INFANT CARE TECHNIQUES

INFANT CARE TECHNIQUES

Holding a baby Dressing a baby Sleeping habits Coping with crying Bottle temperature Burping a baby Feeding Introducing baby foods The five senses Hair care cradle cap Skin care umbilical stump Changing diapers bathing Cleaning a baby Checking baby's temperature Cleaning baby clothes Infant care

How should baby be held?... The baby’s head is large in proportion to the rest of its body. Because the baby’s neck muscles are usually weak, it is important to support the head for about the first three months. Young children need to sit down and have constant assistance in attempting to hold a baby. If unsupported, baby’s head could fall back, causing a case of whiplash! This traditional cradle hold uses both arms of the caregiver, and supports both baby’s neck and back.

How should baby be dressed?... Use the way you are dressed as your guide. In general, baby needs the same number of clothing layers as you have on. If you are wearing a shirt and jacket, baby may need a top and blanket. A hat may be an important accessory, to prevent heat loss through the scalp or sunburn.

Sleeping habits... You can help your baby establish good sleeping habits by developing a bedtime routine. Do not try to minimize daytime noises, such as vacuums, dishwashers, etc. Keep lights on and regular noise levels. If you always rock your baby to sleep, they will come to expect and rely on it. When baby wakes up at night, keep lights, noise, and interaction at a minimum. Delay reaction time to crying if baby has recently been fed and changed, to see if they will go back to sleep on their own.

Specific methods of COPING WITH CRYING : • 1. Walk or dance with the baby. • 2. Rock the baby. • 3. Bounce the baby gently in your arms or on a bed. • 4. Take the baby for a ride in the carriage. • 5. Take the baby for a ride in the car. • 6. Put the baby in a wind-up swing. • 7. Turn up the music on the radio or stereo, run the vacuum, or let the water run in the tub as a • distraction for you and the baby. • 8. Offer the baby a noisy toy, shake it and rattle it. • 9. Sing or talk in a quiet, sing-song way. • 10. Put the baby in a soft front carrier, close to your body. • 11. Lay the baby's tummy down across your lap and gently rub or tap his/her back. • 12. Lay the baby across a warm hot-water bottle on your lap or a bed. • 13. Massage the baby's body and limbs gently; using a warmed lotion, if the weather is cool. • 14. Swaddle the baby tightly. • 15. Feed and burp the baby one more time or offer a little warm water • 16. Offer a pacifier • 17. Hold the baby close and breathe slowly and calmly; the baby may feel your calmness and • become quiet. • 19. Remove yourself and let someone else take over for awhile. If a family member is not • available, consider hiring a sitter for a short period of time.

In an effort to reduce the number of children who died from SIDS (crib death), physicians encouraged parents to lay their babies on their backs to sleep. Back is best... Unfortunately, the fontenals and skill plates are not fully fused during infancy, and can shift. This “back to sleep” philosophy can cause the head to flatten in areas. The solution may be as simple as placing the baby on its side or tummy when it's not sleeping to relieve the constant pressure on the back of the head. The direction the child is placed in the crib should also be varied. In cases of extreme deformity, special helmets can be customized for wear such as the one shown in the picture at the right.

Checking the temperature of baby's bottle... If feeding baby formula or preserved breast milk, some babies prefer their milk and sometimes even the nipple warmed. Test the temperature of the milk by sprinkling a few drops on the back of the hand or the inside of the wrist. It should be tepid…not hot. Use caution if using a microwave to heat the bottle. The milk or formula is heated unevenly. Shake before feeding. Warming milk is NOT necessary, but once baby becomes accustomed to it, they may refuse cold milk.

Burping the baby... As baby sucks, from a bottle even more so than the breast, they swallow air. They try to burp, but the feeling is new for them, and they sometimes end up spitting up their entire lunch in the effort. They could use some assistance from the caregiver. You can place the child up and over the shoulder to pat their back, but you take a chance of spit-up trickling down your back. Place baby in sitting position. Lean them forward, supporting their chin and chest with your hand. Pat their back in an upward motion. You may want to squeeze the cheeks of their face to open the mouth. Continue until you hear the burp of air.

Spitting up vs. vomiting... In older children and adults, an elastic-like muscle at the entry to the stomach closes like a valve to prevent liquids from being pushed back up. In babies, however, this valve or sphincter isn't fully effective until between 6 and 12 months of age. Since it isn't fully developed yet, the valve is easily pushed back by the contents of the stomach - resulting in regurgitation or spitting up. It often happens as the result of overfeeding or because an air bubble is swallowed during feeding. Vomiting, unlike spitting up, is characterized by the forceful expulsion of the contents of the stomach. It is a symptom of gastrointestinal distress and may indicate an illness. Vomiting can quickly lead to dehydration.

Feeding Schedule... Proponents of breastfeeding encourage mothers to feed their babies “on demand”, with no schedule established. It provides baby with comfort as well as nutrition. If bottle feeding, whether it is with formula or expressed breast milk, baby needs one ounce per hour. If they drink 4 ounces, therefore, they can usually wait about 4 hours before they eat again.

Propped bottles... In this busy world today, parents and caregivers may be tempted to prop baby’s bottle on a pillow and go on to other things during feeding time. Don’t do it! Babies choke more often when bottles are propped. They also fall asleep with milk in their mouth, promoting gum disease and tooth decay. Milk runs down the face and into the ears, causing more ear infections. Feeding time is nurturing time, and nurturing means holding baby close, looking into their eyes, giving them your attention and tender, loving care.

Introducing baby foods... Until baby has teeth and is able to chew food well, they should eat only pureed food. Pediatricians recommend starting with a bland rice cereal, followed by oatmeal and then barley cereals. Vegetables such as peas and carrots come next, followed by fruits. There are some foods that should be avoided for the entire first year, as baby has or easily develops allergies to them: chocolate, citrus fruits, peanut butter (it also presents a choking hazard for children under 3), honey (may contain botulism food poisoning), http://assets.babycenter.com/ims/Content/first_solid_food.pdf When starting baby on solid foods, introduce only one new food every 3 days. If your baby has an allergy to this food, you will be able to pinpoint which food is a problem and avoid it. Babies do not need a wide variety of foods in their diet, and very bland foods are flavor- packed for baby!

Blue skin tones... While the color red is associated with most emergencies, with babies it is the color blue. Blue skin means: • Baby is very cold; this shows up first on fingers and toes • Baby is not getting oxygen; this might show up first on the lips of the mouth or in the face If baby displays brief episodes of turning blue for no apparent reason, consult a physician! In the event of choking, perform the Heimlich Maneuver by placing the infant stomach- down across your forearm. Give 5 thumps on the infant’s back with the heel of your hand.

Milia... Mila are tiny white papules, actually plugged sebaceous glands or oil ducts, located over nose, cheek, and chin. They are caused by stimulation from the mother’s hormones, and will disappear in a week or two. Mila are tiny white papules, actually plugged sebaceous glands or oil ducts, located over nose, cheek, and chin. They are caused by stimulation from the mother’s hormones, and will disappear in a week or two. DO NOT SQUEEZE! Milia are NOT pimples, and squeezing could result in permanent scarring. DO NOT SQUEEZE! Milia are NOT pimples, and squeezing could result in permanent scarring.

The infant is learning about their new environment through all 5 senses….especially through the sense of taste. Everything goes into the mouth, so it especially important to keep small items away. The 5 senses... Taste: Baby’s taste buds are immature. They taste sour and bitter, but prefer sweet. They do not taste salt for several months. Hearing and smelling: Both of these senses are well developed at the time of birth…and probably have been since the 2nd trimester of prenatal development. Feeling/touch: By the end of the 8th month of prenatal development, nearly every part of the body is sensitive to heat, cold, pressure, and pain. Sight: Vision is the last of the senses to develop. At birth, the infant can clearly focus on objects within a distance of 8 – 12 inches. The ability to see color develops over time, beginning with the brightest and boldest colors.

Hair care... While many babies are born with a full head of hair, others are nearly bald and stay that way for up to a year. Hair usually does not need to be shampooed daily; twice a week with a non-tearing product may be sufficient. Soft baby brushes are available or regular combs can be used gently.

Hair loss... Babies born with hair often lose it during the first six months of life. This is because hair alternates between two stages, a growing stage and a resting stage, and in newborns, all of the hair follicles enter the resting period at the same time, causing them to fall out. This hair loss is thought to be due to the natural drop in a baby's hormone levels right after birth. (New moms often lose hair for the same reason.) A baby may also have bald patches on his scalp from sleeping in the same position or rubbing his head against the mattress. This may decrease as he starts to move around more on his own, or if you deliberately change the position your baby sleeps in.Some babies not only lose their hair, but also when their new hair comes in it's a completely different color and texture.

Cradle cap is actually a form of dry skin, often due to a lack of circulation in the scalp since baby’s head rests against mattress surfaces for prolonged periods. It looks like white to yellow flaking skin on the scalp. This is not an infection and is not contagious. To help prevent this, use a soft brush or a special scalp brush to brush the scalp vigorously and daily in the opposite direction the hair grows. To try to dissolve existing scalp flakes, you can apply mineral oil to the affected areas and leave it on about 6 to 8 hours, followed by a thorough washing and brushing. Cradle cap...

Skin care... The skin of a newborn baby is very sensitive, particularly on the face and scalp. Applying lotions or oils to the baby's skin is generally not recommended because they can clog pores and cause or aggravate rashes. If baby’s skin is very dry, however, and a lotion is needed, (which is especially true in overdue babies) you should avoid some product ingredients. Make sure the lotion contains: 1. NO GREASE / OIL 2. NO ARTIFICIAL COLORS 3. NO ARTIFICIAL ODORS Keri Lotion is a popular brand of lotion containing no oil or artificial colors and scents.

Care of the umbilical stump... Within about one to three weeks after birth, your newborn's umbilical stump (where the cord was attached at the navel) will turn black, dry out and fall off. If the stump is very moist, you can use rubbing alcohol on a cotton swab to wipe around and under the area one or more times a day. The alcohol evaporates quickly, and causes drying. The baby may cry, but it is because the evaporation causes a cooling effect. It is cold, not burning. Sponge bathe rather than tub bathe the baby, and try to keep the diaper below the belly button until the cord has completely healed. Call the doctor if the belly button becomes red, bleeds or smells bad. The normal belly button is an “innie”, pulled inward as the stump dries and falls off. “Outies” are caused by a weak or split abdominal muscle. This often corrects itself by age 2, but could be repaired if desired for cosmetic reasons at a later age.

Diaper changes... If the urine is dark and your baby has not wet his diapers 6-8 times a day, he may not be getting enough formula or breast milk. Baby may have a bowel movement between every diaper change, or as little as once every day or so. Begin and end diaper change by washing hands in hot, soapy water. Step 1: Unfasten the diaper Step 2: Use the diaper to remove excess feces from skin; place a clean cloth or diaper over the genital area on a boy baby to avoid a “warm shower” during wetting Step 3: Hold baby’s bottom up by gripping ankles and remove soiled diaper Step 4: Fold the dirty diaper in half, with the unsoiled half up Step 5: Clean front of genital area with damp washcloth or baby wipe; wipe from front to back on baby girl to avoid the introduction of bacteria into vagina (causes infections) Step 6: Lift both of baby’s legs and clean bottom.

Step 7: Place top half of diaper under baby’s rear and bring bottom half up between legs; a moisture barrier cream can be used on the skin at this point; NO POWDER as it can be inhaled and/or cause vaginal infections in girls Step 8: Fasten diaper securely

Constipation... Your child is not constipated if his or her stools are soft and pass easily, even if it has been a few days since the last bowel movement. Constipation occurs when stools become hard and are difficult to pass. It is not unusual for a baby to turn red and strain while having a bowel movement even when they are not constipated, so do not use that as an indicator. . Never use artificial laxatives or stool softeners without the orders of a physician. Babies easily become dependent on these chemicals. For natural relief: Mix 1 tablespoon dark Karo syrup in 4 ounces of water and feed from a bottle.

Bathing... Supplies needed: Washcloth or two, towel for drying, large towel to place baby on, mild soap and shampoo, clothes, diaper, basin or tub or sink. The room temperature should be at about 75 degrees. Babies do not cry at bath time because they are afraid of water…they developed in the womb in a bag of water! They cry because they are cold and feel insecure without a diaper and clothing. Try placing a warm washcloth over the baby’s chest. Bathing every other day is adequate.

Checking bath water temperature... Dip your elbow in the water to check the temperature of baby’s bath. The water should be nice and warm, but not hot. Over 4,000 children a year are scalded in hot bath water. Liquid crystal temperature displays on bathtub toys monitor bath water temperatures. Under no circumstances should baby ever be left unattended in or around water…not even for just a minute! Drowning and burns are two of the top five causes of death in children under the age of one year.

The baby's nails may be softer and more pliable than an adults, but they're sharp, and a newborn, who has little control over his flailing limbs, can easily end up scratching his own face. Longer nails also easily become ingrown, and in turn, infected. Little fingernails grow so fast you may have to cut them as often as a few times a week. Toenails require less-frequent trimming. Trimming nails... The best time to trim nails is while he's sleeping, and after a recent bath when they are still very soft.. Press the finger pad away from the nail to avoid nicking the skin, keep a firm hold on your child's hand as you clip, and cut straight across. You can use a pair of baby scissors or clippers made especially for this purpose. If you do nick the skin at the tip of the nail, you can expect it to bleed profusely for quite a long period of time. A band aid is not appropriate on an infant who sucks on their fingers, so you simply apply pressure and hold the area above the heart. It might be easier and safer to use a nail file.

Bulb Syringe... A bulb syringe is used to clean your baby's nose and mouth of formula or mucus. You may use it when your baby spits up, has a stuffy nose or sneezes (this is how he clears his nose). To use, first squeeze the bulb until it is collapsed. Place it in one nostril and quickly release the bulb. This will bring the formula or mucus into the bulb. Remove the bulb syringe from the nose and squeeze the bulb quickly into a tissue to get rid of this material. Repeat for the other nostril (and mouth, if necessary).

Baby's stuffy nose... Itchy, watery eyes and nose are hallmarks of an allergy, as are repeated sneezing attacks and itchy skin that lasts for weeks or months. Also, the mucus coming out of your child's nose will continue to run clear. Allergies aren't associated with fever, and they tend to show up in the spring, summer, and early fall. When baby has a cold, they often run a low grade fever. The mucus from the nose thickens and turns yellow or green. Colds tend to show up from December to April. A common source of the stuffy nose is fabric softener. In an effort to make all of baby’s blankets and clothing soft, it is sometimes overused. If baby doesn’t appear to have a cold or allergy, try cutting down or out the use of fabric softeners. In the meantime, use a bulb syringe to clear the nasal passages.

Cleaning baby's gums... Begin daily mouth-cleaning at birth before teeth appear. Wipe the roof of mouth and insides of cheeks with a clean soft damp fabric cloth. Then use this same cloth, wrapped around your finger, to brush your baby’s gums just as it they had teeth. This cleans and increases circulation in the gumline. Healthy gums…healthy teeth. When the first teeth appear, brush them gently with a small, soft bristled toothbrush. Fluoride toothpaste is not recommended for children under age 3.

Teething... Children typically begin to erupt a tooth between the 6th and 8th month of life. Signs of teething are: drooling, irritability, gum swelling and sensitivity, sleeping problems, refusing food, the urge to bite on hard objects and possibly a low grade fever. The discomfort that results from teething is due to the pressure exerted on the tissue in the mouth, called the periodontal membrane, as the teeth erupt. The front four (incisors) teeth are usually the first to appear. In some cases a bluish swelling is visible shortly before the new tooth arrives. The chewing edge of these teeth may have three small bumps which normally wear off with use. A full set of primary teeth (20) is usually in place by age three. To relieve baby’s pain you can provide specially designed toys for teething including ones to put in the freezer, topical numbing medications, and acetaminophen. No wooden objects. No ice cubes. No toys in the freezer not designed for that purpose.

Taking baby's temperature... Baby is fussy and crying. You suspect they may be sick. An adult’s internal “thermostat” is very sophisticated and will control their temperature quite well. It doesn’t rise too quickly, or too high easily. For a baby, however, that is not the case. Any temperature over 99 degrees is considered a fever, and that temperature can soar quickly to high numbers. The time and effort it takes to measure baby’s temperature will depend on the type of thermometer you are using. Thanks to technological advances, many methods are now available, some more accurate than others.

Hand on forehead: Touching the forehead is somewhat reliable for detecting fevers over 102°F (38.9°C) but tends to miss mild fevers. It might simply be used as an indication of when you should get out a thermometer. Ear thermometers: Many hospitals and medical offices now take your child's temperature using an infrared thermometer that reads the temperature of the eardrum. In general, the eardrum temperature provides a measurement that is as accurate as the rectal temperature. The biggest advantage of this thermometer is that it measures temperatures in less than 2 seconds. It also does not require cooperation by the child and does not cause any discomfort. Ear thermometers for use at home have been developed, but they are expensive.

Digital electronic pacifier thermometers The new electronic pacifier thermometers have a heat sensor and are powered by a button battery. These pacifiers let you measure oral temperature in younger children. They are quite accurate if 0.5°F is added to the digital reading. They take approximately 3 minutes to reach a steady state. An added advantage is their low cost.

Digital electronic thermometers Digital electronic thermometers measure temperatures with a heat sensor and require a button battery. They measure temperatures quickly, usually in less than 30 seconds. The temperature is displayed in numbers on a small screen. The same thermometer can be used to take axillary, rectal, and oral temperatures. (see slide on glass thermometers for more instructions) Digital thermometers tend to be more accurate than glass thermometers. There are several varieties as pictured here and some can be purchased for $10 or less.

Loosen tight clothing • Check the nape of baby’s neck; if it is moist baby may be too hot; remove some clothing and/or adjust room thermostat • Give fluids • Tepid water sponge bath • Give recommended dosage of acetaminophen (non-aspirin fever reducer/pain reliever) or ibuprophen medication Fever is the body's normal and healthy reaction to infection and other illnesses, minor and serious. Fever is a symptom, not a disease. Some babies run fevers frequently, even in response to room temperature and too much clothing. Often the importance of a fever can be determined only when other symptoms are evaluated. What to do for baby's fever...

How high is too high?... It’s time to call a doctor when baby’s temperature is too high. Be prepared to tell the doctor: 1. child’s age in months 2. the method you used to take the temperature 3. the actual thermometer reading 4. what medications or precautions you’ve already taken to relieve the fever.

By definition, colic is when baby cries for 3 hours or more a day, for more than 3 days of a week. Colic... There is no cure for colic. The cause of colic is debated by experts. Some believe it accompanies an immature digestive system (they get a tummy ache after eating), and others believe it accompanies an immature nervous system (inability to cope with all the stimuli of their environment). It's estimated that up to 40% of all infants have colic. It usually starts between the 3rd and 6th week after birth and ends by the time the baby is 3 to 4 months old The parents of a colicky baby feel frustrated, isolated, stressed and helpless to do anything. The condition seems to intensify toward evening hours. It may last from 3 weeks up to 3 months, but rarely beyond.

Washing baby clothes... Avoid washing baby’s clothes with those from the rest of the family. Chemicals from adult deodorants, colognes, hair sprays, etc. could transfer to baby’s clothes in the washing process. • Use soap, not detergent. There are several brands available. Detergent can leave a harsh residue and can remove the fire-retardant that is used on baby clothing. • Rinse twice, to make sure all soap residue is removed. It can cause rashes. • Wash diapers separately. • Use oxygen bleaches, not chlorine bleach. • Avoid the use of fabric softener.

Leading causes of death... For children younger than one year of age, the leading cause of unintentional injury-related death is suffocation (sids), followed by motor vehicle occupant injury, choking, drowning, and fire / burns. The highest rates of suffocation occur when babies are in their cribs or sleeping with their parents. If an object is small enough to slide through a toilet paper tube, it presents a choking hazard to the infant. Use rear-facing child safety seats for babies under 1 year old and up to 20 pounds.

Sudden Infant Death Syndrome... • Sudden Infant Death Syndrome (SIDS) is defined as the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and review of the clinical history. • SIDS is the leading cause of death among infants aged 1–12 months, and is the third leading cause overall of infant mortality in the United States More SIDS deaths happen in colder months ( when babies are bundled up with more blankets and clothing). Babies placed to sleep on their stomachs are much more likely to die of SIDS than babies placed on their backs to sleep. https://www.youtube.com/watch?v=RRrVAghEh7k http://www.nichd.nih.gov/sts/about/environment/room/Pages/default.aspx ] To help hold baby in a back-sleeping position, you can use a blanket. Place baby with his or her feet at the foot of the crib. The blanket should reach no higher than the baby’s chest, and the ends of the blanket should be tucked under the crib mattress.

Some physicians believe that Sudden Infant Death Syndrome is associated with a sleep disorder called sleep apnea. In this condition, the person goes so soundly asleep and muscles are so relaxed, that their airway actually closes off. IF a good gasp reflex is present, they will “gasp” and start breathing again. Many hospitals monitor baby for this reflex before sending them home after birth. Parents have a great deal of difficulty facing the death of any child, but to face the unexplained death of a healthy and contented baby sleeping in it’s crib is almost unbearable. Couples/marriages are often crippled by blame, rage, and guilt after the loss of a baby to SIDS.

Shaken baby syndrome... Shaken Baby Syndrome (SBS) is the collection of signs and symptoms resulting from the violent shaking of an infant or small child. Frustration and stress are the reasons some one shakes a child. A crying child is reported to be the number one reason why people have shaken a child. When shaking occurs, the brain bounces within the skull cavity, bruising the brain tissue. Swelling and bleeding occur. It is a potentially fatal form of child abuse. Approximately 1,200 - 1,400 children are shaken in America each year, for whom treatment is sought. Of these, 25 -30% die as a result of their injuries. The rest have lifelong complications. WHEN YOU CAN’T TAKE IT ANYMORE… WALK AWAY!

Specific methods of COPING WITH CRYING are listed below: • 1. Walk or dance with the baby. • 2. Rock the baby. • 3. Bounce the baby gently in your arms or on a bed. • 4. Take the baby for a ride in the carriage. • 5. Take the baby for a ride in the car. • 6. Put the baby in a wind-up swing. • 7. Turn up the music on the radio or stereo, run the vacuum, or let the water run in the tub as a • distraction for you and the baby. • 8. Offer the baby a noisy toy, shake it and rattle it. • 9. Sing or talk in a quiet, sing-song way. • 10. Put the baby in a soft front carrier, close to your body. • 11. Lay the baby's tummy down across your lap and gently rub or tap his/her back. • 12. Lay the baby across a warm hot-water bottle on your lap or a bed. • 13. Massage the baby's body and limbs gently; using a warmed lotion, if the weather is cool. • 14. Swaddle the baby tightly. • 15. Feed and burp the baby one more time or offer a little warm water. In desperation, add a tiny • bit of sugar to the water or to weak chamomile tea. • 16. Offer a pacifier (the Nuk allows less air to pass in around the baby's mouth and is better for a • colicky baby) and hold it in the baby's mouth if necessary. • 17. Hold the baby close and breathe slowly and calmly; the baby may feel your calmness and • become quiet. • 18. Cross the baby's arms across the chest and hold him or her down on a bed with gentle, firm • pressure. • 19. Remove yourself and let someone else take over for awhile. If a family member is not • available, consider hiring a sitter for a short period of time. • 20. If nothing works, put the baby in his/her bed, close the door, and turn up the TV or radio. • Check the child every 15 minutes or so, for your own peace of mind.

INFANT CARE TECHNIQUES THE END

INFANT CARE TECHNIQUES