Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0020/00204.txt

Text File | 1993-06-14 | 30KB | 515 lines

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$Pretitle{}
$Title{Birth to 6 Months:  Daily Care Basics}
$Subtitle{}
$Author{
Editors of Consumer Guide
Mendelson, Robert A
Mendelson, Lottie M
Meyerhoff, Michael K
Ames, Louise Bates}
$Subject{Birth to 6 Months Daily Care Basics newborn fragile handle Handling
diapers cloth recyclable diapering disposable disposables biodegrade
biodegradable plastic pants store soiled bathe bath bathing umbilical cord
Sponge baths tub bathtub soft spots belly button clean ears cradle cap
scratches fingernail fingernails toenail toenails sleep sleeping position warm
comfortable temperature clothing Layettes bedding flame-retardant toys
teething rings pacifiers clean cleanliness DIAPER RASH rashes genital CARE
GENITALS swaddle swaddles Swaddling swaddled dressing}
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The New Parents' Question & Answer Book


Birth to 6 Months:  Daily Care Basics


     My newborn seems so fragile.  How do I handle her safely?

     When you handle your newborn, it will be natural for you to be gentle and
careful.  But there are a couple of specifics you should keep in mind.  First,
your newborn's head is rather large in comparison to the rest of her body, and
her neck muscles are not yet strong enough to control it.  So whenever you
pick her up, hold her, or move her, you will have to support her head and neck
(see "Handling Your Baby").  Second, your baby will not appreciate abrupt
movements.  She's likely to startle and cry if you scoop her up too quickly.
The best way to help her feel secure is to pick her up slowly and gently and
keep her close to your body whenever you hold her.  You may want to try
holding her cocoonlike in your arms, so she can look up at your face as she
cuddles to the rhythm of your breathing.  You might also try the burping
position, with her head resting on your shoulder and your hand supporting her
neck and back.  You'll need to experiment a little to find the positions that
are most comfortable.  No matter which you choose, however, be sure to provide
the physical support and sense of security that she needs.


     What type of diapers should I use for my baby?

     Today's parents have an assortment of diapers--from prefolded cloth to
disposables--from which to choose.  Which type you choose will depend on a
variety of factors, including cost and convenience.  Many parents opt to use
both types--cloth at home and disposables when away from home.  You may want
to experiment before you settle on a favorite.  See the following questions
for more on the advantages and disadvantages of different types of diapers.


     What are the pros and cons of using cloth diapers?

     Many parents choose traditional cloth diapers, which come prefolded 14 x
20 inches or in the original 27 x 27 inch square shape.  Most cloth diapers
can be folded to fit both infant and toddler, with extra padding where your
baby needs it.  Cloth diapers are generally the least expensive option if you
have easy access to a washer and dryer and can wash them yourself.  A more
expensive but often more convenient option is to use a diaper service, which
will provide cloth diapers, pick them up, wash and sterilize them, and deliver
them back to your door.  Cloth diapers are also "recyclable"; you can wash
them and reuse them over and over again.  On the other hand, using cloth
diapers can be less convenient than using disposables.  Even if you have a
large stock of cloth diapers, you'll have to wash them frequently.  They must
be washed separately from your clothing, and they must be double rinsed.
Another inconvenience concerns what to do with the diapers in between
washings.  If you are away from home, you'll have to find a way to rinse a
soiled diaper and carry it back home.  At home, you'll need to have a place to
keep soiled diapers between washings.  Cloth diapers are also not as airtight
as disposables.  This can be inconvenient for parents, but it may actually be
better for baby's skin.  Because they allow moisture to evaporate, cloth
diapers may help to decrease diaper rash.  On the other hand, because they do
not hold in moisture as well, they may leak, which means you'll have to change
bedding and clothing more often.  Using disposable diaper liners or plastic
pants can help, as can double diapering.  But liners add to expense, and
plastic pants trap moisture next to the skin.  A better solution is to double
diaper, especially at night or if the baby is older.  And finally, unlike
disposables, cloth diapers do not come with built-in fasteners.  The
traditional way to fasten them is to use diaper pins.  If you use these,
you'll need to be careful about pricking the baby.  Another option is to
enclose cloth diapers in the soft plastic "tie at the hip" covers.
Velcro-fastened diaper holders are also available.


     What are the pros and cons of using disposable diapers?

     Disposable diapers are the first choice for many parents.  They're
available in sizes from premature to extra-large toddler.  Some even come with
extra padding in front for boys or in back for girls.  Disposables do tend to
be the most expensive option, but they are more convenient than cloth diapers,
especially when you're away from home.  They are easy to use, store, and
carry.  They come with sticky tabs that hold them in place, so you don't need
diaper pins or special holders.  They save time because there's no diaper
laundering.  And they tend to be less likely to leak.  Unfortunately, some of
the disposables with pleating and elastic around the tummy and thighs are too
efficient; they keep urine in very well, but they don't allow air circulation.
So while they protect clothing and bedding, they may also help promote diaper
rash.  Keeping the diaper fairly loose and checking it frequently for urine or
feces can help.  Another problem with disposable diapers is that while they're
easy to throw away, they do not biodegrade easily.


     How often should I change my baby's diaper?

     Your baby's diaper should be changed whenever it is wet or soiled, which
will be many times throughout the day and night.  This is true no matter which
type of diaper you use but is especially important if you use disposables or
plastic pants over cloth, which can trap moisture against your baby's skin and
cause irritation.  At night, check your baby's diaper when you feed her, and
change it if necessary.  If you use cloth diapers during the day, you're
likely to know right away if her diaper is wet or soiled.  If she's wearing
disposables or plastic pants, you may need to check frequently to see if her
diaper is wet or dirty.


     How do I diaper my baby?

     Some parents use a waist-high changing table, some simply spread a clean
towel on the floor, and others prefer to change their baby on a padded surface
near the sink.  Regardless of which surface you use, never take your hands off
your baby or leave her during diapering.  Even new babies can wriggle and fall
off a raised surface.  Diapering on the floor or using a changing table with a
belt that fastens around your baby's tummy may help to prevent such accidents.
Still, you should be sure that everything you need is within reach before you
begin.  If you discover that you've forgotten something, take the baby with
you to get it.  Never leave your baby unattended for even a second unless
she's in her crib or strapped into her carrier.  Once you've gathered your
equipment, lay the baby on her back and unfasten the wet or soiled diaper.
Gently grasp your baby's ankles, lift her legs and bottom, and take the diaper
off.  Wipe off as much feces as possible with the dirty diaper.  Next, gently
but thoroughly clean the baby's diaper area using a washcloth and warm,
slightly soapy water (use only mild soap made especially for babies).  See
"Preventing Diaper Rash, below" for more on how to clean the diaper area.
Once you've rinsed the diaper area thoroughly, pat it dry.  Then raise the
baby's bottom as before, and slip the clean diaper underneath.  Once you have
arranged the diaper, lay the baby's bottom on it.  Bring the diaper up between
the baby's legs.  If you are using disposables, lay the baby on the end with
the tapes, and tape the back edges over the front.  If you are using cloth
diapers, pin the back edges over the front ones.  When fastening with a pin,
slide your hand between the pin and the baby's skin so she won't get pricked.
Also, be sure the pins are tightly fastened with the heads pointing away from
the baby.  If you use diaper pins or any type of ointment, lotion, or powder,
be sure to keep them out of your baby's reach as you are diapering.  If you
use powder, pour a small amount into your hand first, keeping it away from
your baby's face; inhaling powder can irritate her respiratory tract.


     How should I store and wash soiled cloth diapers?

     To store soiled or wet cloth diapers before washing, you'll need a diaper
pail containing half a cup of vinegar and enough water to cover the diapers.
Diapers that are merely wet can be tossed directly into the pail.  Soiled
diapers, however, should be rinsed before being placed in the pail.  When
you're ready to wash the diapers, drain the pail and place the diapers into
the machine.  Wash the diapers separately from other clothing.  Use hot water
with a minimum amount of soap (not detergent), then double rinse the diapers.
Do not use fabric softener, since it may irritate your baby's sensitive skin.
Be sure the diapers are dried thoroughly, either in the dryer or on the line,
before being folded.


     When and how often should I bathe my baby?

     Babies don't require a daily bath.  In the first two or three weeks of
life, before the umbilical cord heals, your baby shouldn't have a tub bath.  A
sponge bath (in which she's not actually sitting in water) given three to four
times a week is usually adequate at this stage (see How Do I Give My Newborn A
Sponge Bath?).  Her diaper area, face, and neck should be washed whenever
necessary.  Once the umbilical cord has healed, your baby will be ready for a
tub bath (see How Do I Give My Baby A Tub Bath?).  Even then, however, two to
three times a week should be adequate.  More frequent bathing can dry your
baby's skin.  Choose a convenient time for your baby's bath.  You'll need to
give her your undivided attention during the whole process, so aim for a time
when you won't be disturbed.  If the phone rings or someone comes to the door,
have someone else answer it, or just ignore it.  You will not be able to leave
the baby, and taking her with you could cause her to get chilled.  You'll also
want to pick a time that's convenient for your baby.  You don't want to bathe
her immediately after a feeding, nor do you want to bathe her if she's
screaming to be fed.  Try for an awake time between feedings when you both are
relaxed and comfortable.


     Where should I give my baby a sponge bath?

     Sponge baths during the first two to three weeks of life can be given
wherever you and the baby can be comfortable.  Be sure the room is comfortably
warm and that you keep her partially wrapped as you wash her.  If you have a
wide enough counter next to your kitchen sink, you can pad it with fluffy
towels and hold the baby there as you wash her, the sink can be used to hold
the bathwater.  Changing tables can be convenient for sponge baths.  Some
parents, however, prefer to hold the baby on their lap with one hand and wash
her using the free hand.  This can be a little tricky, so if you're unsure of
yourself, use one of the other methods.


     When my baby is ready for a tub bath, should I bathe her in the bathtub?

     The bathtub is probably too large a space for you to comfortably support
and wash your baby.  You'll need to hold her throughout the process, so you'll
want to choose a smaller space.  You can purchase a baby bathtub or a changing
table with a built-in baby tub for this purpose (many of these are designed to
support your baby's head as you bathe her, although you'll still need to keep
a hand on her at all times).  You need not go to this expense, however.  You
can bathe her in a dishpan in the sink or you can simply line the sink with
rubber mats or towels and bathe her there.  You'll need to be sure, however,
that you cover all faucets and that you turn the cold water off last, so that
the faucets are not scalding hot should your baby get near them.  You'll also
have to support her head and back with one hand as you wash her with the
other.  No matter where you choose to bathe your baby, however, be sure the
room is warm and that all slippery surfaces are lined with rubber mats or
towels.


     How do I avoid touching my newborn's soft spots when I wash her hair?

     You don't want to avoid touching your baby's soft spots.  The soft spots,
like the rest of your baby's head, should be washed gently to keep them clean
and prevent cradle cap.  The soft spots, or fontanels, are small areas on the
baby's head where the skull bones have not yet fused.  They are covered with a
tough protective membrane, as well as with skin, so normal handling can't
possibly hurt the baby.  The purpose of the fontanels is to allow the skull
bones to slide over each other slightly during birth so the baby's head can
pass through the birth canal.  They also allow for the tremendous growth in
the baby's brain during the first year of life.  The small fontanel at the
back of the head closes up within one and a half to three months of birth.
The larger fontanel on the top of the baby's head completely closes by 12 to
18 months.


     How should I take care of my newborn's belly button?

     After birth, a clamp is placed on the umbilical cord, and the cord is
cut.  By the time you take your newborn home from the hospital, the clamp will
have been removed.  The stump that remains usually falls off during the second
or third week after birth.  Until the stump has separated and the area has
healed, you'll probably be advised to clean the area with isopropyl (rubbing)
alcohol.  This should be done three to four times a day (or with every diaper
change if that's easier to remember).  To clean the area, pour a small amount
of the alcohol onto a clean cotton ball and wipe the area where the cord stump
meets the skin.  If the stump falls off but the belly button remains moist or
there is a little oozing of fluid or blood, continue to clean the area
regularly with alcohol and cotton until it is clean and dry.  If there remains
a shiny, gray lump where the cord stump separated, an umbilical granuloma may
have formed.  This is another way the cord sometimes heals.  If you notice
such a lump, discuss it with your pediatrician.  He may want to apply a
medication called silver nitrate to help speed healing.  Infections of this
area are very rare.  However, if you notice increasing redness around the
cord, especially if the area is tender, notify your pediatrician at once.


     How should I clean my baby's ears?

     You can clean your baby's outer ears at bath time using a soft, wet cloth
(do not use soap).  Gently wipe the outer ear and ear folds.  Be sure to wipe
behind the ears, since this is a good hiding place for cradle cap (basically,
cradle cap is baby dandruff).  The baby's inner ears, or ear canals, are self
cleaning.  Never use cotton swabs, tissues, your finger, or anything else in
the baby's ear canals.  Not only is it unnecessary, it can be harmful.  The
rule of thumb for cleaning your baby's ears--as well as your own--is to never
put anything smaller then your elbow into the ear.  If you ever suspect that
there is a problem with your baby's ears or with her hearing, consult your
pediatrician.


     My baby scratches herself with her fingernails.  What's the best way to
trim her fingernails and toenails, and how often should I do it?

     Although you can put your newborn in a nightie with sleeves that cover
her hands, you'll still need to keep her fingernails short and smooth.  There
are baby nail scissors and baby nail clippers with rounded edges available,
but these are still very sharp.  Inexperienced, and even some experienced,
parents can sometimes trim too closely and injure the finger, especially when
the baby pulls away unexpectedly.  Using a soft emery board to file the
fingernails down is usually the best method.  It may take two of you to get
the job done at first.  One of you can hold the baby while the other grasps
one of the baby's fingers at a time and carefully files.  File the fingernails
as often as necessary to keep them short and smooth; this may mean once a week
or once every other week, depending upon how quickly your baby's fingernails
grow.  Your baby's toenails grow more slowly than her fingernails, but they
require attention, too.  File or trim them as you do the fingernails, just not
as often.  Don't be surprised if you have trouble even seeing the toenails on
the smallest toes.  A newborn's toenails are not well developed, and they may
grow crooked or look rather odd for a while; just keep them smooth, and avoid
trimming them too short.


     Is it okay to have the baby sleep in our room?  When is the best time to
move her to her own room?

     This is basically a matter of preference.  If it is more convenient or
reassuring for you to have her sleep in your room, then that's what you should
do.  Since you may be feeding your newborn every three, four, or five hours
throughout the night, you may find it helpful to have her bassinet or cradle
in your bedroom.  This is especially true if you prefer to nurse her from a
reclining position.  On the other hand, some parents find that listening to
their baby's noises disturbs their sleep.  In that case, you'd be better off
to put her in her own room.  If you do decide to have the baby sleep in your
room, you'd probably want to move her to her own room when she is down to one
nightly feeding or when she has started sleeping six to eight hours straight
each night.


     When I put my newborn down for the night, is one position preferable to
another?

     Babies often have or develop a favorite sleep position, and they'll let
you know if they're uncomfortable.  For now, however, when you put your
newborn down, you may want to rotate the position.  Putting her down in only
one position may cause her head to flatten a bit, because the bones in her
skull are still pliable.  If she seems to be comfortable in only one position,
though, don't worry; her head will regain its normal shape in a short time.


     How can I be sure my baby is comfortably warm when she's indoors?

     Your baby's temperature control mechanism will not be fully mature until
she is nearly a year old.  Especially in the first few weeks of life, she will
be extremely sensitive to cold and heat, and she can become chilled easily.
Until her body can better regulate its own temperature, you'll need to keep
her comfortably warm.  The most comfortable room temperature for a baby is
between 68 and 72 degrees Fahrenheit.  You'll need to avoid placing her in the
draft from an open window or air conditioner vent, however.  And you'll need
to position her crib away from heat registers; although the warm air won't
hurt her, dust particles blown up by the furnace may irritate her nose and
throat.  Be sure to dress and undress her quickly, and avoid chilling by
drying and dressing her quickly after a bath.  New parents have a tendency to
overdress newborns, so you'll need to use a little common sense in terms of
clothing and blankets.  A good rule of thumb is to dress the baby in one more
layer of clothing than is comfortable for you in the same environment.  If
you're comfortable in a shirt and sweater, the baby will probably be
comfortable in an undershirt, a nightie or sleeper, and a receiving blanket.
When you put her down to sleep, you may need to add another light blanket.  If
the temperature in the house is warmer, however, you may need to remove a
layer or two.  The color of your baby's hands and feet and whether they feel
warm or cold to the touch can give you an indication of whether she's
comfortable or not; remember, though, that a newborn's hands and feet are
usually somewhat cooler than the rest of her body.


     Should I worry about exposing my baby to the elements?

     Since your baby's temperature control mechanism is not fully mature
during this period, you'll need to avoid exposing her to extreme heat, extreme
cold, and direct sunlight whenever possible.  As a general rule, if the
weather outside is uncomfortable for you, it will be uncomfortable for your
baby, too.  Outings are nice, but not necessary on a daily basis.  On the
other hand, if it's pleasant outside and she is dressed appropriately, the
fresh air and stroll can be good for both of you.  If you need to take her out
in cold or inclement weather, dress her in bunting or other clothing that
covers her head, ears, hands, and feet, and then wrap her in a blanket.  For a
quick trip, you can loosely drape part of the blanket over her face for
protection from wind or cold.  If you have to take her out in hot or sunny
weather, dress her in light clothing that covers her arms and legs and a
bonnet that shades her face.  Be sure to keep her in the shade; remember that
sunlight reflected off water, sand, or concrete can cause sunburn even in what
appears to be shade.  Be aware, too, that the metal parts of car seats and
carriages can become hot quickly.


     Is there anything special I should look for when selecting my baby's
clothing?


     Besides comfort, convenience, and ease of cleaning, there are a couple of
safety factors of which you should be aware.  The first is the desirability of
clothing made from flame-retardant fabric.  Many manufacturers now are using
such materials exclusively, but it is wise to read all labels carefully.  The
second factor concerns buttons, ribbons, and other decorative features.  Make
sure that any small item attached to your baby's clothing is fastened
securely.  If a button or whatever is pulled off or falls off, it can
immediately become a choking hazard.  Also, check to see that anything like
zippers or elastics are stitched strongly into place.  If the thread around
such features begins to unravel, the article should be fixed or removed before
accidental ingestion or strangulation becomes a possibility.


     I am trying to be reasonable about clothing for the baby.  Please give me
an idea about what kind of clothing is necessary or desirable.

     Layettes (a term used to describe the clothing/wardrobe for a newborn)
are generally a matter of choice.  You'll probably have, buy, or be given more
articles of clothing for your baby than you need.  The items most likely to be
in short supply are diapers.  Your baby will need a change of diaper whenever
she is wet or soiled, which will be often.  And no matter which type of diaper
you use, you'd be wise to have plenty on hand.  Your baby will also need a
couple of changes of clothing daily.  Generally, at this age, your baby's
daily (and nightly) wear will consist of a diaper; an undershirt; a nightgown,
kimono, sleeper, or pajamas; and a receiving blanket.  She may also need
another blanket or quilt for sleeping.  Other items she may need include a
bonnet for warm-weather outings or a knitted cap for cold-weather outings;
socks or booties if her sleepwear doesn't cover her feet; and sweaters,
bunting, or similar clothing for outings in cooler weather.  If you use cloth
diapers, you may want to have a couple pairs of plastic pants, but use them
sparingly.


     What special care, if any, should be given to the baby's clothing and
bedding?

     Your newborn's skin is especially susceptible to irritation.  So before
coming into contact with your baby's skin, all new and old clothing, diapers,
bedding, towels, etc. should be washed in soap or mild detergent and double
rinsed (for flame-retardant clothing, check the manufacturer's label for any
special washing instructions).  Do not wash them with the rest of your
laundry, and do not use fabric softeners, since many of them contain chemicals
that may irritate your baby's skin.  It's best to continue washing your baby's
things separately for the first few months, until her skin becomes less
sensitive.  Cloth diapers should be washed separately in hot water and double
rinsed.


     Should I worry about keeping my baby's toys, teething rings, pacifiers,
and other things she puts in her mouth squeaky clean?

     You can worry about it, but it is highly doubtful that you'll be able to
keep all such items completely sterile all of the time.  Fortunately, although
they obviously should not be exposed to constant filth, babies are able to
tolerate considerably more dirt and grime in their systems than most new--and
naturally anxious--parents can tolerate them having.  Therefore, when
purchasing or procuring such items, you should make sure that they can be
easily cleaned, and you should give them all a good cleaning on a regular
basis.  But if your baby drops her pacifier on the floor and later picks it up
and puts it in her mouth before you've had a chance to wash it off, don't
panic.  The act probably will cause you a lot more suffering than it will
cause her.


PREVENTING DIAPER RASH

     Careful skin care, frequent diaper changes, and proper diaper care all
help to prevent diaper rash.  Babies of the most conscientious parents can and
do get diaper rashes, but the number and severity can be cut down by following
some simple guidelines.

  -  Change the baby frequently.  Urine and/or feces can have an irritating
     effect on her skin.  The end result is diaper rash.
  -  Avoid letting her sleep in a soiled diaper.
  -  Dress her in loosely fitting diapers and let her go bare-bottomed
     whenever practical.  Air helps to keep her skin dry.
  -  Whenever practical, avoid using plastic pants or diapers with gathers
     around the tummy and thighs.  These can trap moisture close to her skin
     and keep air from circulating through.
  -  When cleaning her diaper area during changing, use water only or water
     with a small amount of soap added.  If you use wipes, alternate their use
     with plain water.
  -  Wash gently in the folds of the genital area for girls and below the
     penis for boys.  Also, make certain the anal area is thoroughly clean.
  -  After washing the diaper area, rinse thoroughly with a clean, wet cloth
     or plain water.  Some moms do this by placing the baby next to or in the
     sink.  If you do, be sure the water is not too warm and that the faucets
     are covered so that they won't burn her skin.  Never leave her
     unattended in or near the sink for even a second.
  -  Pat her bottom dry before putting on a clean diaper.  If you use powder
     or lotion, remember that less is better and that neither is necessary.
  -  Store soiled diapers between washings in a diaper pail containing half a
     cup of vinegar and enough water to cover the diapers.
  -  When laundering diapers, use a mild soap, and run the diapers through the
     rinse cycle twice.  Avoid fabric softeners, which may leave a residue
     that can irritate your baby's skin.


CARE OF THE GENITALS

     Careful skin care in the genital area can help prevent diaper rash and
infections.

  -  When cleaning the genital area, use a soft washcloth.
  -  Use warm water or warm water with a small amount of gentle soap, and
     be sure to rinse thoroughly with clear water.
  -  For newborn girls, wash gently in the folds of the genital area; be sure
     to gently wipe (not rub) from front to back.
  -  For newborn boys who have been circumcised, be sure to follow your
     pediatrician's recommendations for caring for the penis.  If you notice
     bleeding or any sign of infection (pus, redness, or swelling), notify
     your pediatrician.
  -  For newborn boys who have not been circumcised, external washing and
     rinsing is recommended.  Since the natural separation of the foreskin
     from the glans may not be complete for several years, do not attempt to
     forcibly retract the foreskin.  If you can partially retract the foreskin
     without using pressure or causing pain, you can clean the part of the
     glans that is exposed.  Otherwise, leave it alone until the foreskin has
     separated from the glans.
  -  If you have any questions about the care of your newborn's genitals,
     contact your pediatrician.