Guide for First-Time Moms

The basics of newborn care during those first few nerve-wracking months.

Newborns don’t come with a set of instructions. So when you arrive home from the hospital with an infant in your arms, it’s normal to be a little unsure of yourself. Take heart in knowing that parenting is a learning experience, and you will gain confidence — and skills — with each successive diaper change and bath.

While you’re still finding your way around your new role, here are a few tips to help you navigate the basics of baby care.

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Feeding 101

The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months of your baby’s life. Yet whether you decide on breast milk or formula is up to you. Both methods supply your baby with the nutrition she needs for a healthy start in life.

If you are breastfeeding, it can help to work with a lactation consultant — especially if your baby is having trouble latching onto your breast. Nurse about once every 1 to 2 hours, and keep baby on the breast until she seems satisfied or falls asleep. Babies who are getting enough to eat from the breast will produce about six to eight wet diapers a day, as well as yellow, seedy stools.

To bottle feed, you’ll need some supplies on-hand, including formula, bottles, nipples, and a nipple brush. You’ll also have to choose a formula. Most babies eat cow’s milk-based, iron-fortified formula, but if your baby is sensitive to cow’s milk, soy and hypoallergenic formulas are also available. When you feed, hold the bottle at an angle to prevent your little one from swallowing too much air.

Diaper dos and don’ts

Diapering isn’t all that difficult, but you do need to have some supplies on hand before you start. Place some diapers, wipes, and ointment right next to your changing table so you never have to leave your baby unattended. Even a momentary step away from the table is enough time for an active infant to fall off. If you have a boy, also keep an extra clean diaper or cloth nearby to cover baby’s penis, in case he urinates while you’re changing him.

Using a baby wipe or moistened clean cloth, wipe baby from front to back. Never go from back to front, especially in girls — bacteria can get into the vagina and cause an infection.

Once your baby is clean, pat the area dry. If you see any redness or bumps — signs of diaper rash — apply a layer of zinc oxide diaper ointment before putting on a clean diaper. Change your baby’s diaper often to prevent wetness from worsening the diaper rash. “The best way to prevent and treat diaper rash is to keep your baby’s skin as dry and clean as possible,” said dermatologist Lawrence F. Eichenfield, MD, FAAD, chief of pediatric and adolescent dermatology, University of California, San Diego, and Rady Children’s Hospital. “With the right care, diaper rash should clear in about three to four days.”

Umbilical cord and circumcision care

In the womb, the umbilical cord connected your baby to you, and delivered the nutrients he needed to grow. At delivery, the cord was cut, leaving a little stump behind. It should fall off within a couple of weeks. Until that time, keep the area clean and dry.

Fold your baby’s diaper under the cord stump so it’s exposed to the air. This exposure will help it dry faster. Use a damp washcloth to clean the umbilical cord during each diaper change.

If you have a boy and he was circumcised, keep the penis clean while it heals. Wipe it gently with a wet cloth during diaper changes — don’t use baby wipes. Ask your doctor whether you should also apply a bit of petroleum jelly to the penis or front of the diaper. The circumcision site will probably be red at first, but it should heal within seven to 10 days.

Bath time

For the first week or two, until the umbilical stump falls off, give your baby only sponge baths. Use a moistened washcloth with a little bit of gentle baby soap. Keep your baby’s body covered in a towel, except for the part you’re washing. Remember to get into all the little creases and crevices — including under the arms, behind the knees, and between the toes.

Once you transition to a tub, safety is key. If you use an infant tub or basin, make sure it’s sturdy and can hold your baby’s weight. Never leave your child unattended, even for a second. Babies can drown in just an inch or two of water. Also make sure your water heater is set to 120 degrees Fahrenheit or lower to prevent burns.

How often should you give baths? Newborns don’t need daily washing. Three times a week is enough to keep your baby clean and avoid drying out his skin.

Baby sleep

Whether your baby sleeps in a bassinet or crib, he needs to have a smooth surface, free from soft objects that could interfere with her breathing and lead to sudden infant death syndrome (SIDS). “Parents have good intentions but may not understand that blankets, quilts and pillows increase a baby’s risk of SIDS and accidental suffocation,” said Carrie K. Shapiro-Mendoza, PhD, MPH, senior scientist in the CDC’s Division of Reproductive Health in Atlanta. Keep pillows, stuffed animals, and bumpers out of the crib. Instead, put baby to sleep on a firm mattress with only a fitted sheet on top. If it’s cold in the house, put her to bed in heavier pajamas.

Time to call the doctor

As a first time mom, you might jump at every sniffle and cough. Sometimes it’s hard to tell the difference between normal infant responses and more serious health issues. Here are a few signs of a real problem.

Call your pediatrician if you notice that your baby:

• Isn’t feeding well or doesn’t seem to be gaining weight
  
• Seems lethargic or especially irritable
  
• Has bleeding, pus, swelling, or redness around the umbilical cord or circumcision site
  
• Is running a fever (in babies under three months, any fever warrants a call to the doctor)
  
• Is vomiting or has diarrhea
  
• Is making fewer wet diapers or isn’t producing tears
  
• Has a rash