Baby’s fingernails grow quickly and can be very sharp. A newborn’s skin grows up under the fingernail so you should not cut baby’s nails. Instead, wait until your baby is sleeping and use a clean, non-metal nail file to smooth the edges and shorten your baby’s nails.
Skin care and rashes
Baby’s skin is delicate. You should use mild, non-perfumed soap when washing your baby. Most babies’ skin does not need lotions, oils or creams. If you choose to use them, please consult your baby’s doctor for guidance.
Some babies develop tiny white bumps or yellow spots across their noses or chins; these are called milia and will go away on their own in a few weeks. Do not try to pop them. Another common rash is newborn acne, which will go away in about six to eight weeks and does not require treatment. Just wipe the baby’s face with a clean, damp washcloth once or twice a day.
Jaundice is a yellowing of the skin and whites of the eyes developed by 50 to 70 percent of full term babies. It frequently is seen three to seven days after birth. Jaundice is caused by bilirubin, a by-product of the breakdown of red blood cells, and is removed by the liver, which in infants is often immature. Jaundice occurs first in the face, moves down the baby’s trunk, then into the arms and legs. A mild case will resolve itself in one to two weeks. The level is determined by a blood test for bilirubin. If the level gets too high, it is treated with phototherapy, which exposes the skin to a special light that helps the baby break down and eliminate the bilirubin.
To check for jaundice, place your baby near the window (natural lighting) and gently press on the skin over a bony surface like the nose or breast bone. If, when you release the pressure, the baby’s skin looks more yellowish than pink, your baby may have jaundice. Severe jaundice can cause brain damage. Call your baby’s doctor if your baby shows any of the following signs:
- Yellowing of the skin down to the bellybutton or yellowing of the whites of the eyes
- Poor feeding
- Very sleepy or sluggish infant
As a general rule, infants should be dressed in the same type of clothing that adults need to be comfortable, plus one additional layer, such as a onesie or light receiving blanket. Feel the back of your baby’s neck to see if they are too warm or too cool. If too warm, remove one layer of clothing; too cool, add a layer. Do not be afraid to go outside with your baby. A short walk is healthy for both of you; although baby should avoid direct sunlight and be kept in the shade or under cover.
Summer: When going outside in the warm weather, dress your baby in lightweight, long pants and a long-sleeved shirt. A brimmed hat to protect from the sun also is recommended. Babies cannot cool themselves as well as adults, so check your baby often. In addition to a hot and sweaty neck, other signs that your baby may be too warm are bright pink cheeks or skin that is warm to touch.
Winter: In cold weather, it is best to dress baby in layers. You can remove a layer if they get too warm or add a layer if too cool. Babies lose most of their body heat through their head; make sure you have a warm hat for your baby when going outside. Shoes are not needed until baby starts walking, but you should cover baby’s feet with socks. Signs that your baby is too cold may include mottled skin with blotchy spots of color, or blue or gray lips or extremities. If this happens, take your baby to a warm place and add a layer of clothes. At night, dress your baby in warm, footed pajamas or sleepers.
Change your baby’s diaper in a safe place. Infants can roll off any raised surface in seconds if not held, enclosed or restrained. Always have all your supplies within reach. When removing the diaper, use the front of the diaper to remove as much waste as possible. Then use a washcloth with clean, warm water or alcohol-free baby wipes to clean your baby’s genitals and bottom. Wipe from front to back, using a clean area of the wipe each time to help prevent infection. Make sure to clean between skin folds.
Wet diapers: By the end of the first week, baby should wet at least six to eight diapers a day with pale yellow or clear urine. In the first several days, you may see some rusty color in your baby’s diaper; these are uric acid crystals, commonly known as “brick dust.”
Stools: Baby’s first stools are black and sticky, called meconium. They become lighter in color and occur more frequently by the third to fourth day of life. By days five to seven, breastfed babies should be passing soft, seedy, brownish-yellow stools at least three to four times per day. As your baby grows and eats, a typical pattern of stooling will develop. Contact your pediatrician if your baby has diarrhea or becomes constipated.
Signs of Health Issues
Call your baby’s pediatrician if your baby has any of the following:
- Temperature less than 97°F or more than 100.4°F rectally
- Vomiting, more than just spitting up (report the color: green, red, etc.)
- Refusing to take more than two feedings in a row or unable to arouse for feedings
- No energy, difficulty waking up
- Diarrhea (loose, watery stool), especially if there is mucus, blood or a foul smell
- More than two watery stools
- Constipation (hard, pebble-like stool) or if baby does not have a stool for three to four days
- Less than six to eight wet diapers in a 24-hour period (after day 5)
- Hard, excessive crying or irritability with no obvious cause
- Redness or foul-smelling, pus-like discharge around umbilical cord or bleeding more than a few drops
- For male babies, any increasing redness or blue or black areas at the circumcision site or bleeding more than slight spotting that will not stop with pressure
If infant has labored breathing, is struggling to breathe, or appears blue or gray, call 911!!