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ABOUT BABIES SUMMARY
- Baby will need nappies, blanket, warm clothes/hat, singlet
- Car seat baby capsule is for birth - 6 months and is rear facing, going in the back seat
- Relate babies to yourself, eg you sometimes take a short time or a long time to eat your meals.
- Lots of bibs are handy if you have a baby that spills a lot
- A bath in pm tires them out and may help them go off to sleep more easily. If you don't have time, you don't have to bathe them every day just give their face then bottom a wash
- Leave the cord out of nappy to allow to dry
- Motions are green/black colour, called meconium, for the first 1-2 days then changes to a mustard colour. Formula fed babies have light brown/clay coloured motions
- Expect about 6-8 wet nappies/24hrs. Until toilet trained (around 2yrs old), you have approx 7000 nappies that will need changed!
- Weight may go down (up to 10% loss) in first 3 days, then they regain their birth weight in approx 10 days. All babies are different so talk to someone if worried.
- Rough guide re weight 6 months double birth weight and by 1 year 3x birth weight
- Growth indicators for newborn babies: Baby feeds 8 x day, urine clear colour and have 6-8 wet nappies/24hrs. Alert when awake, increased weight and length
- Breast milk is all babies need in the first 6 months
- Newborn babies need one more layer of clothing than you do. Check their temperature using your 2 fingers down their back in-between shoulders, this gives you an idea of their core (central) temperature.
- If using a heater it should have a thermostat. Some gas heaters give off toxic fumes
- Keep cots away from windows as there will be draughts
- If wanting immunisations, these usually start at 6 weeks of age. Hepatitis B and BCG vaccines can be given to shortly after birth.
- Wind can cause abdominal discomfort in babies. It is important to try winding them after feeding. Wind could be due to the baby feeding fast and also sometimes diet related if breastfeeding. Cabbage, leeks and onions can sometimes cause wind.
- To wind your baby try positions that put some gentle pressure on their stomach eg over your shoulder or across your knee, and rub their back at the same time. If after trying for several minutes and they won't bring up wind or they are asleep put them down. If they wake again 15 minutes later try winding again then.
Newborns sleep a lot; on average 16.5 hrs per day and most of the rest of the time they are feeding and getting cuddles. This little person is taking in a lot about their environment and learns about him or herself. They have to learn that their hand is actually attached to them and all the things they can do with it. Their eyesight isn't that great at birth. They can only see about 20-30cm and see things in black and white. Observe to see that they are following objects that are close to them. They have adult vision at three months and their eye colour can change up to 6 months of age. Their hair colour can also change, so your grey/blue-eyed baby with blonde hair may become a brunette with brown eyes.
Hearing is often better than yours, as it hasn't been damaged by loud noise. Signs that they can hear are turning their heads towards noise and getting a fright with a loud bang.
Babies are putting weight on, often doubling their weight at 6 months and tripling by a year. Consider an adult trying to do that! They also have little stomachs. An average sized baby (3.5kg) at birth only holds 20 -30mls. Thus they need to feed often, including during the night.Some babies will sleep through the night by 6 weeks (for 6-8hrs) but not many! So getting up to feed is something you have to resign yourself to. During the day try to have at least one rest time or sleep when baby sleeps.
If breastfeeding it will take time to get it sorted. It is a skill and it takes you and the baby time to learn how to do this. If you are still having problems, talk to Plunket Karitane centres, La Leche League or a Lactation consultant's ph 0800 4 Lactation or look on the LLL webiste here you will find answers to your breastfeeding and parenting questions, drawn from the various resources. Resources come from New Beginnings (publication for parents), Leaven (publication for our volunteer Leaders), Breastfeeding Abstracts (publication for professionals), our Frequently Asked Questions collection, and our podcasts. or MOH breastfeeding question page. http://www.moh.govt.nz
People will tell you that most problems get better. At the start it is hard to know what to do when your baby cries, as it can be quess work. Babies normally cry on average 1-4 hrs in total each day. This is how they communicate. It is hard for parents to listen to their baby cry. With time you get to know your baby and start to work out what they 'may' want. If unsure, work down a list: could they be hungry, tired, wet/dirty, bored or just want a cuddle. If they cry a lot, and you are concerned, always have them checked by a health professional in case it is related to a health problem or colic. See the information on colic and infant health on the Plunket website and the article on BabyWebNZ infant health.If you are finding things aren't getting better and every day is a bad day then you have to ask yourself, could I have postnatal depression? If you are in tears a lot of the time and life just isn't any fun, go talk to your midwife, plunket nurse or doctor. See the article on BabyWebNZ PND.
As a new parent conflicting advice can be difficult. If you try to read all the books re parenting you may get fustrated because there will be conflicting advice and you will be so busy reading books you will have no time to have fun with your child. Let your child also teach you. You will learn from them and talk to other new parents about any helpful hints.
There are a hundred and one books written on babies. Try to avoid any books that read like instruction manuals. Your baby is a human being so each one will be different. It is nice to have some guidelines but strict controls on your baby often won't work. If your baby is hungry feed them. Also they are going to have good and bad days like anyone else. Try to avoid "strict" routines, though a bedtime routine is helpful in letting them know it is time for sleep. Eg bath, a drink, when older read a book and a cuddle then off to bed. They will develop set sleep patterns as they get older, and just when you think you know the times they like to sleep, they change the routine or drop a sleep during the day.
Treat them as an individual and trust yourself. You are their parent and you know this baby better than anyone else. The health professional may know more about health concerns, but you know more about your own baby, you look after them more than anyone else. Everyone has an opinion on parenting. Your opinion is more important than anyone else?s when it comes to your child.
Read some common sense books. The Well Child Tamariki Ora Health book is a good resource, and this is free from your plunket nurse or LMC (midwife, doctor).
Also www.babycentre.com has a lot of useful information. BabyCenter is an online resource for expectant and new parents, filled with parenting information. You can have emails sent to you from this site each week about what you can expect your child to be doing at what age.
Every child is different but this gives you some guidelines re child development.
In the first three months they are learning to hold their head up. This is an important part in the process of learning to walk. They may even start doing baby push-ups from 3 months onwards. This is why it is important to have an awake tummy time on the floor. From around 5 months of age they learn to roll over, but sometimes they can do this from 3 months of age, so never think it is safe to leave your baby on a high surface. A major reason for admissions of children to hospital is falls. Remember, a baby falling off a bed or table is like you falling off the roof of your house!From 2-3 months they will start responding to you more with smiles and baby noises (coos, squeals and laughs). This attachment to you will continue to grow over the next months to a point when they will become scared of strangers and will not like it when you leave them.
Some children will learn to sit unsupported and then crawl as early as 6 months, though crawling normally doesn't start until around 8-9 months. They may crawl backwards instead of forwards or in strange ways. But once they have learnt to move, make sure your house is child proof.They will be jabbering a lot by now. It sounds like they are talking in a foreign language. A few words may come out of it like dada (easier to say than mama) or baba.
From 6 months, children are on solids (pureed food) as well as milk. Teeth start coming through around 6 months of age and sometimes with some tears so it is a good idea to look after them otherwise there will be more tears if they have to get fillings later. If you brush your teeth in front of your child, they will learn what to do.Try using milk teeth toothpaste (adult toothpaste often has strong tastes to it) and a brightly coloured child's toothbrush. You want them to want to do this, as they will have to do this at least two times a day for the rest of their life. Some times a musical or electric toothbrush may make tooth-brushing more fun. Try avoiding sugar and stick to water and milk for drink.
ToddlersThey are starting to understand instructions and often understand more than we give them credit for.
They may also become fussy eaters. Children can at times be fussy eaters. Keep trying them with foods that they may have refused to eat before. With time they may learn to enjoy them again. If you don't they may refuse more and more foods and you will find it hard to provide them with a balanced diet.
WalkersFrom around 10-12 months onwards they are learning to take some steps by themselves. Up till then, they often had been standing supported by something else.
One year old, the first birthday part, well in some ways a second one. When they were born was a birth-day also. This is a big day for your little one and you want to make it special. You wrap the presents, invite people, bake the cake and does your one year old appreciate it? Well they will like the wrapping paper; it's loads of fun to play with.
I saw the first birthday as a little party for me also; look we made it through the first year. Look at my wonderful child and all the things they have learnt to do in the last year.
18 months and beyondNo one warns you that terrible twos start earlier than two. There is so much we aren't warned about! I think this stage
CRYING AND SLEEP
See the article on BabyWebnz re sleep
- Research says newborns normally cry a total of 1-4hrs/day usually pre feed and pre nap (for 10mins). They often have a personal fussy time in the evening. Babies may take up to 10 minutes to settle off to sleep, may grizzle and cry before hand.
- If baby is crying consider are they hungry, have wind, wet/dirty nappy, too hot/cold, uncomfortable or lonely and wanting a cuddle. Listen to cry if very distressed, and if you are worried seek advice from a health professional. If it is colic, this usually appears second week, often worse early evening and babies draw up their legs with the discomfort.
- Newborns sleep approx total of 16-18hrs/24hrs, sleep needs decrease over the first year.
- Signs of being tired: jerky movements, grimaces, grizzling, making fists, yawning, rubbing eyes, staring vacantly into space or crying.
- Signs of wanting a feed: hand to mouth movements, fussiness, sucking action or sounds, cooing or sighing and nuzzling at breast.
EXAMINATION OF YOUR BABY
See the video on: Newborn Baby Check on the following link http://www.birthresources.org/display/BirthResources/Resources
Newborn baby check by Denise Garcia, Midwife from BirthResources. Pre-order the full DVD from the www.birthresources.org merchandise page.
When your baby is 1, 5 and 10 minutes old an APGAR score will be done.
This looks at:
- A for Activity (muscle tone) looking to see that the baby is moving
- P for Pulse, checking that the heart rate is over 100 beats per minute
- G for Grimace (reflex) baby pulls away or uses reflex actions eg cough, sneeze
- A for Appearance (skin colour) by a minute the baby's central body should be a normal pink colour. It may take a few minutes for their hands and feet to change from a blue/pale colour while their circulation system adjusts
- R for Respiration, a pink colour and crying are signs that you baby is breathing
A full examination from head to toe is also done.
Your Well Child health book will list what is examined and when. For more information also see the Ministry of Health web site www.moh.govt.nz.nsf/
See the back page of your Well Child Health book for child sickness danger signals. Remember to ring 111( New Zealand) for an ambulance if it is an emergency.
Phone number for the National Poisons Centre is 0800 764 766 NZ
Phone Healthline on 0800 611 116 NZ available 24hrs/day. Healthline registered nurses assess a person's condition and health needs and recommend the best course of action and a time-frame in which to take action. They can also provide general health information and location of services.
Phone Plunketline on 0800 933 922 24hrs/day NZ. When you call PlunketLine your call will be answered by a Plunket nurse, who can give you advice and information on your child's health
Call an ambulance on 111 NZ. The Ambulance Emergency Communication Centre can give you advice and will send an ambulance if required.
Although we never want it to happen, children and infants do have medical emergencies. These can be very stressful, especially if you are not sure what to do. Knowing how to react, and where to start, are key in keeping calm and doing the right thing.
The most critical emergency is when a child or infant's breathing stops. Often the heart stops beating as well. A range of things can stop a child breathing such as suffocation with a plastic bag, drowning or medical conditions.
Sudden unexpected death in infancy (SUDI) is when a infant dies during sleep. SUDI is the new term for SIDS or cot death. It is the main cause of death of babies.
To reduce the risk of SUDI Plunket recommends to have:
- a smoke-free pregnancy and household
- on their back for sleeping
- a clear face and head free from hazards that can lead to suffocation
- to be close to parents when asleep (in the same room)
See the article on infant and child health on BabyWebNZ
Always see a health professional if concerned about your baby's health. Some common health problems include the following:
- Infection or the flue (virsus). It is a good idea to have a thermometer to check baby's temp if you think they are unwell, (digital ones go under babies arm-pit).
- Jaundice is yellowing of the skin and eyes caused by a build up of waste products (bilirubin). It can make babies sleepy and at high levels is dangerous. Your midwife or doctor will monitor this and the baby may need to go under phototherapy lights if levels get too high.
- Infection around the fingernails called paronychia. Try cleaning with alcohol wipes from the chemist and let your midwife or doctor know about this if it doesn't get better, as sometimes your baby may need antibiotics.
- Sticky eyes can be due to a blocked eye duct. Try gentle massage of the duct with your finger. Clean the eye with normal saline solution from the chemist and drops of breastmilk into the eye can help also as this has a natural antibiotic in it. Again see your midwife or doctor if it doesn't improve or if the discharge is yellow or green in colour or the eye is inflamed.
- Thrush may be present in the mouth or the bottom of babies. If breastfeeding it can be passed from the babies mouth onto your nipples. Thrush is a fungal infection which will cause discomfort.
Please see www.kidshealth.org.nz for the following information:
- How to take a temperature
- Why take my child's temperature?
- What am I measuring?
- What sort of thermometer should I use, and how do I use it?
Most babies start toilet training around 2 years of age but will still need a nappy on at night up to 3 years of age. That will mean you have a lot of nappy changes ahead of you, approximate 7000 nappy changes. It is good to think about the type of nappies you are going to use.
See the nappy page in our BabyWebNZ shopping directory
http://babywebnz.org.nz/display/BabyWebNZ/Shopping_Hygiene and Nappies
Information on www.sydneynappywash.com.au shows how to fold cloth nappies.
- Their head is larger, compared to the rest of their body, than an adults i.e. it is 25% of total body. Babies loose a lot of heat from their head so should wear hats when going outside.
- Neck and head control is poor so you have to support their head when picking them up and feeding. When awake babies need Tummy time to learn to lift their heads up.
- Two fontanelles (soft spots) on skull, smaller closes at 8-12 weeks; larger at front within 18 months.
- 3-6 weeks may get baby acne.
- Usually do not have tears till about 6 weeks. At this time they may get blocked eye ducts.
- If your baby still has a squint after 2 weeks have this reviewed. Babies see approx 20-30cm at birth.
- Sense of colour at 2 months and have adult vision at approximately 3 months.
- Eye colour at birth grey/bluish can change in the first 6 months.
- Distinguish between light and dark and track objects.
- Love looking at faces.
- Looks flat.
- Nose breathers; sneeze to clear their nose.
- Milia may be present these are white spots on the nose (1st 2 weeks) and are from overactive sebaceous glands (oil).
- Love the smell of sweet things i.e. breastmilk.
- Rooting reflex present at birth, where they turn head and open mouth making sucking actions when stroked on cheek or mouth.
- Teeth often first appear 5 - 6 months, usually bottom two then top 2.
- Cry on average 1 - 4 hours in total/day usually pre feed and pre nap. Often have a fussy time late afternoon. It is their way of communicating. They want eg food, nappy change, winding a cuddle or they could be over tired and need sleep.
- If nothing seems to settle them and they draw their legs up they could have colic. If you are concerned about you're baby's crying, talk to a health professional.
- Recognise familiar sounds/voices, like soft rhythmic sounds.
- Turn towards noise and jump at loud bangs.
- Average is 3.5 kg at 40 weeks, may lose up to 10% of birth weight and then regain it back by two weeks of age
- Double their birth weight by around 6 months, triple at 1 year. Have growth spurts.
- Scratch their face with their fingernails may suck on fingers/thumb
- Grasp reflex, when something placed in hand will close hand and curl up fingers into a fist.
- Often swollen at birth.
- Girls can have a small bleeding discharge in the first week due to hormones from their mother.
- Normal to have 6-8 wet nappies every 24 hours
- Meconium (green/black coloured bowel motion/poo) at birth then changes to a mustard colour.
- Formula fed babies motions are more clay coloured, with a higher risk of constipation.
- May appear wrinkled, mottled or bluish at birth and becomes red within a few minutes.
- Vernix is a creamy substance that covers the baby to protect them from the amniotic fluid during the pregnancy. With full term infants this can be present in the skin creases under arms and groin area, with premature babies it may cover them.
- Lanugo is fine downy hair
- Jaundice is a yellow discoloration. If present baby may need treatment under special phototherapy lights.
- Birth Marks may be present including mongolian spots in non-caucasian babies, stork and strawberry marks
- Newborns have very sensitive skin. Nappy rash and heat rash are common.
- With nappy rash (ammonia dermatitis) avoid plastic type nappies, strong soap and laundry powders. Allow baby to have nappy off time
- Become distressed if too hot or cold. Normal body temperature is around 37c. Babies like gentle handling. You should never shake a baby.
- Feed approximately 2 - 4 hourly day and night and sleep 1 - 3 hours in-between. Total average sleep time for a newborn is 16 hours per day. As they get older they sleep for longer stretches during the night and are awake more during the day.
- Feed 2 - 4hrly and as they get older they get faster at this.
- To begin may take 30 - 45 minutes to finish a feed. They will have growth spurts when they feed more often to put on weight.
- They may spill or vomit a small amount. If they projectile vomit large amounts often, they may have a reflux problem, and need reviewed by a health professional.
TRAVELLING WITH BABY
When travelling by car
- Make regular stops, allowing your baby to move around for awhile. Babies should not be be in car seats for a long time ( ie > 1 hour).
- Insure that they don't get too hot and have a baby sunscreen on the window beside them. Dressing your baby in natural breathable clothes also helps to keep them comfortable.
- Babies usually sleep well in car seats. Most parents have heard a story of someone driving around and around the block trying to get their baby to sleep. They have even created baby products that simulate a car ride see www.sleeptight.co.nz . There is research about times babies should stay in car seats, as it is good to remember their spines are still immature. See the Land Transport Authority at www.ltsa.govt.nz
- If staying overnight book the accomodation in advance, ask for a port-a-cot and a quiet room. Most hotels don't have a normal bath but may have a baby bath available. Otherwise you can have a shower with your baby, but it is not always an easy thing to do.
Buggies and strollers
- When stopping in towns that you don't know, it can take some time finding a parents room to change a nappy. Most shopping malls have parent's rooms and are sometimes better than the public ones. I think councils should look at providing better and cleaner parent's rooms. You could always write to your council if your local town doesn't provide good facilities. In New Zealand you can also use the Plunket rooms but in smaller towns these may be only open at limited times. The Plunket web site is www.plunket.org.nz
Front and back-packs
- If you live somewhere with lots of hills a three wheeled buggy is handy. Before buying a buggy, check it can fit into the boot of the car. You may consider having a buggy in the house for walks and a stroller in the car. Some strollers don't recline enough for newborns. You can only use them once your baby has good head control and can sit up.
- With a front-pack, a newborn will usually face inwards and then again when they have head control can face outwards which they often prefer as they want to see everything. They can also see a lot with backpacks, but it also gives them easy access to pull your hair! Wearing a hat resolves this problem.
- If travelling overseas you will need to organise a passport. Taking the photo can take a few attempts. They want a front profile. Also with newborns before 6 months it's hard to know what to record for their details - Eye colour: blue turning brown, hair colour brown turning blonde. Height: changes on a daily basis and signature well that could be interesting.
- Ask the airline for a sky cot and baby food (if on solids) when you make the booking.
- Taking a tri-pillow is useful if breastfeeding. It is also good for them to sleep on. You may find that you get your baby off to sleep in the sky cot and the plane hits turbulence and you have to take them out and onto your knee with the baby seat belt on. So you may find it easier to have them sleep on the tri-pillow on our knee with the seat belt around them. The bulkhead seats have more room, but the armrests are fixed. The airlines often provide you with baby food, but ask about 10 - 15mins in advance of wanting it, as the airhostesses are often busy.
- Breastfeed or give a bottle on the take off and decent as it is meant to help reduce the pressure in their ears by having them suck. Changing his nappy in the toilets is a challenge as there isn't much room.
- What to take with you on the plane: Some airlines provide you with a few nappies and baby wipes on international flights, but best to have your own supply just in case. Some spare clothes for the baby and yourself is a good idea. Depending on their age, consider a spill resistant cup to give him water. If using a baby sedative talk to your doctor about this and any possible side effects. A digital thermometer, bibs, new toys (that he hasn't seen before), baby wipes and baby snacks go in the baby bag. You will have to consider if you plan to take your car seat, as most taxis don't carry them. Also if you have a spare seat beside you, you can bring your car seat on the plane and strap it (like the car) and have your baby sleep in it for a period of time. Talk to the staff re this first to make sure there is room
- There is a web site called flying with kids that has lots of air travel tips see www.flyingwithkids.com
- If going to a completely different time zone it will take him some time to adjust and some nights they will wake wanting to play.