Appointments: (830) 379-6300
520 East Donegan Street, Seguin,TX 78155
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Happy Baby

Newborn Care

General Comments: It has been our experience that most parents encounter the greatest difficulties with their new offspring in the first few weeks and months of life. Babies do the most incomprehensible things! Your infant will act like no other infant about which you have read or heard and create situations for which none of your previous experience or advice offers a solution. Because the baby's actions are different, they are concerning for parents. In fact, the chances are that most, if not all of baby's actions are completely normal.

Below is a discussion of the most common questions/issues we hear about from parents. The list is alphabetical and the topics are listed as follows:

Breathing Diarrhea Smoking
Burping Eyes Sneezing
Circumcision Fever Soft Spot
Clothing Fussy Times Stools
Colic The Head Umbilical Cord Care
Congestion Hiccups Vaginal Discharge
Constipation Jaundice Visitors
Cough Outdoors Vomiting
Diaper Rash Rashes Weight Loss
Diapers Sleeping

Breathing: Infants snort and breathe heavily and irregularly. Sometimes they breathe quickly and sometimes have pauses in their breathing for up to ten seconds. These are normal reactions that will disappear when the baby develops the normal rhythm of breathing and when the centers of breathing muscle control develop in his brain. See also Congestion

Burping: You should burp your baby after feeding on each breast or after every one to two ounces of formula. Don't worry if the baby doesn't burp with each attempt. If there is any air in the stomach, it will come out with burping.

Circumcision Care: The area of the circumcision is usually very red, with a yellow-to-white discharge on the surface of the head of the penis. Do not try to remove the discharge as it is important to the healing process. This resolves over about a week's time. The area should be kept clean. Vaseline applied to the front of the diaper can be used to protect the area. Watch for any swelling or bleeding and call if they occur.

Clothing: Your baby should be dressed comfortably for the weather and conditions. Overdressing can cause heat rashes and, in younger infants, an elevation of the temperature. Underdressing obviously leaves infants in a situation where they might become cold. Both are best avoided by dressing your baby sensibly.

Colic: See Fussiness.

Congestion: Many infants breathe noisily and sound "stuffed up". This is usually normal. The reason is that newborns are what we call "obligate nose-breathers"รข€"they must breathe through their noses. In addition, babies' noses are small and babies breathe much faster than adults. When you combine all of these things, the result is that infant breathing can be loud and sound stuffy. If there is no cough or runny nose, or trouble breathing, this is normal.

Constipation: See "Stools".

Cough: Coughing is not normal. If your newborn baby coughs more than a few times a day, call us. Occasionally, your baby may cough or choke during feedings. This is normal as he or she gets used to eating. Simply sit them up and pat their backs until the episode passes. If choking happens with every feeding, call us.

Diaper Rash: Most infants will get a diaper rash at some point. Usually the first rash is an irritation-type of rash on the bottom that appears at about 4-5 days of age. This looks like red, raw skin and is caused by irritation from frequent stooling. Simply apply a barrier-type diaper cream (Desitin or A&D) with every diaper change and avoid diaper wipes until the rash goes away. If the diaper rash is not better in 3-4 days, call us.

Diapering Issues: Change your baby's diaper as soon as possible after each bowel movement or wetting. The area can be washed with a soft cloth and soap and water. Diaper wipes may be used at any age is intact and not irritated. After cleaning, rinse and pat dry with a soft, clean cloth.

There is little evidence to suggest that one type of diaper, cloth or disposable, is superior to the other. A good diaper service remains an excellent option. Disposables provide convenience, but washing one's own diapers is certainly the most economical option. We suggest that you make the decision based on your own needs and instincts. If you do wash you own diapers, use a mild detergent and do not use fabric softener.

Diarrhea: See "Stools".

The Eyes: The baby's eyes close tightly when exposed to light and frequently he may look cross-eyed. The infant is simply not used to light and hasn't learned to use both eyes together. This goes away by about 2 months of age.

Frequently, newborns get a discharge in the corners of their eyes. This is caused by a blocked or small tear duct. This duct will grow and start to work normally after several weeks to a few months. Simply wipe away the discharge with a warm, moist cloth. If the eye becomes red and/or swollen, call us.

Fever: If your baby has a fever in the first two months, we need to know about it! Small babies are unable to express themselves like older children and adults when they have infections, so a careful examination and blood tests are needed to make sure the fever is not due to a serious infection. We define a fever as a temperature of 100.5 degrees F (38 degrees C) or higher rectally. It is not necessary to take your baby's temperature unless he feels warm. We recommend using a standard digital thermometer and taking the temperature in the rectum. We do not recommend "ear thermometers", as they can be very inaccurate in infants and are more difficult to use correctly. Also, mercury thermometers can be dangerous and should be disposed of properly.

Fussy Times (Colic): All newborn babies have some time each day when they are fussy even though fed and dry. The most common time for this to occur is late afternoon or early evening. A fussy time can last one hour or four or five! No one is completely sure of the cause, but when it gets more severe it is known as colic. Colic begins at about 2 to 3 weeks of age and always goes away by 3 months. We do know that after 6-8 weeks, the periods become shorter and less frequent. The presence of gas that results from swallowed air while crying often adds to the fussiness. There are a number of things you can do to help both you and your baby get through this time more easily.

  • Holding, soothing, comforting. You can't spoil a newborn baby by picking him up when he's unhappy.

  • Increased sucking time. The use of a pacifier during the first few months can help satisfy the need for extra sucking. Parents are often reluctant to offer a pacifier, as they don't want to start a long-lasting habit. An advantage of a pacifier is that it can be used during these first few months when the sucking need is strongest and can then be tossed out.

  • Swaddling the baby, by wrapping the infant snugly in a blanket-or the opposite-giving the infant the space and freedom to move about.

  • Rocking, or a swing, or a ride in the car. If the baby's head is well supported, they can stay in a swing as long as they enjoy it.

  • Something to listen to: music, your heartbeat, a vacuum cleaner, a music box.

  • Getting to know your baby's special likes. Gentle body massage may help relaxation occur. Each solution may help for a short time; then it's time to try another one!

  • Mylicon (simethicone) Drops: These drops are supposed to relieve gas pains. In our experience, they are usually not all that helpful. However, they will not hurt the baby and you may try them if you wish.

  • Rarely, a formula problem leads to fussiness. Please do not change formulas without calling us first.

The Head: The baby's head seems remarkably large, larger than his chest. It may be lopsided or egg-shaped because, in being born, his head, with its very soft bones, had to be molded to the shape of the birth canal in order to pass through it. The head eventually assumes a normal shape. There are two soft spots, or fontanels, one in the front and one in the rear. These allow the skull to grow. The rear spot closes at about three months and the front one between fifteen and eighteen months. These soft spots are protected by a tough membrane, so do not be afraid to touch them. The soft spots may bulge slightly or appear slightly sunken depending on the baby. This is usually normal, but if your baby is not acting right, call us.

Hiccups: Hiccups are normal and represent your baby's immature control of his or her muscles.

Jaundice: This is also known as "yellow jaundice" and is fairly common. It happens when babies start to break down some of the blood cells that they used in the womb but now no longer need. The jaundice usually peaks at around 4 to 5 days of life. As the jaundice level in the body goes up, the yellow color starts on the face and spreads to the toes. If your baby develops a yellow or orange color to the skin on more than just the face, please give us a call.

Outdoors: Babies can be taken outside whenever the weather is pleasant. In the winter, remember that you might want to warm your car before going for a ride. This is especially true on the ride home from the hospital.


  • Some infants develop a fine scale or crust on the scalp, called cradle cap. This frequently comes and goes and is very common. Use a fine comb or a little Vaseline on the scalp. If it becomes thick, call us.

  • Often pin head size pimples with white tops will form on the forehead and the bridge of the nose and face. This is called milia and is caused by little oil glands that have become blocked. No treatment is necessary, and they will soon clear up.

  • Many infants will develop a rash on the face that may come and go and eventually clears up. This is known as newborn acne and is caused by the mother's hormones circulating in the baby's body. No treatment is needed for this problem.

  • Frequently, small red marks appear over the eyelids, nose, and nape of the neck. These are birth marks and will eventually disappear.

  • Some infants develop a red rash with white centers that resemble insect bites. These may appear and disappear in bunches in the first two weeks. This is a normal rash and nothing to be concerned about.

Sleeping: Newborn babies do a lot of sleeping, sometimes as much as twenty or more hours per day. Sleeping on the back provides the best combination of comfort and safety. It is very important that newborns not sleep on soft mattresses, lamb's wool, or pillows as suffocation has been known to occur. Whether your infant should be wrapped snugly is an individual preference. Some very fussy infants do better if they are tightly wrapped while others are fine with just loose covers.

Smoking: Recent studies have indicated that some children's upper respiratory illnesses, asthma, and ear infections are linked to second-hand tobacco smoke. In addition, newborns exposed to tobacco smoke are at increased risk of SIDS (crib death). Parents are strongly encouraged to stop smoking and to avoid smoke-filled environments, especially automobiles and homes. If parents or other household members do smoke, this must be done OUTSIDE!

Sneezing: The baby may sneeze when his nose is stuffed, but this is just his way of blowing his nose and is nothing to worry about.

Soft Spot: See "The Head".

Stools: Stool frequency varies considerably. Some babies have a stool with each feeding, while others will sometimes go days between stools. The appearance of the stools will vary with the type of feeding. Generally, a newborn's stool has a yellow, watery consistency. Many infants will cry and strain when having a bowel movement. This is normal, as babies haven't yet learned how to "poop efficiently" by bearing down.

  • Constipation: If your baby is passing hard, pellet-like stools, then he is constipated. If the stools are soft, there is NO CONSTIPATION, no matter how often the baby stools. Breastfed babies never get constipated. If your newborn is constipated, add 2 tablespoons of Karo Syrup into each 4 ounce bottle of formula until the stools are soft; then, slowly decrease the amount of Karo until it is all gone.

  • Diarrhea: With diarrhea, the stools will be frequent and watery. Please let us know if this is the case.

Umbilical Cord Care: No specific care is needed for your baby's umbilical cord area. You do not need to apply alcohol to the cord area. The cord usually falls off after 1-3 weeks. When this happens, you may notice a blood-tinged discharge, which is normal. Call us if you notice a strong odor or redness around the navel.

Vaginal Discharge: Girls may have a bloody, mucousy discharge from the vagina in the first few weeks of life. This is normal and will soon subside. This is due to the effect on the baby's womb of mother's hormones carried over to the baby's blood stream.

Visitors: There are many people who are interested in you and your baby and who may want to spend time hugging and holding him or her. We urge you to use common sense and limit the number of people coming into contact with your baby. It is very difficult to know who might be sick or carrying some virus that could infect your baby. Please have people wash their hands before holding your baby, as this is the best way to prevent the spread of germs. It is especially important to avoid children during the first eight weeks of life. Obviously, siblings are a different matter and they may need special attention and time with your new baby.

Vomiting: Vomiting in the new baby is a disturbing condition that often doesn't indicate disease. The spilling over of a mouthful or two of milk after a feeding is not true vomiting. It is only an indication that the baby has taken a little more than he can hold and is getting rid of the excess. Sometimes this may continue for an hour or more after a feeding. It does not mean that the feeding, whether breast milk or formula, does not agree with the infant. Occasionally true vomiting occurs where all or part of a feeding shoots out under pressure. It may be due to overfeeding, swallowed air, the wrong position in nursing, or similar mechanical difficulty. If this type of vomiting persists, please call us.

Weight Loss: The average newborn infant weighs between six and nine pounds. Over the first few days of life, your infant will lose weight; the bigger he or she is the more he or she will lose. This is because newborns usually lose up to 7% of their birth weight before they begin to gain.