Congratulations on your new son or daughter. The following information is a guideline about what to expect in your first few weeks home.
Bathing and skin care
Give a brand-new baby sponge baths until the umbilical cord stump has fallen off and the penis is well healed (if your baby was circumcised.) Then you can begin regular baths. Bathing should take place in a warm room, free of drafts. The water should be warm, not hot -- test it before putting your baby in.
Never leave your baby alone in the bath -- not even to answer the phone or get a towel. Babies can easily lose their balance and drown in just a few inches of water. Never use a cotton swab to clean your baby's ears and nose; instead, a washcloth placed over your fingertips is sufficient. After drying the baby well, you can apply a non-perfumed, mild moisturizing lotion to areas of dry skin. Don't use oils except on the scalp -- they can cause rashes.
The umbilical cord usually falls off when your baby is 7-14 days old. (Sometimes it takes as long as 3-4 weeks and this is normal. If not, we can remove it in the office.) Until it falls off, clean the base of the cord with alcohol twice a day. A little bit of mild bleeding or clear drainage from the base of the cord is normal. However, let us know if there is heavy bleeding, pus or foul-smelling drainage, or if the skin around the cord becomes red.
Feeding your baby
Your baby should be burped to release air that is swallowed during feeding and crying. Try to burp your baby halfway through a feeding and then again at the end. To burp your baby, hold him or her against your chest facing over your shoulder, or sit the baby in your lap with his or her chin supported in your hand. Rub or pat the baby's back gently. If the baby doesn't burp, try again before the next feeding.
It's normal when...
Most infants have a number of surprising habits which are very normal.
- All babies sound congested. Adults and older children with stuffy noses will breathe through their mouths, but infants always breathe through their noses. Therefore, they often have a coarse, snuffly sound because their noses and sinus passages are so small. One tiny fleck of mucus in a small baby's nose can sound like a tornado! Babies who are around cigarette smoke or wood smoke are usually even more congested. If a baby is producing lots of mucus, he or she may have a mild cold. (Expect about 10 colds in your baby's first year.) Rather than using over-the- counter decongestants in these small infants, suck the mucus away with a rubber bulb. You can loosen the mucus first with warm saline nose drops. (See our instruction sheet on how to clean out a baby's nose.) If you can't see any mucus, using a bulb probably won't help much. Once kids get bigger and learn how to blow their noses, this problem goes away.
- All babies have irregular breathing. Babies pant and sigh frequently as part of their normal breathing pattern. Babies can have normal pauses in their breathing that can last up to ten seconds. On the other hand, babies should not gasp, turn blue, or have to tug their chests in and out to breathe.
- All young babies grunt, draw up their legs, and turn red when trying to pass a stool. Babies sometimes even cry just before stooling as if it is very painful, then pass a normal, formed soft stool. This is because they cannot sit up and bear down like older children or adults. Unless the stool is rock-hard or contains blood or pus, don't worry about how your baby acts with stooling.
- A new baby's stools are nothing like the normal stools of childhood. Right after birth they are sticky and greenish-black (called meconium.) Bottle fed babies' stools can vary in color and consistency, and can be yellow, green, or brown; they can be firm, mushy, or watery. Breastfed babies can have 2-12 yellow-green runny or mushy stools a day. Most babies, at 2-3 weeks of age, will at some point go 3-4 days without any stools. This is completely normal. Many parents become quite worried and rush for suppositories, laxatives, different formulas, etc. if the baby goes for more than a day without stooling. Resist the urge to do this: not stooling is harmless, but some remedies to induce stooling can be. Remember, stools are waste products left over from what the baby does not digest. If the baby is just very good at absorbing and digesting his or her milk, there may not be much waste product left over! When the baby is ready to have a stool, he or she will have one. Unless the baby goes for more than 5 days without any stool and is otherwise happy and healthy, it is rarely a cause for concern.
- All babies can have blocked tear ducts. Babies have very small tear ducts (found on the inside bottom corner of the eyes.) If blocked, there can be eye mattering and "goopy" drainage. Unless the white part of the eye is red, the eye isn't infected. See our information sheet on blocked tear ducts.
- Babies can get lots of marks, patches, and rashes on their skin in the first few weeks of life. In the first week of life, most infants get at least a little bit jaundiced, but usually this is normal unless the jaundice becomes very severe. In the first week, red "flea bite" splotches are common. For two weeks, hands and feet tend to peel like after being in a bath too long (the baby was in a "bath" for nine months.) They're not attractive, but they're harmless and will go away. If you are concerned about a particular rash, let us know.
- All babies scream and cry - a lot. Some healthy babies, by the time they are 2 months old, can cry for 2 or 3 hours continuously each day. Babies cry to express emotion when anything is wrong: hunger, discomfort, boredom, gas, loneliness, fatigue, and illness. There's no hard or fast rule as to how long you should let a baby cry. However, crying never hurts a healthy baby.
Keeping your baby healthy
Until a baby is about 2 months old, we take any kind of illness very seriously. If your baby has a temperature of above 100.4 before he or she is 2 months old, let us know right away, day or night. (After a baby is about 2 months old, his or her immune system is developed enough to fight off the usual germs, and a fever itself is not really that concerning. See our information sheet on fever for more information.)
The best way to take the temperature in a baby is rectally (in the bottom.) See our information sheet on taking a child's temperature.
In order to keep a baby well through this critical time, no one who is sick should be in the same room as the baby. That means:
- No kisses from older siblings with the sniffles.
- No visitors with coughs or colds. Do not be afraid of asking visitors to come back at another time when they are well. (Learning to say "no" is one of the hardest parts of being a new parent.)
- No trips to the mall or store with the baby. Everyone at Wal-Mart will want to see your beautiful new baby. With dozens of well-wishers leaning over her to coo at her, someone is likely to spread germs to her.
- No daycare or church nursery until 2-3 months old, if you can possibly help it. Again, we assume that in a roomful of toddlers, at least one of them is contagious with something that may be mild for them, but could potentially be much more severe for the baby.
- No smoking in the house, ever. Infants around cigarette smoke have so many more ear, nose, and lung problems. If you can't quit smoking (or make Grandma quit), then at least keep the smoke outside. Just smoking in a different room of the house is useless: all the air in a home recirculates eventually.
You will have lots of questions about your baby in the months to come. Let us know how we can help you.