Bathing & New Born

When can I give my first bath to my baby?
Avoid bathing in the hospital and till umbilical cords have fallen off. During this time, sponging with lukewarm water is enough.

How often can we bathe?
Giving bath 2-3 times a week is enough, and duration should not be more than 5-10 minutes. Use warm water and cotton wool.

  • Use a non-slip bath mat
  • Use warm (not hot) water, about 37°C or 38°C
  • Shampoo your baby’s hair last
  • Use a soft washcloth to gently clean your baby’s face, then their neck and body, leaving the genitals and bottom until last.
  • Try to avoid bubble baths– it can irritate skin and genitalia and may cause nappy rash.

Which soap is best for my kid?
Even if you don’t use any soap during the first m, then there are no issues. However, if you are using soap must look for the following things.

  • The pH of soap should be 5.5
  • Fragrance-free
  • A high moisturizer containing soap

Can I apply oil to my baby?
Use coconut oil – Note, your touch is more important than any oil. Avoid vigorous massage. Avoid massage immediately after feeding.

What about Powder application for my newborn baby?
No talcum powders. But you can use fragrance-free corn starch-based powder for your baby.

How to wipe/clean the potty of my baby?
Use lukewarm water with cotton balls. Avoid baby wipes.

What is the best sleep position for my kid?
Supine or lateral position is acceptable but avoids prone position because of the risk of SIDS (Sudden Infant Death syndrome)

Care after Birth & Breast feeding

Now you are always be treated as a mother-baby dyad. That’s the beauty of being a mother.

When can I give my first bath to my baby?
Avoid bathing in the hospital and till umbilical cords have fallen off. During this time, sponging with lukewarm water is enough.

What a mother should do immediately after Birth ?

  • ZERO SEPARATION– Always keep your baby in contact with skin (SKIN TO SKIN) to prevent hypothermia (Cold)
  • ROOMING IN- Always keep your babies by the side of the mother's bed. This would help in improving the bonding between the mum and the newborn.
  • Cover the baby's head with a cap. Cover the mother and baby with a warm cloth.

Breast Feeding: Always look for Signs of Hunger every 2 to 3 hours during 24 hours. Successful breastfeeding depends on two essential components

1. Correct Body Positioning

  • Be relaxed and comfortable
  • Sit straight with a well-supported back
  • Trunk facing forward and lap flat
  • Baby neck straight or bent slightly back and body straight
  • The baby body turned toward the mother
  • Baby body close to mother body and facing breast
  • The whole baby body supported

2. Correct Attachment

  • Chin touching breast
  • Mouth wide and open
  • Lower lip turned outward
  • More areola seen above the baby mouth

When should my baby get First feed after birth ?
Ideally, as soon as possible, your baby must get your first milk within one hour after birth.

Do I need to Wash my Breast Nipple before feeding ?
No. Your breast skin contains many good bacteria that help your newborn baby, and that bacteria also prevents local infection around the breast.

What should I eat while breastfeeding ?
Most mothers can eat whatever she wants to eat in their regular daily diet. The baby will taste through your milk, and they start to get ready for table foods when they are about six months old.

How long can we breastfeed my babies ?
You can continue breastfeeding even beyond two years of age; however, your baby would start learning to eat complimentary feed from 6 months.

Colic Pain in Newborn

What is Infantile colic?
It is not uncommon for normalnewborn babies to cry up to 2 hours a day. A baby with colic usually cries more than 3 hours a day. Kids typically start having colic pain around the 4th week of life & it can last up to 4 months of age. Often colic happensduring evening time only.

What else besides colic can make a baby cry more than usual?
Always look for the following reasons

  • Too hungry
  • Overheat or too cold
  • Wet diaper
  • Nose block
  • Rarely milk allergy

Cradle Cap & Dandruff

What is Cradle Cap or Dandruff of Infant ?
Cradle cap is a scaly-like lesion that commonly affects the scalp, also known as seborrheic dermatitis. This generally resolves spontaneously over weeks.

How can we treat ourselves at home ?

  • Apply a small amount of vegetable oil like (Coconut oil) over head
  • Leave it for overnight
  • During bathing, remove it with a soft brush (or toothbrush)
  • Use shampoo daily

I am doing all these, what next ?
Better meet your paediatrician, who may prescribe you mild steroid cream and ketoconazole shampoo to be applied twice per week for two weeks.

Hearing Screen in newborn

Do we need to do a hearing screening of my baby ?
Screening is an essential tool to early pick up of any disease. And hearing defect has a long term impact on many children's learning process.

How it's being done on any newborn ?
OAE (O to Acoustic Emission) is an elementary& painless test, which takes just 10 minutes. It can be done at the bedside by an audiologist. You should not be worried if case OAE test gets failed because it could be due to fluids in-ear. We need to get it done again, and sometimes a detailed BERA test would be required.

Which group of newborns are at higher risk of developing hearing loss ?
Neonates with the following conditions are more prone.

  • NICU admission for more than 2-3 days
  • History of Severe jaundice of Infection
  • Prematurely born
  • If required, a ventilator for a longer period
  • Family History of hearing loss
  • Any abnormality of the external ear

Neonatal Jaundice

What is Neonatal Jaundice or Hyperbilirubinemia ?
Yellow discoloration of the eye & skin is called newborn Jaundice. If your kid's palm & soles are looking, it could be due to the very high level of Jaundice.

What are the symptoms of severe Jaundice ?
These are dangerous signs of Jaundice

  • Yellow palm & soles
  • Fever
  • Feeding difficulty
  • Excessive sleepy than usual
  • Irritable and difficult to console
  • Bending of neck or body backward

Why it so common during the Neonatal Period ?
Common reasons for developing Jaundice during the neonatal period are generally due to the following reasons.

  • Born Prematurely
  • G6PD deficiency
  • Hypothyroid
  • Birth weight more than 4 kg
  • Blood clots present anywhere in the body
  • Hypothyroid
  • Low birth weight (Birth weight less than 2500 grams)
  • Mother Blood group negative & baby blood group Positive or Mother blood group O & baby Blood group A/B/AB

Any association with the mother's blood group ?
Mother Blood group negative & baby blood group Positive or Mother blood group O & baby Blood group A/B/AB.

How can we prevent my kid from severe Jaundice?
Frequent breastfeeding, meaning every 2 to 3 hours. Follow the rule of 8 X 8- if your baby is getting feeds 8 times & passing stools 8 times every 24 hours, then chances of getting Jaundice would be less.

My baby was admitted to nursery for very high Jaundice. What precautions and investigations do I need to have for my kid ?
During the first 24 hours of life, any jaundice or any level more than 20 mg/dl is considered high. Get your kid's blood group/RH typing/DCT/G6PD/Thyroid level along with Hearing Test (BERA) done as soon as possible.

What's light therapy or Phototherapy ?
Phototherapy is the most common treatment offered for newborn Jaundice. The baby's skin is exposed to special blue light. This would break bilirubin, which is easier to eliminate in the stool and urine. Babies are usually naked (wearing diapers) with eye & genitals covered.

How can we prevent my kid from severe Jaundice?
Frequent breastfeeding, meaning every 2 to 3 hours. Follow the rule of 8 X 8- if your baby is getting feeds 8 times & passing stools 8 times every 24 hours, then chances of getting Jaundice would be less.

Can sunlight help in the improvement of Jaundice ?
Exposure to sunlight was previously thought to be helpful but is no longer recommended due to sunburn risk unless ultraviolet rays are filtered out. Sunburn does not occur with the lights used in Phototherapy. Recently in Africa, Sunlight therapy with special FILTER was used successfully for mild Jaundice. However, neither it's available nor recommended in India.

Can I Take food like turmeric, or will my kid wear Yellow clothes ?
Yes, instead, it contains a lot of antioxidants, which would be helpful for the mother.

Should I look for Stool Color ?
Yes, if your baby is yellow and if diaper staining with urine is yellow and stool is white pale in color, then meet your doctor immediately.

Newborn Care after Discharge/At Home

Congratulation, now you are going Home. All first-time mum has many queries & a lot of apprehensions about the care of their tiny baby at home.

Check before Discharge

  • Weight of baby – Any weight loss of more than 10 % would require close follow up.
  • Follow Rule of 8 X 8: if you are feeding 8 times & your baby is passing 8 stools per day during the first few days of life, then there should not be any problematic issues.
  • Check Baby blood group, G6PD level, or jaundice level checked by instruments.
  • Check Immunization: Must Get BCG (for Tuberculosis), Hepatitis B vaccine, Oral Polio Vaccine & Injection Vitamin K1 to prevent bleeding

At Home
A newborn is more prone to develop hypothermia because of a large surface area per unit of body weight.

  • Keep the baby clothed and wrapped with the head covered
  • Avoid bathing, especially in cool weather
  • Keep the baby close to the mother
  • Frequent Breastfeeding
  • Use kangaroo care if your baby birth weight is less than 2500 grams

What should I watch in my Babies during the first two weeks of life ?
You must visit a hospital or call your neonatologist in case of the following symptoms

  • Looking too much yellow (Jaundice) especially palm & soles
  • Excessive Lethargy – Not feeding well, passing infrequent urine
  • Looking blue
  • Umbilical Discharge
  • Eye discharge
  • Any Pustules/skin lesions
  • Excessive Irritable and inconsolable cry

Skin Care of Newborn Baby

Why it's different from Older Kids ?
The newborn skin is very fragile, immature & sensitive to trauma and infection. While choosing the best soaps, powder, and oils, we should be cautious.

Shall we remove/clean Vernix (white layers over the body) from baby skin immediately after birth ?
Vernix is an entirely naturally occurring fat sticking over the skin of the newly born babies. This protects the baby from heat loss, excessive water loss & gives the right amount of immunity. So we should not remove this from the skin.

When can we bathe my baby ?
Avoid bathing in the hospital and till umbilical cords have fallen off. During this time, sponging with lukewarm water is enough.

How often can we bathe ?
Giving bath 2-3 times a week is enough, and duration should not be more than 5 minutes. Use warm water and cotton wool.

  • Use warm (not hot) water, about 37°C or 38°C.
  • Shampoo your baby's hair last
  • Use a soft washcloth to gently clean your baby's face, then their neck and body, leaving the genitals and bottom until last.

Can we use oil for massage ?
Oil or moisturizer smoothens the skin. Vegetable oils are used most preferable, especially Coconut oil. They are safe and scientifically proven even in premature babies. We can also use Olive oil. We should avoid using almond and Mustard oil, which can damage newborn skin. However, it's the mother touch, which is essential rather than the type of oils.

Which powder is best for my newborn baby ?
Avoid all powders during the newborn period; however, you can use CORNSTARCH-based powder. Overuses of powder can lead to rash, or inhalation of powder can be hazardous.

The best treatment for rashes (Potty area) ?

  • Change diaper Frequently
  • Use coconut oil frequently
  • Use any ZIN OXIDE based cream
  • Avoid steroid
  • Exclusive breastfeeding

Which is the best soap for my kids ?
Any baby soap having pH closer to normal skin is less irritating.

Care at Delivery/Labor Room

Any baby born before your due date (EDD- Expected Date of Delivery, which is equal to 40 weeks of gestational age) is essentially preterm. So, they would require special care during delivery.

  • Every effort should be made to deliver at 40 weeks
  • Naturally delivered baby usually have lesser problems as compared to a baby who born after cesarean section

What you should ask your gynecologist & pediatrician

AIM - ZERO SEPARATION FROM MOTHER

  • Trial of Normal Vaginal Delivery
  • Don’t cut the umbilical cord immediately- Wait at least for 60 seconds (one minute) - This is known as DCC (Delayed Cord Clamping), and meanwhile, your baby should be on your abdomen and not on the warmer trolley. After one minute, keep your baby in between your breast- This is known as SKIN TO SKIN CONTACT.
  • Start breastfeeding immediately.
  • Cover the baby's head with a cap. Cover the mother and baby with a warm cloth.
  • Don’t be haste in giving injection &doing weight of the baby

Benefits of DCC (Delayed Cord Clamping) & SKIN TO SKIN CONTACT

  • Less hypothermia (cold episodes)
  • Less pain in Mother
  • Better & successful breastfeeding
  • Lesser anemia (low hemoglobin) in kids
  • Better brain development

Safe Ear Piercing in Kids

Conventionally ear piercing would be performed by the Jewelers. But as we know, kid's skin is fragile, and they are more prone to get an infection, allergy, or sometimes severe infection like hepatitis or HIV because of poor hygienic conditions.

At our place, we are using
INVERNESS (USA) EAR PIERCING SYSTEM https://invernesscorp.com/our-piercing-system

What's the advantage of this System

  • Safe
  • Painless
  • Less allergenic
  • Using Gun system
  • It takes just 10 seconds

What's the best time to get Ear piercing

  • Never during New born periods because they have tiny earlobes
  • Chances of getting it misplaced and infections are always high
  • Immature Immune System
  • Wait till six months of age

Are the procedure painless
Yes, we are using a gun system, and it takes not more than a minute for the whole procedure without any bleeding and almost painless.
Sometimes in very apprehensive parents/kids, we can spray local anesthetics for Pain Relief.

When do you need to consult a Neonatologist?

Fetal Reasons

  • If your level II (Anomaly Scan) showed any congenital anomaly, then you must consult with a neonatologist who can counsel you regarding future related problems after birth.
  • If the antenatal scan revealed hydronephrosis/hydrocephalus/echogenic mass in the heart/cyst in the abdominal cavity lung.
  • If your blood tests revealed any evidence of congenital infections (e.g., CMV/herpes/syphilis/toxoplasma etc.)

Neonatal Reasons

  • Your baby is not gaining weight
  • Jaundice is persisting, or stool color is clay-colored with dark urine.
  • Born premature & not achieving their milestones.
  • If your baby is excessively crying/irritable on breastfeeding with lots of gas and or vomiting or you are suffering from breast pain/nipple injury.
  • Any kids who required NICU (Neonatal ICU) stays for any reason.
  • Any newborn baby who received ventilatory support.
  • Persistent rashes over face/scalp/body and not responding to usual treatment.
  • If you have any chance to deliver a premature baby.
  • If your baby’s birth weight was less than 2500 grams.
  • Vomiting after each feed and not improving
  • For neuro developmental monitoring

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