First Days Home

Summary

Give new parents the information they need for their baby’s first weeks at home. Our new 2003 edition includes updated information about car seats, the benefits of breastfeeding to the mother, milk and soy-based formulas, using a dishwasher for bottle sterilization, bathing tips, SIDS prevention, taking the baby’s temperature, safety issues including ‘shaken baby syndrome’, cesarean recovery, and the risk factors for postpartum depression. A diversity of families are shown throughout the video. The video is divided into color coded chapters so viewers can locate information easily. They’ll find this video an invaluable reference they’ll want to watch again and again.

Chapters Include:

1. Your Baby's Appearance
2. Breastfeeding
3. Bottle Feeding
4. Sleeping
5. Crying and Comforting
6. Bathing, Diapering and Dressing
7. Your Baby’s Health
8. Your Baby's Safety
9. Caring for Yourself
10. Working as a Family

Details

• Molding
  • Head slightly mis-shaped after passing through birth canal
• Fontanelles
  • "Soft spots" that allow brain to grow
• Cross-eyed
  • Eye muscles not fully developed
• Vision
  • Baby's can see objects 8-15 inches away
• Eye color
  • Born with blue eyes
  • Color changes after a few months
• Breathing
  • Babies breathe through noses
  • Swollen nasal passages lead to stuffy breathing sounds
• Swollen Genitals
  • Babies born with swollen genitals
  • Swelling goes away after a few days

• Bonding
  • Creates bond between mother and child
• Provides Protection
  • Fewer ear and lung infections
  • Less diarrhea and related illnesses
  • Less likely to develop allergies
  • Lowers risk of developing
    • Juvenile diabetes
    • Chronic digestive disease
    • Neurological diseases
    • Certain forms of cancer
• Colostrum
  • Develops first few days after birth
• Stimulate Milk Production
  • Frequent nursing
  • Quick shower
  • Warm compresses on breasts
• Feeding Positions
  1. Cradle hold
     • Cradle baby's head in crook of arm
     • Baby's back rest on forearm
     • Hold buttocks in palm of your hand
     • Place a pillow in lap for support
  2. Football hold
     • Tuck baby's body between your body and arm
     • Use a pillow for support
  3. Side lying
     • Lie in a bed side by side with your baby facing you
  4. Cesarean birth
     • Football hold best choice while you recover
• Latch
  • Proper latching technique
    • Baby needs nipple and areola in mouth for milk transfer
  • Improper latch on
    • Common cause of sore nipples
  • Baby positioning
    • Tickle baby's lower lip with nipple
    • Baby's mouth is open, pull baby toward breast
    • Moving jaw indicates good sucking
    • Stimulate nursing by rubbing baby's back
    • Baby's nose and cheeks should be touching breast
  • Break Suction
    • Slide finger along the nipple into the baby's gum
    • Break the suction
    • Do not pull right out of baby's mouth
  • Poor sucking position
    • Spend time making sure you and baby are properly positioned to avoid sore nipples
  • Nipple soreness
    • Express breast milk and rub into nipple tissue
    • Consult healthcare provider about use of lotions or medications for your nipples
• Feeding Schedule
  • Babies normally eat every two to three hours
  • Baby Hunger Indicators
    • Bringing hands to the mouth
    • Rooting or sucking motions
    • Becoming very active
  • Encouraging Tired Baby to Nurse
    • Change their diaper
    • Gently rub back, head or bottom of feet
• Burping
  • Nurse baby with 1st breast and then burp
  • Burping Your Baby (I)
    1. Place your child across your lap or shoulder
    2. Pat baby's back
  • Burping Your Baby (II)
    1. Sit newborn sideways in your lap
    2. Pat while you hold baby's chin with thumb and forefinger
• Finished Nursing
  • Baby will fall asleep
  • Turn away
  • Encourage nursing if baby gets just a little milk
    • Rub baby's head
    • Change positions
    • Wiping baby's face with a wet washcloth
• Alternate breasts
  • Most newborns don't empty the 2nd breast as well as the 1st
  • Place safety pin on bra strap for next feeding
• Indications that baby is getting enough milk
  • Six or more wet diapers and one stool each day
  • Baby should look relaxed and content
• Nutrition
  • Babies get all nutrition from breast milk
  • supplemental bottles of formula or water not needed
  • AAP recommends breastfeeding for 12 months
• Benefits for the breastfeeding mother
  • Quick return to pre-pregnancy weight
  • Reduce risk of certain cancers
  • Reduce uterus faster
  • Build bone strength
• Returning to work
  • Express and store breast milk
• Contacts for Questions/ Difficulties
  • Lactation consultant
  • Nurse
  • Childbirth educator
  • Healthcare provider

• Formula
  • Guidelines
    • Baby needs to be on formula for first year of life
    • Cow's milk is not adequate: do not use
  • Varieties
    • Soy based formula
    • Milk based formula
    • Iron fortified formula
  • Forms
    • Ready to use
    • Concentrated liquid
    • Powder
  • Mixing
    • Concentrate and Powder are mixed with water
    • Remove impurities from the water by boiling it
    • Let water cool, then add to concentrate or powder
  • Bottles and Nipples
    • Wide selection each with advantages and disadvantages
    • Many try a few types before making a choice
  • Mixing and Storing Formula
    • Follow directions on manufacturer's package
  • Refrigerated Formula
    • Place in a container of hot water
    • Test temperature on your wrist
    • Turn bottle upside down to test formula flow
    • Never microwave formula
• Feeding
  • Position
    • Hold baby in semi-reclining position
  • Burping
    • Burp baby after every one to one and a half ounces
    • Babies usually spit up while burping
    • Alternate feeding position for eye muscle development
  • Cleaning bottle
    • Chlorinated water: hand wash nipple or clean them in the dishwasher
    • Non-chlorinated water: hand wash utensils and boil
  • Frequency of feeding
    • Babies eat every three to four hours
    • Take three to four ounces at each feeding
  • Demand Feeding
    • Babies will let you know when they are hungry
    • Make sure to schedule a feeding every three to four hours

• Unpredictable Sleeping Patterns
  • Day and Night
    • Babies don't know the difference
    • Makes it difficult to make baby sleep more, less or at certain times
    • Help baby learn by designating feeding time and play time
  • Noises
    • Baby does not need to be in quiet surroundings to sleep
    • Ordinary noises are not disturbing
    • Can encourage your baby to be awake during the day and sleep at night
• Sleeping
  • Crib
    • Put baby to sleep in crib or bassinette
  • Techniques to Help Baby Sleep
    • Holding and rocking
    • Playing soothing music
    • Singing softly
  • Positioning
    • Healthy full term babies should sleep on their backs
    • Healthy babies should not sleep on stomachs
    • If newborn has had problems with breathing, swallowing, or vomiting, check with healthcare provider

• Crying
  • Baby Communication
    • Hungry
    • Tired
    • Over excited
    • Frustrated
    • Wet
    • Too warm or cold
    • Lonely
    • Sick
    • Answer cry to determine what's wrong
• Comforting
  • Touching and cuddling
    • Use a sling or carrier
  • Swaddling
    • Wrapping baby in a warm soft surface
    • Helps baby sleep
    • Keeps away drafts
    • Holds baby securely
  • Rocking
    • Calms crying
  • Rhythmic tones
    • Soft music
    • Recorded heartbeat
    • Fan
    • All calm crying
  • Sleeping while in motion
    • Take baby for walk outside
    • Ride in the car
    • Do not get baby in habit of getting into car to calm crying or sleep
  • Colic
    • Extreme fussiness or crying that usually occurs at the same time each day
    • No known cause
    • Begins two weeks after birth and disappears after 3-4 months
    • If baby is very fussy and difficult to comfort contact healthcare provider
  • Parental Frustration
    • Take a break from baby
    • Allow friend or relative to take over
    • Contact healthcare provider for more suggestions
  • Shaken Baby Syndrome
    • Do not shake baby
    • Shaking can cause permanent damage or death

• Bathing
  • Frequency
    • Baby does not need a bath everyday
    • Diaper area should be cleaned regularly
    • Wash face, neck and hands daily
• Sponge Baths
  • Given until umbilical cord falls off and heals
  • Gather supplies
    • Mild soap
    • Tearless shampoo
    • A large towel
    • Washcloths
    • Clean clothes
    • Diaper
  • Rules for washing baby
    • Keep them safe
    • Keep them warm
    • Wash from clean to dirty, face first, diaper last
    • Bathe baby first then shampoo to avoid heat loss
  • Steps for washing baby
    1. Wrap baby in towel or hooded receiving blanket
    2. Reveal only parts that are being washed at that time
    3. Wash baby's eyes and face with washcloth and water
    4. Wash outside of baby's ears
    5. Do not put anything inside baby's ears not even cotton swabs
    6. Clean from neck down with soap
    7. Clean the neck
    8. Wash chest, tummy, under the arms, hands and back
    9. Dry and put shirt on upper body
    10. Clean legs and feet
    11. Clean diaper area
        • Vagina
          • Wash from front to back
          • Vaginal discharge is normal
        • Circumcised Penis
          • Appears red for first few days
          • Normal to notice a yellow coating
          • Call Healthcare provider if redness persists, penis swells, or crusted sores appear
          • After cleaning, apply a lubricant
        • Uncircumcised Penis
          • Do not pull back foreskin
    12. Umbilical Cord
        • Use alcohol on cotton ball or swab
        • Clean around base and over the surface
        • Area should not be red or inflamed and should not have drainage
        • Falls off within 10-15 days: Normal to see discharge
        • Clean at every diaper change
    13. Shampoo
        1. Wet newborn's hair with washcloth
        2. Massage shampoo into scalp
        3. Rinse with wet washcloth
        4. Pat dry with towel
        5. Cover baby's head with blanket or towel
• Diapering
  • Stool
    • Meconium
      • Passed during 1st 24 hours
      • Greenish black, sticky substance
    • Color
      • May appear green or brown and eventually turn yellow
    • Breastfed Babies
      • Soft, odorless, golden colored stool
    • Bottle fed Babies
      • Formed, smellier dark stool
  • Disposable Diapers
    • Start with Newborn Size
    • Lining
      • Thicker lining in different places for boys and girls
    • Leak prevention
      • Elasticized waist and leg bands
  • Cleaning Diaper area
    • Clean diaper area with soft cloth and warm water
    • Clean umbilical cord with Alcohol
    • No need for powder or lotions since baby's skin has natural oils
  • Diaper Rash
    • Expose baby's bottom to air
    • Contact health care provider if rash lasts longer than 2 days
    • Ointments and creams may be recommended
• Dressing
  • Choosing clothing
    • Make choices that are easy for you
    • Loose shirtsleeves are easy for baby's hands
    • Front fastening clothing eliminates turning baby
    • Materials that stretch make it easy to dress baby
  • Seasonal Dressing
    • Summer Dressing
      • t-shirt and diaper should be enough
      • Choose cotton over synthetic materials
    • Winter Dressing
      • Dress baby in same amount of clothing you would wear
      • Add one more layer and a hat for extra protection
    • Bed time
      • One piece sleepers
      • Pants with feet

• PKU
  • Serious disorder called Phenylketonuria
  • Blood test done at hospital or soon after discharge
• Jaundice
  • Appears as a yellow tint in the skin
  • Caused by bilirubin
  • Appears 2nd or 3rd day after birth, peaks, then goes away
  • Contact healthcare provider if baby looks yellow or tan
  • Mild jaundice is harmless
  • Bilirubin levels are high, baby treated in an isolette with phototherapy
• Healthcare Visits
  • Limit exposure of baby to other children and anyone that is sick
  • Great time to ask questions
• Immunizations
  • Some receive 1st immunization at hospital
  • Immunization schedule
    • Begins two weeks after birth
    • One month
    • Two months
    • Four months
    • Six and Nine months
    • Second year
    • Between four and six years
  • Need to keep record of immunizations
• When to Call for Help
  • A temperature above one hundred point four or below ninety-eight degrees Fahrenheit
  • The baby's breathing changes
  • The baby is vomiting
  • The baby's skin has turned yellowish
  • Your baby refuses to eat through two or more feedings
  • Your baby has had watery diarrhea three to four times
  • Your baby does not urinate for eight hours
  • Your baby is unusually sleepy and difficult to wake up
  • Keep a list of important numbers by the phone
• Temperature Taking
  • Rectal temperature
    • Ask your healthcare provider for instructions
  • Auxiliary Temperature
    • Hold baby on lap
    • Insert bulb of thermometer in either armpit
  • Glass thermometer
    • Not recommended because they are harmful if broken
  • Digital Thermometer
    • Follow manufacturer's instructions carefully
  • No oral temperature taking
• Nail Care
  • Baby's fingernails grow rapidly
  • Use emery board to file them
  • Do not bite or clip the nails
  • Try to file nails when baby is asleep

• Bath Safety
  • Never leave newborn alone in tub, sink or around water
  • Check temperature of bath water on wrist
  • Keep one hand on baby, wash with the other
• Crib Safety
  • Crib should have slats no more than 2 3/8 inches apart
  • Corners should be rounded
  • Crib should be free of posts, knobs, splinters, cracks, and lead based paint
  • Crib should be in overall good condition
  • Inherited crib should comply with requirements
  • Crib's mattress should fit snugly with no gaps
  • Bumper pads should not be used
  • Mattress should be lowered before baby begins to sit up
  • Pillows and toys should not be in crib
• Toy Safety
  • Toys should be free of small parts
  • Toys should be age appropriate
  • Check with Consumer Product Safety Commission for any recalls
• Car Seat Safety
  • Use a car seat to protect your child
  • Required by law once you leave the hospital
  • Check for sticker “Meets Federal Motor Vehicle Safety Standard”
  • Inherited Car Seat Guidelines
    • Less than 6 years old
    • Has all its parts and instruction manual
    • Has never been in a crash
    • Has not been recalled, and if so, recall has been repaired
  • Infant Seats
    • Installed in the rear facing position
    • Weight: 20-35 pounds
  • Convertible Seats
    • Used for infants rear facing
    • Used for children front facing once weight requirements permit
  • Booster Seats
    • Front facing seat
    • Weight: 40 pounds until time child can be restrained properly with a seat belt
  • Rear facing guidelines
    • Children fewer than twenty pounds
    • Children less than a year old regardless of weight
    • As long as seat allows since it is safest position for a child
  • Installation
    • Make sure seat is compatible with your car
    • Read car seat and vehicle's owner's manual before installation
    • Car seat shoulder strap should be at or below child's shoulders
    • Straps must fit snugly
    • You should not be able to twist fingers underneath strap or pinch excess webbing
    • Do not overdress baby
    • Use rolled receiving blanket for head support
    • Make sure seat belt is tight around seat
    • Use a locking clip if seat belt is not tight
    • LATCH
      • Lower anchors and tethers for children
      • Self contained, do not need car's seat belt
    • Air bags
      • Never put infant in front seat with air bag
      • Consult instruction manual for side airbags
    • Never leave a child alone in a car
    • Contact National Highway Safety Administration for help with car seat installation

• Uterine Cramps
  • Menstrual like cramps that occur after delivery
  • Stimulated by breastfeeding
• Uterine Massage
  • Decreases Post Partum Bleeding
  • Press in lower abdomen in circular motions
  • Do massage 3-4 times per day for 3-4 days
• Lochia
  • Vaginal discharge of blood after birth
  • Starts heavy and gets lighter about six weeks after birth
  • Should not have foul odor
  • Call Healthcare provider with questions
• Episiotomy
  • Incision to widen birth canal
  • Apply ice pack to area
  • Sitz bath to relieve soreness
  • Shallow tub of water to relieve pain
• Hemorrhoids
  • Swollen blood vessels around anus
  • Avoid constipation
  • Witch hazel to reduce soreness
• Kegel Exercises
  • Tighten pelvic floor muscles
  • Contract muscles used to stop urine flow
  • Ten kegels in a set and 3-5 sets everyday
• Cesarean Birth
  • Avoid lifting heavy objects
  • No strenuous exercise
• Engorgement
  • Breasts feel tender, full and hard
  • Wear a supportive bra
  • Apply ice packs
• Night Sweats
  • Body's ways of releasing retained fluid
  • Occurs for two to three days after delivery
• Reasons to Call Healthcare Provider
  • Increased vaginal bleeding or passing a large clot
  • Foul smelling vaginal discharge
  • Fever above 100.4° or flu-like symptoms
  • Burning, bloody or frequent urination
  • Phlebitis, which is a tender red area on the leg that feels warm
  • Painful breasts with red spots or streaks
• Baby Blues
  • Causes
    • Changes in hormonal levels
    • Coping with a physical recovery
    • Poor eating habits
    • Fatigue
    • Lack of sleep
    • Inexperience or lack of confidence with newborn babies
    • Loneliness or isolation from other adults
    • Constant full time demands of an infant
  • Begin as soon as three days after birth and last two weeks
• Post Partum Depression
  • Risks
    • you or a family member has a history of depression or mental illness
    • you had a complicated or difficult labor
    • you have a lack of social support
    • you have experienced a recent life changing event such as the loss of a loved one or job
  • Symptoms
    • Excessive worrying or crying
    • Extreme changes in appetite
    • Inability to sleep
    • Inability to care for your baby or yourself
  • Talk to a healthcare professional if you experience any symptoms
  • Join a support group to ease tensions
• Nutrition
  • Follow food guide pyramid when making food choices
  • Breastfeeding moms need 500 more calories a day
• Healthcare Appointment
  • See doctor 6 weeks after delivery
  • Discuss whether or not should continue taking prenatal vitamins
  • Discuss instituting new exercise routine

• Enjoy time as a Family
  • Family and friends should support mom by helping out
• Single Mom
  • Make sure you have assistance
  • Avoid long visits
• Renew Relationship
  • Spend time with baby's father
  • Sex
    • Wait 3-6 weeks before resuming sex
    • Birth Control
      • Breastfeeding moms still need to protect themselves
      • No hormonal methods
      • Use spermicide or condoms
      • Diaphragm and Cap need new one fitted
• Ask Questions of Healthcare Team