Well Baby Care
Loving and Caring for your New Baby
Please call us for any of these problems so that we may discuss them with you.
Give your baby a good soapy bath, including the head and face every day or two. For general cleansing, use Dove, Purpose, Tone, or mild baby soap. Be sure to rinse the soap away completely. Several body areas deserve special attention.
As a courtesy, our offices will confirm physical exam appointments 3 days in advance and again 2 hours before your scheduled appointment time. If you must cancel your appointment, you must call at least 24 hours in advance, or you will be assessed a $75 missed appointment fee.
For a complete list of the Well Child physical exam schedule as well as lots of information and tips, please refer to our “Baby Book” which is now available “on line”. The updated vaccine schedule in available in the Medical Web Site section. Regular well-child exams are routinely scheduled at two weeks, four weeks, then at 2, 4, 6, 9, 12, 15, 18, and 24 months. Thereafter exams are scheduled yearly. Well-child exams at 21 and 30 months are optional and may not be covered by your insurance company. Please note, the 2 month, 6 month, 12 month, 4 year and 11 year visits must be on or after the child’s birthday due to immunization schedules.
It is important to keep the cord clean and dry. Several times daily, apply rubbing alcohol on a Q-tip to the remnants of umbilical cord where it attaches to the skin. The alcohol helps keep the cord clean and dry. The cord usually falls off between five and fifteen days after birth, and you may expect some bleeding at the separation site for a day or two. Since we want to keep the cord dry, it is necessary to limit bathing to a washcloth or sponge bath until the cord has fallen off.
Some babies develop a greasy scaling on the scalp called “cradle cap.” It is often is most prominent over the fontanel (soft spot on the top of the baby’s head) because parents are afraid to scrub over these areas briskly. Usually a soft brush or toothbrush will remove the scaling skin. If cradle cap is a problem despite adequate cleansing, we should check the baby to exclude other skin conditions that might need special treatment.
If your son is circumcised, the end of the penis will look red and swollen for several days. During his bath, merely squeeze some soapy water over the penis from a washcloth and rinse it. After the circumcision site has healed, it is important at each bath to gently retract the foreskin and wash away any white secretions that have accumulated. No special care is needed for uncircumcised boys. the foreskin usually cannot be pulled back until the child is older. No attempts to force it back should be made.
Baby girls have a surprising amount of sticky, white vaginal discharge. During the first two or three weeks of life, the discharge may be tinged with blood. This is normal and no cause for alarm. It is important to wash these secretions, which accumulate between the baby girl’s labia (lips of the vagina) at the daily bath. Little girls should always be washed from the front backwards.
Most babies will do beautifully by merely keeping them clean and dry, but you should respond to your individual baby’s skin in a common sense fashion. For instance, if your baby has dry, flaky skin, it would be appropriate to apply a moisturizing lotion after the bath.
All babies develop a little diaper rash at some time because it is impossible to keep them dry. Diaper rashes result from moisture and heat irritating the skin in the diaper area. If a rash develops, redouble your efforts to keep the baby in a dry diaper. Leaving the baby’s bottom exposed to air during nap time may be helpful. Baby oils, lotions, and powders seem to cause more diaper rash than they prevent. Occasionally, a thin layer of a diaper cream may enhance healing. Plastic pants will aggravate the rash by holding in the moisture and heat. Avoid their use if you are having problems with diaper rashes. If the rash is not improving with this approach, please call us.
The number of normal movements in infants varies greatly. Some babies have as many as one bowel movement after each feeding, while others may have only one stool every two to three days. This does not indicate constipation. The consistency of a infant’s stool varies from a pasty solid to a liquid with the consistency of thick soup. The color variation from yellow to green to brown has no significance. Breast fed babies tend to have softer, more frequent stools. It is normal for a baby to grunt and strain in order to have a bowel movement. A few babies will even cry. This does not mean the baby is constipated. Constipation exists when stools are hard and dry no matter how frequent or infrequent they may be. If constipation occurs, dilute prune juice or pear juice with water 1:1, and feed one to two ounces a day. Consult us before using laxatives, enemas, or suppositories.
An infant requires no more clothing than an adult, except for a hat if it is cold. Thus, you can judge the quantity of clothes your baby needs by what you are comfortable in. The clothes for your baby should be loose fitting.
All babies cry. Nothing can be more frustrating to a new parent than being unable to quiet your baby. Every baby has its own temperament; some won’t stop crying until they wear themselves out. At times like these, remind yourself that crying will not harm a baby. Of course, babies also cry because they are uncomfortable. A wet, dirty diaper is cause for discomfort. Hunger is probably the most common of discomforts. Crying may mean that the baby just wants attention; if so, he will calm down when picked up. You cannot “spoil” a baby by holding and loving him too much, so don’t hesitate to touch and hold your baby as much as you want.
Upon discharge from the nursery, a healthy baby is ready to adjust to outside weather, meet new people and even travel. Again, common sense should prevail. Extremes in temperature and sick visitors do represent a risk to babies. We do not recommend putting a baby in a day care or church nursery until the baby is at least six to eight weeks of age. Ideally, keeping your infant away from others helps prevent illness. Realistically, many parents need day care assistance. We would recommend holding off as long as possible before day care placement.
We see no problem with the use of a pacifier. All babies have a strong sucking need. The type of pacifier makes little difference. However, be sure it is well made with a shield larger than the baby’s mouth. Never tie it or anything else around the baby’s neck. Most babies lose interest in the pacifier before a year of age.
Some babies will sleep 20 to 24 hours a day during their first weeks at home. Other babies may require much less sleep. It is suggested that you stimulate an infant at least every 3 to 4 hours during the day with activity or feedings, leaving the late evening hours to sleep for longer periods of time. It is often discouraging to already tired parents when an infant seemingly has his nights and days reversed, but with time the infant will adjust his sleep cycles.
The baby’s mattress should be firm and flat. No pillow should be used. Protect the mattress with a waterproof cover, covered by a soft baby sheet and one or two cotton blankets. Do not wrap the baby in a blanket because this often interferes with his freedom to kick.
A baby needs to feel the loving comfort of being held, but also should have time alone. Ideally, an infant should sleep in his own bed. A baby should not be allowed to fall asleep with a bottle in his mouth as this may lead to tooth decay and ear infections.
The American Academy of Pediatrics recommends that normal infants be placed on their backs to sleep. This sleep position has been shown to dramatically reduce the risk of Sudden Infant Death Syndrome (SIDS), also known as Crib Death. When you are putting your healthy child to bed, please remember BACK TO SLEEP.
Another important risk factor for SIDS is maternal smoking.
If your child has special medical needs and you have questions about appropriate sleep position, please talk with your doctor.
The newborn infant must be watched and evaluated more carefully if he gets sick in the first three months of life. Signs of illness include:
- Fever of 100.4 degrees (F) or greater by rectal thermometer. Please take the temperature before calling the office.
- Vomiting (not just “spitting up”) or refusal of food several feedings in a row.
- Excessive crying.
- Listlessness.
- Loose, runny bowel movements.
- Any unusual rash.