Just the
two of you
How to care for
your new baby
Congratulations!
You and your baby are beginning a journey of love and discovery.
You’ll learn each other’s ways and discover all the special joys of the
unique bond between a mother and her child. This booklet will make
these first days easier by helping you recognize your baby’s needs
and respond with confidence.
A BRAND-NEW PERSON
Your baby is her own person from the very start, growing and
developing at her own pace, in her own way. There’s no need to
compare her with other babies. Your doctor will make sure she’s
growing normally. Just enjoy her and give her the love and care she
needs to develop physically and learn about her new world.
A WORD ABOUT WEIGHT
Many mothers feel concern when their babies lose weight shortly after
birth. This is normal. Babies are born with some extra fluid that they
lose in the first days after birth. It takes them a little while to catch up.
Your baby may take as long as two weeks to regain her birth weight,
but this is nothing to worry about. Your baby’s regular checkups will
make sure she’s on track. All you have to do is give her normal feeding
and care.
2
Contents
4Common infant behaviors and conditions
5Feeding
5
Breastfeeding
6 Bottle feeding
7 How to prepare bottles of formula
10Bowel habits and diapering
11Baths
12Umbilical cord care
12Marks on the skin
13Crying
14Fevers
15Car safety and air travel
16Vaccines and screenings
18Calling the doctor
3
Common infant
behaviors and conditions
Babies have all kinds of behaviors that you may find unfamiliar or be
uncertain about. With your instincts and a little information, you’ll do
just fine. The behaviors below are all normal for newborns. Follow
these tips as you get in the swing of caring for your new baby.
Crossed eyes: Nothing to worry about. Babies don’t track movement
with their eyes until three to six months.
Blood from the navel: A spot of blood from the navel is common for
up to three weeks. (See page 12 for cord care.)
Breast swelling: This is normal in newborns. The cause is hormones
remaining from her time in your womb.
Gas: It’s not unusual for a baby to have gas. Rumbling in the
abdomen is a common symptom. You may also see her belly
distended or feel it a little firmer than usual. Often she will pass this
gas, or you can try burping her.
Hiccups: Hiccupping often happens and many times doesn’t bother
babies. If your baby seems annoyed by hiccups, a teaspoon of Karo
syrup or sugar in 2 ounces of water should relieve her.
Loose stools: For the first two to three weeks, babies pass loose or
watery stools. These are called transitional stools. They may look
seedy and have mucus or a spot of blood.
Mucus or blood from vagina: This is common and can last up to
three weeks. The cause is hormones remaining from her time in
your womb.
Sneezing and coughing: Babies can get a buildup of mucus or
curds of milk. Sneezing and coughing help a baby clear her nose
and throat.
Straining: Babies strain to pass stools and gas. Sometimes they
strain for no apparent reason. This is normal behavior.
4
Feeding
For the first few weeks, feed your baby any time she wants to be fed.
Over time, she’ll develop her own feeding schedule. Some babies
want to be fed every couple hours. Others will wait as long as four
hours between feedings. By 6–8 weeks, your baby will be on a fourhour schedule and probably not wake up for a 2 a.m. feeding.
BURPING
Every baby swallows air while feeding. To get rid of this air, hold your
baby upright over your shoulder and pat her back. You may also hold
her sitting and leaning slightly forward on your lap. Pat her back until
she burps. Newborns should be burped after each 2 ounces of bottle
feeding or five minutes of nursing. Older babies can wait until they’re
through feeding. Sometimes your baby may not burp. This is normal.
There’s no need to force a burp.
SPITTING UP
Most babies spit up now and then after feeding. This may continue
until your baby is as old as 10 months. Avoid problems related to
spitting up after feeding by holding your baby sitting upright or on
your shoulder. You may also lay her on her side.
Forceful vomiting is different from spitting up. Report vomiting to
your baby’s doctor.
BREASTFEEDING
Your milk is the best food for your baby. We recommend you
breastfeed your baby or at least give breastfeeding a good try.
Mercy hospitals have breastfeeding experts (lactation consultants)
to help you and your baby get started and establish good
breastfeeding habits.
New breastfeeding mothers are sometimes concerned their babies
aren’t getting enough food. Newborns often don’t nurse strongly in
the first few days. This is normal and doesn’t mean you don’t have
enough milk.
5
These breastfeeding basics can supplement what you learn from
your lactation consultant:
• Clean your nipples with water before feeding.
• Use both breasts at each feeding in the first weeks to encourage milk
production. Later you may alternate breasts from one feeding to
the next.
• Let your baby nurse as long as she wants. This encourages
milk production.
• Feed your baby as often as she wants in the first weeks. This also
encourages milk production.
• If your nipples are sore or cracked, rub them with breast milk and let
them air dry. Alternately, you can use a cream or ointment such as
lanolin or coconut oil. If it persists, have your lactation consultant check
your baby’s latch.
• Avoid drugs, including caffeine, laxatives and pain medications, while
you’re nursing. You may pass these to your baby through your milk.
Check with your doctor before taking any medication.
• Some foods you eat may cause your baby discomforts such as upset
stomach or loose stools. Berries, cabbage, chocolate, garlic, greens,
onions, peppers, spices and tomatoes are common problem foods.
Stop eating any foods you suspect are bothering your baby.
• Breastfed babies have stools that resemble mustard. This is normal.
BOTTLE FEEDING
Infant formula is designed to provide complete nutrition. Your baby
can digest it easily and will grow normally if fed formula. Bottle-fed
babies get all the vitamins and minerals they need from formula.
When mixing formula, you may want to use bottled water that has no
or low fluoride.
Formula comes in three forms: ready to use, concentrate and powder.
Whichever form you use, follow all instructions on the label.
6
Ready to use: Cans and
bottles need no
refrigeration and are
sterile until you open
them. You don’t need to
measure or to warm the
bottle: simply pour into a
sterilized bottle. You can
refrigerate any leftovers.
Concentrate:
Concentrate makes it
easy to prepare formula
by measuring and mixing with water. Once you open a bottle of
concentrate, you need to refrigerate it. You’ll need to warm bottles
made with refrigerated concentrate.
Powder: Powdered formula is less expensive and the powder can be
stored at room temperature. It’s important to mix the powder fully
with water so the formula has no lumps.
Soy-based formulas: Most formulas are based on cow’s milk and can
irritate some babies. Soy-based formulas may help. If your baby often
has an upset stomach or loose stools, talk with your doctor about
changing the formula you feed her.
HOW TO PREPARE BOTTLES OF FORMULA
When using concentrate or powdered formula, it’s most convenient to
prepare a day’s worth of bottles in advance, refrigerate them and
warm them as needed. It’s easiest to use 8-ounce bottles because
these allow you fill them with as much or as little formula as your
baby needs.
Bottles, nipples and formula should be sterile until your baby is
12 months old. Follow instructions on the next page to prepare and
sterilize bottles of formula. We recommend having eight bottles in
case one or two break.
7
Utensils needed
• Bottles (eight)
• Nipples and caps (six sets)
• Bottle brush
• Bottle sterilizer or a lidded pot deep enough that the lid doesn’t touch
the bottles
• Can opener
• Quart measuring pitcher
• Long-handled spoon
• Funnel
• Jars for nipples and caps
Cleaning utensils
Clean bottles, nipples and caps with hot water and dish soap. Use the
bottle brush to scrub out all formula residue. Squeeze soapy water
through the nipples. Set bottles upside down to dry. Put nipples and
caps in a clean, covered jar. Clean the can opener, pitcher, spoon and
funnel the same way. Wash the tops of formula cans before opening
them. Sterilize bottles, nipples and caps by boiling for 15–20 minutes in
the sterilizer.
Mixing and portioning formula
Follow package instructions for the proportion of water to formula
concentrate or powder. Prepared bottles may be stored up to 48 hours
in a refrigerator at 35 degrees.
• Sterilize water for making formula by boiling it for 15–20 minutes.
• Measure sterile water into the pitcher.
• Measure formula into the pitcher.
• Stir until all formula is dissolved.
• Pour formula into sterilized bottles.
• Attach the sterilized nipples and caps.
• Put the bottles in the refrigerator.
8
Warming bottles for feeding
Put a bottle in hot (not boiling) water for a few minutes. Don’t
microwave bottles of formula. Test the temperature by sprinkling a
few drops of formula on the inside of your wrist. It should feel
slightly warm.
Care of nipples
Nipples with too small a hole force your baby to suck too hard. She
may not get all the formula she needs. If the hole is too large, she may
not get the sucking satisfaction she wants before she’s full. Test nipples
for the right flow. Hold a bottle full of warm milk upside down. Milk
should drip constantly but not stream from the nipple.
To enlarge a nipple hole, heat a small needle with flame until it glows
red. Slide the needle through the nipple hole. Test again. If necessary,
repeat the enlarging process.
If a nipple hole is too large, the nipple is worn out. Discard it.
Nipples may get gummy. Correct this by boiling the nipples for a
few minutes with a pinch of salt. If the nipples remain gummy,
discard them.
SOLID FOODS
Breastfed babies don’t need solid food until 6–8 months of age.
Bottle-fed babies will also be fine for months without solid food.
Solid food doesn’t help a small infant sleep and can be harmful to your
baby. Feeding a baby solids too early can damage her kidneys and
digestive system. Damage to blood vessels is also possible.
Introducing solids too early also encourages your baby’s body to
produce more fat cells than it needs. These fat cells can stay with your
baby for life and lead to overweight or obesity.
Your doctor will give you a diet for your baby. Follow it to ensure your
baby gets the nutrition she needs without any risk to her health.
9
Bowel habits and diapering
Babies are all different, and their bowel movements vary in size, color
and consistency. Breastfed babies usually have loose, yellow bowel
movements. Many newborns sometimes have loose stools, but a
watery bowel movement after 3 weeks of age may indicate diarrhea.
On the other hand, small, pellet-like stools may indicate constipation.
Babies also vary widely in how often they have bowel movements.
Some may move their bowels with each feeding. Others may have a
bowel movement just once a day or even once every two or three days.
DIAPERING
• Clean your baby with a moistened soft cloth or baby wipe.
• When cleaning a girl, wipe carefully front to back to avoid getting stool
into the vagina.
• Change soiled diapers as soon as possible, especially if your baby’s
diaper area is irritated.
• Always check for irritation or rash, especially in hot weather.
• Treat rashes in the diaper area with a mild cream, such as A&D
or Desitin.
10
Baths
Give your baby only sponge baths until the cord falls off her navel. This
usually takes three to 10 days. (See page 12 for cord care.)
When it’s time to give your baby a tub bath, follow these instructions:
Water: Your baby’s bath water should be a little over 100 degrees. Dip
your elbow in to test. If it feels warm but not hot, the temperature is
right. Use sterilized water to clean your baby’s eyes. To sterilize water,
boil it and let it cool to room temperature.
Soap and shampoo: A mild soap like Ivory Moisture Care, Neutrogena
or Dove is best. Use a “no tears” shampoo.
Face: Wash with soap and a soft cloth.
Eyes: Dip a cotton ball in cool, sterilized water and wipe the eyelids
gently. Look for redness or puffiness. If you see these consult your
baby’s doctor.
Nose and ears: Use a moist (not soaked) cotton swab to clean the
outer areas of the nose and ears. Don’t put the swab into your baby’s
nostrils or ear canal. Her skin is delicate and the swab can damage it
and cause infection.
Mouth: Don’t clean the inside of your baby’s mouth. If you see an
excessive coating or milk curds that persist, call your doctor. These are
symptoms of thrush, which can be treated.
Head: Lather your baby’s head gently with shampoo. Work from front
to back to keep soap out of her eyes.
Body: Wash your baby gently all over, then rinse well to get all the
soap off her skin. Be sure to wash and rinse the creases.
Circumcision: Wash this area very gently with soap. Rinse and dry,
then apply Vaseline to prevent any blood from sticking to the diaper.
Dry your baby thoroughly after her bath. No need to put on lotions or
oil. One bath a day is usually all that’s needed.
11
Umbilical cord care
Keep the stump of the cord dry, and apply alcohol twice a day. A spot
of blood now and then is normal. Give your baby only sponge baths
until the cord dries up and falls off. This usually happens in three to 10
days. It’s not necessary to use a belly band or binder.
Marks on the skin
Newborns often have marks of various kinds. Most cause no harm and
disappear without treatment as the child grows. Compare the marks
you see on your baby’s skin with those listed here:
Flat, red spots: These appear on the forehead, eyelids or on the back
of the neck or head. They become more noticeable with crying or
straining. The spots usually fade with time, and hair will cover those on
the head. No treatment is needed.
Reddish, raised areas: Infants with no marks at birth may develop
these two to three weeks later. The marks are harmless and almost
invariably disappear by age 5. Treatments are available but
usually unnecessary.
Dark, purplish discolorations: At birth, some infants have these marks,
usually on the lower back. They fade over time, sometimes as late as
puberty, and they are harmless and need no treatment.
Brown or black birthmarks: Many adults have these small marks, which
often appear at birth. They cause no harm and need no treatment.
Moles: Like birthmarks, moles are harmless.
“Flea bites”: Two or three days after birth, your baby may appear to
be covered with flea bites. This rash is neither bites nor a disease. The
harmless condition will disappear in a few days without treatment.
White spots: These can appear on the tip of the nose. These need no
treatment and will disappear.
White bumps: Your baby may develop small white bumps all over her
face. These will fall off and leave no trace.
12
Prickly heat: This red rash may appear if your baby is dressed too
warmly or the room is too warm. It’s usually on the face, neck and
shoulders and may come and go.
If marks on your baby’s skin don’t look like any of those described
here, or if you’re concerned about marks or a rash, call your
baby’s doctor.
Crying
Babies cry for many reasons. When your baby cries, she’ll stimulate
your instinct to hold and comfort her, and this is a healthy, normal
response. Give your baby plenty of attention all the time and pick her
up if she’s crying quietly. She wants to be held and your presence gives
her a feeling of security.
Many times however, your baby will cry because of a basic need: she
may be wet, hungry, cold or feeling cramped. Check your baby’s
diaper and change it if necessary. Offer your breast or a bottle. If her
hands and feet are cold, she may need another blanket or other
warming. Sometimes clothing or blankets may be too tight: try
loosening these.
WHEN TO LET YOUR BABY FUSS OR CRY
Your baby can develop the habit of crying too often if you pick her up
and hold her every time she cries. If you’ve checked for basic needs,
try letting her fuss or cry a bit. It won’t hurt her and she’ll learn to
comfort herself.
WHEN TO CHECK WITH THE DOCTOR
If your baby isn’t comforted with attention to basic needs or keeps
crying even when you hold her, she may need medical attention.
Consult your doctor if her crying persists longer than two hours.
13
Fevers
Fevers are common in infants. Usually these are nothing to worry
about. Babies can have a surprisingly high fever without any danger to
their health. Only when a baby’s temperature reaches 106 degrees is
there risk of harm.
TREATING A FEVER
If your baby’s temperature (taken rectally) is below 101 degrees, you
don’t need to do anything about it. If you like and your baby isn’t
vomiting, you may offer her cool liquids.
For a newborn (to 3 months) with a fever above 101 degrees, give
0.4 ml of acetaminophen (Tylenol) and call your doctor immediately.
To cool a feverish baby, bathe her in a slightly cool tub for five to
20 minutes. DO NOT use alcohol or ice or wrap a baby in wet cloths.
CONVULSIONS
Some babies can have fever convulsions (febrile seizures) when their
temperature rises, usually over 101 degrees. Febrile seizures can cause
unconsciousness and/or uncontrollable shaking of arms and legs. Rare
symptoms include eye rolling and stiffness. Febrile seizures usually last
less than 15 minutes.
Febrile seizures are almost always harmless. All you need to do is
protect your baby from falling, choking or otherwise hurting herself,
but don’t restrain her. These seizures don’t indicate or cause epilepsy.
When the seizure has ended, take your baby to the doctor. They’ll
check to see that your baby is healthy.
If the seizure lasts longer than five minutes, call for an ambulance or
take your child immediately to your doctor or an emergency medical
facility, such as urgent care or the emergency room. They’ll determine
the type of seizure and decide whether anything needs to be done.
Usually there’s no problem.
14
Car safety and air travel
The law requires all children riding in a car, including newborns, to be
securely buckled into an approved car seat. Buying and installing a car
seat can be complicated, and you may want a little help. A staff
member at the hospital will help you with your car seat. They’ll make
sure you know how to buckle your baby in securely and how to buckle
the seat correctly into your car’s backseat.
These tips can help you get started looking for a car seat:
• The seat should be new or in good repair.
• Choose a car seat that’s sized for infants or has padding to hold an
infant upright.
• A car seat that’s been in a crash more severe than a fender bender
should be discarded.
• Use caution when accepting or buying a used car seat.
For more information about car seat safety, look on
safecar.gov/parents.
15
TIPS FOR AIR TRAVEL
Free flight for babies: Airlines often allow an infant traveling with
an adult to fly free. Your baby will have to sit on your lap, however,
unless you secure an airline bassinet.
Airline bassinets: Some airlines will supply a special bassinet that
attaches to the wall in front of the front row of seats. It’s not always
easy to get those front seats or to be sure of getting a bassinet.
Book flights as early as possible and make sure the airline commits
to providing the bassinet. Some sources advise calling more than
once to confirm the bassinet and avoid mix ups.
Early boarding: Ask for early boarding so you can get situated with
your baby before other passengers arrive.
Vaccinations and
screenings
NEWBORN SCREENINGS
We screen your baby shortly after birth for a variety of conditions.
In the rare case when a baby tests positive for a condition, early
screenings enable us to respond appropriately. These screenings
are required by law.
VACCINES
Vaccines (immunizations) protect your baby from many disabling
and fatal diseases, including:
• Diphtheria
• Tetanus (lockjaw)
16
• Pertussis (whooping cough)
• Polio
• Measles
• Mumps
• German measles (rubella)
• Hepatitis B
• Chicken pox
Vaccines are very safe. The tiny risk associated with them is far
smaller than the risk of your child being harmed by the diseases they
protect against. Mercy Health strongly recommends following your
doctor’s recommendations for all vaccinations.
VACCINES AND AUTISM
Some sources claim that vaccines can cause autism. This is false.
The United States Centers for Disease Control (CDC) issued a
definitive statement in 2011 that the supposed link between
vaccines and autism has been disproven. It was claimed that a
particular ingredient in vaccines, thimerosal, caused autism. In
addition to this claim being proven false, thimerosal was remove
from vaccines or reduced to trace amounts (except in some flu
vaccines) by 2001. Vaccines will not cause your baby to
develop autism.
17
Calling the doctor
If you believe your baby is in danger, call 911.
18
NON-EMERGENCIES
Throughout this booklet, there are directions to call your baby’s
doctor in certain situations. Look for the section that relates to
your current situation. You may find an instruction to call the
doctor or be assured there’s nothing to worry about.
You should also call if your baby’s behavior indicates something is
wrong, but she has no specific symptoms. If you’re unsure of a
situation, a call to the doctor can clarify and determine whether
your baby needs medical attention.
Feel free to call with general questions about caring for your baby.
Office staff are very knowledgeable and, if necessary, will give your
question to the doctor.
Call your baby’s doctor at the number on the back of this booklet.
AFTER HOURS
Babies get sick at all times of the day and night. Feel free to call
your doctor’s office at any time. Someone will answer, take your
phone number and basic information about your situation, and the
doctor on call will call you back.
INFORMATION TO HAVE READY
When you call a doctor’s office, they will want information to help
the doctor understand the situation quickly. The list below includes
common facts the assistant or nurse may ask for:
• Particular signs or symptoms you’re calling about
• The time when you first noticed these symptoms
• Your baby’s general appearance and anything unusual
• Your baby’s temperature
• Frequency of vomiting or diarrhea
• The time when your baby last urinated
• Any treatments and medications you’ve given, including times
and doses
• Your pharmacy’s phone number
19
Your baby’s doctor
Name
Phone
BIRTH DATA
Name
Birth date
Birth weight
Length
Discharge weight
A Catholic healthcare ministry
serving Ohio and Kentucky
mercy.com
4
8545TOLWEB (12-16)