A time to feed, bathe and clean

Your baby is a bundle of joy but looking after this precious little one can be quite a challenge especially for a first-time mother. Here Dr. Pujitha Wickremasinghe, a Consultant Paediatrician at the Lady Ridgeway Hospital for children speaks to Melanie Amarasooriya on caring for a new-born. The first part of this article was published in last month's MediScene

While breastfeeding, the mother should take a balanced diet and plenty of liquids so that milk production is maintained.
Mothers also worry about the frequency of feeding. The baby should usually be fed whenever he/she feels hungry, that is whenever the baby wakes up and cries. One feed should last about 20 to 30 minutes. During this time, you can keep the baby awake by tickling his/her soles or stroking the ears.

If he/she does not wake up frequently, it is advisable to wake him/her up once in three hours during the daytime and once in four hours at night for a feed.

It is important to burp the baby to get rid of the air in the stomach. This is ideally done halfway through feeding. When you are breastfeeding it is important to feed him/her on one breast till you feel it is completely empty. The composition of the first part of the milk is different from the latter and both are important for adequate growth of the baby. If you change the baby over to the other breast before it gets empty you will be feeding the child only with the first part of the milk.

The baby should be fed with the whole areola (the dark area around the nipple) in his/her mouth, not only the nipple. Otherwise the feeding will be inadequate as well as the mother will get sore nipples.Watch whether the baby is making any noise while sucking. If so, he/she may not be sucking properly.

About formula milk

For any baby, the best option is breast milk and he/she should be exclusively breastfed up to four to six months. That means no other food or drink, not even water, is necessary during this time. All the baby's nutritional needs are met by breast milk, so there is no need for formula milk.

If the baby is small and cannot suck well, you can express breast milk into a clean cup and feed him/her with a spoon. Another option is the bottle with a fixed spoon which is available in the market. Never attempt to feed baby with a bottle with a teat because he will find it is easier to suck at the bottle and get used to it. This does not help in developing his/her jaw muscles and oral musculature. Ultimately, he/she will not suck properly at the breast and this will eventually lead to less milk production. Also it is difficult to clean a teat properly so that the chances are that infections can get transmitted.

A baby should be dressed in a baby shirt, nappy and cap. The head is the area where babies lose heat very much and so, a cap is advisable. But make sure that all the baby's clothes are cotton. On cold days a pair of socks will help the baby stay warm.
Always remember to change the nappies frequently – whenever the child passes urine or stools.

Most mothers use pampers on their children which, though convenient, can irritate baby's skin when urine gets collected.

Bathing and cleaning

You can bathe your child from the second day onwards. This should be done using lukewarm water and should not take long. It is best not to put your baby in a tub while bathing, especially if it is a girl. This is to avoid germs entering the urinary passage.

Immediately after a bath, wipe the baby dry and dress him/her up to keep warm. Always wipe around the umbilical stump if it has not fallen. You can apply a small amount of surgical spirit on the umbilical stump until it falls.

Thereafter it is not necessary to apply antiseptic to the cord. Keeping it dry and clean is sufficient.

Cleaning the ears with cotton buds should not be done as you can be pushing in the wax that comes out. Also small cotton whisks may get trapped inside the ear and cause problems. Just clean the ear lobe to remove any wax if it has come out.

Apart from bathing it is necessary to wipe the baby with a damp cotton cloth after passing urine and stools. It should be done from front to back, especially in girls to avoid the urinary passage getting contaminated with germs in stools. Remember to wipe the baby's neck area with lukewarm water to remove the milk collected between neck folds after each feed, at least twice a day.

The baby's skin can be dried after baths. Applying a small amount of baby cream is recommended. Other than that, talc and cologne are not suitable as they can irritate the skin, and also lead to fungal infections.

Baby's nails should be cut short after a bath, preferably when he/she is sleeping. There is a specific pair of scissors for this purpose with rounded ends. Otherwise, long nails can harm the baby.

Keep the baby on his/her tummy after feeds with the head turned to a side. If that is not convenient, put him/her on his/her right side. This is advisable because if the baby vomits, it prevents the vomitus entering the lungs. Also this allows the stomach to empty quickly and the baby will be hungry frequently.