Baby-care basics

• Getting Help After the Birth
• Handling a Newborn
• Bonding and Soothing Techniques
• Diapering Dos and Don'ts
• Bathing Basics
• Circumcision and Umbilical Cord Care
• Feeding and Burping Your Baby
• Sleeping

Getting Help After the Birth
Consider recruiting help from friends and family to get through this time, which can be very hectic and overwhelming. While in the hospital, use the expertise around you. Many hospitals have feeding specialists or lactation consultants who can help you get started nursing or bottle-feeding. In addition, nurses are a great resource to show you how to hold, burp, change, and care for your baby.
For help at home, you could hire a baby nurse or a responsible neighborhood teenager to help you for a short time after the birth. Relatives and friends can also be a great resource. But if you don't feel up to having guests or you have other concerns, don't feel guilty about placing restrictions on visitors.

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Handling Your Newborn
If you haven't spent a lot of time around newborn babies, their fragility may be intimidating. Here are a few points to remember:

• Be sure to support your baby's head and neck. Cradle the head when carrying your baby and support the head when carrying the baby upright or when you lay him or her down.
• Do not to shake your newborn, whether in play or in frustration. Vigorous shaking can cause bleeding in the brain and even death. If you need to wake your infant, don't do it by shaking — instead, tickle your baby's feet or blow gently on a cheek
• Make sure your baby is securely fastened into the carrier, stroller, or car seat. Limit car rides and any other activity that would be too rough or bouncy.
• Remember that your newborn is not ready for rough play, such as being jiggled on the knee or thrown in the air.

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Bonding and Soothing Techniques
Bonding occurs during the sensitive time in the first hours and days after birth when parents make a deep connection with their infant. Physical closeness promotes an emotional connection, and this attachment will allow parents to make the sacrifices necessary to care for their child.

For infants, the attachment contributes to their emotional growth, which also affects their development in other areas, such as physical growth. Another way to think of bonding is "falling in love" with your baby. Children who don't have a parent or adult in their life who loves them unconditionally can have greater problems as they mature.

Begin bonding by cradling your baby in your lap and gently stroking him or her in different patterns. If you and your partner both hold and touch your infant frequently, the baby will soon come to know the difference between your touches. Each of you should also take the opportunity to be "skin-to-skin," holding your newborn against your own skin while feeding or cradling.

Babies, especially premature babies and those with medical problems, may respond to infant massage. Research has shown that certain types of massage can enhance bonding and help with infant digestion and growth. Many books and videos cover infant massage — askyour baby's doctorfor recommendations. A word of caution — babies are not as strong as adults, so massage your baby gently.

Babies usually love vocal sounds, such as talking, babbling, singing, and cooing. Your baby will probably also love listening to music. Baby rattles and musical mobiles are other good ways to stimulate your infant's hearing. If your little one is being fussy, try singing, reciting poetry and nursery rhymes, or reading aloud as you sway or rock your baby gently in a chair.

Some babies can be unusually sensitive to touch, light, or sound, and might startle and cry easily, sleep less than you might expect, or turn their faces away when you speak or sing to them. Keep noise and light levels moderate.

Swaddling is another soothing technique first-time parents should learn. Swaddling keeps a baby's arms close to the body and legs securely bound. Not only does this keep a baby warm, but the surrounding pressure seems to give most newborns a sense of security and comfort.
Here's how to swaddle a baby:

1. Spread out the receiving blanket, with one corner folded over slightly.
2. Lay the baby face-up on the blanket with his or her head at the folded corner.
3. Wrap the left corner over the body and tuck it beneath.
4. Bring the bottom corner up over the baby's feet.
5. Wrap the right corner around the baby, leaving only the neck and head exposed.

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Diapering Dos and Don'ts
Whether you use cloth or disposable diapers, you will need about 10 diapers a day, or about 70 a week.
Before diapering a baby, make sure you have all supplies within reach so you won't have to leave your baby unattended on the changing table. You'll need:

• a clean diaper
• a fastener (if cloth is used)
• diaper ointment if the baby has a rash
• a container of warm water
• cotton balls
• clean washcloth or diaper wipes

After each bowel movement or if the diaper is wet, lay your baby on his or her back and remove the dirty diaper. Use the water, cotton balls, and washcloth or the wipes to gently wipe your baby's genital area clean. When removing a boy's diaper, do so carefully because exposure to the air may make him urinate. When wiping a girl, wipe her bottom from front to back to avoid a urinary tract infection. If your baby has a rash, apply ointment. Always remember to wash your hands thoroughly after changing a diaper.

Diaper rash is a common concern. Usually the rash will be red and bumpy and will go away with a warm bath, some diaper cream, and a little time out of the diaper. Most rashes occur because the baby's skin is sensitive and becomes irritated by the wet diaper. If your baby has had juice, the stool can become acidic and cause a rash.

To prevent or heal diaper rash, try these tips:

• Change your baby's diaper frequently, and as soon as possible after bowel movements.
• After cleaning the area with mild soap and water or a wipe, apply a diaper rash or "barrier" cream. Creams with zinc oxide are preferable because they form a barrier against moisture.
• If you use cloth diapers, wash them in dye- and fragrance-free detergents.
• Let the baby go undiapered for part of the day. This gives the skin a chance to air out.
• If the diaper rash continues for more than 3 days, call your doctor — it may be caused by a fungal infection that requires a prescription.

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Bathing Basics
You should give your baby only a sponge bath until:
• the umbilical cord falls off (1–4 weeks)
• the circumcision heals (1–2 weeks)
• the naval heals completely (1–4 weeks)
A bath two or three times a week in the first year is sufficient. More frequent bathing may be drying to the skin.

You'll need the following items before bathing your baby:

• a soft, clean washcloth
• mild, unscented baby soap and shampoo
• a soft brush to stimulate the baby's scalp
• towels or blankets
• an infant tub filled with warm — not hot! — water (to test the water temperature, feel the water with your elbow or wrist). An infant tub is a plastic tub that can fit in the bathtub and is better fitted for the infant and makes bath time easier to manage.
• a clean diaper
• clean clothes

Sponge baths. For a sponge bath, pick a warm room and a flat surface, such as a changing table, floor, or counter. Undress your baby down to a shirt and diaper. Wipe your infant's eyes with a washcloth dampened with water only, starting with one eye and wiping from the inner corner to the outer corner. Use a clean corner of the washcloth to wash the other eye. Clean your baby's nose and ears with the washcloth. Then wet the cloth again, and using a little soap, wash his or her face gently and pat it dry. Next, using baby shampoo, create a lather and gently wash your baby's head and rinse. Using a wet cloth and soap, gently wash the rest of the baby, paying special attention to creases under the arms, behind the ears, around the neck, and the genital area. Once you have washed those areas, make sure they are dry and then diaper and dress your baby.

Tub baths. When your baby is ready for tub baths, the first baths should be gentle and brief. If he or she becomes upset, go back to sponge baths for a week or two, then try the bath again.
Undress your baby and then place him or her in the water immediately to prevent chills. Use one of your hands to support the head and the other hand to guide the baby in feet-first. Speaking gently, slowly lower your baby the rest of the way into the tub. Use a washcloth to wash his or her face and hair. Gently massage your baby's scalp with the pads of your fingers or a soft baby hairbrush, including the area over the fontanelles (soft spots) on the top of the head. When you rinse the soap or shampoo from your baby's head, cup your hand across the forehead so the suds run toward the sides and soap doesn't get into the eyes. After the bath, wrap your baby in a towel immediately, making sure to cover his or her head. Baby towels with hoods are great for keeping a freshly washed baby warm.

Female genitalia. When cleaning the baby's vagina, wipe gently from front to back. This will reduce the possibility of urinary tract infection. Some infants will have a vaginal discharge with or without a slight amount of blood. This is normal within the first week of life and is related to thematernal hormones. Do not scrub excessively in an attempt to remove all of the white cheesy secretions which are present and which protect the sensitive skin within the folds of the vagina. The labia normally remain slightly swollen for at least 2-3 weeks and are also related to hormonal changes.

While bathing your infant, never leave the baby alone. If you need to leave the bathroom, wrap the baby in a towel and take him or her with you.

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Circumcision and Umbilical Cord Care
Immediately after circumcision, the tip of the penis is usually covered with gauze coated with petroleum jelly to keep the wound from sticking to the diaper. Gently wipe the tip clean with warm water after a diaper change. Redness or irritation of the penis should heal within a few days, but if the redness or swelling increases or if pus-filled blisters form, infection may be present and you should callyour baby's doctorimmediately.

If the Plastibell system was used, the plastic ring should fall of in 6-7 days. You probably received a brochure that describes the healing process. If you have any questions about this, please contact your obstetrician first and thenyour baby's doctorif you do not receive a satisfactory explanation.

Umbilical cord care in newborns is also important. To help prevent infection, keep the umbilical cord clean and dry by using rubbing alcohol at least four times a day until the cord stump dries up and falls off, usually in 10 days to 3 weeks. The infant's navel area shouldn't be submerged in water until this happens. Until it falls off, the cord stump will change color from yellow to brown or black — this is normal. After it is removed, there may be a small amount of fluid drainage and bleeding, even for several days. Just keep on cleaning this occasionally to remove the old blood. Callyour baby's doctorif the navel area becomes reddened or if a foul odor or discharge develops.

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Feeding and Burping Your Baby
Whether feeding your newborn by breast or a bottle, you may be stumped as to how often to do so. Generally, it's recommended that babies be fed on demand — whenever they seem hungry. Your baby may cue you by crying, putting fingers in his or her mouth, or making sucking noises.
A newborn baby may need to be fed as often as every 2 hours or perhaps more frequently. If you're breastfeeding, give your baby the chance to nurse about 10–15 minutes at each breast. If you're formula-feeding, your baby will most likely take about 2–3 ounces (60–90 milliliters) at each feeding.

Some newborns may need to be awakened every few hours to make sure they get enough to eat. Callyour baby's doctorif you need to awaken your newborn frequently or if your baby doesn't seem interested in eating or sucking.

If you're formula-feeding, you can more easily monitor if your baby is getting enough to eat. However, if you're breastfeeding, you may wonder — but if your baby seems satisfied, produces about six wet diapers and several stools a day, sleeps well, and is gaining weight regularly, then he or she is probably eating enough. Talk to your doctor if you have concerns about your child's growth or feeding schedule.

Babies often swallow air during feedings, which can make them fussy. You can prevent this by burping your baby frequently. If you are bottle-feeding, burp your baby every 2–3 ounces (60–90 milliliters).

If you're breastfeeding, burp your baby each time he or she switches breasts using one of the following burping strategies:

• Hold your baby upright with his or her head on your shoulder. Support your baby's head and back while gently patting the back with your other hand.
• Sit your baby on your lap. Support your baby's chest and head with one hand and gently rub his or her back with the other.
• Lay your baby face-down on your lap. Support your baby's head in the crook of your arm and gently pat or rub his or her back.
• If your baby hasn't burped after several minutes, finish the feeding you've started. Afterward, burp your baby again and keep him or her in an upright position for 10–15 minutes to avoid spitting up.
  

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Sleeping Basics
As a new parent, you may be surprised to learn that your newborn, who seems to need you every minute of the day, actually sleeps about 16 hours or more! Newborns typically sleep for periods of 3–4 hours. Don't expect yours to sleep through the night — the digestive system of babies is so small that they need nourishment every few hours and should be awakened if they haven't been fed for 5 hours.

When can you expect your baby to sleep through the night? About 90% of babies sleep through the night (between 6–8 hours) at 3 months of age, but if yours doesn't, it's not a cause for concern. Like adults, babies must develop their own sleep patterns and cycles, so if your newborn is gaining weight and appears healthy, don't despair if he or she hasn't slept through the night at 3 months.

It's important to place babies on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). In addition, remove all fluffy bedding, quilts, sheepskins, stuffed animals, and pillows from the crib to ensure that your baby doesn't get tangled in them. Also be sure to alternate the position of your baby's head from night to night (first right, then left, and so on) to prevent the development of a flat spot on one side of the head.

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