5. Undress your baby down to the
diaper. Swaddle your baby in a blanket or towel.
6. Bathe your baby from head to
toe. Start by holding your baby in a "football hold," with the
baby's body tucked under your arm and your hand supporting the
baby's lower head and neck.
7. Wash your baby's face and neck
with clear water. Wipe baby's eyes from the inner corner out
toward baby's ears. Use the corner of the washcloth to clean
the outer parts of baby's ears. Never stick anything smaller
than your forefinger in or around the baby's ears.
8. Shampoo baby's head (with or
without hair) with a mild, fragrance-free shampoo. You only need
a drop or two of shampoo. Massage with your fingertips all over
baby's head. It is okay to massage over the fontanels (soft spots).
9. Rinse with warm water, using
a small cup, the sink sprayer, or a wet washcloth. Dry the head
and cover with towel.
10. Uncover the top half of baby's body. Use a washcloth
with very little soap to sponge off baby's arms, hands, chest,
and back. Be sure to rinse off all of the soap. Soap can be very
drying and irritating to a baby's tender skin. Dry off the parts
you have washed.
11. Rewrap the towel or blanket so the baby's legs are
uncovered. Wash baby's legs and feet, getting in between the
toes. Dry baby off, again making sure baby is dry between her
toes.
12. Wash the diaper area last. If your baby boy was circumcised,
do not use soap on his penis until the area has been healed.
It could sting! On uncircumcised boys, clean around the penis
until you are able to pull it back gently for cleaning. For baby
girls, always wipe front to back. You may notice a cheesy substance
(vernix) still clinging to the folds of your baby girl's genitals
(private parts). This is just Mother Nature's "diaper gel" and
will wear off on its own in a few days. Do not try to scrub it
off. You will just make your baby's bottom sore.
13. Be careful handling a wet baby. They can be very slippery.
14. Dress or swaddle the baby before doing anything else.
You do not want the baby to get too cold.
15. Rinse the basin well and let it air dry.
What is cradle cap?
Cradle cap is a buildup of yellowish scales on the baby's scalp.
It is caused by overactive oil and sweat gland on the baby's
head. To treat it, soften the scales by rubbing in a small amount
of lotion or baby oil. Leave it on a little while (even overnight).
Then shampoo the baby's head, scrubbing with your finger-tips
to loosen the scales. Sometimes a soft-bristled brush helps,
too. Cradle cap looks worse than it is. In time, it will go away
on its own.
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How about
my baby's fingernails & toenails?
Babies have soft, thin nails. They grow amazingly fast and they
can scratch. Trim the baby's nails while she is asleep- about
2 weeks of age and after. Use special baby nail clippers or round-tipped
cuticle scissors. Cutting the nails is easier after a bath because
they are even softer and have loosened a bit around the edges.
Cut nails straight across to prevent ingrown nails.
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How do I give my baby a tub bath?
A tub bath starts off the same way as a sponge bath:
1. Choose a warm, draft-free room
for the bath. You can use a sink for a tub bath as long as you
have scrubbed it clean. Put a thick towel in the sink for your
baby to sit on. Or use a small tub or baby bathtub. Some of these
have a foam liner so your baby is cushioned and does not slip
around as much. A foam liner can grow germs easily! Be sure
to rinse it very well and air dry it completely after each use.
2. Put a 'do not disturb' sign
on your door and take the phone off the hook. You do not want
anything to interrupt you. Never leave a baby alone in a tub, even
only an inch of water.
3. Get all of your supplies:
4. Wash your baby's face with
clear water and the washcloth. Clean the eyes from the inside
corner out (nose to ears). Use a corner of the washcloth to clean
the outer parts of the baby's ears. Never use cotton swabs
or anything smaller than your forefinger to clean the baby's
ears.
5. Put about 3 inches of comfortably
warm water in the tub. Use your inner wrist to test the temperature.
6. Undress your baby and wrap
in a bath towel. Hold your baby in the football hold. Shampoo
the head with a very small amount of shampoo. Rinse well with
warm water and dry the head well. Babies lose most
of their body heat through their heads. So dry thoroughly
so baby will not get cold with wet hair.
7. Unwrap the baby. Slip your
arm closest to the head behind the back. With that hand, grasp
the far arm by placing your fingers under the arm and wrapping
your thumb over the shoulder. Hold on tightly! Slip
your other hand under your baby's bottom, and wrap your fingers
around baby's far thigh the same way (see figure A).
8. Gently lift your baby and place
your baby slowly in the water. Talk soothingly, especially the
first time you put him in the tub. After a few times, your baby
will wiggle with delight when your baby sees
the tub. But for now, it is new and kind of scary.
9. Keep your hand in place around
your baby's back and arm. Use your free hand to sponge your baby
off in the water. Use a small amount of soap. Be sure to clean
in all the little creases in the neck, elbows,
and behind the knees. (see figure B).
10. After sponging off your baby's arms, chest, and legs,
clean from front to back between the legs. Then take your free
hand across your baby's
chest and grab your baby's far arm with that hand.
Bend baby forward over that arm and use your other
hand (now free)
to sponge off your baby's back (see figure C).
11. Again, holding your baby like you did during step
7, lift the baby gently out of the tub and place him on the bath
towel. Hold tight! The baby will be very slippery!
12. Dry your baby thoroughly. Be sure to get between the
fingers and toes.
13. After dressing or swaddling your baby, rinse the tub
completely and let it dry.
Figures A, B, & C: Tub bathing.
Care of the Genital Area
For the first few days, your baby's genitalia may be swollen.
This is normal and the swelling will decrease in a few days.
The genital area should be cleansed thoroughly at every diaper
change.
Boys
Care of the Newly Circumcised Penis
Immediately after the circumcision, your son will be diapered
in a special way. A folded cloth diaper with petroleum jelly
applied to the front, next to the penis, will be positioned inside
a disposable diaper. This will remain on for approximately two
hours. This special diaper will help prevent excessive bleeding.
The petroleum jelly will protect the glans (tip of the penis)
from burning when he urinates, and also from drying and sticking
to the diaper.
Your nurse will check your son frequently for urination and
any excessive bleeding.
After the initial two-hour period, he will need only a single
diaper with the petroleum jelly applied on the front of the diaper.
You will continue to apply petroleum jelly to the front of the
diaper with each diaper change for 3 more days. After the circumcision,
the glans is bright red in color and swollen. Within one or two
days, you will notice a decrease in the swelling and see a yellow
covering over the reddened glans. This is normal, new tissue
growth. The healing will occur in three to four days and is complete
when the glans is pink. During the first two days, pouring warm
water over the penis is sufficient for cleaning. After this time,
you may use mild soap.
Care of the Uncircumcised Penis
Wash the penis with mild soap and water. It is not necessary
or recommended to retract the infant's foreskin to clean the
penis. The foreskin of an uncircumcised penis should never be
forced back. When natural separation of the foreskin and glans
occur (most foreskins are retractable by age 5), your son can
be taught to gently retract his foreskin and wash while bathing.
Girls
To avoid infection, be sure to wipe your daughter's genital
area from front to back. During the first few days, it is not
uncommon to see a small amount of mucus, possibly blood-tinged,
come from the vagina. This is normal.
Umbilical Cord Care
The plastic cord clamp is removed before your baby goes home,
but if the cord is not dry enough, the clamp may be left on and
can be removed at your baby's first doctor visit-or by the visiting
nurse. The area at the base of the cord should be cleaned after
sponge bathing and after every diaper change. To do this, wipe
the cord gently with a cotton ball/swab soaked in rubbing alcohol.
Don't be afraid to touch or move the cord to clean it well at
the base. Your baby may cry because the alcohol feels cold. To
promote drying of the cord, keep clothing and your baby's diaper
off the belly button until it is healed. The cord will darken,
dry, and fall off in seven to ten days. You should continue to
apply alcohol until the area is healed, about another one to
two days.
Clothing
Dress your baby as you would dress yourself. Babies do not need
extra clothing or blankets while indoors. Dress your baby to
avoid chilling when you go outside in cold weather. Cover your
baby's head with a hat or blanket. During the summer months,
limit exposure to sunlight since baby's skin sunburns easily.
Light weight clothing and a hat or bonnet will protect your baby's
skin. Prevent your baby's skin from touching a car seat that
has been in the sun since it can easily become hot enough to
cause burns.
Bowel Movements and Urination
After birth, your baby should urinate and have a bowel movement
within the first 24 hours. The first BMs (meconium) are dark,
green/black and sticky. After the first few days, the appearance
of your baby's BM will gradually change, becoming green and then
yellow. Infant BMs are normally soft and pasty, the consistency
of soft butter. They are not formed and vary considerably in
the number per day.
If you are breastfeeding your baby, you can expect your baby
to have one to six seedy (containing seedy little particles)
BMs each day. If your baby is receiving formula, the stools will
be slightly firmer and occur once or twice per day. In addition,
your baby should have six to eight wet diapers per day. This
tells you that your baby is getting enough to drink.
Diaper Rash
One of the best ways to prevent
diaper rash is to keep your baby clean and dry. Wipe your baby
with a moist cloth and pat dry each time you change the diaper.
If you use cloth diapers, wash them in mild soap, rinse thoroughly
and avoid the type of fabric softener used in the dryer. If a
diaper rash occurs, it helps to keep the diaper off and let the
skin air dry. Non-prescription ointments may help as well. Diaper
rash that occurs during the first two weeks of life, or diaper
rash that does not improve, should be seen by your baby's doctor.
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Feeding Your Baby
Your baby will establish a feeding
pattern. Newborns will breastfeed from 5-20 minute at a feeding.
Bottle fed newborns will eat ½ ounce to 2 ounces of formula at
a feeding. Most babies like to eat every 2-3 hours. Newborns
need to be fed at least every three to four hours. By the time
babies are hungry, they usually cry. Earlier feeding cues include
smacking their lips, sucking on hand or fist, or searching for
a nipple with their mouth. Your nurse can help you identify your
baby's cues. Whether you breast or bottle feed, many helpful
resources are available at the hospital and in the community.
Pacifiers
Babies need to satisfy their sucking
reflex. Some babies need only the amount of sucking done at feeding
time, but others want more. Not only is sucking satisfying, but
it exercises the muscles in and around the mouth. This is important
because using the tongue, lip, and jaw muscles prepares a child
for learning to talk. Babies often suck thumbs or hands in the
uterus before birth. If your baby has a strong desire to suck,
a pacifier may help meet this need. A safe pacifier has a large,
flat, round base (at least 1 ¾ inch across), an easily grasped
handle, and is made of non-toxic material. DO NOT tie a pacifier
string around your baby's neck since it could strangle your baby.
Safety
When you put your baby down, remember
that babies are able to move around. Siderails or a safety belt
will prevent them from rolling or falling off a changing table
or bed.
It is normal for babies to spit
up small amounts after eating. To prevent choking, place your
baby in a side-lying position propped with a blanket roll in
front and back (away from your baby's face) after feedings.
Your baby's crib should have slats
no more than 2 3/8" apart, and the mattress should be snug-fitting.
Avoid fluffy bedding that baby may sink into, preventing him
or her from breathing fresh air. Do not place your baby on a
waterbed. Secure side rails and child-proof side-locks are important
crib safety features.
Avoid strangulation by making sure
there are no hanging objects in the crib within reach of your
baby. Items such as necklaces, pacifiers on strings, and long
ribbons or ties at your baby's neckline, or on toys, can be dangerous.
One of the most important ways to
protect your baby is to always use an approve car seat for every
car ride. Most states, including Michigan, require that all children
under 4 years of age must ride in a car seat. It is important
to know how your particular car seat works. Most will not work
with passive restraint system seat belts that move on a track
when the door is opened. A "locking clip" or "safety clip" will
be needed to secure over-the-shoulder seat belts. Most car seats
come with these or they can be obtained at car dealerships. Babies
under 20 pounds should be positioned to face the rear of the
car. The safest place in the car is in the middle of the backseat.
Do not put a baby's car seat in a seat equipped with an air bag.
Be sure to have your baby's car seat ready in your car for the
trip home from the hospital.
Sleeping
Most newborns sleep about 20 hours
a day, though some sleep more, and some will sleep less. As your
baby grows older, the amount of sleep required will decrease.
You may encourage longer periods of sleep at night by keeping
your baby awake in the evening. The best sleeping position for
your baby is on the side or back-not the stomach.
One of the easiest ways to lower
the risk of SIDS (sudden infant death syndrome which is the sudden/unexplained
death of a baby under one year of age) is to put your baby on
his or her Back to Sleep, even for naps. Research now
shows that fewer babies die of SIDS when they sleep on their
backs on a firm mattress, away from soft, fluffy, loose bedding
and stuffed toys. Your baby can be on his or her stomach when
your baby is awake and someone is watching. Sleeping with you
or any other family member is not recommended. Adult beds usually
have a soft mattress and lots of bedding. It increases the risk
for SIDS as well as suffocation.
Taking
Your Baby's Temperature
It is not necessary to take your
baby's temperature unless you think your baby is sick. You may
take the baby's temperature under the arm by placing the tip
of the thermometer in the armpit and holding the arm to the side
of the baby's body for about three minutes if a glass thermometer
is used or until it beeps if a digital thermometer is used. An
underarm temperature should be between 97° F and 99 °F (or 36.2° C
and 37.2° C). Your baby's doctor may recommend a rectal method
to check your baby's temperature. If using a rectal thermometer,
lubricate it with Vaseline on the tip of the thermometer. Place
your baby on his or her back. This can be done on a changing
table or across your lap. Holding your baby's ankles with one
hand to keep the legs still, gently insert the lubricated thermometer
into the rectum approximately ¼ inch. Hold the thermometer in
place for one minute. The normal range for a rectal thermometer
for a newborn is less than 100.4 °F (38.1°C). Inform your baby's
doctor of any elevated temperature.
When to
Call Your Baby's Doctor
Please call whenever you are worried,
but report the following immediately:
Information provided by UMHS perinatal education committee March,
2005
