What to do once, your baby is home?

Most first-time parents are anxious and concerned right after they take the baby home. It takes about six weeks for most couples to feel better about having a baby. Here’s a short-list of things you can do to make things a little easier:

• Be patient with the baby and with your husband, and forgive easily. This is new for all of you and takes some getting used to. Respond with affection and learn baby’s cues. 
• Ask friends and family for help with cleaning, shopping, meals and caring for other children. Everyone needs help with a new baby!
• Try to rest whenever you can; sleep (or at least lie down) when the baby sleeps.
• Ask your husband to help out; we show you ways he can here.
• Browse our website and watch our How To videos on holding and carrying baby, changing diapers, swaddling, giving baths, baby massage, holding baby skin-to-skin and soothing your crying baby.

Learning baby’s cues

Learn to speak your baby’s language so you can respond to her needs and she won’t have to escalate to crying.

• Hungry: rooting (turning her head toward your hand when you stroke her cheek). Tongue thrusts. Sucking. Hands in mouth.
• Tired: stare off and yawn. Rub at ears or eyes. May turn her head from side to side as though fighting sleep. Eyes may roll back under eyelids. Shaking arms or hands.
• Too hot: breathes rapidly and may have a clammy neck.
• Too cold: shaking and skin may be marbled looking.
• Bored or over-stimulated: turns away from something. Looks away.
• Calming themselves: may do a repetitive, moaning cry.
• Pain: sudden, louder than normal cry that might be high-pitched. May hold his breath for longer.

Holding baby skin-to-skin

Holding your baby skin-to-skin is a very powerful way of bonding with baby and is the best thing for his physical, mental and emotional health. It will reduce baby’s stress, which means much less crying and better physical and emotional development. This is because the baby feels SAFE on his mother, hearing the familiar heartbeat, voice and smell; this all stabilizes baby’s heart rate, breathing and temperature. If your baby was born prematurely, it is even more important to practice skin-to-skin.

It will help with breastfeeding, triggering the right hormones which makes the milk flow, and will also help fight those “Baby Blues” and postpartum depression. Fathers especially can benefit from practicing skin-to-skin as it is an excellent way to help bond with his new baby, and give you a break.

Here’s how to do it:

1. Place baby naked, wearing only a diaper and hat, on your bare chest so that you are nestled chest to chest.
2. Turn baby’s face to the side in a position that opens baby’s airway.
3. Place blanket over the baby.
4. Make sure you are comfortable as well; ask for pillows or adjust the bed so you are at a gentle recline (not lying flat or sitting up straight).
5. Allow baby to stay snuggled for at least one hour.
6. Continue to practice skin-to-skin for at least three months.

Remember, you can’t spoil your baby with too many cuddles or attention.

Diaper change        

Make sure you place baby on a firm flat surface and if the surface is raised (like a change table), keep one hand on baby at all times. For your newborn, make sure you use wipes that are alcohol and perfume free, or just plain water and a clean cloth, to avoid irritation. When changing a boy’s diaper, cover up his genitals to avoid being sprayed. When changing a girl’s, wipe front to back to avoid infections. For boys and girls, fold down the upper edge to avoid the umbilical area.                              

Here are some important facts to remember about your baby’s toileting:

• Baby should have 3-5 wet diapers and 3-4 soiled diapers by 3-5 days of age. Baby should have 4-6 wet diapers and 3-6 soiled diapers per day by 5-7 days of
age.
• Stools in the first few days are meconium; greenish black, tarry poop. After Day 3 or so: Breastfed baby poop is a yellowy mustard color with a consistency like peanut butter or cottage cheese, and very mild smell. Formula-fed baby poop is more putty-like with a stronger smell, and constipation more common.
• Don’t be surprised that if in the first few months you experience ‘diaper blowout’, where poop shoots out and up baby’s back or down her leg. Don’t worry this is normal. But if you notice any blood, talk to your baby’s doctor.
• For breastfed babies, at about 6 weeks it is normal for baby’s stool output to drop to around 1 per day, however babies can often go several days or even a week without a bowl movement. This happens because breastmilk leaves very little solid waste to be eliminated from baby’s digestive system. It is not a reason to add formula, teas, prune juice or other foods to the baby’s diet. Try extra nursings, and also massaging his belly gently and bicycling his legs.
• When baby starts solids after six months of age, they can often become constipated. If breastfeeding, simply offer more nursings. You can also try offering baby water, pear or prune juice (no sugar added) and avoid constipating foods like cereals or banana.

Diaper Rash

Your baby might get diaper rash. This appears as a patchwork of bright red skin on baby's bottom. It might make your baby fussy and especially upset during a diaper change. It is often due to wet or infrequently changed diapers, skin sensitivity, chafing/rubbing from tightfitting diapers or clothing, or irritation from a new product like wipes, diapers, creams or laundry detergent. Also when babies start solids they can get diaper rashes. Generally, a diaper rash can be easily treated at home by:

• Changing diapers more frequently.
• Giving baby more diaper-free time; even a few minutes of extra airing time during each change.
• Using diaper ointment.
• Changing products e.g. getting larger diaper, using alcohol/fragrance-free wipes, etc.

 If baby's skin doesn't improve after a few days of home treatment, talk with your doctor. See your doctor if the rash is severe, gets worse despite home treatment, bleeds or oozes, causes pain when baby is peeing or pooing, or if baby also has a fever.

Bathing your baby

Until the umbilical stump falls off, only sponge bath baby using a warm, damp washcloth every few days. Thoroughly clean the genital area after each diaper change.

Caring for the Umbilical Stump

Your baby's umbilical cord stump will drop off in about 10 days. Until then, here's what to do:

• Keep the stump clean and dry. Tuck your baby's diaper below the cord so that the cord is exposed to the air. Dress baby in loose clothing or if it’s warm just use a diaper and t-shirt.
• To clean the umbilical stump, use a clean cloth dipped in plain lukewarm water, then let it air dry (research has proven it is best not to use alcohol). Do this during bath time and in-between if the stump area becomes dirty or sticky. Other than that, leave it alone and let it fall off on its own.
• Don’t try and pull the stump off, even if it looks like it hanging by a thread. Keep the diaper from touching the stump by folding down the upper edge.
• Give the stump as much air as possible by
• Call the doctor if the skin around the stump is red, if the stump is leaking yellowish fluid, if it smells bad, if baby cries when you touch it, or if it hasn’t fallen off within four weeks.

Bathing Baby

After the umbilical stump has fallen off and the area has healed, baby can start having baths. It is only necessary every few days or so as baths can dry out baby’s skin. If your baby likes baths, you can do them more regularly (just use cream afterwards), but if they don’t (some cry the entire time), do them quickly and less frequently.

Bathing your newborn will probably be scary at first, as they are very floppy, wriggly and slippery, especially when you add a little soap! Remain calm and maintain a firm grip. You might want to have someone help you the first few times. Remember, never leave the baby alone in the bath, or turn your back, even for a few seconds. Watch our video for how to give baby a bath and the things you will need.

Baths are a really nice way to calm some fussy babies, although generally it is recommended to do it when baby is awake and contented. Often mothers use it as part of the bedtime routine once baby is a few months old as the warm water can make babies sleepy.

Baby’s Nails

Trim baby’s nails a few times each week as they grow fast and can easily scratch her face, and yours! In the early weeks, you can usually peel them off with your fingers as they are very soft. You can also carefully clip with baby nail scissors or clippers, or a nail file.

Dressing your baby

Dressing a newborn can be tricky since they are so floppy. Make sure you support baby’s back and head well, either in your lap or lying on a flat firm surface. To dress her, stretch the clothing neckline and pull it over baby’s head, then put your hand into the armhole from the outside and grasp your baby’s hand to pull it through. To undress her, first take off the sleeves one at a time and then stretch the neckline, lifting it free of her chin and face as you gently slip it off. Here are some other things to keep in mind:

• Do use layers when dressing baby so you can add and subtract as needed. Dress baby in one more layer than you are wearing.
• Don’t overdress/over-bundle baby as they can overheat easily. Remove layers once indoors.
• Do use a hat when outside, but also make sure baby gets some sunshine to absorb Vitamin D.
• Don’t use hands or feet to gauge baby’s temperature as they are always cooler. Use the back of the neck, chest or arms. 

Swaddling Baby

Swaddling is when you snuggly wrap a thin blanket around your baby so that it covers most of her body below the neck. Swaddling can help keep your baby calm, soothe her when she cries or is fussy, and help her sleep better during naps and at bedtime. This is because babies are born with the Moro, or startle, reflex. When your baby is startled or feels a loss in support, he will suddenly throw out her arms and quickly bring them back in. This reflex disappears by 3 months. Babies will have this during sleep and it will often wake them, which is why swaddling for sleep is helpful since it keeps the arms down and helps baby feel secure. Watch our video to learn a few different swaddling methods. 

Keep your swaddled baby safe when sleeping by checking that:

• The blanket is snug around your baby, but not too tight. Your baby should breathe easily. His head and neck shouldn't be covered by the blanket. Slide two or three of your fingers between his chest and the blanket to make sure he has room to breathe.
• Your baby can move his hips and feet. Tightly wrapping a baby’s legs while they’re straight may make him more likely to have hip dysplasia. This condition happens when a baby has an abnormal hip joint where the top of a hip bone doesn't stay firmly in the hip socket.
• The blanket doesn't have any loose ends. If the blanket unwraps, it could cover your baby’s face and put him in danger of suffocation or being strangled.
• Your baby isn't overheated. Being wrapped in a blanket can make your baby too hot, especially if he’s wearing thick, heavy clothes. He may be overheated if he’s breathing fast, sweating or his skin appears red.
• You put your baby to sleep on his back on a flat, firm surface, like a crib mattress. Check him while he sleeps to make sure he doesn't roll over on his tummy. Once baby starts rolling onto his tummy, stop swaddling for sleep.

Courtesy of March of Dimes

Sleeping patterns and safety

Sleeping Patterns

Newborns sleep an average of 16+ hours per day, which sounds like a lot, but they wake frequently and rarely sleep more than 3 hours in a continuous period. This is because they spend more time in light sleep for their brain development. They also need to feed often; for breastfed newborns every 1-5-3 hours, for formula babies every 3 hours. By about two months age they will be sleeping longer during the night.

The following is a guideline of the typical sleeping patterns during baby’s first year. But all babies are different and some need more sleep than others. Patterns might also change based on milestones in cognitive and motor development, such as crawling, teething, and with separation anxiety. Let your baby tell you what she needs and look for signs of tiredness e.g. rubbing eyes, pulling ears/hair, yawning, or extra fussiness.

How to Establish Good Sleeping Patterns

• Give your baby a chance to nap frequently and don’t wait until he is over-tired as this will make it harder for him to sleep. You can typically tell if a baby is overtired as they are difficult to put down and/or they wake up soon after you put them to sleep.
• Teach your baby the difference between day and night, which you can start doing as early as two weeks of age.
• Look for signs that your baby is tired, such as rubbing eyes, pulling ears, yawning, or increased fussiness.
• Start a bedtime routine for your baby, as by doing things consistently baby will start to understand cues to go to sleep.
• There is a huge difference of opinion about nursing or rocking baby to sleep versus letting him fall asleep on his own. There is no right or wrong way. Only you and your baby together can decide what is best for you.

What are those Weird Noises?

Babies often moan, groan, whimper, snort and kick in their sleep. This can be worrying, but is often normal. Babies under six months will often change their breathing rhythm during sleep; for example, breathing fast, then slow, then pausing for up to 15 seconds before resuming a normal breathing pattern. If you're worried baby has stopped breathing, simply touch or nudge her gently to see whether she responds. If she doesn't respond, she needs your help immediately. Babies can jerk awake (the moro reflex), grind their teeth, rock back and forth and bang his head against the crib, all of which is normal and not harmful. Babies can also snore and snort, and while this is common especially if baby has a stuffy nose, if snoring is persistent talk to your baby’s doctor.

Sleeping Safety

It is very important to always put baby to sleep on her back. This greatly reduces the risk of Sudden Infant Death Syndrome (SIDS). The peak age of SIDS is between 2-4 months. Most SIDS deaths are associated with sleep, and one of the largest risk factors is stomach sleeping. Since babies have been put to sleep on their back in the U.S., deaths from SIDS has fallen by over 50%. Once babies can roll over and back on their own, at around 4-7 months, it is OK to let them sleep on their stomach if they roll onto it after you put them to sleep on their back. Other ways to reduce SIDS includes:

• Put baby to sleep in a crib or bassinet in your room. This also makes breastfeeding much easier during the night. While baby will likely wake more frequently to feed, studies have shown that mothers get at least as much sleep as when babies sleep in their own room. Plus babies who share a room with their parents sleep for a longer total time than solitary sleepers.
• Ensure baby’s crib/bassinet has a firm flat surface and has no blankets, pillows, toys, stuffed animals or bumper pads. There should be no more than 6cm between slats of crib, and no more than one adult finger between mattress and slats.
• Don’t overheat baby. Baby should be dressed in pajamas, wrapped in a swaddle or in a sleep sack (wearable blanket). Keep room temperature between 16-20C.
• Breastfeed if possible as this has been proven to reduce the risk of SIDS.
• If you don’t breastfeed baby to sleep, try putting baby to sleep using a pacifier during the first year of life.
• Ensure baby is fully immunized and has regular check-ups as this will lower the SIDS risk by 50%.
• Keep baby away from smoking as exposure to secondhand smoke doubles a baby's risk of SIDS. Also, don’t smoke while pregnant as this triples the SIDS risk.

If you plan on having baby sleep in your bed, it is very important to follow these guidelines to keep baby safe and prevent suffocation. About half of all SIDS deaths happen when a baby shares a bed, sofa or sofa chair with another person.

• Don’t let anyone under the influence of alcohol or drugs sleep in the bed.
• Don’t let anyone who smokes sleep in the bed, even if they don’t smoke in bed.
• Don’t let anyone who is too sick or tired to be awakened easily sleep in the bed.
• Don’t let other children sleep next to the baby in the bed.
• Put baby to sleep only on a flat and firm mattress. Do not let baby sleep (with or without you) on a waterbed, an egg-crate mattress, a couch, an armchair, or any other surface that's not firm and could interfere with your baby's breathing.
• Do not leave baby to sleep alone in an adult bed.
• Ensure sheets are firmly tucked in, don’t use heavy duvets/blankets and keep pillows away from baby’s face.
• Don’t swaddle baby, instead use a sleep sack and/or footed pajamas. To avoid overheating, dress baby more lightly than you would if he were sleeping alone.
• Ideally, place your mattress on the floor so if baby rolls off he won’t fall far. If not then place bed against a wall, but check daily to make sure there are no gaps that your baby could slip into and fill any gaps with tightly rolled towels. Don't use a headboard or footboard with slats more than 6cm apart or cutouts as these can entrap a baby's head. Position the bed away from room features that might be a hazard for a baby, such as cords for window blinds, lamps, etc.

Tummy Time

Tummy time is essential from day one to help baby grow strong and develop well. It helps babies learn to push up, roll over, sit up, crawl, and pull to a stand. It also helps prevent ‘flat head’ since babies are put to sleep on their back. Some babies don’t like tummy time as it can be unfamiliar and uncomfortable. If baby cries during tummy time, try to coax him a bit longer by talking or playing with her. A good time to practice tummy time is when baby isn't hungry or tired (wait about an hour after feeding to avoid spit-ups or infant acid reflux). Some parents find it helpful to practice it during each diaper change. 

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Category: Baby Basics