Caring for Your Newborn

For months, you have focused on having a healthy pregnancy and a smooth labor and delivery. Now that your baby has arrived, your focus will shift to life at home. These tips will guide you through the first few weeks at home on how to feed, change and bathe your new baby; ways to keep your baby safe; and when to call the doctor.

This information, along with advice from your baby’s doctor and other healthcare professionals, will help make the transition to life at home with a new baby a safe and happy time for your family.

Diapering your Baby

Diapering will not be one of your favorite chores, but it is one that you will need to learn almost immediately when your baby is born. It may seem that you are changing diapers constantly. This is normal for newborns and will change as your baby grows.


  • A newborn baby should have a minimum of one to three wet diapers daily in the first few days. Once feedings are well established, usually between four to six days, your newborn should have at least six wet diapers a day.
  • At home if your newborn is staying dry for a long period of time (more than 12 hours), he or she may be dehydrated or have a urinary blockage. Notify your pediatrician if you are worried about your baby’s urination.

Bowel Movements

  • Babies have their own stool patterns.
  • The first stools are black and tarry. These are called meconium stools and will lessen after the second or third day. If your baby hasn’t stooled in 36 hours, notify your nurse or pediatrician.
  • After a few days, stool color and texture will change.
  • Breastfed babies will have loose, mustard yellow, “seedy,” mild-smelling stools. They may have several bowel movements a day to one every three to four days.

Changing Your Baby

  • To begin, gather all supplies needed and lay your baby on his or her back.
  • Remove the dirty diaper and roll it up if it is soiled.
  • Lift your baby’s bottom by holding up his or her legs.
  • Next, wipe the baby from front to back, which prevents the spread of bacteria from the baby’s stool. Make sure you clean all of the skin folds and creases.
  • Lift his or her bottom again to place a clean diaper underneath. The top of the diaper should be at waist level.
  • Allow your baby’s bottom to air dry. Apply a diaper rash ointment if needed.
  • Fasten the diaper securely on each side in the front and fold below the belly button.
  • Baby girls often will have a white vaginal discharge and spotting of blood during the first week. This discharge is because of the mother’s hormones. Wipe your baby girl’s genitals from front to back when changing diapers or bathing.
  • For circumcised boys, apply petroleum jelly to the circumcision area at each diaper change for four to seven days to keep it from sticking to the diaper. Yellowish patches are normal to see as it heals. Some physicians use a plastic cover for the circumcision site. The cover should fall off on its own in about eight days.
  • Clean the circumcised penis by dribbling water over it or by gently wiping with a soft washcloth. Do not use soap or wipes on this area until it is fully healed.
  • Wash your hands before and after changing your baby.

Bathing your Baby

Follow these simple steps to bathe your baby, but remember that newborns do not need bathing every day:

  • Gather all supplies needed and wash your hands before starting the bath.
  • Check water temperature with your hand to make sure it is not too hot.
  • To keep your baby from getting too cold when getting a sponge bath, wash part of his or her body at a time, keeping the rest of the body covered with a towel or blanket.
  • Wash your baby’s face and head first. Use only plain water to clean around the eyes.
  • When working your way down the rest of the body, pay special attention to the skin folds to be sure no moisture is left that may cause irritation.
  • Wash the diaper area last.
  • Always wash genitals from front to back.
  • For an uncircumcised boy, keep the penis clean with soap and water. Don’t force skin back from the penis.
  • Avoid oils and powder. Use only unscented lotion if your baby has dry skin.

Umbilical Cord Care

  • Keep the diaper folded down below the umbilical cord to help it dry out faster.
  • The umbilical cord will fall off in one to three weeks.
  • Keep the umbilical cord clean and dry during bathing.
  • Report any redness, drainage or foul-smelling discharge to your baby’s doctor.

Nail Care

  • Keep your baby’s nails short to prevent scratching.
  • Use a file, rather than clippers, to trim nails straight across.
  • You might find it easiest to trim your baby’s nails while he or she is asleep.

Newborn Appearance

Some details of your new baby’s appearance may not be expected though they may be perfectly normal. You
may see the following:

Common Newborn Birthmarks
Stork bites (also called angel kisses or salmon patches) are common birthmarks in children and usually begin
as a flat pink or red area on the skin on the back of the neck, forehead, eyelids or around the nose. Stork bites
usually fade as your child gets older, but faint remnants may persist.

Mongolian spots are dark, flat, bluish-black areas on the lower back or buttocks. These birthmarks will darken
at first and then fade by the time the child is 6 to 7 years old. Occasionally they may be seen on the upper back,
arms or legs. Mongolian spots often are mistaken for bruises.

Café au lait spots are flat, light brown, oval-shaped patches of skin that may occur anywhere on the body. They
do not fade and may even increase in number as your child gets older, especially around adolescence.

Common Newborn Rashes
Newborn acne—More than 30 percent of newborns develop acne of the face, mainly small, red bumps. This
neonatal acne begins at 3 to 4 weeks of age and lasts until 4 to 6 months of age. The cause appears to be the
transfer of maternal androgens (hormones) just before birth. Since it is temporary, no treatment is necessary.
Baby oil or ointments will make it worse.

Drooling rash—Most babies have a rash on the chin or cheeks that comes and goes. This reaction often is
related to contact with food and acid that have been spat up from the stomach. Rinse the baby’s face with water
after every feeding and every spit-up.

Heat rash—Other temporary rashes on the face are heat rashes seen in areas held against the mother’s skin
during nursing (especially in the summertime). Change your baby’s position frequently and put a cool washcloth
on the area.

Erythema toxicum—More than half of all babies get a rash called erythema toxicum on the second or third day of
life. The rash is composed of red blotches with a small white or yellow lump in the center. They look like insect
bites. They may be numerous, may keep occurring and may be anywhere on the body surface. Their cause is
unknown; they are harmless and resolve themselves by 2 weeks of age.

Milia—Milia are tiny white bumps that occur on the faces of many newborn babies. The nose and cheeks most
often are involved, but milia also are seen on the forehead and chin. Although they look like pimples, they are
smaller and not infected. They are blocked-off skin pores and will open up and disappear by 1 to 2 months of
age. No ointments or creams should be applied to them.

Blisters—True blisters (little bumps containing clear fluid) on the skin that occur during the first month of life
must be examined by a doctor. If they are caused by a serious virus, treatment may be required. If you suspect
blisters, call your doctor immediately.

Jaundice in Newborns
What is jaundice?
Jaundice is a yellowing of the skin and whites of the eyes. It is caused by the buildup of a pigment in the blood
called bilirubin. Bilirubin is a yellow pigment released during the normal breakdown of red blood cells. Jaundice
can occur in babies of any race or color.

The liver of a newborn often is immature. Before birth, the mother’s body helps remove bilirubin from the baby’s
blood. Most babies develop jaundice in the first few days of life because it takes a few days for the baby’s liver to
get better at removing bilirubin. Jaundice occurs in approximately six of every 10 newborns.

Will my baby be screened for jaundice?
We screen all babies for jaundice by checking their bilirubin levels before leaving the hospital. At your newborn’s
first office visit, the provider will assess your baby for signs of jaundice as well.

How can I check my baby for jaundice?
Gently press your baby’s forehead, nose or chest with your fingertip. Your baby’s skin should be white once
you remove your fingertip. If a yellowish color is present after you remove your finger, your baby probably has
jaundice. It is very important for your baby to be seen by a nurse or doctor when the baby is between 3 and 5
days old—that’s usually when the bilirubin level is the highest.

Can jaundice hurt my baby?
Most babies have mild jaundice that is harmless. However, in unusual situations, the bilirubin level can get very
high and may cause brain damage. This possibility is why newborns should be checked carefully for jaundice and
then treated to prevent a high bilirubin level.

How is jaundice treated?
Treatment depends on the amount of bilirubin present in your baby’s blood. When necessary, a baby can be
treated with special blue lights called phototherapy. The lights help change bilirubin in the baby’s blood so that it
can be easily disposed of in the urine. Your baby’s doctor will tell you if phototherapy is needed in the hospital.
Sunlight used to be the only treatment available for jaundice, but it is less effective and can burn your baby’s
skin. Never place your baby in direct sunlight to treat jaundice.

When should I call the doctor?
Call your baby’s doctor right away if …
• Your baby’s skin or eyes look more yellow
• Your baby’s abdomen, arms or legs are yellow
• Your baby is jaundiced and is hard to wake, fussy or not well
• Your baby is not wetting at least four diapers a day

When does jaundice go away?
Jaundice usually goes away within a week or two. Consult your baby’s doctor, who can confirm when jaundice is
no longer a concern for your baby.

Safety First

What is infant safe sleep?

Sudden infant death syndrome (SIDS) is the leading cause of death among infants between 1 month and 1 year of age. This is what you can do to help your baby sleep safely and to reduce your baby’s risk of SIDS.

Infant CPR
CPR saves lives: The American Heart Association estimates that up to 200,000 lives could be saved each year if CPR were performed early enough. If you have not had Infant CPR training recently, consider taking a class.
For more information on classes (known as “Friends and Family CPR” at Greenville Memorial Hospital), call 1-877-Prisma Health-INFO (447-4636).

To create a safe sleep environment:

  • Always place a baby on his or her back to sleep, for naps and at night, to reduce the risk of SIDS.
  • Use a firm sleep surface, covered by a fitted sheet; a crib, bassinet, portable crib or play yard that conforms to the safety standards of the Consumer Product Safety Commission (CPSC) is recommended.
  • Your baby should not sleep in an adult bed, on a couch or on a chair alone, with you, or with anyone else.
  • Keep your baby’s sleep area in the same room where you sleep (for the infants first year). Room sharing not bed sharing. Always place the baby in a safety-approved crib, bassinet, portable crib for sleep.
  • Sitting devices like bouncy seats, swings, infant carriers or strollers should not be used for routine sleep.
  • Keep soft objects such as pillows and blankets, toys and bumpers out of your baby’s sleep area.
  • Wedges and positioners should not be used.
  • Do not smoke during pregnancy or allow smoking around your baby.
  • Do not let your baby get too hot during sleep.
  • Breastfeed your baby.
  • Give your baby a dry pacifier that is not attached to a string for naps and at night to reduce the risk of SIDS after breastfeeding is established.
  • Supervised Skin to Skin is recommended to all mothers and infants immediately following birth regardless of feeding or delivery, (as soon as mother is medically stable, awake and able to respond to her newborn) and to continue for at least an hour. Once mother starts to get sleepy, return baby to bassinet.
  • Follow health care provider guidance on your baby’s vaccines and regular health checkups.

For additional information and education on safe sleep please visit:

Car Seat Safety

Before the first ride home, Safe Kids™ Upstate, led by Children’s Hospital of Greenville Health System, encourages you to act on the following questions:

What is the best car seat for my child?

  • It fits the child from birth (or a starting weight of 4 pounds) to 40 pounds.
  • It fits the car/truck/van. Try the seat in the vehicle before buying it.
  • The back of the front seat does not touch the back of the infant carrier or convertible seat.
  • Best practice is to purchase a new car seat. You must know the history of the car seat, and it must be less than six years from the manufacture date. All stickers must be intact and readable.
  • If the car seat has been in a crash—even a minor fender bender—it is not recommended to use that seat.

Where is the safest position to place my child in the back seat?

  • First, check the owner’s manual of your car/truck/van for guidance.
  • Second, make sure the seat back of the front seat will not touch the back of the car seat.
  • As a parent, you make the final call unless the car or car seat manual gives very specific directions. Best practice is to follow the owner’s manual.

When should I install my infant car seat?

  • Install it no later than the seventh month of pregnancy. Babies don’t always arrive when scheduled, and we want you to be ready!
  • If the seat is purchased well before the baby arrives and does not fit the car, you will have time to make adjustments.
  • Purchasing the seat by the early part of the third trimester will give you time to have a prenatal car seat inspection.

What is a car seat inspection?
Safe Kids Upstate has trained certified technicians who can inspect your installed car seat. They will help you make any corrections so that the seat is ready for your new precious cargo. These technicians continue their training to stay current on all advancements and recalls of car seats.

Hand Hygiene

One of the easiest things we can do as parents and caregivers is to wash our hands properly. Hand hygiene saves lives.
Hand hygiene is one of the most important ways to prevent the spread of infections, including the common cold, flu and even hard-to-treat infections such as MRSA (methicillin-resistant Staphylococcus aureus)

You should practice hand hygiene:

  1. Before preparing or eating food
  2. Before touching your eyes, nose or mouth
  3. Before and after changing wound dressings or bandages
  4. After using the restroom
  5. After blowing your nose, coughing or sneezing
  6. After touching hospital surfaces such as bed rails, bedside tables, doorknobs, remote controls or the phone
  7. After feeding or diapering your baby

With soap and water:

  1. Wet your hands with warm water. Use liquid soap if possible. Apply a nickel- or-quarter-sized amount of soap to your hands.
  2. Rub your hands together until the soap forms a lather. Then run the lather over the tops of your hands, in-between fingers and in the area around and under the fingernails.
  3. Continue rubbing your hands for 20 seconds. Need a timer? Imagine singing the “Happy Birthday” song twice.
  4. Rinse your hands well under running water.
  5. Dry your hands using a paper towel if possible. Then use your paper towel to turn off the faucet and to open the door if needed.
  6. When to use soap and water:
    -When your hands look dirty
    -After you use the bathroom
    -Before you eat or prepare food

With an alcohol-based hand rub:

  1. Follow directions on the bottle for how much product to use.
  2. Rub hands together and then rub the product over the top of your hands, in-between your fingers and in the area around and under the fingernails.
  3. Continue rubbing until your hands are dry. If enough rub was used to kill germs, it should take at least 15 seconds of rubbing before your hands feel dry. You should not rinse your hands with water or dry them with a towel.
  4. When to use an alcohol-based hand rub:
    -When your hands do not look dirty
    -If soap and water are not available