Keeping Your Baby Clean

The gentle art of newborn bathing and cord care

Bathing

While baths are not absolutely necessary every day for the first couple of weeks, it is okay to bathe baby if you wish.

Sponge baths should be given while your baby's umbilical cord is still attached and also as a boy's circumcision incision heals. Do not tub bathe your baby the first one to two weeks to allow healing for the circumcision and umbilical cord. A sponge bath can get them squeaky clean as you can gently wipe down areas with a soft, wet cloth. These areas include the baby's bottom, behind the ears, the head and creases of the neck where milk or spit-up can run. First start by gentling wiping one baby eye then the other using different parts of the wash cloth as to not spread any bacteria from one eye to another, then wash the face, torso, arms, legs and last the genital/bottom area. 

The ears should be cleaned with a soft cloth or cotton swab, but never stick a cotton swab into the ear canal! It is also a good idea to start gently exfoliating the baby's scalp at each bath with a very soft brush or comb.

Whether you are sponge bathing or tub bathing you will need to have the room comfortably warm (72ºF) and free of draft. Check water temperature with your elbow or wrist. Never leave your baby unattended in the bath water! Make sure you have everything you need before you begin the bath; wash basin, wash cloth, mild soap, towels, diapers - all should be within easy reach.

Cradle Cap

Babies can develop what is known as "cradle cap," which looks like a very bad case of skin rash or dandruff. Oily flakes may continue to appear for a month and sometimes longer. There is nothing you can do to stop the flakes, but you can minimize cradle cap by using a mild baby shampoo and brushing the scalp with a soft baby brush the opposite way the hair grows. Be careful not to scrub; a gentle motion is all that is needed. Some moms camouflage cradle cap with a bit of hypoallergenic baby lotion.

Cord Care

To some parents, taking care of the umbilical cord is intimidating. As long as you are gentle, you should not worry about hurting your baby. The cord heals from the inside out and is sealed from the inside long before the outside. However, never pull on the cord as this can cause pain and bleeding.

Be sure to keep the cord clean and dry. 

Contact your pediatrician if you observe:

• Fever
• Bleeding
• Swollen, red skin around the cord
• Yellow puss discharge
• Foul smelling discharge

Genital Care

Caring for an uncircumcised penis
Keep your baby's penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Usually, it is not fully retractable until a boy is 3 to 5 years old, or even until after puberty. Never force it.

When the foreskin is fully retractable, teach your son to wash underneath it each day.

Caring for the circumcised penis
Extra care is required for a circumcised penis. The foreskin will be removed one of two ways: 1) surgical incision or 2) a Plastibell ring. Both methods are considered safe and effective.

If the surgical procedure is performed, the head of the penis will be red or yellow-coated and "raw" looking initially with tenderness subsiding in three to four days. A scab at the incision may remain for up to two weeks.

If the foreskin is removed with the Plastibell ring method, the ring will fall off within two weeks. Do not pull it off.

After the circumcision, you can help comfort your baby by holding him and nursing him often.

• The penis will take 7 to 10 days to heal. A gauze dressing will be applied to the penis. This is removed at the first diaper change or on your doctor's order.
• Use petroleum jelly (Vaseline) to keep the bandage from sticking on the area with each diaper change for 24 hours.
• Keep the area as clean as possible. Wash gently with water, and be sure to clean away any bits of stool. Pat the area dry.
• Secure the diaper loosely away from the penis for several days to prevent uncomfortable pressure.
• Place your baby on his back to avoid pressure on the circumcision.

Call your doctor if:

• You see more than a few drops of blood at any time during the healing process.
• The redness and swelling around the circumcision does not start to go down in 48 hours.
• Your baby develops a fever.
• Your baby seems to be sick.
• Your baby is not urinating regularly (6-8 wet diapers a day).

Vagina Care

Newborn girls may have a white, pink, or slightly bloody discharge after birth. This is normal and should go away within a few weeks. During diaper changes, gently wash the area with water. With a clean washcloth, always wipe the vagina from front to back as to not accidentally bring bacteria from the bottom into the vagina that could cause an infection.

Diapering

Newborns go through about 10 diapers a day. You need to be sure your baby's bottom remains clean. Wipe the bottom with a washcloth or wipe whenever you change him. Keeping your baby's bottom dry will prevent irritation or diaper rash.

Bowel Movements

For the first day or two, your baby will have black, sticky, tar-like stools called meconium. Over the next few days, as your baby eats more, the stools will change from black to brown to yellow.

A breastfed baby will have at least 3-4 yellow bowel movements a day once your mature milk is in. A formula-fed baby will have one every day and sometimes every other day. If you feel that your baby is constipated, consult your pediatrician.

Wet Diapers

Your baby will be wetting about 6-8 times a day. The urine should be clear. Counting wet diapers is a way of knowing your baby is staying well hydrated. If your baby is not urinating enough, call your pediatrician.

Diaper Rash

Common causes of diaper rash include:

• Irritation by urine and stools.
• Irritation by diarrhea, which causes the acid in the stool to burn the skin.
• Fungal infection, also known as monilia, candida or yeast.

Prevention of diaper rash:

• To prevent diaper rashes, infants should be changed frequently.
• Keep your baby out of a diaper for short periods to allow the skin to dry. This is especially helpful in the prevention and treatment of mild cases of diaper rash.
• If a rash develops, it is best not to use rubber or plastic pants until it is healed.
• Wash the baby's clothes separately in a mild detergent and rinse well avoiding fabric softeners.
• If you suspect your child has a fungal infection, contact your physician in order to have the diagnosis confirmed. Make sure you follow the directions and other recommendations if the physician prescribes medication.
• Check with your pediatrician about the best treatment for your baby's diaper rash.