Caring for Your Baby and Yourself

How do I wash my baby

• Tub bathing is recommended even when the umbilical cord is attached. This helps with decreased heat loss and makes sure the umbilical cord does not get infected.
• Do not bathe baby every day as it dries the skin and can lead to increased irritation. Bathing baby every 2-3 days is recommended.
• Bathe baby 2 hours after a feeding or just before the next feeding.
• Arrange all your needed supplies within easy reach before you start the bath: wash cloth soap/body wash, and a few towels.
• Use a mild, unscented, and hypoallergenic soap or body wash.
• The bath water should feel warm to your elbow or inner wrist.
• Never turn your back or leave your baby alone during the bath, not even for a second.
• Always keep at least one hand on your baby when in the bath or on the table.
• Do the bath in a warm room (about 22 to 27°C), free of drafts.
• When washing your baby, think cleanest to dirtiest.

FACE: Gently wipe the baby's face with a clean wet washcloth without soap.
EYES: Using the same cloth with no soap you used for your baby's face, and wipe your baby's eyes from the inner corner, moving outwards using a different part of the washcloth.
EARS: Wipe outer part of ears and behind the ears with the tip of the washcloth. Never use Q-tips inside baby's ears.
HAIR: You can wash baby's hair in the tub or wrap the baby in a warm towel and wash the hair before washing the body. Lather baby's hair using a very small amount of mild soap or shampoo. Rinse your baby's hair thoroughly and rub dry. Make sure to gently place your fingers over the opening in your baby's ears to prevent water from going inside the ears.
BODY: Be sure to thoroughly wash and rinse the folds around your baby's neck, creases under the arms and between fingers. Wash baby's legs and between toes.
DIAPER AREA: Clean baby's diaper area with warm water and a washcloth, or you can use unscented, hypoallergenic wipes. Always clean from front to back to prevent a urinary tract infection.
Girls: Wash gently with unscented soap and water, between the labial folds (often swollen), from front to back. Mucous discharge with pink tinged blood is normal and is because your baby received some of your hormones at birth. This usually lasts about 5 days and is normal. Rinse baby's bottom with water from the tub.
Boys: Wash gently, with unscented soap and water, lifting the scrotum up to clean underneath. The scrotum is often enlarged and looks darkened and red in colour. Do not push back skin or clean under foreskin if penis is uncircumcised. Toddlers (at approx. 3 yrs of age) can be taught to pull back skin for cleansing. Rinse baby's bottom with water from the tub.

• Thoroughly dry baby's entire body, especially between skin creases and folds, and put diaper on. Brush and comb baby's hair.

How do I keep my baby's umbilical cord clean?

• Daily cleansing may be done with plain water (during bathing).
• The umbilical cord can be gently pat dry or air-dried.
• More frequent cleaning (with diaper changes) using a water-moistened Q-tip will help keep baby's umbilical cord clean.
• Always keep the umbilical cord clean and dry. Diapers should be folded down and away from the umbilical cord area to prevent contamination of the umbilical cord with urine or feces.
• The clamp and umbilical cord does not hurt your baby as there are no nerves in the umbilical cord.
• The cord area heals on its own and the cord will gradually dry and fall off at approximately 10-14 days after birth.
• Slight bleeding (drops of blood) and redness of the skin surrounding the umbilicus, may occur briefly as the cord falls off.
• The umbilical cord may be infected if your baby has a fever, or there is an odd smell coming from the umbilical cord.

Call your health care provider or public health nurse if you are concerned.

My baby is a few days old. Why does my baby's skin look yellow?

• Jaundice is yellow colouring of the skin and eyes.
• Jaundiced babies may be sleepy and difficult to awaken for feedings.
• It usually shows up on the skin and whites of the eyes during the baby's first 3-5 days of life.
• IMPORTANT: Take your baby to your health care provider right away if your baby develops jaundice. Severe jaundice can cause brain damage.

My baby has crusty patches of skin on his/her head. What should I do?

• Some babies have scaly and crusty patches of skin on their scalp. This is called cradle cap and is common in the first few months after birth.
• Soften the crust by brushing baby oil or mineral oil through your baby's hair and leave on overnight.
• Prior to bathing, thoroughly comb oil through hair with a fine-toothed comb and then remove the loosened crusts by following the guidelines for washing baby's hair.

How do I take care of my baby's skin?

• Apply olive oil or zinc oxide cream to your baby's bottom and between the legs if needed for skin redness.
• Do not use powder on your baby as it can cause breathing difficulties.
• Use unscented, hypoallergenic skin lotions or oils to keep the skin moist as needed.
• Do not expose baby to direct sunlight or place baby by a bright window to avoid the harmful solar rays and risk of dehydration.
• Do not use sunscreen on your baby until your baby is 6 months of age or older.

What should my baby look like?

• If your baby has tiny white raised dots on baby's face and nose area (also known as milia), these are due to blocked oil glands. They disappear on their own within the first few weeks of life.
• A newborn rash usually appears after birth and normally disappears on its own in 1-2 weeks with no treatment necessary.
• Your baby's head may not be completely round after birth. It becomes more round during the first few months of age.

How do I take care of my baby's nails?

• The easiest way to trim baby's nails is when he/she is sleeping. Use an emery board to file your baby's nails for the first few weeks.
• Once the nails grow beyond the nail bed (after a few weeks), you can use nail clippers with a rounded edge or blunt nail scissors. Cut the nails straight across, near the end of the nail, as you hold the skin away from the nail so you don't damage the nail beds.
• It is not a good idea to bite or chew off baby's nails – germs & bacteria from your mouth could lead to infection in the baby's finger.
• Avoid covering baby's hands with mittens. When they put their hands to their mouths, they may be indicating a feeding cue or soothing themselves.

How do I change my baby's diapers?

• Have everything you need before you lay your baby down to change the diaper
• Change your baby each time the diaper is dirty or wet.
• Use a clean washcloth with warm water or disposable baby wipes for the diaper area - wipe from front to back
• You may need to change the diaper before and after each feeding
• Tabs come from the back of the diaper and fasten at the front
• Never leave your baby unattended – If you can't reach what you need take your baby with you
• Wash your hands after each diaper change to prevent the spread of germs

How do I dress my baby?

• Your baby generally needs one more layer of clothing than you are wearing.
• Do not put too many clothes or blankets on your baby.
• The usual clothing is a diaper, undershirt, sleeper, and a light weight blanket or sweater.
• Cotton clothing is best and safest – it is soft and non-flammable.
• When you take your baby outside, place a hat on your baby's head for protection and for baby's body heat control.
• To check if your baby is too hot, place your hand on the back of his/her neck. Your baby should not be sweating.

Crying

My baby sometimes cries and it seems like it's for no reason. Is this normal?

• Babies cry to communicate and let you know if they need something.
• Most babies cry often, up to 1-3 hours per day, from 2-8 weeks of age.
• Babies will often be fussy around supper time and into the early evening or night.

When my baby cries, what can I do to soothe and calm my baby?

• Try to understand why your baby is crying so you can try to help.
• Respond to your baby's cry by picking your baby up and holding her/him Skin to Skin. Your baby is placed on your bare chest wearing only a diaper and covered with a blanket. You can do this to decrease your baby’s stress and to keep your bay warm and comforted
• Possible reasons for crying baby:

Hunger

• If baby is putting hands in their mouth and showing feeding cues, try feeding your baby.
Pain or Discomfort

• Hold your baby Skin to Skin to soothe and calm her/him.
• If baby was just fed, try burping or rub baby's back.
• Check baby's diaper and change their diaper if it is wet/soiled.
Too Hot or Too Cold

• Babies should be dressed with as many layers as you plus one more layer.
• Check that the room temperature is not too cold or hot.
• Your baby should not be cool to the touch.
Tired or Over Stimulated

• Hold your baby Skin to Skin to soothe and calm her/him.
Needs Change
• Cuddle with your baby and sing/speak softly, say "ssshhh" by his/her ear.
• Go into a different room so baby can look at different things or other people.
• Read, play, talk, sing, hold your baby every day.
Sometimes baby's cry "just because"
• Hold your baby Skin to Skin and use motions – rhythmic rocking, swaying, gentle movements, taking your baby for a walk in the stroller, or going for a car ride.
• Change the baby's position – carrying over your arm, in a sling, or in an infant carrier.
• Play different types of music for your baby and read to your baby right from birth. They enjoy looking and listening to you and respond to voices, sounds, and the rhythm of the music or story.
• Bathe your baby or take your baby in the bath with you.

IMPORTANT: Do not shake or throw your baby at anytime as this could cause damage to your baby’s brain known as Shaken Baby Syndrome.

Call your health care provider of Telehealth at 1.800.797.0000 if you your baby's cry sounds different to you or you are unable to soothe him/her after trying everything.

How do I take my baby's temperature?

• Tympanic thermometers are NOT accurate with children under 3 years of age.
• Forehead strips or pacifier thermometers are NOT good ways to take a baby's temperature.
• It is recommended to use an easy-to-read digital thermometer.
• Place the tip of a digital thermometer snugly under the centre of your baby's armpit.
• Hold baby firmly to avoid quick movements while thermometer is in place.
• A digital thermometer will beep when ready.
• Normal temperature, taken under your baby's armpit is:
  36.5° C - 37.5° C (97.6 F – 99.5 F)
• You do not need to check your baby's temperature regularly unless:
• you feel your baby is sick,
• has a fever, or
• you have been directed to by your health care provider
• A fever is a temperature higher than the normal body temperature.

Call or visit your health care provider if your baby has a fever. If you have concerns you can seek advice from Telehealth Ontario at 1.800.797.0000.

How do I burp my baby?

• Try to burp your baby after feeding on each breast to bring up any air bubbles and prevent baby from spitting up.
• Gently rub or pat baby's back until baby burps (may take 1-2 minutes).
• If your baby doesn't burp after 1-2 minutes and is happy, they probably don't need to burp.
• When you give your baby a bottle with formula you should burp your baby after every ounce they drink or halfway through the feeding.
• Spitting up small amounts of formula after burping can be normal.

Is it normal for my baby to spit up and have hiccups?

• Hiccups are natural and common in the first few months of life. They often go away by themselves.
• Babies naturally try to clear their nasal & oral passages by sneezing, coughing and spitting up.
• Spitting up small amounts after feeding or burping is common in the first few months of life and is different than vomiting.

What do I do if my baby is vomiting?

• Sit baby forward and gently pat or rub their back.
• Vomiting is forceful throwing up of large amounts of liquid.
• Frequent explosive vomiting (projectile) requires your baby to be seen by a health care provider.

Call your health care provider if your baby is unable to keep any fluids down, as this can lead to dehydration.

What do I need to know about car seats? (10 videos)

• Too many children have been seriously injured or killed in a sudden stop or crash because they haven't been properly buckled up, or not buckled up at all, when riding in a car. PLEASE, take a few extra minutes to make sure your child is properly buckled up in a car seat appropriate for their height and weight.
• NOT ONLY IS IT IMPORTANT FOR THE SAFETY OF YOUR CHILD, IT IS THE LAW!
• The driver is responsible to make sure all passengers have a seat belt fastened and will be held liable should any accident occur.
• Not all car seats and seat belts are the same. Choose a child restraint system that is appropriate for your child and for your car.

What is Shaken Baby Syndrome?

• Shaken Baby Syndrome occurs when a baby is shaken hard with force, usually in a moment of anger.
• This shaking can damage a baby's brain, cause blindness, paralysis, mental retardation, and seizures.
• Never shake, hit or throw a child at any age.
• Do not shake your baby if they are choking as this may make them worse.
• Only leave your baby with caregivers who you can trust to control their anger.
• A baby's constant crying can be stressful, and a dangerous trigger for caregivers to harm babies.

Try suggestions to deal with infant crying on this website or the Canadian Paediatric Society website at
caringforkids.cps.ca or Peel Health website at parentinginpeel.ca.

What is SIDS (Sudden Infant Death Syndrome)?

• Sudden infant death syndrome (SIDS) is the unexpected death of a baby under one year of age and occurs while the baby is sleeping.
• The cause is unknown, although the research recommends the following steps to lessen the risk of SIDS:
• Babies should sleep on their backs on a firm, flat surface. It is not necessary to force babies to sleep on their back when they are able to turn from their back to their tummy on their own.
• Avoid soft mattresses, fluffy pillows, comforters, stuffed toys, and bumper pads in your baby's crib as these can prevent good air circulation around baby's face or head.
• Breastfeeding has many benefits and may give protection against SIDS.
• Do Not smoke inside your home or car - not only for your baby's health but also to reduce the risk of SIDS.
• Keep your baby warm, not hot – If room temperature is comfortable for you, it is comfortable for baby. To check if your baby is too hot, place your hand on the back your baby's neck. Your baby should not be sweating. Dress your baby with the same amount of layers as you would need to be comfortable.
• Breastfeeding has many benefits and may give protection against SIDS.

Visit Canada.ca for a Back to Sleep handout.

Do I need to keep using the spray bottle (peri-care) I was using in the hospital?

• The spray bottle (peri-care) is used to lessen discomfort, prevent infection and promote healing
• Continue until there is no vaginal discharge and your perineum (area between the anus and the vulva [the labial opening to the vagina) is comfortable.
• Rinse your perineum with warm water, using a plastic peri-care bottle every time you use the toilet. Pat yourself dry with toilet paper from front to back.
• Spray water while passing urine to decrease stinging.
• Try pulling in your muscles prior to sitting down.
• Sit on a pillow or soft surface for added cushioning.

How do I take care of the incision from my Caesarean Section?

• Keep you incision clean and dry. Use mild unscented soap and warm water in the shower to wash your incision and pat dry with a towel.
• Air dry your incision while lying down (if necessary - hold your tummy up)
• Your staples are removed after 4-6 days, and the stitches on your inside will dissolve on their own.
• While you cough or sneeze: Use your hands or a pillow to support the incision and decrease the strain on your muscles and avoid pain. Make sure to cough and sneeze into your arm – not into your hands.
• When getting out of bed: ensure you straighten your back up before walking to decrease back strain.
• It takes 4-6 weeks to feel in good health again from the time of surgery. Give yourself time to rest and heal.

Call your health care provider if:

• you have a fever
• your incision becomes red and swollen, or
• bleeding/discharge is leaking from your incision.

When will my stitches dissolve?

• Stitches will dissolve within 7-10 days.
• Cleanse area well with your peri-care bottle and let stitches air-out to help healing.
• It should heal by the end of the 3rd week.

How long should my bleeding last?

• The amount and colour of the vaginal bleeding changes as the lining of the uterus heals.
• Bright, red bleeding, like a moderate - heavy period occurs for the first 3 days. The amount of blood should continue to lessen and change colour. Blood may contain clots that should not be larger than a quarter.
• The blood-flow usually appears pink to brown in colour by the 3rd day after you give birth to your baby.
• By about the 10th day after you give birth to your baby, the blood flow should be pale yellow or white, which continues for 2-8 weeks.

Sometimes I notice a slight increase in the amount of my vaginal bleeding. Is this normal?

• It is normal to experience more vaginal bleeding and cramping when breastfeeding, or with increased activity.

Call your health care provider if:

• you notice the reappearance of bright red blood after the first 3 days
• your vaginal bleeding becomes much heavier (soaking a pad or more in an hour)
• you pass clots the size of a plum or larger, or
• there is a strong odor from your vagina.

When will I get my period again?

• It usually takes 1-4 months for your body to be ready to have your period again.
• If you're breastfeeding, it may take longer, 4-6 months to get your period. Once you stop breastfeeding, you period may return in 1-3 months.
• Do not use tampons within the first 6 weeks after having your baby.
• Many women believe they will not get pregnant while breastfeeding but they can unless their baby is less than 6 months old, they are exclusively breastfeeding their baby 6 or more times per day and have not had a period. This is known as the Lactational Amenorrhea Method (LAM) of contraception. You are less likely to ovulate, have a period or become pregnant, while following these guidelines however this is not guaranteed.

For the first few days after my baby was born, I would get strong cramps when I breastfed. What should I do?

• Some women notice "afterpains" that feel like menstrual cramps as a result of the uterus shrinking back to its pre-pregnant size. These pains feel like mild labour and are usually stronger when breastfeeding or by women who have given birth to other children before.
  Normally, afterpains start to lessen and go away within a few days to 2 weeks.
• Take any pain medication 30 minutes before breastfeeding and before you become very uncomfortable.

What if my pain is too much?

• Normally, regular over-the-counter pain medication taken as directed should be enough to keep you comfortable.
• The use of codeine (a drug made mainly from morphine, used as a painkiller and sedative) is not considered safe for babies during breastfeeding. Because babies need close monitoring when you are on codeine, you will not be on it when you are sent home.
• If your pain medication is not keeping you comfortable, speak to your health care provider.

What can I do for the pain from my hemorrhoids?

• Apply hemorrhoid cream and/or witch hazel (Tucks) pads after peri-care to lessen discomfort and promote healing
• Try sitting on a soft pillow
• Keep bowel movements soft by eating a high fiber diet (bran cereal/muffins, vegetables & fruit) and drinking when thirsty
• Use a stool softener or mild laxative as directed by your health care provider

Is there anything special I should eat when breastfeeding?

• It is important that you continue to eat a well balanced diet following Canada's Food Guide and eat a variety of the four food groups as recommended: (1) vegetables and fruit, (2) grain products, (3) milk products, and (4) meat and alternatives.
• Have easily prepared foods available (bread, yogurt, cheese, and fruits)
• Try to eat smaller meals more often - about 5 – 6 meals throughout the day.
• Drink when you are thirsty - you may feel thirstier than usual with breastfeeding.
• You do not have to drink milk to make milk. However, you need to get enough calcium by consuming the recommended servings of milk/ milk products.
• Try to increase the amount of dietary fibre (apples, prunes, beans, lentils, bran cereals) for soft bowel movements.

Visit https://food-guide.canada.ca/en/ for Canada's Food Guide and other healthy eating resources.

Can I have an occasional glass of alcohol if I'm breastfeeding?

• The safest choice is to avoid alcohol exposure to your baby.
• Alcohol and other medications pass freely into breastmilk.
• The presence of alcohol in breastmilk changes the flavour of the breastmilk, and decreases the amount of breastmilk your baby will take.
• Occasional use of alcohol does not mean you have to stop breastfeeding.

Can I have caffeine while I breastfeed?

• Coffee, tea, chocolate, and drinks containing caffeine (1-2 cups per day), are considered safe during breastfeeding in small amounts.
• Breastfeeding mothers need to consider the amount of caffeine they intake from all sources of their diet.
• A large caffeine intake (more than 3 cups coffee per day) while breastfeeding may lead to babies that are jittery, and colicky.
• Caffeine may also decrease milk supply.

Should I continue taking my vitamins?

• If you were taking a prenatal vitamin you can continue taking it during breastfeeding
• If taking iron supplements as directed by your health care provider ensure a high fibre diet and drink more fluids to lessen possible constipation. Stools often become black in colour while taking iron supplements.
• Iron-rich food sources include: red meats, dark meat from chicken or turkey, fish and seafood. Also, cereals, bread, pasta, lentils, dried peas and beans, seeds and nuts, dried fruit, dark green leafy vegetables, broccoli, eggs, and tofu.
• Combine foods high in iron with foods containing vitamin C to increase iron absorption (Foods that contain vitamin C help your body to absorb iron)
• Vitamin C food sources include: oranges, strawberries, kiwis, raspberries, and 100% fruit juices.

Can I smoke while breastfeeding?

• Breastfeeding mothers are recommended to stop smoking.
• Nicotine in cigarettes passes into breastmilk and may cause infant colic (constant and inconsolable crying by healthy infants - usually between the ages of 2 and 16 weeks) and decreased milk production.
• Exposure of children to second hand cigarette smoke has been shown to increase the risk for respiratory illnesses such as Asthma, and Sudden Infant Death Syndrome (SIDS).
• Do not smoke in the same room or in the car with your infant.
• Do not smoke 2-3 hours before and/or during breastfeeding.
• It's never too late to quit smoking. If you are trying to quit smoking, nicotine patch or nicotine gum can be used during breastfeeding.

What types of drugs should I avoid while breastfeeding?

• Avoid illegal street drugs –marijuana, cocaine, heroin, etc.
• These substances pass through your breastmilk and can affect your baby.

How much rest should I have?

• Try taking rest periods during the day. Sleep when your baby is sleeping because you can expect to be awake frequently - especially at night.
• Limit visitors for the first few weeks.
• Gradually increase your activity each day, depending on your energy.
• Welcome support from your partner, family, and friends, so you can focus on taking care of your baby.
• Let go of chores that don't have to be done, such as housework. Consider creating a list and asking friends and family to help out.

Can I exercise after I give birth to my baby?

• Exercise is important to help your body recover after pregnancy and childbirth.
• Try to keep good posture while walking, standing, or sitting. Gently pull in your tummy and relax your neck and shoulder muscles.
• Kegel exercises (exercises involving controlled tightening and release of the muscles at the base of the pelvis) will help return muscle tone to the vagina that was stretched during childbirth.

Sometimes I feel sad and tearful and everyone says you should feel happy when you have a new baby. What should I do?

• Take rest periods during the day. Sleep when your baby sleeps. Gradually increase your activity each day, as you get back your energy.
• 50%–75% of women experience "postpartum or baby blues" lasting a few hours to 1-2 weeks, generally occurring in the first few days or weeks after birth.
• You may feel: restless, irritable, tearful, discouraged, depressed or helpless.
• This is part of the normal reaction to physiological shifts and adjustments that occur following birth.

How do I know if I have postpartum depression?

• 1 in 5 mothers will have a postpartum mood disorder – the "blues" that don't go away or symptoms that last more than 2 weeks.
• Symptoms may begin during pregnancy or anytime within the first 18 months after having a baby, stillbirth, pregnancy loss or adoption of a child.
• You may feel: irritability, exhaustion, numbness, loneliness, guilt, depression, worthless, difficulty concentrating, and inability to cope and take care of yourself or your baby. You may have repeated thoughts of death or even killing yourself or your baby.
• Risk factors for postpartum mood disorders are: depression and/or anxiety including panic attacks in pregnancy, recent stressful life events, lack of social supports, personal or family history of mental illness, depression.
• Men can also experience emotional difficulty, especially if their partner has postpartum mood disorder.
• Tips: Talk to your partner, and family members as often as possible about your feelings. Let them know what you and your baby might need, and how they can help you care for your baby and yourself. (examples: nap in late afternoon, let family help by doing chores or taking baby for a walk while you nap)
• Contact your health care provider or public health nurse to find out about support programs

I don't seem to have any interest in having sex anymore, because I'm always so tired. What should I do?

• It is important that you and your partner talk about the way parenting is affecting your life; your sex life and your feelings and needs. Sometimes, new parents do not want sex.
• Many new parents initially experience a decreased desire for sex. They are too tired from the night feedings and the constant care the baby requires.
• Parents may also be concerned that during sex their baby may start to cry.
• They may also be afraid of getting an infection or becoming pregnant.
• Sexual activity may be safely resumed after birth once the mother's vaginal bleeding has stopped and she feels comfortable. Some new parents prefer to wait until after the 6 week check-up with their health care provider before engaging in sexuality activity.

Is it common to experience vaginal dryness?

• It is common to experience a decrease in vaginal lubrication due to hormonal changes after childbirth. This will last longer if you are breast-feeding.
• Plan to use a water soluble lubricant available from a pharmacy.

I'm afraid of getting pregnant. What should I do?

• Many women believe they will not get pregnant while breastfeeding but they can unless their baby is less than 6 months old, they are exclusively breastfeeding their baby 6 or more times per day and have not had a period. This is known as the Lactational Amenorrhea Method (LAM) of contraception. You are less likely to ovulate, have a period or become pregnant, while following these guidelines however this is not guaranteed. Some methods of birth control may not be suitable for you if you are breast-feeding. You may want to use a condom with spermicide until you talk to your health care provider.