Newborn Care Guide
Bathing
Your baby may or may not enjoy bath time at first. Little or no soap is needed to keep a baby clean. Always pay special attention to a baby's genitals. Do not force the foreskin back on uncircumcised boys. It will gradually retract by three years of age. Little girls should be wiped from front to back rather than from back to front when being cleaned.
Gently spread the outer lips apart to cleanse stool and secretions from the inner lips and to help prevent adhesions. To avoid scalding accidents, set your water heater thermostat to 120 degrees F. Always check your baby's bath water before placing your baby in the tub.
Give your baby a sponge bath until the cord and plastibell have fallen off. At that time, tub baths can begin. Give the bath at any time of day that is convenient for you. It isn't necessary for the infant to receive a bath every day. Bathe your baby 2-3 times per week with a mild soap. (Soap is not necessary for young infants, but if used, it should be gentle like any commercial baby soap, Ivory, Dove, or Caress.) In between, plain water baths are okay. Avoid using soap on the baby's face.
Before beginning a sponge bath, gather all the supplies together. You will need a container for the warm water (or use a sink); washcloth and towel, baby shampoo, alcohol for cord care, and clean clothes.
Give the bath in a room that is warm and free of drafts. Bathe the baby on a surface that is comfortable and safe. If you use a counter, you can pad it with towels.
Never leave your baby alone on an unprotected surface. Keep one hand on the infant at all times to prevent falls. As you give the baby a bath, keep the baby warm by exposing only the area you are washing. Wash and dry the baby's body, one part at a time, to prevent chilling. Clean the diaper area last, using the principle of "clean to less clean". Start by washing the face with clear water. Use a separate clean area of the washcloth to wipe each eye. Wash from the inner comer out. Wash carefully behind the ears where spit-up milk may accumulate. Use only a soft washcloth wrapped around your finger to wash the ears. Never use Q-tips in the ears or nose of your baby.
Shampoo the head while holding the baby in a football hold (tuck the baby under an arm and hold him/her securely against your hip). This allows one hand to be free to wash the hair. Although the fontanel or "soft spot" may seem delicate, a tough membrane covers it. Washing will not injure the area over it. Use a towel to dry the hair well to prevent heat loss. Combing out the hair will hasten drying.
Tub bath: The procedure is very similar to that for a sponge bath. Place approximately 3 inches of warm water in the tub. It may be helpful to wash the baby's face and hair before placing in the tub. Keeping the baby dressed until after the hair is washed helps prevent chilling.
Umbilical Cord Care
Most parents hope that this will fall off before they leave the hospital. No such luck! However, relax ...it is very easy to care for and will fall off within 7 to 14 days. When you change your baby's diaper, fold the diaper down away from the cord and clean the base of the cord with alcohol. Your baby may cry, not because it bums or stings, but because it is cold. When the cord does fall off, continue to apply alcohol for 2 - 3 days to keep the stump dry and the area dean. A small amount of bleeding from the cord stump may be normal. However, if it continues, or if you notice any odor, redness, or discharge, call the pediatric clinic. Never "help the cord along" by pulling on it or trying to remove it.
Notify a health care provider if the cord stump has a foul odor, has drainage in spite of good cleaning, or if there is a reddened area on the skin around the cord.
Circumcision
The decision to have your son circumcised or not is a personal one based on your cultural, religious, and personal beliefs. The American Academy of Pediatrics stated in 1975 that there are no valid medical indications for circumcision in the newborn period. They revised that statement in 1989 to reflect the increased evidence that routine circumcision appears to reduce the incidence of urinary tract infection and reduces the risk of cancer of the penis. It has also been suggested that uncircumcised men exposed to HIV and other sexually transmitted diseases during heterosexual intercourse appear more susceptible to infection. However, there is disagreement as to whether this relates to poor hygiene or circumcision. Claims that circumcision of the male decreases the incidence of cervical cancer in his partner are not conclusive. The most common complications of circumcision are bleeding and infection.
At Carl R. Darnall Army Medical Center, most infants are circumcised using a plastibell. The plastibell will fall off by itself in 5 - 8 days. The head of the penis will look red and sore. A yellow exudate will normally form over the surgical site. To clean the penis, simply squeeze a clean towel soaked in warm water over the plastic ring each time the diaper is changed. Notify the pediatric clinic if you notice an increase in redness, swelling or drainage from the site, any blood spots larger than a quarter, inability to urinate, plastibell doesn't fall off in 8 days, or ring has slipped onto the shaft of the penis.
Notify a health care provider if: no urine has been passed within 12 hours of circumcision; you smell a foul odor or there is a large amount of foul discharge; or you see bright red blood on the diaper.
Sleep Patterns & Positioning
Parents are often confused about when infants should sleep through the night. Newborns should not be expected to sleep through the night. By 12 weeks of life, 70% of full-term infants are able to sleep at least 5 hours at night. By 12 to 16 weeks of life, they will sleep for 9 to 11 hours.
The American Academy of Pediatrics recommends that infants be place on their back or side for about the first 6 months of life. This will help reduce the risks of SIDS and of aspiration if the baby should throw up.
- Babies need their own beds to sleep in, and if space allows, their own room by age 2 to 4 months, to allow parents to continue as couples, undisturbed by early morning awakening and nighttime crying. This also will help the baby learn to put himself or herself back to sleep during the night when a little older and doesn't need night time feedings any more.
- During these first few months; your- baby's sleep-wake cycle may be confusing and tiring. Try to nap when your baby does.
- Often babies cry in the early to late evening hours and nothing seems to help. This period of crying usually stops in a few weeks as they mature and learn to stay awake for longer periods of time.
Newborn Screening Tests
The PKU test is required by State Law and was done before you left the hospital. This test is repeated at the two weeks well baby visit at. You will be notified only if the test is abnormal. Other screening tests are not done on a routine basis. If your baby needs a special test, such as hearing, or certain inherited conditions, your health care provider will discuss this with you and arrange for the tests to be scheduled.
Infectious Diseases
Help keep your baby healthy by limiting the number of visitors and making sure all company is healthy. Avoid exposing the baby to anyone who has an infectious disease (flu, colds, measles, chicken-pox, etc.) Avoid crowded places the first several months of life.
page last modified on: 5/7/2013