This was my baby's first photo.
It is often shocking to people. This one is a little easier on the viewer.
But, people prefer this one. The one where she is stronger, away from the sterile equipment, and the feeding tube is hidden.
I love all of the photos. She is my baby, my girl, my fighter, my survivor. I loved every single bit of that preemie girl. No tube, alarm, incubator, or hospital wrist band could change the depth of my love. What changed was how I could care for her. The planned going home outfit, the bassinet, the infant toys were not in the picture. My baby was not going home with me. Learning how to provide newborn care for my preemie in the NICU was a delicate journey. My access to her gradually increased as her strength gradually increased. As with any first time mom, I was on a journey. Yes, a journey complicated by prematurity, but a journey of how to care for my newborn. The fabulous NICU nurses taught me in real-time how to take care of my newborn, tips that can be used my any mother. First time parents all experience some degree of panic when it comes to newborn care. Continue reading to learn these NICU tips to making newborn care simple.
Newborn Care - Your Baby Needs:
- Skin to Skin: First and most importantly, was skin to skin contact. Each morning I would gather my little love and snuggle her skin to skin. No blanket in between. No shirt in between. Her precious skin to my yearning skin. I would drape her with a blanket and put a little hat on her head to help keep her warm. But skin to skin. Skin to skin all day long. Research abounds on the benefits of skin to skin contact between a newborn and the mother and between infants and a mother. Skin to skin snuggling leads to a happier baby and can calm babies quickly. In addition, skin to skin contact stabilizes the baby's body temperature, blood sugar, heart rate, and breathing rate. Babies who are kept skin to skin with the mother are more likely to latch successfully when the breast is offered.
- Newborn Bath Frequency: Your newborn does not need a bath every day, not every other day. Bathing a newborn every 2-3 days is completely sufficient. Bathing your baby too often can dry out their skin. If you are changing diapers in a timely manner and wiping their face after a spit-up, the main areas of attention are already being cleaned: that cute tushie and sweet face. My daughter has had dry skin since birth. It was recommended we only bath her every 4 days. I know that little hooded towel is so cute and you are excited to begin this often soothing routine, but there will be plenty of baths in your future!
- Newborn Bath Time: When you are bathing your newborn, use comfortably warm water tested with your elbow to make sure it is not too hot. Newborn baths are easiest at the kitchen sink. Kitchen sinks are at the right height for you to feel comfortable and keep your little love secure. Use a plastic, rubber, or inflatable tub in the sink or place a folded towel on the bottom of your sink to prevent slipping. I found it helpful to have not only her hooded towel ready, but also a towel draped over my shoulder. Removal from the tub to a warm towel on my chest was now quick and soon to be followed by her warm hooded towel. Begin washing your baby's head and face with a soft cloth, move to neck, shoulders, arms, belly, and legs. Save their tushie and genitalia for last. Newborn skin is sensitive; there is no need to use soap or shampoo unless your baby has particularly oily skin. When you do use a soap, choose a mild soap specifically labeled for a baby, limit the soap's time on the skin, and avoid scrubbing any area.
- Newborn Diapering: Well, if you do not know it by now, prepare yourself for A LOT of diaper changes. Seriously, A LOT! Newborns should be changed for urine eery 2-3 hours and promptly for a bowel movement. Expect to change newborn diapers 12-15 times a day. No joke! Here is a NICU tip: urine is sterile and you do not need to wipe a baby's bottom after every wet diaper. If your baby has been in a wet diaper for more than 2-3 hours (perhaps you are a lucky parent with a newborn who sleeps for 4-5 hours at night!), you can give a wipe to freshen up the area. Of course, a bowel movement will require wiping, lots of wiping. If you wipe, allow the area to dry before securing a clean diaper. Two reminders! Boys benefit (actually you benefit) from placing a cloth over their penis when changing their diaper. Girls should always be wiped from front to back, making sure to clean any poop from the folds of her labia.
- Newborn Diaper Rash: Avoid the dreaded rash by changing your baby frequently, limiting the use of wipes, and letting your baby air-dry completely before placing the next diaper. There is no need to apply ointment or diaper rash cream as a preventative measure. However, if you see an area with a red appearance apply Vaseline or A&D Ointment. These two creams will create a barrier between your baby's sensitive skin and the poop or pee. If the rash becomes worse, use a cream with zinc (i.e. Desitin) to aide in healing the skin.
- Newborn Cord Care: Guess what? No need to worry about cord care! That's right, you actually do not have to do anything to care for your baby's umbilical cord stump. The stump typically falls off between two and three weeks after birth. Some chose to swab alcohol around the stump to facilitate the drying and eventual detachment process, but this is not necessary. Regarding cord care, there is only one thing you should do: fold the top of the diaper down in the front, so that the cord stump is not irritated by the top of the diaper. When the cord stump does detach, you may notice a slight stinky smell, a yellowish discharge, or a little blood. No need to worry, this is all normal and part of the process of healing. However, if the smell and discharge do not disappear within a few days or the skin around the site looks red or infected, definitely consult your pediatrician.
- Newborn Breastfeeding: Please take advantage of any lactation support available in the maternity ward of your hospital or at your obstetrician's office. They are fountains of knowledge about breastfeeding. Lactation specialists at our hospital helped size me correctly for breast shields, turns out I was using a size too small. Due to my daughter's prematurity feeding was difficult by breast or bottle. To make our breastfeeding attempts a little easier on her and me, the lactation consultant recommended I use nipple shields. My daughter never became a pro at breastfeeding, but these tips helped her master some degree of breast feeding and for me to have efficient pumping for bottle use.
- Keep in mind that for most new mommies, breastfeeding is initially challenging. It's not just you! You and your baby will need a couple of weeks to get into the swing of things. In general, nurse early and often! That means within the first hour of birth and every two hours thereafter. Remember those first couple of weeks can be challenging, but soon latching and feeding will become a smooth process and a routine will develop. Plan on 8-12 feedings a day, hopefully with a 4 hour stretch at night where both of you are sleeping. New mommies often worry that their baby is not getting enough to eat. In general, if your baby is urinating 6-10 times a day, calms after nursing, is producing mustard-yellow poop, and has regained his/her birth weight within 2 weeks, you and baby are doing just fine!
- Remember your milk supply works on the premise of supply and demand! Your baby breast feeding stimulates demand which in turn stimulates supply.
- Also remember to work with a lactation specialist or a seasoned nurse to help with various holds for breastfeeding and supporting a strong efficient latch.
- Newborn bottle feeding: Some mothers prefer to bottle feed over breast feeding. Some mothers, like me, had to bottle feed due to particulars regarding my daughter's development. Some mothers have to bottle feed due to their baby's gastric sensitivities. Nursing is fabulous! Bottle-feeding is fabulous! You know why? Because you are still feeding, nurturing, and bonding with your baby no matter your method! Bottle or breast feeding does not make you a fabulous mother or your baby superior to another baby. Feeding your baby makes you a fabulous mother, and all babies are equally fabulous!
- With bottle feeding you will be able to track how much he/she is drinking at each feed. Don't panic if there is variation! Also, try not to compare how much your baby drinks against the quantities of another baby. Initially your baby will take only .5 to 1.5 ounces or breast milk or formula a day. Over the course of a few days this will increase to 12 to 24 ounces a day.
- Whether you breast feed or bottle feed, documenting length of time nursing, quantity consumed during bottle feed, times of each feeding, and number of pees/poops can be helpful. I used a notebook and pencil (I'm a bit old fashioned), while some of my friends chose an app to document their feeding particulars. Documentation and charting can help reassure you that your baby has received enough nutrition, is peeing and pooping regularly, remember which side you breast feed from, and help you recognize an emerging schedule. I had no memory in the early months, so my notebook chart served as my visual memory.
- Never place a bottle of milk in the microwave! Never! Microwaving can create hot spots which will scald your baby's mouth and it destroys valuable antibodies in breast milk. So don't even think about it. You can use a bottle warmer, or just simply place the bottle in a bowl of hot water for a few minutes. Yep, that easy. Always test milk on your wrist for temperature before offering it to your baby. Keep in mind that babies do not need their milk warm. Nope, they sure don't! There is absolutely no medical reason to warm your baby's milk. Some babies prefer their milk warm, some at room temperature, some chilly, and some just do not care what temperature it is. We warmed our daughter's milk in the beginning, primarily due to the fact that she was a preemie and was working hard to regulate her body temperature. However, we soon found that she consumed room temperature milk and milk from the fridge with the same zeal.
- Regarding formulas: If your baby is born premature, has any medical concerns, or there is a family history of cow's milk intolerance, follow your pediatrician's recommendation for a specialized formula. Otherwise, doctor's agree that you should start with a standard cow's milk based formula first. Make sure the formula you chose is iron-fortified and contains DHA and AHA. DHA and AHA are fatty acids that have been linked to better vision and higher intelligence. If your baby does not do well on a standard cow's milk formula, consult your pediatrician before trying a new one.
- Please mix formulas with care! Read the recommended ratios carefully whenever you make a bottle. An incorrect ratio can be dangerous for your baby.
- Newborn Burping: Burping is a natural body function. With babies, we just need to help move those air bubbles out. Typically lifting your baby towards your chest with his/her head above your shoulder and patting his/her back will prompt a burp. Some babies burp easily, some take a while. Some babies don't consume much air when they drink and may burp infrequently. Some babies respond to patting lower on the back instead of between their shoulder blades. Some babies prefer to be seated on your lap, tilted forward with their head and neck supported by your hand and then patted. Some babies burp with greater ease when they are laid on their belly across your lap (the compression on their belly helps speed those air bubbles out). Some babies respond to a pat, pat, rub sequence. There is no protocol on how to burp! Just make sure to burp half way through a feeding session or when you switch breasts, and at the end of a feeding session.
The first few weeks or months can certainly be exhausting and challenging as you learn to care for your newborn, find a routine, and develop confidence in your skills.
Don't fret momma, you are fabulous and you will take excellent care of your baby! Remember to reach out to your friends, pediatrician, and specialist (i.e. lactation) for support.