Department of Health
John J. Dreyzehner, MD, MPH, Commissioner

Getting Ready

Getting Ready for Your Baby

The day you bring your baby home is exciting and special. You’ll want to have everything ready so that you can get off to a great start. Here are some of the things you’ll need.

Car Seat

• Learn how to correctly install your baby’s car seat before you go to the hospital.
• Read your vehicle owner’s manual.

Crib

• Crib slats shouldn’t be more than 2-3/8 inches apart.
  
• Cribs should not be painted with lead paint or varnish.
  
• Do not use a drop-side crib.
• Do not use cribs older than 10 years or cribs that are broken or have been modified.

Changing Table

• Use a strap to hold your baby when possible and keep one hand on her at all times.
• Keep supplies within easy reach.

Baby Monitor

• This makes it easy to hear the baby from any room.

Diapers

• You need about 70 cloth or disposable diapers a week for a newborn.
• For cloth diapers, you’ll need diaper wraps or plastic pants.
  

Layette
The following list of items will get you started. Your baby may need other items, depending upon the season (warmer blankets for winter and a wide- brimmed hat for summer).

• 6 to 8 T-shirts or onesies 4 to 6 receiving blankets
  
• 6 to 8 sleepers
• 2 sweaters
  4 to 6 booties or socks
• Washcloths and hooded towels

Resources
In addition to choosing a health care provider for your baby, it’s also important to know where to look for quality support and education. These organizations can help:

• American Academy of Pediatrics - Call (847) 434-4000 or visit www.healthychildren.org for children’s health and parenting publications
• La Leche League - Call (800) LALECHE for breastfeeding consultations and publications
• March of Dimes - 1-888-MODIMES or www.marchofdimes.com
• The Tennessee Department of Health would like to thank the March of Dimes for permission to use the copy from their brochure, NEWBORN CARE, for this web page.

Immunizations

Infant immunization is a simple, effective and inexpensive way to protect children from potentially deadly childhood diseases, such as measles, whooping cough, diphtheria, and chickenpox. Children are most vulnerable to contracting these preventable diseases during the first two years of life, and need 80 percent of their vaccinations by their second birthday. Children in Tennessee must have certain required immunizations in order to attend child care or school.

For more information about recommended and required immunizations click here

Feeding

Feeding Your Baby

You’ll want to decide, before your baby is born whether to breastfeed or bottle-feed. Talk it over with your partner and your doctor. While healthy babies grow well with breast or bottle, breast milk provides special nourishment and protection from allergies and infections that formula does not. Whatever method you use, be sure to burp your baby during and after each feeding. Put a cloth on your shoulder and hold baby upright. Gently pat or rub her back.

Breastfeeding

• Breastfed newborns need to eat 8 to 12 times in 24 hours (usually once every 2 to 3 hours). In the first few days before your milk comes in, your breasts fill with colostrum. Colostrum has extra antibodies and other substances to help your baby fight infection, and just enough nutrients for a newborn. As your baby feeds, her nursing signals your body to start making milk.
• Sit up and hold your baby with her tummy touching your tummy. Cup your breast and tickle her lip with your nipple. When she opens her mouth, firmly bring her to your breast. To start milk flowing, your baby has to have at least one/half inch of your areola (the darker skin around the nipple) in her mouth. You should hear and see her swallow within a minute or two. If your nipples hurt or are cracked or bleeding, the baby has not latched on correctly. Check with your health care provider for further help.
• To be sure your baby is getting enough milk; look for at least 6 to 8 wet diapers and several bowel movements per day.

Feeding With Formula

• Formula may be based on cow’s milk, soy or foods less likely to set off allergies. It comes ready to serve, or in liquid or powder you mix with water. Check with your baby’s doctor to see what kind of formula you will need.
• Newborns eat about 2 to 3 ounces of formula every 3 to 4 hours.
• Never heat a bottle in the microwave.
• Wash bottles, nipples, and anything used to prepare formula in hot, soapy water. Ask your doctor if you need to boil anything(including water to mix formula).
• Never put your baby to bed with a bottle because it’s possible she could choke. Putting a baby to bed with a bottle can also cause them to develop cavities.

Starting Solid Foods

• Don’t start your baby on solid foods before 4 to 6 months unless told otherwise by your doctor. Early solids may add too many calories. They also may not be digested well or cause allergic reactions, because your baby’s digestive tract and immune system are not yet mature.
• Start with rice cereal, then soft, smooth purees. Try one food at a time, and wait 3 to 5 days before adding a new food. That way, if your baby has a rash or other reaction, you’ll know what caused the problem.

Resources

In addition to choosing a health care provider for your baby, it’s also important to know where to look for quality support and education. These organizations can help:

• American Academy of Pediatrics - Call (847) 434-4000 or visit www.healthychildren.org for children’s health and parenting publications
• La Leche League - Call (800) LALECHE for breastfeeding consultations and publications
• March of Dimes - 1-888-MODIMES or www.marchofdimes.com

The Tennessee Department of Health would like to thank the March of Dimes for permission to use the copy from their brochure, NEWBORN CARE, for this web page.

Caring

Caring for Your Baby

Printable version

Your Baby’s Doctor

It’s a good idea to choose a doctor for your baby before she is born. Meet with your baby’s doctor toward the end of your pregnancy so you’ll be comfortable with the office before you bring your baby in for her first visit. When first meeting with your baby’s doctor, ask:

• When will my baby’s first checkup be?
• How often should I bring her in for checkups?
• How far in advance should I schedule appointments?
• How do I schedule an appointment if she gets sick?
• What do I do in case of an emergency?

THE MEDICINE CABINET

Stock your baby’s medicine cabinet now, so you’ll have what you need on hand:

• A rectal thermometer and lubricant
• Alcohol wipe swabs
• Non-aspirin liquid pain reliever (use only as directed by your baby's doctor)
• Number for Poison Control Center (1-800-222-1222)
• Nail clippers (for infants)
• Saline drops
• Suction bulb for the nose

Caring for the Umbilical Cord

The umbilical cord stump drops off in a few weeks. Until then, keep it clean and dry.

• Tuck the diaper below the cord. Each time you change your baby’s diaper, dip a cotton swab in rubbing alcohol and gently clean the area where cord and belly meet.
• A bit of blood may spot the diaper when the stump drops off.
• If you see pus or redness or the baby cries when you touch the area, call your baby’s health care provider.

Holding Your Baby

• To support a newborn’s weak neck and heavy head, place the palm of your hand on the baby’s neck and back. Cradle the head with your fingers.

Diapering Your Baby

• Clean the diaper area with diaper wipes (or plain water on a soft cloth for a newborn or baby with sensitive skin). Take extra care with creases and folds. Wipe girls front to back to avoid infection. Pat dry. Use ointments only to help clear up diaper rash. Don’t use talcum powder because it can irritate the baby’s lungs.

Bathing Your Baby

• A bath every 2 to 3 days is plenty if your keep the diaper area clean. Use mild baby soaps and shampoos.
• Sponge baths are best until your baby’s belly button heals. Lay her on a padded towel in a warm room. Dip a cotton ball into plain water and gently wipe her face. Then dip a washcloth in a bowl of warm, soapy water to wash her body. Do the diaper area last. Wash off soap with plain water. Keep her warm by covering any area you’re not washing with a towel.
• When she’s older, you can bathe your baby in a small plastic tub or the sink. Line it with a sponge or towel to make it less slippery and use just a few inches of warm water. Test the water with your hand to make sure it’s not too hot before putting her in the tub or sink. The water should be warm, but not hot. Put soap, a container of clean, warm rinse water, washcloth and towel within reach. Gently wash her face first with plain water, then use a soapy washcloth or your hand on her body. Wash the diaper area last. Rinse her with clean water. Then wrap your baby in a towel and pat her dry.
• Never leave a baby alone in a bathtub or sink, even for just a few seconds.
• To wash your baby’s head, wet it a bit and wash with just a little shampoo. Tip her head back so no soapy water runs into her eyes and gently pour clean water over the hair.

Soothing A Crying Baby

• Never shake your baby. If your baby will not quit crying, and you have made sure that your baby is not hungry, not wet/dirty or not in pain, then it is okay to put your baby in its crib and let it cry for a few minutes. Never shake your baby to try to get it to stop crying.
• Babies cry when they need to be fed, changed, cuddled or calmed, or when they don’t feel well. Newborns sometimes cry up to 3 hours a day (not all at once). If your newborn can’t be soothed, or pulls up her legs and passes gas often, she may have colic. No one knows just what causes colic. Sometimes, a breastfeeding mother’s diet or a type of formula can be causing the problem.
• You won’t spoil your baby by responding quickly. Studies show that babies whose parents respond quickly in their first 6 months cry less in the next 6 months. To calm your baby, try soft music, walking, rocking, holding the baby in a sling or front carrier, or swaddling her in a blanket. Car rides and soft, consistent noises like running water or a vacuum cleaner sometimes work. Make tapes of any sound that soothes your baby.

Resources

In addition to choosing a health care provider for your baby, it’s also important to know where to look for quality support and education. These organizations can help:

• American Academy of Pediatrics - Call (847) 434-4000 or visit www.healthychildren.org for children’s health and Parenting publications
• La Leche League - Call (800) LALECHE breastfeeding consultations and publications
• March of Dimes - 1-888-MODIMES or www.marchofdimes.com
  

When Your Baby is Sick

Printable version

As babies get older, their bodies are better able to fight off sickness. A low fever in a newborn may be more serious than a higher fever in a 7-month old. At any age, always call your baby’s doctor for advice if he seems very sleepy, doesn’t want to play or eat or can’t be comforted.

Colds

Stuffy noses make it hard for babies to breathe and eat. To help your baby breathe, try putting a few saline drops in her nose. Wait minute and then suction out mucus. If this doesn’t work, call your baby’s health care provider. To help your child breathe easier while she is sleeping, put a pillow under her mattress to elevate her head and use a cool-mist humidifier. (Be sure to clean the humidifier frequently to avoid mold growth.)

Gas

• Crying and pulling up legs can be a sign of gas.
• Burp your baby more often when feeding.
• Try softly rubbing your baby’s tummy or slowly bringing her knees to her chest.
• Ask your baby’s doctor if simethicone drops or switching formulas might help.

Vomiting

• Many babies spit up a bit after eating and when burping. Vomiting, however, is much more forceful. Call your baby’s doctor if the vomiting lasts more than 24 hours, if the baby has diarrhea, a swollen belly, seems in pain or is very tired or irritable. You should also call your doctor if the vomit is ever bloody or dark green. Check with your baby’s health care provider about giving an electrolyte solution to put back lost fluids, salt and sugars.

Fever

• Fever means the body is fighting illness or infection.
• For an infant under 3 months, call your baby’s doctor right away if the baby’s temperature is 100.2 F or more.
• For babies and children of any age, call your doctor right away if your child is sleeping more than normal, if you cannot awaken your child, if your child is not eating or drinking, or if you think your child is not acting like his or her usual self. Check with your child’s doctor about using a non-aspiring pain reliever to lower fever.
• Never use aspirin in babies or children.

Rashes

• Dry, scaly skin may be eczema, which should be treated by your baby’s health care provider.
• Tiny red bumps may be prickly heat. Loose, cool, cotton clothes and bedding may help.
• For diaper rash, change diapers more often and clean area carefully with warm water. Air-dry your baby’s bottom for a while each day. Use a diaper rash ointment or cream to keep wetness away from skin and help clear up rash.

Cradle Cap

• Soften scaly flakes on the scalp with a bit of baby oil and a soft brush. This kind of flaking is very common in newborns.

Handling Stress

Printable version

Being a parent is difficult. No one expects you to know how to do it all. Challenges such as unemployment or a child with special needs can add to family tension. If you think stress may be affecting the way you treat your child, or if you just want the extra support that most parents need at some point, try the following:

Talk to someone.

Tell a friend, healthcare provider, or a leader in your faith community about what you are experiencing. Or, join a support group for parents

Seek respite care when you need a break.

Everyone needs time for themselves. Respite care or crisis care provides a safe place for your children so you can take care of yourself.

Call a helpline.

• The Tennessee Parent Helpline (1-800-CHILDREN or 1-800- 356-6767) is a 24-hour, toll-free helpline providing supportive listening, information and referrals for families experiencing problems or stress, or just in need of someone to talk to.
• The Tennessee Statewide Crisis Line is also available toll-free, 24 hours a day to provide confidential help for those having feelings such as depression, anxiety, helplessness or thoughts of harming themselves or others. Call 1-855-CRISIS-1.

Seek counseling.

Individual, couple, or family counseling can identify and reinforce healthy ways to communicate and parent.

Take a parenting class.

No one is born knowing how to be a good parent. It is an acquired skill. Parenting classes can give you the skills you need to raise a happy, healthy child.

Accept help.

You do not have to do it all. Accept offers of help from trusted family, friends, and neighbors. Do not be afraid to ask for help if you feel that you need it.