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Also, see our Checklist of Items to keep in your Home and Other Items for Later On.
BATHS
Bathe your baby every one to two
days. Use a mild cleanser such as baby bath soap or Dove. Sponge bath until the
navel and circumcision is completely healed and dry. Use of Q-tips in the ears,
nose and mouth is not recommended. Avoid oils, lotions or powders unless
directed since they frequently irritate the skin.
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CARE OF THE NAVEL
When your baby
arrives home, he will have a drying remnant on his naval cord. This usually
falls of between 7 to 10 days but will occasionally remain attached for as long
as three weeks. Until it falls off, clean around and on the navel with a cotton
ball dipped in rubbing alcohol three time a day. Keep the navel dry, the diaper
folded back off the navel and open to air. After the cored remnant drops off, it
may ooze bloody mucus for several days to a week. Clean the inside with a cotton
ball soaked in alcohol until the area is completely healed. Remember do not give
a tub bath until healing is complete. Please call us if oozing persists, if the
discharge contains pus, or if redness appears on the surrounding abdomen.
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CIRCUMCISION
After the circumcision has
been performed special care for your son s penis is important. Your obstetrician
normally performs your baby's circumcision on the day prior to discharge or on
your last day in the hospital.
During the circumcision, the foreskin that
overlies the glans (head) of the penis is separated and removed. After this
procedure gauze that is lubricated with Vaseline is wrapped around the head of
the penis. This helps any initial bleeding to stop as well as keeps the newly
circumcised penis clean and lubricated. This gauze normally will stay in place
for the first day or two and then either fall off or can be removed by you.
While the gauze is in place, keep it clean by using a washcloth and rinsing
water over the area. Apply a layer of Vaseline with each diaper change. Once the
gauze falls off or is removed, apply a generous amount of Vaseline to the
healing penis at each diaper change at least 4-5 times a day. As the area of the
circumcision begins to heal it may ooze a natural granulation secretion but
should not appear like thick pus or smell malodorous as these may be signs of a
secondary infection and you should give us a call. During the first several days
it is not unusual to see areas of dried blood on the diaper. However continued
or profuse bleeding is abnormal and requires immediate attention.
Normally by the 10th day after the circumcision
was performed, the infant's penis appears almost completely healed. Continue to
apply the Vaseline until your baby's doctor visit at one week of age.
CARING FOR THE UN-CIRCUMCISED
PENIS IS A VERY SIMPLE PROCEDURE:
Keep it clean and leave it alone!
There is no need to retract the foreskin over
the head of the penis (glans) during infancy. As your son grows older, the
foreskin overlying the glans will naturally disattach and become easy and pain
-free to retract, allowing for proper hygiene. This process takes years. Usually
by age 4-5 years, most boys should be taught to clean themselves in the shower.
Efforts at retracting the foreskin at an earlier age are painful and may cause
the foreskin to become inflamed and even infected.
Sometimes uncircumcised infants may get an
infection over the foreskin covering the head of the penis. If this area appears
reddened or inflamed and is discharging pus or appears painful to touch ....
call us.
Otherwise, keep the penis externally clean from
urine and stool and DO NOT retract the foreskin.
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COLDS AND SNIFFLY NOSES
Many babies
have noisy, gurgly breathing in the first months of life. They may also sneeze.
This does not necessarily mean they have a cold. If the congestion seems to be
bothering your baby you can use saline drops such as AYR or homemade drops. To
make saline drops, mix 1/4 teaspoon salt into 4 ounces of water. Boil the water
and dissolve the salt in it. Allow mixture to cool. Place 2 drops in each
nostril and gently suction out your baby's nose with a bulb syringe. Always make
a new batch of saline every 24 hours.
A humidifier or cool mist vaporizer may also
help stuffy noses (Remember to change the water and clean everyday). Elevate
your baby's head by sitting your baby upright in the car seat or elevate your
baby's head of bed by placing a rolled towel under the mattress. We do not like
to use over-the-counter cold remedies in young infants (less than 6 months of
age). Call us if your baby's symptoms seem to be worsening or persisting longer
than usual, if your baby refuses to breastfed or take a bottle, or if she has a
fever (any temperature more than 100.4 rectally in an infant less than 2 months
old).
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CONSTIPATION
This is a word that we use
to mean no bowel movement for 2-3 days, usually associated with hard, formed
stools. Not all children (or adults) have stools everyday, and for some every 3
days may be normal. Some breastfed babies stool every 8-9 days. If your baby is
having difficulty stooling and is less than one month old, please give us a call
before using the following. If your baby is greater than one month old, add a
teaspoon of DARK Karo syrup to 2-3 bottles of formula (or breast milk) per day.
Never give your baby a laxative, suppository or enema without first contacting
us.
Note: All infants will seem to
"strain" with bowel movements. This is because their muscles and
nerves are not really working together yet. Your baby is not constipated if the
stools are soft, even if they occur infrequently.
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CRADLE CAP
Cradle cap or infant
seborrhea is an accumulation of scaly, sometimes greasy skin on the scalp. It
usually starts with yellow oily scalp and may spread to the forehead, cheeks or
ears. In dark skinned children it often leaves lighter areas as it heals but
returns to normal color with time. Washing your baby's scalp with Dove soap
during her bath can control mild cradle cap, Putting oils in the scalp will only
make it worse. More severe cases are usually controlled by shampooing with
Sebulex Shampoo or Selsun Blue Shampoo 2 times per week using a baby brush or
soft toothbrush to work in the shampoo (always avoid the eye area). Affected
areas of the face and neck may also be treated by applying a 0.5% or 1%
hydrocortisone cream 2 times daily (again avoid the eyes). Call us if your
baby's seborrhea does not respond to this treatment within 2 weeks.
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CRYING AND COLIC
Many babies will have fussy periods. It can be
normal for babies to cry several hours per day.
What Should You do if your Baby is Fussy:
Remember fussy periods are normal. Check to see that nothing else is wrong with
your baby. Does your baby have a fever? Does your baby need a diaper change or
need to be fed? Make sure your baby's clothes are comfortable and not
irritating. If nothing else is wrong, your baby may respond to being held,
walked around or rocked gently. Gentle massage and swaddling your baby may also
be helpful. At this age, you cannot spoil your baby. If you feel yourself
getting frustrated, have someone else care for your baby for a short while if
you can. This might help you both.
COLIC
Colic is defined as an overly
fussy baby, usually 2 weeks to 3 months of age, who is difficult to console.
Typically the infants draw their knees to their chest and seem to have more
"gas" than usual. No one is sure what causes infants to behave this
way, nor do we know why some babies have these symptoms while others do not.
Things that vibrate are usually best for soothing colicky babies - car rides,
running vacuum cleaners, washing machines, swings etc. Call us if your baby
cannot be consoled by any method; if she refuses to breastfed or take a bottle,
or if she is irritable with fever (any temperature more than 100.4 rectally in
an infant less than 2 months old).
Colic is very frustrating for parents -
sometimes you will need to ask a friend or relative to care for the baby so that
you can get some rest.
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DIARRHEA
It is not uncommon for infants
to have frequent loose stool during the early weeks of life. This usually
settles down to 1 to 6 stools per day by about two weeks of age. This is not
diarrhea. There are many causes of diarrhea, the most common of which is a
virus. Continue to nurse or bottle feed.
You should call us if your infant has more than
8 - 10 loose stools per day, if there is blood in the stools, or if she shows
any signs of dehydration (no urine in 8-10 hours, dry mouth, no tears with
crying, or a sunken soft spot). Do not give any medications to stop the
diarrhea.
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FEVER
Fever does not cause brain
damage. Fever is simply the body's reaction to and attempt at fighting some kind
of virus or infection. You should be concerned about any fever in an infant less
than 2 months old (more than 100.4 rectally). Always give us a call before using
any Tylenol.
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JAUNDICE
The word jaundice comes from
the French word "'aune" which means yellow. Almost half of all full
term babies and about 75-80% of pre term infants will become jaundiced or
appear slightly "yellow or orange" tinged.
The most common form of jaundice in the
newborn period is called "physiological jaundice". The cause of
physiological jaundice is twofold:
- There is an increase in destruction of red
blood cells during the birthing process as well as an increase in the turnover
of old red blood cells, thus an increase in the conversion of hemoglobin to bilirubin. This
bilirubin is then processed by the liver to so that it may be
excreted through the stool.
- The infant liver can only process a certain
amount of bilirubin at a time. Non-processed bilirubin levels are increased in
the blood which gives the yellow appearance on the sclera (white part) of the
eyes and the skin.
This form of jaundice is normally safe and
causes no significant health issues. It is extremely important that you notify
us if your baby's skin appears yellow/orange to you. Some infants may require
"phototherapy" if the bilirubin levels in the blood exceed a certain
level. Physiological jaundice normally peaks around 3-4 days of life. Keep your
baby in a "well lit" room (natural light: i.e.. near a window) as this
will help process some of the bilirubin in the blood. Direct sunlight is not a
good idea!
If your baby appears yellow/orange tinged or
you're just not sure.... Call us for advice!
When babies develops jaundice (yellow -orange
skin tint) because of a medical condition or illness, this is referred to as
"pathological jaundice. Pathological jaundice may develop insidiously
(within the first 24 hours of life) or weeks later.
PLEASE REMEMBER... Don't blame your breast milk
for your baby's jaundice! Your breast milk is actually
helpful in decreasing the bilirubin levels in your infants blood through good
nutrition and increased stooling. If your infant is wetting at least 6-7 diapers per
24 hours, your infants hydration status should be adequate. If your infant is
not wetting the adequate number of diapers per day, please call
us.
If your infants bilirubin exceeds a certain
level or the speed of turning yellow is rapid (within the first 24 hrs), your
doctor may elect to place your infant under "photo therapy". This may
be in the form of placing your infant under special lights or using a
"bili-blanket" (a lighted pad that wraps around your infants chest).
Your doctor will monitor your infants bilirubin blood level. Adequate nutrition
and hydration is essential and assists in lowering the bilirubin in your
infant's blood.
Phototherapy is safe and is being offered now
as home therapy.
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SAFETY
Accidents and accidental poisonings are
frequent causes of death and injury to infants and children.
- Remember your baby needs her own car seat and
should be placed rear facing for the first year.
- Never let your baby ride on an
adult's lap in the car.
- Keep crib sides up and latched when you turn away from
your baby.
- Never leave your baby alone on the changing table or any elevated
surface.
- Use only unbreakable toys without sharp edges or small parts.
- Keep all
hot objects and food out of reach.
- Never hold a hot beverage while holding your
baby.
- Keep electrical cords out of reach.
- Cover all unused electrical
outlets.
- Keep all household products and medicines locked up and out of
reach.
- Have on hand two ounces of Syrup of Ipecac for your emergency medicine
chest. This can be used to induce vomiting when necessary, but before you use it
call us or the POISON CONTROL CENTER at 828-9123 (Richmond) or 1-800-552-6333.
- Cigarette smoking is not good for you; in addition, babies exposed to
second-hand smoke are more prone to respiratory illnesses, so do not allow
smoking around your baby.
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SPITTING
All babies spit to some
degree. That is because their nerves and muscles do not work perfectly for the
first weeks of life. This does resolve with time. Some babies do spit worse than
others. But, if your baby is gaining weight, she is not losing everything as you
may think after she spits up on you. To make spitting less of a problem, make
sure that you are not overfeeding your baby. Most newborns take 1-3 ounces every
2-4 hours, while a baby a few weeks old may be able to take a little more
formula or breast milk and feed less often. Try to burp your baby after every
1 to 2 ounces (sit baby on your lap and lean forward; rub slow circles on her
back for several minutes until she burp; do not bounce or jiggle the baby
during or after feeds). Leave your baby upright in a seat, leaning slightly to
the right, for 30 minutes after feeding. If your baby is gaining weight, be
patient, and this will get better as your child matures. If your baby does not
seem to be gaining weight or is losing weight, please give us a call.
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STOOLS
During the early days of life,
your baby may have frequent loose stools but this usually settles down to 1 to 6
stools per day by two weeks of age. Breastfed babies initially may have more
frequent and looser stools than bottle fed babies. On the other hand, some
babies have only one large loose stool every two or more days. The usual stool
appears as "soupy oatmeal" and is yellow in color. Formula fed babies
stools range from yellow to brown and possibly green.
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CHECKLIST OF ITEMS TO KEEP IN YOUR HOME
- Thermometer
- Saline Drops
- Cool Mist Humidifier
- Neosporin
- Band-Aids
- Gauze
- Antiseptic soap
- Medicine dropper (one teaspoon)
- Diaper Cream
- 1% Hydrocortisone cream
- Vaseline
- Sebulex
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OTHER ITEMS FOR LATER ON
Always check with us before
you use them.
- Acetaminophen
- Pedialyte
- Diphenhydramine (Benadryl)
- Milk of Magnesia
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