NEWBORN VISIT
PINELLAS PEDIATRICS Celia DiMarco MD Kathy McNeely MD 461-3163
Height _________% _______Weight ________ %________ Head Circ ________ %________
CARE OF NEWBORN SKIN
BATHING
Daily bathing is not necessary, usually a sponge bath every 2-3 days at this age is fine. Frequent bathing removes the natural oils from the skin and can cause drying, irritation, and itchiness. Bathe your baby in plain water or with a small amount of mild, non-irritating, tear-free soap. Choose skin cleansers that are fragrance-free and gentle such as Dove or Cataphyll. These are less irritating than other products that may be advertised as mild or non-irritating.
CORD CARE
Keep the cord clean and dry. Germs easily grow on the old tissue of the umbilical stump. Fold
the diaper down and away from the stump to keep it aired out and dry. Apply alcohol to the stump daily. The cord usually comes off in a week or two, but on occasion it can take 3 weeks or so.
SKIN CARE
Many babies have scaling of the skin at birth or within the first 2-3 weeks. This flaking will gradually resolve. Treatment with moisturizers is not necessary. White Vaseline with no additives or preservatives is safe and effective as a moisturizer. Gentle creams also are fine, such as Aveeno.
DIAPER AREA
It is easier to prevent diaper rash than to treat it. Change the diaper frequently, especially right after the first sign of soiling. Diapers with absorbent gel will reduce the chance of diaper rash by 50%. Super-absorbent diapers are superior at keeping skin dry. Zinc Oxide cream can be used
to protect the skin, put a little on with each diaper change. Powders such as cornstarch or talcum powder can help dry the skin, but care must be taken to prevent the baby from breathing in the powder. Once powders get wet, their protective effect is lost. Barrier creams such as Zinc Oxide
or A&D work better. In uncircumcised boys, there is no need to attempt to retract the foreskin until 3 to 4 years of age.
DIAPER RASH
Soak in warm water or Aveeno colloidal Oatmeal bath followed by a thick layer of protective cream such as Zinc Oxide. After 3 days of diaper rash, it is very likely that yeast is growing on the skin. Apply a thin layer of yeast cream such as Lotrimin or Clotrimazole Ointment before applying the Zinc Oxide cream. ½% hydrocortisone ointment may also be applied 2 times a day for only 3-4 days if there is a lot of inflammation.
SUN EXPOSURE
Infant skin should be protected from the sun. Accumulative lifetime sun exposures lead to an increased risk of developing skin cancers and premature aging. Avoid the midday sun and cover with lightweight clothing and shade with a canopy. Some sunscreens are sensitizing and will cause an itchy rash after several applications. Use sunscreens made for babies. Sunscreens have not been studied well in infants and the skin of infants is thin and easily absorbs chemicals placed on it. Avoid sun exposure and sunscreens until after 6 months of age.
CRADLE CAP
Cradle cap is due to thick flakes of skin on the scalp. Rub a little baby oil on the scalp and leave overnight. This softens and loosens the scales so that some can be brushed off and shampooed away the next morning. Cradle cap gradually improves and is usually gone by two months of age.
WHAT TO DO WHEN A BABY CRIES
- Listen for the type of cry and watch her other behaviors. Soon you will learn what these signals are telling you:
- I’m hungry; I’m dirty or uncomfortable.
- I’m bored and want to go for a walk or dance around the house.
- I just have too much pent up energy and just need to cry it out.
Try these things:
- Change him.
- Try feeding her.
- If it is soon after a nursing or bottle, try to burp him.
- Help him find his thumb to suckle.
- Swaddle her so her legs and arms are firmly contained.
- Cuddle him and speak softly and comfortingly until you break through the crying. Massage his back and limbs gently.
- Sing to her and dance around the house (avoid shaking her).
- Let him cry it out.
She may not need to eat but just want to suckle. Encourage him to find his thumb. Thumb suckers are better self-soothers, better sleepers. He can always find his thumb in the night, but only you can find the pacifier. Most kids don’t get any long term problems with thumbs or pacifiers and these can be very helpful to a baby to help him learn to soothe himself. Don’t be afraid to try, you both may be very grateful. Babies that are held more cry less. Enjoy this time with your baby. Don’t be too rushed. Try to make your life simpler and not do too many things. Take some time to rest and cuddle your baby.
Signs and Symptoms of Illness.
Increased fussiness, a marked increase in sleeping, or significantly decreased appetite may be a sign that your baby is getting sick. Take a rectal temperature. Fever in newborns can be a sign of serious illness. Please call our office right away if your newborn has a rectal temperature of 100.4 or more or if you feel that your newborn is getting sick. In the newborn period, the immune system is not mature and serious illnesses can develop quickly.
Maternal Fatigue and Feelings of Sadness. This can be an exhausting time. You are still recovering from childbirth and your baby requires such frequent feedings that it is hard to get enough sleep. It is common to feel sad or overwhelmed and tearful at times. Fortunately this time will pass soon. Try not to do too much. Rest when your baby is resting. Your priority is this little baby. Accept or ask for help from others. Encourage Dad to help and praise how he handles things, even if it is not quite the way you would have done it.
Car Seats
A rear-facing infant seat or convertible seat should be used for children up to at least 20 pounds and at least 1 year old and should be used until the seat is completely outgrown based on the car seat manufacturer recommendations for height and weight limits.
Rev 6.07