Caring for Your Newborn
Your newborn is as delicate as he looks. Hence, it is important to handle him with care.
- A baby has little control over his head as his neck muscles are still weak. By the time he is about 6 months old, his neck muscles and head control should be stronger.
- Always support the head and neck. Cradle the head when carrying your baby, and support it when carrying him upright, and when laying him down.
- Never shake your newborn. This can cause bleeding in the brain and even death.
- Your newborn baby is not ready for rough play. Do not jiggle him on your knee or throw him into the air. Do not do anything too bouncy or rough.
- If you put the baby in a carrier, a stroller or a car seat, always make sure that he is positioned correctly and the seat belts are properly fastened.
- Do not go up an escalator with your baby in a stroller. Take the lift instead.
What you might notice in newborns
Your baby’s head may have an odd shape. It may look like a cone or elongated. This is because his skull bones had to shift and overlap due to pressure from the narrow birth canal, while he was being delivered. It would be more obvious if forceps or a vacuum extractor was used during delivery. Do not worry, his head will return to a more rounded shape within a few days.
These soft parts of the head are called fontanelles. They are at the top and back of the baby’s head, where the skull bones have not yet grown together, and they may bulge slightly when your baby cries or exerts himself. They usually close up within 12 -18 months.
Hair and scalp
Some newborns have fine hair covering their back, shoulders, forehead and temples. This is called lanugo. It will clear up after a few weeks.
Your baby’s eyelids may be puffy and swollen. This is because of pressure on the face during delivery. As your baby spent the last few weeks before birth in a very cramped space, his nose may be flattened or pushed to the side, and his outer ears may be folded over. These will correct themselves in a few weeks so there is no need to worry.
The top layer of your baby’s skin will flake off so be prepared to see skin peeling off from his hands and feet for the first couple of weeks. You may notice white, pimple-like spots on the face. These are called milia. They are harmless and will disappear after a few weeks.
You may also notice small red bumps. This is newborn acne, and will disappear after a few months. Some babies may have bluish-grey patches on the buttocks or lower back. These are called Mongolian spots which usually disappear after a few years.
Your baby’s legs may look bowed or bent. This is due to the lack of space in the womb. Most will straighten out on their own as your baby starts to stand and walk although some babies may need medical attention.
Other body parts
Both boys and girls may have swollen breasts as hormones from the mother pass into the baby’s system before birth. Girls may have a little vaginal discharge or bleeding. This is normal and will stop after several days. Boys may have fluid around the scrotum. This is called a hydrocele. It can take 6 -12 months to disappear.
Basic newborn care
Bathing a newborn can get a little challenging as he is so tiny and fragile. Be assured the experience will get better with practice.
- Keep the water in the baby bath tub shallow.
- Remember to add hot water to cold water while filling the tub to prevent scalding accidents.
- Check the temperature of the water with your elbow before putting the baby in. It should be warm, not hot. Pour in a little hypoallergenic baby bath liquid.
- Undress the baby and wrap him up in a towel. Clean his eyes first, then his face using moist cotton balls. Use a new cotton ball for each part of the face.
- Tuck him under your arm like a football, supporting his head with the same hand. Wash his hair. Dry his hair so that he will not catch a chill.
- Remove the towel and gently put him into the water. Support the head, neck and shoulders with your arm.
- Use a napkin to gently wash him under his armpit, then turn him over to wash his bottom and genitals. A young baby needs constant support in water. Never leave him unattended.
- Lift the baby out of the tub, wrap him in a dry towel and dry him thoroughly. Put on a clean nappy and clothes.
All newborns pass out meconium – stools that are thick, sticky, black or greenish-black for the first 2 - 3 days. Thereafter breastfed babies tend to have yellow stools that are mostly runny with small seed-like objects. Breastfed babies use up to 6 - 8 diapers a day until they are about 6 weeks old; and thereafter about 5 - 6 diapers a day.
- Change the baby’s diaper when it is wet or soiled. Clean the genital area with each change.
- Apply a protective ointment or cream with each diaper change. Use one with zinc oxide, which acts as a moisture barrier.
- Remove the baby’s diaper for some time each day so that his skin has a chance to air-dry.
- If you use cloth diapers, wash them with a fragrance-free detergent.
- Consult the baby’s doctor if there is a rash.
- Diaper changing should be done away from the kitchen or any food preparation area.
- Clean the surface of the changing mat with disinfectant wipes after each use.
- Dispose of used diapers immediately.
- Empty rubbish bins or diaper bins regularly.
- Wash your hands properly after each diaper change.
In the hospital, you will see babies all wrapped up. Swaddling provides newborns with a sense of security and comfort as this is the position they were cocooned in while in the womb. You’ll need a thin large square blanket (wrap) to do this:
- Spread the blanket on a flat surface and fold down the top corner.
- Lay your baby on his back. Put the baby in the middle of the blanket, with his head on the fold.
- Wrap one side of the blanket over the baby, tucking the end under his back beneath his opposite arm.
- Pull the bottom of the blanket up and over the tummy.
- Bring the other side of the blanket over your baby and tuck it under his back.
- Make sure it is not too tight, but not so loose that it will fall apart once the baby moves.
Enjoy bonding time with your baby by holding him close to your chest, cuddling or giving him a light massage. Giving your baby a massage after his bath each evening before he goes to bed is a good way to calm him down, indicate to him that it is bedtime and get him in the mood for sleep.
Babies love attention and sounds, so talk, sing, coo, and babble to him often. If he is fussing, try singing or reciting nursery rhymes. The beat and rhythm of these will soothe him as well. Some babies like the long “shh” sound. They can calm down and even fall asleep when this is repeated to them over and over again. It is okay to pick your baby up and carry him when he cries. He needs to know that someone is there for him.
Newborns tend to swallow air while feeding, especially if they are drinking from a bottle. It is important to burp the baby after each feed. You may even need to stop a feed halfway to burp him if he is getting irritable. Here are some positions that will help your baby burp.
- Over-the-shoulder burp: Put the baby on your shoulder so that his tummy is pressed against it. Pat or rub his back gently in an upward sweeping movement. Make sure you have a cloth protecting your shoulder.
- Over-the-hand burp: Sit the baby on your lap. Grasp his chin gently with your hand. Lean him forward and rest most of his weight against the palm of your hand and your arm. Pat or rub him gently on the back.
Cleaning and care of different parts of your baby
Wash each eye gently with a cotton ball that has been dampened with warm, boiled water that has cooled down.
Ears are self-cleaning. Ear wax and dust will gradually be pushed out to the surface so that these are easy to get rid of. A gentle wipe with a soft washcloth or a damp cotton ball is enough. Never stick anything into your baby’s ears.
Use a cotton ball dampened with warm, boiled water to gently clean off any dried mucus around your baby’s nose.
Use a moist cotton ball to wipe the area. For girls, always wipe from front to back to avoid transferring bacteria from the anus to the vagina.
The umbilical cord stump
Keep it clean and dry. Do not put any medicated oil on it or in your baby’s belly button. Use cord spirit to clean the cord every day. The stump will change colour from yellowish-green to brown and black, and eventually fall off by itself in 12 - 15 days. In the meantime, keep diapers below the stump so that it is exposed to air, not urine. Sometimes, when the stump falls off, there may be a little blood. Your baby will not feel pain as there are no nerve fibres in the umbilical cord.
Many newborns have long and sharp fingernails and toenails. Put mittens and booties on him so that he will not scratch himself. Avoid trimming these during the first few weeks as the nails are very soft. When the nails have hardened a little, use baby clippers or scissors to trim them. You may find it easier to do this while your baby is sleeping or nursing.
This article was originally published on the website of the Health Promotion Board. Reproduced with permission.