Newborn Care

Mindy Weighing Newborn

FOR THE BABY:

  1. Watch your baby. No one knows your baby as well as you do.  Call your midwife if you are concerned about anything with your baby.
  2. Cord Care:
    • Watch the cord, which usually falls off within three to 14 days after birth. It is normal for the cord to have an odor just before it falls off.
    • There should not be oozing at the cut end nor any redness where attached.
    • Do not let the cord become urine soaked.
    • Keep the baby’s diaper folded down so it doesn’t irritate the cord.
    • Please do not use alcohol, hydrogen peroxide, or honey on the cord.
    • After the cord falls off, the belly button may ooze clear, blood-tinged fluid for several days. Wipe gently with herbal bath if needed.
  3.  Urinating:
    • Your baby should urinate within the first 24 hours. Until your milk comes in, generally between two to five days postpartum, wet diapers may not be too frequent.
    • Baby should have a wet diaper for each day he/she is old. So on day one, one wet diaper, and on day two, two wet diapers. And so forth.
    • If you are concerned about whether or not your baby is peeing, you can place a tissue or paper towel in the diaper. The urine should look clear to pale yellow.
    • Sometimes babies pass uric acid crystals in their urine. This will look like a red or brick dust stain in the diaper and is normal in the first 24 to 48 hours. Please call if you see any after that time. Baby girls may have some spots of bloody mucus in their diapers, which is a normal response to your labor hormones.
  4. Bowel Movements:
    • Your baby’s first bowel movements are a black, tarry, sticky substance called meconium. The first bowel movement should be passed within 24 hours of birth and can be washed off with warm water or wipes. Many families use disposable diapers while their baby is passing meconium then switch to cloth. Please consider elimination communication and cloth diapering.
    • Applying coconutoil to your baby’s bottom will keep the meconium from sticking to his skin.
    • The stools will transition from meconium to a green-brown and then yellow-mustard color. This happens as your milk comes in. Once your milk is in, the yellow-mustard bowel movements will have a cottage cheese look, like curdles. This is normal.
    • Most newborns have a bowel movement with every feeding. Babieswho are only breastfeeding may not have a bowel movement after every feeding or even every day. This is because there is little to no waste with breast milk.
    • Chiropractic adjustments, massage, and cranial sacral work are very helpful to a baby who seems to be having digestive issues.
  5.  Warmth:
    • Keep baby warm, but not smothered. Your baby needs skin to skin contact to regulate their temperature, so it is up to you to make sure s/he is not too warm or cold. When your baby is skin to skin on your chest, your body will change temperature to keep baby warm.
    • Normal temperature ranges: 97.7 to 99.5 F underarm; heart rate: 110 to 160 (newborn) per minute; respirations per minute: 30 to 70 (when calm)
    • Baby’s hands and feet may turn blue. This is normal and has to do with their immature circulatory system.
    • Lots of body contact is a language that even the newest babies understand. Communicating with a newborn is mostly through touch. Stay near or with baby at all times. Provide skin to skin contact with the baby wearing only a diaper. Cuddle, rock, and carry your infant in a sling. You cannot spoil a baby. Baby them while they are babies and you will not have to later.
  6. Nurse at least every two hours. Baby can have one three to four hour sleep stretch in a 24 hour period.  Babies cannot tell time so schedules are out of the question. Be grateful for frequent nursing; it will keep mother from getting engorged and from excessive bleeding. Nursing will protect baby against jaundice and dehydration.
  7. Jaundice:
    • Most babies are born with extra red blood cells that are broken down and eliminated from the body in the first week of life. Bilirubinis a byproduct of this process and is a yellow pigment. Jaundice results when excess bilirubin accumulates in the blood.
    • More than half of all newborns become jaundiced within the first week of life. This is temporary and normal, and usually resolves itself without treatment.
    • Be aware of timing, severity, and location of jaundice. Normal jaundice starts on the second to third day of life and peaks at five to seven days after birth. It starts in the face and spreads downward as the blood level of bilirubin increases. It is usually gone by two weeks after birth.
    • Breastmilk will help rid the body of bilirubin, so nurse on demand. If your baby is sleepy or lethargic, you will need to wake him/her up and stimulate him/her to nurse often enough.
    • If your baby looks yellow, uncover him/her completely, and nurse baby in the sunshine. Having your baby naked in indirect sunlight for five to 15 minutes, several times a day, will help normal jaundice resolve more quickly. Even through a window or on an overcast day, the sun’s ultraviolet rays are a safe and effective treatment for normal jaundice. Nursing often is a must!
    • Less commonly, breastfed newborns have prolonged jaundice that lasts into the first few months of life. This is generally not a cause for concern (depending on the severity of the jaundice) when there are no other signs of illness or distress.
    • Contact me if your baby is jaundiced within the first 24 hours of birth, or if jaundice suddenly appears after the fifth day.
  8. If baby is a “lazy nurser”, here are a few tricks you can try: stimulating the baby with skin-to-skin contact, singing, stroking the cap of the baby’s head, or taking a bath with baby. Nursing often is a must.
  9. A newborn screening (PKU etc.) blood test is scheduled at 48 hours for babies born at home.
  10. The American Academy of Pediatrics does not recommend routine circumcision.  There is no medical reason to circumcise (In fact, there are medical reasons mot to.) Please consider reading some books on the subject. If circumcision is required please consider waiting until the 8th day (when newborn clotting factors peak) to prevent hemorrhage. Also please consider staying with your baby during the procedure.
  11. Enjoy your baby’s infancy. For the moment, the baby comes first. Be ruthless about this, or you will be overwhelmed with conflicting demands and feel awful about the baby being neglected. There is a honeymoon phase of parenthood when the new baby is all-absorbing, and this is as it should be. Do not let society rob you, and your family of the full enjoyment of this short time with baby. His / her needs, though consistent, are few and simple: and momma is the only one who can fully meet them during the early weeks. Baby’s infancy is so short and time flies – in 6-8 months he/she will be crawling away from you to meet the world and you will have to let baby go more each day. Enjoy this in arms time while you can.
  12. Breasts and Genitalia:
    • You may notice that your baby’s breast tissue may seem very prominent in the first few weeks. Some may even have a drop or two of pale white secretions, called “witches milk”. This is due to the hormones transferred to the baby in the womb and will go away as time progresses. The same hormones may cause the scrotum to be enlarged or the labia to be swollen.
    • Your baby girl may pass some thick white mucus (like ovulatory mucus) and possibly some blood from her vagina for up to a few days. This is caused by hormones as well. This is normal, temporary, and there is no cause for concern.
    • For baby boys, do not attempt to retract the foreskin. The foreskin is adhered to the glands of the penis.
  13. Bathing:
    • The herbal bath that is in your birth kit makes for a great bath for your baby. When you draw a bath for yourself, you can put your baby in the bath with you. This will help the cord stump dry up and fight off infection.
    • Do not give the baby a bath using commercial products such as Johnson and Johnson. These products are not good for the cord and can cause an infection. Just use the herbal bath as long as the cord is attached, and even after the cord falls off and the umbilicus is healing from the inside out.
  14. Eyes:
    • Sometimes babies may have a red spot or two in the eyes, caused by blood vessels which broke during birth. This will go away on its own.
    • Babies’ tear ducts do not create tears right away, which can allow for bacteria to grow. The eyesmay get a yellow/green discharge or become a little crusty. You can wipe them with a warm washcloth. If the discharge is green, please call your midwife.
    • Breastmilk is antibacterial and makes handy eyewash to prevent further discharge. You can also help your baby’s tear ducts by massaging them.
    • Most often, baby’s eyes are completely fine and there is no need for any of the above. Just be sure to watch out for any redness, swelling, or discharge. Particularly, if you have a known history of gonorrhea or chlamydia.
  15. Gas and Colic:
    • Gas is not always preventable, but there are many things you can do to help.
    • Gently massage your baby’s belly in a clockwise, circular motion to help move gas bubbles through.
    • Bicycle or roll your baby’s legs up to his/her chest to help bring the gas out.
    • You can also give your baby an herbal bath to help relax the muscles.
    • Spitting up is a common occurrence and does not mean that your baby is eating too much.
    • Taking your little one to a chiropractor and/or massage therapist can be very helpful as well.
  16. Skin:
    • Your baby’s skin may be dry and peeling within the first weeks after birth, which is normal as the baby switches from water skin to air skin.
    • Do not use mineral oil or baby oil on the baby (it leeches vitamins out of the skin).
    • You may notice that your baby’s hands and feet get a bluish tinge, especially if they get cool. It is not normal for the baby’s trunk, lips, or mouth to turn blue. If you notice this, call me or the baby’s care provider.
    • Introducing anything other than natural products to the baby’s skin often results in a reaction or irritation. Coconut oil is a good choice.
    • The baby may develop what is commonly called “normal newborn rash” (small red bumps with a white or yellow top), or its many variations. This does not require any treatment.
    • Watch for any pustules that break open to reveal pus. If you see any, please contact your care provider.
  17. WARNING SIGNS (If YOU NOTICE THESE IN YOUR BABY PLEASE CALL ME RIGHT AWAY!)
    • Temperature of 99.4 or higher
    • Diarrhea
    • Poor feeding
    • Pale or bluish color
    • Lethargy
    • Floppiness
    • Severe jaundice
    • Persistent restless crying
    • Bleeding from any body opening
    • Bruises of unknown origin
    • High-pitched cry
    • Vomiting
    • Glassy-eyed look

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