Taking Care of Your Baby and Yourself by Robert McLaughlin

Taking Care of Your Baby and Yourself

Table of Contents YOUR HOSPITAL STAY .....................................2 Before You Come to the Hospital.................... 2 Pre-Registration............................................ 2 Choosing a Pediatrician................................. 2 Visiting Hours............................................... 3 Things to Bring............................................. 3 Things We Will Provide.................................. 4 Car Seat...................................................... 4 Family Birth Center (L&D)............................. 4 Fetal Monitoring........................................... 4 Intravenous (IV) Fluids.................................. 4 Pain Relief................................................... 5 Visiting........................................................ 5 Delivery Positions......................................... 5 Skin-to-Skin................................................. 5 Photography................................................. 5 Immediate Recovery Period........................... 5 Rooming In.................................................. 6 Crib............................................................. 6 Laboratory Testing........................................ 6 Pulse Oximetry Screening.............................. 6 Newborn Hearing Screening........................... 6 Birth Certificates and Social Security.............. 6 Baby Photos................................................. 7 Health and Safety......................................... 7 Security....................................................... 8 Going Home................................................. 8

TAKING CARE OF YOUR NEWBORN...... 12 Getting to Know Your Baby.......................... 12 Your Newborn’s Appearance......................... 12 BREASTFEEDING YOUR BABY............... 13 Feeding Your Baby...................................... 13 Burping Your Baby...................................... 13 Breastfeeding Your Baby.............................. 14 Latch On................................................... 14 Skin-to-Skin = Protection............................ 14 Positioning................................................. 15 Breaking Suction........................................ 15 Milk Ejection Reflex.................................... 15 Engorgement.............................................. 15 Sore Nipples.............................................. 15 Things to Remember About Breastfeeding..... 16 FORMULA FEEDING YOUR BABY.......... 16 Bottle Feeding Your Baby............................ 16 Formula Preparation................................... 16 Signs You May Need to Change Formulas...... 18 Is Your Baby Getting Enough to Eat?............. 18 Signs That Your Baby is Not Getting Enough Formula ................................................... 18 Is Your Baby Getting Too Much Formula?...... 18 Other Feedings........................................... 18 GENERAL INFANT CARE........................ 19 Room Temperature...................................... 19 Clothing..................................................... 19 Bulb Syringe.............................................. 19 Bath Time.................................................. 20 Taking Your Baby’s Temperature................... 21 When to Call Your Baby’s Doctor................... 22 Home Safety.............................................. 22 Keeping Your Baby Healthy.......................... 22 Reduce the Risk of Sudden Infant Death Syndrome (SIDS)........................................ 23 Never Shake Your Baby!.............................. 23

CARING FOR YOURSELF AT HOME......... 9 Recovery Period............................................ 9 Lochia and Uterus........................................ 9 Perineum, Hemorrhoids and Hygiene.............. 9 Breast Care ............................................... 10 Baby Blues................................................ 10 Contraception............................................. 10 Cesarean Birth........................................... 11 Postpartum Exam....................................... 11 Pregnancy Leave......................................... 11 When to Call Your Doctor............................. 11

Taking Care of Your Baby and Yourself

Your Hospital Stay Before You Come to the Hospital

Welcome to the Mother-Baby Care Unit at Mercy Medical Center Merced. Our family-oriented care unit provides you and your family with the opportunity to develop a positive relationship with your new baby. This booklet contains information about the care that you and your baby will receive here during your labor, delivery and postpartum experiences. It is our hope that you will be well on your way to being comfortable with caring for yourself and your new baby before you are discharged from our hospital. This booklet also contains some information that we hope you will find useful in continuing to be comfortable with your role as a new mother at home.

Please take a few minutes to read all of the information in this guide. We hope it will answer some of your questions and help you and your baby get to know each other comfortably and safely.

Pre-registration You can pre-register before you go into labor through the Admitting Office between the hours of 9:00 am and 5:00pm, Monday through Friday. You can also register online at www.mercymercedcares. org. Call (209)564-5200 for more information. Please bring your clinic card and your insurance card with you when you come into the Family Birth Center.

Choosing a Pediatrician Choose a doctor for your baby just as you chose a doctor for your pregnancy. You may wish to visit the office or interview that doctor about services and hospital privileges before your delivery date. You may also want to discuss circumcision with your pediatrician. Some will perform this procedure in the hospital before discharge, but others prefer to wait until the first office visit. You should also check with your insurance carrier, as some companies do not cover the procedure.

Taking Care of Your Baby and Yourself

Visiting Hours

Visitors are allowed at any time you wish. If you do not wish to have visitors, please let your nurse know. Visitors may be in your room with you or in the department waiting room. They may not wait in the hallways of our department. We ask that visitors check in at the front desk in the hospital lobby before coming to the Family Birth Center. Please make sure they know what name you are using during your stay with us.

Your Hospital Stay Be sure everyone (including visitors) who touches your baby washes their hands first with soap and water or uses the waterless gel provided in your room. • Do not let any staff member take your baby unless they are wearing a hospital security picture ID. • Never leave your baby alone in the room. • Never fall asleep while holding your baby.

Children 13 years of aga and younger must be with a responsible adult at all times. They must not be left in your care, as you are a patient here in the hospital.

Things to Bring To make your stay more comfortable, you may wish to bring a few things from home. Your own gown or pajamas, a good support bra, underwear, slippers, and personal toiletries may be some of the items you wish to bring. Please also bring a list of any medications you are taking, including over the counter preparations such as vitamins or herbs. You will need clean loose fitting clothing for yourself, blankets and clothing for your baby and a car seat (you may leave the base in the car) for your discharge home.

Car Seat

Things We Will Provide During your stay, we will provide disposable underwear, sanitary pads, hospital gowns and any breastfeeding supplies you may need. We will provide t-shirts, receiving blankets, disposable diapers and wipes for your baby. During your stay we will provide baby formula if you are not planning to breastfeed your baby. We will, also, provide a complementary diaper bag when you go home. DO NOT BRING ANY ELECTRICAL APPLIANCES, JEWELRY, CREDIT CARDS, MONEY OR OTHER VALUABLES TO THE HOSPITAL WITH YOU.

As of January 1, 2012, California State Law requires all children younger than eight years old, or under 4 feet 9 inches, to be secured in a car seat or booster. In addition, all kids younger than eight, must be secured in the back seat. Infants less than 20 pounds need to be secured facing the rear seat of the car. If the car has a passenger airbag, the baby must ride in the back seat to avoid being injured by the airbag in an accident. Make sure you are comfortable with the operation of your car seat before coming to the hospital. Be sure to follow the manufacturer’s instructions. A car seat should always be used when traveling. Please note that the hospital staff is NOT permitted to assist with the placement of your baby in your car seat.

Taking Care of Your Baby and Yourself

(FBC) Labor & Delivery

epidural. There are criteria that must be met before an epidural can be placed. Your Family Birth Center nurse will discuss your plans for pain relief with you.

You should talk to your doctor about routine care at one of your office visits before you go into labor. Episiotomies, enemas and shaving are not routine and their use depends on your doctor or your condition at the time of labor.

Visiting We encourage you to have a support person or people with you during your labor. This person or these people must remain in your room or go to the department waiting room. They may not wait in the hallways of our department. During the time you are in the pushing stage of labor you will be permitted to have your support person and two others with you until after the delivery and recovery period. We ask that your visitor respect your need to rest and heal and only your support person be present after 11:00 pm.

It may be difficult to know when your labor starts. You may want to come in for a labor check if you have cramping, a lower back ache that comes and goes or regular contractions, even if your baby is not due yet. If your water breaks or if you have vaginal bleeding, you should come to Labor & Delivery right away. If you have any questions, you may call your doctor or (209) 564-5200 to speak with a Family Birth Center nurse.

Fetal Monitoring On admission, your Labor & Delivery nurse will carefully monitor the progress of your labor and the well being of your unborn baby. Fetal monitoring is routine upon admission. When it is determined that your baby is in good condition, you may walk or move about in between monitoring. If you have complications, you may need continuous monitoring. This will be discussed with you, if it is needed.

Intravenous (IV) Fluids

Going Home Early

Most women will have an IV at some point in their labor process. Depending on your condition, your Labor & Delivery nurse may choose to start one right away or to wait until you need medications. When your condition requires it, this decision will be made together with you and your doctor.

Pain Relief There are a number of pain relief options available to you during your labor process. Some women choose to use only the techniques learned from childbirth classes. These can involve comfort measures such as walking in the hall, sitting in a rocking chair or showering. Others will want to have pain medication that can be given through their IV at appropriate times. Still others will want a procedure called an

If you plan to leave the hospital less than 24 hours after delivery, please let your nurse or doctor know in advance. â&#x20AC;˘ Remember to call your medical care providers when you get home for follow-up appointments with your doctor and your babyâ&#x20AC;&#x2122;s doctor

Taking Care of Your Baby and Yourself

Delivery Positions Most women deliver in a semi-sitting position. Your labor nurse will assist you in changing positions to make your birth as easy as possible. Your doctor may have preferences as well and you should discuss any concerns or requests with him or her. Our labor beds have many built-in positioning aids that you can use to assist in the pushing phase of your labor.

Skin-to-Skin As soon as possible after a vaginal delivery, your baby will be positioned on the mother’s chest. This skin-to-skin contact helps to calm the baby and stimulates the mother’s body to begin recovering from the work of labor. Newborns are usually especially alert during the first “golden hour”.

These contractions are sometimes called “after pains” and may be stronger during breastfeeding. You will be instructed to continue massaging your own fundus at intervals and let the nurse know if it doesn’t feel hard. Your nurse will observe your perineum for swelling and bruising. The perineum is the area around the vagina. You may have had an episiotomy or laceration that was repaired. You may be intact. An ice pack will be offered to reduce the swelling and relieve the discomfort that follows swelling. Your first time up after delivery, you will be assisted to the bathroom and instructed on “peri-care”. You should continue this care at home until the area is well healed. You will be encouraged to empty your bladder often, even if you don’t feel the urge to go. An overfilled bladder moves the uterus upward and will not allow it to remain firm, contract and empty of lochia properly. An overfilled bladder will, also, lose muscle tone and make it even more difficult to empty.

If you need to have a cesarean section, you will be in the recovery room in our department where your baby can be placed skin-to-skin as your condition allows and you can enjoy all of the same emotions and sense of attachment a mother who has a vaginal birth experiences.

Rooming In

Photography

Within the first hour after delivery, your baby will be given a Vitamin K shot and have an antibiotic eye ointment instilled in both eyes. When you are ready, or if your baby’s condition requires it earlier, your baby will be moved to the nursery for his or her initial examination, bath and cord care. Footprints for your complementary birth certificate are generally taken at this time.

Many parents like to photograph their birth experience. Your nurse can explain current video and still photography policies to you. We request that you ask permission from staff members first, as some people are uncomfortable having their pictures taken.

Immediate Recovery Period

It is best if your baby stays with you in your room 24 hours a day. A nurse will be assigned to care for you and will teach you to care for your baby. We encourage questions, as we want you to feel comfortable taking your baby home. In giving you the most time to be with your baby, we can assist with any problems you may encounter during breastfeeding or with general infant care.

Immediately following delivery, your nurse will check you frequently to make sure your body is recovering appropriately from your birthing experience. Your nurse will check your temperature, pulse, respirations and blood pressure frequently. Your nurse will assess your uterus and bleeding. Massaging the fundus (the upper part of your uterus) will help keep the uterus firm and minimize blood loss. During the first 24 hours after delivery, your lochia (the blood flow) can be heavy with some clots. Your uterus will continue to contract after your baby is born.

We do understand that there are times when you are just too tired, physically unable to care for your baby (immediately after a cesarean section) or want to shower.

Taking Care of Your Baby and Yourself

Crib

program and is covered by most insurance plans. Results of the screening are immediately available to you. When your baby passes his or her hearing screening, you will receive a handout with information so that you can continue to evaluate your baby’s hearing as he or she grows.

The storage under your baby’s crib contains diapers and all supplies you need to care for your baby during your stay. Please ask your nurse if you need replacements or assistance. Upon discharge, the blankets and t-shirts must be left in the baby’s crib, as the linen is hospital property.

Laboratory Testing Before your baby is discharged, he or she will have several routine blood tests. Cord blood is collected at the time of delivery. Depending on mother’s blood type, it may be tested or just stored. One blood test required on all babies, tests for metabolic disorders. The results are sent to the doctor caring for your baby. You will receive a copy of the information on where the test results will be sent before you go home. If you have any questions on what these tests are, please refer to the pamphlet given to you on admission or ask your baby’s doctor. At approximately 20 hours of age your newborn will be assessed for the risk of hyperbilirubinemia (newborn jaundice). Using light instead of a needle, your nurse will use a BiliChek handheld device to measure your newborn’s bilirubin levels right in your room. Based on the results, further tests may be required using serum bilirubin levels. (Blood draw). These results will be available before your baby is discharged from the hospital.

Newborn Hearing Screening

During your hospital stay, your baby will have a hearing screen. Hearing loss is invisible and can be found in 2-4 out of every 1,000 babies. In the first months and years of life, your baby will be developing communication skills. A baby with a hearing loss may not develop normal language skills. With early identification of hearing loss, you and your baby can be referred to the appropriate services. This screening is simple and takes only a few minutes to perform.

Pulse Oximetry Screening Pulse oximetry is a simple and painless bedside test used to measure how much oxygen is in the blood. Mercy Medical Center routinely screens all newborns when the baby is 24-48 hours of age. The screening is helpful in determining if an infant’s heart and lungs are healthy. A doctor or nurse practitioner may ask for more testing such as an ultrasound of the heart, or echocardiogram (or “echo”) when a low pulse ox reading is identified. The echo will screen for a serious problem in the structure of the heart or the blood flow through the heart. Pulse ox can identify a baby with serious CHD (Congenital Heart Defects) before he or she leaves the Family Birth Center.

Birth Certificates and Social Security The Health Information Clerk will visit you in your hospital room. Please have your own and your baby’s father’s Social Security numbers available, as well as both your names, birth dates and places of birth. If you are not married, the baby’s father can fill out paternity papers at the time the birth certificate is prepared. You will receive an application for a legal copy of the birth certificate, as well as a complementary birth certificate with your baby’s footprints before discharge. An application for a Social Security card will automatically be sent for your baby. You will be given a receipt as proof of application before discharge. It takes about 6-8 weeks to receive the card in the mail.

Baby Photos Pictures are taken by an outside company. The photographer comes to our department daily. Please

Newborn hearing screening is a state-supported

Taking Care of Your Baby and Yourself

check with your nurse in the morning if you have not seeen the photographer and wish to have pictures taken, as they are here fora limited time each day. A variety of color photo packages of your baby’s picture will be offered to you. Purchase of pictures is optional. You are welcome to dress up your baby for this picture.

Health and Safety

Postpartum Care

During your stay with us, there are a few basic guidelines that you and your family will need to observe: • All visitors, especially your children, need to be healthy and free of any signs of illness. • Anyone touching or holding your baby should first wash their hands with soap and water or use the waterless gel provided in the room. You should wash your hands after every diaper change and after using the bathroom. • Please ask any questions you may have about your care or the care of your baby. • Do not leave your baby alone in your room or on your bed. If you need to leave your baby momentarily, please ask your nurse for assistance. • When you place your baby in the crib, lay your baby on his or her back. Babies should never be placed on their stomachs. • While we encourage you to hold and carry your baby in your room, for your baby’s safety and security, we ask that you place him or her in the crib when you are walking in the hall. • Mercy is a non-smoking facility. For everyone’s health, please do not smoke.

If you have a fever over 100.5° F (38° C), call your doctor. • If your vaginal bleeding is heavy enough to soak a pad in less than two hours, call your doctor. • If you have vaginal discharge that smells bad, call your doctor. • If your cesarean incision becomes hot, hard, red or sore, or if it drains, call your doctor. • If you have unusual pain or redness on your legs, call your doctor. • If a hot, hard, red, sore area develops on your breast, call your doctor. • If you are taking any pain medication, like codeine, do not drive. • If you feel unable to care for your baby or cry for long periods, call your doctor.

Security Matching armbands with identification numbers will be placed on you, your baby and one designated support person. Whenever your baby leaves your room, these identification numbers must be checked before your infant is returned to you or your support person. If both armbands accidentally fall off your baby, let your nurse know immediately, so that they can be replaced more securely on your infant.

Taking Care of Your Baby and Yourself

All hospital personnel wear picture identification at all times. Please DO NOT let anyone take your baby from your room unless this picture ID has a pink stripe running across the bottom of it. If you have any questions about who is taking your baby or why they are taking your baby, please call your nurse. We, also, offer a state-of-the-art infant security system at Mercy Medical Center. Your baby will have an electronic device placed on his/her umbilical cord, attached to the cord clamp at the time of delivery. If it is tampered with, or, if your baby gets too close to an exit, it. If you find that it has accidentally fallen off your baby’s foot let your nurse know immediately, so that it can be replaced. Both our Labor & Delivery and Mother/Baby units are closed to the general public. Visitors must use a special doorbell and request permission to enter. Please, make sure that your visitors are aware of the name that you are admitted under, as that is the name listed on our rosters.

Going Home Your doctor will write your discharge orders the morning you go home. Your baby’s doctor will write orders for your baby. When this has occurred, your nurse will bring your written instructions to go over with you and have you sign. It is a good idea to bring the car seat to your room, so that you can check the fit for your baby. If your doctor prescribes any medication, you will be asked the name of the pharmacy you use, so we may call or fax your medication order. This way, it should be ready for you upon discharge. After you go home, you will need to call your doctor’s and your baby’s doctor’s offices to schedule follow-up appointments. If your doctors have given you appointments already, they will be noted on your instructions. You will only need to call, if you are unable to keep these appointments.

Baby Care For the ﬁrst day, a baby’s stools are normally dark greenish-black and sticky. • It is normal for babies to lose up to 10 percent of their birth weight in the ﬁrst week. • With proper care, your baby’s umbilical cord will dry and fall off in one to two weeks.

Taking Care of Your Baby and Yourself

Caring For Yourself at Home

Lochia and Uterus

Recovery Period During the first week at home, you should only be taking care of yourself and your baby. Rest is very important. We recommend that you do not plan big gatherings and limit visitors, travel and housework during this time. Try to match your waking and sleeping hours to your baby’s. Nap when you can. Don’t be afraid to ask for help when you need it. Remember that the best thing you can do to take care of your baby is to take care of yourself. Strenuous activities should be avoided for at least two weeks. It’s best not to lift anything heavier than your baby during this time. Gradually begin a mild exercise program that includes walking. It takes time to return to your pre-pregnant state. Try to stand up straight tightening your tummy muscles. Avoid tampons, douches or sexual intercourse until you see your doctor for your postpartum checkup, usually in 4-6 weeks. Practice doing Kegal’s exercises to tighten the muscles of the pelvic floor that were stretched during birth. This is how it is done: while you are urinating, stop the stream. The muscles used to stop the stream are the ones you want to practice tightening. Once you can successfully stop your urine, you can tighten these same muscles anywhere or anytime. Consult with your doctor before beginning any kind of exercise program.

Lochia is the normal vaginal discharge that begins immediately after you give birth. For the first few days, you can expect a heavy vaginal bleeding with some clots, especially when you get up after lying down for a long period of time. The vaginal bleeding will lessen and become darker, lasting 2 to 6 weeks. Then, a yellowish, mucous discharge will occur. The first menstrual period may return within 6 weeks to several months after birth. About 2 weeks after birth, your uterus contracts down below the pubic bone where it can no longer be felt. “After pains” are cramps caused by your uterus shrinking in size. They last about one week and are most commonly felt during breastfeeding. Talk to your doctor if you think you need pain medication.

Perineum, Hemorrhoids and Hygiene One of the things new mothers often complain about is pain and itching in the perineum. If you had an episiotomy or tears in the perineum during your delivery, then you may experience some pain. Another reason for pain in the rectal area may be hemorrhoids, which are caused by pressure on the veins in the rectal area during pregnancy and delivery. You may continue to use the Dermoplast and Tucks pads you received after your delivery. If you run out, they may be purchased at any pharmacy without a prescription. For comfort, you may want to try a “sitz bath”. Simply fill your bathtub with enough warm water to cover your perineum and soak for 10-15 minutes several times a day for 5-7 days. This promotes healing and provides relief from the discomfort. Remember that the stitches will dissolve slowly.

Remember your body is healing. It is important that you eat a well-balanced diet and don’t skip meals. You should, also, be drinking 8-10 glasses of water daily to replace lost body fluids and to help your body recover from the birth of your baby. Continue to take your prenatal vitamins, especially if you are breastfeeding. Be sure to take any medications ordered by your doctor, which may include iron pills.

A daily shower is necessary for good hygiene and the prevention of infection. Don’t forget to continue with “peri-care” and put on a clean sanitary pad after using the toilet. Use your Tucks pads after having a bowel movement to clean the rectal area.

Taking Care of Your Baby and Yourself

You should avoid constipation during this time. Drink lots of fluids and increase the fiber in your diet (fruits, vegetables, whole grains). A glass of prune juice is usually helpful. If you have problems having a bowel movement, your doctor may advise you on using a stool softener.

Breast Care After you’ve had your baby, your milk will come in 3-4 days whether you are breastfeeding or not. You should wear a well-fitting bra (no underwire) to support your breasts. If your bra becomes wet, change it. If you use breast pads, avoid those with a plastic lining and change them frequently. If your breasts become engorged (swollen, uncomfortable or hard), avoid hot showers as this may increase swelling. Ice packs can be placed on the sides of the breasts for 10-15 minutes several times a day to help lessen discomfort. Be sure to place a layer of cloth between the ice pace and your breasts. Tylenol (acetaminophen) or Motrin (ibuprofen) may be used for discomfort. If you are breastfeeding your baby, allow your nipples to air-dry after nursing. Do not use any soap, lotion or creams on your nipples. Instead, express a little breast milk and rub it on your nipples as a natural lubricant. Some women experience problems with blocked ducts. A blocked duct is a hard, red sore area. Try to open the duct by massaging that area while nursing. If the blockage persists, becomes hot to the touch or you run a fever, call your doctor immediately. If you are bottle-feeding your baby, some leakage of milk is normal. Try not to express milk manually. Avoid breast stimulation for about 10 days or until your breasts are soft and the milk supply disappears. “Breast binding” is not recommended.

Baby Blues This is a very exciting time in your life. It is, also, one during which you may experience many conflicting emotions. Emotional mood swings are very common after giving birth, especially when you are tired. You may feel over-worked and sleep deprived with no end in sight. You may find yourself feeling irritable, cry easily, become discouraged and feel inadequate. The “baby blues” or “postpartum blues” often occur after delivery and are temporary feelings caused by hormone changes, fatigue, discomfort, and adjustments to your new baby and changes in the family structure. Whatever your feelings, allow yourself to experience them. Trying to deny your feelings or holding in your emotions can intensify the “baby blues”. Share your feelings with loved ones and try to get more rest. If you are unable to care for your baby or yourself, feel afraid or cry for long periods of time, call your doctor. If you are feeling alone – cut off from friends and loved ones, can’t sleep even when your baby does, or have thoughts of hurting yourself or your baby, call your doctor, a friend or go to the emergency room.

Contraception Pregnancy can occur at the first ovulation after delivery, even if your periods have not become normal and even if you are breastfeeding. Avoid sexual intercourse until you see your doctor for contraceptive advice. If you were using a diaphragm prior to pregnancy, you will need to be refitted. Foam and condoms are a good backup method. For specific information about birth control, talk to your doctor.

Taking Care of Your Baby and Yourself

Cesarean Birth

Pregnancy Leave

After giving birth to your baby by cesarean section, your incision site may hurt, especially at the corners. Sharp and/or burning sensations can occur for 1-6 weeks. You may remove your steristrips, if you have them, about 10 days after your surgery. You may bathe or shower and clean your incision gently with soap and water. Just pat the incision dry. If your incision is hot, hard, red, swollen, painful or drains, call your doctor.

Pregnancy-leave laws differ with each company. Employed women get 6-8 weeks of California disability after they give birth. Complications can extend disability, but this does NOT include fatigue, nursing, bonding, social problems or “not feeling well”.

You should NOT drive for at least 2 weeks after your surgery or while taking a narcotic pain medication. You may climb stairs, if you feel OK. Do try to limit your trips up and down to 2-3 times a day. Lift nothing heavier than your baby until your doctor says it’s OK to do so.

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If you have a temperature over 100.5˚F or severe chills

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Bleeding enough to soak a pad in 1-2 hours, large clots or foul-smelling vaginal discharge

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Fainting, persistent dizziness or trouble breathing

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Pain or a burning sensation when urinating or an increase in the frequency of urination

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Severe constipation or diarrhea

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Painful breastfeeding or a hot reddened area on your breast or bleeding from your nipples

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Unusual pain, redness or swelling in your legs

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Extreme discomfort or sudden swelling of your episiotomy or perineum

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Redness or drainage from your abdominal incision, if you had a cesarean delivery

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“Baby blues” lasting longer than 1-2 weeks, or if you have negative feelings toward yourself or your baby

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Headaches, seeing spots and/or feeling nauseous or throwing up

Postpartum Exam It is important that you visit your doctor for a postpartum exam – in 1-2 weeks after a cesarean section or in 4-6 weeks after a vaginal delivery. If needed, your MD may schedule your follow up appointment sooner. He or she will make sure that your body is returning to a normal state. After you see your doctor for your cesarean section exam, you may begin gradually increasing your activities. For a vaginal delivery, you may, also, begin gradually increasing your activities after 1-2 weeks. If you have any particular problems related to your health, including diet and exercise, discuss them with your doctor at this visit. Remember: • Don’t lift anything heavier than your baby until your doctor says it’s OK to do so. Get help with any housekeeping chores that need to be done and let slide anything that can wait. • Limit the number of times you climb stairs to 2-3 times a day. • Nothing goes in the vagina for 6 weeks – no tampons, no douching and no sexual intercourse.

When to Call Your Doctor

Taking Care of Your Baby and Yourself

Taking Care of Your Newborn at Home Getting to Know Your Baby Your baby is an individual from the day he or she is born. As your baby’s parents, you will come to know your baby best. All babies sneeze, yawn, have hiccups, pass gas, cough, cry and get fussy. These are normal human behaviors. Sneezing is the only way your baby can clear his or her nose. This does not mean that your baby has a cold. Hiccups are normal and do not need to be relieved. Sometimes, sneezes and hiccups mean that your baby is over-stimulated and needs some quiet time. Crying is your baby’s way of saying, “I’m wet; I’m hungry; I’m too hot; I’m too cold; I’m bored; I want to be held”. You will gradually learn what your baby means when he or she cries. Your baby needs and enjoys an abundance of loving and cuddling these first few months and you may give him or her lots of attention without fear of spoiling. Cuddling is one of the best ways to soothe a fussy baby, but even more important, your baby is reassured by such comforting. By meeting your baby’s needs for love and attention, you help him or her learn to trust this new world.

Your Newborn’s Appearance Your baby’s head shape usually is not perfectly round. This is called molding and will disappear in a few weeks. There may, also, be a fluid or blood collection under the skin on the head. Fluid (caput) will disappear in a few days, usually before you go home. The blood collection (cephalhematoma) will take longer to disappear. Neither will cause any damage to your baby. You may notice that your baby’s head appears large for his or her body. This is a perfectly normal finding. You may see and feel your baby’s pulse in the fontanel on your baby’s head, commonly referred to as your baby’s “soft spot”. This is normal. The “soft spot” closes slowly, usually between 9-18 months.

“Stork bites” are reddish areas, usually found at the base of the neck, between the eyes or on the eyelids, but can appear in other places on the head. They will most often disappear by the time your baby is 2 years old. Milia are small white spots found mostly on the face. They are plugged sweat glands that usually disappear in a few days. Do NOT squeeze or pick at them. A newborn’s peeling of the outer layers of skin is normal. Your baby may, also have a newborn rash that may come and go for a few days. If your baby has fuzzy hair on his or her body, this is called lanugo and gradually falls out. Newborn rash is a pink/red spotty rash that sometimes has white areas in the middle of the spots. It can appear anywhere on your baby’s body, usually 24-48 hours after birth and disappears in a few days. This rash can come and go and is nothing to worry about. Mongolian spots are usually found on babies of darker complexion and should not be confused with bruises. They usually appear on the buttocks, but can be found on the back, arms and legs. They may take up to 4-5 years to fade. Your baby may have swollen breasts. Your daughter may have swollen labia and a vaginal discharge that is white, mucous-like or it may be bloody. Your son may have swollen testicles. All these are normal results of maternal hormones and will gradually disappear. The umbilical cord will fall off in approximately 7-14 days. It can be cleaned with rubbing alcohol or left dry depending on your baby’s doctor’s preference. When it falls off, there may be a few drops of dark blood noted. If there is heavy or continuous bleeding, a foul smell, redness or discharge from the umbilical cord, call your baby’s doctor right away.

Taking Care of Your Baby and Yourself

Breastfeeding Your Baby Feeding Your Baby Feeding your baby is one of the most enjoyable ways of getting to know your baby and is one of the most important skills you will need to develop after giving birth. Nothing is quite as satisfying as cuddling, talking to and making eye-to-eye contact with your baby during feeding. At feeding time, besides receiving nourishment to grow healthy and strong, your baby develops a feeling of security from your loving care. Both you and your baby should be comfortable at feeding time. Choose a position that will help you relax as you feed your baby. For your baby’s comfort, make sure he or she is warm and dry. For your baby’s protection, always wash your hands before feeding your baby. Our nurses will assist you in learning to feed your new baby. We want to make the feeding experience pleasant and successful for you and your baby.

Burping Your Baby Burping your baby helps remove air he or she may have swallowed during feeding. Breast-fed babies may not swallow much air, but should be burped after each breast. Bottle-fed babies should be burped several times during, as well as after, each feeding. Sometimes your baby may not be able to burp. Do not try to force your baby to burp, if you’re unsuccessful the first few tries. And, don’t be alarmed if your baby spits up a little milk when being burped. To burp your baby, hold him or her upright over your shoulder and pat or rub the back. Being in an upright position helps any swallowed air to come to the top of the stomach for easier burping.

B Breastfeeding Be patient with yourself and your baby — learning to breastfeed takes practice! • It will take three to five days after birth for your breastmilk to come in. Until then, your baby gets a nutritious substance called colostrum. • Your baby needs to nurse every one to three hours, with at least 10 minutes of sucking and swallowing per feeding. • From the end of the first week through the first month, your baby should have at least six wet diapers and three or more stools every 24 hours.

An equally effective method is to support your baby in a sitting position on your lap, leaning slightly forward. One hand supports your baby’s head under the chin on the lower jawbone and the other hand pats or rubs his or her back.

Taking Care of Your Baby and Yourself

Breastfeeding Your Baby Breastfeeding is a natural, learned, experience, but it is not automatic. It takes time for you to learn and for you to teach your baby what to do. So, sit back, relax and be patient and willing to work through the first week of breastfeeding. For 1 or 2 days after birth, is perfectly normal for your baby to be sleepy. He or she may have a hard time staying awake for feeding, but you should try to allow your baby to feed on demand. Do not allow your baby sleep longer than 2.5 hours during the day time. Wake your baby for feedings. If your baby is sleepy, try unwrapping his or her blankets or removing some clothing. Try talking to your baby and rubbing or stroking him or her. You can, also, try changing the diaper. If your baby is still too sleepy to breastfeed, try again in 30 minutes.

whenever he or she is hungry to increase your milk supply. Do NOT supplement with formula or other liquids during this time without talking to your baby’s doctor. It may take 18-24 hours for your milk supply to increase to meet your baby’s demands.

Latch On Correct latch on is the key to a pleasant and rewarding breastfeeding experience. Using the C-hold, your 4 fingers under your breast and your thumb on top, and making sure your fingers are behind the areola, the dark brown area around your nipple, tickle your baby’s lower lip with your nipple. When your baby’s mouth opens wide, quickly bring your baby to your breast. Make sure that a large part of the areola is drawn in with the nipple. Be sure your breast does not block your baby’s nostrils. If breastfeeding is painful, break the suction and try to latch on again. You may have to do this several times until your baby is latched on properly.

Watch for signs of your baby being in a light sleep state, such as mouth or body movements. If you notice these signs, it might be a good time to try to wake your baby for feeding. Breast milk usually comes in 3-5 days after birth. Until then, your baby will be getting a yellowish fluid called colostrum. Colostrum is the perfect food for your baby’s first few days. Your colostrum is sweet and concentrated in small amounts to match your baby’s small stomach. Colostrum is easily digested and has a laxative effect that helps your baby pass meconium easily. Frequent feeding stimulates milk production. The more you nurse your baby, the more milk you will have. Your baby needs to nurse 10 to 14 times a day (every 1-3 hours). Frequent feedings allow your baby to get what he or she needs and will help maintain your baby’s weight. Do not allow your baby to sleep through the night or for long periods of time for the first few weeks.

It is important that you actually hear your baby swallowing milk. As the colostrum changes to mature milk, the fluid volume increases. At first, you should hear your baby swallow several times during a feeding. As your mature milk “comes in”, you should hear your baby swallow with every suck.

Skin-to-Skin = Protection We highly encourage skin-to-skin for all newborns. The benefits are: • • • •

It is normal for your baby to have several growth spurts during the first weeks and months after birth. Your baby will show signs of hunger more frequently during these times. Feed your baby

Increased bonfing with the infant Keeps your baby warm or cool depending on his or her need Reduces crying Increases quiet and alert state

Taking Care of Your Baby and Yourself

Positioning

Milk Ejection Reflex

It is important that you are comfortable and relaxed while breastfeeding your baby. There are different ways to hold or position your baby for feeding. The easiest position, if your stitches aren’t too sore, is sitting up with your back supported and straight, also known as the “cradle hold”. Hold your baby as close to you as possible at the level of your breast with his or her whole body turned towards yours – tummy to tummy. For support, you can use pillows on your lap and under your arm. If necessary, tuck your baby’s lower arm under your breast.

After your breast milk comes in, you may experience a tingling or “pins and needles” sensation in your breasts when feeding. This is called the milk ejection or “let down” reflex, Even when you’re not sure your milk has “let down”, you know your baby is getting milk when you can see and hear him or her swallowing.

Another position, the “football hold” is especially useful if you cannot get your baby close to your breast or if your abdomen is painful, such as after a cesarean section. You still need to be sitting up with your back supported with a few pillows at your side. Your baby’s head will face your breast with his or her body tucked under your arm. A third position is the “side-lying hold”. You lay on your side with pillow supporting your back. Your baby lies on his or her side facing you and as close as possible. If turning over is difficult, positioning a few pillows under your baby will help him or her to reach your top breast. If you are having problems with one position, try another until you are comfortable. Your nurse will help you to get your baby positioned and latched on properly.

Breaking Suction Before taking your baby off the breast, you must first break the suction from your baby’s mouth. You can press down on your breast near the baby’s mouth until the nipple is released. You can insert a clean finger into the corner of your baby’s mouth or gently pull down on your baby’s chin. By breaking the suction, you will prevent damage to your sensitive nipple tissue.

Engorgement When your milk comes in, it is common for your breasts to feel full and heavy. Sometimes, the breasts may become hard and uncomfortable. This is called engorgement. If your breasts become engorged, there are several things you can do to relieve the discomfort. Try breastfeeding your baby more frequently, at least every 1-3 hours. Hand express breast milk or use a breast pump just enough to relieve discomfort or to get your breasts soft enough for your baby to latch on for feeding. Engorgement is not usually a problem after the first week.

Sore Nipples The most common cause of sore nipples is incorrect latching on. Make sure your baby has enough of the areola in his or her mouth with each feeding. You are both still learning. You may have to break the suction and reposition several times to get the baby latched on correctly. You can begin your feeding session with the breast that is least sore, as your baby will be most vigorous with his or her sucking at the start of a feeding. Try varying your positions with each feeding. A different feeding position will have the baby sucking on a different part of your nipple.

Taking Care of Your Baby and Yourself

Things to Remember About Breastfeeding To be a successful breastfeeding mom, you must remember to take care of yourself. Get some rest between feedings. Drink lots of fluids, at least 64 ounces or 8 large glasses every day. Make a habit of drinking water, juice or milk while you are nursing. Caffeine passes through your breast milk; so limit how much caffeine you drink. You will probably want to limit it to the morning hours. Nutrition is important to keep you feeling well. Eat a variety of nutritious foods every day. Fruits, vegetables, milk, protein are all good choices for you. Some medications can affect your baby or milk supply. Some laxatives you take may cause your baby to have loose stools and a stomachache. Some antihistamines and birth control pills can decrease your milk supply. Please discuss medications with your doctor or your baby’s doctor before taking them.

Formula Feeding Your Baby

baby so that his or her head is slightly higher than the stomach. This will prevent formula from entering your baby’s inner ear, which can cause frequent ear infections. Tilt the bottle so the nipple is completely filled with formula. This helps your baby receive formula instead of air. Air in your baby’s stomach may give him or her a false sense of being full and may also cause discomfort. Place the nipple on your baby’s lower lip. When your baby’s mouth opens wide, place as much of the nipple as possible into his or her mouth. Make sure the nipple is placed over the tongue and pointed toward the roof of your baby’s mouth. This will stimulate your baby to suck. Sucking is part of your baby’s pleasure at feeding time. Your baby may continue to suck on a nipple even after it has collapsed. You should check occasionally during the feeding by removing the nipple to be sure that it hasn’t collapsed. Never prop a bottle or leave your baby alone to feed. The bottle may slip and your baby could choke. Remember that your baby needs the security and pleasure of being held at feeding time. During the first few days, your baby may take only ½ to 1 ounce of formula per feeding. Most babies will feed for 15-20 minutes per feeding. By the end of the first week, he or she may be taking as much as 4 ounces per feeding. Your baby may take less at some feedings and more at others. This is perfectly normal. You should never force your baby to finish every bottle. Overfed babies may become fussy or gassy and may spit up formula.

Formula Preparation

Bottle Feeding Your Baby Formula feeding, like any other skill, takes practice for you and your baby. Be sure to feed your baby every 3 to 4 hours throughout the day and evening. You do not need to wake your baby at night to eat, unless he or she has slept more than 5 hours. Always hold your baby when you feed him or her. This will help prevent choking accidents and actually helps your baby’s brain develop. Hold your

All items used in preparing your baby’s formula must be kept clean. Wash your hands before cleaning your baby’s bottles or preparing formula. Scrub the bottles, nipples and caps with hot water and detergent using a bottle brush. Remember to squeeze water through the nipple holes. Clean the measuring cup, can opener and any other equipment you use as well. If you have a dishwasher, you may wash these items on the top rack using hot water.

Taking Care of Your Baby and Yourself

Test nipples regularly to make sure the holes are the right size. If the nipple holes are too small, your baby may tire of sucking before getting all the formula he or she needs. If the holes are too large, your baby will get too much formula too fast. Your baby may also get so much air that he or she spits up part or all of the feeding. When nipple holes are the right size, warm infant formula should drip smoothly without forming a stream. When nipples become sticky or cracked, throw them away.

temperature by sprinkling a few drops on the inside of your wrist. The formula should feel warm, not hot. Any formula at room temperature should be fed to your baby within 1 hour. After that, it should be thrown away.

If you use well water or if you’re not sure where your water comes from, boil it for at least 5 minutes before mixing. Allow it to cool before feeding your baby. Prepared formula must be stored in the refrigerator and used within 48 hours. Any prepared formula or opened cans of liquid formula should be thrown out after 48 hours. Opened cans of powdered formula may be stored for one month. Feed the formula to your baby at room temperature. No warming is necessary unless you’ve prepared several bottles and have refrigerated them. NEVER MICROWAVE FORMULA. Microwaving destroys the proteins in the formula. It can also cause severe burns in your baby’s mouth, even if you shake the bottle. Warm the bottle by placing it in a container of hot water. Before feeding your baby, check the

There are several kinds of nipples available in just about any store that sells baby supplies. You may have to try different types of nipples until you find what works best for your baby. Always check the labels and the expiration or “use before” date on the bottom of the can when purchasing and preparing formula. It is your personal choice whether to buy ready-to-feed formula, concentrated liquid formula or powdered formula. There are no significant differences in the nutritional value or how babies tolerate these various types of formula. Powdered and concentrated liquid formulas need to be mixed with water. Ready-tofeed formulas do not need to be mixed with water. Read and follow the directions on the can.

Formula Feeding Learning to formula feed takes practice! • Feed your baby every two to four hours throughout the day and evening. • Wash your hands before preparing formula, feeding your baby, or cleaning feeding supplies. • Read and follow directions on formula packages carefully to avoid harming your baby. • Never heat formula in a microwave oven. • Always hold your baby while feeding. • If your baby vomits large amounts of formula after most or all feedings, call your baby’s doctor. • New and used feeding supplies should be cleaned with a bottle brush in hot soapy water and rinsed in hot water.

Taking Care of Your Baby and Yourself

Signs That You May Need to Change Formulas

Is Your Baby Getting Too Much Formula?

Don’t change your baby’s formula without talking to your baby’s doctor first. It is something to consider if your baby refuses to eat, cries a lot, acts like his or her stomach is hurting, or develops diarrhea or constipation.

If your baby tends to gulp down the formula, choke or vomit, check to see if the nipple holes are too large. When you hold the bottle upside down, the formula should come out in drops, not in a stream. If it is a stream, you may need to replace the nipple. If the holes are the proper size, you can help your baby learn to slow down by stopping after each ½-1 ounce to burp and cuddle him or her before resuming the feeding.

Is Your Baby Getting Enough to Eat? When your baby is content after most feedings and eating 10-14 times in 24 hours for breastfed babies and 6-12 times in 24 hours for bottle-fed babies, you can be confident your baby is getting enough to eat. Another way to be certain is to count the number of wet diapers and bowel movements (stools). For the first few days of life, your baby should have at least: • • •

•

Day 1 – 1 wet diaper and/or 1 dark green stool called meconium Day 2 – 2 wet diapers and/or meconium stools Day 3 – 3 wet diapers and/or brownish green stools. Stools are now more frequent, looser and in smaller amounts. Day 4 – 4 wet diapers and/or mustard yellow, loose stools with small curds for breastfed babies and yellowish green pasty stools for bottle-fed babies.

By the end of the first week through the first month of life, you should be seeing at least 6-8 wet diapers with 3 or more stools every 24 hours. Your baby should be content after most feedings and show a steady weight gain.

Signs That Your Baby Is Not Getting Enough Formula Watch for these signs to tell if your baby is not getting enough formula: • Your baby is NOT content after most feedings • Your baby sucks his or her hands or needs a pacifier to stay quiet • Your baby is eating less than 6 times in a 24 hour period You may need to increase the amount of formula at each feeding or feed your baby more frequently.

If your baby seems to have trouble finishing all of the formula you have prepared, he or she is probably getting too much. It is normal for your baby to spit up a small amount of formula, particularly when you burp him or her. However, if your baby vomits large amounts of formula after most or all of his or her feedings, call your baby’s doctor.

Other Feedings Your baby should drink only breast milk or formula for the first 6 months. Do not give your baby under one year of age tap water or sugary liquids (soft drinks or juices) to drink, particularly from a bottle. The sugar can harm your baby’s teeth and cause diarrhea. Regular milk, even if boiled, is also, not recommended for the first year of life. Do NOT add honey to your baby’s water, formula or food during the first year of life. Do NOT dip your baby’s pacifier in honey or use honey as a medicine. Honey can cause infant botulism. Infant botulism is bacteria that can grow in your baby’s intestines and makes a strong poison that affects your baby’s nerves and muscles. Talk to your baby’s doctor about using honey for your baby. It is generally recommended that babies not get solid foods until 6 months of age. Talk to your baby’s doctor about the best time to introduce your baby to solid foods.

Taking Care of Your Baby and Yourself

General Infant Care Room Temperature Try to keep an even, comfortable temperature in your baby’s room, just as you would for yourself. Do not allow your baby to be in a draft, such as from an air vent or window.

Clothing Dress your baby according to the temperature. When it is warm, your baby does not require any more clothing than you would wear. In cold weather, dress your baby in only one more layer than you would wear. A hat or covering over your baby’s head is recommended as your baby can lose as much as 25% of his or her body heat from the head. Protect your baby’s tender skin from the sun while outside by providing loose cotton clothing and a sun hat and sunshade for the stroller and car seat.

Bulb Syringe Use a bulb syringe like the one you received in the hospital to remove extra mucus from your baby’s nose or mouth. Squeeze the bulb completely before placing the tip into one of your baby’s nostrils or into the corner of his or her mouth. Release the pressure on the bulb while holding it in place. Remove the syringe from your baby’s nose or mouth, and then empty the mucus by squeezing the bulb and releasing. Clean your bulb syringe with warm soapy water.

C Safety at Home Infants weighing less than 20 pounds must be secured in a federally approved, rear-facing safety seat for all car rides. • Babies weighing more than 20 pounds may be secured in a forward-facing seat until they are 6 years old or weigh 60 pounds. • To avoid injury, children should never ride in a passenger seat with an airbag. • A baby should never be left alone in a bathtub — even with only a few inches of water.

Taking Care of Your Baby and Yourself

Bath Time There is no “best” time of day to bathe your baby. It might be good to plan your baby’s bath for before a feeding. Your baby might become irritated when being handled in the bath and a full stomach can lead to spitting up. The room you use should be warm and free of drafts. Keeping bath supplies together will save time and steps. During the first few weeks before the cord has fallen off and the belly button has healed, give your baby a sponge bath. His or her face and diaper area will require frequent washing because food, urine and stools can irritate your baby’s skin. The rest of the body may only need washing a few times a week. When you give your baby his or her sponge bath, be sure to pull down the skin around the cord and dry it well. There are no nerve endings in the umbilical cord, so it is not painful to your baby. Depending on your baby’s doctor, you may clean the skin around the cord with alcohol or just leave it dry. After the cord has fallen off and the belly button has healed, you may find it more convenient to give your baby a bath in a small tub. Make sure the bath water is not too hot. We recommend that the temperature of your baby’s bath water be 100.4° F, which is just warm when checked with your elbow. 3-5” of water, enough to allow your baby to settle into the water with his or her shoulders covered, is enough. Don’t make bath time too long as the bath water will cool rapidly and your baby may get chilled. While supporting your baby’s head, wash his or her face with plain warm water and a soft cloth. Do not use soap. To clean the eyes, using a soft cloth or cotton ball, start from the bridge of the nose and wipe toward the ear. If there is continuous eye drainage, notify your baby’s doctor. Use a different cotton ball or a different part of the cloth for each eye. Clean only the outer portion and behind your baby’s ears. Your baby’s doctor will clean the inner portion of your baby’s ears, if necessary.

Wash your baby’s head with a mild shampoo, working from the front to the back to keep suds out of your baby’s eyes. Use a small comb or brush to stimulate the scalp while shampooing to prevent cradle cap from forming. If your baby has cradle cap, you can remove it by applying baby lotion to the affected areas, waiting 30 minutes, loosening the scales with a soft bristled hairbrush and then shampooing out the scales. Use a mild soap and warm water to wash your baby’s body. Be sure to wash in the folds of the skin such as the neck, arms and legs. Also, check between the toes and fingers, since these are areas where your baby can collect lint and milk. Wash your daughter’s genitals by separating the labia and wiping from the front to the back, being careful not to wipe stool or other material into the vagina. You might notice a white, creamy substance in the folds of the labia. This is normal vaginal discharge and you do not need to scrub or pick it out. Also, remember that it is not uncommon for her to have a bloody or mucous discharge. Any prolonged bleeding should be reported to your baby’s doctor. When washing your son’s genitals, be sure to lift the penis and scrotum and gently clean around and under them. It is not necessary to pull back the foreskin on your uncircumcised son. You might notice a white, creamy substance from the penis. This is a normal discharge that can be gently wiped away. Wash your son’s circumcised penis by rinsing it with water until it heals. Rinse your baby well and gently pat him or her dry with a towel. Lotions, oils and powders are not recommended for your baby. Your baby does not need to be bathed every day. Never leave your baby alone in the bathtub.

Taking Care of Your Baby and Yourself

Taking Your Baby’s Temperature While you’re in the hospital, we take your baby’s temperature every 4 hours. This is to make sure that your baby can control his or her own body temperature. By the time you go home, you will not need to check your baby’s temperature unless you think he or she is ill. Under the armpit is the recommended method of taking a baby’s temperature. Make sure to use a clean thermometer that does NOT contain mercury. Lifting up your baby’s arm, place the bulb of the thermometer in the middle of your baby’s armpit. Hold that arm and the thermometer against his or her side for 3-5 minutes. Take out the thermometer and read it. If your baby’s temperature is 100° F (37.8° C) or higher, take some clothes off your baby and recheck it in 30 minutes. If it remains above 100° F, call your baby’s doctor. If your baby’s temperature is less than 97.6° F (37.6° C), put some more clothes on your baby and take his or her temperature again in 30 minutes. If it remains less than 97.6° F, call your doctor. Axillary (underarm) normal range is 97.6° F (36.4° C) to 99.6° F (37.6° C)

A Your Baby’s Health

Please read this section carefully and don’t hesitate to call your doctor if your baby has any of the symptoms described. • Watch for signs of sickness and trust your maternal instincts. If you are worried about your baby or feel something is “not right,” call your doctor. • We encourage you to take a class in infant safety and CPR like the one offered through the Mercy Health Education Center . Call 209.564.4300 for more information.

Taking Care of Your Baby and Yourself

When to Call Your Baby’s Doctor

your baby. What is appropriate for an older child may not be appropriate for your new baby.

If your son or daughter: • •

• • •

• •

• • • • •

Has a temperature above 100.4° F or below 97.4 ° F axillary Is not urinating by the 3Rd day at least 3-4 times in a 24 hr period or if his or her urine has a strong smell and is dark in color Has not had a bowel movement in 24 hours and your baby’s abdomen is swollen and feels tight Has diarrhea – watery, mucousy, bloody or foulsmelling stools or more than 6 in 24 hours Appears jaundiced (the skin is yellow), especially the whites of the eyes and is not eating well Has any unusual rash Is continually fussy, has a high-pitched scream and cannot be soothed or calmed down without obvious cause Is listless, never cries, won’t wake up for feedings or refuses to eat Vomits all of a feeding or has any forceful, “projectile” vomiting (small “spit-ups” are common after feeding), if his or her vomit is green in color Has consistent, rapid breathing – more than 60 breaths per minute Has a runny nose, cough or difficulty breathing Has blue or mottled skin Has dry skin and a lack of tears with crying The “soft spot” on his or her head is sunken

As your baby becomes mobile, lock all cabinets and drawers with childproof cabinet locks and safety latches, if you don’t want your baby in them. Move all cleaning supplies out of reach to top shelves of cabinets that can’t be locked. Use outlet covers to prevent wet fingers from being stuck in them and shocking your son or daughter. Be careful of electrical appliances, including irons, hair blowers and curling irons that your baby can pull down to the floor. Keep your baby’s toys away from unsafe areas. Never leave your baby alone in the bathroom or tub. Your baby, at a young age, is unstable sitting up and could fall over reaching for a toy. It only takes a little water to cause damage to your son or daughter, including accidental drowning. As he or she grows, objects dropped into the toilet need to be retrieved and he or she could fall in trying to get the object out. Outdoors, buckets of water, wading pools and regular pools are very inviting as things to play in. Be extra vigilant when your baby is outdoors to keep him or her away from them.

Keeping Your Baby Healthy

Also, call your baby’s doctor if you have and special concerns or uneasy feelings about your baby.

To make sure your baby stays healthy, he or she should have regular medical examinations. Your baby’s first checkup is usually 1-5 days after your take your baby home from the hospital and will be written on your discharge instructions.

Home Safety

If your baby becomes sick, you need to call to get your baby seen sooner.

Babies are naturally curious and reach for everything in sight. They are unable to judge distances. To prevent falls and injuries, always remember to use the safety straps on changing tables and high chairs and keep your baby within your reach.

Your baby’s doctor will check on his or her growth and development and immunize him or her against childhood diseases. Immunizations start at an early age. Your baby’s doctor will let you know when his or her immunizations should start.

Remember that everything will end up in your baby’s mouth. Consider each toy you will leave with

Taking Care of Your Baby and Yourself

Reduce the Risk of Sudden Infant Death Syndrome (SIDS) SIDS is the sudden and unexplained death of an infant under one year of age. It remains the leading cause of infant death past the first 30 days of life. One of the most important things you can do to reduce the risk of SIDS is to put your healthy baby on his or her back to sleep. Do this whenever you put your son or daughter down for a nap or for the night. Never put your baby on his or her stomach to sleep. Use a firm surface for sleep with no soft objects under your baby. Avoid overheating your baby by putting lots of blankets on top of him or her. Your baby should be in his or her own crib or bassinet for sleeping, not in your bed. You may keep the crib or bassinet near you at night. Smoking has been identified as a risk factor for SIDS. Donâ&#x20AC;&#x2122;t let anyone smoke around your baby.

Never Shake Your Baby Shaken Baby Syndrome describes the serious brain injuries that can occur when an infant or young child is severely shaken. Young children, especially babies, have very weak neck muscles and do not yet have full support of their heavy heads. When they are shaken, their fragile brains move back and forth within their skulls. This can cause serious injuries including: blindness, seizures, paralysis, delays in normal development, brain damage and death.

Thank You We hope that you enjoyed your stay with us and that we were able to help you in becoming comfortable in your role as new parents. We would like to leave you with some phone numbers should you have any questions regarding yourself or your baby. Family Birth Center Mother/Baby Emergency Room

564-5200 564-5200 564-5130

Taking Care of Your Baby and Yourself