Many first-time parents experience a surge of fear when they’re discharged from the hospital and sent into the world with a brand-new baby. No matter how much you prepare, nothing can get you ready for the realization that you’re suddenly in charge—and woefully unqualified for the job. The truth is: Babies are both the easiest and the hardest thing in the world to take care of. But like millions of parents before you, you’ll figure it out. Here’s what you need to do …
Your baby will come out of the gate ready to eat. If you’re breastfeeding, go ahead and give it a try in the delivery room. An early start will decrease your odds of experiencing nursing woes down the road. From there, you’ll be on feeding duty around the clock. “Generally, breastfed babies need to eat every hour and a half to two hours since breast milk empties out of the belly quickly,” says Mary Ellen Renna, MD, pediatrician in New York City and expert for Earth’s Best.
Nursing is not always an effortless endeavor, so prepare yourself for the task ahead of time by researching the process and potential pitfalls and lining up a lactation consultant. Although you’re equipped with all you need (your breasts), there are a few things you can grab before baby arrives to make your life easier, such as a nursing pillow, a few supportive nursing bras, a breast pump (you’re likely eligible for one through the Affordable Care Act) and some ointment for sore or chapped nipples.
Formula-fed newborns will have about three to four hours between feedings (instead of one to two). But, Renna notes, “Each infant has different needs, so check with your pediatrician to ensure the right feeding schedule for your baby.”
When choosing a formula, whether as a supplement to breast milk or as baby’s sole food source, Renna suggests parents start with a cow’s milk-based option. “Look for an infant formula with omega-3 DHA and omega-6 ARA fatty acids. Iron fortification is also important,” she says, adding that prebiotic fiber and lutein are pluses.
Although you’ll be waking up your baby to feed through the night at first (or, more likely, he’ll be waking you), this won’t last forever. Renna explains that most babies lose weight after birth, but begin to gain it back as feeding is established. Most return to their birth weight by 2 weeks of age. Once this happens, you can stop setting your alarm for night meals. However, keep waking baby for feedings during the day, advises Renna, to help him sort out day and night.
As baby feeds, air can get trapped in the gastro- intestinal system, which can cause discomfort if it isn’t dispelled. Burping baby before switching breasts (or after a few ounces of formula) can help. Hold baby upright on your shoulder or on his stomach across your lap, and gently but firmly rub or pat his back to encourage a good belch. (If your baby isn’t a big burper, don’t stress. All little guys operate a bit differently, and some won’t require it.)
Spit-up is common, but if your baby is spitting up a large amount after every meal and you’re worried he isn’t ingesting enough to gain weight and thrive, give your doctor a call.
- All infants should come home from the hospital in a rear-facing car seat that is suitable for their weight. A newborn insert or headrest might be necessary for baby’s comfort and proper head positioning.
- The recline of the seat should be checked via the car seat’s angle indicator. (Find out how yours works in the manual.) Baby’s head should not fall forward.
- Shoulder straps should sit at or below the shoulders and be pulled snug. Move the straps to the lowest available position prior to baby’s arrival, but know how to adjust them if necessary.
- Once baby is fastened in, pull the chest clip up to armpit level.
- Keep all coverings outside the harness. A blanket or coat can be tucked around the harness, not under it, to ensure the most secure fit.
For tips on installing your baby’s car seat, visit safercar.gov/parents.
CHANGE HIS DIAPER.
If you’ve never in your life changed a diaper, you’re about to get some serious on-the-job training. Just be warned that the first stools you’ll encounter will be pretty darn gross.
Baby’s first diapers will be full of a greenish-black substance called meconium, which has a hard-to-wipe tarry consistency that many compare to motor oil. Luckily, meconium typically passes out of baby’s system within the first 24 hours. After a few days of transitional stools (and steady meals), your baby’s bowel
movements will become “normal”—very loose and mustardy yellow for nursing babies, a little pastier (about the consistency of peanut butter) and browner for formula-fed babies.
Formula-fed tots might poop less than their breastfed peers, but as a general rule, six to eight diapers a day is typical, says Greg Martin, MD, NICU medical director at Banner University Medical Center and Cardon Children’s Medical Center. If you notice blood in the stool, red or black stool, or very hard stool, Martin advises giving doc a call.
At each diaper change, be sure to fully clean baby’s rear end, either with a baby wipe or a damp cloth, and allow it to dry for a few moments before fastening on a new diaper to prevent the skin from becoming irritated. If baby does get a rash, apply over-the-counter ointment to help it heal. (Moms of kiddos who are prone to rashes will often use diaper ointment daily as a preventative measure.) If you can’t kick a rash with what’s available on the shelves, make an appointment with your pediatrician.
Did you know? Meconium is made up of amniotic fluid, mucus, skin cells and other substances ingested in utero.
It’s a fact: Babies cry. (Some more than others.) It’s the only means they have to let you know some- thing is off. When baby begins fussing, run down the checklist of things that might need fixing:
- Is he hungry?
- Does he need to burp?
- Is his diaper wet or soiled?
- Is he too warm or too cold?
- Is his clothing too tight? (Check elastics on socks and sleepers.)
- Is he uncomfortable?
- Does he need a change of scenery?
If you tick down the list of potential problems, you’ll likely land on something and be able to fix it in a jiffy. Sometimes, your baby might just need you. He could be feeling overwhelmed or overtired. A little time in mommy’s arms might do the trick.
If your baby is screaming as though he’s in pain, get serious about figuring out what’s wrong. (Gas is a common offender.)
If baby is just fussy but doesn’t appear to be in pain, try some movement: bounce, sway or walk with baby in your arms. You can also try putting him in his bouncer or swing—maybe he doesn’t want to be held. It’s a whole lot of trial and error. But rest assured that you’ll learn baby’s likes and dislikes in no time, and soothing him when he’s upset will get much easier.
- Difficulty breathing, including flaring of the nostrils or taking more than 60 breaths per minute.
- Feeding fewer than eight times per day.
- Wetting and/or soiling fewer than six diapers per day for more than one day.
- Foul-smelling discharge, pus or redness around the umbilical cord stump.
- Bluish color around the mouth.
- Yellow tint to the skin.
- Excessive sleepiness (difficult to wake).
- Forceful vomiting.
- Body temperature below 97.5 or above 100 degrees.
REMEMBER: Your pediatrician wants the best for your baby. Don’t ever worry about calling with a question, even if you just touched base the day before. That’s what doc’s there for.
LET HIM SLEEP.
Although it might feel like baby never sleeps, he actually does—just not at convenient times or in long stretches. Newborns sleep about 16 to 17 hours a day and likely won’t stay awake for longer than an hour or two at a time for the first couple months of life.
It’s important to practice sleep safety right from the get-go. The U.S. Department of Health and Human Services’ “Safe to Sleep” campaign encourages parents to follow these guidelines to creating a safe spot for baby to sleep:
- Put baby to sleep on a firm sleep surface with no loose coverings.
- Keep baby’s sleep area completely clear—no blankets, pillows,
stuffed animals or other items.
- Keep baby warm with a wearable blanket or one-piece sleeper.
- Don’t use a traditional bumper in baby’s crib.
- Never allow anyone to smoke around your baby.
- Always place baby on his back to sleep.
- Keep baby’s sleep spot near yours—but don’t share a space. (Try a bassinet, cradle or co-sleeping unit by your bed.)
It’s a given that baby will spend a fair amount of time sleeping in your arms his first week, but to make your life easier down the road, be sure that he also learns to sleep on his own. After a couple of weeks, introduce a bedtime routine (think: bath, book or lullaby, feed, bed), and keep middle-of-the-night interactions to a minimum. Simply change, feed and tuck him back in, saving the lights, smiles and conversations for daytime. This will help him figure out when it’s play time and when it’s sleep time. Whenever you can, lie him down while he’s still awake but drowsy, so he can start learning how to fall asleep on his own.
Your newbie isn’t capable of manipulating you— frankly, he doesn’t know how—so don’t worry about spoiling him by holding him too much. As a newborn, what he’ll find most soothing is skin-to- skin contact, or kangaroo care. (See sidebar below.) Practicing this regularly during the newborn period can help babies cry less, sleep better and facilitate brain development.
However, even just shirt-to-sleeper contact can be beneficial for your babe. Snuggle him close, talk to him (he’ll recognize both your voice and your heartbeat from his time in the womb), and lean in near his face while you speak softly to him. (He’ll have limited eyesight for a bit as his vision develops.) He’s in a whole new world, and he’ll need lots of comfort and security from you as he gets assimilated to life on the outside.
Kangaroo care 101
Hold your diapered baby on your bare chest. Cover yourself and baby with a blanket to stay warm, making sure his nose and mouth are unobstructed. Snuggling together like this will keep baby’s body temperature stable, regulate his breathing and heart rate and facilitate weight gain. You’ll enjoy easier breastfeeding, decreased stress levels and a reduced risk of postpartum depression. Experts recommend going skin-to-skin immediately after birth and observing the practice regularly in baby’s early days.
It will be all sponge baths and spot-cleaning until baby’s cord stump has fallen off and he can take a dip in a “real” bath. Keep in mind that wee ones don’t necessarily need to bathe daily. If you clean up as you go (after spit-up, diaper explosions, etc.), baby will stay pretty fresh. However, many parents do like to incorporate a daily bath into their routine. Jody Levine, MD, pediatrician, dermatologist and advisor to Mustela, says that’s fine—on one condition: “Use gentle products … that are specially formulated and developed for newborns and babies.” In addition to a gentle soap, she advocates for applying a made-for-baby moisturizer soon after toweling off to prevent your little one’s skin from drying out.
Good to know … Your baby’s cord stump doesn’t need any treatment. Simply expose it to air often and keep it dry, and it’ll fall off on its own when the time is right.
Sponge bath 101
Babies don’t always love their baths (it can get chilly!), so follow these steps for easily and effectively getting your wee one clean.
- Gather all your supplies: baby soap, two washcloths, a towel, cotton balls and a basin filled with lukewarm water.
- Place baby on a firm but comfortable surface that you don’t mind getting a little damp, such as a changing table pad.
- Undress baby, and use the towel to cover whatever parts aren’t being washed. Be sure to keep one hand on baby at all times.
- Start with baby’s face, dipping the cotton balls in the water and softly wiping baby’s eyes from the bridge
of his nose outward. (There’s no need for soap on baby’s face.)
- Lightly suds up one washcloth, and use it to wash baby’s hair (or scalp). Dampen the other cloth with only water, and use it to rinse off the soap.
- Repeat this down the length of baby’s body, taking care to clean and rinse inside folds and rolls.
- Don’t get water on baby’s umbilical cord stump.
- When baby is clean and rinsed, wrap him up in the towel and gently pat him dry.
You are baby’s only line of defense at this stage in his life, so take your job seriously. Follow safety recommendations for sleeping, eating and traveling (check those car seat straps!), don’t leave him unattended with animals or small children, and don’t expose him to uncomfortable temperatures or elements.
Furthermore, particularly if it’s cold and flu season, use your common sense: Greg Martin, MD, advises, “Keep [your baby] away from anyone [who is] sick, and use good hand-washing practices.” It’s OK to limit visitors if you feel it’s necessary, and although some might laugh at the mom who greets everyone at the door with a bottle of hand sanitizer, there’s no shame in doing whatever you think is necessary for keeping your baby happy and healthy.