General Guidelines
Bathing and Skin Care
Proper bathing and skin care for your newborn
A newborn's skin is soft and delicate. Proper skin care and bathing can help maintain the health and texture of the baby's skin while providing a pleasant experience for both of you.
Contrary to popular thought, most babies do not need a bath every single day. With all the diaper changes and wiping of the mouth and nose after feedings, most babies may only need to be bathed 2 or 3 times a week or every other day.
Baths can be given any time of day. Bathing before a feeding often works well. Many parents prefer to bathe their baby in the evening, as part of the bedtime ritual. This works well especially if bath time is relaxing and soothing for the baby.
Sponge baths are required at first. Bathing in a tub of water should not be done until the baby's umbilical cord falls off, and a baby boy's circumcision heals, to prevent infection.
- Thick towels or a sponge-type bath cushion
- Soft washcloths
- Basin or clean sink
- Cotton balls
- Baby shampoo and baby soap (nonirritating)
- Hooded baby towel
- Clean diaper and clothing
- Make sure the room is warm, without drafts (about 75° F).
- Gather all equipment and supplies in advance.
- Add warm water to a clean sink or basin (warm to the inside of your wrist or elbow).
- Place baby on a bath cushion or thick towels on a surface that is waist high.
- Keep the baby covered with a towel or blanket.
- NEVER take your hands off the baby, even for a moment. If you have forgotten something, wrap up the baby in a towel and take him or her with you.
- Start with the baby's face. Use 1 moistened, clean cotton ball to wipe each eye, starting at the bridge of the nose then wiping out to the corner of the eye.
- Wash the rest of the baby's face with a soft, moist washcloth without soap.
- Clean the outside folds of the ears with a soft washcloth. DO NOT insert a cotton swab into the baby's ear canal because of the risk of damage to the ear drum.
- Add a small amount of baby soap to the water or washcloth, and gently bathe the rest of the baby from the neck down. Uncover only one area at a time. Rinse with a clean washcloth or a small cup of water. Be sure to avoid getting the umbilical cord wet.
- Wash the baby's head last with shampoo on a washcloth. Rinse, being careful not to let water run over the baby's face. Holding the baby firmly with your arm under his or her back and your wrist and hand supporting his or her neck, you can use a high faucet to rinse the hair.
- Scrubbing is not necessary, but most babies enjoy their arms and legs being massaged with gentle strokes during a bath.
- Wrap the baby in a hooded bath towel and cuddle your clean baby close.
- Follow cord care instructions given by your baby's doctor.
- Use a soft baby brush to comb out your baby's hair. DO NOT use a hair dryer on hot to dry a baby's hair because of the risk of burns.
- Expect your baby to cry the first few times you bathe him or her. Usually, this is just because a bath is a new experience. However, be sure to check that the water is not too warm or cold or that soap has not gotten in your baby's eyes.
Once your baby's umbilical cord has fallen off and the stump is healed, and after a boy's circumcision has healed, you can give your baby a tub bath. This can be a pleasurable experience for you and your baby. However, some babies may not like to be bathed, especially the first few times. Talk softly or sing and try some bath toys if your baby protests.
- Baby bathtub (preferably with a bottom drain plug)
- Nonslip mat or pad
- Bath thermometer (these often have "safe" bath temperature ranges marked on them)
When bathing your baby in a tub:
- Clear the counter or table top of breakable objects and electrical appliances to prevent injury.
- Fill the tub with warm water, using a bath thermometer.
- Follow the same general bathing instructions for a sponge bath.
- NEVER take your hands off your baby, or walk away, even for a moment.
- Be sure to clean the bathtub after each use.
A baby's soft and delicate skin needs special care. Generally it is best to use products made especially for babies, but your baby's doctor can advise you about other products. Products for adults may be too harsh for a baby and may contain irritants or allergens. Many parents like to use lotions for the sweet baby smell. However, unless the baby's skin is dry, lotions really are not needed. Powders should be avoided, unless they are recommended by your baby's doctor. When using any powder, put the powder in your hand and then apply it to the baby's skin. Shaking powder into the air releases dust and talc which can make it hard for the baby to breathe.
Many babies have rashes and bumps that are normal. Some rashes may be a sign of a problem or infection. Diaper rash can be irritating to the baby and needs to be treated. If you have concerns about a rash, or your baby is uncomfortable or has a fever, call your baby's doctor.
Laundry detergents may cause irritation to a baby's delicate skin. Even if you use a detergent marketed for baby laundry, it is a good idea to rinse the laundry an extra time to remove residues.
The first cries of a newborn baby are often music to the ears of parents. However, over the next weeks and months, this "music" can become grating and painful. This is especially true when all attempts fail to stop the crying.
Surprisingly, crying does not produce tears until after the first month or two. Crying is the way babies communicate. They cry because of hunger, discomfort, frustration, fatigue, and even loneliness. Sometimes, cries can easily be answered with food, or a diaper change. Other times, it can be a mystery and crying stops as quickly as it begins.
You will soon learn differences in cries, from a cry of "I'm hungry" to "I've been overstimulated." It is important to respond to your baby's cries. Contrary to old wives' tales, young babies cannot be spoiled by being picked up when crying. Being held is reassuring and comforting when a baby cannot express him/herself any other way.
Some techniques to help console a crying baby include the following:
- Take care of physical problems first--hunger, diaper change, need to burp.
- Walk with baby in a sling or in a stroller.
- Rock your baby in a rhythmic, gentle motion.
- Try a baby swing or rocking cradle.
- Gently pat or stroke on the back or chest.
- Try swaddling the baby.
- Go for a ride in the car.
- Turn on some white noise (such as a washing machine or vacuum cleaner).
No matter how frustrated you may become, NEVER SHAKE A BABY. This can cause severe injury to the baby's fragile brain. If you become angry or frustrated, allow someone else to take over for a while. If you are alone, put the baby down in a safe place, such as the crib, and go to another room for a few moments. This will give you time to collect yourself. Then you can return to your baby and try a different tactic to comfort your baby.
Behavior Changes
A change in behavior may be one of the first signs of illness in a newborn. Although a baby's activity level, appetite, and cries normally vary from day to day, even hour to hour, a distinct change in any of these areas may signal illness.
Generally, if your baby is alert and active when awake, is feeding well, and can be comforted when crying, occasional differences in these areas are normal. Consult your baby's doctor if you have concerns about your baby's behavior. Some behavior changes may indicate an illness is present, including the following:
- Listlessness or lethargy. Lethargic or listless babies appear to have little or no energy, are drowsy or sluggish, and may sleep longer than usual. They may be hard to wake for feedings and even when awake, are not alert or attentive to sounds and visual stimulation. Sometimes, this can develop slowly and a parent may not notice the gradual change. Lethargy may be a sign of infection or other condition, such as low blood glucose (sugar). Consult your baby's doctor if your he or she becomes lethargic or has a change in activity level.
- Poor feeding. Feeding problems may include difficulty with a baby's suck at the breast or bottle, lack of hunger, problems with spitting up, and weight loss.
- Feeding difficulties due to a sucking problem may show up when a baby starts out at birth with a strong, vigorous suck and gradually become less effective at feedings over time, or when a baby starts out with a weak suck and does not eat effectively. This is especially common if he or she was born prematurely. Babies with a weak suck may not pull strongly or have a good latch while breastfeeding. The mother may not hear the baby swallowing or gulping during feedings. A mother's breasts may not feel full right before a feeding or she may not notice her breasts getting softer (emptying) after a feeding. Bottle-fed babies with a weak suck may need the bottle nipple "worked" or pumped to stimulate a suck. Feedings with either breastfed or bottle-fed babies with a weak suck may take a very long time, often more than 45 minutes.
- After the first day or so, most newborns are ready to eat every 3 to 4 hours and show signs of hunger by sucking on fingers or a hand, crying, and making rooting motions. A sick baby may refuse feedings. A baby who sleeps continuously and shows little interest in feeding may be ill.
- Spitting up and dribbling milk with burps or after feedings is fairly common in newborns. This is because the sphincter muscle between the stomach and the esophagus (the tube from the mouth to stomach) is weak and immature. However, forceful or projectile vomiting, or spitting up large amounts of milk after most feedings, can indicate a problem. In formula-fed babies, vomiting may occur after overfeeding, or because of an intolerance to formula. In breastfed or formula-fed babies, a physical condition that prevents normal digestion may cause vomiting. Discolored or green-tinged vomit may mean the baby has an intestinal obstruction.
- Weight loss up to about 10% of birthweight is normal in the first 2 to 3 days after birth. However, the baby should reach his or her birthweight by 10 or 11 days old. Signs a baby is not gaining weight may include a thin, drawn face, loose skin, and a decreased number of wet or soiled diapers. Most doctors want to see a newborn in the office at the end of the first week to check his or her weight. Lack of weight gain or continued weight loss in a young baby may be a sign of illness or other conditions that need to be treated.
Feeding problems can be a sign of other conditions and may lead to serious illness if untreated. Consult your baby's doctor if your baby has any difficulties taking or digesting feedings.
- Persistent crying or irritability. All babies cry?this is their only way of communicating their needs to you. Babies also develop different types of cries for different needs, including hunger, sleepiness, loneliness, in need of a diaper change, and pain. At first, parents may not know how to interpret cries, but they usually can console a baby by meeting those needs. However, a baby who is continuously fretful and fussy, or cries for long periods, may be ill. Also, a baby may be very irritable if he or she is hurting. Colic, a common intestinal problem, can cause babies to cry inconsolably. Jitteriness or trembling may also be signs of illness.
Examine your baby carefully to make sure there is not a physical problem, such as clothing pinching the baby, or a diaper pin sticking the baby. There may be a thread or even a hair tightly wound on a finger or toe. Look at the baby's abdomen for signs of swelling. Consult your baby's doctor promptly if your baby is crying for longer than usual or has other signs of illness.
Infant Play
What can I do to help promote play in my infant?
While all children are different and may enjoy different toys and interactions, the following are suggestions for activities and toys for the infant:
- Hang brightly colored objects near your infant
- Hang mobiles with high-contrast patterns
- Sing and talk to your infant
- Play music
- Rock your infant, take him or her for walks
- Likes bright objects
- Enjoys pictures and mirrors
- Likes rattles
- Enjoys infant swing
- Enjoys car rides
What you can do as a parent:
- Sing and talk to your infant
- Play music
- Rock your infant, take him or her for walks
- Likes brightly-colored objects
- Likes to hold toys
- Enjoys rattles or bells
- Likes swings and strollers
What you can do as a parent:
- Talk to your infant
- Encourage your infant to crawl and sit by placing him or her on the floor
- Enjoys large toys with bright colors that move
- Likes to play peek-a-boo
What you can do as a parent:
- Call your infant by name
- Speak clearly to your child and encourage different sounds
- Name body parts, foods, and people
- Tell your infant simple commands
- Play pat-a-cake
- Begin saying words that tell what you are doing
- Encourage your infant to crawl by placing toys beyond his or her reach
- Enjoys looking at books
- Likes hearing sounds of animals
- Enjoys large toys that can be pushed and pulled
What you can do as a parent:
- Take your infant to different places and outings
- Play ball with your infant
- Read to your infant
- Tell your infant names of body parts
- Birth to 6 months:
- Mobiles
- Mirrors that will not break
- Music boxes
- Bells and rattles
- Stuffed animals
- Swings
- 6 to 12 months:
- Blocks
- Brightly colored toys
- Books
- Balls
- Cup and spoon
- Jack-in-the-box
- Rattles
- Teething toys
- Toys that can be pushed and pulled