Bathing Your Newborn

Baby's bath time needsA newborn doesn’t need a bath every day.  In fact, the World Health Organization and American Academy of Pediatrics don’t recommend a first bath until the baby is over 24 hours old.  Once your little one comes home, daily baths are still not necessary.  Doing so may cause skin dryness or worsen sensitive skin.  Although it is important to  clean your baby’s face after each feeding and keep the diaper area clean, it is safe to give a bath with soap every two days.  Because infants put their hands in their mouths frequently, the hands should be wiped with a damp cloth several times a day.

Until the umbilical cord stump falls off and the navel area has completely healed, give your baby a sponge bath instead of a tub bath.  Immersing the umbilical cord stump in water keeps it too moist which delays its separation.  On average, the stump falls off by day six of life.  If your baby boy had a circumcision procedure, sponge baths should be continued until the site has fully healed, about one week later.  

Bathe your baby in a warm room that is free of drafts.  Keep a towel or wrap nearby to dry your baby as soon as the bath is over.  Newborns can quickly lose body heat.  Bath time is a great time to bond with your newborn.  For your baby’s bath, you will need:

• a bowl or tub of warm water large enough for a sponge or a tub bath
• baby soap and a pH balanced baby shampoo (ask your pediatrician for suggestions)
• a soft cotton wash cloth and towel;  one with a hood is nice
• a set of clean clothes and a clean diaper

Sponge bath

When giving a sponge bath, wash the “cleanest areas” first (i.e. hands, chest, face), and the “dirtiest areas” (i.e. diaper area) last.  Keep your baby warm during the sponge bath by only undressing the parts you are bathing, or covering him with a soft towel.  After the bath, wrap him in a towel to prevent the loss of body heat.

Tub bath

Always keep one hand on your baby during a tub bath to prevent a drowning accident.  Put about 3 inches of warm water in an infant tub or a clean sink.  Your home water heater should be set no higher than 120 degrees Fahrenheit to prevent unintentional burns.  Always test the water temperature before putting your baby in it.  Use your elbow instead of your hands;  your hands are accustomed to hotter water than the rest of your body.  The water should feel warm, but not hot.  Fold a small towel, and place it in the bottom of the sink or tub to prevent slipping.  Talk to him as you lower him into the water;  not all babies enjoy tub baths at first.

Bath-time safety

Babies can have a bath at any time of the day, so choose a time that is not so busy for you.  It is better to skip a bath than to squeeze it into a busy day.  Bath time can be fun, but there are safety measures that should be taken to prevent accidents.  

• Never, ever leave your baby alone while giving him a bath.  If you are interrupted, take him with you, or put him in his crib.
• Keep the water level shallow.  However, unattended infants can drown in one to two inches of water.
• Silence your telephone, or allow calls to go to voicemail.
• Don’t bathe your baby in the kitchen sink while the dishwasher is running;  hot water can back flow into the sink, causing a scald burn.
• To prevent an accidental scald burn, set the thermostat on the home water heater below 120°F.

Hair and scalp care

 

Because infants lose more heat from their heads, wash your baby’s hair before placing him in the tub.  Dry the hair well before undressing him for bathing.  Holding your baby in a “football position” may make it easier to wash his hair.  Unless directed by a doctor, use a “tears free” baby shampoo.  Wash your baby’s hair and scalp twice a week, massaging in a small amount of baby shampoo added to a soft washcloth.  It’s okay to clean the “soft spot” area since it’s protected by a thick membrane.  While rinsing the hair, allow the water to run toward the back of the head to keep the shampoo away from the eyes.  Even a “no tears” shampoo may sting.  Dry the hair well with a towel to prevent the loss of body heat.

Some infants develop yellow, greasy scales on the scalp, eyebrows, and behind his ears, commonly called “cradle cap.”  This is an infant form of what adults experience as dandruff, and it can spread from head to toe.  Although the exact cause is unknown, it is thought to be associated with an immune reaction to a fungus that is part of the skin flora.  Most infants outgrow it by their first birthday.  

The flakes of “cradle cap” can be removed in the following way:

  • Gently rubbing a small amount of baby oil onto the scalp.
  • Massage the scalp until the scales loosen.
  • Brush or comb the scales out of his hair.
  • Wash the oil and scales off with baby shampoo.

This last step is important because excess oil left on the scalp can worsen “cradle cap.”  Rinse his scalp well after shampooing;  any soap left on the scalp can cause irritation.  “Cradle cap” is not pretty, but it does not bother or harm your baby.  It is not contagious.  If your baby continues to have “cradle cap” as a toddler or the flakes are thick enough to pull out the hair, speak with your doctor.

Face, ears, nose, and eyes

Mother drying baby in towel

Wash your baby’s face with a soft cloth, taking care not to rub or irritate the skin.  Your baby may develop baby acne, a red pimply rash on his face, after the first few weeks of life.  No special treatment is needed.  Gently washing your baby’s face with mild soap and water every day may help, but it should self-resolve in three months.  There is no need to clean inside your baby’s ears.  Simply wash behind the ears where spit-up milk can accumulate.  If there are “cradle cap” flakes on the eye lashes, gently wash the eyelids.  Not all babies tolerate this;  your baby may squirm.

It’s OK to get water in your baby’s ears.  Avoid using cotton swabs (Q-tips);  you could damage the eardrum.  To get the water out, just gently turn her head to the side, and let the water run out.  Then, dry the outside of the ear with a soft towel.

Newborns primarily breathe through their noses, especially while feeding.  Therefore, it is important to keep this airway free of mucous until he learns to breathe through his mouth.  Sneezing is your baby’s way of clearing his nose;  it is not a sign of an illness.  Some nasal mucous is normal, especially if your infant has lots of spit-ups.  During illnesses, however, too much mucous can cause nasal congestion, making it harder for your baby to breathe.  Clean the mucous from your baby’s nose by suctioning it with a bulb syringe.  To do this, squeeze the bulb first, then gently place the tip of the syringe in front area of the nostril. Release the bulb to suck out the mucous, then expel the mucous into a tissue.  Repeat these steps until your baby is able to breathe easier.  It can be helpful to put a few drops of saline in each nostril before using the suction bulb to loosen the mucous.  If mucous has dried on the outside of the nose, dab it with a damp cloth until it softens, then wash it off.  Do not use cotton swabs (Q-tips) to clean inside your baby’s nose.  A sudden movement by your baby could cause an injury.   Clean the suction bulb well before using it again.

Some infants develop a clear or milky-white mucous discharge from one or both eyes.  The most common reason for this is a clogged tear duct.  To clean mucous from his eyes, lie your baby on his back, and turn his head toward the eye you are cleaning.  Wipe the eye from the inner side, by the nasal bridge, toward the outer edge with a soft cloth and plain water.  Try not to spread mucous from one eye into the other eye.  If the discharge starts after you are home from the hospital, call your pediatrician.  He or she will demonstrate how to massage the area to unclog the tear duct.  If the mucous becomes yellow or green, this could be a sign of an infection which warrants a call to your pediatrician.

Skin care

Our skin protects our bodies from infection which can occur easily on broken, irritated skin.  Therefore, it is very important to protect your baby’s skin.  Many rashes begin as a skin irritation.  It is best to avoid using soaps and lotions with harsh chemicals or fragrances that may irritate your baby’s skin.  Any soaps used for bathing should be rinsed well from the skin.  Scrubbing your baby’s skin can also cause irritation.  Gentle washing is all that is needed.

Rashes that appear briefly are typically nothing to worry about.  However, pimples or blisters could mean that your baby has an infection.  If you see this type of rash, especially in the diaper area, call your pediatrician.

Be sure to wash all skin folds and creases.  This includes the front of the neck where milk collects during feedings.  To clean this area, as your baby lies on his back, place your hand under his shoulders, lifting them up slightly.  This will cause his head to tilt back enough for you to clean his neck.

Peeling skin is normal during the first few weeks of life as healthy new skin lies just below the outer, shedding layer.  After a bath, it’s okay to apply small amounts of fragrance-free moisturizing lotion or cream.  This will prevent skin dryness, but will have no effect on newborn skin peeling.  You should not use any powders;  some contain talc which can irritate a baby’s lungs.  Lotions and oils may be unnecessary for many infants, so speak to your pediatrician before you using of any of these products.

Genitals

Be sure to wash your baby’s genitals.  Newborn girls may have a slightly creamy vaginal discharge during the first few days of life.  Sometimes, there is a trace of blood.  This discharge is normal, and should not be a cause for concern.  Your hormones, still present in your baby’s bloodstream, are the cause of the discharge.  They should be out of her bloodstream within a few days.  If this discharge lasts more than a week, call your pediatrician.  To clean her genital area, wash from front to back with plain water.  Also, don’t forget to clean her skin folds.

If your son has not been circumcised, you do not need to retract the foreskin when cleaning his penis.  Full retraction may not be possible for several years.  You may notice a waxy material, called smegma, on the head of the penis.  This is normal, but should be washed off.  Over time, more smegma will accumulate under the foreskin to allow retraction in the future.

If your son has been circumcised, be gentle while bathing and drying his penis until it heals.  To wash it, squeeze plain, warm water from a clean wash cloth over the penis, then let it air dry.  Your doctor may recommend the use of a protective ointment to prevent irritation from the diaper.  Once the penis heals, you can wash it in the same way as the rest of the body.

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Caring For Your Newborn Booklet

Caring For Your Newborn

Table of Contents
Introduction
Congratulations!
Caring Begins at Birth
Your Newborn’s Hospital Check-up
Ten Fingers and Ten Toes
Special Care for Your Newborn
When Your Newborn Cries
Changing Your Newborn’s Diaper
Feeding Your Newborn – breast or bottle feeding
Feeding Your Newborn – spit ups, weight gain, BMs
Bathing Your Newborn
Dressing Your Newborn
Shhh!! We’re Sleeping
Keeping Your Baby Safe
Your Newborn’s Admirers
Taking Your Newborn Out
If Your Newborn Gets a Cold
If You Have Questions
Well-baby Check-ups
When to Call Your Pediatrician
Take Care of Yourself, Too
Teddy Beat Drying

Page Contents