A crash course for the early days...
A crash course for the early days
By Wendy Haff
It's a fact:
Blenders come with more instructions than babies. There's no standard
operations manual, and though there's a wealth of baby care books on
the market, in the first hectic weeks after your baby's birth, you
may not have many opportunities for reading, anyway. So here are the
stripped down, need-to-know facts. Think of them as the instructions
on the box, until you have time to read the manual.
First feedings
You were probably encouraged at the hospital to feed your baby 'on
demand.' You know that means feed the baby when he's hungry - but how
can you tell?
Your baby will tell you, and not necessarily by 'demanding' food with
a loud cry.
'Each baby has little cues that the mother will quickly learn,' says
Irene Buckland-Foster, manager of public health nursing at the
Middlesex-London Health Unit. Lip-smacking, turning the head towards
your breast, sucking on a fist - once you learn the signs, 'you can
watch for those cues, and put the baby to the breast before he or she
is ravenous and crying uncontrollably.'
On the other hand, 'demand feeding' implies that you should wait for
the baby's cues - which isn't necessarily true for a few very sleepy
babies.
'Some people will take 'feeding on demand' at face value, and not
wake a very sleepy baby,' notes Diane O'Brien, a public health nurse
with the Middlesex-London health Unit. If your baby isn't gaining
well, and sleeps for long stretches, your doctor or midwife may
suggest waking him every three or four hours for a feed, at least for
the first few weeks.
At the other end of the spectrum are those babies who seem to think
two or three hours is far too long to go without eating.
'Moms feel very threatened when someone says, 'You're feeding that
baby AGAIN?'' O'Brien observes. But while your baby is very young,
frequent feeding will help establish your milk supply and minimize
engorgement. The interval between feeds will usually lengthen as your
baby matures. After feeding, most parents try to encourage their baby
to burp, since swallowed air can make little tummies uncomfortable.
To get out the gas, hold the baby against your body, with her head
pointed over your shoulder, and rub or pat her back.
Don't be surprised, though, if your breastfed baby doesn't reward you
with much of a belch. 'Breastfed babies don't tend to burp quite as
much, or spit up as formula-fed babies do,' explains Buckland-Foster.
Many nursing mothers wonder if their babies are getting enough milk.
The simplest sign: What goes in must come out - or, more accurately,
what comes out must have gone in. 'By day three or four, babies
should be wetting three or four diapers a day, and by day six, six to
eight wet diapers,' says Dr. Dorli Herman, a family physician in
London, Ontario. Can't tell because of those ultra-absorbent
disposables? Herman recommends putting a folded tissue in the diaper
at each change for a day or two. In the first month, one (or more)
substantial bowel movements daily is another indicator your baby is
feeding well.
The other sign your baby is thriving is weight gain, and your baby's
doctor will want to check in the first few weeks to ensure she
regains her birth weight, usually at a rate of about an ounce per
day.
Insufficient milk intake is usually related to the way the baby is
latched at the breast. If you are finding breastfeeding
uncomfortable, having trouble latching the baby on, or if your baby
doesn't seem to be actually drinking much at the breast, ask a
breastfeeding counsellor for help.
You may want to call your local maternity ward or health unit for
suggestions.
Diaper Detail
Whether using cloth or disposables, keep the front of the diaper
folded down for the first few weeks, to allow the cord stump to air.
Change diapers frequently to avoid rash, but for the sake of
everyone's sleep, you can probably skip nighttime changes unless the
baby poops or is already rashy.
Ointments, petroleum jelly, and baby wipes are a matter of style more
than substance. While some hospitals still teach new parents to swab
the baby's bottom with petroleum jelly at each diaper change, this
isn't really necessary, says Herman. Wipes are convenient, but a
washcloth and plain water (plus a little gentle soap if things get
really ugly) works just as well, she adds.
If your baby develops a rash in the diaper area, a barrier cream may
prevent further irritation. Zinc-based creams are a little stickier,
and therefore may offer more protection, than plain petroleum jelly.
Keeping the baby's bottom clean, and allowing air to reach the area
by leaving the diaper off for an hour or so every day may also
encourage healing.
However, if a rash is very red and angry-looking, particularly in
skin creases, or lingers for more than a few days, it may be a yeast
infection called thrush. (This can also appear as white spots in the
baby's mouth, that can't be gently wiped away.) In this case, consult
with your doctor - thrush needs special anti-fungal medication.
Bathing Beauty
This is another subject on which you can expect conflicting advice,
sometimes within the same hospital! 'Some nurses are still
demonstrating a sponge bath,' notes Buckland-Foster, 'and others,
because they're not so worried about the cord anymore, are just
immersing the baby.' And if you have a home birth, often the midwives
will immerse mom and baby together in a soothing post-birth herbal
bath.
It all boils down to your comfort level - and your baby's. If you'd
rather sponge-bathe until the cord drops off, that's fine. Babies may
prefer this, too, notes O'Brien, 'Sometimes newborns don't like baths
because they're open and exposed.' If you're nervous about holding a
wiggly, slippery baby, one of those terry-covered bath stands may
give you a bit more confidence. Taking baby into the bath with you is
another option: Undress your baby and put him in a towel-lined baby
seat beside the tub; sit down, and then pick her up or have your
partner hand her to you. Just make sure the water is warm, not hot.
Sponge or tub, have everything at hand before you start. Move
from 'clean' (face, hands, etc.) to 'dirty,' with your washcloth,
saving the soap for the diaper area. Again, simple is fine - no need
for fancy products. As for soap, choose something gentle and non-
drying. Herman recommends Cetaphil, which comes in a convenient gel.
How often should you bathe your baby? That depends in part on
how 'poopy' your baby gets from day to day, and your preference. Once
every couple of days is probably more than enough. And because
babies' hair isn't oily, a once-a-week shampoo is usually all that's
needed.
Hush Little Baby
As your relationship with your baby takes shape, you'll quickly learn
what soothes your baby, and be able to differentiate between 'Hey-Mom-
I'm-hungry' grumbling and 'I'm-just-having-one-of-those-days'
fussing.
If baby is fed, changed, burped, and still unhappy, there are several
strategies you can try. If your baby has already eaten and still
wants to suck for comfort, Herman notes that washing your hands and
letting her suck on your little finger while holding her close is
often settling.
In many cultures, parents don't wait until the baby cries to pick him
up. Mothers and fathers, grandparents and siblings the world over
carry newborns much of the day, slung over the back or hip in a
length of cloth. While this hasn't been common practice in Canada,
science has begun to bear out the wisdom of wearing your baby.
'There's actually some research to suggest the more you hold babies,
the less they're likely to cry,' even when they're older, notes Irene
Buckland-Foster. Baby carriers or slings foster this kind of
closeness, and leave at least one parental hand free.
Inventive parents have discovered all kinds of additional baby
soothers: Car rides, perching atop the dryer secured in a car seat
(but never unattended - the vibrations can move the seat), sitting
under the kitchen fan, being held by a parent who is singing at the
top of his lungs, baby swings, bouncy chairs, gadgets that produce in
utero noises or car sounds all may be worth a try. Simply being held
is usually comforting, especially if combined with a motion like
rocking or walking.
But what if your baby cries for hours at a time, and doesn't respond
to normal comfort measures? Colic - defined as inconsolable,
unexplained crying that lasts for more than three hours a day - is a
word all parents dread. It's important to know that colic doesn't
affect the baby's health (although it takes its toll on parental
nerves!) and it will end, usually by four months. If your baby seems
colicky, says Herman, have your doctor check the baby, just to be
sure she's healthy and thriving. And look after yourself as well as
your baby: 'Preserve your own sanity by taking breaks and not feeling
guilty handing the baby over to somebody who can look after him for a
couple of hours,' she advises.
The Scoop on Poop
A favourite conversation topic of newborns' parents, diaper contents
receive a lot of scrutiny. What's normal, and what's not?
Bowel movements in the first three days or so after the birth are the
sticky, blackish-green meconium Robin Williams describes as a cross
between toxic waste and Velcro. For breastfed babies, this gives way
to something that won't let you look at Dijon mustard the same way
again.
Often grainy looking, the stools of a breastfed newborn really do
resemble deli mustard. (If you witness a deposit during a diaper
change, the geyser-like phenomenon is alarming, but perfectly
normal!) A weird colour may be caused by something in Mom's diet, and
usually isn't a problem. (The only exception is black stools, after
the initial meconium, since this can be a sign of bleeding.) Formula-
fed babies' stools tend to be darker in colour and less frequent than
in breastfed babies.
A breastfed newborn may poop during every feeding, and new parents
can be understandably alarmed. But soft, frequent stools do not
signal diarrhea in a breastfed baby (do call your doctor if the poop
actually seems watery, though). Nor, after one month, do infrequent
stools signal constipation. O'Brien explains that, after one
month, 'Often you'll find the baby can go three days, or even seven
days, without a stool.' (Note: The writer's personal family record is
ten days with no ill effects, aside from parental worry.)
So what is constipation? The key isn't frequency, but consistency.
Hard stools, which are difficult to pass, are rare in breastfed
babies. Constipation is more common in their bottle-fed counterparts.
If your baby does get constipated, it's not an emergency. However,
you'll probably want to check with your doctor.
The Weird and Wonderful
My baby seems to hiccup constantly. Should I give gripe water?
No. Hiccuping is perfectly normal, say both public health nurse Diane
O'Brien and Dr. Dorli Herman.
Is it normal to spit up after feeding?
Unless the baby is vomiting very forcefully, this is no cause for
alarm, says Herman. 'It's very common for kids to spit up after a
feeding because the sphincter that keeps the food in the stomach is
very immature.'
My breasts are soft. Is my baby getting enough milk?
After your milk supply is established, your breasts often won't be
hard unless you miss a feeding. The baby's diapers and weight gain
are better indicators.
My baby seems 'snuffly' all the time. Could she have allergies?
Babies are nose-breathers, notes Herman, and any little bit of mucous
rattles around and sounds terrible, but usually isn't a result of
allergies. If it interferes with feeding, giving nasal saline drops
beforehand may help.
What is this gucky eye discharge?
Conjunctivitis, an eye infection, is quite uncommon in newborns,
Herman says. A blocked tear duct is a more likely explanation. She
recommends gently cleansing the material away a few times a day with
a clean, damp cloth.
This case of cradle cap looks like tree bark.
Should I wash my baby's hair more often?
No, says Herman. 'Cradle cap is pretty normal, and washing doesn't
help.' If you want, massage oil into the scales lift them out of the
hair with a fine-toothed comb. But Herman warns the oil may be hard
to shampoo out.
My baby's toenails look deformed. Are they?
According to Herman, probably not. 'Babies' toenails are always
really weird; not to worry.'
What are these white 'pimples' on my baby's face?
'At about one month, there's a big gap in the photo album, because
the baby has infant acne,' says Herman. It's not serious, and washing
or picking at them won't help and may make it worse.
It usually passes within a week or two.
My baby's skin looks dry and flaky. Should I moisturize it?
'In the first few days of life, a lot of babies, especially if
they're post-term, have some skin that looks dry, but it's normal,'
says Herman. Moisturizing isn't necessary, but if it makes you feel
better, go ahead. Use a mild, unscented lotion or oil.
Cord Care
For first-time parents, that oogy-looking cord stump can be a little
off-putting. No wonder that in past years, experts recommended
swabbing it with alcohol. However, a large randomized study at
McMaster University has since changed this practice in many
hospitals: Researchers found that the cord actually dropped off
sooner in babies whose cords were left alone, and that alcohol didn't
prevent infection.
The cord will usually drop off by two weeks after birth. In the
meantime, allow it to air as much as possible, and watch for any
redness or pus at the site, which may indicate an infection needing a
doctor's attention.
Back to Sleep
Here's another recommendation that has changed: When you do put the
baby to bed, place him on his back. This seems to drastically reduce
the incidence of SIDS (sudden infant death syndrome). Puffy
comforters and pillows should also be avoided, because they may
interfere with breathing.
Should your baby sleep with you? This is a debate that can turn
surprisingly vitriolic. 'I tell moms when I visit - if you're okay
with bringing your baby to bed, do it,' O'Brien says. If your baby
does sleep in your room, you may wake more frequently, but it also
makes nighttime feeding much simpler. Of course, use common sense to
make the family bed safe as well as convenient: Babies should never
sleep on a waterbed. A firm mattress is best, and keep pillows away
from the baby. For protection from falling, put the bed against the
wall and tuck the baby in between it and you, or move your mattress
to the floor. Don't take your baby to bed after drinking or using
medication that makes you sleepy, which will make it more difficult
for the baby to rouse you. And, of course, never leave a baby alone
in an adult bed.
Which brings us to night waking. Again, this is highly variable: A
lot of babies are catnappers who don't go down for more than an hour
or two at a time for the first few months, while some newborns will
conk out for five hours. Keeping night feeds quiet, dark and calm may
help babies adjust their inner clock and start sleeping longer at
night. Young babies need their night feeds, though, so parenting
really is a round-the-clock job. 'Don't plan for much sleep in the
first three months, for sure,' Herman says baldly.
Dressing Down
While your mother may have bundled you until you resembled a sausage,
experts no longer recommend it. Newborns do need to be kept warm -
but not overheated.
'I would say, what you're wearing, plus a light undershirt, would be
it,' Herman says. For sleeping, 'in a house of normal temperature, an
undershirt, a sleeper, and a blanket,' is all babies need. How do you
tell if your baby is too hot or too cool? Fussing or appearing
restless is one cue. A newborn's hands or feet are normally cool, but
touching the back of her neck will give you a more accurate idea of
whether or not she's overheated.
How Can I Tell if my Baby is Sick?
Consult your physician if your baby has any of the following:
fever
fever with rash
forceful vomiting or vomiting bile (which is greenish/yellow in
colour)
persistent wheezing or couging
excessive irritability or fussiness
l excessive drowsiness, unresponsiveness
l sunken fontanelles (soft spots)
l difficulty feeding
l infrequent wet diapers
l blood in stool
If your baby doesn't exhibit these symptoms, but you're still feeling
uneasy, by all means call your doctor or midwife. Parental instinct
is a valid reason for getting medical advice.
You're the Expert!
As a new parent, you'll have no shortage of advice thrown at you. The
trick, Herman says, is picking one or two people whose advice you
value, and sticking to your sources. The one piece of advice most
health-care professionals, and parents, agree on? 'Trust your
instincts,' says Dr. Herman. 'People through the centuries have
raised babies in conditions much less hospitable than our own
houses.'
'There's a huge learning curve parents go through; they learn so
quickly the nuances of the baby's behaviour,' says Linda O'Mara, a
professor of nursing at McMaster University. Parents usually know
when something's 'off,' she adds. If you think something's wrong,
don't hesitate to call your doctor, or public health nurse.
Otherwise, try to relax and enjoy your baby. Remember, says
O'Mara, 'Kids survive parents who are learning.'
By Wendy Haff
It's a fact:
Blenders come with more instructions than babies. There's no standard
operations manual, and though there's a wealth of baby care books on
the market, in the first hectic weeks after your baby's birth, you
may not have many opportunities for reading, anyway. So here are the
stripped down, need-to-know facts. Think of them as the instructions
on the box, until you have time to read the manual.
First feedings
You were probably encouraged at the hospital to feed your baby 'on
demand.' You know that means feed the baby when he's hungry - but how
can you tell?
Your baby will tell you, and not necessarily by 'demanding' food with
a loud cry.
'Each baby has little cues that the mother will quickly learn,' says
Irene Buckland-Foster, manager of public health nursing at the
Middlesex-London Health Unit. Lip-smacking, turning the head towards
your breast, sucking on a fist - once you learn the signs, 'you can
watch for those cues, and put the baby to the breast before he or she
is ravenous and crying uncontrollably.'
On the other hand, 'demand feeding' implies that you should wait for
the baby's cues - which isn't necessarily true for a few very sleepy
babies.
'Some people will take 'feeding on demand' at face value, and not
wake a very sleepy baby,' notes Diane O'Brien, a public health nurse
with the Middlesex-London health Unit. If your baby isn't gaining
well, and sleeps for long stretches, your doctor or midwife may
suggest waking him every three or four hours for a feed, at least for
the first few weeks.
At the other end of the spectrum are those babies who seem to think
two or three hours is far too long to go without eating.
'Moms feel very threatened when someone says, 'You're feeding that
baby AGAIN?'' O'Brien observes. But while your baby is very young,
frequent feeding will help establish your milk supply and minimize
engorgement. The interval between feeds will usually lengthen as your
baby matures. After feeding, most parents try to encourage their baby
to burp, since swallowed air can make little tummies uncomfortable.
To get out the gas, hold the baby against your body, with her head
pointed over your shoulder, and rub or pat her back.
Don't be surprised, though, if your breastfed baby doesn't reward you
with much of a belch. 'Breastfed babies don't tend to burp quite as
much, or spit up as formula-fed babies do,' explains Buckland-Foster.
Many nursing mothers wonder if their babies are getting enough milk.
The simplest sign: What goes in must come out - or, more accurately,
what comes out must have gone in. 'By day three or four, babies
should be wetting three or four diapers a day, and by day six, six to
eight wet diapers,' says Dr. Dorli Herman, a family physician in
London, Ontario. Can't tell because of those ultra-absorbent
disposables? Herman recommends putting a folded tissue in the diaper
at each change for a day or two. In the first month, one (or more)
substantial bowel movements daily is another indicator your baby is
feeding well.
The other sign your baby is thriving is weight gain, and your baby's
doctor will want to check in the first few weeks to ensure she
regains her birth weight, usually at a rate of about an ounce per
day.
Insufficient milk intake is usually related to the way the baby is
latched at the breast. If you are finding breastfeeding
uncomfortable, having trouble latching the baby on, or if your baby
doesn't seem to be actually drinking much at the breast, ask a
breastfeeding counsellor for help.
You may want to call your local maternity ward or health unit for
suggestions.
Diaper Detail
Whether using cloth or disposables, keep the front of the diaper
folded down for the first few weeks, to allow the cord stump to air.
Change diapers frequently to avoid rash, but for the sake of
everyone's sleep, you can probably skip nighttime changes unless the
baby poops or is already rashy.
Ointments, petroleum jelly, and baby wipes are a matter of style more
than substance. While some hospitals still teach new parents to swab
the baby's bottom with petroleum jelly at each diaper change, this
isn't really necessary, says Herman. Wipes are convenient, but a
washcloth and plain water (plus a little gentle soap if things get
really ugly) works just as well, she adds.
If your baby develops a rash in the diaper area, a barrier cream may
prevent further irritation. Zinc-based creams are a little stickier,
and therefore may offer more protection, than plain petroleum jelly.
Keeping the baby's bottom clean, and allowing air to reach the area
by leaving the diaper off for an hour or so every day may also
encourage healing.
However, if a rash is very red and angry-looking, particularly in
skin creases, or lingers for more than a few days, it may be a yeast
infection called thrush. (This can also appear as white spots in the
baby's mouth, that can't be gently wiped away.) In this case, consult
with your doctor - thrush needs special anti-fungal medication.
Bathing Beauty
This is another subject on which you can expect conflicting advice,
sometimes within the same hospital! 'Some nurses are still
demonstrating a sponge bath,' notes Buckland-Foster, 'and others,
because they're not so worried about the cord anymore, are just
immersing the baby.' And if you have a home birth, often the midwives
will immerse mom and baby together in a soothing post-birth herbal
bath.
It all boils down to your comfort level - and your baby's. If you'd
rather sponge-bathe until the cord drops off, that's fine. Babies may
prefer this, too, notes O'Brien, 'Sometimes newborns don't like baths
because they're open and exposed.' If you're nervous about holding a
wiggly, slippery baby, one of those terry-covered bath stands may
give you a bit more confidence. Taking baby into the bath with you is
another option: Undress your baby and put him in a towel-lined baby
seat beside the tub; sit down, and then pick her up or have your
partner hand her to you. Just make sure the water is warm, not hot.
Sponge or tub, have everything at hand before you start. Move
from 'clean' (face, hands, etc.) to 'dirty,' with your washcloth,
saving the soap for the diaper area. Again, simple is fine - no need
for fancy products. As for soap, choose something gentle and non-
drying. Herman recommends Cetaphil, which comes in a convenient gel.
How often should you bathe your baby? That depends in part on
how 'poopy' your baby gets from day to day, and your preference. Once
every couple of days is probably more than enough. And because
babies' hair isn't oily, a once-a-week shampoo is usually all that's
needed.
Hush Little Baby
As your relationship with your baby takes shape, you'll quickly learn
what soothes your baby, and be able to differentiate between 'Hey-Mom-
I'm-hungry' grumbling and 'I'm-just-having-one-of-those-days'
fussing.
If baby is fed, changed, burped, and still unhappy, there are several
strategies you can try. If your baby has already eaten and still
wants to suck for comfort, Herman notes that washing your hands and
letting her suck on your little finger while holding her close is
often settling.
In many cultures, parents don't wait until the baby cries to pick him
up. Mothers and fathers, grandparents and siblings the world over
carry newborns much of the day, slung over the back or hip in a
length of cloth. While this hasn't been common practice in Canada,
science has begun to bear out the wisdom of wearing your baby.
'There's actually some research to suggest the more you hold babies,
the less they're likely to cry,' even when they're older, notes Irene
Buckland-Foster. Baby carriers or slings foster this kind of
closeness, and leave at least one parental hand free.
Inventive parents have discovered all kinds of additional baby
soothers: Car rides, perching atop the dryer secured in a car seat
(but never unattended - the vibrations can move the seat), sitting
under the kitchen fan, being held by a parent who is singing at the
top of his lungs, baby swings, bouncy chairs, gadgets that produce in
utero noises or car sounds all may be worth a try. Simply being held
is usually comforting, especially if combined with a motion like
rocking or walking.
But what if your baby cries for hours at a time, and doesn't respond
to normal comfort measures? Colic - defined as inconsolable,
unexplained crying that lasts for more than three hours a day - is a
word all parents dread. It's important to know that colic doesn't
affect the baby's health (although it takes its toll on parental
nerves!) and it will end, usually by four months. If your baby seems
colicky, says Herman, have your doctor check the baby, just to be
sure she's healthy and thriving. And look after yourself as well as
your baby: 'Preserve your own sanity by taking breaks and not feeling
guilty handing the baby over to somebody who can look after him for a
couple of hours,' she advises.
The Scoop on Poop
A favourite conversation topic of newborns' parents, diaper contents
receive a lot of scrutiny. What's normal, and what's not?
Bowel movements in the first three days or so after the birth are the
sticky, blackish-green meconium Robin Williams describes as a cross
between toxic waste and Velcro. For breastfed babies, this gives way
to something that won't let you look at Dijon mustard the same way
again.
Often grainy looking, the stools of a breastfed newborn really do
resemble deli mustard. (If you witness a deposit during a diaper
change, the geyser-like phenomenon is alarming, but perfectly
normal!) A weird colour may be caused by something in Mom's diet, and
usually isn't a problem. (The only exception is black stools, after
the initial meconium, since this can be a sign of bleeding.) Formula-
fed babies' stools tend to be darker in colour and less frequent than
in breastfed babies.
A breastfed newborn may poop during every feeding, and new parents
can be understandably alarmed. But soft, frequent stools do not
signal diarrhea in a breastfed baby (do call your doctor if the poop
actually seems watery, though). Nor, after one month, do infrequent
stools signal constipation. O'Brien explains that, after one
month, 'Often you'll find the baby can go three days, or even seven
days, without a stool.' (Note: The writer's personal family record is
ten days with no ill effects, aside from parental worry.)
So what is constipation? The key isn't frequency, but consistency.
Hard stools, which are difficult to pass, are rare in breastfed
babies. Constipation is more common in their bottle-fed counterparts.
If your baby does get constipated, it's not an emergency. However,
you'll probably want to check with your doctor.
The Weird and Wonderful
My baby seems to hiccup constantly. Should I give gripe water?
No. Hiccuping is perfectly normal, say both public health nurse Diane
O'Brien and Dr. Dorli Herman.
Is it normal to spit up after feeding?
Unless the baby is vomiting very forcefully, this is no cause for
alarm, says Herman. 'It's very common for kids to spit up after a
feeding because the sphincter that keeps the food in the stomach is
very immature.'
My breasts are soft. Is my baby getting enough milk?
After your milk supply is established, your breasts often won't be
hard unless you miss a feeding. The baby's diapers and weight gain
are better indicators.
My baby seems 'snuffly' all the time. Could she have allergies?
Babies are nose-breathers, notes Herman, and any little bit of mucous
rattles around and sounds terrible, but usually isn't a result of
allergies. If it interferes with feeding, giving nasal saline drops
beforehand may help.
What is this gucky eye discharge?
Conjunctivitis, an eye infection, is quite uncommon in newborns,
Herman says. A blocked tear duct is a more likely explanation. She
recommends gently cleansing the material away a few times a day with
a clean, damp cloth.
This case of cradle cap looks like tree bark.
Should I wash my baby's hair more often?
No, says Herman. 'Cradle cap is pretty normal, and washing doesn't
help.' If you want, massage oil into the scales lift them out of the
hair with a fine-toothed comb. But Herman warns the oil may be hard
to shampoo out.
My baby's toenails look deformed. Are they?
According to Herman, probably not. 'Babies' toenails are always
really weird; not to worry.'
What are these white 'pimples' on my baby's face?
'At about one month, there's a big gap in the photo album, because
the baby has infant acne,' says Herman. It's not serious, and washing
or picking at them won't help and may make it worse.
It usually passes within a week or two.
My baby's skin looks dry and flaky. Should I moisturize it?
'In the first few days of life, a lot of babies, especially if
they're post-term, have some skin that looks dry, but it's normal,'
says Herman. Moisturizing isn't necessary, but if it makes you feel
better, go ahead. Use a mild, unscented lotion or oil.
Cord Care
For first-time parents, that oogy-looking cord stump can be a little
off-putting. No wonder that in past years, experts recommended
swabbing it with alcohol. However, a large randomized study at
McMaster University has since changed this practice in many
hospitals: Researchers found that the cord actually dropped off
sooner in babies whose cords were left alone, and that alcohol didn't
prevent infection.
The cord will usually drop off by two weeks after birth. In the
meantime, allow it to air as much as possible, and watch for any
redness or pus at the site, which may indicate an infection needing a
doctor's attention.
Back to Sleep
Here's another recommendation that has changed: When you do put the
baby to bed, place him on his back. This seems to drastically reduce
the incidence of SIDS (sudden infant death syndrome). Puffy
comforters and pillows should also be avoided, because they may
interfere with breathing.
Should your baby sleep with you? This is a debate that can turn
surprisingly vitriolic. 'I tell moms when I visit - if you're okay
with bringing your baby to bed, do it,' O'Brien says. If your baby
does sleep in your room, you may wake more frequently, but it also
makes nighttime feeding much simpler. Of course, use common sense to
make the family bed safe as well as convenient: Babies should never
sleep on a waterbed. A firm mattress is best, and keep pillows away
from the baby. For protection from falling, put the bed against the
wall and tuck the baby in between it and you, or move your mattress
to the floor. Don't take your baby to bed after drinking or using
medication that makes you sleepy, which will make it more difficult
for the baby to rouse you. And, of course, never leave a baby alone
in an adult bed.
Which brings us to night waking. Again, this is highly variable: A
lot of babies are catnappers who don't go down for more than an hour
or two at a time for the first few months, while some newborns will
conk out for five hours. Keeping night feeds quiet, dark and calm may
help babies adjust their inner clock and start sleeping longer at
night. Young babies need their night feeds, though, so parenting
really is a round-the-clock job. 'Don't plan for much sleep in the
first three months, for sure,' Herman says baldly.
Dressing Down
While your mother may have bundled you until you resembled a sausage,
experts no longer recommend it. Newborns do need to be kept warm -
but not overheated.
'I would say, what you're wearing, plus a light undershirt, would be
it,' Herman says. For sleeping, 'in a house of normal temperature, an
undershirt, a sleeper, and a blanket,' is all babies need. How do you
tell if your baby is too hot or too cool? Fussing or appearing
restless is one cue. A newborn's hands or feet are normally cool, but
touching the back of her neck will give you a more accurate idea of
whether or not she's overheated.
How Can I Tell if my Baby is Sick?
Consult your physician if your baby has any of the following:
fever
fever with rash
forceful vomiting or vomiting bile (which is greenish/yellow in
colour)
persistent wheezing or couging
excessive irritability or fussiness
l excessive drowsiness, unresponsiveness
l sunken fontanelles (soft spots)
l difficulty feeding
l infrequent wet diapers
l blood in stool
If your baby doesn't exhibit these symptoms, but you're still feeling
uneasy, by all means call your doctor or midwife. Parental instinct
is a valid reason for getting medical advice.
You're the Expert!
As a new parent, you'll have no shortage of advice thrown at you. The
trick, Herman says, is picking one or two people whose advice you
value, and sticking to your sources. The one piece of advice most
health-care professionals, and parents, agree on? 'Trust your
instincts,' says Dr. Herman. 'People through the centuries have
raised babies in conditions much less hospitable than our own
houses.'
'There's a huge learning curve parents go through; they learn so
quickly the nuances of the baby's behaviour,' says Linda O'Mara, a
professor of nursing at McMaster University. Parents usually know
when something's 'off,' she adds. If you think something's wrong,
don't hesitate to call your doctor, or public health nurse.
Otherwise, try to relax and enjoy your baby. Remember, says
O'Mara, 'Kids survive parents who are learning.'
