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Archive for Newborn Care

Cleaning Newborn Sensitive Bits

By Jan Murray

Your newborn is tougher than you think but there are a few sensitive areas that need to be handled with a little more care. These include the ears, eyes, nose, umbilical stump, and genitals.

Cleaning the ears

Earwax is formed in the outer ear canal and travels towards the outer ear edges with jaw movement. Ear wax is assists in natural ear cleaning and lubrication and protects the inner ear from bacteria, fungi, water and insects. Problems of infection and impacted earwax arise if wax builds up in the inner ear canal. Therefore, clean the ears using a moistened cotton wool ball or soft wipe only around the outer ear folds and behind the ear; NEVER put a cotton bud or other narrow implement inside the ear canal as it can perforate the ear drum and push wax further in.

Cleaning the eyes

Clean the eyes using cotton wool balls or soft wipes moistened in clean water. Using a clean moistened piece for each eye, wipe the eye area from the nose edge to the outside. At times you may notice the eyes weeping and stuck together. This is referred to as ‘sticky eye’ and is not an uncommon or harmful condition and is usually due to blocked tear ducts that more often than not resolve themselves.

Cleaning sticky eyes

Eyes can remain sticky for several weeks and often months despite regular cleansing. It is important to keep the eyes cleansed. If you are breastfeeding, squirt a little milk into bubs eyes. This helps cleanse and protect the eye from infection. To help release the blocked tear duct, firmly massage the inner canthus area (inner end) of the effected eye. Always clear the eyes of built up matter before nursing and seek professional advice if the eye becomes red or discharge increases.

Clearing the nose and sneezing

Your newborn starts life as a nose breather. Therefore, it is important to keep the nose clear. He cannot blow his nose or cough effectively so he sneezes regularly to clear his air passages. Keep his nasal secretions moist to assist clearing. Do this by regular feeding and squirt a little water or normal saline up the nose. A humidifier may help keep air moist. When nasal secretions are moist, use a little rubber bulb purchased from a pharmacy or twist the end of a tissue and gently grip any matter at the base of the nose. NEVER push cotton buds (or anything for that matter) up into the nasal space.

Cleaning the umbilical stump

The umbilical cord changes in appearance and odour until the point of separation (7-10 days). It becomes darker, dryer and maybe a little offensive. Clean with a cotton tip applicator dipped in normal saline or cool boiled water and a little added sea-salt if gets contaminated with poo. When the area is inflammation, cleanse and protect the skin with a natural barrier cream. Continue to air and keep dry and seek professional advice if the area continues to weep or bleed for longer than a week after the dried cord stump has fallen off.

Cleaning boy bits

When wiping baby boy genital bits don’t forget to gently lift up the scrotum and wipe underneath. Change his diaper every three to four hours as urine or poop left in contact with skin for too long forms an acid that burns. Never pull back the foreskin of an uncircumcised penis as this can do harm. A daily bathe will keep this area clean and don’t stop self-discovery, it’s normal.

Cleaning girl privates

Baby girls’ vaginal area is delicate so avoid wiping deep into the inner vaginal folds. The white substance you’ll see is natural and stays to give added cleaning and protection. Gently hold the vaginal folds apart and wipe downwards with a soft diaper liner or cotton wool ball soaked in warm water. Avoid using treated cleansing wipes as these often aggravate delicate skin and mucosa and disrupt the natural PH balance. Change her diaper every three to four hours as urine or poop left in contact with her skin for too long forms an acid that burns. Always wipe the vaginal area in a downward direction to avoid wiping faecal matter into the short urethra. A discharge of blood streaked mucous may appear in the first six weeks. This is a pseudo-menstruation so just gently wipe it away, it’s normal.

Video Clip on how to bath a newborn . . .

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This article was brought to you by Jan Murray, Private Child Health Consultant an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance.

Summer with a Newborn

By Jan Murray

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The Australian summer can bring extremely hot weather that lasts for months. The heat can be humid with rain or dry with wind and no rain. Whatever kind of summer you experience the effects of hot temperatures can be stressful for you and dangerous for newborns. Keeping cool yourself helps babies feel relaxed and comfortable; try cooling down with frequent quick showers and regular cold drinks.

Newborns are unable to regulate their body temperature like adults do, which leaves them at risk of overheating and dehydrating. Babies can become too hot internally when lost liquids are not adequately replaced. Newborns lose fluids regularly from weeing, pooing, vomiting and perspiring and the lack of liquid causes little bodies to dehydrate and overheat. When dehydration is severe the risk of heatstroke and SIDS is increased. Keep an eye on the bottom end. Newborns need to have at least six wet nappies in a twenty-four hour period—less than six is an indication that babies are becoming dry. Newborns may poo after every feed or only every few days or so. Poo should not be hard pebbles as this is constipation and a sign of not enough fluid. Offer babies extra liquid at regular intervals during the day. Either extra short breast feeds or if using infant formula give cooled boiled water between milk feeds.

Humid, hot, and airless environments cause fungal infections to thrive. Keep a check on places such as the nappy area, under baby’s chin, between creases and folds, as well as your nipple area. You can reduce the risk of thrush developing by regularly exposing these areas to air and keeping them clean and dry; if you are breastfeeding, eating yoghurt and reducing your yeast and sugar intake can also help. When reddened areas won’t go away with these measures seek professional advice.

Skin-to-skin contact is important for newborn development but it can make you both hot and sticky. When breast feeding on steamy days, if you place a wet cloth under your arm or around the back of your neck, and a small cotton cloth between you and your baby it can make feeding a little more comfortable.

Water is cooling. Ensure babies have a sponge down with a wet cloth, bath or shower at least daily. Wet your hand or a washer with lukewarm water and regularly wipe over bubs head on really hot days. If infant skin is dry, add a little natural oil to the bath water or moisturise the skin after a bath.

While feeling hot can make anyone irritable, the heat can also make it particularly difficult for newborns to settle and go to sleep. But don’t worry, there are some things that you can do to help keep them cool. Increase airflow in the cot by using a firm cotton mattress and remove any waterproof protectors, as these hold in heat. Spread a towel over the mattress under the sheet to absorb perspiration and be sure to remove any unnecessary bedding, toys and bumpers from the cot. Use natural cotton or bamboo fabric for clothes and bedding as synthetic materials trap heat and can cause babies to overheat.

For additional cooling, if you don’t have the luxury of air-conditioning, drape wet towels and a dish of water in front of an oscillating fan. Dress babies in only a nappy and light cotton wrap to sleep. When regulating an air-conditioner, take into account their fat layers, prematurity and general health, and set temperature to around 24°C. At this heat, babies would need a loose sleep-suit and swaddling wrap and perhaps another cotton blanket over the top. If bub is too hot his head will be sweaty as this is where newborns loose heat. Because babies loose heat from the head, place their feet at the end of the cot, which allows air flow around the head—this is also in line with SIDS safe sleeping recommendations.

If your house is hot, escape in an air-conditioned car or to an air-conditioned shopping centre or library for a break. When going for a walk, avoid going between 10am and 3pm as this is when the sun is most harmful. Avoid having babies in a stroller for too long as these tend to be hot and airless. This also applies to the car restraint when the car is stopped. These contraptions can heat up very quickly and cause body temperatures to rapidly rise, which can put babies at risk of a febrile convulsion. It is also important to use UV protectors on windows and over strollers to stop the sun’s strong rays from burning delicate skin.

Enjoy summertime with your newborn but remain alert to the hazards of heat. Seek professional help if your baby has less than six wet nappies in a twenty-four hour period, has dark circles under dry eyes, hot dry skin, sunken fontanels (soft spot on his head) a dry mouth and tongue or is floppy and difficult to arouse.

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance.

Baby Poo What’s Normal

Baby poo is a good indicator of how your baby is tolerating feeding. Therefore, it is a good idea to know what normal baby poo looks like.

What does normal baby poo look like?

A newborn’s first bowel movement is greenish-black, thick and sticky. These first poos consist of epithelial cells, lanugo, mucus, amniotic fluid, bile, and water, which are intestinal substances that an unborn foetus ingests while in the womb.

As a newborn begins to ingest colostrum (mother’s first breast liquid), breast milk and or infant formula poo will change from greenish-black to dark brown that is less sticky.

When a baby is breastfeeding the poo will progress to a mustard colour containing tiny, white, grainy seed-like pieces.  It is a loose consistency and can occur at every nappy change or every few days or even up to 14 days. Unlike formula fed babies, it is rare for breast fed babies to get constipated.

When a baby is regularly ingesting infant formula poo is a pasty consistency and often green in colour (each brand of infant formula creates a slightly different variation of the colour green). Bowel movements can be less frequent than a breast fed baby but he will need to be passing a poo every day or every second day to avoid getting constipated.

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A baby that is breastfeed with top ups of infant formula will have a variation in-between these two poos, which will depend on the ratio of breast milk to formula.

What does abnormal baby poo look like?

ABNORMAL BABY POOP INDICATES THE NEED FOR FURTHER ASSESSMENT BY A HEALTH PROFESSIONAL.

1. Green frothy poo and possibly associated with irritability, bloating, wind and nappy rash
2. Very liquid consistency with no white seedy bits
3. Poo is a pebble like consistency
4. A formula fed baby who has not passed a poo for 3 or more days
5. Poo with streaks of blood in it
6. Green poo with a stringy egg white consistency
7. Projectile vomiting after 3 consecutive feeds associated with no bowel movement

Moving on: Introducing solids to your baby

When thinking about introducing solids to your baby, my eBook ‘taste it’  provides answers to your questions and easy and nutritional first food ideas.

or read more about what is normal in a developing baby by downloading my eBook
‘Mum, Baby & Toddler – together we learn’

Jan Murray has committed to studying and working as a Registered Nurse, Midwife and Child Health Nurse for over 25 years. Jan is a mother of 5 and co-founded and directs Settle Petal. Through her business Jan provides information and support for parents with babies and toddlers to develop their knowledge base and confidence. Receive your FREE Routines eBook at http://myoptinpage.com/?pid=2151223 to help babies settle, sleep and grow.

Keeping Baby Warm

By Jan Murray

When night air becomes colder the ambient temperature in your child’s room can drop quite significantly at around 3am.

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If your baby is waking around that time, make sure she is warm enough.

Sleeping bags made from natural fibres are great for warmth once your baby is out of a wrap. Unnatural fibres such as polyester can trap heat, making it difficult for your baby to regulate her body temperature.

Helping Babies and Toddlers Sleep
A thermostatically controlled heater can be useful during the cold winter months but be careful not to overheat your baby’s room and don’t leave a heater switched on all night. Episodes of SIDS are more common in winter as a result of overheating.

Avoid sleeping babies and toddlers with electric blankets on, hot water bottles or heated wheat-bags. Your baby cannot always escape from a bed, throw off bedding, or get out of a cot to cool down. A baby that becomes too hot is at an increased risk of SIDS. Keep a window a tiny bit open for fresh air.

It is advisable to keep bedroom temperature below 24°C (75.2°F) but observing how hot your baby looks and feels is a better indicator of acceptable room temperature than a monitor. Feel down onto your baby’s chest as hands and feet are usually cold. Look to see that her head is not sweating or her face is not flushed. Babies regulate their temperature through their head. Make sure their face is uncovered, while lying on their back to sleep.

Avoid sleeping your baby between two adults. Babies can become smothered by adult doonas and can overheat between two hot bodies.

Learn more about babies Mum, Baby & Toddler

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.

Plagiocephalie Or Flat Head Area in a Baby

Plagiocephalie or flattened head area can develop in babies after birth. This occurs from  applying constant pressure on one part of their head.

The first 6 – 8 weeks of babies life is the most important time to avoid a flattened head area (Plagiocephalie) developing. This is because the bones in a newborn’s head are thin and flexible and the head is soft and easy to mould.

Four reasons why flat areas may occur in a baby’s head:

1. Lying in one position for long periods of time.

2. By always turning the head to the same side when lying on their back (favouring looking out a window to the light).

3. Always sitting in a propped up position. May occur in babies who suffer from reflux pain.

4. Birth trauma resulting in neck pain – leaving a baby to favour a pain free position.

Discover eight important steps to facilitate a baby developing muscle balance and therefore decreasing the risk of developing a flattened head area.

1. Alternate the head position when putting them down to sleep.

2. Alternate laying baby at different ends of the cot when putting him to bed.

3. A period of tummy time during every play time.

4. Change the position of the toys when babies are on the floor so they move their head to different angles.

5. Vary holding and carrying positions.

6. Changing the side that a baby carry sling is worn on.

7. When picking babies up, approach them from different sides of the body.

8. Visit a baby accredited chiropractor or physiotherapist to assess baby’s head alignment, especially after a long or difficult birth, forceps assisted birth or birth by caesarean section. Babies who do not feed well from a particular side, hate tummy time or suffer from considerable wind, may have an alignment issue requiring attention.

Seek professional help EARLY if you see baby’s head becoming flattened in areas or the head constantly tilts to one side or he favours facing a certain direction.

A physiotherapist may advise a cranial helmet be worn for a period of time if a baby’s head remains flat beyond five to six months.

Feel more confident in your parenting journey by reading ‘Mum, Baby & Toddler – together we learn’

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Jan Murray has been committed to studying and working as a Registered Nurse, Midwife and Child Health Nurse for over 25 years. Jan is a mother of 5, Child Health Consultant who co-founded and directs Settle Petal. Jan provides information and support for parents to develop their knowledge base and confidence. Receive your FREE Routine at http://myoptinpage.com/?pid=2151223 to unlock a secret to helping babies settle, sleep and grow.

Infant Misshapen Head

By Jan Murray

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No doubt you have noticed uneven head shapes on babies. But while their head shape is largely genetic, how you position your baby when she is sleeping, resting or laying around during the early weeks and months can have an effect. This is because infant heads have several bones with pliable connections that expand as the brain grows. Couple this mouldable softness with the fact that she spends a lot of time laying on her back and it leaves her at risk of developing plagiocephalie.

Flat spots can occur in various parts of the head depending on the area baby tends to favour, which is why you may hear it called ‘positional’ plagiocephalie. A flat head shape will not interfere with brain growth but if severe enough and left untreated it may result in uneven skull growth and other associated problems such as orthodontic and visual issues later in life.

To reduce long term effects of misshapen heads it is a good idea to have your baby checked regularly by a child health professional, particularly during the first three months when heads are easily flattened from external pressure but are also easily managed back into the correct shape. Early corrective and preventative measures are best, as between 6 and 12 months of age treatment is much more difficult and after 12 months the opportunity for correction is minimal.

Your little one can sometimes find moving their head into certain positions difficult. This may be due to pain or discomfort as a result of a forceps assisted birth or from torticollis—a congenital shortening and tightening of muscles on one side of the neck. Both these conditions will improve with time but during the healing process bub risks a flat area developing on the head. In either of these conditions your baby may also be unsettled with neck pain when she stretches out her neck during tummy time or when she positions herself to feed from a particular breast.

Occasionally, an asymmetrical head shape is caused by the early closure of cranial sutures, the area that allows the skull to expand. This is an uncommon condition known as craniosynostosis, which requires corrective surgery and is picked up at regular child health checks.

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Being aware of how flat areas form is important for knowing how to prevent or correct a flat head. For example, your baby may adopt the same position every time she is put down because her eyes are drawn to a stream of light coming through a crack in the door or through the curtains. She will also stretch her head in the direction where she can see you, the television or other siblings playing. If your baby is always placed in the same side of a side-by-side stroller or fed from the same side when feeding from a bottle this may also lead to the formation of a flattened area. Even constantly having her propped up in a rocker or bouncer in an attempt to alleviate uncomfortable symptoms of gastro-oesophageal reflux can result in the skull becoming flattened at the back.

Once an area on the head begins to flatten it becomes a comfortable spot to naturally rest her head but there are some things that you can do to help prevent this happening.

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Start soon after birth by placing your baby at alternative ends of the cot or bassinette to sleep, while still placing her feet close to the end. Make supervised tummy time a regular part of each wake period during the day. Increase the length of time on her tummy as she and gets older and gains neck strength. Side lying is also good while bub is awake and being watched. Don’t always cradle her the same way. Instead, while safe in your arms, let her see the world from different angles (using a sling can be helpful here too). Be conscious of her feeding positions. If you are feeding from only one breast, a mix of under-arm feeds (also known as football hold) and across-your-lap feeds is a good idea. If you are bottle feeding change the arm you feed from each feed.

Some additional devices or a rolled cloth can be helpful in some situations to restrict her head turning to the flat spot. In severe cases of flat head syndrome in an older baby (usually 5 – 8 months old), a customised corrective helmet may be required. This is a decision made by your child health professional. But rest assured, even if a helmet is necessary it is only temporary. Your baby may not like it at first but as a teenager with a beautiful head shape and no orthodontic issues—she will thank you.

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References:

Deformational_Plagiocephaly.pdf

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This article was brought to you by Jan Murray, Private Child Health Consultant who is an internationally renowned expert in her field. Jan encourages parents in the area of infant sleep, nutrition, activities and family balance. Jan publishes regular ezine and blog articles to provide free parenting tips, tools and resources to educate and support those caring for young babies and children.