Common Health Issues

Baby Bath, Feeding and Nursing Guidelines

• By Rich Health Editorial Team
• June 05, 2023

Your doctor will advise you how soon your baby may have a real bath—probably when he is two weeks old, though some doctors prefer having babies sponge-bathed for the first month or so. Any convenient time when you are not rushed by other duties—provided it is not immediately after feeding—is all right for his bath.

 

Baby Bath Guidelines

Any draft-free, warm room (23°C or so) is suitable. Use a plastic baby bath or similar soft tub with a wide rim to rest your elbow on. Wear an apron to protect your clothes. Be sure to wash your hands and have everything you need ready before you start. Put about two 32°C to 37°C (test it with your wrist or elbow; it should feel comfortably warm but not hot), and line the bottom of the tub with a clean diaper or small towel so the baby won’t skid around.

 

 

You will soon learn how to hold the baby; your left hand under his left arm, with your thumb over and your fingers under it, so that your wrist supports his head. (Reverse this if you are left-handed). Use a mild, unscented soap and a soft washcloth; but do not soap the baby’s face. If a little mucus stays in his nose, twist a bit of cotton (do not put it on a stick), moisten it in water, and insert it gently a little way into the nostril, holding onto it as you twist so that the mucus sticks to it when you pull it out.

 

 

 

Wash the baby’s scalp once or twice a week, tilting his head back so that no soap gets in his eyes. If he has any ‘cradle cap’ (infant seborrhea of the scalp) and daily shampooing does not help, consult your doctor about the use of a suitable ointment. You may need to apply it several times a day and use a fine-toothed comb to loosen the scales until the condition clears up.

 

 

 

Soap his body lightly with your hands or the cloth, paying special attention to the folds and creases behind the ears, under the chin, and around the genital organs. (Again, don’t use cotton-tipped sticks, and do not try to clean his eyes or the insides of his ears—use a corner of the washcloth for the creases.) If a boy’s penis needs special cleaning, your doctor or the hospital nurse will show you what to do. You may find it easiest to place the baby on a towel in your lap for the soaping and then—slowly—lower him into the tub for rinsing. Let the baby splash about a little, and then lift him out carefully (wet babies are slippery), wrap a towel around him, and gently but thoroughly pat him dry, especially in the creases.

 

 

Nursing the Baby

Your breasts require little care. Just before each feeding, wash your hands. (Some mothers also sponge their nipples with cotton moistened in clear water.) If your breasts leak milk between feedings or just before you nurse, you can place cotton (not plastic-coated) nursing pads inside your brassiere, but make sure no wisps of cotton remain on your nipples when you feed the baby.

 

As a rule, babies are nursed at both breasts during each feeding, with one breast being offered first at one feeding, and the other first at the next. Make sure the baby gets the entire areola (the dark area around the nipple) into his mouth as well as the nipple; it is the action of his gums as they compress the areola that makes the milk flow. (Also make sure the baby’s nose is not pressed against your breast so as to interfere with his breathing.) If your baby does not empty the breasts completely, your doctor may instruct you to empty them by hand after the feeding in order to encourage the supply of milk.

 

 

Some babies nurse rapidly and some slowly, but in general they take the greatest part of the milk from each breast in the first five to seven minutes. The average feeding is about 15 to 20 minutes, with 30 to 45 minutes considered the maximum time a baby should be left to nurse.

 

 

Once or twice during the nursing period, and just afterwards, burp the baby by holding him over your shoulder so that any air he has swallowed will be expelled. (You can also sit him up or lay him face down in your lap, and gently rub or pat his back) Protect your clothing with a clean diaper. If he positively will not burp and he is old enough to sit in an infant seat, you can strap him there until the bubble comes up. If nursing makes your nipples sore, ask your doctor or clinic what to do.

 

 

Many nursing mothers worry about how to tell whether a baby is getting enough, especially if the infant is fussy after feedings. In general, as long as the baby is gaining well and seems happy, he is probably getting what he needs. The average weight gain is about 0.7kg to 0.9kg a month during the first three months; by six months the weight increase is down to about 0.4kg a month, and by nine months, about 0.3kg per month.

 

 

The average baby also doubles his birth weight in approximately five months. But, of course, many healthy babies are not ‘average,’ and most of them don’t need to be weighed except when they visit the doctor. If your doctor is concerned about poor weight gain, excessive crying, or possible digestive difficulties, you can buy a baby scale to use at home; but do not weigh the baby more often than the doctor advises.

 

The Bottle-fed Baby

A formula is milk that has been modified to make it resemble mother’s milk as much as possible. Most people today prefer to use commercially prepared, ready-mixed formulas, either in concentrated liquid or powdered form. Preparing your own is cheaper, however. Be sure you have a refrigerator in good working condition and a pure water supply.

 

 

Even though sterilization of bottles and equipment is no longer as widely practiced as it once was, to be on the safe side, boil the water used in mixing the formula for 20 minutes and keep it in a clean, covered jar in the refrigerator. If your house has a well or cistern and a septic system, you must boil the water because of possible contamination.

 

To prepare the formula, carefully follow the directions on the container. Clean the top of the can with soap and water, then rinse, before opening it with a clean punch-type opener. It is easier to use up the entire can and prepare a number of bottles for storage in the refrigerator, rather than to prepare one bottle at a time and cover the can for refrigeration.

 

 

Use bottles, caps and nipples that have been washed in clean, hot water with detergent and a brush. Before washing, squeeze nipple holes to be sure they are open. Rinse everything well and let stand in a rack to dry. Bottles—but not nipples—can also be washed in an automatic dishwasher; nipples tend to get baked dry in the drying cycle. If you have a disposable nurser kit, follow the directions for cleaning and preparing bottles that come with it.

 

 

If your refrigerator stops working, prepare each bottle just before a feeding from boiled water and powdered formula. (The usual proportion is one tablespoon of powder for each two oz. of water) Throw away any unrefrigerated formula that isn’t used within 30 to 40 minutes, especially in hot weather; germs multiply rapidly in unchilled milk. The powdered formulas need not be refrigerated before mixing, but it should be kept well covered. Do not give any added vitamins or iron unless they are prescribed by a doctor. If your baby proves to be sensitive to milk, there are nonmilk formulas available; many have a soybean base.

 

A baby’s bottle can be given warmed, at room temperature, or straight out of the refrigerator if he doesn’t mind, but try to be consistent about this. You can warm the bottle in a saucepan of water on the stove. Test it by squeezing a few drops on your wrist, and if it feels hot, cool it down to body temperature.

 

Few people nowadays take the trouble to make their own formulas, but if you wish to do so, ask your doctor for a suitable ‘recipe.’

 

When you give the feeding, cradle the baby in your arm in a semi-sitting position and hold the bottle so that its neck is always completely filled with milk and the baby does not suck the air. If the baby takes more than 20 minutes to empty the bottle, the nipple holes may be too small or the nipple may be collapsed. (Holes can be enlarged; follow the directions that come with the nipples) 

 

 

If the baby takes the milk too fast, the hole may be too large, and a new nipple should be used. Remember, babies do not necessarily need the same amount at each feeding, so do not urge a balky baby to take more than he wants. Burp him as you would a breast-fed baby, making sure to get the burp up before you put him back to bed. 

 

During both breast and bottle feedings sit in a comfortable armchair or rocker. Never prop a newborn’s bottle in his crib, and avoid doing so with an older baby’s unless you absolutely must i.e. if you are trying to feed twins at the same time. The bottle can fall over, causing the baby to suck in air, or the milk can flow too fast and choke him.

 

Water

Both breast-fed and bottle-fed babies occasionally need drinking water, especially when they are sick or during hot weather. You can offer a few ounces of boiled water between (but not just before) feedings. Do not worry if the baby sometimes refuses it. Most babies get enough fluid in their milk and many do not like plain water.

Vitamins

Babies need vitamins. Vitamins A and D are already added to whole and evaporated milk; vitamins A, C and D, as well as other vitamins and minerals, are usually added to commercial formulas. (Breast milk contains little vitamin D, however.) Strained orange juice, which can be given whether your doctor so recommends, is rich in vitamin C. If your doctor prescribes vitamin-supplement drops, remember to tell what formula you are using. He may also suggest fluoride drops to strengthen the baby’s teeth if you live in an area where the water is not fluoridated.

 

Your doctor or clinic will give you a list of new items to add to your baby’s diet. Do not be distressed if the baby rejects them at first. It is wise to introduce new foods, such as cereals and strained fruits, one at a time and in very small servings. If allergic reactions develop or a particular food disagrees with the baby, you will then be able to pinpoint the cause.

 

Sources and References

Reader’s Digest Family Health Guide and Medical Encyclopedia

Newborn Skin Care by Jonathan Dyer 

Seborrheic Dermatitis by Dan Tucker and Sadia Masood