newborn care information

The World of Pediatrics has included this page to assist new parents in caring for their newborn infants.

This is a wonderful time in your lives and full of joy. However, we completely understand that it can, also, be confusing and even scary at times taking care of a person so small and helpless.

We have addressed some of the most common questions and concerns that we have found among our parents to be and new parents. Congratulations and we wish you the all the best in the years to come!

Your Baby at the Hospital

Below is a list of items that you might find useful to have on hand at the hospital:

  • Vaseline or petroleum jelly – It is great to put on your babies bottom and genital area before their first stool. Use it like diaper cream each and every time that you change their diaper to keep meconium stools (tar like, black, newborn stools) from sticking to babies bottoms and making it difficult to clean them properly.
  • NO BABY POWDER – Disposable diapers are able to wick away moisture from the baby's bottom, so this is no longer necessary. Also, it can be inhaled into a newborn's or infant's lungs and you want to avoid this.
  • Mittens – Mittens are put on your newborn's hands to keep them from scratching themselves with their nails.
  • Booties or Socks - Booties or Socks help your baby retain body heat and keep their temperature stable.
  • Caps – Caps help your baby retain body heat and keep their temperature stable.
  • Car Seat- An infant car seat is required prior to discharge from most hospitals.
  • Baby Clothes - A few infant gowns. A take home outfit is nice to have, too. Also, remember many hospitals take newborn pictures.
  • Infant Blankets – Soft infant blankets help keep your baby warm and swaddling them makes them feel safe.
  • Newborn diapers and wipes – Although many hospitals supply these, you may want to bring some with you.
  • Pacifiers – You may want to take several types (newborn or 0 sized), because your newborn will have a preference.
Your Baby at Home

The items listed below are suggestions of what you might find useful to have at home.

Basic Necessities

  • Rectal Thermometer
  • Digital Thermometer
  • Nail Clippers
  • Nail File
  • Bulb syringe
  • Petroleum Jelly
  • First Aid Kit
  • Humidifier
  • Saline Nose Drops
  • Infant Tylenol
  • Mylicon
  • Antibiotic Cream (Neosporin)
  • Diaper Rash Ointment
  • Q-tips
  • Cotton Balls
  • Baby Washcloths (at least 6-12)
  • Baby Hooded Towels (at least 3-6)
  • Baby tub
  • Baby soap (combined formula for hair and body are easier)
  • Lotion (Aquaphor is recommended)
  • Brush and Comb
  • Diapers
  • Wipes
  • Diaper Bag with changing pad
  • Bottles with nipples (minimum 12)
  • Bottle Brush
  • Mild Laundry Detergent (Free and Clear of Dyes and Perfumes)
  • Dryer Sheets or Laundry Softener (Free and Clear of Dyes and Perfumes)
  • Bleach
  • Spray Sanitizer & Disinfectant (example: Lysol)
  • Pacifiers (several types size 0 or newborn, your baby will have a preference)
  • Cloth Diapers - Folded (several packages- you will need these for burp cloths)

Basic Layette

  • Onesies (at least 3-6)
  • Hats and Booties (at least 3-6)
  • Receiving Blankets (at least 3-6)
  • Sleep & Play outfits (at least 3-6)
  • Bibs (at least 3-6) Gowns (at least 3-6)
  • Gowns (at least 3-6)
  • Diapers (Figure using 8 disposable diapers per day minimum)
  • Wipes
  • Cloth Diapers (burp cloths)
  • Baby Hooded Towels and Washcloths

Crib and Basinet Bedding

  • Bedding Set (Comforter, skirt, fitted sheet, diaper stacker.)
  • Fitted Sheets (3-6, you will need several changes)
  • Mattress Pads (3-4, you will need many changes)

Furniture & Durable Baby Accessories

  • Basinet
  • Basinet Mattress
  • Crib
  • Crib Mattress
  • Rocking Chair
  • Stroller
  • Bouncer Infant Seat
  • Diaper Pail
  • Baby Monitor
  • Highchair (not immediately)
  • Playpen (not immediately)
  • Changing Table
  • Changing Pad and Several Covers
  • Baby Bath Tub & Insert

Safety Necessities

  • Smoke Detector for Baby's Room
  • Carbon Monoxide Detector
  • Outlet Covers
  • Drawer Latches
  • Safety Gates
  • TV and VCR Covers
  • Bathtub Spout Cover

If you are breast feeding

  • Nursing Pillow
  • Nursing Stool
  • Nursing Pads (12-14, Washable, 100% Cotton)
  • Nighttime Nursing Gowns (2-4)
  • Nursing Bras 3-6
  • Nursing Tops or shirts with buttons down the front
  • Breast Pump (Electric is easier and faster)

Helpful Extras to Make Life More Comfortable

  • Baby Carrier (ie. front pack or sling)
  • Swing
  • Car Rear Window Mirrors (Allows you to see your baby in the back seat.)
  • Head support - Padded Seat
  • Soothing Music that contains Heartbeat and Womb Sounds
  • Crib Mobile
  • Foot and Wrist Rattles
  • Dishwasher Basket for Nipples and Rings
  • Car Seat Protector (Protects upholstery beneath and around the car seat.)
  • Stroller Cup Holder (Attaches to handle or side.)
  • Baby Milestones and Memories Book
  • Nightlight
  • Newborn Toys

Things to Buy Later...5 months and older

  • Bath Seat
  • Exercise saucer
  • Books
  • Feeding Dishes with Covers and Utensils
  • Tub Toys
  • Toddler Car Seat
Umbilical Cord Care

Your newborn’s umbilical cord usually falls off after 7-10 days. DO NOT PULL THE CORD OFF. Our office should be informed of any redness, foul odor, or drainage from around the site. Keep your baby’s diaper folded down below the naval to keep the area dry and let air in.

Circumcision

Whether to circumcise your child or not is a personal decision. Your obstetrician can perform the circumcision in the hospital before your baby is discharged or a mohel can perform the circumcision when it is customary. If your child is circumcised, apply petroleum jelly to the tip of the penis with each diaper change and cover with a gauze pad for approximately one week when circumcision should be healed. Our office should be informed of any bleeding, unusual swelling, drainage, inability to urinate, or pain during urination.

Normal Childhood Sleep Patterns

All children are different, but the average newborn up to eight weeks of age will sleep a total of 16-18 hours a day and require about 1-3 feedings per night. The average infant from eight weeks old to six months of age will typically sleep a total of 14-16 hours a day, including about 6-8 hours per night. Infants from six months old to twelve months of age, also sleep approximately 14-16 hours per day, but approximately 10-12 hours of this time is at night.

Guideline for providing a good sleeping environment:

  • A white noise machine can help a child sleep with sounds of the ocean or rain.
  • The room should be dark, cool, and quiet.
  • Dress your child appropriately for the temperature (not too warm and not too cold)
  • Once you and your child have discovered your schedule, Keep To It (Have a consistent time to wake-up, consistent nap time, and consistent time to go to bed)
  • Limit play to calm activities an hour or so before bedtime
  • Keep a consistent bedtime routine (e.g. bath, brush teeth, toilet, story)
  • Allow a child to have soothing objects to comfort them. Many times it is a such a favorite blanket or stuffed animal. (Hint: once your child latches on to a particular object, go buy several backup replacements in case they are lost, damaged, or need to be washed.)
Safe Sleep Guidelines

The Academy of Pediatrics recommends that all infants should be placed on their backs when being put down to sleep until at least twelve months of age.

Use a crib that meets federal safety standards (many old cribs do not meet current guidelines). The mattress should fit snugly against the crib with no more than a two finger space between the mattress and the crib. The mattress should, also, be a firm mattress so that the child doesn't sink. Don't use crib bumpers; an infant's head can become wedged between the bumper and the mattress.

Don't fill the crib with stuffed animals or let the baby sleep on soft bedding such as comforters, pillows, beanbag cushions, or sheepskins. Make certain that in the event that your child rolls over and is face down on bedding or the mattress, that they can still get sufficient oxygen.

Don't EVER let your infant sleep on an adult waterbed. DO NOT EVER PUT PILLOWS IN YOUR INFANT'S BED.

Newborn Fever

Regardless of your child's age, you should contact our office if a fever of any level has persisted for longer than three days. If your child is not drinking, can not be comforted, is irritable, cries constantly, cannot sleep, and is not feeding well, please contact your pediatrician immediately. If your child is having difficulty breathing, is lethargic, is having a seizure, or has a convulsion call 911 immediately.

Fever is a symptom or sign that a child's immune system is trying to fight off an infection or illness. A fever can make a child miserable and uncomfortable.

Newborn fevers (infants less than 3 months old) are treated differently than older children. You should inform our office immediately if any infant between birth to 3 months of age has a rectal temperature of 100.4° F or under 97.5° F. A low grade fever in an infant this young could signal a serious infection such as a kidney infection or a systemic infection like group B strep. All infants under 2 months with a rectal temperature over 100.4° F need to be seen by our office immediately so they can have the necessary tests to rule out bacterial infection. Also, because bacteria in newborns can more easily pass into the spinal fluid, a spinal tap may be needed to determine that the child is not in the process of developing meningitis.

For young infants, temperatures should be taken rectally. Place the infant on its abdomen or on its back with knees to chest. Insert a thermometer gently into the anus about 1/4 of an inch. Squeeze the buttocks together to keep the thermometer in place instead of holding it in your hand. You can remove it in about 30 seconds or when you hear a digital thermometer beep.

Axillary temperatures can be used for toddlers and older children. Put a standard thermometer under the child's arm so it touches both layers of skin. Hold it for one minute or until digital beeps.

Tympanic thermometers usually read slightly high if a child is crying. Sometimes you will get a 103 or 104 reading when the child is actually 102. The temperature reading can also be underestimated if there is a lot of wax in the ears, or the child is moving.

Note: Feeling the child's forehead or kissing their cheek is not a reliable way to tell if your child has a fever.

Contact your pediatrician for any of the following fevers:
birth - 3 months: 100° F rectal temp
3 months - 12 months: 101° F rectal temp
Any child with a temperature of 102.5° F or higher

IMPORTANT NOTE: If your child has had immunizations, a temperature of 101 - 102 per rectum is not unusual at 24-48 hours. If this occurs you still need to speak with your pediatrician's office.

Diaper Rash

Diaper rash is a common occurrence for most infants. The rash can vary from mild to severe. It is caused by irritation of the skin from urine and bowel movements. Changing an infant's diaper immediately after your child has urinated and/or had a bowel movement and cleansing the skin thoroughly are the most effective measures you can take to prevent diaper rash. Using petroleum jelly or a diaper cream to protect the skin prior to putting a fresh diaper on can also help protect your child's sensitive skin from developing a diaper rash. In the event that your child develops a diaper rash, with proper care and treatment the rash is usually better in 3-5 days.

To aid in caring for diaper rash:

  • Change diapers frequently. Make sure your baby's bottom is completely dry before closing up the fresh diaper. Increase air exposure.
  • Leave baby's bottom exposed to air for 15 minutes 4 times per day, either during naps or after a bowel movement. Put a towel or diaper under your baby. When diaper is on, fasten it loosely.
  • Rinse skin with warm water and a wash cloth. Do not use diaper wipes when baby has a diaper rash, because they have alcohol and can burn and exacerbate the condition. If the rash is quite raw, use warm water soaks for 15 minutes 3 times per day.
  • If the rash is bright red, weeping, continues to look worse, or does not respond in 3 days of warm water cleansing and air exposure, your child may have a yeast infection. Please, contact your pediatrician for an appointment.
  • Please, contact our office for an appointment.

CONTACT OUR OFFICE IF:

  • If the rash has yellow pus, pimples, blisters, spreading redness or open sores.
  • If the rash is red, weeping, or bleeding
  • If the rash doesn't improve in 3 days
Constipation

Constipation occurs when bowel movements are abnormally hard and infrequent accompanied by pain and discomfort.

It is a common practice for babies to grunt, push, strain, draw up their legs, squat, and become flushed in the face during passage of bowel movements, but they shouldn't cry. If they are straining, you can assist your baby by holding their knees toward or against the chest to give them something to push against. Your baby, over time, will go through bowel pattern changes. They might change from having bowel movements 3 - 4 times every day to having one bowel movement every 3 - 4 days. This is normal as long as the stool stays soft and/or your child is not in pain.

Constipation can usually be relieved or diminished with changes to your child's diet. You may want to try gradually increasing your child's water/liquid intake. If your child is eating solid foods, increase the amount of high fiber foods that they eat. This includes fruits and vegetables like prunes, apricots, raisins, plums, peas, beans, etc. Increase their whole grain foods like cereals, whole grain muffins, graham crackers, oatmeal, brown rice and whole wheat bread. You should limit the amount of bananas, cheese, white bread and potatoes that they get. Just try a few changes at a time until the issue has been resolved.

If your child is between 6 months and 1 year of age, give one ounce of water per each month of age (not to exceed a total of 6 ounces) each day. If this does not work, then you can try to give 2 ounces of a 50/50 blend of water and fruit juice (apple, white grape, or pear) each day.

If your child is older than one year of age, increase their water intake to 4-5 glasses per day. Also, you may give apple and/or prune juice twice a day.

CONTACT OUR OFFICE IF:

  • If your child has cramps and/or pain that lasts over 2 hours
  • If your child doesn't have a bowel movement in 2-3 days after diet changes.
  • If your child has blood in the stool
  • If your child begins to vomit, run a fever, or other symptoms manifest themselves.
  • DO NOT use any laxatives, enemas, or suppositories without consulting your pediatrician.
Gas

All babies experience gas and gas pains during their infancy. Excessive gassiness can be caused by exposure to gas producing foods, an underdeveloped digestive system, or air bubbles that become caught in the infant's stomach. Finding relief in your baby’s gas will make him/her a much more content baby.

Steps recommended to help relieve gas pains:

  • Burp your infant often. In order to relieve and prevent gas, a baby needs to be burped during feedings. This will reduce the amount of air that becomes trapped in the stomach.
  • Consider your infant's diet or your diet if breastfeeding. If you are breastfeeding and your baby seems to get gas after you eat a particular food, you should avoid it. Once the baby begins solids, eliminate any foods that his tummy does not tolerate well.
  • Apply pressure to the stomach area. Lightly pressing on a baby's tummy can help her pass the trapped gas.
  • Work his legs. Pumping your infant's legs back and forth while he lays on his back will help him experience less gas pains.
  • Give gas relief drops. These over the counter drops contain simethicone which has been found to help treat gas pain. Mylicon is a popular manufacturer of simethicone drops.
Check-up and Immunization Schedule
Typical Newborn and Infant Check-up and Immunization Schedule as of 2008
Age Physical Exam Immunizations Tests/Screenings
Birth Exam Hep B #1 at hospital Hearing, Metabolic Screening (after 24 hrs.)
48 Hours to 1 Week Exam    
2 Weeks Exam    
1 Month Exam Hep B #2  
2 Months Exam IPV #1, DTaP #1, Hep B #2 (if not given at 1 month), Hib #1, PCV7 #1, Rotavirus #1  
4 Months Exam IPV #2, DTaP #2, Hib #2, PCV7 #2, Rotavirus #2  
6 Months Exam IPV #3, DTaP #3, Hep B #3, Hib #3, PCV7 #3, Rotavirus #3 Influenza if Fall/Winter and then annually  
9 Months Exam Hep B #3 (if not given at 6 months) Iron
12 Months Exam Varicella # 1, PCV7 #4 Lead Level
15 Months Exam MMR #1, Hep A #1, Hib #4, DTAP #4  
18 Months Exam    
2 Years Exam Hep A #2 Iron, Lead Level
Notes: Combinations may be used. Schedule subject to change depending on combinations used and availability of vaccines as determined by the CDC.
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