New Mom's Survival Guide

Everything you need to know about sleeping, breastfeeding, crying and more!

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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 yourself as well as your baby in those exciting but often frustrating first weeks. Let's get started!

First Things First

How to get motherhood off to a great start while you're still 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 [Watch our How To Breastfeed: Deep Latch Technique video for step-by-step tips], you can squeeze the yellowish colostrum—the precursor to real breast milk that's packed with immune-boosting nutrients—directly into his mouth. For more information, see The Ultimate Guide To Breastfeeding your one-stop resource for everything you need to know about breastfeeding—from buying that first nursing bra to deciding when to wean.

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.

Know How to Use the Car Seat
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.

1. 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. [For tips see: First 48 Hours After The Birth].

2. 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.

3. 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.

Visit fitpregnancy.com/latchvideo for step-by-step instructions and accompanying photos.

breastfeeding video

4. 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.

5. 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.

6. 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.

Discuss Options with Your Pediatrician

These include dairy, soy and hypoallergenic formulas. 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.

Keep it Safe

✱ 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.

Visit fitpregnancy.com/newbornbath for tips on how to bathe a newborn baby.

With the right gear and these expert tips, you can bathe your baby with ease. These tub-time essentials make a splash.

Your Baby's Sleep

Expert answers to new parents' most common questions about this crazy-making topic

Q: My baby seems to have his days and nights confused. What can I do?

A: "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.

Q: Are bedtime rituals really important?

A: Yes. "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.

Q: If I rock my baby to sleep, won't he become dependent on it?

A: "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.

Q: Should my baby nap on a schedule?

A: 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 9 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.

Q: When can I put my baby down to sleep and go have a glass of wine?

A: 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."

Sleep Close to Your 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.

If you are a strong believer in the family bed, safety is paramount. "Make sure no one is a smoker, that there are no other children in the bed and that neither parent has used drugs or alcohol or is excessively tired," says McKenna. (Also see "Protect Your Baby From SIDS, below")

Protect your baby from SIDS

✱ Always place your baby on his back on a firm mattress, never on plush mattresses, waterbeds, sofa cushions or any other soft surfaces. These precautions should be taken anywhere he sleeps, such as at day care or grandma's house.

✱ Make sure that your baby's face and head stay uncovered during sleep. Dressing him in a wearable blanket, or "sleep sack," is ideal.

✱ Never place blankets, fluffy comforters, bumpers, pillows, stuffed toys or other soft objects in the baby's crib.

✱ Keep the room at a comfortable temperature and don't over-bundle your baby; overheating has been linked to SIDS. Running a fan in the baby's room has also been shown to reduce the risk of SIDS.

✱ Do not expose your baby to cigarette smoke.

✱ The American Academy of Pediatrics recommends offering pacifiers from the age of 1 month to 1 year at naps and bedtimes to help reduce the risk of SIDS.

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. Taking His Temperature
✱ Dip the end of a digital rectal thermometer (the most accurate type for infants) into petroleum jelly.

✱ Lay the baby on his belly, and slowly insert the thermometer just past the tip into his rectum.

✱ Gently press his buttock cheeks closed for one to two minutes, then remove the thermometer. See "The Truth About Your Baby's Fever,", for what to do if his temperature is high.

3. 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.

Follow these four tips to swaddle your baby safely fitpregnancy.com/swaddle.

✱ 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.

The Truth About Your Baby's Fever:

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 101Ëš 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.

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)

Taking Care of Yourself

Tips to manage post-delivery problems, from cramps to depression.

Meeting a new baby's demands can be especially difficult when you have postpartum issues of your own. Here are some solutions:

PROBLEM: Perineal Pain Whether you had an episiotomy or your perineum tore during labor and had to be stitched, it's probably uncomfortable for you to sit, walk or use the bathroom.

RELIEF TIPS Try a sitz bath (sit in a few inches of warm water) for a few minutes several times a day; use a squirt-bottle to rinse yourself with warm water after you urinate; ice the area; sit on a "doughnut" or horseshoe-shaped nursing pillow to take some pressure off the area; or soak cotton balls in witch hazel and place them down under. For information on healing after a Cesarean section, go to fitpregnancy.com/csectionrecovery.

PROBLEM: Cramping and Bleeding When your uterus begins to contract and shrink after delivery, you may have menstrual-like cramping as well as bleeding that's usually heavier than a menstrual period. Don't use tampons, because they can introduce infection; wear overnight sanitary pads instead.

RELIEF TIPS Breastfeed! Nursing increases production of the hormone oxytocin, which stimulates the uterus to contract, reducing bleeding. Try a heating pad and warm showers and ask your doctor which pain meds are safe if you're nursing.

PROBLEM: Hemorrhoids These swollen blood vessels surrounding the rectum are the result of constipation during pregnancy and/or pushing during labor and can last several weeks.

RELIEF TIPS Try sitz baths, ice packs, Preparation H or Tucks pads. Some women swear by placing a slice of raw potato on their bottom for 10 minutes several times daily.

PROBLEM: "Baby Blues"/Postpartum Depession Most new moms experience some sadness, tears, mood swings and irritability in the first days and weeks after giving birth. This is normal, but more severe and long-lasting symptoms can indicate postpartum depression.

RELIEF TIPS To minimize your risk of postpartum depression, sleep as much as you can (nap when the baby does), accept all offers of help and devote a bit of time to yourself every day. Even a 15-minute walk can recharge you. If you have severe depression that lasts longer than two weeks, call your doctor, as you may need treatment. Visit postpartum.net and read Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression by Shoshana S. Bennett and Pec Indman (Moodswings Press).

Call Your Doctor if You Have:

✱ A fever of 100.4° F or higher
✱ Increased bleeding or vaginal discharge
✱ Nausea and vomiting
✱ Pain during urination
✱ Pain, swelling or tenderness in your legs
✱ Red streaks or painful new lumps on your breasts
✱ Redness, discharge or pain from an episiotomy, perineal tear or abdominal incision that fails to subside or that worsens
✱ Severe pain in your lower abdomen
✱ Severe depression

Learn much more For articles on every aspect of new motherhood, go to fitpregnancy.com/parenting/real-mom-stories.

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