General health checks
There are a number of tests that are considered mainstream for newborns to be given in the days following birth. These are important for detecting disorders or illnesses that might not be obvious at birth. These tests will not diagnose particular illnesses but rather indicate whether a child needs more tests. These ‘newborn screening’ tests can identify signs of more than 30 congenital disorders.
The screening is voluntary, free, and not invasive. It involves taking blood from your newborns heel with a needle, which is then used to detect certain genetic and/or metabolic conditions that may develop before symptoms become obvious. You can opt out of newborn screening, but the advantages of having the tests done far outweigh the short discomfort your baby might feel. It is suggested that watching their baby have blood taken is more distressing for the new mum than it is for your baby!
The blood from the heel prick test is also sometimes used for a tandem mass spectrometry test. This test tests for more than 30 exceedingly rare disorders that relate to how your baby’s body will break down fat and protein.
Another common test is a hearing test, which may be administered at birth or at one of your follow up doctor’s visits.
Immunisation and vaccinations
In Australia, the government insists your child is up to date with their immunisation as outlined in the national immunisation program, unless they have an exemption. If you have any questions about the benefits of immunising, the best thing you can do is talk to your healthcare professional in detail. Your decisions about your baby’s immunisation will have lasting effects on them throughout their life and is not a decision to be taken lightly or influenced by inexpert advice.
Health concerns
As a new parent, you are likely to have many concerns regarding your baby’s health. Some of the most common health problems for young babies include coughs, fevers, colds, and vomiting. Newborns are also liable to suffer form nappy rash, skin irritations and cradle cap. Many of these problems are not serious, and it is important to know how to care for your sick baby, and know the warning signs for more serious issues. Don’t hesitate to contact your health professional if you aren’t sure and are worried – trust your instincts with your baby.
Common health problems for babies
- Nappy rash
- Skin irritations
- Cradle cap
Signs of serious illness and conditions
Sometimes it is hard to know when your baby’s illness is a serious issue, or if it is a common and minor condition. You should call your doctor, or healthcare professional straight away if your baby exhibits any of the following:
- Your baby has a high temperature or fever of over 38°C.
- Your baby has a fit, or convulsion.
- Your baby vomits green fluid.
- Your baby has a lump in the groin area, or hernia.
- Your baby has an apneic episode (stops breathing for more than 15 seconds)
- There are also other signs that can indicate serious illness. If your baby’s behaviour indicates more than one of the following you should seek medical advice
- Excessive drowsiness (Less alert than usual, less aware of surroundings than usual).
- Decreased activity (considerably less active, less interested in activities).
- Breathing difficulty (coughing, short shallow breath, labored breathing).
- Poor circulation (baby is pale, hands and feet might be cold to touch).
- Feeding less (around half their normal intake).
- Less wet nappies (less than 4 in 24 hour period).
When to see your doctor
You should see your doctor if you are worried about your baby. Your doctor is there to diagnose and treat any illnesses you and your baby might have, but they are also there to answer your questions and reassure you. Most healthcare professionals understand the anxiousness that comes with being unsure as a new parent, and will be happy to see you to ease your concern.
Daily Care
Nappies
When it comes to choosing what kind of nappies you want to use for your child, there are many different factors you should take into consideration. People might choose either reusable or disposable nappies for a variety of reasons, including convenience and both financial and environmental concerns. Both types of nappy have roughly equal amounts of pros and cons, and the decision is entirely personal.
Disposable vs reusable nappies
Disposable nappies
Disposable nappies come in a variety of sizes and styles, are readily available at supermarkets and convenience stores, and are considered to be superior when it comes to wetness protection. Disposable nappies are convenient, easy to use and dispose of (hence the name). It is also easy to change your brand and style of nappy if you find that one isn’t working for you. Without an investment in a long term product, you are free to explore other options at any time.
It’s not all good news though, unfortunately, disposable nappies are pretty widely regarded as being bad for the environment. They are made out of synthetic materials which end up in landfill and can take many years to break down. They are expensive, and can add up to thousands of dollars over the course of time your child will be in nappies. Some people also find disposable nappies make their child more susceptible to nappy rash and other skin irritation.
Reusable nappies
Reusable, or cloth, nappies come in many different styles, types, colours and can be made from a variety of materials. They are widely available both on the internet and from local sellers and re-sellers. They are, in comparison to disposable nappies, very affordable, and can be reused for any subsequent children you might have, which cuts costs even further. They are increasing in popularity as consumers become more aware of environmental factors in their everyday lives, and now many services exist that can launder and return your cloth nappies, adding to their convenience. They are widely considered to be less likely to give your baby nappy rash and other skin irritations.
As with disposable nappies, reusable nappies also have their downfalls. They are expensive, with an initial outlay that could be in the thousands depending on brands and quantities. They create laundry, which takes time and uses resources like water and power, especially when tumble drying. They are bulkier than disposables, and some children’s clothing may not fit over them properly, and need to be carried around even when soiled if you are out and about. Some people also find that reusable nappies are not as absorbent as disposables, and can leak more readily and/or cause nappy rash and skin irritations.
Nappy rash
Nappy rash is a common skin irritation in newborns and babies. It is caused by the skin being in prolonged contact with the moisture from a soiled nappy, rubbing or chafing from the nappy itself, or (rarely) could be a result of allergic dermatitis.
Nappy rash is easily treatable by changing baby’s nappy frequently and when required. Make sure that when you change baby’s nappy you are also cleaning their genital area thoroughly. Let your baby spend time with no nappy on, as fresh air and a controlled amount of sunlight is very beneficial to clearing up skin irritations. Nappy rash ointment and creams are also very readily available from stores and are very effective.
Clothing
Dressing newborns
When dressing newborns the most important thing to remember is that babies cannot regulate their own temperature. The best thing to do as a general rule is to dress newborns in layers, the same amount as you would wear to keep warm/cool in weather plus one layer for warmth. Dressing in layers also makes it easy to both add and remove layers as the temperature rises or lowers unexpectedly.
The best kinds of clothing for newborn babies are made from mostly natural fibres, with minimal strings, buttons and other adornments. All in one suits that snap up the front are the most convenient and make adding layers over the top easy. Newborns should wear socks and booties, but avoid dressing in shoes as they can impede foot development.
Dressing for bed
When it comes to dressing your baby for bed, you should use much the same rule of thumb as you would for dressing during the day; dress them in the same amount of clothes you would wear, plus one layer for warmth. Make sure they will be warm enough throughout the night if they roll out of the blankets. Avoid dressing baby in a hat or bonnet while he or she sleeps as they will be unable to cool themselves down if they overheat. Headwear may also become loose in the night and be a chocking hazard in bed.
Dressing baby in an ‘infant sleeping bag’ is a great way to keep baby warm in bed. Infant sleeping bags that have fitted necks and armholes help keep your baby’s head and face uncovered while allowing him or her some room to move their legs. They also stop baby’s legs and feet from getting caught in the cot railings.
Wrapping your baby in a muslin or cotton wrap is also another option for sleep time. Some babies find being wrapped to be calming and can help to develop a more settled sleep pattern. When wrapping your baby it is important to find a technique that your baby is most comfortable in, some babies prefer their arms wrapped up near their chins, and some prefer their arms down by their sides. The most important thing when wrapping a baby is to make sure that the wrap does not cover a baby’s face, or impede on their breathing in any way.
Tips for dressing baby
Dress baby by lying him or her down on an open, flat surface. Start by stretching the neck of the outfit over baby’s head and pulling down, being careful not to let the material scrape over baby’s face, as that may cause distress. You can then reach through each sleeve and gently pull their hands through. If the outfit you are dressing baby in clips or zips up the front, lay it out flat on the changing surface and then lay baby over the top.
General Hygiene
Cleaning baby’s face and head
It is important to keep baby’s face and head clean throughout the day. Use fresh clean cotton wool balls soaked in warm (but not hot) water to wipe your baby’s eyes, starting from the inside (nose) and wiping outwards (ears). Use fresh cotton wool for each eye. Use new cotton wool to wipe around your baby’s nostrils, and the same technique to clean behind and around baby’s ears. Avoid cleaning inside the nostrils and ears as the skin is easily damaged. Use fresh cotton wool to wipe under the neck and chin, and over the face to keep baby nice and fresh.
Keeping baby’s umbilical cord clean
You should always wash your hands before touching your baby’s umbilical cord, and avoid touching it at all whenever possible. When you bath your baby make sure that the umbilical stump is dried properly before redressing, and make sure to fold nappies and clothing away from it. Your baby’s umbilical stump will mostly likely fall off within a week or two naturally, and you shouldn’t try to help it along as this can be detrimental. If your baby’s umbilical stump is red, hot or swollen, you should contact your healthcare professional for advice.
Caring for baby’s genitals
Keeping your baby’s genitals clean and fresh is very important to your baby’s general hygiene. Not properly cleaning your baby when changing nappies and bathing can lead to illness and serious skin irritations.
If your baby is a girl, make sure you clean her vagina from front to back to avoid spreading bacteria from her bottom to her genitals. Always use a fresh wipe for each part of her genitals you clean. In the bath you can use a washcloth and clean her genitals as part of your routine, still taking care to wipe from front to back. It is normal for your daughter to have a slight amount of discharge from her vagina; this is from being exposed to the hormones in the mother’s body before birth. If you are worried or concerned about your baby, you should call your doctor.
Boys genitals also require thorough cleaning. Use baby wipes, or cotton wool if you prefer, to clean around his penis and scrotum, taking care to not spread bacteria from his bottom to his genitals. If your son is uncircumcised, you can clean his penis as part of his regular bath. His foreskin will remain attached to the head of his penis, and will separate itself by around age 2. If your son has been circumcised, you can also continue to clean his penis as part of his regular bath, but you might also rub some petroleum jelly on it afterwards so as to stop it from rubbing on his nappy. Your son’s penis might take between 7 and 10 days to heal, and may appear red and swollen. Giving your baby ‘nappy-free time’ and letting fresh air circulate around his penis will help it to heal more quickly. If you are worried or concerned about your baby, you should call your doctor.
Bath time
Preparing the bath
You can bath your newborn in a specialty bath, a small tub, or even in the kitchen sink. Make sure before you start to bath baby that you have everything you need within arms reach, including towels, nappies and clothing for after you are finished in the bath. Fill up your tub with approximately 5cm of warm (but not hot) water. It is fine to wash baby in just clean water, but if you would like to use a bath wash, make sure that it is one specifically designed for babies, as their skin is more sensitive than adults.
Giving the bath
When it comes to giving your baby a bath, remember that you need to start at the top and work your way down your baby’s body. After you have undressed your baby, support them by holding them under their arms and neck and lower them gently into the water by their feet first until they are submerged over the shoulders. Take a clean washer and wipe baby’s eyes, ears and face. You can wet baby’s hair, but do not use shampoo or conditioner, as baby doesn’t need it. Move down the body to clean baby’s arms, hands, legs and feet. You should always clean your child’s genitals last, so as not to spread any bacteria to other parts of the body. Some babies will really enjoy the bath and will want to stay and play in it after you are finished washing, but it is important to remember that babies get cold very quickly and not to stay in the water too long.
When to bath
You can bathe your baby up to once a day, but as a newborn it is not considered necessary to do so, as long as you are keeping your baby clean. Some parents who have babies that really enjoy baths might be tempted to bathe more often, but this can lead to baby having dry skin. You can bathe your baby at any time during the day, whether you prefer to do so in the morning, throughout the day or as part of a calming night routine is entirely up to you.
What if my baby doesn’t like baths?
If your baby doesn’t like baths, you can bath him or her once or twice a week and ‘top and tail’ the other days. ‘Top and tail’ refers to thoroughly cleaning your baby’s eyes, ears, nose, face and head, and genital area with warm water-soaked cotton wool. To work up baby’s tolerance to bath time, try making it an interactive experience. Singing, playing and splashing in the bath can help baby to feel more relaxed and enjoy it more. The earlier that baby comes to like bath time the easier it will be once they start to get a little older.
Nail care
Newborns fingernails are tiny and sweet, but they can also be incredibly sharp. Trimming your baby’s nails regularly will help stop him or her from scratching both themself, and you with these tiny weapons. You can buy specialty baby nail clippers, or use nail scissors to trim them down. It is best to get someone to help you by holding your baby and calming them while you gently push their fingertip away from the nail and cut. Another technique is to cut baby’s nails while they sleep, eat, or are in some other way distracted. If you are worried about cutting the skin around the nail by accident, you can use a soft emery board and file the nail back, taking care to only file the nail and not the fingertips.
Teeth and gums
Tooth development
At birth, babies have a full set of primary, or ‘baby’ teeth in their gums, which will grow upwards and ‘erupt’ through the gums. This usually occurs slowly over several weeks or months, generally starting at around 6 – 10 months; although some children wont start to erupt until 12 months of age. Most babies will have a full set of primary teeth by age 3.
In some cases, babies can be born with one or two teeth already erupted. These are known as ‘natal teeth’ and are considered to be relatively uncommon. They aren’t connected with a sturdy root system like primary teeth, and are often wobbly. Natal teeth are usually removed shortly after birth while the newborn is still in hospital, to reduce the risk of the tooth becoming free and the child choking on it. If for whatever reason your doctor does not remove natal teeth, you should consult a specialty dentist as soon as possible to discuss options.
Gum care
Caring for your child’s dental wellbeing starts as soon as you come home with baby. Encouraging healthy habits from a very young age will help when your child is old enough to brush their teeth themselves. You can get your baby used to having a foreign item in their mouth by wetting a clean washer and running it gently over their gums, tongue and roof of mouth.
Singing a special ‘teeth-brushing’ song or having a special routine with dental care can help to make the experience fun for baby. Setting your child up with good oral hygiene from a young age will benefit them greatly in the future.
Early tooth decay prevention
To avoid any early tooth decay, avoid giving your child anything sweet, including juice in a bottle, or covering a dummy in honey, as the sugar is bad for tooth and gum development.
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