HOW TO TAKE CARE OF NEW BORN BABY AT HOME

How To Take Care of Newborn At home After Discharge From Hospital ?

Most of the parents after discharge from hospital will have lot of quires and doubts regarding the things they do for baby at home. To make things easy and help the mother or care taker to do right things for the wellbeing of baby here i compiled few things after a wide research of many years adding my experience .

The skin of a newborn or an infant is different from the adult skin. Skin of the term newborn is 40-60 times thinner, less hydrated and has reduced natural moisturizing factor (NMF) compared to the adult skin .

Routine care of skin in term baby:

Ideal care of skin of newborn comprises of gentle cleansing, protection of barrier function, prevention of dryness of skin, avoidance of maceration in the body folds and exposure to toxins, prevention of trauma and promotion of normal development of skin .

When to give First Bath for a Newborn ?

WHO recommends that the first bath should be given after 24 hours of birth..

Early bathing before 24 hours in newborn can lead to hypothermia, increased demand of oxygen, unstable vital signs and disruption of behavior.

• Following the first bath either baby can be given daily bath but make sure umbilical stump is dried well after bath  or till the umbilicus stump falls off ,sponge bath with soap solution and hot water can be done.

• After Umbilical stump falls off after 5-7 days , regular bath can be done including head.

• Before giving bath gentle massage with baby oil and few excercises for 10-15 mins to be done .

Baby Body Massage:

• Do 30 mins prior to the bath. 

• Be gentle .

• For 10-15 mins .

How To do Massage?

• Can be done  by mother, father, grandparents, caregiver or nurse.

• Full body massage to be given when the baby is quiet, alert and active, preferably one  hour after feed.

• To be given in a warm room.

• Massage provider should avoid having long nails or wearing any jewelry in the hands.

• Should be slow and gentle but firm enough for the baby to feel secure.

Which oil to Use for Oil Massage ?

• Coconut oil, sunflower oil, synthetic oil , any baby oil and mineral can be used  .

• Olive oil and musturd oil cant be used.

• Warm the oil little before giving massage .

         [Why Oil Massage :Massage promotes circulation and relaxation of the different areas of the body and tones the muscles. It relieves the physical and emotional stress in the baby and supports the baby’s ability to fulfill the individual developmental potential .Increased levels of gastrin, insulin and insulin like growth factor 1 that enhances the food absorption, weight gain contributing to increase growth.]

When and how long to bath ?

• After Oil massage leave the baby for 30 mins and give bath.

• Bath needs to be done morning and evening (massage once a day is enough).

• Bathing time should  not exceed 15 minutes.(Prolonged bath can lead to decreased temperature of baby  (hypothermia ),hydrated skin is fragile with increased threshold for injury .)

• Use low PH 5.5  soap solutions  or syndet soaps for bath .

• Use hot water to give bath .

• Water should be hot enough where you can place ur hand.

• Don't use fuming /very hot water as it can damage the superficial skin layers and make the baby skin to become dry.

(Myth: Very hot water bath makes the baby to grow faster and make active and sleep well.

Fact: it causes dry skin and damages layers of skin)

• If choosing to give a tub bath, depth of the water should be 5 cm, up to the hip of the baby. As bath tub and bath toys are potential sources of infection, they must always be disinfected .

• Use of bubble baths and bath additives should be avoided as these may increase the skin pH and cause irritation.

• Don't blow the ears , nose or put the finger inside the mouth to clean the tongue and throat( it can cause injuries inside mouth and make baby to vomit).

Head bath for Baby :

• Can be done 2-3 times per week.

• Use baby shampoos which are free from fragrance and tear free.

• Dry hair with soft cloth, Don't use dryer for drying hair .

Care After  Bath:

• Wipe the baby skin with soft cotton cloth.

• Clean the ears , nose and skin folds  under neck and near groin with soft cotton cloth .

• Don't sprinkle powder on body and face or Put sambrani  for hair ( it causes respiratory allergies).

• Apply thin layer of moisturizer lotion after 10 mins of bath .

• Don't apply Kajal to eyes even it is home made one ( as it causes conjunctivitis ).

Care of the Diaper Area : 

Major problem seen in babies is diaper rashes 

• Maximum try to avoid diapers.

• Cloth napkins are preferable.

• Diapers should be changed frequently in order to prevent diaper dermatitis .

• Duration could vary from every 2 hours in neonates to every 3-4 hours in infants.

• If frequent change of napkins is not possible, application of mineral oil to the skin over the diaper area will act as a barrier.

• Baby wipes that are mild on the infant skin may be used .

• Every time putting a diper apply thin layer of mineral oil or diaper cream.

• Wipes should be free of fragrance and alcohol.

Care of the Umbilical Cord :

• Keep the stump outside the diaper.

• Cord stump falls on 5-7 days, there can be little bleeding.

• If any pus or blood from stump , clean with alcohol swab and keep it dry/

• Umbilical cord should be cleaned with lukewarm water and kept dry and clean.

• Care taker’s hands should be washed before and after cord care.

• If the stump is soiled, it should be washed with water and syndet /mild soap and dried thoroughly with soft, clean cloth.

• No need to applyanything  on the cord stump.

• Diaper should be cladded below the stump.

• No bandage should be applied on the stump .

Care of the Scalp :

• Baby shampoos which are free from fragrance and tear free can be used.

• Hair wash can be given once or twice a week or as and when required in case of soiling .

Care of Nails 

• Nails should be cut and kept short .

• Nails should be cut after 5 days using baby nail cutter ( but one with lens) .

Use of Baby Talcum Powders :

• Routine use of powders is not advocated in neonates and young infants

• Puffs should not be used as it may result in accidental inhalation of powder .

• Powder should not be applied in the groins, neck, arm and leg folds. ( As it forms plaques ).

Normal Things in Babies :Things not to get panic about.

• Sneezing – Just put Nasoclear or saline nasal drops 2 drops per nostril

• Blocked nose and noisy breathing- as nostrils are small.

• Watery discharge from eye – if persists beyond 1 week discuss with doctor .

• Small erythematous rashes on skin of  face , back and buttocks.

• Hiccups before and after feed- remedy Just keep the baby upright for 10-15 mins .

• Crying while passing urine and motions and while passing gas.

• Passing stools after every feeds.

• Daily 10 times stools or passing once in 3-4 days motion.

• White discharge from vagina – because of maternal hormones .

• Bleeding from vagina – Because of maternal hormones .

• Greenish patches on butts and back- Called as Mongolian patches- taken 1-2 years to go off.

• Small white dots on the nose and cheeks – Called as Milia – Takes 1-2 weeks to go.

• Pus and bleeding from umbilicus site once stump falls off- Clean with spirit cotton or alcohol swab and keep dry . 

Danger Signs :When to contact doctor:

• Fever (Axillary temperature) over 100.4’F (38’C) or less than 97.5’ F (36.5’C)

• Rapid breathing rate over 60 per min

• Retractions or pulling in of the ribs with respiration.

• Blue coloring on the lips and oral cavity and hands and feet.

• Foul smell, redness/purulent discharge, or bleeding from the umbilical cord.

• Yellow coloring of the body up to palms and soles or when yellowish ness is seen beyond 2 weeks of life.

• Crying, irritability or twitching movements which do not improve with cuddling and comfort.

• A sleepy baby who cannot be awakened enough to feed.

• Any signs of sickness (i.e., cough, diarrhea more than 15 times , pale color stools )

• The baby’s appetite or suck becomes poor or weak.Recurrent vomiting, blood or bile in the vomit

• Excessive loss of weight (More than 10% of birth weight)

• If your baby has one of the above signs, please take to pediatric causality or child health OPD immediately.

Things Not to be done :

• Avoid doing hard massages.

• Don't give very hot water bath- will cause dry skin

• Avoid blowing nose and ears after bath, don't use fingers to take out phlegm

• Don't sprinkle powder , put sambrani ,put Kajal to eyes- causes allergy and conjunctivitis.

• Don't give honey or cows milk , coconut water or donkey milk.

• Avoid diapers , use cloth nappies.

• Don't give gripe water , Bonnison for digestion- can cause gastritis.

• Avoid Bottle feeding