Baby-Care Basics

Essential skills for every brand-new parent.

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Used to be, a new mom spent several days in the hospital after giving birth learning how to take care of her baby. But today, many mothers go home exhausted 48 hours after delivery.

"The teaching that used to take place during those longer hospital stays isn't getting done, and mothers are too tired to read the discharge instructions the hospital gives them," says Suzanne Corrigan, M.D., clinical associate professor at the University of Texas Southwestern Medical Center in Dallas. "If it's just you, your husband and the baby at home, you need all the help you can get."

As a new mom, you can circumvent this trend by asking for help, both at the hospital and at home, and by reading up before you are discharged, starting with this baby-care primer.

But don't get so anxious and bogged down in the practical details of caring for your newborn that you don't savor the special moments that happen every day. Relax and enjoy your time together. Remember, in a decade or so, this same cuddly bundle may slap a "Do Not Enter!" sign on her bedroom door.

How to Calm a Crying Baby Before long, you'll be able to distinguish your baby's hunger cry from her fatigue cry. In the meantime, first make sure she's not wet, hungry, or overly hot or cold. Then try these methods of soothing her:

-Nurse her.

-Rock, sway or walk with the baby in your arms or in a sling or front carrier.

-Stroke her head or tummy, or give her a gentle full-body massage. Patting her back may release a trapped burp.

-Take her outside for a short time. Fresh air and new distractions often do the trick.

-Swaddle her snugly in a "security blanket."

-Sing or talk to her.

Remember that too much stimulation can overwhelm your baby and make her cry more. Lower your voice, move more slowly, stop whatever hasn't been working and simply cuddle your baby in a dimly lit room.

You can see more about soothing a baby with this video from Dr. Harvey Karp. It has step-by-steps directions for soothing a baby.

How to Care for the Cord Stump The indigo-blue dye that is used to paint your baby's umbilical cord stump helps prevents infection, but it also keeps the cord from detaching as quickly as it used to — in most cases it takes two to three weeks. As a result, you'll spend more time cleaning the area than your mother did in her day. Don't let this fact scare you off. "Everybody's afraid of the cord stump," says Corrigan, "but it has no pain endings. It's basically dead tissue, like a scab that needs to fall off.

Until that happens, keep your baby's umbilical cord stump dry and stick to sponge baths. Also, use newborn diapers with a specially designed cutout, or simply fold the diaper below the stump. Cleaning the area with alcohol at every diaper change also will help dry up the stump. Pull the skin away from the base and clean all the way around it using a Q-tip, rather than a cotton ball, for easier access and more precision.

How to Bathe Your Baby As long as you're doing a good job of cleaning your baby's diaper area during changes, two or three baths a week probably are plenty. A sponge bath with water usually will do the trick, especially until the umbilical cord stump falls off. In the winter months, when skin is likely to become dry or flaky, you may want to bathe her even less. Whether you're giving a sponge or tub bath, always test the water temperature using your elbow or the inside of your wrist (the water should be lukewarm), and have all your supplies — towel, washcloth, baby soap and shampoo — within reach before you begin. Stick with mild, unscented products formulated for babies.

Encircle your baby with your arm and hold her firmly under her armpit. Wash her face with plain water only, then move from the cleanest to the dirtiest parts (do the diaper area last). "Pay special attention to the folds in the neck, under the arms and the creases in joints, which are especially prone to rashes," says Linda Carlson, R.N., M.S., a pediatric nurse practitioner who teaches pediatrics at Georgia Southern University in Statesboro, Ga. To keep your baby from getting cold, shampoo her hair at the end of the bath.

Although some little ones enjoy a post-bath massage, oils and lotions are not necessary, and many experts caution against using powders, which are easily inhaled.

How to Care for the Circumcised Penis After some circumcisions, the penis is wrapped in petroleum jelly-impregnated gauze for 24 to 48 hours. In this case, continue to cover the penis with petroleum jelly as the penis heals — usually less than a week. "This acts as a barrier to urine and stool, as well as a lubricant to keep any remaining foreskin or the diaper from sticking to the glans [the head of the penis]," says Miriam Bar-on, M.D., a professor of pediatrics at Loyola University's Ronald McDonald Children's Hospital in Chicago. If the penis is not covered by gauze and stool gets on it, all you generally need to do is clean the area with clear water.

You can use a rectal or underarm (also called axillary) reading to diagnose fever in a newborn. (Ear thermometers can be used but aren't as accurate.) For a rectal reading, lubricate the thermometer with petroleum jelly, insert the instrument about an inch and leave it in, holding it steady, for three minutes. Fever in an infant is defined as an oral temperature of more than 100.5° F; to get the oral equivalent, add 1 degree to an underarm reading, or subtract a degree from a rectal reading.

How to Dress Her for Comfort Your baby generally should wear one more layer of clothing than you do. If her chest or abdomen feels cool, or if she's shivering, she may not be dressed warmly enough. You can't tell whether she is too chilly by feeling her hands and feet, which may be cool because her circulatory system still is developing. Instead, says Bar-on, look for mottling — blotchy, marbled-looking skin — on the shoulders and chest (mottled arms and legs aren't cause for concern). Note: Darker-skinned babies may not appear mottled.

Not all babies sweat effectively, but a damp neck may signal an infant who is too hot. Fast breathing also can be a sign of overheating. Overbundling and soft bedding such as quilts and comforters have been linked to sudden infant death syndrome, so rather than bundling up your baby when she sleeps, turn up the heat a bit and dress her lightly.

How to Trim Your Baby's Nails Your baby's tiny but terribly sharp nails probably will need to be trimmed before you're even discharged from the hospital. Carlson suggests using nail scissors with rounded tips designed especially for infants, as they give you more control than clippers. You might want to trim your baby's nails when she's asleep or after you've fed her and she's calm and drowsy, but keep in mind that you may not be able to do all 10 fingers in one sitting.

How to Read a Dirty Diaper Think of wet and poopy diapers as signs that your baby's digestive system is working and she's getting enough to eat. In this regard, urine is more important than poop. "Urine output determines if your baby is taking in enough fluid," Bar-on explains. There should be a minimum of four to six wet diapers a day by the baby's fifth day of life.

Poop output is more variable. "Formula-fed babies may have two or three bowel movements a day, probably tapering to once a day, once every other day, or once every three or four days," says Corrigan. "Anything is normal as long as the baby is not passing hard little balls, which means she's constipated."

Some breastfed babies have a bowel movement for every feeding, while others go as long as several days. "You have to establish what's normal for your child," says Bar-on, but be on the lookout for diarrhea, which can quickly dehydrate a newborn. It's normal for babies to have loose, mushy stools, but something is wrong if the poop is watery rather than the consistency of mustard or pudding. A breastfed baby's stools typically are yellow and "seedy," while a formula-fed baby's can be tan, yellow or green.

When changing diapers, wipe little girls from front to back to avoid urinary tract infections. Some doctors say commercial baby wipes are too harsh for newborns, especially breastfed babies, who typically have more frequent bowel movements. If your pediatrician agrees, use a wet baby washcloth or cotton balls instead.

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