New Parents : I'm Scared of Dropping Him Caring for your newborn baby (part 1)

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Q: Even though we have a toddler, I'm still scared I'll drop the baby. Do other dads feel like this?
A: This is a normal and natural feeling and affects the majority of all new dads (and many moms!). Babies seem to be such fragile little creatures, especially because of their size compared to you. However, they are in fact quite resilient to inept handling and are a lot stronger than they look. Remember the tough journey they have just undergone to be born! If you have so far avoided handling your baby much, try to overcome your fears by watching your partner change your baby or bathe him, then offer to help so that you can give your partner a rest. Once you have changed a few diapers, or done some burping sessions, you will find that your confidence in handling your baby begins to grow quickly. The more contact you have with your baby, the more confident you will become over time, and your partner will also benefit from the added support and help you are providing and from knowing that she can feel confident leaving you in charge of the baby sometimes.
Q: Our baby screams whenever he goes near water. How can we make bathing him less stressful?
A: There is no right or wrong way to bathe a baby, but with a little care and organization it can actually become quite a playful and fun experience (see Bathing and washing). This may seem hard to believe at the moment, and it is certainly the case that many newborn babies initially scream throughout their bathtime. However, the main reason why babies do this is because they don't like to feel cold. To keep your baby comfortable during a bathing session, make sure that the room you bathe him in is sufficiently warm and draft-free, which will help him relax and feel less distressed. Also, always gather everything you need ready before the bathing session so that you don't have to go and fetch items mid-way through a session, and of course never leave your baby unattended.

If you are feeling stressed during your baby's bathtime, he may be sensing this, which could be adding to his upset. The biggest fear that moms and dads have is of dropping their baby while bathing him, so you could initially try bathing at ground level to help you to build your confidence. Also, remember to communicate with your baby the whole time while you are bathing him—talking to him constantly in a soothing tone, or singing to him, will help distract and reassure him and in turn you are likely to feel far more relaxed, which will have a positive effect on your baby.

If you are still concerned about handling your baby, then seek help from your partner, if he or she is more confident, or talk to your nurse or pediatrician who will be more than happy to offer you additional advice and support.

Q: Our newborn sleeps so much—it's wonderful, but should I be waking him for a feeding?
A: While many newborn babies sleep for what seems to be a very short amount of time, some do sleep for quite long periods. One factor that may influence how long your baby sleeps is how he is fed. The makeup of formula is very different than that of breast milk and sits in a baby's stomach longer. So formula-fed babies tend to sleep for longer periods and are, in fact, encouraged to do so to prevent overfeeding and constipation. However, a bottle-fed baby shouldn't be left without a feeding for more than six hours and it is recommended that bottle-fed babies should have no fewer than six feedings a day. So if your baby sleeps well at night, daytime feedings will need to be closer together and you may need to wake him to feed him.

Breast-fed babies are very different feeders. Many feed 10–12 times a day, or even more, and there are times when they “cluster feed” and the feedings blend into one very long feeding. However, there are some breast-fed babies who do not feed regularly and appear sleepy. These babies may be tired, sedated by maternal medication during labor, or just very sore as a result of the birth.

Immediately after the birth, babies have fat and fluid reserves that can sustain them for a day or two. However, if your baby is very sleepy for the first 24–48 hours, you should still try to stimulate him every few hours and wake him for feedings. There are several things you can do to encourage a sleepy baby to feed, such as lying your baby naked on your chest so that you get skin-to-skin contact, which can encourage him to root for the nipple and feed; massaging him; dripping expressed milk onto his lips; and changing his diaper to encourage him to wake. However, do not force him to feed by, for example, pushing him toward the breast, since this could put him off breast-feeding.

You can also start to express milk every two to three hours to stimulate your breasts to produce milk. Your nurse will assess your baby to make sure that he is not becoming dehydrated or passing concentrated urine; that his bowel movements are changing color to yellow; and that he is not jaundiced, since mild jaundice can make a baby a little drowsy.

Q: I'm scared to touch my baby's cord stump—should I clean it?
A: The cord stump is the end of the umbilicus that housed the arteries and veins that fed your baby and removed waste products in pregnancy. It is common for parents to not want to touch the stump. However, the stump can become infected since its base can get moist, and harmful bacteria that live naturally on our skin may grow in this moist area before it falls off, usually by the tenth day. If the cord stump is clean, there is no need to touch it, but if it becomes soiled, it should be cleaned with damp cotton pads. Once it has fallen off, the “wound” needs cleaning until it heals, since the navel and surrounding area can also become inflamed. If the stumps smells offensive or is sticky, contact your pediatrician.
Q: What is meconium?
A: Meconium is a waste product from your baby's bowels. It is dark brown/green in color and its texture is quite sticky and thick. Meconium is formed from as early as 12 weeks gestation and contains dead skin cells and debris from the amniotic fluid that the baby swallows and digests throughout pregnancy. It is usually expelled after birth in the first few stools, but it can be passed in pregnancy or labor when it may be a sign that the baby is distressed. If meconium is seen before the birth, the baby will be monitored carefully during the labor and birth.
Q: How often should I change my baby's diaper?
A: Your baby's own toilet habits will dictate how often to change his diapers. However, you should check his diaper fairly regularly, since wetness and the ammonia contained in urine and the digestive enzymes in stools can quickly irritate a baby's sensitive skin. Some babies need changing around 6–8 times a day, while others require a diaper change as often as 10–12 times a day, for example, breast-fed babies who poop much more frequently than bottle-fed babies. As your baby gets older, he will need changing less frequently.
Q: Is there anything I should look out for when I'm changing his diaper?
A: A baby's urine is pale after birth and then yellows within the next few days. There may be a pinky-orange stain in your baby's diaper, which is concentrated urine from when he was in the uterus and is quite normal. As long as your baby urinates at least four times a day and there is no blood present, there is nothing for you to worry about. The black-green meconium passed after the birth gradually changes to a yellow color as normal digestion begins.

Breast-fed babies tend to pass stools that are runny and mustard-yellow, which can look similar to diarrhea, while a formula-fed baby's stools will be much firmer and a seedy pale yellow. Some babies have a bowel movement with every feeding, since feeding stimulates peristalsis, or muscular contractions, in the gut; others, particularly bottle-fed babies, may only pass a stool once a week. If the stool is hard and dry, or there is any mucus or blood in the stool, talk to your doctor.

Q: How should we deal with diaper rash?
A: Diaper rash is painful for the baby, but also distressing for parents, who may feel that they should have been able to prevent it. The reasons for diaper rash include infrequent diaper changes allowing irritants to stay in contact with the skin; if an emollient cream has not been used; or if the baby has a yeast infection that is irritating sensitive skin. Also, changing a baby's diaper too regularly can sometimes be harmful because the baby may be sensitive to the wipes being used.

The most usual way to deal with diaper rash is to “air” the bottom as often as is practical. After thorough handwashing, clean your baby's bottom carefully with cotton balls and warm tap water and/or emollient creams, which lubricate the skin and stop it from becoming too dry, and avoid soaps or wipes. Then leave your baby without a diaper on an absorbent mat or towel for a while. When you change his diaper, apply an emollient or barrier cream thinly so that it protects the skin but does not prevent the diaper from soaking up urine. Appropriate ointments and creams include zinc oxide or petroleum jelly. Acid Mantle, an effective diaper rash cream can be applied under a layer of zinc oxide. A pure lanolin cream may also be helpful.

Occasionally, a moderate or severe diaper rash may be infected. In this case, treatment with antibiotics may be necessary. Also, to reduce inflammation, a hydrocortisone cream may be suggested by your baby's pediatrician for application once a day, to reduce the inflammation of the diaper rash and give it a better chance to heal. An antifungal cream will also be recommended since many moderate to severe rashes are infected with the yeast Candida albicans. If the rash persists after 7–10 days, the doctor may recommend an antifungal syrup to try to treat the whole bowel for yeast infection. If this occurs, an antifungal cream may be prescribed for use on the nipples after feeding (always wash before the next feeding). If the diaper rash still shows no sign of healing, your doctor may refer your baby to a dermatologist.

Q: Should we use baby wipes or just cotton pads when changing a diaper?
A: Most authorities would advise that you stick to warm water and cotton balls or pads, or a soft cloth, to clean your newborn baby when changing his diapers. Any soaps, perfumed or otherwise, or baby wipes should be used with some caution since, although baby products are specially designed to be kinder on a baby's sensitive new skin, they can still irritate the tender skin. The best idea is to avoid baby wipes entirely until your baby is around one month old.
Q: My baby's scalp has become scaly. Is this cradle cap and what should I do about it?
A: Cradle cap, or seborrheic dermatitis, is a common condition in young babies, appearing as yellow, scaly patches on the scalp. This condition is harmless and will clear up on its own over time. However, if you are concerned that it is unsightly, gently massage some olive oil into the scalp, leave this on overnight, and then wash your baby's hair in the morning with a mild baby shampoo; most of the flakes should disappear. Don't pick at the scales since this could damage the skin and increase the chance of infection.
Q: What temperature should our house be when we bring our new baby home?
A: Babies find it hard to maintain their body temperature. Maternity units are notoriously hot as they are dealing with babies who have just been born and are still wet from the delivery. Once you are home maintain room temperature at one that is comfortable for you or between 65 and 70° F (18 and 21° C). Babies are at risk of crib death .  if they become too hot due to being in a warm room or being overwrapped.

However, the room temperature is a guideline only and you should learn to check for other signs that your baby is too hot or too cold. As a guide, a baby's hands and feet feel cool and their heads feel hot since they tend to lose heat through their heads. Check his temperature by feeling your baby's chest with the back of your hand, not your fingers, since they may be cold. If your baby feels warm to touch, he is probably warm enough. If he is hot or sweaty, remove a layer of clothing or a blanket or sheet. If he is cold, add a layer. Comforters are not recommended until your baby is at least a year old to avoid overheating.

If your baby is unwell, hot, and shivery, your immediate reaction may be to wrap and cuddle him, but this can raise his temperature. Instead, remove a few layers so that your baby can cool down. Call your pediatrician if your baby has a temperature over 100.4° F (38° C) rectally or if he is particularly unresponsive and listless.

Q: How should I place my baby in the crib?
A: The CDC and American Academy of Pediatrics recommend that your baby should be placed on his back with his feet toward the bottom of the crib to prevent him from wriggling under the blankets and possibly suffocating himself . Light cotton blankets and sheets, available in crib sizes, should be used rather than quilts or comforters, so that layers can be built up or taken off. The blankets and sheets should be tucked under the baby's arms so that your baby is less likely to pull them over his face. Swaddling is another method of wrapping your baby which some babies find comforting .
Q: Is it OK to swaddle our baby? there seem to be conflicting opinions.
A: Swaddling means wrapping your baby in a light cotton blanket or sheet, the idea being to keep him feeling warm and secure in the outside world . When swaddled, the baby is so well wrapped that his arms and legs become “strapped” to his sides, restricting the movement of the limbs. There are differing views as to whether a baby should be swaddled. The practice of swaddling is very popular in Asian and Eastern European areas. Its popularity is also on the rise in the US, especially since parents have been encouraged to put babies in their own cribs to sleep rather than bedsharing. It is also thought that the swaddling may help a baby sleep comfortably on his back.

The CDC warns of the risks of overheating a baby so any swaddling should be done with a light cotton sheet or blanket and the room must not be too warm. On the other hand, some believe that swaddled babies risk getting cold since they cannot maintain their temperature by moving.

Q: Should my baby wear his hat indoors?
A: One factor known to increase the risk of crib death (SIDS) is an overheated baby. Although babies lose excess heat from their heads and it is a good idea to cover a baby's head outside if it is cold or windy, the baby's hat should be removed indoors or when you enter an area that is warm, such as on a bus or going into a store, even if it means waking your baby.

There are some exceptions. If a baby was born prematurely, had a very low birth weight, or has difficulty maintaining his temperature then they may need to wear a hat indoors. However, once these babies are a healthy weight or able to maintain their body temperature, this no longer applies.

Q: He screams when I undress him. What can I do?
A: Babies use crying as their means of communication. It may be that when you undress him, he is either protesting that he is cold or that he does not like the feeling of air on his skin, which he is unused to after being snuggled in the womb for nine months. Try to keep the changing time as short as possible, making sure he is not in a drafty or cold environment. Afterward, comfort your baby by rocking him; swaddling and keeping him in an upright position can also soothe him.
Q: When can we take him out?
A: Some recommend waiting for 1–2 weeks before going out, but this will depend on individual circumstances. When you feel well enough, you could try going out for a short walk, but bear in mind it will be the same distance to get back, so do not overdo it. You may have a local park you could visit or simply have a walk around the block—it's best to keep it simple at first until you get used to being out together. You are likely to feel somewhat nervous at first about taking your baby outside of the home, but, as with most aspects of baby care, once you get used to going out you will probably lose much of your anxiety. As you start to increase the distance and time away from home, make sure you have taken everything you will need to care for your baby while you are out. This will include changing equipment, and blankets, stroller covers, or sun screens to protect your baby from different weather conditions. The time of year will also affect how long you stay out.
Q: Can he sleep for long in his car seat?
A: There are rules to suggest how long a baby should remain in a car seat, but bear in mind that being fixed in one position for long periods of time would be uncomfortable for anyone, regardless of age. Generally, it is not recommended that babies be left for a long period of time in car seats since there is a risk of overheating and if they fall asleep curled up in this position it may affect their breathing, and can encourage trapped gas, causing discomfort. You should be careful when carrying your baby in a car seat since they tend to be heavy and you are more prone to back injuries in the postpartum period.
Q: My wife won't let me do a thing but I want to get better at it. How can I help?
A: Some women feel that it is their responsibility to care for the baby, but it is well documented that a couple's relationship is strengthened when the care is shared. This involves joint decision-making and making choices regarding care together. Babies can pick up on positive and negative feelings expressed by their parents, and it is important for all concerned that both the mother and the father bond with the child. Offer to perform routine tasks in front of her to instill her confidence in your ability. This may take time, but the reward is worth it. She will also benefit from being able to take breaks, confident in the knowledge that you can manage as well as she can.
Q: My friend's baby had colic and she had a miserable few months with it. Will my baby get it?
A: The term “colic” refers to when babies seem to cry continually and cannot be soothed . Although obviously distressing for the baby, it is equally upsetting for the parents to listen to their baby crying so painfully for so long. As no one knows exactly why colic occurs, it is impossible to say whether or not your baby will suffer from it. However, there are several theories as to what causes colic. One is that the baby's intestines are immature and working too hard, causing cramps. Another is that the bowel movements are too slow and the air in the bowel is trapped. Another theory is that the baby is eating too much, too fast, and has air trapped. None of these is proven and all we know is that colic occurs in around 10–15 percent of babies.
Q: My baby cries continually. I'm not having much success with breast-feeding—is he hungry?
A: Newborn babies cry on average for two and a half hours each day. Crying is your baby's only means of communication and so he cries to get you to respond to his needs, whether he is hungry, wet, or just wants to be cuddled. Some babies cry more and may struggle when you try to comfort them, which can make you anxious. If you are anxious about breast-feeding, your baby may sense this and begin to cry. Sometimes, it is necessary to take a step back and try to relax. Taking a warm bath with your baby skin-to-skin can help calm you both and may help you relax more while feeding. Once warm and calm, your baby may try to get into a good position to feed. Ensure he latches on well and does not cause pain after the first few sucks. Allowing your baby to feed as and when he wants is important. As your baby gets older, the regularity of feedings will settle and the intervals will lengthen.

Other reasons why babies cry include being overstimulated (try a bath skin-to-skin); being uncomfortable (try burping); being wet (change his diaper); being cold or hot (change the clothing and room temperature); wanting comfort (try swaddling); or boredom (talk to your baby, sing, and play with him).

Q: My midwife says that our baby comfort sucks. I'm reluctant to introduce a pacifier—should we?
A: If a baby has latched on well at the breast and has sucked and swallowed well during a long feeding, and then settles on the breast taking small sucks and not swallowing, he is comfort sucking. Many babies like to comfort suck, not just breast-fed ones. If your baby falls asleep, you may be able to gently ease him off the breast, or if you are comfortable, leave him there. Your baby may comfort suck for many reasons. He may be stimulating the breast to increase your milk supply; he may be “cluster” feeding and dozing before the next feeding; or he may want to snuggle close. Comfort sucking is thought to steady the baby's heart rate, relax his stomach, and help him to settle down.

Some parents think pacifiers are the best way to get a baby to sleep, day or night; others think they should be used only at night, and some believe they should not be used at all. The American Academy of Pediatrics updated its SIDS guidelines in 2005 to include use of pacifiers. Studies show that babies who suck their thumbs as well as those who are offered pacifiers have a significant decrease in the incidence of SIDS. If your baby likes to suck, you can offer him a clean finger to suck on; later on, some babies comfort themselves by sucking on their own thumb or finger.

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