Baby's First Week | UnityPoint Health
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Baby's First Week

A Guide to Newborn Care

Congratulations on the birth of your new baby! Bringing home a baby is an exciting time and you may have a lot of questions! From feeding to bathing, UnityPoint Health is here to help you navigate this new journey.

We've pulled together a list of frequently asked questions during a baby's first week of life. Use these answers as a guide, but never hesitate to contact your child's provider if you have additional questions or immediate needs.

Download our guide to baby's first week.

Bathing/Skincare

How often should I bathe my baby?

Babies do not require frequent bathing, as you are cleaning their "dirty parts", such as their face and diaper area, multiple times per day.

Giving a bath every 2-3 days is sufficient. We recommend a sponge bath until the umbilical cord has separated and circumcision is healed.

Why does my baby look yellow?

It is common for babies to have jaundice in the first week or two of life. This is a condition that causes yellowing of the skin and eyes. Many babies have signs of jaundice before discharge from the hospital. To monitor jaundice, we check a level called bilirubin. Bilirubin is a pigment produced when the body breaks down red blood cells. We measure this either with a special device that is scanned on the skin, or by checking a blood level. Many babies have a mild degree of jaundice that goes away by itself. If your baby has certain risk factors identified in the hospital, the hospital provider may ask you to bring your baby in for a jaundice check shortly after discharge. Once you get home, if you notice a significant increase in the yellow color of your baby's skin or eyes, or if your baby becomes sleepy and difficult to feed, contact your provider to see if your baby needs to come in for a jaundice check.

My son was circumcised - how should I take care of it?

A circumcision takes 1-2 weeks to fully heal. Many circumcised boys are discharged from the hospital with a supply of gauze and petroleum jelly to apply with diaper changes. Continue using these until the area is fully healed; this keeps the healing area from sticking to the diaper. It is normal for there to be some yellow material stuck to the tip of the penis; this is part of the healing process. There may also be mild swelling, redness or bruising along the edge of the circumcision. If there is excessive redness or drainage, check with your provider to make sure it is healing as it should. Your provider can also counsel you regarding any need to pull back skin after examining the circumcised area.

My son was not circumcised - how do I clean his diaper area?

In the newborn period, the only care required for an uncircumcised boy is to gently wash the outside of his penis with soap and water at bath time, and to wipe the outside with diaper changes. There is no need to retract the foreskin at this time. Your provider can counsel you about further care as your son gets older.

How do I care for my baby's skin?

It is normal for babies to have dry, peeling skin in the first 2-3 weeks of life. We do not recommend use of lotion, as it will won't help the dry skin, and may lead to skin irritation. Occasionally we will advise use of Aquaphor or petroleum jelly in areas that become exceptionally dry and cracked, such as in the creases of the wrists and ankles.

Baby rashes are common. Some babies develop a rash called erythema toxicum, a blotchy red rash with raised center that looks similar to insect bites. Babies can develop infantile acne at a few weeks of age, that consists of red bumps and pimples on the face, scalp and upper torso.

Many newborn rashes resolve on their own and are not harmful; if you notice that your baby has a rash, check with your provider to determine the proper care.

Babies can develop some redness around the anal opening as their skin is getting used to contact with stool and frequent wiping. If your baby develops some redness in the diaper area, you can use diaper cream to protect the skin. If a diaper rash is not responding to this treatment, check with your provider for further options.

How do I care for baby's belly button?

The umbilical cord stump will usually dry up and fall off in the first 1-2 weeks of life. Try to keep the area dry, and fold down the diaper to allow air to get to the area. If you bathe baby, you can gently wash around the area and blot dry, but you do not need to apply alcohol or other cleansers. As the cord separates, you may see a small amount of bleeding from the cord. You may also notice yellow discharge at the base of the belly button, where the cord is separating. These are both a normal part of the cord stump separating. It is also common for the cord stump to be a bit smelly before coming off. If you see excessive drainage from the umbilical area, if odor seems excessive, or if there is redness spreading onto the belly, contact your provider for further advice.

Cold Symptoms/Medications

How do I know if my baby is ill?

Signs of illness may be subtle in a newborn- please do not hesitate to call us if you have a concern! If you think your baby has a fever, we recommend taking a rectal temperature. While this may seem uncomfortable, babies typically tolerate it well. You can coat the thermometer with petroleum jelly if desired. If your baby has a rectal temperature of 100.4F or higher, call your provider right away. If your provider is unavailable, take your baby to the emergency department.

Other symptoms of illness may include excessive sleepiness, poor feeding or inconsolable fussiness. If you are concerned that your baby looks blue, or there is a concern about your baby's breathing, call your provider or seek emergency services if symptoms are severe.

Should I give my newborn acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) if they seem fussy or have a fever?

In a newborn baby, we recommend that you immediately contact a provider if a baby is fussy or feverish enough to consider giving one of these medications. In most cases, baby will need a medical evaluation to determine the best course of care. DO NOT give acetaminophen to a newborn unless instructed by your provider. Ibuprofen should not be used until 6 months of age or older.

My baby always seems stuffed up - what should I do?

It is very common for newborn babies to be congested. Their nasal passages are very small, and a tiny bit of mucus or swelling can plug them up. If the baby seems to be comfortable, and can sleep and feed normally, you do not need to do anything about the noisy breathing. If baby is having a hard time feeding or sleeping, you can put use baby saline drops (available over the counter) and use a nasal aspirator to suction the nose, such as the bulb syringe you received in the hospital. Most of the time, nasal congestion does not mean your baby has a cold or allergies, but your provider can help you if you have further questions.

Crying/Fussiness

What do I do when my baby cries?

Babies cry. sometimes a lot. They can cry for a couple of hours or more per day. This can be especially hard for parents who are tired and getting used to a whole new way of life. Babies cry for many reasons- when they are hungry, tired, wet, cold, or sometimes for no reason at all. With time, you will recognize different cries that mean "feed me" or "cuddle me" or "I need to go to sleep." In the meantime, when your baby cries, try feeding, burping or changing baby. If all your baby's needs have been met, and they are still crying, it is okay to let them cry for a bit. You can try the 5 S's to soothe baby: swaddling, side/stomach positioning while awake, shushing, swinging and sucking (developed by Harvey Karp, MD, FAAP in The Happiest Baby on the Block). In time you will find techniques that work well to soothe your baby.

Sometimes a fussy baby can test a parent's patience. This is normal. Be sure to reach out for help if you need a break. Take turns caring for baby or ask a friend or relative to come and take over for a bit. Also, if crying seems excessive, high pitched, or if nothing calms your baby, talk with your provider.

This is a lot harder than I thought. Am I doing something wrong?

Raising a human is a big job! Unfortunately, new parents are surrounded by lots of "perfect" images of parenthood, along with loads and loads of conflicting information. It is normal to feel exhausted and to have days where parenthood doesn't feel like whole lot of fun. In many cases, this is a normal response to a huge lifestyle change. However, if you or your partner are feeling excessively down, or are having difficulty caring for yourself or your baby- there is help. Please talk to your baby's or your own provider.

There will also be moments of wonder, the miracle of watching a new life unfold, and funny memories. Cherish these moments! And remember, we are your partner in caring for your child, always there to answer questions, and help you along this amazing journey.

Dirty Diapers

How many wet and dirty diapers?

In the first week of life, babies should have about one wet diaper per day of age (for example, 3 wet diapers on day 3). After that, watch for at least 5 wet diapers per day. At the beginning, the amount of urine is often small, but as the days go by, the diapers will be more saturated.

Baby girls can sometimes have a mucus discharge from the vagina, or even a small amount of bleeding. This is a normal hormonal response and will resolve within the first couple of weeks. If there seems to be a lot of bleeding, check with your provider. Babies can also develop "brick-dust" urine; the urine will have a pinkish-orange color and leave a powdery residue on the diaper. This is common and will go away on its own.

Baby's first stools will be dark, tarry and sticky. By a few days of age, the stools will transition to a greenish color, and eventually to yellow.

Breastmilk stools are often quite runny, and they are bright yellow with small white curds mixed in. Formula stools can be yellow to green and are often a bit thicker in consistency. A breastfed baby may have a bowel movement after nearly every feeding once mom's milk is in. A formula fed baby may only have a bowel movement once or twice a day. If you have concerns about the frequency of wet or dirty diapers, please check with your provider.

Types of baby poop & what they mean

Feeding/Weight Gain

What should I feed my baby?

Newborn babies should only be fed breast milk or formula. They should not be fed plain water, juice or other liquids. Breast milk and formula provide new babies the balance of nutrition, fluid and electrolytes that a baby needs; feeding other liquids can be dangerous. Newborns also do not need rice cereal or other solid foods. Your provider will talk to you about appropriate times to introduce other liquids and solid foods when your baby is older.

What do I need to know about breastfeeding my baby?

First, remember that breastfeeding is a learning process both for mom and baby. In the first few days and even weeks, it can feel like breastfeeding takes a lot of time and mental energy, but it will get easier! Newborns should nurse 8-12 times per day, usually for 10-15 minutes per side. Mom's milk usually starts to come in on the third day after baby is born. Most babies tolerate this wait well, but if your baby seems extra fussy, speak with your provider regarding supplemental formula. We often schedule a weight check within a few days of discharge to make sure this process is going smoothly and to monitor baby's weight. If you have excessive pain with nursing, please let your provider know, as this can signal a medical issue such as a tongue-tie. In addition, be sure to call Lactation Services with breastfeeding questions. Your area may also have breastfeeding support groups that can be a valuable resource.

What if my baby is formula-fed?

Continue to use the formula that your baby started in the hospital. If you started with nursing and are transitioning to formula, or if you believe that your baby needs a different formula, please discuss these questions with your provider. They can help you make an informed decision about which formula to use. Most babies are taking about 1-2 oz by the time or discharge and have increased to 2-3 oz per feeding by the 2-week check. If your baby is acting hungry after feedings (fussing or rooting), you can try increasing feedings by 1/2 oz at a time. Babies usually feed every 2-3 hours around the clock. If you have city water, tap water can usually be used to mix formula. If you have well water, discuss options with your provider. Formula should always be mixed according to package instructions, as diluted or concentrated formula can cause serious problems for the baby. If you are having trouble obtaining formula for your baby, please talk to your provider about programs in your area that can help.

How quickly should my baby gain weight?

It is normal for babies to lose weight in the first few days of life; we expect up to a 10% loss of body weight. The initial rate of weight gain will vary depending on whether a baby is breast- or formula-fed, and on any other underlying health issues that may impact feeding. Most babies are starting to gain weight by the end of the first week of life. Most babies are at or past their birth weight by their 2-week check-up. Your provider can give you more specific guidance regarding weight gain expectations for your baby.

Virtual lactation services

Breastfeeding basics: 6 benefits and 6 challenges

What is the proper way to store breast milk?

When pumping breast milk, be sure to wash your hands beforehand and clean all equipment. Store milk in small batches of 2-4 ounces. You can use the following guidelines for safe breastmilk storage:

  • 4 hours at room temperature
  • 4 days in the refrigerator
  • 9 months in the regular freezer
  • Up to one year in a deep freezer

First Appointment

When do I need to bring my baby in for well care?

When do I need to bring my baby in for well care? Visits in the first few days will vary depending on your baby's needs; the hospital provider will let you know when to go in for a first visit when you are discharged. You may have additional visits in the first two weeks to monitor weight gain or jaundice. Your baby will have a visit at two weeks of age, and if all is going well, your next visit will be at two months. Typically, your baby will be seen at 2, 4, 6, 9 and 12 months in the first year of life, although this may vary depending on your baby's needs.

What about immunizations?

Your baby may have received a Hepatitis B vaccine in the hospital; the next set of immunizations is due at two months of age. Immunizations are an important way to protect your baby; the vaccine schedule recommended by the CDC has been carefully studied for safety and effectiveness. If you have specific questions about immunizations or our immunization schedule, please ask your provider.

Gas/Spit Up

What should I do if my baby spits up?

It is common for babies to spit up, and most of the time, this does not indicate a major problem. A common reason for spitting up is overfeeding- baby is eating more than their tummy can hold. This can happen if mom has an oversupply of breast milk, or if a baby fusses and is fed too much in an effort to soothe. Sometimes spitting up is caused by an air bubble in the tummy. Babies can be "happy spitters." They may spit up frequently but are happy, feed well and are growing well. These babies will typically outgrow spitting up sometime in the first year of life and need no special medical treatment.

To help with spitting up, burp your baby frequently during and after feedings. If they do not burp well after a feeding, try again in 10 or 15 minutes and you may have success. Try to keep your baby upright for 20 minutes after feeding and try not to jostle or move them too much right after they eat. We do not recommend wedges or other positioners due to SIDS risk, but you can try putting a thin blanket or towel under a firm crib mattress to elevate the head of the bed or elevate the legs of a bassinet.

If your baby seems to have pain with spitting up, is having very forceful vomiting, is not feeding well, or has a green color or blood in the vomit, please contact your provider for further advice.

My baby seems gassy – what should I do?

Gassiness is common in babies; if it is not bothering baby, you do not need to do anything to treat it. If your baby seems fussy or uncomfortable, try bicycling the legs or massaging baby's tummy. A warm washcloth or bath can also soothe the tummy. If your baby is formula-fed, letting bubbles settle before feeding can help. Burping can also help by eliminating bubbles of air that travel through the gut. Gas drops are safe, but not always effective; check with your provider before trying. If gas is associated with severe pain, feeding difficulty, or abnormal stools, please discuss with your provider.

Postpartum Depression

According to the National Institutes of Health, approximately one in eight women suffer from postpartum depression (PPD). It can affect any woman regardless of age, race, income, culture or education, and generally, PPD begins within three months of delivery but can on-set at any time, even as late as one year after delivery. A report in the Journal of the American Medical Association found that 10 percent of men or non-birthing parents worldwide showed signs of depression, often referred to as paternal postpartum or postnatal depression or (PPPD), from the first trimester of their partner's pregnancy through six months after the child was born.

Common Postpartum Depression symptoms include:

  • Feelings of worthlessness; excessive guilt
  • Loss of pleasure or interest
  • Loss of energy, tiredness
  • Low (anxious or depressed) mood
  • Psychomotor agitation (restlessness, jittery, hand-wringing)
  • Poor concentration, memory
  • Poor appetite
  • Sleep disturbance
  • Suicidal thoughts (seek help immediately; National Lifeline 1-800-273-TALK)

Your doctor can help you determine if you are struggling with PPD. He or she will ask you questions and may give you a brief assessment questionnaire to help determine your condition. If it is determined you are at risk for PPD, your doctor will make a referral to a mental health provider for a more thorough assessment and to begin treatment. You may also seek counseling on your own without a referral.

Treating a new father/non-birthing parent for PPD can affect the overall health of a family. It's important to address these mood changes as soon as possible.

Sleeping

Where should my baby sleep?

The sleep recommendations provided are intended to reduce the risk of sleep- related infant deaths, commonly known as SIDS. We recommend placing baby to sleep on a firm crib mattress, bassinet, or portable crib with a fitted sheet designed for that mattress. A CPSC (Consumer Product Safety Commission) certified bedside sleeper may also be used. Nothing else should be placed in the crib- just baby and a tight-fitting sheet. There should be nothing loose in the crib, such as a pillow, blanket, or stuffed animal. Baby should always be placed on the back to sleep. If baby falls asleep in a swing, infant seat, or carrier, move them to a firm sleep surface as soon as possible. You can swaddle your baby to sleep; make sure the swaddle is loose enough to allow baby to breathe comfortable and to allow movement of the hips. Use of a pacifier is fine for sleeping; it can reduce the risk of SIDS. For breast fed babies, wait until breastfeeding is well established before offering a pacifier. It is recommended that baby sleep in parents' room for the first 6 months. However, bed-sharing is not recommended.

How much should my baby sleep?

In the newborn period, babies may sleep up to 16-18 hours per day. By 4 weeks of age, the sleep total for a 24-hour period may be closer to 14 hours. Newborn babies typically wake up every 2-4 hours to feed and this pattern can extend for several months.