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Skin to Skin: Comforting Your Baby
Holding your baby on your chest is the best place for your baby to
adjust to the outside world. Babies held skin to skin cry less, are
calmer, and stay warmer. Holding your baby near you this way also
stimulates your breast milk production. This position is good for both
breastfed and bottle-fed babies. Start doing this as soon as possible
after your baby is born.
To cuddle your baby skin to skin, dress her only in a diaper and lay her
belly-down directly on your chest with her face turned to either side.
Place a blanket over both of you, making sure it does not cover your
baby's face.
Babies can also cuddle skin to skin with mom in a side lying position.
Lay with your lower arm extended forward, creating a protected space for
your baby below your arm and near your breast for easy breastfeeding.
Snuggle your baby this way as often as possible, especially during the
first weeks home from the hospital. Partners can also hold the baby skin
to skin.
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Jaundice
What it is
All babies are born with extra red blood cells. After birth, the extra
red blood cells break down and release a substance called bilirubin in
the baby's blood. When there is too much bilirubin in the blood, the
baby becomes jaundiced and her skin looks yellow. Jaundice also causes
your baby to be sleepy and she may not feed well. Your baby gets rid of
bilirubin in her stools. When your baby is feeding well, she will have
frequent stools that will remove bilirubin from her system.
Why it is important
It's very important to watch your baby for jaundice during the first
week home. Most newborns become a little jaundiced — this is normal.
However, some babies will have a higher level of jaundice that is more
serious and requires monitoring or phototherapy treatment. Untreated
jaundice that becomes too high may cause brain damage.
When a baby has jaundice, you will see it (yellowish color) first in the
face and as it increases, you will see it on the baby's chest, tummy,
and legs. You may also notice that the white area of your baby's eyes
look yellow. Your nurse will do a skin test with a bilimeter to check
your baby for jaundice before you go home after delivery. If it is
elevated, the doctor will order a blood test. Once you go home, continue
to watch your baby for jaundice. Pay attention to skin color changes,
alertness, feeding, and stooling.
What to do
Hold your baby in natural light in front of a window and notice the
color of her skin as you press down on her nose, chest, and thighs. If
your baby is of light complexion, notice whether the skin looks yellow
instead of creamy-white under where you pressed. If your baby has a
naturally darker complexion, color changes may be more subtle. Look at
your baby's eyes and check to see if the white area looks yellow.
Encourage your baby to eat often. Breast milk contains colostrum, which
has a laxative effect. Frequent breastfeedings starting at birth will
help your baby get rid of bilirubin in her stools. When your baby does
not pass her meconium stools, the bilirubin can build up in her system
causing the jaundice to increase.
Most jaundice typically goes away in one to two weeks; however, some
babies will need phototherapy to treat the jaundice. If your baby's skin
looks yellow, if she is sleepy and/or not feeding well (8 to 12 feedings
per day) or stooling well (at least 2 to 4 stools per day by day 4),
call your baby's doctor. He or she will do a blood test to measure the
bilirubin level and decide if your baby needs phototherapy.
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Sleep Positions
When you put your baby down to sleep, the safest position is on her
back. Sudden infant death syndrome (SIDS) has declined more than 50
percent since babies started sleeping on their backs instead of their
tummies.
Place your baby on her back on a firm, flat mattress in the crib. Dress
your baby in an extra nighttime sleeper for warmth rather than covering
her with loose blankets. Using a single swaddling blanket is OK.
Do not put pillows or toys in the baby's bed that could cover her face.
Having a fan turned on in your baby's room may also be helpful in
lowering the risk of SIDS for your baby.
The American Academy of Pediatrics recommends babies sleep in their own
bed or a co-sleeper bed near you. If your baby does sleep with you, lay
down in a side-lying position with your lower arm extended forward
creating a protected area for your baby below your arm. Your arm will
prevent you or your partner from rolling over onto your baby. Turn your
baby onto her back and make sure no blankets cover the baby.
There shouldn't be any space between the bed and the wall or headboard
that your baby could slip through.
It is important that you do not smoke, drink alcohol, or take other
drugs because these activities are associated with a higher risk of
injury for your baby while sleeping with you.
Tummy Time
Your baby should have "tummy time" every day. Place your baby on her
tummy when she is awake and someone is watching her. Tummy time gives
your baby the chance to lift and turn her head. This strengthens her
neck and shoulder muscles so she can learn to hold her head and roll
over. It also helps to prevent flat spots on the back of the baby's
head.
Umbilical Cord Care
Your baby's umbilical cord will dry up and fall off within 1 to 3 weeks.
During this time, keep the area around the cord clean and dry. It is
fine to bathe your baby during this time. Simply dry the area around the
cord after bathing. Your baby's belly button will be drawn deep into the
abdomen by the cord drying. Don't worry if it doesn't look like a normal
belly button during the healing period. You can only tell what it is
going to look like after the cord falls off.
As the cord dries, you may notice an odor. This is normal and not a
problem. Also, as the cord is coming off, there may be dried blood at
the site, or oozing, the same as when a scab comes off. This is also
normal and may last 3 to 4 days. After the cord falls off, you may see
dried blood left inside the belly button, which you can wash off gently
with warm water.
Infection in the cord area is very rare. If the cord is infected, it
will be tender when you touch it, be swollen or have a large area of
redness around it, or there will be pus coming out of the site. If you
think the cord is infected, call your doctor’s office.
Temperature
Your baby wants to be at a comfortable temperature, just as you do. It
is possible for a baby to be too hot or too cold. If your baby is held
up against your body, he will absorb warmth, just as you would, so he or
she probably won’t need any extra layers of clothing or blankets. If
your baby is lying on a bed, she will need more layers of clothing to
stay warm. Newborns have very small bodies, and don’t produce much heat
themselves, but they readily absorb heat when they are held.
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If your baby is too hot, he or she may perspire. Check your baby's
hairline or the back of his neck to make sure he is not sweating. If
your baby is too cold, his skin may feel cool. Babies who are dressed
and swaddled, or who have hats on and mittens covering their hands, can
be too hot.
Check your baby's temperature if you have any questions. It's best to
take an infant's temperature under his arm (axillary). Hold the arm
firmly down over the thermometer until it beeps. If the result doesn't
seem correct, take it under the other arm.
Taking the temperature in the baby's ear (tympanic) isn't recommended
because it is hard to get good readings using this method. In addition,
taking the temperature by feeling across the baby's forehead or using a
temporal artery thermometer isn't recommended because this requires
using another method to confirm baby's temperature is higher than
normal.
Normal newborn temperature is around 97.8 to 98.8 F (axillary). If your
baby is warmer than this, think about whether or not he is overdressed,
adjust the clothing, and recheck the temperature within 30-45 minutes.
If your baby continues to have a temperature of 100.0 F or higher on two
separate readings, he has a fever and you need to call the Consulting
Nurse Service.
Warning Signs During the First Two Weeks
Call your health care provider if you have any concerns about your baby
or if your baby has any of these signs:
Baby is feeding less than eight times per day.
Baby does not have enough wet or dirty diapers according to the number
of days old. (See the diaper chart in Feeding Your Baby.)
Baby seems to struggle to breathe, makes grunting noises or flares her
nostrils when breathing, or takes more than 60 breaths per minute.
Baby's sleeping periods last more than 5 hours after the first day of
life.
Baby's skin color is bluish around the mouth, or skin color turns
yellow.
Baby is shaking or irritable and cannot be comforted, or is sleepy and
difficult to wake.
Baby's temperature is below 97.5° F or above 100.0° F in two separate
readings taken 30 minutes apart after adjusting clothing and room
temperature.
Baby is vomiting forcefully and it projects several inches away from the
baby. Don't confuse this with normal spitting up that happens when some
milk dribbles out with burping.
Umbilical cord has foul smelling drainage or pus around it.
You may notice a pinkish or rust colored stain in your baby's diaper.
This is normal for the first 3 to 4 days. It is caused by uric acid
crystals that occur when the baby's urine is concentrated and indicates
that it is important to feed your baby as often as possible. You do not
need to call your provider for this. |