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Newborn Care

This information is provided to develop and build the confidence of soon-to-be or new parents as the step to parenthood begins. Learn how to care for your new baby-to-be with this comprehensive, on-line course.

You have just had your baby (or getting ready to) and you feel elated that you were able to bring such a lovely human being into this world. You feel privileged to have your mother and/or mother-in-law there to help you, as well as your partner and the help of the nurses at the hospital. Then---reality hits.

You return home and you don't know how to be a parent. You may feel overwhelmed and inadequate. You don't know where to start to become a parent!! That is what we will discuss - the transition of pregnancy to the reality of being full-time parents!! It may seem like a mystery at first, but after going through some of the information, you will be much more comfortable in your ability to parent. No two babies are alike-and you will know your baby the best, so listen to your instincts. And honestly, all new parents feel overwhelmed at some point or another. I remember coming home, crying all the way there and then not knowing what to do when I got there.

QUICK TRIVIA QUESTION:
How many diapers do you think you will go through in a week's time with your newborn?
Be prepared with approximately 70 diapers per week or 2,000 - 2,500 per year!

General Information About the Newborn

CHOOSING A PHYSICIAN
You will need to choose a doctor for your baby prior to the birth. You may choose a family doctor or pediatrician, who specializes in children, such as Dr. Steven Joyce. Most clinics offer a free appointment for you to meet with your baby's doctor. You will be visiting this doctor frequently in the first few years, so take that into consideration as well as your comfort level. The well baby exams occur to monitor your baby's growth and development and a wonderful opportunity for you to ask questions.

VISITORS
You should try and limit the number of people (especially children) that come visit you the first few weeks you are home. This allows your baby's immunity time to develop. In some instances, this may be difficult, but remember, your baby is counting on you to take care of all his/her needs. If family/friends want to hold your new baby, insist that they wash their hands with soap and water first. It is not being rude.

"SOFT SPOTS" ON THE HEAD
Fontanels are defined as the space at the intersection sutures connecting the infant skull bones. This allows for the brain to grow. The anterior fontanel (diamond-shaped area) is the larger spot on top of the head. The post fontanel is on the back of the head is much smaller. Be aware of these areas and be gentle around them.

Physical And Mental Development of the Newborn

Let's talk about the newborn and what they can do:

Newborn Senses:
Did you know that babies can see, hear, smell, taste and feel?

  • Babies can hear well before they are born and listen to you in utero. They love the sound of your voice and anyone that is close to you.
  • Babies have the sense of touch and love to have skin-to-skin contact. This can occur during breastfeeding or anytime you wish. The dad can participate by taking off his shirt and placing the diapered only baby on his chest. This actually improves brain development. Have your heard of Kangaroo Care? This is when preterm infants are given skin-to-skin contact as a treatment option that has results-proven positive affects on the baby.
  • Babies know their mom's breast milk. They actually could pick it out in a taste test if that was possible.
  • Babies can see at an optimal distant for breastfeeding (approximately 10-12 inches). Babies do have a preference to the human face and can focus on the contrast of color - such as black and white. The eye muscles will be weak and it is common for them to look cross-eyed. The eye muscles and the development of color vision, typically occur at 3 months.

Brain Development:
Their brains are developing every day. It is important to stimulate your baby's senses and help achieve optimal brain development. But babies don't need much at this point except love, attention, holding, and playing. They do not need expensive toys. Human contact is what they desire.

Be careful not to overstimulate your baby. Look for cues; if they start looking away when you play, or start arching their back, then discontinue the activity.

There are various games babies and parents can play in the first four months of age to encourage their development. Play is an essential part of your baby's development and a great way to bond together as a family. These games will build your baby's language, social, and motor (large and small-muscle) skills while you're having fun.

Babies go through sleep/wake cycles. A perfect time to interact with your newborn is in the quiet alert stage where they are looking around without crying, being hungry or sleepy. This state usually only lasts about 10 minutes as a newborn and will grow with time.

  • Language Games
    • Speak softly to your baby and use his name often. He/She can locate your voice within a few hours of birth.
    • Pause after talking to your baby to watch for his/her response.
    • Vary your tone of voice to include not only baby talk but also your everyday speech.
  • Social Games
    • When your baby smiles, praise him and smile back. This will reinforce his smiling.
    • When you and your baby are in eye contact, slowly move your head from side to side to encourage his eyes to follow you.
  • Motor Games
    • To encourage head turning, place your baby on a blanket on the floor and arrange brightly colored toys on each side of him.
    • During a diaper change, bend and straighten his leg in a bicycling motion.
    • Encourage TUMMY TIME with your baby. Since babies spend so much time on their backs to reduce the risk of SIDS, giving them supervised time on their bellies will help develop those large muscles. They will eventually try to push up with their arms straight (raising his chest off the floor when he is on his tummy). Encourage this behavior by holding a toy at eye level in front of him.

Crying versus Colic

CRYING
All babies cry, but parents usually expect to hear it only occasionally. The average newborn cries approximately 2-3 hours a day, peaking at 4-6 weeks (this does drop off significantly by the third month). Crying is normal and the baby's only way of communicating what he/she wants and needs. Soon, you will begin to learn about your baby and why he/she is crying. The sounds will differ and you will be able to determine the difference between your child's hunger cries, crying for a dirty diaper or from being tired. You will learn their schedule and that will help you determine the child's need.

Sometimes you may not figure out what the baby's needs are-this is normal. As adults, we sometimes don't know what we need either. Always respond promptly to the child. It makes them feel secure and loved - remember, you cannot spoil them with love.

First, determine why your baby may be crying. Is your baby hungry, have a wet/dirty diaper, is too hot or cold or maybe needs to be burped? If these don't seem to be the cause, try some soothing strategies:

  • Give them something to suck on such as a pacifier, a finger, a teething ring, etc.
  • Try moving them-rocking chairs, mechanical swings, strollers, car rides, infant carriers, walking, or dancing.
  • White noise-fans, air conditioning, vacuums, dishwashers, clothes dryer
  • A calm environment-dimmed lights, soothing music, a blank wall.

Sometimes you need to watch what you eat if you are breastfeeding-certain foods may be irritating to your baby's system (dairy products, onions, caffeine, peppers, cabbage-to name a few). Some researchers question this theory.

COLIC
Colic is often a broad term parents tend to use if their baby cries or is fussy sometimes. Realistically, there is a large difference. It often can be described by the mom as understanding what the needs are of the child and still not being able to comfort her/him. Medically, colic is defined when a baby cries more than 3 hours a day, for 3 days of the week for a period of more than 3 weeks. Approximately 20% of babies (1 in 5) have true colic. Colic generally begins at 2-3 weeks old and ends by 2-3 months, peaking at around 5-6 weeks of age.

My son had colic, but even as a nurse, I did not know it. I kept down playing the fussiness at every doctor visit because he was gaining weight, going to the bathroom regularly, eating and wasn't throwing up a lot. Physically, he appeared normal. But, he was fussy ALL the time and never slept for more than an hour on most occasions. We finally realized at 5 months, he was allergic to milk and soy and then at 9 months he had severe acid reflux (both of which he had since close to birth!) Unfortunately, because of this, he never learned good sleeping habits. But, he did outgrow both conditions, luckily. So, the moral of the story, do not be afraid to talk to your physician.

When you are worried about the baby, though, don't immediately come to the conclusion they need to be on medicine, or if you are formula feeding, changing their formulas. Always talk with your physician about your concerns and let them examine the child to rule out any medical conditions. Write things down prior to the office visit such as questions and observations of the infant so you are better able to talk to them at the office. Being sleep-deprived really plays a number on your ability to recall information.

Remember to take care of yourself! Try and take a break from your baby's colic by hiring a babysitter or allowing friends and relatives to hold your baby!! Ask for help!

Infant Massage

Massaging your baby can enhance the emotional bond with your child and can calm him/her down, improve sleep patterns and aid with digestion. It is also a wonderful opportunity for other family members to share special time with the infant.

To prepare: Choose a point when you're relaxed and won't be interrupted. Don't plan to do it when the baby has a full stomach or is hungry.

Positioning: Make sure you are comfortable. Sit on the floor or the bed and put your baby on your lap or lay the baby on his/her back on a towel/blanket. Talk or sing to the baby throughout the procedure or use music.

Massage Oils: Natural oils are best-almond oil or a fresh bottle of vegetable oil scented with a drop of fragrance, such as lemon, vanilla, or lavender. Warm a few drops between your hands. Don't use oil on the head or face.

Watch for baby's comfort level: It is important to respect your baby's space and integrity. Ask permission, even if your baby can't give verbal consent. Stop if you sense overstimulation. A newborn may enjoy only 2-5 minutes, whereas a 2 month old might love a more elaborate one.

RUBBING YOUR BABY THE RIGHT WAY

  1. Begin by making tiny circles on your baby's head. Then smooth your baby's forehead-with both hands at the center, gently press outward as if stoking the pages of a book. Make small circles around your baby's jaw. Massaging around your baby's mouth may comfort him during teething.
  2. Warm the oil between your hands and stroke your baby's chest like an open book.
  3. Roll each arm between your hands like kneading bread. You can also use smooth, straight strokes from the shoulders to the fingers. Open and massage each finger of each hand.
  4. Massage the tummy, one hand following the other, from your baby's right side to the left.
  5. Roll each leg between your two hands or use a straight motion from the hips to the feet: massage each foot with your thumb rubbing from heel to toes. Rub each toe and sing "This Little Piggy."

Stroke your baby's back-first back and forth across the back, then in long, sweeping lines from shoulders to feet. You can also make little circles down either side of the baby's spine with your thumbs, while staying away from the spine area. End with a kiss to grow on.

Newborn Feeding Options

FEEDING YOUR BABY
You will want to attend a breastfeeding class prior to your delivery to make an educated decision regarding how you will feed your newborn. The benefits of breastfeeding have largely been documented. Breastfeeding is both convenient and economical.

BREASTFEEDING

  • Breastfed newborns usually eat 8-12 times in a 24-hour period of time (once every 2-3 hours). The first few days your baby will get colostrum, which is very concentrated, thus the newborn only needs a small amount. Colostrum has extra antibodies to help fight infection. As the baby nurses, this stimulates the production of milk, which comes in around 48-72 hours after birth.

FEEDING WITH FORMULA

  • Formula may be based on cow's milk or soy. Formula comes in ready to serve liquid or powder that you mix with water.
  • Newborns eat about 2-3 ounces of formula every 3-4 hours a day.
  • There are many different bottles to choose from. You can decide what works best for you and your baby. Some babies have a preference for a certain type of nipple.
  • Never prop a bottle-the baby could choke on the formula. Hold baby and give the baby the love they need to grow and thrive.
  • Never heat a bottle in the microwave. It could have hot spots and burn their delicate mouth. Instead, warm the bottle in warm water.
  • Wash bottles, nipples, and anything used to prepare formula in hot, soapy water and sterilize with boiling water before first use and occasionally thereafter.

BURPING
Most babies spit up. It can be a little burp to a full gusher. It may be messy, but normal. It doesn't mean there is something wrong with your baby. If it seems to be excessive or your baby is not gaining weight, talk to your physician.

Burping your baby during and after feedings will help. You can burp the baby in their sitting position, over your shoulder or lying on your lap. Also, keep your baby in an upright position for approximately 30 minutes after eating.

STARTING SOLIDS
You will hear stories about people beginning to feed their infants rice cereal or other foods at a very early age (even within 6 weeks). You probably even have had your mom or mother-in-law telling you these things - that you started "food" at a very early age. The American Academy of Pediatrics (AAP) does not recommend this. Newborns' bodies and digestive system are not mature enough to handle this, nor are their bodies ready for it. It can lead to allergies, obesity and many other medical conditions. Some people think that if their baby is more full at bedtime, then they will sleep longer. This can backfire on you, because their system can't digest it and it makes them sick. Babies do not have the ability to digest this type of food until they are 4 - 6 months old.

Infant Positioning and Prevention of SIDS

Probably by now, you have heard about the back to sleep campaign. The message includes always placing your child on their backs for naps and to sleep. This is recommended over the side and stomach-lying position. This precaution significantly lowers the risk of SIDS. Other risk factors include smoking. Do not allow anyone to smoke in the baby's home or around the baby. Also, eliminate any loose crib borders, loose blankets, or stuffed animals from the crib. New research has shown that having your child suck on a pacifier while resting/sleeping also reduces the risk of SIDS.

Remember to do all of these precautions, because they significantly lower the risk. Fortunately, there is new research being done all the time to help rule out this type of death.

General Care of Your Baby

WEIGHT LOSS AND GAIN
The average newborn weighs approximately 7 ½ pounds. Infants typically lose weight (4-10 ounces) in the first few days of life, which usually amounts to approximately 10% of their birth weight. Most regain their birth weight by 10 days, double it by the fifth month, and triple it by one year. 

SLEEP PATTERNS

Sleep patterns of infants can cause concern for new parents because they are exhausted from their lack of sleep. Newborns sleep approximately 18 hours a day, often in 3-4 hour stretches between meals. They do not care about daytime and nighttime. Most infants wake up for feedings every 2-3 hours until 6-8 weeks of age. Each baby establishes his/her own sleep patterns. Understand that due to the baby's stomach size, they are not able to develop a sleep pattern like an adult. BE PATIENT!!

TIPS FOR THE SLEEPING BABY
ALWAYS, ALWAYS place the baby on his/her back to reduce the risk of SIDS. Remove any items from the crib (pillows, stuffed animals, etc.) that could possibly cause the baby to suffocate.

Within 30 minutes or so prior to bedtime, slow the pace of infant activity and prepare your baby for the night. Play should be a quiet, avoid loud noises, and keep her/him calm. Do not try to rush.

  • Learn how your baby responds to different stimulation. What calms your baby or what causes your baby to fuss? Observe for visual cues, touch, movement, or noise.
  • Teach the baby to self-soothe. After approximately six weeks, the baby is old enough to start soothing himself/herself. In the meantime, pacifiers work very well.
  • Skin to skin contact is often helpful to calm your newborn. Your heart beat and breathing can be soothing.
  • Watch for foods you eat if you are breastfeeding. Spicy or garlicky foods may upset your baby, although new research is showing this may not be so much of a concern.
  • We often hear that babies have their days and nights "mixed-up." But, honestly, they don't know any different. As a parent, we can help them with this transition. Some things to do:
    • When feeding and changing the infant during the night, keep things very calm, quiet and dark. Don't stimulate them or wake them too much.
    • During the day, open the blinds and let the light shine in. Talk to your baby, sing and play! Allow your baby to recognize the difference.
    • Once you are a little more comfortable with your routine or schedule, start placing your baby to bed when she is drowsy, but still awake. You can still rock and cuddle, just lie them down in the crib before they are fast asleep. This will help them learn to fall asleep on their own, self-soothe and teach the baby good sleep patterns.

BOWEL FUNCTION
Babies frequently have changes in the number, color, and consistency of their stools. These changes occur day to day and are of no concern as long as the newborn is eating normally and has no symptoms of an illness. Breastfed babies have more liquid, runny, mustard colored stools that are seedy in consistency. Formula fed babies generally have stools that are yellowish-tan. All babies can have stools that vary from gray, to green, to brown in color on occasion. The number of stools can vary from 6-8 each day to one every other day.

Constipation in newborns is present when stools are small, firm, and pebble-like. The number or frequency has nothing to do with constipation as in adults. Babies often grunt, strain and turn red in the face during normal bowel movements and likewise is usually not an indicator of constipation.

Diarrhea is characterized by stools that are usually frequent and associated with excessive water. Call your doctor if diarrhea persists more than one day or if it is associated with bleeding.

DIAPER RASH
All babies get diaper rash at some time or another. Diaper rash is an inflamed red, even pimply appearance on your baby's bottom, caused by the delicate skin being constantly exposed to chemical irritants in urine and feces. Most diaper rashes respond to treatment within a matter of a few days. Less frequently, the infant may be allergic to disposable diapers, laundry detergent or it may be the result of a food allergy.

Treatment and prevention:

  • Change your baby frequently and quickly. Check for wetness about every hour.
  • Make sure your baby's skin is dry before diapering. Pat the skin dry with special attention to creases.
  • Try different types of diapers and wipes.
  • Use over-the-counter ointments.
  • Give baby's bottom some airtime-even a few minutes between diaper changes.

HOW TO BATHE YOUR BABY (Giving a sponge bath)
Babies often cry at bath time not because they do not like baths, but rather they don't like to be undressed and cold. So, try and keep the baby covered as much as possible during the bath either with their clothes or a towel.

Materials you will need:

  • Washcloth
  • Mild soap
  • Baby shampoo
  • Cotton balls
  • Hooded towel
  • Diaper
  • Clean clothes
  • Rubbing alcohol
  • Cotton swabs
  • Comb/Brush

Place all of your supplies in the same area that you will be bathing the baby so you can always stay with your child.

It is recommended that you give your baby a sponge bath until the umbilical cord falls off or once a circumcision is healed. There are differing opinions on this, so feel free to ask your physician their preference. Giving a baby a bath can be very time consuming the first time you do it, but soon it will become second hand!

**Make sure and clean your baby from the cleanest part of the body to the dirtiest.**

  • Begin the bath by washing your newborn's face with plain water. Do not forget to go behind the ears and under the chin. Most babies don't have much of a neck, so make sure if they spit up, you clean this area really well and dry it also. If your baby has a lot of hair and it starts to look oily, feel free to wash it with each bath with baby shampoo. Otherwise, it is not necessary to use shampoo every time.
  • Wash your baby's chest, arms, and hands, making sure to cleanse thoroughly between his/her fingers. If you can use a mild soap and cotton ball or washcloth, rinse immediately to avoid drying or irritating the area.
  • Wash your baby's back. With a washcloth or towel, gently pat dry the upper half of the body. Vigorous rubbing would irritate your baby's skin. Feel free to cover the exposed area with a towel to keep them warm.
  • Then the legs and feet, especially between the toes. Gently pat dry.
  • When you are finished, dry your baby thoroughly with a towel and put on a fresh diaper and clothing.
  • Last but not least, don't forget about the genital area. With girls, always wipe from front to back.

** Make it a social time by singing "This Little Piggy" or play with measuring cups.

(Giving a tub bath) - don't put in regular tub until they can sit on their own really well - use a tub ring, once they can sit well. NEVER leave the baby unattended or even take your hand away. They easily tip over or slip through the tub ring.

**Never, ever leave them alone, not even for a minute. They can drown in a couple inches of water. Remove all distractions or take child with you if phone rings or door bell rings. ***

  • Make sure the water is not too hot or too cold. Prepare your items.
  • You may find it easier to wash your baby's head first as one does with the sponge bath.
  • Lower your baby into the bath by supporting the shoulders with one hand and the legs or bottom with the other. They may even cry, but continue to immerse her by smiling and talking to them as she is placed gently in the tub. The first few baths will need to be fairly quick.
  • As you bathe your baby, keep one hand under her armpit so that her head stays out of the water, use your other hand to wash, and then rinse her body.
  • After your baby is clean and rinsed, lift her gently onto a towel and dry her thoroughly. Babies are slippery.
  • Place a clean diaper and clothes on the baby.

TIPS:

  • Bathe the baby before you feed the baby. Otherwise the motion may cause the baby to spit up.
  • Pick an area in the house where you will be comfortable bathing.
  • Make sure all bath supplies are within reach. NEVER leave your baby unattended.
  • Choose a draft-free area.
  • You can wear a pair of white cotton gloves to make you feel more secure as you hold your baby in water.

WASHING YOUR BABY'S HAIR

  • Once or twice a week is usually enough.
  • Use baby shampoo if there is enough hair, otherwise it is not necessary.
  • Hold the baby utilizing a reclining position. Don't allow water or shampoo to flow into his/her face.
  • Use a very small amount of baby shampoo and work up a lather.
  • Use tepid water to work up a lather on the head either from a cupped hand or squeezing a washcloth.
  • Never rinse the head directly from the faucet.
  • Pat the hair dry with a soft towel.
  • Talk or sing to the baby during the procedure to decrease fear.
  • If your baby is experiencing cradle cap (baby dandruff), massage some baby oil on the area 20 minutes before the bath and then shampoo it out. Cradle cap is very normal, especially in our cold, dry climate in the winter.

CORD CARE
The baby will come home with a cord stump where the cord was clamped immediately after birth. This cord does not have any nerve ending, thus does not hurt the baby in any way. The area will need to be cleansed to prevent infection and help speed the drying process. The cord typically falls off by itself after 1-4 weeks.

  • To prevent infection and speed the drying of the cord, clean around the cord with a cotton swab dipped in alcohol with each diaper change or at least three times a day. New research is showing that water may work just as well, so feel free to ask your physician what their preference may be.
  • To avoid irritation, don't cover the area with a diaper or plastic pants. Fold the diaper over and away from the cord area.
  • Continue this till the cord falls off-don't be surprised if you see a few drops of blood the day the cord falls off. This is normal.
  • As the cord falls off, the center will appear yellow. If it has a pus like discharge, has an offensive odor, or if the area is hot, red, and swollen, call the baby's doctor.

DIAPERING YOUR BABY
It is a good idea to have a specific area to change the baby as you will be utilizing this area every 2-3 hours. In this area, have all your supplies readily available so you never have to leave the child - or cause a bigger mess!

  • You will need diapers, ointment, washcloths or wipes and a change of clothes.
  • Lay your baby on her back, secure the infant by using the strap on the changing table and unfasten soiled diaper. Baby's can urinate erratically and frequently, so always be prepared when even changing their diapers. No parent can get through the newborn period without getting wet! Cover a boy's penis with a tissue or towel when changing or place a towel beneath a girl.
  • Clean the diaper area with diaper wipes or a soft cloth wettened with plain water. Take extra care in the creases and folds. Wipe girls front to back to avoid infection. Pat dry. Use ointments to help clear up or prevent diaper rash. Don't use talcum powder since a baby can breathe in the fine particles that can irritate the baby's lungs. When using wipes-try them once-if you don't see a reaction, you can continue.
  • Replace with a clean diaper. Place fairly tightly - a loose diaper won't hold what it needs to! Make sure and fold down the diaper if the baby's cord is still intact.

Health

As the parent, don't forget to take care of yourself! Since your baby relies on you for all their care, you must stay well. Also, don't feel bad if you are experiencing crying spells or crying for any reason. In fact, 80% of new moms go through some type of postpartum blues or depression. Please make sure and ask for help. Most people want to help, but sometimes do not know how to help! Have them assist with cleaning, cooking or laundry while you get used to your baby and spend one on one time with them. If you are feeling frustrated from a fussy baby (everyone feels that way at one time or another) and don't have anyone to help you, feel free to lay your baby down on their back in the crib for a few minutes as you utilize some stress-reducing activities. Do not feel guilty about this - it will not harm the baby and you will be a better parent because of it! Don't ever shake your baby. It is never safe for your baby to be shaken - it does not take much for a baby to experience Shaken Baby Syndrome.

JAUNDICE
Jaundice can be described as the yellowish discoloration of the skin and the whites of the eyes that is a common occurrence in newborn babies. In fact, 60% of normal infants develop jaundice. This condition is the result of an excess of bilirubin in the bloodstream, when the liver is not as efficient as an adult's liver to remove the bilirubin from the blood. In premature infants, because the liver is even less mature than full-term infants, the condition may even last longer. Treatment of this condition is determined by the physician based on the cause and severity of jaundice.

BABY ILLNESS WARNING SIGNS
Every experienced parent feels worried as they adjust to a new baby's habits, needs, and personality. Further anxiety occurs if the newborn starts exhibiting signs and symptoms of illness. Breastfeeding helps build the baby's immunity.

If you are in question of your baby's health, always check their temperature. Talk with you baby's doctor on their preference - whether it is by a rectal or axillary (under the arm) measurement. Often a regular digital thermometer is much more accurate than some of the thermometers on the market - and is much cheaper!

As babies get older, their bodies are better able to fight off sickness. A low fever in a newborn may be more serious than a higher fever in a 7-month old. At any age, always call your baby's doctor for advice if a sick baby seems very sleepy, doesn't want to play, eat or can not be comforted.

The six most common ailments are listed below that require a physician's attention:

  • FEVER
    • Infant younger than two months old
    • Fever over 100.4
    • Fever not responding to usual measures
    • Fever plus a rash
    • Fever for longer than two to three days
  • RESPIRATORY ILLNESS
    • Coughing to the point of vomiting
    • A deep chest cough
    • Labored or rapid breathing
    • Wheezing
    • Cold lasting longer than two weeks
    • Fever developing several days after a cold begins

RSV is very common in young children. It is caused by a virus and resembles a common cold, but can be very difficult for a child to get over.

  • EAR INFECTIONS
    • Sleeplessness several days after cold begins
    • Repeated vomiting
    • Persistent fever/irritability after two days of treatment
    • Inconsolable crying especially when lying down
    • Redness or swelling behind the ear
    • History of ear infections
  • VOMITING/DIARRHEA
    • High fever. Unable to retain clear liquids.
    • Signs of dehydration
    • Bloody stools
    • Bright yellow or green vomit
    • Diarrhea lasting longer than seven days
  • CONSTIPATION
    • Infant feeding poorly or vomiting
    • Abdominal swelling
    • Infant in pain
    • Blood in the stool
    • Home remedies don't help
      (Your infant may cry and pull up his/her legs if feeling gas pains.)
  • RASHES
    • Fever
    • Child acts sick
    • Rash doesn't respond to simple measures in a few days

IMMUNIZATIONS
Sometimes referred to as shots or vaccinations to protect your child against a variety of diseases that can be prevented. You can retrieve the schedule for these from your physician's office. It is important to receive and then record every shot your child receives. This record will be critical when your child enters school. Often the first immunization is for Hepatitis B, in which the first dose is administered in the hospital after birth.

Safety

There are three different forms of acceptable car seats:

  • Carrier - up to 20 pounds, rear-facing only. If money is an issue, you don't need one. It is mainly for convenience to carry your baby in if he/she is asleep.
  • Convertible - front and rear facing
  • Booster - not till over 40 pounds

The National Highway Traffic Safety Administration estimates that consumers incorrectly use or install car seats 85% of the time.

  • Babies need to face-backward in the car seat until AT LEAST 20 pounds and are at least one year old.
  • Make sure the seat is installed tightly enough. When jiggled in the area where the safety belt is pulled through, the chair should not move more than an inch in any direction.
  • The harness straps should be tightened so that slack cannot be pinched between an adult's thumb and forefinger.
  • The infant seat must be angled enough so the child does not flop around, but no more than 40 degrees from vertical.
  • The harness straps must be placed in the right slots-at or right below the shoulder in the rear-facing position. In the forward-facing position, straps should come through the uppermost slots.
  • The harness clip should be placed at the child's armpit level.
  • Make sure the safety belt is in locked mode.

Additional Safety Tips:

Crib

  • width of 3 adult fingers between slates in crib
  • mattress fits snugly along bed frame - no more than 2 fingers between the mattress and crib
  • no pillow
  • only a thin blanket to cover them, use a blanket sleeper or better yet, wrap the baby in a blanket using Dr. Karp's technique from the Happiest Baby on the Block (see www.thehappiestbaby.com)
  • use fitted sheets

Outdoor safety

  • keep infant out of direct sun until > 1 year
  • always place a hat on your baby
  • don't use a sunscreen with SPF in it under 6 months of age (tender skin can absorb the chemical involved and their body won't be able to eliminate it). Instead, very lightly cover all parts of their body with light clothing, blanket or shade.
  • After 6 months, use SPF > 15 and cover all exposed areas except eyelids
  • Don't use DEET

Bath Safety

  • keep water at 120 degrees or lower to prevent skin burns
  • never, ever leave a child less than 6 years old alone in the tub
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Mercy Medical Center Sioux City | 801 Fifth Street, Sioux City Iowa 51102 | 712-279-2010