Basic Newborn Training

That floppy neck, those mysterious cries, the tiny, doll-like body ... yes, caring for a newborn can be baffling and even downright scary, especially for the uninitiated. Never fear, though—our simple, mom-proven tips will make you an expert in no time.


How to calm a crying baby

Before long, you'll be able to decipher the different causes of your baby's many cries and know how to respond appropriately. Until then, make sure she's not wet, hungry or overly hot or cold. Next try these methods of soothing her:

- Breastfeed her or give her a bottle.

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

- Stroke her head or tummy, or give her a gentle full-body massage. Also pat your baby's back; doing so may release a trapped burp.

- Take her outside for a short time, making sure she's dressed appropriately for the weather. Fresh air and new distractions often do the trick.

- Sing or talk to her in a calming voice.

- Remember that too much stimulation can overwhelm your baby and make her cry more. If this seems to be the case, lower your voice, move more slowly, stop whatever hasn't been working and simply cuddle her in a dimly lit room.

- Try the "5 S's" recommended by pediatrician Harvey Karp, M.D., author of The Happiest Baby on the Block (Bantam): Swaddle her snugly, then place her on her side or stomach and swing her back and forth in your arms while making "shushing" noises that are as loud as the baby's crying. Also let her suck—whether on a pacifier, bottle, your nipple or a clean finger.

How to care for the cord stump

The indigo-blue dye used on your baby's umbilical cord stump helps prevent infection, but you'll still need to keep the area clean and dry until the stump falls off—which usually happens sometime between two and three weeks postpartum. If the idea of caring for the stump leaves you feeling a bit queasy, you're not alone. "Everybody's afraid of the cord stump," says Suzanne Corrigan, M.D., clinical associate professor at the University of Texas Southwestern Medical Center in Dallas, "but it has no pain endings. It's basically dead tissue, like a scab that needs to fall off."

Until that happens, stick to sponge baths. Also choose newborn diapers with a specially designed cutout, or simply fold the diaper below the stump. Cleaning the area with alcohol at every diaper change will help dry the stump; pull the skin away from the base and use a Q-tip dipped in alcohol to clean all the way around it. (Some experts recommend not using alcohol; check with your doctor to see what he prefers.)

How to bathe your baby

As long as you're doing a good job of cleaning your baby's diaper area, two or three baths a week usually are plenty (barring any particularly messy diaper blowouts, of course). 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 a 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—hooded towel, washcloth, and baby soap and shampoo if you're using them—within reach before you begin. If you do use soap and shampoo, stick with mild, unscented products formulated for babies.

When you're ready to start bathing, gently lower your baby into a baby bathtub or sink. Encircle her 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); use soap on these areas if you like. "Pay special attention to the folds in the neck, under the arms and the creases in joints, which are prone to rashes," says Linda Carlson, RN, M.S., an adjunct faculty member at the School of Nursing at Georgia Southern University in Statesboro, Ga. To keep your baby from getting cold, shampoo her hair last.

Although some little ones enjoy a post-bath massage, don't feel that you have to use oils and lotions. Also consider skipping powders; some experts caution against them, since they are easily inhaled.

How to care for the penis

If your baby is circumcised, his penis will be wrapped in petroleum jelly-saturated gauze for approximately 24 to 48 hours. Continue to cover the tip of the penis with petroleum jelly once the gauze is removed (usually at the hospital) to help it heal—which typically takes about 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 head of the penis," says Miriam Baron, M.D., an associate dean at the University of Nevada School of Medicine in Las Vegas. If the penis is not covered by gauze and comes into contact with stool, thoroughly clean the area with warm water.

How to take a temperature

Use a digital rectal or underarm (also called axillary) reading to diagnose fever in a newborn; steer clear of ear thermometers, which aren't as accurate. For a rectal reading, lubricate the end of the thermometer with petroleum jelly, gently insert the tip about
1 inch into your baby's rectum and leave it in, holding it steady, for three minutes.

Fever in an infant is defined as an oral temperature of more than 100.4° F; to get the oral equivalent, add 1 degree to an underarm reading, or subtract 1 degree from a rectal reading. If your newborn does have a fever higher than 100.4° F, call your doctor.

How to dress her for comfort

In general, your baby should wear one more layer of clothing than you do. You can't tell whether she is too chilly by feeling her hands and feet, which may be cool because her circulatory system is still developing. Instead, check her chest or abdomen: If either feels cool or if she's shivering, she may not be dressed warmly enough. Baron also recommends looking for mottling—blotchy, marbled-looking skin—on the shoulders and chest (mottled arms and legs aren't cause for concern). Note that darker-skinned babies, even if they are cold, may not appear mottled.

It's also important that she's not overly warm. Not all babies sweat effectively, but a damp neck may signal that an infant 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 (SIDS), so rather than bundling up your baby when she sleeps, turn up the heat a bit and dress her lightly, preferably in a blanket sack.

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. Since babies have a tendency to clench their fists, you might want to trim your infant's nails when she's asleep or drowsy.

How to 'read' a dirty diaper

Think of wet and poopy diapers as signs your baby'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," Baron explains. Look for a minimum of six wet diapers every 24 hours by the baby's fifth day of life.

Poop output is more variable. "Formula-fed infants 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." As for breastfed babies: Some have one bowel movement for every feeding, while others go as long as several days between stools.

"Whether your baby takes formula or breast milk, you have to establish what's normal for your child," says Baron, 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.

Speaking of stools, when changing diapers, wipe little girls from front to back to help prevent 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 warm, wet baby wash cloth, cotton ball or soft paper towel instead.