JAMA Patient Information: Caring for a newborn baby

Caring for a newborn is one of the greatest challenges a parent or caregiver faces. A new baby is completely dependent on loved ones to care for him or her.

A study in the September 22/29, 1999, issue of The Journal of the American Medical Association (Kotagal et al) reports that full-term babies born in Ohio covered by Medicaid who were discharged from the hospital following a short stay did not fare badly. Although the percentage of babies discharged just a day after a vaginal delivery and within two days of a cesarean birth have increased, this did not result in an increased rate of readmission to the hospital.

Feeding:
You should decide whether to breastfeed or bottle-feed before your baby is born. Breast milk provides the best nutrition for your baby and helps build stronger immunity to illnesses. However, if you decide or your doctor recommends that you do not breastfeed for any reason, bottle feeding your baby is a good alternative. You should feed your baby on demand. A newborn usually needs a feeding every two to three hours in the first month and less frequently as he or she grows older. Each feeding should last no more than 10 to 20 minutes.

Bathing:
A newborn only needs to be bathed two or three times a week during the first year. You should only give sponge baths during the first two weeks or until the umbilical cord falls off. You can then bathe the baby in a basin filled with two inches of warm water. Be sure to support the baby's head at all times during the bathing. Never leave your baby unattended in the bath.

Sleep:
Good sleep is essential for your baby's health. Always place your baby on his or her back to sleep to reduce the risk of sudden infant death syndrome (SIDS). Make sure the crib mattress is firm and covered by a sheet with no pillows or blankets that could block the baby's mouth or nose. Talk to the baby's doctor about what position is best if you have any concerns.

Immunizations:
Your baby needs to get a number of vaccinations within the first year that protect against 10 major childhood diseases. The baby should receive most of the immunizations before his or her second birthday. Be sure to work with the baby's doctor to stay current on the recommended immunization schedule.

When to See a Doctor:

• Excessive crying. It's normal for your baby to cry when he or she is hungry, needs to be burped, is cold, or needs a clean diaper; however, if the baby's cries sound peculiar or last for an unusual length of time, it could be a medical problem.
• Abnormal sleep. A newborn will spend most of the time sleeping. However, if the baby is rarely alert, does not wake up for feedings, or seems too tired or uninterested to eat, see your child's doctor right away.
• Infection of the umbilical cord. If you notice that the stump becomes infected (pus or red skin at the base of the cord, or crying when you touch the cord or skin next to it), alert the baby's doctor.

Things To Do:

• Give your baby lots of love and attention. You can't "spoil" a baby at this age.
• Whenever you travel in a car, place your baby in safety seat that is installed correctly in the back seat facing the back.
• Create a safe environment for your newborn by child-proofing your home.
• Take your baby for all the recommended checkups and vaccinations.
• Don't allow smoking or smoke around your baby.
• Keep your baby out of the sun (sunscreen shouldn't be applied to infants younger than 6 months).

Source: American Medical Association