Consumer Information

Caring For Your Baby

GENERAL INFORMATION:

How do I care for my newborn baby? Having a new baby in your house can be a time of joy and wonder. As a new parent, you have a lot to learn. It is common for new parents to feel anxious about caring for their new baby. You may feel more anxious if you have not spent much time around babies. Family, friends, and your baby's caregiver can help and support you in your new role as a parent. Spending time with your baby will help you understand your baby's needs. The following information will help you learn how to care for your baby.

Why is my baby's breathing not regular sometimes?

Your baby may not seem to breathe regularly. This means that he may take short breaths and then hold his breath for a few seconds. Your baby may then take a deep breath. This irregular breathing is common during the first weeks of life. Irregular breathing is also more common in premature (born too early) babies. By the end of the first month, your baby's breathing should be more regular.
Babies also make many different noises when breathing, such as gurgling or snorting. Most of the noises are caused by air passing through small breathing passages. These sounds are normal and will go away as your baby grows.

What are the choices for feeding my baby? There are many ways to feed your baby. Talk to your caregiver and your baby's caregiver. Ask them to give you more information about feeding your baby. You may feed your baby in the following ways:

You may breast feed.
You may choose to pump your breasts with a special pump, and feed breast milk from a bottle. Breast milk may also be saved and frozen to be given at a later time.
You may feed your baby formula from a bottle.
You may feed your baby both breast milk and formula.

What should I know about burping my baby?

When should I burp my baby? Babies swallow lots of air when they suck from the breast or a bottle. Air that stays in the stomach may cause your baby to have gas pains. Burping brings up the extra air that your baby has swallowed. Burp your baby about every two to three ounces if you are bottle feeding. Breast fed babies should be burped about every five minutes and when switching breasts. If you cannot make your baby burp, try feeding him a little more. Always burp your baby when his feeding is over. Some babies spit up when they burp. Put a soft washcloth or burp cloth under your baby's chin to catch spit up. Instead, you may put the cloth across your shoulder or lap.
How do I burp my baby? You can burp your baby in any of the following ways.
- Over the shoulder: Hold your baby against your chest or shoulder. Support your baby's bottom with one hand. Use your other hand to gently pat or rub your baby's back. Wait for your baby to burp. This can take a few minutes sometimes.
- Across the lap: Carefully place your baby across your lap. He should face down with his head, chest, and belly resting on your lap. Holding him securely with one hand, use the other hand to rub or pat his back. Wait for your baby to burp.
- Sitting up: Sit your baby upright on your lap. Use one hand to support his upper chest and chin. Use the other hand to pat or rub his back. Do not let your baby's head flop backward. Wait for your baby to burp.

How can I keep my baby safe while in the car? Always buckle your baby into a safety seat in the car. This is one of the most important things you can do to keep your baby safe. Make sure you have a safety seat that meets the federal safety standards. It is also very important to properly put the safety seat in your car and to always use it correctly. Ask your baby's caregiver for information about car safety seats. Some people are specially-trained to install (put in) car seats properly. They may be at your police department or car dealerships. If you need help putting in a car seat, talk to your baby's caregiver. Ask for information on how to contact these people. During your baby's first year, and until he weighs over 22 pounds, do the following:

Use an "infant only" or "rear-facing convertible" car seat.
The car seat should face the rear (back end) of the car.
Your baby should always ride in the middle of the back seat of your car.
Always make sure the harness straps are at or below your baby's shoulder level.

How do I take care of my baby's umbilical cord stump?

How do I clean my baby's umbilical (um-BIL-i-kal) cord stump? Keep your baby's cord stump clean and dry until it falls off. Some caregivers may suggest using alcohol and a cotton swab to clean your baby's umbilical cord. Other caregivers may suggest letting the cord air-dry instead of using alcohol. Ask your caregiver how you should care for your baby's umbilical cord. You may need to clean the stump every time you change your baby's diaper until the stump falls off. Fold the top of your baby's diaper down below the stump area. The air will help dry the stump.
When will my baby's cord stump fall off? Your baby's cord stump should fall off in one to three weeks. Do not try to pull it off, even if it is hanging on by a thin piece of tissue (skin). It is normal to see a few drops of blood when the stump begins to fall off. Keep cleaning the belly button area with alcohol until it heals. Your baby's belly button should be healed in five to ten days. No special care is needed after this time.
When should I call my baby's caregiver? Most babies do not have trouble with their umbilical cord stump healing. If the area around your baby's cord stump has yellow or green discharge and smells bad, call his caregiver. Call if the skin around the belly button is tender and red. Your baby may have an infection (in-FEK-shun) around the cord stump.

What should I know about caring for my baby boy's circumcision?

What is a circumcision (cerk-kum-SIZH-un), and what does it look like? A circumcision is a surgical procedure to remove the foreskin of the penis. After your son has been circumcised, the tip of his penis will look raw or have a yellowish coating. It may stay red and have a small amount of yellow discharge until it heals. Your baby's penis should heal in about seven to ten days.
How do I care for my baby's circumcision? After the circumcision, your baby's penis may have a plastic ring that will come off in five to eight days. Instead, the penis may be covered with special gauze or with petroleum jelly and a bandage. This bandage may come off the first time you change your son's wet diaper. Follow the caregiver's instructions on how to change your baby's bandage. Keep the penis as clean as possible. Clean your baby's penis with warm water only. Gently blot or squeeze the water from a wet cloth or cotton ball onto the penis. Do not use soap or diaper wipes to clean the circumcision area. This could sting or irritate your baby's penis.
When should I call my baby's caregiver? Call if your son cannot urinate more than eight hours after the circumcision. Call if the penis begins to bleed and will not stop. Call if the penis becomes redder, swollen, or has pus three or more days after the circumcision. Your baby may have an infection (in-FEK-shun).

What should I know about my baby's crying?

Why does my baby cry? Crying is your baby's way of "talking" to you. Babies cry in different ways for different reasons. Your baby may cry to tell you he is hungry, has a wet diaper, or is lonely. He may cry because he wants to be left alone or because he needs to get rid of extra energy. Spending time with your baby will help you learn the different types of cries your baby has. The best way to deal with your baby's crying during his first months is to come to him when he cries. You cannot spoil your baby by giving him attention.
What should I do if I do not know why my baby is crying? Most babies have fussy times during the day. Crying spells may last from 15 minutes to an hour or longer, and often occur in the late afternoon or evening. Some babies cry to help themselves go to sleep. You should not worry if your baby cries for five to ten minutes before going to sleep. With time, your baby should outgrow this type of crying.
How can I comfort my baby when he is crying? If your baby is fed, has a dry diaper, and is comfortable, he may still cry. Try some of these ways to comfort your baby when he crying:
- Hold your baby and rock him either in a rocking chair or in your arms.
- Wrap your baby snugly in a soft blanket.
- Gently pat your baby's back or chest.
- Stroke or rub your baby's head.
- Quietly sing or talk to your baby.
- Play soft, soothing music.
- Put your baby in his car seat and take him for a car ride. The motion of the car may lull him to sleep.
- Take your baby for a stroller ride.
- Burp your baby to get rid of extra gas.
- Give your baby a soothing, warm bath.
How can I help myself if my baby's crying is too hard for me to listen to? Listening to your baby cry and being unable to stop the crying can be very stressful. As you become more stressed, your baby may feel this and cry even more. Ask your partner, family member, or friend to help you. Ask them to care for your baby while you take a break. Take a walk around the block or run an errand by yourself to calm down. Taking a break is a healthy way to refresh yourself. Then you can feel calmer and can more patiently meet your baby's needs. Never shake your baby to try to stop his crying. This can cause blindness or life-long damage to his brain.

How do I change my baby's diaper? Check your baby's diaper often to make sure it is not wet or full of bowel movement (BM). You may use disposable (throw-away) diapers or cloth diapers for your baby. You may buy your own cloth diapers or may choose to use a diaper service. Talk to your baby's caregiver about the best choice of diapers. Do the following when changing your baby's diaper:

Gather your supplies. Put them within easy reach so you do not need to leave your baby during the diaper change.
- Clean disposable diaper or cloth diaper.
- Diaper pins, fasteners, plastic pants, or diaper wraps if using cloth diapers.
- Clean clothes in case the diaper has leaked.
- Diaper rash ointment or petroleum jelly, if your baby has a rash.
- Washcloth or cotton balls, and a pan of warm water. You may use diaper wipes instead.
Lay your baby down on a flat surface. Use your baby's changing table, a bed, or the floor. Put a blanket or changing cloth on the surface before laying your baby down.
Never leave your baby alone when changing his diaper, not even for one minute. If you need to leave the room, put the diaper back on and take your baby with you.
Remove the dirty diaper. Remove the diaper pins or plastic tabs. If using diaper pins, close the pins and put them safely away from your baby. Use the diaper to wipe off most of the BM. Keep your baby boy's penis covered with the diaper to keep him from urinating on you.
Clean your baby's bottom (rear end). Clean your baby's bottom with a wet washcloth, wet cotton ball, or diaper wipe. Do not use diaper wipes if your baby has a rash or circumcision that has not yet healed. Wash between the fat creases of the legs. Gently lift both legs and wash the buttocks. Always wipe from front to back when cleaning baby girls. Wipe under the penis and scrotum for baby boys. Apply ointment or petroleum jelly as directed by your baby's caregiver if your baby has a rash.
Put on a clean diaper. Lift both your baby's legs and put the clean diaper beneath his buttocks. Gently direct your baby boy's penis down as the diaper is put on. If the umbilical cord is on, fold the diaper down to keep the stump dry and exposed to air. Keep from sticking your baby with diaper pins by putting your fingers between his skin and the diaper. Put the pins through the diaper. Put plastic pants or a diaper wrap over the cloth diaper. This will help to prevent leaks of urine or BM. Change your baby's clothes if they are dirty.
Clean up. Put your baby in a safe place (where he cannot fall) before putting away the dirty diaper. Drop BM from cloth diapers into the toilet. Put the dirty cloth diaper into a covered diaper bucket. A disposable diaper can be folded over, tightly re-taped, and thrown away in the trash can or a diaper bucket.
Wash your hands when you are finished. This will help prevent the spread of germs.

How do I clean my baby's ears? Earwax helps keep your baby's ears clean and healthy. Do not put anything, such as cotton tip applicators, into your baby's ears to remove wax. These can hurt your baby's ear and push wax further into the ear. Earwax should come out of the ear on its own. Use a wet washcloth or cotton ball to clean only the outer part of your baby's ears. Talk to your baby's caregiver if you think your baby has too much earwax.

How do I clean my baby's uncircumcised penis? The rounded tip of the penis is called the glans. The foreskin or prepuce (PREE-pus) covers the glans. When your baby is born, his foreskin cannot be pulled back from the glans. By about age 10, your baby's foreskin may be easily pulled back from the glans. No special care is needed for your baby's foreskin if he is not circumcised. Wash your baby's foreskin when bathing him. Do not try to push the foreskin back unless your baby's caregiver tells you to.

How do I clean my baby's nose?

The inside of your baby's nose needs no special cleaning. Do not use your fingers or fingernails to clean your baby's nose. Do not stick cotton tip applicators (swabs) or twisted paper tissues into your baby's nose. Wipe the outside of your baby's nose with a soft tissue or washcloth if he has a runny nose.
Use a rubber bulb syringe to suction the nose if your baby has a lot of mucus. Point the bulb syringe away from the baby's face and squeeze the bulb. Gently put the tip into one of your baby's nostrils (nose openings). Close the other nostril with your fingers. Release the bulb so that it sucks up the mucus. Empty the bulb syringe into a tissue and do it again if needed. Do this again in the other nostril. The bulb syringe should be boiled in water for 10 minutes after each use. This will kill most of the bacteria on the bulb syringe.

What should I know about my baby's sleep?

How much do babies sleep? It is common for newborns to sleep more than half of the day during the first few weeks after birth. Because your baby has a small stomach, he may need to eat often. He may cry for a feeding every two to four hours both day and night. Ask your baby's caregiver about nighttime feeding schedules. When you feed your baby at night, change your baby's diaper and keep the lights dim or off. Right after this feeding, do not play with your baby. Put him down immediately and go back to bed. This way, your baby will learn that nighttime is not playtime too. By three months old, many babies are able to sleep through the night.
How should I lay my baby down in his bed? Place your baby on his back when you put him down for a nap or for the night. Do this until your baby is at least six months old. If your baby is in a crib, always put the side rails up when you are not right next to him. It is okay for your baby to be on his stomach while awake, but only if you are watching him.
How can I keep my baby safe while he sleeps?
- Place your baby on his back on a firm, flat mattress. Make sure the mattress is tight fitting in the crib. Cover the mattress with a fitted sheet that is made especially for crib mattresses.
- Remove all soft things from your baby's crib while he sleeps. Your baby can suffocate (stop breathing and die) if his face gets caught in soft items. Soft items include quilts, pillows, and pillow-type bumper pads. Also remove thick comforters, stuffed animals, beanbags, and sheepskin.
- If you do not want to use a blanket, have your baby sleep in a sleeper. If you do use a blanket, tuck the blanket in at the end of the bed. Place your baby so that his feet are near the foot (end) of the crib. The blanket should cover your baby up to his chest or neck.
- Do not let your baby sleep on a waterbed. Do not let your baby sleep in the middle of your bed, couch, or other soft surface. If his face gets caught in these soft surfaces, he can suffocate.
- Put your baby in a place that has boundaries (sides) when he sleeps. Best choices are a crib or bassinet.
- Choose a safe bed for your baby. Your baby should sleep in a crib that meets federal safety standards. Buy a new crib only if it has a safety certification seal (tag) on it. Make sure your baby's bed does not have loose, missing, or broken pieces. Crib slats should be no more than 2-3/8 inches (6 centimeters) apart. For information on more safety tips and the safest products for babies, contact the following organization:
  - U.S. Consumer Product Safety Commission
    Office of Information and Public Affairs
    Washington, District of Columbia 20207-0001
    Phone: 1-800-638-2772
    Web Address: www.cpsc.gov

Is it okay for me to smoke around my baby? No. Do not smoke or let visitors smoke around your baby. Babies who are around people who smoke get sick more often. Your baby will be more likely to have lung infections if you or visitors smoke in the house. If your baby is around smoke and gets sick, the sickness will probably last longer.

How can I keep my baby from spitting up? During the first months, many babies spit up their breast milk or formula. Your baby may spit up because he has swallowed too much air or has eaten too fast or too much. Being too playful with your baby after feedings may cause him to spit up. Most of the time, your baby will stop spitting up by seven months old. You may try the following to keep your baby from spitting up as much:

Try to slow down your baby's feedings. Remove the bottle or breast after your baby drinks an ounce of formula or every three to four minutes.
Burp your baby after every ounce of formula. If you breast feed your baby, burp him when he pauses while nursing or when you switch to the other breast.
Make sure the nipple hole is not too big or too small if you are bottle feeding.
Do not bounce or be too playful with your baby for at least 30 minutes after feedings.
Hold your baby so that his head is higher than the rest of his body during feedings. Put him in an upright infant seat or hold him upright for 30 minutes after feeding.

How do I sponge bathe my baby? What are some important things to know about sponge bathing? Some babies love baths, while others cry through the entire bath time. Your baby's feelings about his bath may change over time. Be patient while your baby gets used to getting wet and being undressed, bathed, and handled.

Sponge bathe your baby for the first three or four weeks. Sponge bathe your baby until his umbilical cord stump falls off and belly button heals. If your baby is a boy who was circumcised, sponge bathe him until the circumcision heals.
Bathe your baby two to three times per week during his first year. Your baby does not need a bath every day. Too much bathing may dry out his skin. If you think your baby's skin is too dry, try bathing your baby less often. Bathe him only one or two times each week during his first year of life. Bathing your baby before naps or bedtime may relax your baby and help him sleep better.
Sponge bathe your baby in a warm place that is flat, safe, and comfortable. This could be the changing table, floor, bed, or counter next to the sink. If you bathe your baby on a surface above the floor, always keep one hand on him. If you bathe your baby on a changing table, use the safety strap to keep your baby from rolling off. Cover the surface with a soft blanket or towel.
Use warm (not hot) water. Prevent burns by testing your baby's bath water before bathing him. Drip some bath water onto the inside of your wrist or inner arm. It should feel warm, not hot on your skin. Keep your hot water heater set at a temperature less than 120 °F (48.9 °C).
Never leave your baby alone while sponge bathing him, not even for a minute. If you must leave the room, wrap your baby in a towel and take him with you.
Sponge bathe your baby gently and quickly (in less than 10 minutes). Cover your baby's body with a soft towel. Wash his face and hair first. Dry your baby's hair well so he does not get too cold. Next, unwrap your baby from his towel and diaper. Wash the rest of your baby's body with soap and water. Dry him and dress him as soon as possible. Follow your baby's caregiver instructions on how to care for his umbilical cord stump after the bath. Keep his cord stump dry during the bath.

Checklist for bathing your baby:

__ 1. Gather your supplies. Put them within easy reach so you do not need to leave your baby during his bath.
- Water basin (tub, basin, or pan).
- Mild soap and shampoo. Baby soap and shampoo are best to use.
- Soft, clean washcloth and towel.
- Clean diaper and clothes.
- Baby nail clippers.
__ 2. Wash your baby's face first. Use a wet washcloth and no soap. Rinse off the eyelids with fresh water. Use a clean part of the washcloth to wipe from the inside of each eye and out toward the ear. Wash in and behind the ears. Do not put cotton swabs in your baby's ears. This could hurt your baby's ears. Your baby's head and hair may be washed one or two times a week with baby shampoo. Rinse his head with a washcloth to get rid of all shampoo.
__ 3. Wash the rest of your baby's body. Go down your baby's body carefully washing the creased areas under the neck, arms, and between the legs. Do not get your baby's umbilical cord stump wet. Always wash your baby's diaper area (his bottom) last. Do not use soap on your baby girl's genital area because it may irritate the area. Wipe your baby girl's bottom from front to back to keep from spreading germs. Lift your baby boy's scrotum and wash under it.
__ 4. Rinse the soap off well and dry your baby. Newborn babies usually do not need lotion, oil, or powders for their skin. If your baby has dry patches on his skin, warm a small amount of unscented baby lotion in the palm of your hand. Rub the lotion onto your baby's dry patches. Once he is dry, dress your baby quickly so he does not get too cold.
__ 5. Clip your baby's nails right after his bath. Your baby's nails should be very soft after his bath. Use baby nail clippers, a soft emery board, or rounded-tip toenail scissors. If your baby is too active after the bath, try clipping the nails when your baby is sleeping. Trim your baby's fingernails so that they are short enough that he cannot scratch himself. Your baby's fingernails may grow quickly and need trimming one or two times per week. Your baby's toenails may grow slower and need trimming less often.

How do I tub bathe my baby? You may start tub bathing your baby after his cord stump falls off and heals. If you have a baby boy who was circumcised, wait until his circumcision heals before tub bathing him.

Use a baby bathtub or a clean, plastic dishpan. Fill it with two to three inches (five to eight centimeters) of warm water. Test your baby's bath water by dripping it onto the inside of your wrist or inner arm. It should feel warm, not hot on your skin. If you have a bath thermometer, make sure the water temperature is 90°F to 100°F (32.3°C to 37.8°C). Keep your hot water heater set at a temperature less than 120°F (48.9°C). The family bathtub may be used when your baby is six months old.
Set your baby's tub inside an adult bathtub or sink. Do not put the tub on a countertop. Once the countertop and your baby get wet, they become slippery and may cause your baby to fall.
Slowly put your baby's body into the water. Support the back of his head and neck with one hand. Hold his bottom (rear end) with your other hand. Once your baby is in the tub, keep his face above the water level at all times. While bathing, support the back of your baby's head and neck with one hand. Use your other hand to wash your baby.
Shampoo your baby's hair. Gently support and hold the back of your baby's head close to the water. Rub baby shampoo onto your baby's head. Use a cup to rinse off the shampoo. This will keep the water and shampoo from going into your baby's face and eyes. Baby shampoo that gets in your baby's eyes may make his eyes sting.
Never leave your baby alone while tub bathing him. Your baby can drown in even a few inches of water. If you must leave the room, wrap your baby in a towel and take him with you.
Get the bath ready and have everything you need within easy reach. Wash, dry, and dress your baby.

What are other reasons to call my baby's caregiver:

Call your baby's caregiver for a follow-up visit. Write down questions you have about caring for your baby. This way you will remember to ask these questions during your baby's next visit.
You feel depressed and cannot take care of your baby.
Your child has a fever (increased body temperature).
Your baby's eyes are red, swollen, or have a yellow sticky discharge. This may mean that your baby has an eye infection (in-FEK-shun) which needs treatment.
Your baby is not waking up on his own for feedings. He seems too tired to eat or is not interested in feedings.
Your baby's belly is very hard and swollen, even when he is calm and resting. Ask your baby’s caregiver how often your baby should have stools. Ask him what to do if your baby does not have stools, or begins throwing up.
Your baby coughs very often during the day, or chokes very often during each feeding.
Your baby is very fussy, crying more than he normally does, and you cannot calm him down. Call if your baby is crying or shrieking for more than five or ten minutes because you think he is in pain.
Your baby has a rash which is not getting better. Call if your baby's skin turns very yellow.
You have questions or concerns about your baby.

Seek care immediately if:

Your baby’s lips or mouth are a bluish-color and he is breathing faster.
Call your caregiver right away if you or anyone in your household feels like hurting your baby.

CARE AGREEMENT:

You have the right to help plan your baby's care. To help with this plan, you must learn about your baby's health condition and how it may be treated. You can then discuss treatment options with your baby's caregivers. Work with them to decide what care may be used to treat your baby.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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