Care of Your Newborn: To Have and to Hold

Your baby is here, and you are all excited. know how you can give him the best care

How Do You Take Care of Your Newborn Baby?

Your newborn is not as delicate as he looks. However it is important to handle him with care.

Handling Baby

A baby has little control over his head until his neck muscles strengthen when he is about 6 months old.

Always support the head and neck when you are carrying your baby, and laying him down.
Never shake your newborn. This can cause bleeding/swelling in the brain and even death.
Your newborn baby is not ready for rough play. Do not jiggle him on your knee or throw him into the air.
If you put the baby in a carrier, a stroller or a car seat, always make sure that he is positioned correctly and the seat belts are properly fastened.
Do not go up an escalator with your baby in a stroller. Use the lift instead.

What You Might Notice In Newborns

Head - Your baby’s head may have an uneven shape. It may look like a cone or elongated. This is because his skull bones overlap due to pressure from the narrow birth canal, while he was being delivered. Do not worry, his head (skull) will return to a normal shape as he grows.
Soft spots - These soft parts of the head are called fontanelles. They are at the front and back of the baby’s head, where the skull bones have not yet grown together. The front soft part (anterior fontanelle) is usually easily felt and diamond shaped. It may bulge slightly when your baby cries or exerts himself. It usually closes up within 12 -18 months.
Face - Your baby’s eyelids may be puffy and swollen for the first few days after birth. This is normal because of pressure on the face during delivery. After his eyelid-swelling goes away, he will open his eyes easily.
Skin - The top layer of your baby’s skin will flake off from his hands and feet for the first couple of weeks. You may notice white, pimple-like spots on the face. These are called milia. They are harmless and will disappear after a few weeks. You may also notice small red bumps on his cheeks at one month. This is newborn acne, and will disappear after a few months. Some babies may have bluish-grey patches on the buttocks or lower back. These are called Mongolian spots which usually disappear after a few years.
Legs - Your baby’s legs may look bowed or bent. This appearance is normal.
Other body parts - Both boys and girls may have swollen breasts as the mother's hormones pass into the baby’s blood before birth. Girls may have a little vaginal discharge or bleeding. This is normal and will stop after several days. Boys may have fluid around the scrotum. This is called a hydrocele. It may take 6 -12 months to disappear. If the boy's testes appear very swollen, please see a doctor.

If there are significant physical findings, your baby's doctor doing the routine newborn screening will let you know. If you notice something about your baby that you are unsure of, ask a doctor or nurse.

Basic Newborn Care

Bathing

Bathing a newborn can be challenging. This may be a new skill to you, so don't be afraid to ask, learn and practise. Some pointers:

Keep the water in the baby bath tub shallow.
Remember to add hot water to cold water while filling the tub to prevent scalds. Check the temperature of the water with your elbow before bathing the baby. It should be warm and comfortable, not hot.
Undress the baby and wrap him up in a towel. Clean his eyes first, then his face using moist cotton balls (without soap). Use a new cotton ball for each part of the face.
Tuck him under your arm like a football, supporting his head with the same hand. Wash his hair. Dry his hair so that he will not catch a chill.
Remove the towel and gently put him into the water. Support the head, neck and shoulders with your arm.
Use a soft cloth to gently wash him under his armpit, then turn him over to wash his bottoms and genitals.
Lift the baby out of the tub, wrap him in a dry towel and dry him thoroughly. Put on a clean nappy and clothes.

Note:

A young baby needs constant support in water. Never leave him unattended in the bath tub and on the changing table.

Cleaning and Care of Different Parts of Your Baby

Eyes

Wash each eye gently with a wet cotton ball (use boiled water that has cooled down).

Ears

Ears are self-cleaning. Ear wax and dust will gradually be pushed out to the surface so that these are easy to get rid of. A gentle wipe with a soft washcloth or a damp cotton ball of the outer ear is adequate. Never insert anything into your baby’s ear canal.

Nose

Use a wet cotton ball dampened with warm, boiled water to gently clean off any dried mucus around your baby’s nose. Never insert anything into your baby’s nose.

Genitals

Use a wet cotton ball to wipe the area. For girls, always wipe from front to back to avoid transferring bacteria from the anus to the vagina / urinary opening.

Umbilical cord stump

Bathe the baby as you normally do, then lightly dab the stump dry with a clean towel. Do not put any medicated oil on it or in your baby’s belly button. The stump will change colour from yellowish-green to brown and black, and eventually fall off by itself in 1 - 2 weeks. In the meantime, keep diapers below the stump so that it is exposed to air, not urine. When the stump falls off, there may be a little blood or yellow discharge for a few days.

Nails

Newborns may have long, sharp and soft fingernails and toenails. Put mittens and booties on him so that he will not scratch himself. Avoid trimming these during the first few weeks as the nails are very soft. When the nails have hardened over a few weeks, use baby clippers or scissors to trim them. You may find it easier to do this while your baby is sleeping, and get another adult to help.

Diapering

Newborns pass out meconium - stools that are thick, sticky, black or greenish-black for the first 2 - 3 days. Thereafter breastfed babies tend to have yellow stools that are mostly runny with small seed-like objects. Newborn babies generally use up to 6 - 8 diapers a day.

Change the baby’s diaper when it is soiled or heavy with urine. Clean the genital area with each change.
You may apply a protective ointment or cream with each diaper change.
If you use cloth diapers, wash them with a fragrance-free detergent.
Consult the baby’s doctor if there is a rash in his diaper area.

Hygiene Tips

Diaper changing should not be done in the kitchen or any food preparation area.
Clean the surface of the changing mat with disinfectant wipes after each use.
Dispose of used diapers immediately in the rubbish bin or diaper bin.
Empty the rubbish bin or diaper bin regularly.
Wash your hands with soap and water after each diaper change.

Swaddling

In the hospital, you will see babies all wrapped up. Swaddling provides newborns with a sense of security and comfort as this is the position they were cocooned in while in the womb. You’ll need a thin large square blanket (wrap) to do this:

Spread the blanket on a flat surface and fold down the top corner.
Lay your baby on his back. Put the baby's body in the middle of the blanket, with his head on the fold.
Wrap one side of the blanket over the baby, tucking the end under his back beneath his opposite arm.
Pull the bottom of the blanket up and over the tummy.
Bring the other side of the blanket over your baby and tuck it under his back.
Make sure it is not too tight, but not so loose that it will fall apart once the baby moves. Ensure that his head and face are not covered.

After a few weeks, your baby need not be swaddled all the time, especially when he is awake.

Bonding

Enjoy bonding time with your baby by holding him close to your chest, cuddling or giving him a light massage. Giving your baby a massage after his bath each evening before he goes to bed is a good way to calm him down, indicate to him that it is bedtime and get him in the mood for sleep.

Soothing

Babies love attention and sounds, so talk, sing and coo to him often. If he is fussing, try singing or reciting nursery rhymes. The beat and rhythm of these will soothe him as well. Some babies like the long “shh” sound. They can calm down when this is repeated to them. It is normal to pick your baby up and carry him when he cries. He needs to know that someone is there to comfort him.

Burping

Newborns may swallow excessive air while feeding, especially if they are drinking from a bottle. It is important to burp the baby after each feed, to relieve the gas in the stomach. You may even need to stop a feed halfway to burp him if he is getting irritable. Here are some positions that will help your baby burp.

Over-the-shoulder burp: Put the baby on your chest and over your shoulder so that his tummy is pressed against it. Pat or rub his back gently. Make sure you have a cloth protecting your shoulder.
Over-the-hand burp: Sit the baby on your lap. Grasp his chin gently with your hand. Lean him forward and rest most of his weight against the palm of your hand and your arm. Pat or rub him gently on the back.

Why is He Crying?

Crying is a form of communication. Below are some reasons why he/she may cry.

Cause	Signs	What to do
Late sign of hunger	Sucking the fists, turning towards your breasts and ‘rooting’ when you pick him up.	Feed him. Always respond to early signs of hunger to avoid this.
Wind / colic	Crying occurs in the evenings, between 1-2 months old. Baby is well in between crying time.	Burp him, especially if he is bottle-fed. Some doctors may prescribe colic drops with Simethicone to help him pass wind.
Soiled diaper	His diaper is heavy and smelly.	Change his diaper immediately.
Too cold / hot	He is uncomfortable and may be crying.	Feel his body. If he is cold, put on more clothing or increase the room temperature. If he is too hot, remove some clothing, change to light clothing or decrease the room temperature. Check his temperature to make sure he is well.
Over-stimulation	He is tired but cannot sleep, so he is frustrated.	Calm him down by giving him a warm bath, relax him with a massage or carry him and try to soothe him.
Loneliness	He loves to be with you, and cries when you put him down.	Carry him close to you and stay within his sight as often as possible.
Illness	He may have a runny nose and a cough and feel hot to the touch, be more irritable or drowsy.	Check his temperature. If it is above 37.5˚C, bring him to the doctor.