Newborn Baby, Infant and Child Health Care

While your baby’s needs will be taken care of in the hospital, you will need a number of essential things at the ready once your baby comes home. Here’s a list of things you should have at home when your baby arrives:

• Newborn baby diapers (you will need to get a lot of these depending on your baby’s age, but watch out for diaper rashes)
• A comfortable baby hat
• A swaddling cloth or blanket made of soft fabric deemed safe for newborns
• Four-five sets of baby clothes
• A breast pump (in case you have trouble lactating or breastfeeding)
• Baby bottles with soft nipples and sterilising equipment
• Baby wipes or soft cleaning cloth
• Diaper rash cream, according to the recommendation of your doctor
• A crib or bassinet, since your baby needs a separate, firm and safe sleep environment
• Soft towels and washcloths
• A baby tub to bathe your baby safely

Newborn babies are very delicate, and handling them is not everyone’s cup of tea. Since a baby’s neck muscles are weak, you will primarily need to learn how to hold the baby properly. If you cannot hold the baby safely and securely, he or she won’t be comfortable enough to fall asleep or feed properly either. Here’s what you should and should not do while handling a baby:

• Always wash your hands or use a hand sanitizer before handling a baby. 
• Cradle the baby’s neck and head securely on your palms or in the crook of your arm. 
• Be very careful while picking up, placing down or shifting the baby from one place to the other.
• Never shake the baby, since this can cause bleeding in the brain, which in turn can lead to death.
• Do not wake your baby while he or she is sleeping. If you absolutely need to, tickle the feet or blow on either cheek, but never shake or jerk the baby awake.
• Always secure the baby properly while using a carrier, stroller, bassinet or car seat.

According to the American Academy of Pediatricians and the World Health Organization, it’s very important to exclusively breastfeed the baby for the first six months. There are a number of benefits of breastfeeding for both the mother and the child, so this process should not be avoided unless you have been infected by the human immunodeficiency virus (HIV), have trouble lactating or do not want to breastfeed at all. 

In these cases, the baby is usually bottle-fed formula milk, but you should be aware that formula milk is made of cow’s milk, which does not have the same antibodies as breast milk does. These antibodies are important because apart from being the sole source of nutrition for the baby, breast milk also provides the baby with primary immunization from a number of diseases. Until the baby receives all the vaccines, the antibodies from breast milk play a vital role in building the baby’s immune system and keeping him or her safe.

Whether you’re breastfeeding or bottle-feeding your baby, here’s are a few things you should know:

• Babies should be fed on demand, based on cues like crying, making sucking noises or sucking on the thumb or other fingers.
• Newborn babies need to be fed every two-three hours. As they grow older, the feeding volume and duration will increase, but the number of feedings will decrease.
• Hold the baby properly in place before helping him or her latch on to the breast. This might take some time in the beginning, but you will ease into it gradually and so will your baby.
• If you’re breastfeeding, make sure your baby nurses on both breasts. If you don’t do this, then you are more likely to get sore breasts, breast pain, nipple pain and other issues.
• Make sure your baby is eating enough. Your breasts should feel fuller before the feeding and lighter afterwards. If you’re bottle-feeding then it’ll be easier to note if your baby is eating enough, thanks to the measurements on the bottle.
• If your baby doesn’t seem interested in feeding or suckling, consult your paediatrician immediately.

Babies often swallow air during feeding, which is why it’s very important to burp them after feeds, or while switching from one breast to the other. Your baby will let you know if he or she needs to be burped during feeds by being gassy, spitting up and being fussy. Here are a few tips you can use to help your baby burp:

• Hold your baby upright by supporting his or her head and neck.
• You can hold the baby upright against your chest, on your lap or on the knee.
• Always pat the baby’s back gently. 
• If the baby is not burping properly, then shift positions.
• Sitting on a rocking chair can also help with burping.
• If your baby spits up too much do consult the doctor to find out if he or she has infant reflux (gastroesophageal reflux disease or GERD).

Whether you use disposable diapers or reusable, soft cloth diapers, you should know that cleaning and changing the baby will have to be done at least 10 times a day in the beginning. It’s a lot of work and can be exhausting, but it’s also vital that you do it the right way. If your baby is not cleaned properly or on time, it can lead to bacterial infections and fungal infections.

You will need to ensure that the following things are at hand throughout the day so that you can change your baby’s diaper without much hassle:

• A fresh, clean diaper
• Safe fasteners which don’t rub against the baby’s umbilical stump
• Diaper cream or ointment recommended by the doctor
• Baby wipes, clean washcloth or cotton balls and lukewarm water

You need to check if the baby has pooped or peed and clean him or her up as soon as possible. Your baby will let you know about bowel and bladder movements by crying, but if you miss the cue it can lead to complications and it will be more difficult to soothe him or her afterwards. Here’s how you should go about cleaning your baby and changing diapers:

• Wash your hands properly before handling the baby.
• Place the baby on a changing board or on a clean and dry oilcloth.
• Remove the diaper carefully by lifting the baby’s legs.
• Clean the baby’s bottom and genitals gently with clean baby wipes, washcloth or cotton balls.
• Make sure you clean the baby, especially if you have a baby girl, front to back - i.e. clean away from the genitals toward the anus. If you do it the other way around, it can lead to urinary tract infection (UTI).
• Apply a diaper cream or ointment to avoid or heal a diaper rash, but make sure that it’s safe for your baby.
• Lift the baby’s legs and place a fresh, clean diaper and fasten it properly.
• Wash your hands thoroughly with soap and water, dry them and moisturise before touching the baby again.

It’s very important to remember that all babies might look dirty right after they are born, but that’s just the amniotic fluid that helped them survive during pregnancy. The nurses at the hospital clean up the baby, and if you ask, they will also show you how to properly and safely sponge bathe the baby. You should exclusively sponge bathe the baby until the umbilical stump dries and falls off naturally in the first month after birth. The same rule applies for the baby if he has been circumcised.

You will need the following things for a sponge bath:

• A soft, clean washcloth
• Cotton balls
• A mild, unscented baby soap and shampoo
• Soft towels
• Clean diaper
• Fresh baby clothes
• A flat, clean surface

Here’s how to sponge bathe the baby safely:

• Make sure you have a clean and safe flat surface to bathe the baby.
• Ensure that the room is warm so that the baby doesn’t catch a cold.
• Fill a small tub or sink with clean and lukewarm water (check the temperature with your elbow). Place the tub right next to the flat surface where you plan to bathe your baby.
• Place a towel on the flat surface, place your baby there and undress him or her.
• Wipe the baby’s eyes first with a clean cotton ball dipped in water. Don’t use any soap.
• Clean the nose, face and ears next, and gently pat the face dry with a soft, dry cloth.
• Now use mild baby soap and water to clean the baby’s body, paying special attention to the areas under the arms, behind the ears, and creases.
• Make sure you clean the baby’s genitals properly by going front to back, especially if you have a baby girl.

Once your baby is ready for a tub bath, you can give him or her a bath twice or thrice a week for the duration of the first year. Here are a few things you should remember while bathing your baby in the tub:

• Make sure the bath is brief and gentle, especially in the beginning. 
• Bathe your baby in a warm room instead of the bathroom. 
• Make sure the bath water is lukewarm and never hot.
• You must hold your baby upright and support his or her head, neck and back properly.
• Always place the baby feet-in first.
• Talk or sing to the baby continuously to soothe him or her.
• Make sure soap or shampoo water or suds do not reach your baby’s eyes and nose.
• Always start the bath with the face and head, and follow through to the rest of the body.
• Do not skip cleaning the genitals properly during baths.
• Wrap your baby with a clean and dry soft towel immediately after the bath to make sure he or she doesn’t catch a cold.
• Never leave the baby alone in the tub. If you need to leave the area in the middle of a bath, wrap your baby snugly in a clean towel and take him or her along.

The umbilical cord is the way your baby received nutrition during the pregnancy, and once your baby is delivered, the cord is cut and clamped. This umbilical stump usually dries and falls off naturally within four weeks. But until it does, it’s very important to care for your baby’s umbilical stump. Here are a few things you should remember:

• The stump should be clean, dry and healed properly. 
• Do not use any soap, water or rubbing alcohol to clean the umbilical stump.
• Do not give the baby a tub bath until the umbilical stump falls off naturally.
• Do not try to poke or pull off the stump to help the falling off. It should happen naturally.
• Always place the baby’s diaper well below the stump to avoid moisture and infection.
• If the baby’s navel area looks red, develops a rash or smells foul, consult your paediatrician immediately. 
• It’s a good practice to preserve the baby’s umbilical stump once it falls off, since it has stem cells and blood which can later be used to treat the baby in case of diseases like sickle-cell disease, leukaemia, or metabolic disorders like Wilson's disease, etc.

Bonding with your baby is one of the most enjoyable parts of newborn and infant care. This bonding is also very important for your baby's development and for improving the parents’ affection. Skin-to-skin touch, cradling, singing, talking and breastfeeding help build this bond. It’s very important that this emotional bond not be restricted to the mother and child. The bond between the father and the baby is equally important. 

This emotional attachment can also help soothe the baby whenever he or she is upset, hungry, angry, anxious or scared. Here are a few things you should try to soothe the baby, especially when he or she is crying:

• Swaddling the baby will make him or her feel secure.
• Gently rock or lightly swing the baby in your arms.
• Singing or playing songs with a soothing or catchy rhythm can help.
• Turn on the fan, vacuum cleaner or any machine that makes a low yet persistent white noise.
• Gently massage the baby’s legs, arms, back, chest and face with soft strokes.

A newborn baby sleeps for 16 hours or more during the first few weeks of life, but this is never at one go since the baby will wake up for feeds, after pooping or peeing, and if there is any disturbance. Until the baby is four to six months old, his or her sleep pattern will make it difficult for you to sleep well for eight straight hours. There are a number of tips you can use on how to get sleep with a newborn baby.

During the first year of the baby’s life, he or she might be at risk of sudden infant death syndrome (SIDS), so it’s very important to maintain a safe sleep environment for the baby. Here are a few things you should remember:

• Make sure the baby sleeps in the same room, but does not share a bed with you.
• Always put the baby to sleep on his or her back.
• Make sure there are no loose toys, comforters, pillows, etc., around the bed.
• Keep the room dark and use dim lights whenever the baby is sleeping.
• Sleep while the baby is sleeping to get enough rest during the first few months.
• Do not wake your baby up while he or she is sleeping - this sleep is vital to the baby's development.

Keeping a track of your baby’s development and general health is very important. Since your baby cannot communicate directly, his or her body will show symptoms of any health issues. You should be cautious about these to ensure that your baby is healthy and developing properly. Here are a few things you should keep in mind about your baby’s health:

Vaccinate: Make sure your baby receives all the vaccines he or she needs. This will ensure that the baby does not get any major illnesses. The first round of vaccines will start with a hepatitis B vaccine within the first 24 hours, followed by vaccines for rotavirus, whooping cough, diphtheria, tetanus, polio and pneumococcal disease in three rounds (usually administered in the second, fourth and sixth months). Immunizations for flu, chicken pox, measles, mumps, rubella, hepatitis A and others will be administered as your baby grows older.

Doctor’s checkups: You should never miss an appointment with your paediatrician, even if you do consult them on a regular basis on the phone. This is because the doctor needs to do a thorough physical checkup of the baby to know if everything is as it should be. These checkups will be scheduled frequently during the first six months.

Maintain a milestones diary: Most hospitals provide new parents with a milestone diary, but even if they don’t, you should maintain a record of your baby’s development in the first 12-18 months. This will help you keep a track of your baby’s development, especially related to weight, height, cognitive development and motor skills. 

Medical essentials: There are a number of medicines and medical tools that are deemed baby-safe. Consult your paediatrician before stocking up on them. Keep them handy. These essentials must include:

• Digital rectal thermometer
• Diaper rash cream
• Baby soap
• Baby lotion
• Petroleum jelly
• Medicine droppers
• Cotton swabs and balls
• Infant acetaminophen for fever (or any other medicine recommended by your paediatrician)
• Antibiotic cream
• Tweezers and baby nail clippers

While taking care of a newborn or infant might seem difficult and overwhelming, it’s important to remember that a majority of new parents go through the same things that you will. Being informed, staying in touch with your doctor and talking to experienced parents can help in this regard. Make sure you ask enough questions - remember there are no wrong or silly questions when it comes to your baby's safety and well-being. Here are a few things you should remember while bringing up your baby:

• Bonding with the baby early on is very important for both the mother and father. Do not assume that the bond between father and baby isn’t that important.
• Setting a routine for yourself and the baby is vital. Meals, physical activity and sleep should be regularised as soon as possible. You can start building a baby bedtime routine in the second week after your baby is born.
• Engaging family and friends in child care in the early days is necessary because it takes some load off the parents and helps the baby adapt to community and society bonds faster. Make sure to engage any older siblings, too, to make them feel included, rather than jealous of the baby.
• Both parents, father and mother, are at risk of depression because having a baby is a huge change in lifestyle. Make sure the parents take some time to rebuild their relationship and adapt to parenthood together.
• Consulting doctors and experienced parents, even socialising with other new parents, can help you understand baby development better and adapt well.