the first time

Caring for a newborn can be overwhelming, as it often means experiencing brand-new challenges. Our guide will help you through that first car ride, first illness, first crying jag and more——we even give you the scoop on poop.

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> First car rideThe time to figure out how to install your baby’s car seat—and get her properly secured in it—is before she’s even born. Following these steps well in advance of your due date will help you feel more comfortable during that special trip home from the hospital. First, even if you normally aren’t the type to do so, read the car-seat manual carefully. Next, install the car seat in your vehicle’s back seat—preferably in the center of the seat—according to the manufacturer’s instructions. (Note that all babies should ride in a rear-facing car seat until they are at least 1 year old and weigh a minimum of 20 pounds.) Finally, follow these tips from Joe Colella, a safety-training manager for the National Safe Kids Campaign:

> Recline the car seat so that your baby’s head rests flat against the back (again, follow the manufacturer’s instructions). > Only add items such as a head support or rolled towel that are approved for use with your specific seat. > Use harness straps in harness slots that are at or slightly below your baby’s shoulder level, and keep the straps snug and flat, with the chest clip at armpit level. More than 80 percent of child safety seats are selected, used or installed improperly, according to Safe Kids, so you should have an expert check your work. For sites near you offering free inspections, visit www.safekids.org or call 800-441-1888. — samantha phillips

> First bath Many doctors believe it’s OK to bathe a newborn even before the umbilical cord stump has fallen off, as long as the area is thoroughly dried afterward. (The American Academy of Pediatrics still recommends sponge baths only for the first seven to 10 days, or until the stump drops off.) For the first full bath, have everything ready on the edge of the tub ahead of time—washcloth, baby soap and shampoo, cotton balls, towel and a plastic cup for rinsing. Soften the lights and warm the room. Place a plastic tub specially designed for infants in your bathtub or sink. Fill it with a few inches of warm water (between 90° and 98° F) and ease your baby into it. Encircle her body firmly with one arm, keeping her head supported, and gently wash her body with the other. Pay special attention to the genital area, behind the ears, and the folds under the arms and neck. Wash you baby’s hair last (if at all) so she doesn’t get cold. Never leave your baby in the bath unattended or turn your back on her. Finally, don’t go overboard and dry out her delicate skin: Two or three baths a week are plenty. — Elizabeth Rusch

> First crying jag It’s difficult to listen to a baby cry, but think of it this way: Crying is her only way of communicating with you. Check to see if her diaper is soiled, if her feet or hands feel too warm or too cold (a sign that you need to remove or add clothing) or if her diaper is pinching her skin. Watch your baby for a few seconds to try to read her cues. A hungry baby may lick her lips and try to suck on anything near her mouth. An overtired or overstimulated baby might flail her arms and turn her head away; her cry may be persistent and even escalate. If your baby doesn’t seem hungry or overtired, try soothing her: Walk with her, rock her and sing to her. Taking her outside might work, too. Tight swaddling also soothes many babies because it imitates the comfort of the womb, says Harvey Karp, M.D., author of The Happiest Baby on the Block (Bantam Books, 2002). Try holding your baby sideways and jiggling her with fast, tiny motions while you “shush” near her ear. If you get frustrated, ask your husband or another caregiver to comfort your baby while you take a break. — e.r.

> First illness Always err on the side of caution if your baby seems sick and you’re not sure whether to call the pediatrician. That said, the following symptoms should have you on the phone immediately (see box below for tips on calling).

> A fever of 100.4° F or higher (see below for the proper way to obtain the most accurate reading) > Changes in eating habits, such as repeatedly refusing to nurse > Very watery stools > Excessive sleepiness or unresponsiveness > Excessive irritability > Redness or swelling at the base of the umbilical cord > A red and swollen or painful rash anywhere on the body The most accurate way to take an infant’s temperature is with a digital rectal thermometer. Coat the end with petroleum jelly and, with your baby lying on her stomach, slowly insert the thermometer into her rectum just beyond the tip. Gently press the buttock cheeks closed for one minute and remove the thermometer. — e.r.

> First outing A change of scenery will do both you and your baby good, so get the stroller rolling or the front carrier snapped and take a walk together as soon as you feel up to it. During the first four to six weeks, you’ll want to take extra care to avoid exposing your baby to illness, says Linda Keller, M.D., a pediatrician in Miami. That means steering clear of the mall or other public places where strangers are likely to peer into the stroller at your cute newborn and pass along their germs. Infants need some exposure to daylight because vitamin D, which the sun helps the body produce, can prevent the bone disease rickets. Ideally, your baby won’t be in direct sunlight, but if she is even for a short time, be sure she’s dressed in a long-sleeved cotton shirt and pants, as well as a hat with a brim. (Avoid overbundling, as newborns easily become overheated.) Apply a small amount of baby sunblock (at least SPF 15) on exposed areas 30 minutes before going outdoors. — s.p.

> First vaccines At the second well-baby visit, usually at about age 2 months, most babies receive the following vaccines: diphtheria, tetanus and pertussis (DTaP); polio (IPV or OPV); the pneumococcal conjugate vaccine to protect against meningitis and other infections; and the Hib vaccine to prevent pneumonia, infections of the blood, joints and bones, and other problems. The second dose of these vaccines often is administered two months later. Your doctor or nurse should provide information that explains possible reactions to the vaccines. Steel yourself: The first shots are when many babies shed tears for the first time—and believe it, so will you. A few hours later or the next day, your baby may be fussy, drowsy and/or have a low-grade fever, along with redness or swelling at the injection site. Call your doctor if your baby experiences any of these rare side effects: high fever (105° F), seizures or persistent crying. — s.p.

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