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Caring for Your Newborn

How often do you bathe a newborn? Do babies need lotion? We have the information you need about when and how to bathe your new baby. You'll also find information on trimming your baby's nails, clearing your baby's nose, diapering technquies, and so much more. Read on to become a parenting whiz.

How do I clean or clear my baby's nose?

Just like big people, baby's need to clear their noses. But unlike older children or adults, they can't blow, or even pick their noses. But don't worry, we have an answer for how to clear your baby's nose.

Dr. Heeten Masters, a pediatrician at Cook Children’s in Arlington, Texas, describes how to clear a baby’s stuffy nose with bulb suction. In this video, he explains how to use nasal saline with a bulb suction and demonstrates techniques to clear your baby’s stuffy nose. At Cook Children’s, our pediatricians are with you every question of the way.

Diaper like a pro

New parents spend a lot of time changing diapers. Indeed, babies may use 10 diapers a day or more.

Diaper changing might seem complicated at first. But with a little practice, you'll find that keeping your baby clean and dry is easy.

Still need to find a pediatrician? We've got you covered

Getting Ready

Before you begin, gather a few supplies:

  • a diaper
  • fasteners (if you are using cloth prefold diapers)
  • a container of warm water and cotton balls (for babies with sensitive skin) or a clean washcloth or diaper wipes
  • diaper ointment or petroleum jelly (for preventing and treating rashes)
  • a changing pad or cloth diaper for placing under your baby

Make sure your supplies are all within reach. Babies should never be left unattended, even for a second. Even newborns can surprise parents with their ability to roll.

Wiping

Using the wet washcloth, cotton balls, or baby wipes, gently wipe you baby clean from the front to the back (never wipe from back to front, especially on girls, or you could spread the bacteria that can cause urinary tract infections). You might want to lift your baby's legs by the ankles to get underneath. Don't forget the creases in the thighs and buttocks.

For boys, keep a clean diaper over the penis during changing because exposure to air often causes boys to urinate — on you, the walls, or anything else within range.

Once you've finished wiping, pat your baby dry with a clean washcloth and apply diaper ointment.

Disposable Diapers

If you're using disposable diapers:

  • Open the diaper and slide it under your baby while gently lifting his or her legs and feet. The back part with the adhesive strips should be about level with your baby's bellybutton.
  • Bring the front part of the diaper up between your baby's legs and onto his or her belly.
  • Bring the adhesive strips around and fasten snugly. Be careful not to stick the tape onto your baby's skin.

Here are a few extra tips to keep in mind:

  • Garbage should be emptied regularly (about once a day) if you're using disposables. This prevents a stinky diaper pail and the growth of bacteria.
  • If you find any marks around your baby's legs and waist, the diaper is too tight. Go for a looser fit next time. If that doesn't help, your baby may be ready for the next size diaper.
  • If a rash develops at the diaper openings around your baby's leg and waist, change the brand of diaper you're using. Sometimes babies become sensitive to certain brands of diapers.
  • If diapering a boy, place the penis in a downward position before fastening the diaper. This will help prevent leaks from creeping up above the waistline.
  • Fold down the waistline of the diaper if your baby's umbilical cord has not fallen off yet to keep that area dry. Continue to do this for a few days after the cord has fallen off to prevent irritation.
  • Always wash your hands well after changing your baby's diaper to prevent the spread of germs.

Cloth Diapers

Most parents choose disposable diapers because of their convenience. But some parents opt for cloth diapers, which can be more affordable (if you wash them yourself). Some believe that cloth diapers are more environmentally friendly, but there's some debate over whether this is actually true.

Cloth diapers come in many shapes and sizes. Traditional cloth diapers usually come prefolded or in a square and require pinning. More modern types are fitted or contoured like disposable diapers, and come with Velcro closures or snaps. Other cloth-diapering accessories include absorbent liners (some are flushable), diaper doublers for extra protection at night, and diaper covers to help prevent leaks.

If you're using traditional cloth diapers, there are several ways to fasten them. One of the more commonly used ways is the triangular fold:

  • Fold the square in half to form a triangle. (For newborns or smaller babies, you might need to fold the long side of the triangle down a few inches so it fits your baby better.)
  • Place your baby in the diaper by gently lifting the baby's feet and legs and sliding the diaper under. The longest side of the triangle should be behind your baby's back, with the opposite corner pointing down toward the feet.
  • Bring the front part of the diaper up between your baby's legs and onto his or her belly.
  • Bring one side around so it overlaps the center part.
  • Bring the other side around so it overlaps the other two parts. Fasten all three parts together with a safety pin.

Another method is the rectangular fold, which is similar to the fold of disposable diapers:

  • Fold the diaper into a rectangle. Some parents find it helpful to make an extra fold in the diaper so that extra material covers the area the baby will wet the most — in the front for a boy and on the bottom for a girl.
  • Position the diaper under your baby, with the long sides facing the same direction as your baby.
  • Bring the bottom up onto your baby's belly.
  • Bring one side around and fasten with a safety pin, then do the same on the other side.

Here are some tips to keep in mind when using cloth diapers:

  • If using diapers that require pinning, use oversize pins with plastic safety heads. To prevent pricking the baby, keep your hand between the pin and his or her skin. If this makes you nervous, use diaper tape that comes in a dispenser.
  • Wet diapers can be tossed right into the diaper pail, but soiled diapers should be emptied into the toilet first — especially if your baby is formula-fed or on solids. Some people rinse the diaper before washing it. You may also choose to spray the diapers with water and baking soda for better odor control.
  • If you're washing the diapers yourself, wash them separately from other laundry, using a mild detergent that is hypoallergenic or recommended for infant clothing. Don't use fabric softener or antistatic products, which can cause rashes on babies' sensitive skin. Use hot water and double rinse each wash.
  • Always wash your hands well after changing your baby's diaper to prevent the spread of germs.

Preventing Diaper Rash

It's common for babies to have some diaper rash. But if the rash happens often, lasts for more than 2 or 3 days, or gets worse, call your health care provider. Also let your provider know if your baby has a fever with the rash or if the rash seems painful, is bright red, or has blisters.

To prevent and help heal diaper rash, keep these tips in mind:

  • Change diapers often, and right after bowel movements. Clean the area gently. Wiping vigorously or rubbing can further irritate the rash.
  • Use a diaper ointment to prevent and heal rashes. Look for one with zinc oxide, which acts as a barrier against moisture. A&D ointment is also soothing for minor rashes.
  • Let your baby go undiapered for part of the day, laying your little one on top of a few diapering cloths. (If you have a boy, place another cloth diaper over his penis when he's on his back so he doesn't spray you.)
  • If you use cloth diapers, wash them in dye- and fragrance-free detergents, and avoid drying them with scented drying sheets.

Once you have these basics down, you'll be a diapering pro in no time!

Trimming your baby's nails

Trimming your little one's nails can be a bit scary, especially at first. But keeping nails short is important to your baby's safety. Because they lack muscle control, infants can easily scratch and cut their own delicate skin while happily waving their hands and feet.

It's also important to keep babies' nails trimmed once they start interacting and playing with other kids who could be scratched, especially in childcare settings.

Some parents find it easier to accomplish the nail-trimming task with a partner: one person holding the baby to keep the little one from squirming and the other trimming the nails.

First, find a good position that allows you easy access to your baby's hands. This may mean placing your baby in your lap, sitting with him or her in a rocker, or even waiting until your baby's asleep. Make sure you are in an area with good lighting so that you can see what you're doing.

Then:

  • Hold your baby's palm and finger steady with one hand and cut with the other.
  • You should cut your baby's nails with baby nail scissors, which have rounded tips for safety, or baby clippers. Many baby nail-care kits also come with nail files or emery boards, but if you cut your baby's nails short enough and make sure to keep the nail edges rounded instead of jagged, you may not need to use these.

    However, if you're hesitant to try baby nail scissors or clippers and your baby will stay still long enough to cooperate, you can use an emery board to file the nails down without the risk of giving your little one any nicks.
  • If you accidentally draw blood (a common occurrence with fussy, fidgeting babies), don't worry. Using a sterile gauze pad, gently apply pressure to stop the bleeding. But don't put a bandage around the tiny cut — babies love to put their fingers in their mouths and can dislodge the bandage and choke on it.

Because babies' nails tend to grow quickly from infancy to toddlerhood, they may need to be trimmed as often as once or twice a week. Some newborns need their nails to be trimmed even more often than that during the first few weeks of life.

Reviewed by: Larissa Hirsch, MD
Date reviewed: June 2017

How do I clear my baby's tear ducts?

Sometimes newborns need help clearing their tear ducts. It might sound scary, but it's really simple. Dr. Garza, a Cook Children’s pediatrician in Keller, Texas, shows you how to effectively clear your babies tear ducts.


Caring for a colicky baby

Your baby cries every evening for hours at a time, and the crying has worn you down to the point where you feel like joining in. What could be upsetting your child?

Newborns cry and get fussy sometimes. During the first 3 months of life, they cry more than any other time. But when a baby who is otherwise healthy has several periods a week of fussiness, high-pitched crying, and difficulty being comforted, it's a sign of a condition called colic.

Colic is defined as crying for more than 3 hours a day, for more than 3 days a week, for at least 3 weeks. But doctors may diagnose a baby as having colic before that point. Colic usually doesn't point to any health problems and eventually goes away on its own.

About Colic

It's estimated that up to 40% of all infants have colic. It usually starts between the 3rd and 6th week after birth and ends by the time the baby is 3 to 4 months old. If the baby is still crying excessively after that, another health problem may be to blame.

Here are some key facts about colic:

  • Colicky babies have a healthy sucking reflex and a good appetite and are otherwise healthy and growing well. Call your doctor if your baby isn't feeding well, isn't gaining weight, or doesn't have a strong sucking reflex.
  • Colicky babies may spit up from time to time just as non-colicky babies do. But if your baby is actually vomiting and/or losing weight, call the doctor. (Vomiting is a forceful throwing up of stomach contents through the mouth, whereas spitting up is an easy flow of stomach contents out of the mouth.) Vomiting repeatedly is not a sign of colic.
  • Colicky babies typically have normal stools (poop). If your baby has diarrhea or blood in the stool, call your doctor.

What Causes Colic?

Doctors aren't sure what causes colic. Cow's milk intolerance has been suggested as a possible culprit, but doctors now believe that this is rarely the case. Breastfed babies get colic too; in these cases, dietary changes by the mother may help the colic to ease. Some breastfeeding women find that getting rid of caffeine in their diet helps, while others see improvements when they eliminate dairy, soy, egg, or wheat products.

Some colicky babies also have gas, but it's not clear if the gas causes colic or if the babies develop gas as a result of swallowing too much air while crying.

Some theories suggest that colic happens when food moves too quickly through a baby's digestive system or is incompletely digested. Other theories are that colic is due to a baby's temperament, that some babies just take a little bit longer to get adjusted to the world, or that some have undiagnosed gastroesophageal reflux (GER). Other research suggests that colic may be an early form of migraine headache. It's also been found that infants of mothers who smoke are more likely to have colic.

Treating Colic

No single treatment has been proven to make colic go away. But there are ways to make life easier for both you and your colicky baby.

First, if your baby is not hungry, don't try to continue the feeding. Instead, try to console your little one — you won't be "spoiling" the baby with your attention. You can also:

  • Walk with your baby or sit in a rocking chair, trying various positions.
  • Try burping your baby more often during feedings.
  • Place your baby across your lap on his or her belly and rub your baby's back.
  • Put your baby in a swing or vibrating seat. The motion may have a soothing effect.
  • Put your baby in an infant car seat in the back of the car and go for a ride. The vibration and movement of the car are often calming.
  • Play music — some babies respond to sound as well as movement.
  • Place your baby in the same room as a running clothes dryer, white noise machine, or vacuum — some infants find the constant low noise soothing.
  • Some babies need decreased stimulation. Babies 2 months and younger may do well swaddled in a darkened room.

Caring for a colicky baby can be extremely frustrating, so be sure to take care of yourself, too. Don't blame yourself or your baby for the constant crying — colic is nobody's fault. Try to relax, and remember that your baby will eventually outgrow this phase.

In the meantime, if you need a break from your baby's crying, take one. Friends and relatives are often happy to watch your baby when you need some time to yourself. If no one is immediately available, it's OK to put the baby down in the crib and take a break before making another attempt at soothing your little one. If at any time you feel like you might hurt yourself or the baby, put the baby down in the crib and call for help immediately. Never shake a baby.

If your baby has a temperature of 100.4°F (38°C) or higher, is crying for more than 2 hours at a time, is inconsolable, isn't feeding well, has diarrhea or persistent vomiting, or is less awake or alert than usual, call your doctor right away. Also call your doctor if you're unsure whether your baby's crying is colic or a symptom of another illness.

Cradle cap

Rough, scaly patches of skin on their newborn's scalp can be alarming to new parents, but usually are nothing to worry about. Most likely, they're due to a harmless condition many babies develop called cradle cap.

About Cradle Cap

Cradle cap is the common term for seborrheic dermatitis, or seborrhea, which is called dandruff in older kids and adults.

It's a relatively common condition in newborns and children as old as 3 and causes thick white or yellow scales on the scalp. Some kids just get scales in a small patch; others have scales all over their heads. Sometimes, cradle cap can even occur on the eyebrows, eyelids, ears, crease of the nose, back of the neck, diaper area, or armpits. In a few cases, such as in babies who have eczema or dry skin, cradle cap can cause cracked skin that itches and oozes a small amount of clear yellow drainage.

Cradle cap is not contagious and it isn't an indication of poor hygiene. Most of the time, it just goes away on its own. In severe or persistent cases, though, a doctor may recommend a medicated shampoo or lotion. Washing your baby's scalp daily with mild shampoo also can help to loosen and remove the scales caused by cradle cap.

Though it might look to be uncomfortable or irritating to the skin, cradle cap generally doesn't bother kids.

Causes

The exact cause of cradle cap isn't known, although some researchers believe it's due to an overproduction of skin oil (sebum) in the oil glands and hair follicles. A type of yeast (fungus) called malassezia can grow in the sebum along with bacteria, and this may be another factor in the development of cradle cap.

Seborrhea happens most often in babies and teenagers. In both of these times in a person's life, hormone levels are high, which also might play a role in the condition.

Certain factors — like weather extremes, oily skin, problems with the immune system, stress, and other skin disorders — can make it more likely that a child will get cradle cap.

Symptoms

Cradle cap looks different on every baby. It can be grouped together in bunches, or crops, or it can be spread far apart on the body. Affected areas will usually have one or more of these symptoms:

  • thick plaques or crusts (especially on the scalp, but sometimes on the ears, eyelids, eyebrows, nose, neck, groin, or armpits)
  • greasy or oily patches of skin, often covered with white or yellow scales
  • skin flakes (dandruff)

In a very few cases, babies with cradle cap will have skin that is a little red or itchy, and some might even have hair loss, though the hair usually grows back after the cradle cap is gone.

When to See a Doctor

In most cases, cradle cap will be easy to identify at home just by looking at it. However, call your child's doctor if:

  • you are treating cradle cap for the first time
  • your child has seborrhea in places where he or she doesn't have hair
  • you've tried home treatments without success
  • the rash gets worse or covers large parts of the body
  • the rash is causing hair loss or becomes itchy
  • the affected skin becomes firm and red, starts to drain fluid, or feels warm, which could be signs of an infection
  • your child has a weakened immune system and develops seborrhea
  • your child has seborrhea and is having trouble gaining weight

Curing cradle cap

While most cases of cradle cap don't require any treatment, you may want to loosen and remove the scales on your baby's scalp. This usually can be done by gently massaging your baby's scalp with your fingers or a washcloth and washing your baby's hair once a day with mild baby shampoo while scales are present.

After the scales have disappeared, you can control the seborrhea by shampooing just twice a week. Brush your child's hair with a clean, soft brush before rinsing off the shampoo to loosen the scales.

If the scales don't loosen easily, consider rubbing a small amount of mineral oil (avoid using olive oil) onto your baby's scalp. Allow the oil to soak into the scales for a few minutes, and then brush and shampoo your baby's hair as usual. Be sure to wash the oil away each time — too much oil may cause scales to build up and could make cradle cap worse.

If regular shampooing doesn't help, ask your doctor about nonprescription medicated or dandruff shampoos. These shampoos contain ingredients such as salicylic acid, coal tar, zinc, selenium, and ketoconazole that can help treat dryness and flaking. Some stronger forms of these medicines do require a prescription.

If you use one of these medicated shampoos, rub a little shampoo into your child's scalp and let it soak in for at least 2 minutes. Then wash the shampoo out and repeat the process one more time. You might need to do this daily or twice weekly at first, but after the cradle cap is under control, you may only have to use medicated shampoos once a month.

For seborrhea on other parts of the body, or if your child has irritated skin, steroid creams like hydrocortisone can help. Make sure to ask your baby's doctor before using hydrocortisone.

Cradle cap may disappear for months at a time and then suddenly reappear, but by following the steps above, you should be able to control it.

Reviewed by: Rupal Christine Gupta, MD
Date reviewed: April 2016

Good dental care starts now

Learn how to prevent tooth decay in your baby by Dr. Nichols, a Cook Children’s pediatrician in Southlake, Texas.

What Is Oral Thrush?

Oral thrush is a very common yeast infection in babies. It causes irritation in and around a baby's mouth.

What Are the Signs and Symptoms of Oral Thrush?

Oral thrush (also called oral candidiasis) can affect anyone, but is most common in babies younger than 6 months old and in older adults.

A baby with oral thrush might have cracked skin in the corners of the mouth or white patches on the lips, tongue, or inside the cheeks that look a little like cottage cheese but can't be wiped away.

Some babies may not feed well or are uncomfortable when sucking because their mouth feels sore, but many babies don't feel any pain or discomfort.

What Causes Oral Thrush?

Oral thrush is caused by the overgrowth of a yeast (a type of fungus) called Candida albicans.

Most people (including infants) naturally have Candida in their mouths and digestive tracts, which is considered normal growth. Usually, a healthy immune system and some "good" bacteria control the amount of this fungus in the body.

But if the immune system is weakened (from an illness or medicines like chemotherapy) or not fully developed (as in babies), Candida in the digestive tract can overgrow and lead to an infection. Candida overgrowth also causes diaper rash and vaginal yeast infections. Babies can have oral thrush and a diaper rash at the same time.

Candida overgrowth also can happen after a baby has been given antibiotics for a bacterial infection because antibiotics can kill off the "good" bacteria that keep the Candida from growing. Oral thrush also can happen after the use of steroid medicines.

How Is Oral Thrush Treated?

See your doctor if you think your baby may have thrush. Some cases go away without medical treatment within a week or two, but the doctor may prescribe an antifungal solution for your baby's mouth. This medicine is usually applied several times a day by "painting" it on the inside of the mouth and tongue with a sponge applicator.

Depending on your baby's age, the doctor also might suggest adding yogurt with lactobacilli to your baby's diet. The lactobacilli are "good" bacteria that can help get rid of the yeast in your child's mouth.

If your baby keeps getting oral thrush, especially if he or she is older than 9 months old, talk with your doctor because this might be a sign of another health issue.

Can Oral Thrush Be Prevented?

Oral thrush is a common infection in babies, but you can help prevent it:

  • If you formula-feed your baby or use a pacifier, thoroughly clean the nipples and pacifiers in hot water or a dishwasher after each use. That way, if there's yeast on the bottle nipple or pacifier, your baby won't be reinfected. Store milk and prepared bottles in the refrigerator to prevent yeast from growing.
  • If you breastfeed and your nipples are red and sore, you might have a yeast infection on your nipples, which you and your baby can pass back and forth. Talk to your doctor, who might recommend using an antifungal ointment on your nipples while your baby is treated with the antifungal solution.

When can I take my baby out in the sun?

Do newborns need sunscreen? Is sunscreen safe for infants? Dr. Desiree Harris, a pediatrician at Cook Children’s in Arlington, Texas, talks about at what age your baby can be in the sun and how you can protect them from the sun. When is a newborn old enough to wear sunscreen? Dr. Harris recommends what kind of sunscreen parents should use on babies and how often to apply.

Reviewed by: Yamini Durani, MD
Date reviewed: January 2015

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