Baby Care

In addition to feeding, your newborn has sleep and hygiene needs. The following sections give some guidelines for caring for your baby’s other needs.

Diapering
A newborn usually goes through 8 to 12 diapers (sometimes more) a day for the first month of life. You can prevent diaper rashes by changing your baby's diaper as soon as possible after each bowel movement or wetting. Clean the diaper area with a soft cloth or towelette and water. Avoid using commercial diaper wipes for the first few weeks of life. Baby powder is not recommended.

Using cloth or disposable diapers is a personal choice. Both types have pros and cons, yet work equally well. If you choose to use cloth diapers, it is most convenient to use a diaper service. If you would like to wash the diapers at home, use a detergent in your washer and remember to thoroughly rinse the diapers.

Wet and Soiled Diapers: A healthy, well-hydrated newborn will have at least 6 wet diapers in a 24-hour period. Sometimes it can be difficult to tell if the baby has wet because the diapers are so absorbent. If you are not sure if a diaper is wet, it may be necessary to rip the diaper open to feel for dampness.

Newborn babies have different bowel movement patterns than older infants. The first few bowel movements are called meconium. This stool is black, tarry, and sticks to the baby’s bottom. After your baby begins to digest his first feedings, the bowel movements change to a dark brownish-green stool for a few days. After this transitional stool, breast-fed babies have small, frequent, yellow stools with a pasty, watery, or curd-like consistency. Most breast-fed babies may have a stool with every feeding. Most bottle-fed babies usually have 2 to 4 soft, brown, green, or yellow stools each day. Your baby may have a bowel movement after each feeding or may have 1 to 2 stools a day. Some babies go 48 hours without a bowel movement and are normal. Your baby may strain when he has a stool, but unless the stool is hard and pellet-like, this is perfectly normal.

Baby Boys: At birth, the foreskin (skin that covers the penis) and the glans (tip of the penis) cannot be separated. Forcefully pushing back the foreskin can be harmful. Between 2 and 5 years of age, the foreskin will naturally separate from the glans and retract on its own. Many baby boys are circumcised soon after birth.

The decision to circumcise or not is a personal decision you will need to make. Special care of the penis is needed whether you choose to circumcise or not.

If your baby boy has not been circumcised, do not try to pull the foreskin back. During diaper changes and baths, simply wash the outside of the penis. Additional care will be needed when your boy is older.

If your baby boy has been circumcised, the glans of the penis will look red, shiny and may ooze some sticky fluid. To help the healing, use petroleum jelly (Vaseline) on a gauze dressing and place over the penis. This will protect the penis from urine, stool, and keep it from sticking to the diaper. Use clean gauze with every diaper change for 3-5 days. Try not to touch the healing circumcision. During a diaper change, wash the area by squeezing water over the penis. Watch for swelling, bleeding or pus and call your baby’s health care provider if you notice any of these signs.

Baby Girls: It is important with girls to always wipe from front to back during diaper changes and baths. Gently separate her labia and wash the area with water. Your baby girl may have a slight vaginal discharge for the first few weeks of life. It may be white to pink. This is normal.

Umbilical Cord Care (Belly Button)
The umbilical cord was clamped and cut after birth. The plastic clamp is usually removed before you go home from the hospital. The cord stump turns black and dries up until it separates in 1 to 3 weeks, sometimes longer. It is important to keep the area clean and dry to prevent infection.

To care for the cord stump, use rubbing alcohol on a cotton ball or swab at every diaper change. Gently pull the skin away from the cord, and clean around the base of the cord where it touches the skin. This will not hurt your baby.

Sometimes after the cord falls off, there may be a few drops of blood, but this is no cause for worry. Continue to clean it with alcohol until it looks healed. If the area around the cord becomes red or has pus coming from it, call your baby’s health care provider.

Sometimes babies have a hernia or swelling of the belly button. It is harmless and painless. Do not tape a coin or place a bandage over the hernia. It usually resolves on its own as your child grows.

Bathing
Until the cord stump falls off and the navel heals (and circumcision), your baby should not have a tub bath. However, you will still need to wash your baby. This is done by a sponge bath. Using warm water and a wash cloth, simply wipe your baby from head to toe. Keep your baby wrapped in a towel to avoid a chill.

When it is time to bathe your baby in the tub or bathinette, gather all the supplies prior to undressing your baby and putting him in the water. Never leave your baby unattended while in the tub. The room should be warm and free of drafts.

To wash the hair, use a small amount of tear-free baby shampoo. Gently lather the hair and rinse well. Be careful to keep the shampoo out of the eyes.

The face, eyes, and ears should be washed with plain water. The folds of the ears may be washed with a cotton swab and water. Do not put the swab into the ear. A small amount of a gentle soap or cleanser is needed to wash the baby’s body. Pay close attention to the skin folds of the neck, underarms, and diaper areas. Rinse these areas well. Always thoroughly dry your baby before diapering and dressing. Use of baby lotion, oil, or powder is not recommended.

Comfort
Room Temperature: Try to keep an even, comfortable temperature in the baby’s room. On hot days, provide ventilation. On cold days, cover your baby so that he stays warm and comfortable. Do not tuck your baby’s blankets under the mattress or swaddle your baby too tightly.

Outdoors: You may take your baby outside when you feel physically up to it. Some fresh air and a change of scenery will do wonders for the both of you. Take care to dress the baby appropriately for the weather. Do not expose your baby’s skin to direct sunlight. Keep your baby away from sick people and crowds to avoid contact with infections.

Clothing: Your baby does not require any more, if as much, clothing as an adult. Dress him according to the temperature. Try not to over- or under-dress him. Some babies are allergic to certain materials, so watch for rashes in clothing contact areas.

Sleep
The American Academy of Pediatrics now recommends that all babies sleep on their backs. Many studies have shown that this sleep position reduces the incidence of Sudden Infant Death Syndrome (SIDS). Wedge-shaped pillows should not be used to keep your baby on his back.

Newborn babies sleep most of the day. The average newborn sleeps 17 hours per day, but the range is 12 to 23 hours a day. Sleep patterns vary with individual babies, and these patterns will change as your baby grows. Your baby will sleep as much as he needs. There is little you can do to make your baby sleep more or less.

Babies sleep best when placed in a crib or bassinet. It is important that the baby’s mattress is flat, firm, and fits snugly in the crib or bassinet. There should not be any gaps between the sides of the crib or bassinet and the mattress. Pillows and heavy blankets, quilts or comforters should never be used in the crib or bassinet. The slats in the crib should not be wider than 2 3/8 inches apart.