For the first day or so, your baby may have bluish hands and feet. This is normal. The face and body should be pink. If they are not, call your midwife right away.
Rarely (about 1 in 2000 babies) a baby will get a beta strep infection during the delivery. Beta strep is a normal organism in the mother’s body, but it can be deadly to a baby if the baby becomes sick with it. Usually a baby will show signs of infection within the first 2-3 hours after birth, and your midwife will have been there to see and take care of it. Very rarely, the signs do not appear until several hours later. Watch your baby to see that his or her color is normal, he or she seems active (for a newborn) and alert, and seems well. If your baby seems lethargic, seems sick, is a dusky color all over, has a fever, or has labored breathing, call your midwife immediately. Don’t wait another hour to see how it goes.
Babies cannot regulate their temperature very well, so be sure to keep the baby skin-to-skin with you, or wrapped in blankets. Don’t expose the baby to drafts, or let the baby sleep near an exterior wall of your home in the winter. Don’t put the baby on cold surfaces. Don’t overdress or underdress the baby. Dress the baby as you would dress yourself.
For the first few days the baby’s feces will be black and tarry. This is called meconium, and is normal. It will gradually turn green, then a seedy mustard color as the breastmilk works through the baby’s digestive system. You may not be able to tell if the baby is urinating because a newborn’s urine is so dilute you can hardly see a yellow color. Check diapers for wetness. You should have at least 6-8 wet diapers a day. Sometimes you may see orange or red crystals in the urine. This is harmless, but does indicate the baby may be dehydrating. Nurse more often.
Do not use talcum powder when diapering; it can damage the baby’s lungs. You can use a natural powder that does not contain talc, or cornstarch. (Watch for diaper rash if you use cornstarch because it can feed bacteria.) For diaper rash, try to catch it as quickly as you can. Use a natural ointment or a zinc oxide ointment (such as Desitin). Wash off the baby’s bottom at each changing with plain water and a gentle baby cleanser (like Phisoderm for Babies).
We do not recommend “Baby Magic” products for your baby. For dry skin, use plain olive or almond oil. It is very common for babies to develop a pimple-like rash on their bodies. It is just their way of trying to get accustomed to the outside world and things like clothes. If your baby gets this rash, just keep the baby clean, don’t use any chemicals on the baby (including skin cleanser), and try putting natural fiber clothes on the baby (like 100% cotton). If the rash seems to get pussy or otherwise abnormal, see your newborn's health care provider.
Babies do not need to be bathed every day. However, when you want to give your baby a bath, keep the water warm (not hot) and the room warm (about 80 degrees--babies lose heat quickly). Use a very gentle cleanser like Phisoderm for Babies. Once you take the baby out of the water, wrap him or her in a towel and dry quickly. Dress the baby immediately to avoid heat loss. If your baby was born with a lot of vernix (white, waxy substance on the skin), don’t try to wash it off. Just rub it into the skin.
Some babies don’t get jaundice (yellow skin), but it is very common and is perfectly normal. It should peak around the third day and gradually fade. To help the baby deal with the bilirubin (the pigment in the blood that causes the yellow appearance), nurse the baby as often as you can. Do not give water supplements. Place the baby (with diaper only) in a sunny window for no more than 10 minutes each day (cover the eyes). If the jaundice is severe, or if the baby also seems lethargic or sick during a period of jaundice, call your health care provider and have it checked.
Newborns normally breathe irregularly, and they often make little noises. However if you see a breathing rate of more than 80 breaths per minute, or if you see bluish color, retractions at the ribs, grunting, labored breathing, or flaring nostrils, call your pediatrician immediately.
Nursing is very important for both you and the baby. A newborn needs to nurse every 2-3 hours around the clock. Do not supplement with water or formula, as they can both disrupt your milk supply and harm the baby. If your nipples are sore or cracked, call your midwife or a lactation consultant for help positioning, and use Lansinoh (a medical grade lanolin you can apply to the nipples). Do not buy any other brand of lanolin since they are NOT the same and are NOT ok for nursing. For more information on breastfeeding, see our Breastfeeding Information and Support page.
Newborns sleep a lot, usually 20 or more hours a day for the first few weeks. However, don’t let your baby sleep more than four hours at a stretch, except for the very first long sleep. He or she needs to eat. Otherwise the baby will get progressively weaker and harder to awaken. Call your midwife or your pediatrician if you have trouble waking your baby.
The umbilical cord will dry up and fall off, usually within the first 10 days. Keep the cord out of the diaper as the urine will keep it wet and often cause infection. You do not need to do anything (such as apply alcohol) unless the cord gets wet with urine or otherwise gets slimy or smells bad. In that case, dab the cord with alcohol twice a day until it falls off to prevent infection and promote dryness. The cord clamp can be removed after the first 24 hours, but don’t try to do this yourself. Your midwife will do this for you at the first postpartum visit. Watch the cord area for redness, puffiness, or pus, as these are signs of infection. Call your midwife for help if you see them.
All babies cry to communicate that they need something. The most common reasons are hunger, wet diaper, tiredness, or pain (such as gas pains or needing to be burped), and usually the crying will stop when the need is met. Sometimes, however, babies cry excessively and are inconsolable. We call this crying colic, and it’s cause is unknown. You can try catnip and fennel tea, Hyland’s homeopathic colic remedy (both available at your local health food store), carrying the baby in a baby carrier, running the vacuum cleaner (high frequency sound calms the baby), and gentle massage to the baby’s abdomen. If it continues or if your baby’s cry is high-pitched or does not sound like a normal cry to you, call your pediatrician as this can indicate a serious problem.
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- T. F. January 2015