Baby Care Basics
Reproduced with permission from Babycare: Back to Basics™ leaflet by Sharon Trotter, Midwife.
Recent research suggests that it is safer to bath your baby in plain water for at least the first month of life. At birth, the top layer of your baby's skin is very thin and absorbent. This means it is more sensitive to damage from germs, chemicals and water loss. Over the first month (longer in premature infants) your baby's skin matures and develops its own natural protective barrier. The maintenance of this barrier is vital and damage can lead to the development of skin conditions. It is important to remember that anything placed on, in or around your baby has the potential to harm. With this in mind, the following guidelines will help to give your baby the best possible start in life.
Cord care for the healthy term baby: Keep this area clean and dry. The best way to achieve this is to leave the area alone. After the first bath in plain water, pat dry with a clean towel. Fold the nappy back, at each change, until the cord falls off. In the first few days, it is advisable to only top'n'tail your baby to allow the cord to separate naturally. Wet cotton wool can be used if the area becomes soiled, otherwise leave it alone. There is no need to use antiseptic wipes or powders. The cord clamp may or may not be removed, depending on hospital policy. If the cord or surrounding area becomes red or smelly, notify a member of staff. This advice is based on the World Health Organization (WHO) recommendations published in 1999. Cord care for the sick or premature baby: This may differ slightly, due to the increased risk of infection. Antiseptic solutions and/or powders may be used for the first few days. Otherwise cord care should be the same as for any other baby. Be guided by staff in the neonatal unit and they will advise you on the best possible care for your baby.
It is very important to wash your hands thoroughly before and after carrying out any baby care.
Your baby's first bath will be in plain water. This will help to protect the delicate skin while it is vulnerable to germs, chemicals and water loss. Wash cloths should be avoided as they can be harsh. Hand washing your baby, cotton wool (organic is better) or a natural sponge are gentler. A baby comb can be used to gently remove any debris from thick hair after delivery. Please bring a baby brush and comb set into hospital with you.
It is best to leave the delicate area around the eyes untouched. If it does become sticky, please notify a member of staff and they will advise you. The ears and nose should also be left alone and cotton buds should be avoided.
Vernix (the white sticky substance that covers your baby's skin in the womb) should always be left to absorb naturally. This is nature's own moisturiser and gives added protection against infection in the first few days.
Premature babies' skin is even more delicate, so it is important to take extra care. Research has shown that massaging premature infants, using pure vegetable oils, can give some protection against skin infections. Be guided by staff in the neonatal unit. They will be happy to advise you.
If your baby is overdue, his / her skin may well be dry and cracked. This is to be expected, as the protective vernix has all been absorbed. Don't be tempted to use any creams or lotions as this may do more harm than good. The top layer of your baby's skin will peel off over the next few days, leaving perfect skin underneath. Continue with plain water only for at least the first month.
Skin-to-skin contact and baby massage
The benefits of skin-to-skin contact cannot be overstated. It should be positively encouraged from birth. As well as promoting successful breastfeeding, skin-to-skin contact stabilises your baby's heart rate and temperature. Baby massage follows on naturally from this and is now widely practised. It is advisable to avoid nut oils, petroleum based oils, or oils with perfumes, if there is any history of allergies in your family. Choose a properly qualified massage therapist for your baby and ask for their advice on suitable oils.
Remember not to use any products on broken skin.
Continue bathing your baby with plain water for at least the first month before gradually introducing baby products. By this time the skin's natural barrier will have developed. These products should be free from sulphates (SLS and SLES), colours and strong perfumes.
Baby wipes should also be avoided for the first month. Once introduced, try to use ones which are mild and free from alcohol and strong perfumes.
It is safer to file nails with a soft nail file rather than use scissors, which can leave sharp edges. Baby nails that have started to come away, can be peeled off gently.
Shampoo is not necessary when your baby is under a year old. Once you have introduced baby bath products, simply rinse your baby's hair in the bath water solution. If you use shampoo, this should be sulphate free (SLS and SLES).
It is advisable to use a thin layer of barrier cream on the nappy area. The ideal preparation should be free from preservatives, colours, perfumes, antiseptics, as well as clinically proven to be effective in the treatment of nappy rash. If after a few weeks you wish to use a moisturiser, choose products that are emollient based. These will not dry out the skin, but they will give it some protection.
When washing your baby's clothes and bedding, remember not to overload your washing machine to ensure thorough rinsing. Fabric conditioners, if used, should be mild and free from colours and strong perfumes.
Cloth nappies are as efficient as disposable ones and do not present a higher risk of nappy rash.
Breastfeeding is obviously the best choice for your baby as it gives some protection against allergies developing.
Skin-to-skin contact in the period immediately after birth, as well as during breastfeeding, is an excellent way of helping to colonise your baby's skin with friendly and protective bacteria. This in turn will reduce the risk of skin infections developing.
Whether you breastfeed or bottle-feed, remember to introduce weaning carefully. The World Health Organisation advises that weaning should not start before your baby is six months old. Your health visitor or dietician will be happy to advise you on what foods to introduce and when. This is especially important if there is a history of allergies in your family. Like breastfeeding, weaning should always be 'baby-led'.
From the age of six months babies should be encouraged to drink from cups without teats or spouts, these are often called 'open top cups'. The Department of Health advises that babies over one year old should not drink from bottles.
Cot death - how you can reduce the risks
cot death is sometimes called Sudden Infant Death Syndrome or SIDS
How to keep your sleeping baby safe:
- are smokers (no matter where or when you smoke)
- have been drinking alcohol
- take medication or drugs that make you drowsy
- feel very tired.
Using dummies - what you need to know
" Claims that dummies reduce the risk of cot death are not based on strong evidence. Brian Palmer DDS, internationally recognised researcher, has done extensive research on the possible increased risk of SIDS linked to bottle feeding and the use of dummies. For more information visit Brian Palmer's website (www.brianpalmerdds.com)
" Remember that, when used a lot, dummies may permanently change the shape of a baby's mouth and jaw, affecting its correct development. This may in turn lead to breathing difficulties for your baby. This is called Obstructive Sleep Apnoea (OSA) [back to top]
You may still receive free samples, whilst in the maternity unit or shortly afterwards. However, we recommend you do not introduce the baby skincare products until your baby is at least one month old.
This information is a guide and whilst every effort is made by TIPS Ltd to ensure the information is accurate and up-to-date, please seek the advice of your midwife, health visitor, lactation consultant or GP if you have any queries or concerns.
References: National Institute for Clinical Excellence (2006). Routine postnatal care of women and their babies. Quick reference guide. London: NICE.
Palmer B (2008). SIDS, dummies, sleep (article submitted for publication). Presented at the LCGB Conference, Breastfeeding - International perspectives, Leeds 29 March 2008. For more information go to www.brianpalmerdds.com
Trotter S (2004). Care of the newborn: proposed new guidelines. British Journal of Midwifery, 12 (3): 152-7
Trotter S (2006). Neonatal skincare: why change is vital. RCM Midwives Journal, 9(4):134-8.
Trotter S (2007). Baby products - it's all in the labelling. MIDIRS Midwifery Digest, 17:2, 263-266.
Trotter S (2008). Neonatal skin & cordcare - the way forward. Nursing in Practice (January/February) Number 40 - (Dermatology): 40-45.
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Sharon Trotter© 2008
This leaflet is sponsored by an educational grant from Ceuta Healthcare Ltd and Weleda (UK).