Parenting Advice

Baby's First Few Weeks

Overview
Your baby's finally arrived! And mixed with your overwhelming love and pride is probably a good dose of anxiety: How will you know just what he needs when he needs it? First and foremost, trust your instincts. As you and your baby spend time together, you'll become more and more in tune with each other. But a little preparation helps, too. Here's what you need to know about bonding, holding. and bathing your baby, and more.

Bonding basics
Your baby may not be able to move around much or babble yet, but he's bonding with you through every touch, coo, and loving look you give him. Don't worry if at first you don't feel that you two are really bonding. The process takes time. Just relax, and try:
- Holding him skin to skin
- Looking into his eyes
- Talking to him
- Cuddling with him
- How to hold your newborn

Always...
Support her head by placing your hand or arm behind her neck.

Use a position that your baby enjoys. Some need a little space, while others feel secure only when held close.

Bend at the knees -- not the waist -- when picking up something while holding your infant.

Hold your baby close to you when handing her to someone else. Let that person slide his arms underneath her before you remove yours.

Never...

Handle your infant with jerky movements, which could jostle her still-growing and delicate brain.

Wear your baby in a carrier while you're cooking, slicing vegetables, or engaging in other potentially risky activities.

Hold your baby in the car; always buckle her into a rear-facing infant car seat that's safely secured in the backseat.

Shake a baby -- even in play. Infants under 6 months are susceptible to "shaken baby syndrome" -- bruising and bleeding of the brain, spinal cord injury, eye damage, and even death -- as a result of having their heads shaken.

Jaundice: signs and treatment
More than half of all newborns develop jaundice, a medical term describing a yellowish skin coloration. The yellow color is caused by an excess of bilirubin, a chemical produced during the normal breakdown and replacement of red blood cells. In older children and adults, bilirubin is automatically eliminated from the body very quickly. But a baby's immature liver sometimes isn't able to process all of it, and its buildup causes jaundice.

To check for jaundice, hold your baby in natural light or in a room that has fluorescent lights and:
Press your fingertip gently against your baby's forehead or the tip of his nose. The skin should look white (for babies of all races). If it looks yellowish, report it to your physician.

Check the whites of your baby's eyes. If they look yellow, call your doctor.

Jaundice is usually harmless and clears up after a few days, but your doctor will use regular blood tests to keep close tabs on it because extreme cases can cause brain damage. If your child's condition does not improve, your doctor may recommend phototherapy. This common treatment -- in which the baby is placed under ultrafluorescent lights in the hospital -- will clear up jaundice in a day or two. You can also ask your pediatrician about renting a portable phototherapy machine that you can use at home.

Umbilical cord care
Your baby's umbilical stump will fall off during the first few weeks. Until then:
Do...
Fold the front of your baby's diaper below the navel so it doesn't irritate or moisten the area around the stump.

Give a sponge bath only (see "Bathtime know-how," below). It's okay if the stump gets a little wet -- just towel it dry.

Call the pediatrician if:
1. The belly button oozes pus or leaves more than a dab of blood on the diaper (it's normal for there to be small drops of blood on the diaper when the stump is healing or after the cord falls off).

2. The skin at the base of the stump turns red, is painful when you touch it, or has a bad odor. This may signal an infection that needs immediate medical attention.

Don't...
Use rubbing alcohol. Studies show that if you use it on your baby's umbilical cord, the stump can take up to two days longer to fall off than if you keep the cord dry.

Put ointment on the cord unless it's prescribed by your doctor to treat an infection.

Bathtime know-how
For the first week or two -- until the cord stump falls off -- a sponge bath is all your baby needs. To give her one:
- Gather your supplies: a basin of warm water, mild baby soap, shampoo, a washcloth, cotton balls, and a baby towel (preferably one with a hood).
- Undress her, wrap her in a towel, and lay her on a padded surface. Never take your hands or eyes off her.
- Keep the parts of her body you're not washing covered with the towel to keep her warm.
- Clean the upper eyelids gently with a washcloth soaked in warm water. Remove drainage from the eyes with moistened cotton balls.
- Wipe the outer part of the ears.
- Wash the creases of the neck, arms, and legs.
- For the genital area, gently wipe from front to back. If you have a boy and he's uncircumcised, don't retract his foreskin; a gentle cleaning is sufficient. Do the same for a circumcised penis, and wash under his scrotum.
- Rinse off shampoo by squeezing clean water from a wet washcloth onto your baby's hair while holding her securely over the sink.
- Diaper and dress her.

Guarding against SIDS
Sudden infant death syndrome (SIDS) -- when a baby unexpectedly stops breathing and dies in his sleep -- occurs in 1 in 1,400 American babies a year, usually before 6 months of age. There is no known cause of SIDS, but research indicates that certain precautions lower the risk. Be sure to:
- Always put your baby to sleep on his back
- Make your home a smoke-free environment, and don't allow others to smoke around your baby.
- Leave bedding like comforters or pillows out of your baby's crib.

Keep the temperature in your baby's room between 68F and 72F, so your child won't overheat while sleeping.

Breastfeed for as long as possible to build your baby's immunity to upper respiratory infections.

Meconium and bowel movements
For the first few days after birth, your baby's bowel movement will be sticky and greenish-black. This substance, called meconium, is perfectly normal. It's what filled your baby's intestines while she was in the womb, and once her body gets rid of it, her poop will look yellowish-orange, with seedlike particles.

After about a week (and for about the next six months), the consistency and frequency of your baby's bowel movements will depend on whether she's breastfed or formula-fed. While it's normal for an infant to have a bowel movement anywhere from five or six times a day to once every couple of days, breastfed infants tend to poop less often; breast milk is so readily digested that it leaves little bulk.

If your child has any of the following symptoms, call your pediatrician. They could indicate an infection or food allergy (either to formula or what's in your breast milk):
- You see mucus or blood in her stool.
- She has diarrhea.
- She hasn't pooped during her first week.
- Her stools remain black and sticky after the first week.
- Colic

Generally, a baby is deemed colicky if he shows sudden and unexplained outbursts of crying in accordance with the "rule of threes" -- crying at least three hours a day, for three days a week, beginning within the first three weeks of life. It's painful to hear and stressful to deal with, since the most you can do is try to calm your baby until his colicky phase passes -- usually by 3 months of age.

When to call the doctor
Call immediately if you notice any of the following in your baby:
- A fever higher than 100°F
- Difficulty breathing
- Forceful or repeated vomiting
- Persistent diarrhea
- Blood in his urine or stool
- Frequent, inconsolable, or high-pitched crying
- Persistent lethargy
- Yellow - or orange-hued skin or eyes
- A rash, blisters, or irritated skin
- White patches in his mouth, which may indicate thrush (the condition isn't serious, but it can make your baby uncomfortable and unable to nurse or bottle-feed well)
- Any unusual discharge from his eyes, nails, navel, or genitals

Taking care of yourself
As much as you've longed for your baby's arrival, all the feeding, diaper changing, and sleepless nights can leave you feeling pretty depleted. Don't forget: You need some TLC right now, too. Be sure to get plenty of...

Liquids. They're especially important if you're breastfeeding.

Energy-boosting foods. Keep a stash of healthy snacks in a few rooms around your house so they're always accessible.

Sleep. Well, as much as you can get!

Support. Asking for help from relatives and friends -- or even hiring a doula or a baby nurse -- isn't a sign of weakness or inability; it's a sign that you're doing everything in your power to take the best possible care of your newborn.

Summary
The first few weeks at home with a new baby are joyous -- but they can also be tough. You worry about his sleep, milk intake, comfort -- everything -- and you're settling into a new, very different routine from what you were used to (all on much less sleep than you're used to!). Just take it one day at a time, and don't be too hard on yourself. You'll feel like a pro in no time.