Caring for your Newborn: 14 Questions Answered

After nearly 40 weeks of waiting, you’ve brought your baby home and you’re giving parenting all you’ve got. Yet you can’t help but wonder, is everything you’ve got enough? After all, your life has now changed drastically; your schedule has upended, you’re holding your baby as if she were made of precious glass, and you can’t even remember the last time you showered or slept.

As your baby grows, your sleepless nights and hectic days will probably be filled with pure joy - and more questions and concerns. Don’t worry. You’ll soon feel like a pro in the babycare game. And to help you get there sooner, here are answers to some common newborn concerns.

1. My baby seems to have dandruff. How do I get rid of it?
The dandruff you are referring to is called cradle cap, a common condition among newborns. It can be easily treated by applying mineral oil daily to the scalp and gently massaging it in for a few minutes before baby’s bath or leaving it on overnight. If it is severe, you may have to use a small amount of dandruff shampoo - massage in for a few minutes, then rinse. Do this once or twice a week until it disappears.

2. My baby keeps crying, does that mean he’s colicky?
Francesca Tatad-To, M.D., pediatrician at The Medical City, says, “Nobody knows what really causes colic, but colic typically manifests as incessant crying for one to three hours with no identifiable cause. It generally occurs at the same time each day and may go on for two to six weeks. It is more common in newborns (six weeks of age and older), and rare in older infants and toddlers. There is no universal solution for colic, but there are some things that consistently work for particular babies. You can try gently rocking your baby, making a shushing sound, turning on something that makes white noise (like an electric fan), or putting your child in something that vibrates (like a car). Medications like simethicone (anti-gas drops) or traditional remedies like gripe water may provide relief for some infants as well.”

3. My daughter has pimples on her face. I thought newborns are supposed to have perfect skin?
Newborn acne and whiteheads are extremely common. They are not nice to look at, but are not harmful and will eventually go away on their own. They usually worsen before they improve. No treatment is needed for these, though the application of expressed breast milk may improve their appearance. If the lesions look inflamed or infected, consult your pediatrician.

4. My baby seems a little yellow. How will I be able to tell if he has jaundice?
According to Dr. Tatad-To, in general, parents and most lay persons are not trained to identify jaundice. It takes years of practice and experience to identify jaundice in its early stages, so this is best left to the professionals. Any degree of yellowing of the skin in a newborn infant requires further evaluation (such as a full physical examination, a review of feeding habits and elimination pattern, and possibly a blood test). It is crucial that babies be brought to their doctor within two to three days of discharge from the hospital so they can be evaluated for jaundice. While severe jaundice does have serious complications, most cases of jaundice during this period are normal and will resolve spontaneously.

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5. My baby’s breathing seems to be irregular. Is this dangerous?
Many babies exhibit periodic breathing - breathing slows down and then speeds up periodically. No baby should really “stop” breathing. If you notice that your baby does this, call your doctor immediately.

6. How can I tell if my baby is gaining enough weight?
Dr. Tatad-To says, “There is no prescribed amount of milk babies are required to take in order to grow adequately. Ideally, babies should be breastfed or given expressed breast milk on demand and their growth then evaluated. If their elimination pattern is normal (one to several bowel movements a day; six to eight wet diapers a day after the first week of life) and they are gaining weight adequately (one pound every two weeks in the first four months), then there’s no need to measure baby’s intake. Mothers with babies on formula should discuss ideal intake with their pediatrician as each child is different. In general, a baby requires much less than what is recommended on the formula label.”

7. Why does my baby seem to get startled easily while sleeping?
This is normal and to be expected. But if your baby’s sleep is disturbed because he startles easily, it may be best to keep him swaddled during the first few months. This keeps the reflex under control and helps him sleep more comfortably.

8. My daughter has a bright red blotch on her skin. Will this go away? Is this a birthmark?
Dr. Tatad-To says it is hard to say whether a mark is a birthmark without first examining it. There are many reasons for marks in babies - rashes, bites, birth marks, and even marks from trauma (the birthing process is quite traumatic and many babies will have some marks as a result). To be sure, have your baby checked by his pediatrician.

9. There are white spots on my newborn’s gums and tongue. Are these teeth?
These white spots on your baby’s gums are more likely to be tiny fluid-filled papules or cysts. These are harmless cysts common in newborns and will soon disappear, leaving gums clear. Dr. Tatad-To adds, “White spots on a newborn’s tongue can also simply be residue from milk or may be a yeast infection called thrush. If the white spots can be scraped off, then they are likely milk residues. If not, they are more likely yeast. Thrush can spread to the inside of the cheeks and gums and may be painful or irritating. While thrush is a common infection in newborns, babies who are suspected to have this condition should be taken to the doctor for appropriate treatment and medical advice.

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10. My newborn’s stool is greenish black. Is this normal?
The tarry greenish, black substance you’re referring to is called meconium. This is the substance that gradually filled your baby’s intestines during his stay in your uterus. The fact that he has expelled it is a good thing—this means his bowels are unobstructed. After the first 24 hours, when he has expelled all his meconium, his poop will change into transitional stools. The book What To Expect The First Year by Arlene Eisenberg, Heidi Murkoff, and Sandee Hathaway lists the different types of baby poop:
Sticky, tar-like; black or dark green: Meconium, a newborn’s first stools.
Grainy; greenish yellow or brown: Transitional stools, which start turning up on the third or fourth day after birth.

• Seedy, curdy, creamy or lumpy; light yellow to mustard or bright green - normal breast milk stools
• Slightly formed; light brownish to bright yellow to dark green - normal formula stools
• Frequent, watery; greener than usual - diarrhea
• Hard, pellet-like; mucus or blood streaked - constipation
• Black - due to iron supplementation
• Red streaked - rectal fissures or milk allergy
• Mucusy; green or light yellow - a virus such as a cold or stomach bug.

11. My newborn spits up so often. I’m worried he’s not getting enough milk.
Dr. Tatad-To says, “There are many reasons why a baby may spit up: poor feeding technique, overfeeding, feeding intolerance, gastroesophageal reflux disease, or a less common condition such as a mechanical block in the gastrointestinal tract. It is first important to determine the cause of the spit up and if it is benign (from poor feeding techniques, overfeeding). If an infant has gastroesophageal reflux, this must be addressed accordingly. Some babies are ‘happy spitters’ - they gain weight well and do not manifest any complications from spitting up often. If the weight gain in these babies is adequate, then it is assumed that their milk intake is adequate as well.” Eisenberg, Murkoff, and Hathaway advise that to minimize the air the baby gulps down while drinking milk, don’t feed him when he’s crying; keep him upright while feeding (and afterwards). If bottle feeding, make sure the bottle is tilted so that milk (and not air!) fills the teat. Also avoid bouncing the baby while feeding and immediately after. And remember to burp him during and after a meal.

12. The cord still has not fallen off my baby’s belly button. It looks awful. Could it be infected?
If you’ve been taking care to keep the umbilical cord dry and clean, an infection is highly unlikely. Healing belly buttons, according to Eisenberg, Murkoff, and Hathaway, usually look and smell worse than they actually are.
 
Some doctors still recommend swabbing the area with alcohol to prevent infection and promote healing, but studies show that the cord heals as well without it. Until the cord has dried and fallen off, keep the area dry (no tub baths), fold down the baby’s nappy so the navel is exposed to air, and clean with alcohol if recommended. If you do note a redness in the surrounding skin (which may be caused by an infection or irritation from alcohol application), or discharge from the navel or from the base of the umbilical cord, see your doctor.

13. My son’s feet seem to fold inwards, will they straighten out on their own?  
Eisenberg, Murkoff, and Hathaway explain that most babies appear bowlegged and pigeon-toed because of the normal rotational curves of the legs of a newborn and because the tight quarters in the uterus usually forces one or both feet into odd positions. In the months ahead, babies’ feet usually straighten out as he learns how to crawl, stand, and walk. In the unlikely event that your baby’s feet do not straighten out on their own, casting or special shoes may be recommended at a later date. It would be best to consult your doctor to see what treatment, if any, is appropriate for his condition.
 
14. My baby’s head seems to be pointed because of the push out of the birth canal. How do I correct this?
It is common for babies to have a “cone head” at birth, particularly if born vaginally. This normally corrects on its own within a few days from birth, says Dr. Tatad-To.

Sources:

• Francesca Tatad-To, a U.S.-trained specialist in Pediatrics and Newborn Medicine  
• What to Expect The First Year by Arlene Eisenberg, Heidi Murkoff, and Sandee Hathaway

Photo from sxc.hu