You've just made it home from the hospital, are totally exhausted, and starting to get a little overwhelmed by all this new mom stuff. (Are we right?) Boy, do we hear you. Those first few weeks (hey, even those first few months) with baby can be pretty intense. With so much to remember and so many "firsts" to cover, it's easy to be left feeling a bit unprepared. Lucky for you, we've put together the ultimate new mom survival guide, packed with all the need-to-know basics you may have missed in those massive baby books (that probably put you on information overload. Need some swaddling help ASAP? Wondering whether baby's poop is normal? Read on and we'll help put your mind at ease.
Q: Cutting baby's nails?
The safest way to keep a newborn’s nails short is to just file them and not cut them at all. Since the skin of the fingers is usually attached to the back of the nail, cutting the nails often results in nipping the fingertip too (ouch!). Even though the bleeding is minor and can be stopped quickly with a little pressure, it's very upsetting to the parent — and always seems like a lot more blood than it really is! Once baby is a little older (18 months), you can cut their nails while they’re asleep..
Q: Umbilical cord care?
"Umbilical cord care has changed dramatically over the last 20 years, with a less-is-more attitude adopted by most hospitals," says Paula Prezioso, MD, a doctor at Pediatric Associates of New York City and an Assistant Professor of Pediatrics at the NYU Medical School. "Originally, a triple dye solution was painted onto the cord at birth, which dried it quickly and allowed it to fall off within a week. This was replaced with the equally effective (and less staining) alcohol, which dried the cord in a week or two."
Now, many hospitals recommend doing nothing but keeping the cord dry. "The one problem is babies can’t take a real bath until the cord is off and healed—sponge baths are okay as long as the cord is kept dry," Prezioso says. "The problem with this is it may take up to a month for the cord to fall of—a long time not to bathe baby! That’s why I personally recommend using alcohol on the cord with each diaper change to see a complete healing in less than two weeks."
Q: Treating baby acne?
You might be surprised to find that baby's newborn skin isn't perfectly pink and smooth as expected. In fact, some babies develop baby acne, which is characterized by red bumps on the cheeks, chin and forehead, and can appear anywhere from birth to 3 months of age. You may also see white bumps that resemble whiteheads on the same areas. If these disappear just weeks after birth, they’re called milia. Though milia are confused with acne, they're actually just dead skin that’s trapped in small pockets on the skin’s surface. They can also appear inside the mouth, and when they do they are known as Epstein’s pearls.
Clearly baby’s bumpy skin isn't the result of binging on pizza or fries! So where did it come from? Well, it's linked to hormones. While experts haven't found any specific reasons why babies get acne, they do know that the big culprits are the hormones baby inherited from you during pregnancy. According to Jennifer Shu, MD, FAAP, a pediatrician at Children's Medical Group in Atlanta there's unfortunately no way to prevent baby’s bumps. It may be tempting to treat them like you would your own breakouts but that's a huge no-no. Never try to use any of your adult acne treatments on baby and keep your hands off (no pinching or popping!). Instead, wash baby’s face one to three times a day with warm water and always pat dry. Do not use extra soaps or lotions. While it should clear up by 4 to 6 months of age, if baby’s acne refuses to tame, talk to your doctor about other possible treatments. And keep in mind that baby acne is extremely common in newborns and does not indicate future skin problems (whew).
Q: Swaddling how-to?
Just like a haircut, huh? It always looks so much better when they do it. But, think of all the practice those nurses have had... it's no wonder they can perform miracles with receiving blankets. So keep trying — eventually you'll get the hang of it. Your baby loves swaddling, because being in a tight bundle makes her feel like she's back in the comfy quarters of your womb. She may even sleep better swaddled, and if that's not an incentive, we're not sure what is.
So here's what to do. Lay out a lightweight blanket on your bed or the floor in a diamond shape. Picture a clock face. Fold the top corner (12 o'clock) down about 6 inches. Put your baby here, with her head just above the fold and her feet pointing toward 6 o'clock. Pick up the right-hand corner of the blanket (3 o'clock) and wrap it firmly over her right arm and chest, then behind her back (under her left arm). Next take the 6 o'clock corner of the blanket and pull it up over her feet, tucking it under her chin. Finally, pull the remaining corner (9 o'clock) across her body and around and under her back. Done!
Q: What baby wants?
This is one of the biggest questions I get, and the answer is... you just will. Parents worry so much about how they'll know if the baby is happy or sick or whatever else. Dads especially are so nervous — they assume the mom will just know, that the instinct is delivered with the placenta or something.
It never ceases to amaze me what these same parents say when they come in at the one month visit. They tell me exactly what their baby likes, what it doesn't like, how it likes to be held, and so on. It just cracks me up, how this "helpless” baby that can't even talk is so completely able to communicate exactly what it wants. Somehow, it just works.
Q: Important vaccines?
We know it’s painful to watch baby get poked and even worse to hear the inevitable crying, but immunizations are crucial for his or her health. If baby is extremely sick, then your pediatrician will probably modify the immunization schedule. Otherwise, baby should get vaccinated on a regular basis following the guidelines from the American Academy of Pediatrics and the CDC. Though some children do suffer from mild reactions to immunizations, very few become seriously ill, and any pediatrician will reassure you that the benefits of having antibodies (needed to fight infections) far outweigh the risks of baby getting shots. So what exactly do these shots protect baby from? We broke it down with help from the AAP:
Hepatitis B Vaccine (HepB)
It prevents: Hepatitis B, a chronic or acute liver disease that can lead to liver failure and cancer.
When baby gets it: The first dose should be given before baby's discharged from the hospital after birth. A second dose should happen between 1 and 2 months of age. If, for some reason, baby doesn’t get the hepatitis B vaccine at the hospital,he or she will need three doses—at 0, 1 and 6 months—and the final dosage should be administered no earlier than 24 weeks old.
If mom is hepatitis B surface antigen (HBsAg) positive, baby should get the vaccine—plus hepatitis B immune globulin—within 12 hours of birth, and then receive three more doses of the vaccine between 9 and 18 months, and be tested for HBsAg and the antibody to HBsAg one to two months after completion of the dosages.
Rotavirus Vaccine (RV)
It prevents: Rotavirus, the most common cause of diarrhea and vomiting in infants and young children, which can cause severe dehydration in babies. It’s not a shot—this vaccine is taken orally.
When baby gets it: Between 2 months and 4 months of age, in two to three doses, depending on the brand of vaccine baby gets. He or she may also need another dose at 6 months, so double-check with your doctor.
Possible side effects: Fussiness, and some babies may have mild, temporary diarrhea or vomiting
Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine (DTaP)
It prevents: This is a combination vaccine to protect against diphtheria, tetanus and pertussis. Diphtheria used to be a major cause of childhood illness and death. Now, it only occurs in a few cases a year, thanks to this vaccine. Tetanus is a serious illness that causes painful tightening of the jaw muscles. Pertussis is also known as the whooping cough, a highly contagious respiratory infection.
When baby gets it: At 2 months, 4 months and 6 months, and then again between 15 and 18 months and 4 to 6 years
Possible side effects: Tenderness, swelling, redness, fever and/or loss of appetite within two days of receiving the shot
Haemophilus Influenzae Type B Conjugate Vaccine (Hib)
It prevents: “Hib” disease, which you probably haven’t heard of, but it’s very harmful. Hib was the leading cause of bacterial meningitis in children before the vaccine was developed. Kids with Hib may suffer permanent brain damage or have serious complications, like pneumonia.
When baby gets it: At 2 months, 4 months and 6 months, and between 12 and 15 months
Possible side effects: Fever, redness and/or tenderness at the site of the shot
It prevents: Streptococcus pneumoniae, an illness that can be serious and even lead to death. It can cause blood infections, ear infections, meningitis and pneumonia in children. The vaccine protects children for three years, when they are most vulnerable to the disease.
When baby gets it: At 2 months, 4 months and 6 months, and a booster given between 12 and 15 months
Possible side effects: Low-grade fever, redness and/or tenderness at injection site
It prevents: Polio, once a widespread epidemic that killed and paralyzed thousands of people.
When baby gets it: At 2 months, 4 months, 6 to 18 months and 4 to 6 years
Possible side effects: Soreness or redness near the site of injection; an allergic reaction rarely occurs
It prevents: The flu—which, according to the Centers for Disease Control and Prevention, is more dangerous to children than the common cold. The strains included in the 2015-2016 vaccine are H1N1, H3N2 and the influenza B virus.
When baby gets it: Annually, from age 6 months.
Possible side effects: Fever, aches, soreness, redness and/or swelling where the shot was given
It prevents: Measles, mumps and rubella, dangerous diseases that can cause rashes and fevers and that can lead to serious conditions like pneumonia, meningitis, seizures and deafness.
When baby gets it: One dose at 12 to 15 months and a second dose at 4 to 6 years.
Possible side effects: Rash, slight fever, joint aches, and/or swelling in neck and salivary glands a week or two after receiving the shot
Diaper rashes are par for the course in a new baby's life. It happens when baby’s sensitive skin has been sitting in moisture for too long, and some babies' skin is more sensitive than others’. The best way to prevent diaper rash is to apply a barrier diaper cream that contains zinc oxide, which protects the skin from the moisture in the diaper. Another good way is to let your baby's butt dry out a few times a day — lay down a waterproof pad and just let your baby hang out diaper-less...he may even enjoy it! Sometimes the naturally occurring yeast on the skin can also super-infect a diaper rash, causing painful or itchy little red bumps, usually around the anus or in the folds in the genital area. When you see that, consult your pediatrician for a prescription antifungal cream.
Can I Use Baby Wipes On My Newborn?
According to pediatrician Jennifer Shu, diaper wipes are just fine for newborns. The only exception is if baby develops redness or a rash (other than diaper rash), which is indicative of sensitive skin. In that case, use cotton balls or squares (they'll probably give you some at the hospital) dipped in warm water. When baby is ready for regular wipes, choose ones that are alcohol-free and unscented to prevent irritation. If you do notice any irritation besides diaper rash, switch brands until you find one that doesn't cause a reaction. Talk with your pediatrician about any irritations that seem severe or don't seem to improve.
Changing Table Safety?
The most important way to keep your baby safe on the changing table: Make sure she doesn't fall off. This may sound silly, but we definitely get phone calls about babies who roll off the bed or changing table... before their parents even think they can roll! Never leave a baby unattended. It's also important to make sure all creams and medicines are out of reach. You never know what they will try to put into their mouths.
Safety measures for grown-ups definitely include shielding yourself from a potential shower — both boy and girl babies have been know to spray their parents with pee and poop! But seriously, it is very important to wash your hands well after changing and handling diapers. Bacteria that normally live in the gut and are sometimes found in stool can cause diseases when ingested by mouth. So, if you have even microscopic traces of fecal matter on your hands when handling food, you and your entire family can get sick.