Newborn Care Guide
Unless ordered by the health care provider, we do not routinely recommend use of creams, powders, oils, or lotions to apply to your baby's bottom. Powders can accumulate in skin folds, causing irritation and skin rashes. Tiny particles can also be aspirated into the lungs. Oils and creams can function as a moisture barrier but must be applied to dry skin. They can seal in moisture if they are applied to skin that is not completely dry.
Clean-up time can be as simple as using plain soap and water. There are many types of baby wipes on the market, and each of these proclaims some ingredient guaranteed to clean your baby's bottom better than the competitors. They are convenient when you go out with baby but the added expense is not necessary at home. Bowel movements can be cleaned off with soap and water using cotton squares or washcloths. Wet diaper changes usually clean up just fine with warm water on the cloth. When cleaning messy diapers, clean most of the mess with the diaper. Make sure that little girls are cleaned from front to back and that a clean cloth or a portion of the cloth is used for each wipe. Rinse with another cloth. Separate all the folds in baby's upper legs and wipe in there, too. Lift baby's bottom up a little by holding both ankles together and raising them together toward the head. Wipe baby's backside to complete the cleanup. Dry every skin fold, including the crease between the buttocks.
One helpful hint: When changing a baby boy, keep a diaper draped over his penis. Many an unwary parent has experienced not only a shower, but also a clean up job that included baby (again), the wall, changing table, and floor!
A milky white, mucus discharge is very common in little girls during the first week of life. It is the result of the withdrawal of maternal estrogen. If it is blood tinged, it is referred to as pseudomenstruation (menstruation-like). Usually only a few blood spots will be seen on the diaper.
Also, for both boys and girls, uric acid is found in large amounts in the urine of the newborn. Occasionally, this substance will leave a pink stain in the diaper which parents mistake for blood.
Diaper Rash & Skin Care
Diaper rash can be anything from slight reddening of the skin to severe inflammation with actual sores on the skin. It results from ammonia irritation and can develop rapidly if the skin is not kept clean and dry. A & D ointment, zinc oxide, or commercial diaper rash preparations may be applied. It is important to cleanse the skin well, removing excess cream from previous applications, before applying more cream. Wash the diaper area well with soap and water. Exposure to air is also recommended. If the rash becomes severe, pustules or crusted areas develop, your baby may have an infection. You should call the pediatrician or nurse practitioner for treatment.
Urination & Bowel Movements
Here is the topic you have all been waiting for! Nothing makes a new father quake in his boots more than the thought of changing dirty diapers! Sometimes the concept of "shared responsibilities" stops with this issue! Actually it is not as bad as it sounds. Stools should be yellow, soft, and pasty. With breastfeeding, a baby's stools are usually looser than with bottle-feeding and have seed-like particles. They may occur after each feeding or there may be one very large stool every 4 to 9 days. "Straining", grunting, and turning red in the face do not mean constipation; hard little pellets of stool do.
Your baby's first stools are called meconium. This is a black, sticky, odorless substance that is present in the baby's intestines while in the womb. Most babies pass meconium within the first 24 hours. Breastfeeding encourages rapid passage of meconium as colostrum (the first food from the breast) acts as a laxative to help expel meconium quickly.
Once meconium has been eliminated and the baby is receiving breast milk or formula, you will notice what are called "transitional" stools. These transitional stools will change from the black meconium to greenish-brown to a yellowish color with seed-like components if your baby is breastfed, or a brown color if baby is bottle-fed. Your baby may have several bowel movements per day, or only 1 every 1-2 days. Breast-fed infants have frequent and looser bowel movements. Constipation is present only when the baby's stool is excessively dry or firm (little round balls or pellets). It is normal for newborns to grunt or frown when they have a stool - this does not mean that it hurts them or that they are constipated. Constipation is defined as: A stool that is excessively dry or hard.
If it has been more than 2 days between bowel movements and your baby is uncomfortable (crying, pulling up the legs to the tummy, a firm abdomen.
If condition does not clear up, call the pediatric clinic. Do not use home remedies or over-the counter medicines without checking with your baby's health care provider.
Babies with diarrhea will pass an increased number of stools, and the color and consistency will change. Because the contents move through the intestines more quickly than normal, the color will be greener and the stools will be more liquid than usual. There may be a water ring - an area in the diaper where the liquid has absorbed, sometimes around an area of more solid stool. Diarrhea can be dangerous and can result from bacterial infection or formula intolerance. If your baby has diarrhea, you need to contact the pediatric clinic or ER for further guidance. It can lead to rapid loss of electrolytes, fluid and dehydration.
Stools Of Breastfed Infants
As the composition of your breast milk changes from colostrum to true milk, so will the nature of baby's stools. They become soft, semi-liquid or liquid, loose, and seedy in appearance. The color is usually daffodil-yellow with many variations of the shade, and these stools often tend to explode from the rectum. The frequency of stooling can range from as often as eight times per day to as frequently as once every few days. It is very rare for a totally breastfed baby to become constipated. Breast milk is such a perfect food for your baby that it is digested very efficiently and it may take several days for enough fecal matter to accumulate to stimulate the bowels to move. Sometimes all you will see is a dark yellow stain.
Stools Of Formula Fed Infants
The meconium stools will change to a brown-green transitional stool and then to a semi formed brownish stool with a fairly strong odor. Baby will probably move his bowels two to three times per day.
Urination
New babies urinate frequently. Six to twelve wet diapers in a 24-hour period are normal. Urine should be pale in color and should not have a fishy or foul smell. If the urine is dark yellow or very concentrated, it may mean that baby needs to be fed more frequently. Babies will normally be wet at each feeding.
page last modified on: 5/7/2013