A rough estimate can be made that the baby is at the right temperature by  –

• Keeping the room temperature at 18-22 degree centigrade. (Buy a room thermometer).
• Baby has to be pink in colour always. If the hands and legs are bluish/ mottled they could be cold. Warming them up by putting on socks/ skin to skin contact will reverse it in a few minutes. If it doesn’t, then call a doctor.
• Baby should be comfortable(not wriggling or crying uncomfortably)
• Baby should gain weight adequately( 20 to 40 grams every day-depending on the gestation of the baby ). Remember baby spends energy to maintain body temperature. Hence the more the cold, the more the weight loss.
• A rough estimate of right dress for the baby-
  Always add an extra cotton Dress to whatever you are wearing.( example- If you wearing a shirt and a sweater, then give the baby a shirt, sweater+ Cotton dress)

FEEDING BASICS

• There is a difference in feeding a preterm baby ( baby born before 37 weeks gestation) and Term babies( born after 37 weeks gestation)
• Term babies have higher birth weight ( hence more stores of energy) and their brain functioning is more mature. They know when they feel hungry, feel cold etc. Hence in them ‘Demand Feed’ is accepted. That means whenever the baby cries for feed, then feed the child as much quantity the child demands.
• In preterm babies ( at least until they reach corrected age of 40 weeks) regular feeding should be established. that is at least once every 4 hours. These babies need more support to maintain adequate body functions.
• Generally, babies are fed ( 120 ml/ kg to 150 ml/kg per day ) in divided doses. Ex if the child is 2 kgs then per day the child requires 120ml X 2 kg = approx. 240 ml/day in divided doses.
• The quantity may vary depending on the clinical condition.If in doubt always consult your doctor.

Features of well-fed baby

• Baby is pink in colour and active
• Sleep comfortably for 2-3 hours after each feed
• Passes adequate urine( at least once 6 hourly) and stool has changed colour to yellow after 5 days of life
• Baby is gaining adequate weight(  15 to 30 gram per day ) depending on gestation at birth

BREASTMILK v/s FORMULA MILK

• Breast milk is the best as it’s perfect for the baby.  Breast milk helps in providing resistance to infections, and adequate minerals and nutrients ideal for baby
• There is less incidence of Allergy, Loose stools, Obesity in later life and more Intelligence Quotient in babies on breast milk
• First-time mother may take some time to secrete adequate breast milk. But remember the more you empty the breast( by feeding the child completely from each breast each time or by expressing the milk into a clean container after each feed) the more milk you will have the next time.
• Formula can occasionally be topped up in certain conditions like if there is inadequate breast milk( especially after surgery in other)
• It is believed – Breast milk is for brain development and Formula milk help body development( weight gain)

TO NOTE

• Mothers who breastfeed their babies need plenty of rest as most milk production takes place at sleep. Aim to sleep at least 8 hours at night and 3 hours during the day.
• Mother also have to have extra calories( around 500 Kcal More ) and food rich in vitamins, iron, fibre, nutrients when feeding.
• Drink plenty fluids

FREQUENT QUESTIONS

• Adequacy-
• If you feel the fullness of breast and milk flow then you should have adequate milk.
• Also see above for features of well feed in babies

CRYING

• A healthy baby cries every day. Maybe about 3-5 hours.
• But they are consolable -by carrying them in your arms/ slowly rocking them.
• A healthy baby is comfortable. They feed adequately, sleep comfortable, are happy
• Babies can cry for various reasons from hunger, nose blocks, insect bites to severe medical conditions.
• I recommend to first strip the baby of clothes( still keeping them warm) and look for any obvious signs like colour change/ breathing difficulties/ rashes/ swellings and contact the doctor appropriately

• For first six months, your baby should be in the same room as you when they’re asleep, both day and night.
• Initially, babies are comfortable to sleep in your arms.
• Then help your baby adapt sleeping on the bed, by putting them down before they fall asleep or when they’ve just finished a feed
• Babies should always sleep on a firm mattress with no much padding/ pillows.
• A rough estimate is that baby should have their neck in a neutral position( no flexion of the neck).
• Baby should never share the same cot as you( use a cradle beside the bed)
• If the baby suffers from Reflux you can elevate the bed ( max of 30-degree angle)- Remember the whole bed should be elevated at the head end. Make sure there is no neck flexion
• Never let baby sleep on its tummy.
• Keep distractions to minimum / dim lightroom and right temperature

BATHING THE BABY

• You don’t need to bathe your baby every day. If the baby enjoys it then there is no harm.
• For the first 1 week( until umbilical cord falls off) try Sponge bath( wipe body with wet sponge)
• Use plain water (no detergents/ soap) until the first month.
• Choose a time when the baby is awake and playful (Not sleepy or hungry and never just after a feed).
• Make sure the room is warm.
• The water should be comfortably warm( Dip your hand and make sure)
• Try talking to the baby (or sing) and make it enjoyable
• Try to pat the baby dry
• Never leave your baby alone in the bath, not even for a second.

• If trying a new product, apply the product to the forearm and wait for 30 min to see any allergic response.
• If no redness or irritability, then, generally the product might be safe (Don’t use harsh products on babies).

• Most babies pass stool within 48 hours of being born. If not- Consult your doctor immediately.
• Babies pass dark green stool (Meconium) for first 3-5 days.
• It should start changing to Yellow by 5 days
• It should never be Pale white.
• Babies pass stool frequently( 5-8 times/day) or once in 7-10 days.
• Both extremes are normal, provided there is no s/o dehydration (See below)

BREATHING

• Babies breathe faster than adults.
• But they are comfortable, smiling, looking around and responding.

Rate

• Any baby breathing more than 60 times a minute should be seen by doctor( beware- agitated babies breathe fast. consider counting the rate by observing the chest/ tummy movements for 3 minutes during calm/ sleep and divide total by 3)
• The breathing is smooth and generally not laboured (no in drawing of tummy muscles or chest muscles)
• No abnormal sounds during breathing
• No change in colour.
• Some episodes of sneezing/ coughing(occasional) can be normal in the baby. A child needs to be seen if cough/sneeze is not settling.

• Abnormal drowsiness/ inactive
• Change in colour
• Increased breathing effort/ severe distress
• Unable to feed
• Excess crying/ continuous cough

• Baby is pink, playful, comfortable and warm.
• Passing urine once in 6-8 hours.
• Feeds regularly and sleeps comfortably.
• Tears present in the eye.
• Mouth is moist.
• The soft spot on head(Fontanelle) is at level (not depressed). Gently feel the spot( Never Press it).

• Baby did not pass urine (beyond 18 hours)
• Baby lethargic/ dry/ pale
• Not feeding
• Repeated vomiting/ Loose stools
• Depressed Soft Spot/ No Tears
• If your baby suffers from vomiting/ Diarrhoea- Always consider giving Oral rehydration solution slowly( 5-10 ml every 5 min- though spoon/ syringe/ dropper) and seek medical advice

• Red rash appearing in the nappy area
• Generally due to wet nappies/ Fungal infections
• Fungal infections are more red/ itchy/ and scary at times( Needs medical attention)

• Change your baby’s diaper frequently, soon after bowel movements.
• Clean area with warm water/ wet wipes, apply diaper rash cream.
• Creams with zinc oxide are effective.
• If you use cloth diapers, wash them in dye- and fragrance-free detergents.
• Let the baby go undiapered for part of the day( Keeping baby warm).
• If the diaper rash continues for more than 3 days or seems to be getting worse, call your doctor — it may be caused by a fungal infection that requires a treatment.

CAPUT

It is the swelling overhead( Scalp) in new-born due to Pressure from natural delivery

It is relatively innocent swelling which disappears in a few days

COMPLICATION

Can cause exaggeration of jaundice

Rarely gets infected

If the swelling doesn’t improve over 2 weeks consult a paediatrician