Caring for Your Baby

Bathing your baby

It is recommended to wait 24 hours before bathing your baby. Waiting to bathe improves newborn’s temperature, blood sugar control, helps to improve mother-baby bonding, and breastfeeding success. It is not necessary to bathe your baby while in the hospital, but it can be done upon request.

When you return home, bathing your baby can be an enjoyable experience for both you and your child. Here are some tips to help:

• Give your baby a sponge or tub bath and air-dry the umbilical cord afterwards.
• Bathe in a warm room free of drafts. Use a high surface that does not force you to bend over.
• Bathe your baby at least one and a half to two hours after a feeding, or just before a feed. The activity of the bath may make your baby spit up if he or she has fed recently.
• Never leave your baby unattended during the bath. He or she can wiggle or roll off the surface.

Babies do not need to be bathed every day. Bathing too often can cause your baby’s skin to dry out. Bathe your baby every two to three days, or as needed.

The following steps are useful guidelines as you learn to bathe your baby. You may change these slightly to suit what works best for you and your baby.

Get your supplies ready

You will need:

• towels
• a face cloth
• very mild soap and baby shampoo
• a clean diaper and clothes
• supplies for umbilical cord care
• a basin of water that feels warm to your elbow or inner wrist

Washing your baby's eyes and face

Using a tip of the face cloth, wipe across one eye from the corner at the nose to the outside near the cheek. To prevent the spread of germs, use a separate corner of the face cloth for the other eye.

Wash the rest of the baby's face with the face cloth. Pat your baby's face dry. Clean your baby's ears with the face cloth. Do not use a Q-tip to clean the ears or nostrils, as these tend to push wax and discharge back into the ear or nose.

Washing your baby's body

Follow these steps:

• Lay your baby on a towel on the change table on his/her back.

• Wet baby's upper body, arms, neck and legs. Lather soap on your hands and wash these areas.
• Be sure to wash and dry the folds around your baby's neck and underarm creases. Look for bits of fluff between the toes.
• Rinse the soap off and dry well.
• Turn your baby on his or her stomach. Wet, wash, and rinse your baby's back. Some babies enjoy long smooth strokes down their back, like a back rub. Dry your baby's back well

Don't be concerned if your baby starts to cry. Many babies feel insecure when they are undressed.

Washing your baby's genitals

For little girls: cover your finger with the washcloth and wash from front to back. Do not try to scrub away the creamy, cheese-like material that may be between the labia. You may notice some mucous discharge with blood on it. This is normal from your daughter receiving some of your hormones at birth. It will only last a few days. Wash, rinse and dry your daughter's buttocks and anal area.

For little boys: wash you baby's penis with a washcloth. Never pull back on the foreskin, as this may be harmful. Your son's foreskin will gradually pull back on its own as he grows. Wash, rinse and dry your son's buttocks and anal area.

Always wash your hands before you care for your baby and after diaper changing.

Shampoo your baby's hair

Wrap your baby in a blanket. While holding your baby firmly in the football position with his or her head over the basin, use your free hand to wet your baby's hair. Lather the baby's hair using either a mild soap or baby shampoo. Rinse your baby's hair thoroughly and rub it dry. Wash your baby's hair every three or four days.

For step-by-step instructions on how to bathe a baby, watch this newborn bathing video. While in hospital, you can also find an instructional video on your room television monitor.

Dressing your baby

Put your baby's diaper on first. Tuck it in below the umbilical cord so the cord can air dry. Put your baby's shirt on next and bundle your baby. Feed your baby now if they are hungry. You can clean up your bath supplies later.

Cutting your baby's nails

When babies are born, their nails are soft and must grow out far enough from the skin so that the skin is not cut by mistake. Therefore, fingernails are not usually cut for a few days.

To cut your baby's nails:

• Use blunt nail scissors.
• Cut the nail straight across as you hold the skin away from the nail.
• Put your hand around your baby's fist to ensure baby does not get his or her other fingers in the way. Extend the finger with the nail you are going to cut over your index finger and hold it firmly in place with your thumb. Some parents find it easier to cut fingernails when their baby is asleep.

If your baby is scratching his or her face, you can use the fine side of an emery board to smooth baby's nails.

Umbilical cord care

After the birth of your baby, the umbilical cord will be soft and creamy white in colour. It will shrivel and turn black over the next few days. The cord usually falls off with the clamp about five to ten days after birth.

To help your baby's cord dry and prevent infection, dry the cord after bathing baby or if it becomes wet during a diaper change. Occasionally, as the cord separates it may leave a raw area, which may result in a small amount of blood spotting. This is quite normal. If the cord becomes red or you notice an odour or yellowish discharge from the cord, tell your nurse, midwife or doctor.

Diapering

Record your baby’s wet and soiled diapers. See the Best Start – signs that feeding is going well infographic. A good time to check the diaper is before and after feedings. It makes the baby alert for feedings and ensures that your baby is comfortable.

Wash and dry your baby's bottom each time you change a diaper. Be sure to clean and dry all the creases and folds. Remember to use a barrier cream such as Vaseline on the diaper area only when it is red.

For boys, point the penis downward when applying diapers. Powder and baby oil are not recommended on babies.

Bladder and bowel function

A breastfed baby should have at least two to three wet diapers in the first 48 hours. By the fifth or sixth day, baby should have at least six to eight wet diapers per day. Formula-fed babies will have more wet diapers during the first five to six days.

Bowel movements vary with each baby, but it's normal for your baby to have two or more bowel movements each day. The colour will change from black to dark green to yellow by the fourth day. Breastfed babies tend to have seedier, looser bowel movements. Bowel movements of formula-fed babies are more solid.

Circumcision

If you wish to have your baby boy circumcised, please discuss this with your baby's doctor. As this procedure is not covered by OHIP, a fee for service applies. Your doctor will give you instructions on how to care for your baby's penis after circumcision.

Blood tests

Newborn screening programs identify a range of disorders in infants. Early detection means children can be treated sooner, helping reduce the chance of serious health problems later in life.

The government has expanded screening tests for 27 rare diseases. Your baby will have a heel prick blood sample taken before discharge and all results will be sent to your doctor's office. Your doctor, midwife or nurse can give you more information.

Hiccups

After your baby has been fed, hiccups are quite common during the first few weeks. They do not harm your baby. Quite often they disappear if you have your baby feed a little longer.

Jaundice

Jaundice is common in newborns. It usually begins 24 hours after birth and can continue until the baby is a week old. If your baby has jaundice or needs to be followed up because they are at risk for jaundice, your nurse will explain the plan for you and your baby upon discharge. Call your baby’s doctor if they exhibit any signs or symptoms of jaundice:

• dry skin with a yellow tinge (baby's arms and legs)
• yellow in the whites of the eyes
• Refuses breast or bottle feeding
• Sleepy all the time
• Has lost a lot of weight (more than 10% of birth weight)
• Develops a fever
• Decrease in urine and bowel movements (it is important to note how often your baby is passing urine and stool)

Prior to going home from the hospital, your nurse may check your baby's jaundice level through a blood test. Jaundice can make your baby sleepy and make it difficult to wake him or her for feeding.

It's important to breastfeed your baby every two to three hours throughout the day and night until regular bowel movements are established. If at any time you think your baby is showing signs of jaundice, notify your nurse, midwife or doctor. You can also go to the hospital's Emergency Department to have jaundice levels checked.

For more information on jaundice please refer to your “Neonatal Jaundice: Caring for your Infant” patient information handout or visit the SickKids - About Kids Health website.

Newborn rashes

During the first few days after delivery, you may notice small white spots with a surrounding red area on your baby's skin. These usually appear for about a week and will disappear on their own. If you have any concerns, see your doctor. Baby facial acne is also common.

Hair on the body

Some babies will appear to have excess hair at birth. This fine hair is called lanugo and will fall out over the next few months.

Sleep

It is recommended that you place your baby on his or her back when sleeping. Do not place a baby on their tummy to sleep.

The amount of sleep your baby requires will vary. In the first week of birth, it is important to wake your baby for feeds every three to four hours. Most babies do have “fussy” periods, occurring more frequently in the evening and at night.

For more information, visit the Baby's Breath Canada website.

Vitamin D

It is recommended that you give your baby 400 IU vitamin D daily.

Car seat safety

The proper use of car seats and boosters is required by law. Newborns must ride in a rear-facing car seat that meets current Canadian Motor Vehicle Safety Standards (CMVSS). The car seat should be purchased in Canada and have the CMVSS label and expiry date on it.

Car seat safety resources:

• Ontario Ministry of Transportation
• Government of Canada

You can also call the Ministry of Transportation at 1-800-333-0371.