eyes
• Unusual discharge from eyes, nose, ears, navel, genitals

A great book for every family with little ones is “Be Your Own Pediatrician” by Dr. Wooton. In it he suggests strongly not to break a child’s fever and let it burn at 100-103 *as it releases interferon and killer cells to attack the virus or bacteria causing the infection or child’s ailment.

The fact that you are starting a family your birth should be discussed openly. This is the way children learn positive sexual attitudes. One area where the experts agree is timing- the sooner the better age three to four seems to be the youngest age that a child can understand the concept of being born to a mother. It is suggested that the information be simple and positive. Children love to hear their birth story and will make you tell it over and over.

Here are a few suggestions about what to include:

• How thrilled you were when you heard about your child.
• Songs or poetry your family shared while waiting
• What you thought about the first time you saw your child.
• The celebrations your family shared after your child arrived.
• The first day after your child comes home to join the family, create a book for your child with pictures of his birth and a story that told about your expectations and dreams and how he/she not only met but surpassed everyone.

Thus the emotional climate surrounding the telling process is one which fosters acceptance and positive self-regard. Take care to provide your child with adequate information about his birth without talking about it constantly. Your child will give you cues when "enough is enough". They will let you know when they are at risk for overload.