Breastfeeding

Breast Crawl means that when a newborn is placed on the mother’s abdomen soon after birth, the baby has a natural instinct to find the mother’s breast and start breastfeeding. Breastfeeding should be initiated immediately after birth, preferably within the first hour.

During the first 2–3 days the amount of breast milk may seem small, but this early milk called colostrum is sufficient for the newborn and provides essential nutrients and immunity.

• Do not supplement with powdered milk during the first few days.
• A healthy newborn has enough stored energy to prevent dehydration or hypoglycemia.
• Proper counselling helps mothers feel confident about breastfeeding.

Temperature

• Newborns are at risk of hypothermia, especially during winter.
• Keep the baby warm using proper clothing, blankets, cap, gloves and socks.
• The baby’s temperature is normal if the trunk and extremities are warm and pink.

Body Massage

Body massage is common in India and promotes mother-infant bonding.

• Massage should be started when baby weighs more than 3 kg and after 2 weeks when the cord has fallen.
• Massage improves circulation, muscle tone and growth.
• Preferred oils: coconut oil or sunflower oil.
• Avoid mustard oil, olive oil, mineral oil and synthetic oils.
• Massage should be gentle, smooth and firm.
• Ideal time: 1–2 hours after feeding in a warm room.
• Each session lasts around 15 minutes.

Care of Skin and Scalp

• Clean the baby after birth to remove blood, mucus and meconium.
• Bath or sponge bath should be given next day using lukewarm water.
• Avoid dipping bath until the umbilical cord falls.
• Daily baths are preferred, but in winter 2–3 baths per week are acceptable.
• Crusting and peeling of scalp is common in newborns.
• Baby shampoo may be used to remove crusts.
• Hair and scalp should be washed after the cord falls.

Care of Skin in Preterm Babies

• Strict hand hygiene must be practiced.
• Handle the baby gently.
• Sponge bath until the baby reaches 2.5 kg.
• After that regular bath can be given using a mild cleanser.

Care of Umbilical Cord

• The cord should be kept clean and dry.
• Normally it falls off within 5–10 days.
• Clean with lukewarm water.
• Keep the cord exposed to air.

Care of Diaper Area

• Always wash hands after changing diapers.
• A newborn may need 8–12 diaper changes per day.
• Use dustbin with lid to store used diapers.
• Cloth napkins are recommended and should be changed frequently.
• Clean diaper area using lukewarm water and soft cloth.
• Keep the area dry.
• Barrier creams with Zinc Oxide may be used.

Urination and Bowel Movement

• A well-fed baby urinates 6–8 times per day.
• Less urination may indicate inadequate feeding.
• Breastfed babies usually pass yellow semi-solid stool.
• Sometimes babies may not pass stool daily which is normal.

Help Baby Sleep

After 2–4 weeks newborns develop their own sleep cycle. They may sleep during the day and wake up at night.

• Newborns sleep 16–18 hours per day.
• Mother should rest when the baby sleeps.
• Keep lights dim at night.
• Expose baby to daylight during the day.
• Ensure baby is warm and well fed before sleeping.

Clothing

• Clothing depends on climate and weather.
• Two layers are recommended – inner vest and outer clothing.
• Cotton clothes are best for newborns.
• During winter use woollen clothes with cap, socks and gloves.
• Soft absorbent cloth can be used as diaper.