Newborn Baby Bootcamp: Taking Care of a Newborn

Every new mom and new dad needs some help. Here's everything you need to know about sleeping, breastfeeding, crying and more to get through those first few weeks with a new baby.
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You've no doubt been dreaming about your baby for months: what he'll look like, whether he'll be laid-back like his dad or a Type A like you. But chances are, if it's your first child, you don't know much about taking care of a newborn.

Well, we've been there, and we're here for you, with everything you need to know to care for your baby in those exciting but often frustrating first weeks. Let's get started!

Getting Started in the Hospital

Breastfeed ASAP
Have your newborn "room in" with you rather than stay in the hospital nursery, and ask the nurses not to offer him anything in a bottle. Even if the baby doesn't actually latch on, you can squeeze the yellowish colostrum—the precursor to real breast milk that's packed with immune-boosting nutrients—directly into his mouth. 

Stall the Visitors
Family and friends will want to visit as soon as possible, but you may want to keep them at bay for a bit so that you and your partner can spend time alone with your baby. Because a newborn is usually alert and receptive immediately after birth, it's the perfect time to bond, so look him in the eyes and talk to him. He knows your voice from being in your body and may find it soothing.

Dress Your Baby Right
A cute going-home outfit is irresistible, but remember that babies cannot regulate their body temperature until they're about 6 months old. So dress your newborn carefully. Generally, he should wear the same amount of clothing as you, indoors or outdoors. Don't overbundle him—sweating can cause him to become chilled. Layers are a good way to go.

Car Seat 101

A few weeks before your due date, visit seatcheck.org or call 866-SEAT-CHECK to locate a certified child passenger safety expert who can make sure the car seat is installed properly in your vehicle. Ask your partner to bring the seat to your hospital room when it's time to go home. The basics:

  1. If your baby has too many clothes on, the harness may not fit properly. If it's cold out, put your baby in the seat first, buckle him in, then place blankets on top.
  2. The harness must be snug against the hips and shoulders.
  3. The chest clip should be level with your baby's armpits.
  4. The seat must be installed at a 45-degree angle so that the baby is semi-reclining; his head must not flop forward.
  5. Once the seat is installed, push on it—hard. It shouldn't move more than an inch in any direction.

Breastfeeding Basics

Nursing may be natural, but it can prove difficult for some women. These strategies will help.

Don't Delay
Breastfeeding seems to go more smoothly for women who nurse within an hour of delivery. Don't be afraid to request help—most hospitals have lactation consultants on staff. 

Nurse on Demand
During the first six weeks, it's essential to let your baby nurse whenever he wants. Trying to establish a feeding schedule too early can backfire by interfering with your milk supply. Don't worry about having enough milk—the more your baby eats, the more you'll produce.

Learn to Latch
Your baby needs to have a deep latch in order to get enough milk and to prevent your nipples from becoming damaged and sore. Before you put him to your breast, position him on his side so that his belly is right up against yours. Then tickle his mouth with your nipple to encourage him to open wide; make sure he takes the entire nipple and a good portion of your areola in his mouth.

Create a "Nursing Nest"
Though not essential, a glider, rocker or cushy chair with an ottoman or footstool are helpful. Wherever you nurse, have plenty of pillows (for back support and to help position the baby properly at your breast), water, snacks, a good book and the TV remote.

Feed Your Milk Supply
Drink at least eight glasses of liquids a day. Depending on your age, metabolism and activity level, your calorie needs will likely be 2,200 to 2,400 daily. The good news: Breastfeeding moms tend to lose 1 to 4 pounds a month even with the added calories.

Baby Formula Facts

Some women cannot breastfeed; others need to supplement with formula occasionally. Commercial formulas are largely the same—the U.S. Food and Drug Administration regulates formulas to ensure they're safe and contain the most important nutrients. Ask your pediatrician if she recommends a formula with added iron, DHA, or other nutrients. Your choice of powder, liquid, or concentrate primarily boils down to issues of cost and convenience.

Fear of an allergic reaction makes some parents reluctant to give their babies milk-based formula brands, but only 3 percent to 4 percent of infants have a true milk allergy. Surprisingly, soy formula may not be a good alternative for babies with a milk allergy because those babies may also have an intolerance to soy protein.

However, soy-based formula is a good choice for parents who don't want their babies to eat animal products. Hypoallergenic formulas break down milk proteins so that they're more easily digested.

Try these tips to make formula feeding easier:

  • Heat formula in a pan of warm water or a bottle warmer; microwaving can create dangerous hot spots.
  • Use room-temperature formula within two to four hours; after that, you should discard it.
  • Use refrigerated formula within 48 hours.
  • Don't freeze formula, which robs it of nutritional value.
  • Don't save any formula your baby leaves behind in the bottle. Bacteria from her saliva can contaminate it.

 

Newborn Care from Head to Toe

Follow these simple, doctor-recommended tips for keeping your baby clean and comfy.

Face

It's disconcerting to see a newborn with a red, blotchy face, but baby acne is a common and harmless condition.

Care tip: Wash your baby's face daily with a mild baby soap.

Eyes

Some babies have a yellowish discharge or crusting in the eye or on the lid, which is usually caused by a blocked tear duct. This condition can last several months.

Care tip: Wipe the area using a cotton ball moistened with warm water.

Scalp

Many newborns develop a scaly scalp condition called cradle cap. It typically disappears in the first few months.

Care tip: Wash your baby's hair with a gentle baby shampoo no more than three times a week and gently brush out the scales daily using a baby hairbrush or soft toothbrush.

Nose

Babies' narrow nasal passages tend to fill with mucus.

Care tip: Gently unclog nostrils with an infant-sized nasal bulb syringe or try the trauma-minimizing Nosefrida (nosefrida.com). To loosen mucus, insert saline solution with an eyedropper before suctioning.

Nails

A newborn's nails usually are soft, but they can scratch his sensitive skin.

Care tip: Use baby nail clippers or blunt-nosed scissors. Clip after his bath when nails are soft, or when he's asleep and his fingers are relaxed.

Skin

Some babies develop red, itchy patches called eczema or atopic dermatitis—an inheritable skin condition.

Care tip: Limit baths to 10 minutes, and use a mild, fragrance-free soap and lukewarm water; liberally apply hypoallergenic skin cream immediately afterward. Stick to cotton clothing.

Bottom

Too much moisture plus sensitive skin can equal diaper rash for many babies.

Care tip: Change diapers frequently. Rinse your baby's bottom with water during each change and blot dry. Avoid using wipes; they may irritate skin. Barrier creams, such as petroleum jelly or white zinc oxide, may help.

Umbilical Cord

Keep the umbilical cord stump clean and dry; it will shrivel and fall off within a few weeks.

Care tip: Avoid covering the cord area with a diaper and stick to sponge baths until the stump detaches.

Circumcision

The tip of the penis will be swollen, and a yellow scab will appear.

Care tip: Gently clean the genital area with warm water daily. Use petroleum jelly to protect the site and prevent the penis from sticking to a diaper.

Legs

Newborns' legs are bowed out and the feet are turned in, which is no surprise, given their previous cramped living quarters.

Care tip: Don't worry about it—your baby's legs and feet will straighten in anywhere from six to 18 months.

Feet

Newborns' toes frequently overlap and the nails look ingrown (but aren't).

Care tip: Don't sweat it—this appearance is perfectly normal.

Newborn Sleep Survival Guide

Sleep Close to Baby Being close to his mother regulates a baby's heart rate, immune system, and stress levels and makes breastfeeding easier, says James McKenna, Ph.D., director of the Mother-Baby Behavioral Sleep Laboratory at University of Notre Dame in Indiana. "It also keeps the baby in lighter phases of sleep so he can practice arousing and going back to sleep, which is good in case of any problems, such as sleep apnea."

It may also be linked to a decreased risk of sudden infant death syndrome (SIDS). A bedside or freestanding (but nearby) bassinet is a good option. Various experts, including the American Academy of Pediatrics, advise parents not to sleep with their babies because of the danger of suffocation.

Day vs. Night "Encourage him to switch," says Jodi Mindell, Ph.D., associate director of the Sleep Center, Children's Hospital in Philadelphia and author of Sleeping Through the Night: How Infants, Toddlers and Their Parents Can Get a Good Night's Sleep (HarperCollins). "At night, keep the lights low and move slowly when you feed him. Be boring. Make sure he gets bright light in the morning, and keep him as busy as you can during the day. Make noise. Play with him." In other words, during the day, be interesting.

Bedtime Rituals "Sleep time should be consistent," Mindell says. "Each family has to develop its own routine, but doing the same activities in the same order every day helps the baby anticipate what will come next." Mindell suggests doing three or four winding-down activities for a total of 20 to 30 minutes; these can include massages, baths, lullabies, prayers, rocking, nursing, and reading.

Rocking baby "If you are doing this and your baby is sleeping all night, don't worry," says Jennifer Waldburger, L.C.S.W., co-owner of Los Angeles-based Sleepy Planet and author of the book and DVD The Sleepeasy Solution. "After about four months, if he is waking up, you probably need to let him do the last little bit of falling asleep on his own. You can still rock him as part of the wind-down process, but put him down drowsy, not asleep.

Baby Naps Look to your baby for his evolving schedule after about three months—before that, anything goes. "You don't have to be rigid," Mindell says, "but some structure helps both parents and baby. By age nine months, most babies naturally move to napping at around 9 a.m. and 2 p.m." But don't try to force a schedule on your baby for your convenience.

Crying it Out Waldburger and other experts suggest that when he's about 5 months old, you can experiment with letting your baby cry a bit at night. (That does not mean letting him scream for hours.) Try starting with five minutes, Waldburger suggests; if that's too hard to take, pick him up after three minutes. "It sounds cruel not to pick up a crying baby," she says, "but we find that teaching babies how to calm themselves is really kinder in the long run.

Baby-Care Boot Camp

Taking care of a tiny infant can be scary. Here's the knowledge you need to feel and act like a pro when it comes to three particularly intimidating tasks.

1. Deciphering His Poop 

Sometime during your hospital stay, your baby will pass a thick black or dark-green substance called meconium; this is normal. Within a few days, a breastfed baby will begin having six to eight bowel movements daily; these will be soft and yellow-green and sometimes filled with seedlike particles. If your baby is formula-fed, he will likely have one to two stools per day; they'll be thicker and yellow/tan in color. Unless your baby has signs of diarrhea, wide variations in color, consistency and frequency are normal.

2. Dealing with Crying 

  • Rule out the obvious potential causes: Check to see if the baby's diaper is soiled, if he's too hot or cold, or if his diaper or clothing is pinching him.
  • Let him suck on your breast, a bottle, your finger, or a pacifier. (If you're breastfeeding, don't offer a pacifier until nursing is going smoothly, usually when the baby is 4 weeks to 6 weeks old.)
  • Re-create a womblike environment by swaddling him securely in a blanket with his arms tucked inside. Then hold him snugly on his left side or stomach and jiggle him gently while making loud "shushing" sounds in his ear..
  • Walk, rock, sway, take him for a car or stroller ride, or put him in an infant swing. (Babies love motion!)
  • Above all, keep your cool! If you're tense, your baby will be, too. Remember that babies just cry—and it will pass.

3. Baby Fevers 

Fever can be a sign of serious illness, especially in a baby younger than 2 months old. Call your pediatrician if your newborn's rectal temperature hits 100.4° F; 102° F if your baby is 2 months or older. Also watch for other signs of illness: If your baby just isn't acting right, eating, or drinking, or seems to be in pain, contact the doctor regardless of his temperature. A low-grade fever (99° F to 100° F) itself isn't harmful, so if your baby shows no signs of discomfort, trying to reduce it is not necessary

A temp of 101° F or higher might warrant medication. If your older baby's temperature is this high, giving him Infants' Tylenol may ease his discomfort and help him sleep and eat. (Never give aspirin to a child of any age.) Just remember that reducing a child's fever can pose a problem: When he begins to feel better, it can be difficult to assess how sick he actually is.

However, any fever of 101° F or higher that lasts more than two days, especially if your baby is coughing, warrants a call to the doc to rule out urinary tract or other bacterial infections.

Always Call the Pediatrician if Your Baby...

  • Has a fever of 100.4° F or higher if the baby is 2 months or younger; 102° F if he's older than 2 months
  • Shows changes in his eating patterns, such as refusing to nurse
  • Has very watery or mucusy stools
  • Is excessively sleepy, lethargic or unresponsive
  • Is excessively irritable and cries unconsolably for longer than normal
  • Has a red or swollen rash anywhere on his body 
  • Has redness or swelling at the base of his umbilical cord
  • Exhibits discomfort (e.g., straining) when he moves his bowels
  • Has a distended abdomen or vomits (as opposed to spitting up)

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