Health News – Sushma Shah, Naturopathic Doctor
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Helpful Tips On Newborn Care

Having a new born in the house can be extremely joyful but also very overwhelming at the same time. They do not usually come with a guidebook – and being a first time mum can be very difficult for a lot of women especially if you do not have a lot of support. Here are some helpful tips for your new born.

Feeding

 It is important to feed your newborn as often as possible in the first few weeks after birth, whether you have chosen to breast or bottle feed. Full-term, healthy infants may feed as often as every hour to three hours, and may go as long as 5 hours between feedings during the night given he/she is gaining weight well. Infants usually give cues when they are hungry and may include rooting (turning in towards you with mouth open), sucking on their hands and/or crying. Infants often cannot differentiate between days and nights and can be confused, but this should improve after the first few weeks. Until then, try keeping the room dark and quiet at night and bright during the day.

Breast fed infants should be feeding for 15-20 minutes each breast until they improve and become efficient. Bottle fed infants should start off with the lowest flowing nipple possible and gradually increase with age.

Basic Infant Care

Though infant fingernails are paper thin, they are quite sharp. To avoid scratches, file the nails for the first few months. Nail clippers designed for infants clip delicate skin so it is best to avoid them until the infant is about 6 months of age.

There is no need to bathe the infant everyday for the first few months. Until the umbilical cord falls off (about 3 weeks after birth), babies should only be sponge washed using no soap or sensitive-skin unscented soap. Once the umbilical cord detaches, it is fine to use a baby bath allowing the infant to sit in the water.

Umbilical cord is quite simple. No special care is required, however, you may use ethyl alcohol once daily if it appears dirty. If you notice any redness or swelling surrounding the umbilicus you should call your family practitioner/pediatrician.

It is important to wash all your infants clothing and linen with fragrant-free detergent prior to use. Brand new clothing contains dyes that may irritate the baby’s skin.

Infant skin may appear dry and often peels in the first few weeks. It is not necessary to lotion the areas that are dry/peeling at this time. Areas that may need extra moisture are the wrists and ankles as these areas tend to crack. To avoid that you may apply a light coat of petroleum jelly.

Newborn Jaundice

 Newborn jaundice is a yellow tint to the skin and is quite common in the first few weeks of life. It is caused by a combination of dehydration and red blood cell turnover that a newborn’s liver cannot process as quickly as that of an older child. The most noticeable area to see the yellowing is in the whites of the eye. This is more common in breast fed infants, however, it is important to continue to breastfeed unless instructed otherwise by your healthcare provider. Infants will rid the body of bilirubin (the cause of this jaundice) through the liver and excretion through bowel movements. It is very important that in the first few weeks infants have a bowel movement everyday, especially those with jaundice. Jaundice only becomes dangerous at very high levels, with the upper threshold of normal levels changing with age so your healthcare practitioner may ask you to come in for a visit more often to monitor the levels. Bilirubin is easily checked through a small amount of blood that is sent to a lab.

Bowel Movement/Urine Output

 Infants should be having one bowel movement per day for the first couple of days. Over the following weeks bowel movements tend to slow down significantly. They may begin having a bowel movement per feeding and then slow down to as infrequent as one every five days. This is still considered normal as long as the stool was soft. Bowel movements for breastfed infants typically look yellow, runny and seedy. Bottle fed infants have a pasty texture. Normal stool colours include yellow, brown and/or green. They will often strain or even cry out when a bowel movement is happening, this is normal and will improve over time. Infants should have one wet diaper the first day, two the second day, three the third day and every day afterwards. If your baby is not voiding this much it is important to notify your healthcare practitioner so that hydration may be accessed.

Illness

 Signs of illness in your infant include, but are not limited to, refusal to eat, vomiting (actual vomit not spit-up) and inconsolable crying. If you are concerned that your baby may be sick, you should take a rectal temperature. If the rectal temperature reading is <97 or >100.4 it is a medical emergency in babies less than 2 months. You must call your healthcare practitioner immediately, do not wait until the next day even if the office is closed.

It best to keep your infant away from large crowds to prevent contracting an illness until he/she is at least 2 months old. Family and friends should also wash their hands prior to handling the baby. It is okay to go out for walks or even eat out with your baby as long as you go during an off time, not during peak hours.

Colic

Colic is generally a fussy period your baby has that resolves within hours. It is common during the 3 week mark to the 3 month mark. There is no distinguished cause. You may try gas drops to alleviate the fussiness. Colic and reflux are easily confused with each other so it is important to know the differences between the two. Reflux is fussiness during or after a feeding and you may see back-arching or spit-ups during this time. Reflux can happen both during the day and night. If you are concerned your infant may have reflux it is important that you see a healthcare practitioner to evaluate the cause.

Normal Findings

Spit-ups, sneezing and hiccups are normal in infants. You may find your baby to be mildly congested but that is quite common amongst babies. Infants breathing patterns include rapid and shallow breathing followed by a pause for a few seconds, then slow and deep breaths. This is normal in newborns.

Circumcision Care

 Circumcisions generally take about a week to heal. At every diaper change during this time, use petroleum jelly on the wound. A couple days after the circumcision you may retract the skin from around the glans penis once daily to prevent adhesions.

SIDS Prevention

 The most important step to prevent Sudden Infant Death Syndrome is to place your infant on his or her back while they sleep. This has been proven to decrease SIDS risk by 50%. Another step that is important to take is to make sure your infant sleeps in a crib or bassinet with a firm mattress and a tightly fitted sheet. Avoid blankets, pillows, toys or bumper pads when the baby is sleeping. Make sure you dress your baby warmer for bed due to a lack of blankets, however, do not allow your infant to get too warm as this is also a risk factor. Ideal temperature for the room your baby sleeps in is 68-72 degrees. Never allow someone to smoke in the same room or around your baby. It is not recommended to co-sleep with your baby in beds, recliners, chairs, sofas, etc.

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