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Hello Parenting

You've gone through pregnancy, labor, and delivery, and now you're ready to go home and begin life with your baby. Once home, though, you might feel like you have no idea what you're doing!

These tips can help even the most nervous first-time parents feel confident about caring for a newborn in no time.

Getting Help After the Birth

Consider getting help during this time, which can be very hectic and overwhelming. While in the hospital, talk to the experts around you. Many hospitals have feeding specialists or lactation consultants who can help you get started nursing or bottle-feeding. Nurses also are a great resource to show you how to hold, burp, change, and care for your baby.

Need a pediatrician? Find the right one here

For in-home help, you might want to hire a baby nurse, postpartum doula, or a responsible neighborhood teen to help you for a short time after the birth. Your doctor or the hospital can help you find information about in-home help, and might make a referral to home health agencies.

Relatives and friends often want to help too. Even if you disagree on certain things, don't dismiss their experience. But if you don't feel up to having guests or you have other concerns, don't feel guilty about placing restrictions on visitors.

Handling a Newborn

If you haven't spent a lot of time around newborns, their fragility may be intimidating. Here are a few basics to remember:

  • Wash your hands (or use a hand sanitizer) before handling your baby. Newborns don't have a strong immune system yet, so they're at risk for infection. Make sure that everyone who handles your baby has clean hands.
  • Support your baby's head and neck. Cradle the head when carrying your baby and support the head when carrying the baby upright or when you lay your baby down.
  • Never shake your newborn, whether in play or in frustration. Shaking can cause bleeding in the brain and even death. If you need to wake your infant, don't do it by shaking — instead, tickle your baby's feet or blow gently on a cheek.
  • Make sure your baby is securely fastened into the carrier, stroller, or car seat. Limit any activity that could be too rough or bouncy.
  • Remember that your newborn is not ready for rough play, such as being jiggled on the knee or thrown in the air.

Bonding and Soothing

Bonding, probably one of the most pleasurable parts of infant care, happens during the sensitive time in the first hours and days after birth when parents make a deep connection with their infant. Physical closeness can promote an emotional connection.

For infants, the attachment contributes to their emotional growth, which also affects their development in other areas, such as physical growth. Another way to think of bonding is "falling in love" with your baby. Children thrive from having a parent or other adult in their life who loves them unconditionally.

Begin bonding by cradling your baby and gently stroking him or her in different patterns. Both you and your partner can also take the opportunity to be "skin-to-skin," holding your newborn against your own skin while feeding or cradling.

Babies, especially premature babies and those with medical problems, may respond to infant massage. Certain types of massage may enhance bonding and help with infant growth and development. Many books and videos cover infant massage — ask your doctor for recommendations. Be careful, however — babies are not as strong as adults, so massage your baby gently.

Babies usually love vocal sounds, such as talking, babbling, singing, and cooing. Your baby will probably also love listening to music. Baby rattles and musical mobiles are other good ways to stimulate your infant's hearing. If your little one is being fussy, try singing, reciting poetry and nursery rhymes, or reading aloud as you sway or rock your baby gently in a chair.

Some babies can be unusually sensitive to touch, light, or sound, and might startle and cry easily, sleep less than expected, or turn their faces away when someone speaks or sings to them. If that's the case with your baby, keep noise and light levels low to moderate.

Swaddling, which works well for some babies during their first few weeks, is another soothing technique first-time parents should learn. Proper swaddling keeps a baby's arms close to the body while allowing for some movement of the legs. Not only does swaddling keep a baby warm, but it seems to give most newborns a sense of security and comfort. Swaddling also may help limit the startle reflex, which can wake a baby.

Here's how to swaddle a baby:

  • Spread out the receiving blanket, with one corner folded over slightly.
  • Lay the baby face-up on the blanket with his or her head above the folded corner.
  • Wrap the left corner over the body and tuck it beneath the back of the baby, going under the right arm.
  • Bring the bottom corner up over the baby's feet and pull it toward the head, folding the fabric down if it gets close to the face. Be sure not to wrap too tightly around the hips. Hips and knees should be slightly bent and turned out. Wrapping your baby too tightly may increase the chance of hip dysplasia.
  • Wrap the right corner around the baby, and tuck it under the baby's back on the left side, leaving only the neck and head exposed. To make sure your baby is not wrapped too tight, make sure you can slip a hand between the blanket and your baby's chest, which will allow comfortable breathing. Make sure, however, that the blanket is not so loose that it could become undone.
  • Babies should not be swaddled after they're 2 months old. At this age, some babies can roll over while swaddled, which increases their risk of sudden infant death syndrome (SIDS).

All About Diapering

You'll probably decide before you bring your baby home whether you'll use cloth or disposable diapers. Whichever you use, your little one will dirty diapers about 10 times a day, or about 70 times a week.

Before diapering your baby, make sure you have all supplies within reach so you won't have to leave your infant unattended on the changing table. You'll need:

  • a clean diaper
  • fasteners (if cloth prefold diapers are used)
  • diaper ointment
  • diaper wipes (or a container of warm water and a clean washcloth or cotton balls)

After each bowel movement or if the diaper is wet, lay your baby on his or her back and remove the dirty diaper. Use the water, cotton balls, and washcloth or the wipes to gently wipe your baby's genital area clean. When removing a boy's diaper, do so carefully because exposure to the air may make him urinate. When wiping a girl, wipe her bottom from front to back to avoid a urinary tract infection (UTI). To prevent or heal a rash, apply ointment. Always remember to wash your hands thoroughly after changing a diaper.

Diaper rash is a common concern. Typically the rash is red and bumpy and will go away in a few days with warm baths, some diaper cream, and a little time out of the diaper. Most rashes happen because the baby's skin is sensitive and becomes irritated by the wet or poopy diaper.

To prevent or heal diaper rash, try these tips:

  • Change your baby's diaper often, and as soon as possible after bowel movements.
  • Gently clean the area with mild soap and water (wipes sometimes can be irritating), then apply a very thick layer of diaper rash or "barrier" cream. Creams with zinc oxide are preferred because they form a barrier against moisture.
  • If you use cloth diapers, wash them in dye- and fragrance-free detergents.
  • Let the baby go undiapered for part of the day. This gives the skin a chance to air out.

If the diaper rash continues for more than 3 days or seems to be getting worse, call your doctor — it may be caused by a fungal infection that requires a prescription.

Bathing Basics

You should give your baby a sponge bath until:

  • the umbilical cord falls off and the navel heals completely (1–4 weeks)
  • the circumcision heals (1–2 weeks)

A bath two or three times a week in the first year is fine. More frequent bathing may be drying to the skin.

Have these items ready before bathing your baby:

  • a soft, clean washcloth
  • mild, unscented baby soap and shampoo
  • a soft brush to stimulate the baby's scalp
  • towels or blankets
  • a clean diaper
  • clean clothes

Sponge baths. For a sponge bath, select a safe, flat surface (such as a changing table, floor, or counter) in a warm room. Fill a sink, if nearby, or bowl with warm (not hot!) water. Undress your baby and wrap him or her in a towel. Wipe your infant's eyes with a washcloth (or a clean cotton ball) dampened with water only, starting with one eye and wiping from the inner corner to the outer corner. Use a clean corner of the washcloth or another cotton ball to wash the other eye. Clean your baby's nose and ears with the damp washcloth. Then wet the cloth again and, using a little soap, wash his or her face gently and pat it dry.

Next, using baby shampoo, create a lather and gently wash your baby's head and rinse. Using a wet cloth and soap, gently wash the rest of the baby, paying special attention to creases under the arms, behind the ears, around the neck, and in the genital area. Once you have washed those areas, make sure they are dry and then diaper and dress your baby.

Tub baths. When your baby is ready for tub baths, the first baths should be gentle and brief. If he or she becomes upset, go back to sponge baths for a week or two, then try the bath again.

In addition to the supplies listed above, add:

  • an infant tub with 2 to 3 inches of warm — not hot! — water (to test the water temperature, feel the water with the inside of your elbow or wrist). An infant tub is a plastic tub that can fit in the bathtub; it's a better size for babies and makes bathing easier to manage.

Undress your baby and then place him or her in the water immediately, in a warm room, to prevent chills. Make sure the water in the tub is no more than 2 to 3 inches deep, and that the water is no longer running in the tub. Use one of your hands to support the head and the other hand to guide the baby in feet-first. Speaking gently, slowly lower your baby up to the chest into the tub.

Use a washcloth to wash his or her face and hair. Gently massage your baby's scalp with the pads of your fingers or a soft baby hairbrush, including the area over the fontanelles (soft spots) on the top of the head. When you rinse the soap or shampoo from your baby's head, cup your hand across the forehead so the suds run toward the sides and soap doesn't get into the eyes. Gently wash the rest of your baby's body with water and a small amount of soap.

Throughout the bath, regularly pour water gently over your baby's body so he or she doesn't get cold. After the bath, wrap your baby in a towel immediately, making sure to cover his or her head. Baby towels with hoods are great for keeping a freshly washed baby warm.

While bathing your infant, never leave the baby alone. If you need to leave the bathroom, wrap the baby in a towel and take him or her with you.

Circumcision and Umbilical Cord Care

Immediately after circumcision, the tip of the penis is usually covered with gauze coated with petroleum jelly to keep the wound from sticking to the diaper. Gently wipe the tip clean with warm water after a diaper change, then apply petroleum jelly to the tip so it doesn't stick to the diaper. Redness or irritation of the penis should heal within a few days, but if the redness or swelling increases or if pus-filled blisters form, infection may be present and you should call your baby's doctor immediately.

Umbilical cord care in newborns is also important. Some doctors suggest swabbing the area with rubbing alcohol until the cord stump dries up and falls off, usually in 10 days to 3 weeks, but others recommend leaving the area alone. Talk to your child's doctor to see what he or she prefers.

An infant's navel area shouldn't be submerged in water until the cord stump falls off and the area is healed. Until it falls off, the cord stump will change color from yellow to brown or black — this is normal. Call your doctor if the navel area looks red or if a foul odor or discharge develops.

Feeding and Burping Your Baby

Whether feeding your newborn by breast or a bottle, you may be stumped as to how often to do so. Generally, it's recommended that babies be fed on demand — whenever they seem hungry. Your baby may cue you by crying, putting fingers in his or her mouth, or making sucking noises.

A newborn baby needs to be fed every 2 to 3 hours. If you're breastfeeding, give your baby the chance to nurse about 10–15 minutes at each breast. If you're formula-feeding, your baby will most likely take about 2–3 ounces (60–90 milliliters) at each feeding.

Some newborns may need to be awakened every few hours to make sure they get enough to eat. Call your baby's doctor if you need to wake your newborn often or if your baby doesn't seem interested in eating or sucking.

If you're formula-feeding, you can easily monitor if your baby is getting enough to eat, but if you're breastfeeding, it can be a little trickier. If your baby seems satisfied, produces about six wet diapers and several stools a day, sleeps well, and is gaining weight regularly, then he or she is probably eating enough.

Another good way to tell if your baby is getting milk is to notice if your breasts feel full before feeding your baby and less full after feeding. Talk to your doctor if you have concerns about your child's growth or feeding schedule.

Babies often swallow air during feedings, which can make them fussy. To help prevent this, burp your baby often. Try burping your baby every 2–3 ounces (60–90 milliliters) if you bottle-feed, and each time you switch breasts if you breastfeed.

If your baby tends to be gassy, has gastroesophageal reflux, or seems fussy during feeding, try burping your little one after every ounce during bottle-feeding or every 5 minutes during breastfeeding.

Try these burping tips:

  • Hold your baby upright with his or her head on your shoulder. Support your baby's head and back while gently patting the back with your other hand.
  • Sit your baby on your lap. Support your baby's chest and head with one hand by cradling your baby's chin in the palm of your hand and resting the heel of your hand on your baby's chest (be careful to grip your baby's chin — not throat). Use the other hand to gently pat your baby's back.
  • Lay your baby face-down on your lap. Support your baby's head, making sure it's higher than his or her chest, and gently pat or rub his or her back.

If your baby doesn't burp after a few minutes, change the baby's position and try burping for another few minutes before feeding again. Always burp your baby when feeding time is over, then keep him or her in an upright position for at least 10–15 minutes to avoid spitting up.

Sleeping Basics

As a new parent, you may be surprised to learn that your newborn, who seems to need you every minute of the day, actually sleeps about 16 hours or more!

Newborns typically sleep for periods of 2–4 hours. Don't expect yours to sleep through the night — the digestive system of babies is so small that they need nourishment every few hours and should be awakened if they haven't been fed for 4 hours (or more often if your doctor is concerned about weight gain).

When can you expect your baby to sleep through the night? Many babies sleep through the night (between 6–8 hours) at 3 months of age, but if yours doesn't, it's not a cause for concern. Like adults, babies must develop their own sleep patterns and cycles, so if your newborn is gaining weight and appears healthy, don't despair if he or she hasn't slept through the night at 3 months.

It's important to always place babies on their backs to sleep to reduce the risk of SIDS (sudden infant death syndrome). Other safe sleeping practices include: not using blankets, quilts, sheepskins, stuffed animals, and pillows in the crib or bassinet (these can suffocate a baby); and sharing a bedroom (but not a bed) with the parents for the first 6 months to 1 year. Also be sure to alternate the position of your baby's head from night to night (first right, then left, and so on) to prevent the development of a flat spot on one side of the head.

Many newborns have their days and nights "mixed up." They tend to be more awake and alert at night, and more sleepy during the day. One way to help them is to keep stimulation at night to a minimum. Keep the lights low, such as by using a nightlight. Reserve talking and playing with your baby for the daytime. When your baby wakes up during the day, try to keep him or her awake a little longer by talking and playing.

Even though you may feel anxious about handling a newborn, in a few short weeks you'll develop a routine and be parenting like a pro! If you have questions or concerns, ask your doctor to recommend resources that can help you and your baby grow together.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: January 2018

The postpartum blues

Your new baby is the joy of your life. So why do you feel so sad?

The transition from pregnancy to parenthood is a major life adjustment — both physically and emotionally. During your baby's first few days of life, it's normal to feel emotional highs and lows, something commonly referred to as the "baby blues."

With the baby blues, you might feel happy one minute and tearful or overwhelmed the next. You might find yourself feeling angry, sad, irritable, or discouraged. Feeling this way doesn't mean that you're a "bad" mother or that you don't love your baby.

These mood swings are believed to be caused by hormone changes that happen in a woman's body after she gives birth. Levels of estrogen and progesterone needed during pregnancy suddenly drop, causing shifts in mood. Other factors — like fatigue and sleep deprivation, for example — also can contribute to these feelings.

Fortunately, the baby blues usually only last for a few days or weeks, and usually stop on their own without medical treatment.

If you have a case of the baby blues, try to take care of yourself as much as possible. Eat a healthy diet and get as much rest as you can, especially since exhaustion and sleep deprivation can reinforce and fuel feelings of sadness.

Here are some other things that can help you feel better:

  • Accept help, especially in the first days and weeks after birth.
  • Let family and friends help with errands, food shopping, household chores, or childcare.
  • Let someone prepare a meal or watch your baby while you relax with a shower, bath, or a nap.
  • Get plenty of rest and eat nutritious foods.
  • Talk to loved ones or other new mothers who can help you feel supported and remind you that you're not alone.

If the baby blues last longer than a week or two, or if symptoms become worse, talk to your doctor to discuss whether postpartum depression may be the cause of your emotional lows.

Dads get the blues too!

It's not just a mommy problem. The decision made by the New York Mets' Daniel Murphy to miss opening day so he could attend the birth of his son has placed increased focus on paternity leave for dads. Guess what? Some sports talk show hosts made idiots of themselves by overreacting and making statements without thinking about their consequences (shocking, I know).

Just in time, a new study released online in Pediatrics (the journal of the AAP) describes the risk of depression in fathers of young children (0-5). They started following males in adolescence and followed them for 23 years using a depression scale to document their level of depression.

The scales asked some fairly pointed questions regarding depression. Here are some examples:

  • Were you were bothered by things that do not usually bother you?
  • Did you feel depressed?
  • Did you feel you were too tired to do things?
  • Did you not enjoy life?
  • Did you feel that people disliked you?

I found the results very interesting:

During the first 5 years of their child’s lives, fathers showed a 68 percent increase in depressive symptoms.

Does this surprise you or not?

While the study did not specifically describe the rate of depression in the immediate period after the baby was born, I would suspect that many of these depressive symptoms began to emerge during that time. I have done this new parenting thing a few times (3 times in 5 years). Having a new baby in the house is incredibly exciting and brings so much unspeakable joy. However, that joy comes with many changes.

I never felt that my symptoms rose to the level of depression but there were, at times, feelings of sadness and loss. Let’s walk through some of the reasons and some potential solutions.

Loss of routine

I am a man of routine and consistency.I like waking up, having a cup of coffee, reading and getting ready to go to work. Staying home with my wife for a week after our babies were born was very important to me but I did start to miss my routine.

Try to keep some semblance of your normal routine if possible. Remember that your sleep at night will likely be broken up (I was always the water boy for my breastfeeding wife and the post-feed burper and rocker) so you might want to get to bed earlier than normal so you can keep your morning routine in some form or fashion.

Loss of autonomy

When you got married you might have realized that your decisions were no longer just about yourself anymore. For me, having a baby is that feeling, on steroids. You suddenly feel guilty for wanting to do anything for yourself anymore as if in some way you will miss something or will be needed and not be there.

It sounds like a line from a self-help book, but remember that in order to be a good provider, you have to take care of yourself to some degree first. Find some time to do something by and for yourself at least every few days. For you, that might look like going for a run or going to read a book at Starbucks. But, whatever it is, take a little time for yourself.

Loss of intimacy

Yes, I do mean in the physical way (those OBs and their rules - seriously follow those rules). But, it's much more than that. All of the sudden, you realize that those deep conversations you had with your wife (that you might not have thought were important) are less frequent. You are both tired and have a singular focus that tends to dominate your conversations (When was the last feed? Did I start on the left or right side last time? Is this yellow, runny stool normal?)

Try to find the time and energy to start one deep conversation per day. One great conversation starter in this time period can be: "How are you doing with all of this?" Don't settle for, "Fine." Ask deeper questions. Then, after you've taken the time to hear mom out, you'll probably get a chance to share some things yourself. You'll be glad you did.

The overlying concern for these feelings is that you might begin to feel guilty about having them. You know in your brain that this time is supposed to be one of the happiest times of your life. This tension is common and normal. It might be helpful to seek out other fathers whose advice you feel you can trust to talk through it. They may have more specific advice that will work better for you. The important thing is to resist the urge to tough it out and do it on your own.

Ultimately, you may feel that you are passing over from feeling a little down to actually feeling depressed.  If you have concerns about this, it's best to seek out professional help from your doctor or a counselor.

About the author

Justin Smith, M.D., is a pediatrician at Cook Children's Pediatrics in Trophy Club.  He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his three young children, exercising, reading and writing about parenting and pediatric health issues.

Reviewed by: Mary L. Gavin, MD
Date reviewed: April 2015

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