Infant Care

1. General Information
2. Physical Characteristics
3. Feeding
4. Odds and Ends

Physical Characteristics

1. SKIN

Your baby may have dry skin in the first few days of life. This represents an adjustment of the baby’s skin to the environment. You can use a moisturizing cream or baby oil to soften the skin and help it heal.

Babies sometimes develop a rash in the nursery which comes and goes over the first couple of weeks of life. This rash is characterized by red blotches with small blister-like heads. It is called erythema toxicum, is of unknown cause, is self-limited, and requires no treatment. If multiple persistent blisters develop, the baby should be seen.

Another rash which generally appears between four and eight weeks resembles acne. It also comes and goes, is especially bad when the child is agitated or hot, and goes away without treatment. It is more common in breast-fed infants and in warm weather. Washing the pimples with water and a soft washcloth can help a little. Do not squeeze them.

Diaper rash is very common and Desitin, A&D ointment or Vaseline should be used liberally on any irritation in the diaper area. A worsening diaper rash over three to five days, despite use of creams, probably deserves a phone call to the nurse. We recommend frequent diaper changes to minimize irritation.

2. NAVEL (UMBILICUS)

The umbilical cord represents a potential area for infection in the newborn. When diapering, try to keep the diaper below the navel so it will stay dry. Do not immerse the baby in a tub until the cord falls off. Sponge bathe the baby to keep him clean. Cords usually fall off at five to ten days of age, but can remain on a lot longer, especially if they constantly get wet. It is common for a cord to bleed slightly during the separation process so don’t be frightened by this. Rubbing alcohol does not need to be used routinely. Simply keeping it dry will speed its falling off.

3. GENITALS

FEMALE: The vagina is an area which must be kept very clean. The proximity of the urethra (urinary outlet) creates the potential for introduction of bacteria and thus infection in the bladder. The folds of the labia should be spread open to remove accumulated debris. Always clean top to bottom using a face cloth with water or commercial wipes. Roughly 5-10% of female infants will have vaginal bleeding in the first two to seven days of life. This bleeding represents withdrawal of maternal hormones, is normal, self-limited and benign.

MALE: The circumcised penis should be washed gently with soap and water, two or three times a day. Pat it dry carefully and apply Vaseline until it is no longer sore or raw-looking. The penis often looks swollen, red and irritated for the first few days after circumcision. However, it heals well in seven to ten days. Call us if bleeding persists or a discharge develops. If your son is not circumcised, wash the penis gently as you would other parts of the body. In most cases, the foreskin cannot be retracted, so don’t force it. Nature and time will take care of this.

4. BREASTS

All infants, male or female, may develop breast engorgement. You may feel lumps under their breasts beginning about one week of age. Don’t squeeze the milk out or the baby will continue to produce it. The swelling should be symmetrical and not sore, hot or red. The breast engorgement recedes spontaneously over one to six weeks.

5. HEAD

The fontanel (soft-spot) varies in size from baby to baby and does not close until between 6-18 months. It is often seen to pulsate and this is normal. It will bulge with crying and straining. If it bulges continuously when the baby is quiet, let us know. A flaky whitish or yellowish scale can occur on the scalp and is called cradle cap. Scrubbing with a soft facecloth with soap and water can be helpful. Stubborn cradle cap can require using baby oil to soften the flakes and then washing with Selsun Blue shampoo (do not get it in the eyes). Sometimes a medicated cream from us is necessary.

6. EYES

Yellow material may collect in the corner of the baby’s eyes due to the plugging of the nasolacrimal duct (tear duct). Wipe this material away. If the eyes get red, lids get swollen or there is excessive drainage, let us know.

7. NOSE

All babies sniffle and snort. They also will often sneeze. This does not mean the baby has a cold. If there is drainage from the nose, use a bulb syringe to help remove it to make the baby more comfortable. A cool mist vaporizer or humidifier, especially in the dry heat of homes during the winter can be helpful. Be sure to clean out your humidifier daily with diluted bleach.

8. EARS

The outer part of the ears may be cleaned with a damp cloth or Q-tip. Do not insert a Q-tip into the ears. This only pushes wax further in. You also run the risk of hurting the baby if you put Q-tips in the ears.

9. MOUTH

This is the center of the baby’s universe, yet no special care is required. Small whitish cysts can occasionally be seen on the palate. These are benign and go away by themselves. A fungal infection (oral thrush) occasionally develops in newborns. It looks like milk curds stuck on the insides of the cheeks but cannot be removed easily by a Q-tip. Contact us for medication if this occurs.

10. FINGERNAILS AND TOENAILS

They are usually soft and pliable for one to two weeks after birth. Don’t bother cutting them at this point because they might bleed. Once they are hardened, they may be cut with blunt scissors. Some people find it an easier task when the baby is sleeping. Nails left uncut will break off by themselves making cutting optional. If the baby is scratching himself with his own sharp nails it is fine to gently file them with an emery board.

» back to top

» Next Chapter: FEEDING