After Birth Care

After birth care consists of many things that a parent will come across. After birth care may consist of breastfeeding, circumcision, colic, crib safety, diaper rash, jaundice, newborn screenings, SIDS, and thrush.

Breastfeeding

Providing good nutrition for your newborn is crucial. The best source of that nutrition is a mother's breast milk. Breastfeeding is one of the best ways to provide nutrition to your baby. Breast milk contains just the right amount of fat, sugar, water and protein for human digestion, brain development and growth, according to the National Women's Health Information Center (NWHIC).

Circumcision

Circumcision is the removal of the foreskin from the penis. Circumcision is often done before a baby leaves the hospital. It is sometimes part of a religious ritual. The American Academy of Pediatrics (AAP) does not recommend circumcision as a routine medical procedure. The decision on whether or not circumcision is for your son can be a difficult one for many families.

The American Academy of Family Physicians (AAFP) says that there many circumcision pros and cons.

Some benefits of circumcision in terms of potentially preventing several conditions. These include:

  • UTI's and STD's - Some studies indicate that circumcision may reduce the risk of sexually transmitted diseases and urinary tract infections.
  • Penile cancer - Some studies indicate that circumcision may reduce the risk of this rare form of cancer.
  • Paraphimosis - Some studies indicate that circumcision can reduce the risk of paraphimosis. Paraphimosis is a condition that can happen to men and boys who have not had circumcision. AAFP calls it a serious condition. Paraphimosis happens when the foreskin is pulled back and then becomes stuck behind the head of the penis. Paraphimosis can be painful, result in swelling and even infection, according to AAFP. You should consult a doctor immediately if the situation occurs.

Some complications of circumcision include:

  • Bleeding and infection - As with any surgical procedure, bleeding and infection in the area of the circumcision are a risk. Uncontrolled bleeding may be a sign of a serious underlying blood disorder, such as hemophilia.
  • Meatal stenosis - This term refers to a narrowing of the opening of the penis. Meatal stenosis can be caused by a number of things. The American Academy of Pediatrics (AAP) says, though rare, it is most common in boys who have had a circumcision . The narrowing is the result of scar tissue that formed when the tip of the penis was irritated during the healing process. AAP says the situation can develop in boys, usually between the ages of 3 and 7, and can be repaired by surgery.

Both AAP and AAFP say parents should discuss the issues of circumcision with their doctors, the earlier the better. Circumcision becomes more complicated the older a male gets.

Colic

What is colic?

A colic baby is when your baby cries, and cries, and cries. In fact, nothing you seem to do comforts the child. Perhaps they pull their arms and legs to their bodies, or they stretch them out and stiffen, then pull them in again, or they turn bright red from crying. It has a name. It's called colic.

Causes of Colic

The American Academy of Family Physicians (AAFP) says there is no known cause for colic. When the child cries, they may swallow air and that can swell the stomach. One thing's for sure according to AAFP: it isn't the parent's fault. The National Institute on Nursing Research says about 25 percent of babies are colicky. There is nothing a parent does that causes colic and unfortunately, there isn't a lot they can do to stop it.

Colic Calm

The first thing a parent should do, if they believe the baby is colicky, is talk to their doctor. The baby should be examined to rule out specific medical causes. What a parent can do is try to soothe the baby as best they can. AAFP says don't worry about spoiling the baby with extra attention. The American Academy of Pediatrics (AAP) and AAFP suggest some of the following:

  • Stay calm yourself; if you are anxious and upset you may pass that edginess on to your baby.
  • Apply warmth, perhaps with a warm water bottle to the baby's stomach. Make sure it is warm, never hot.
  • Wrap the child in soft blankets and hold them close.
  • Rock them slowly or put them in an infant swing.
  • Take them for a ride in the car, with them securely fashioned in an approved child safety seat firmly anchored in the back seat.

You might want to start keeping a diary on when the baby starts crying, what you do to help, and when the crying stops. Reviewing the information may help you figure out things that soothe the child. It also gives you some sense of control over what is going on. Be aware of things that happen just before the crying starts. Is there a loud noise, for instance?

You may want to discuss your feeding habits of the child with your doctor. The doctor may suggest changing formulas if that is how the baby is being fed or recommend changes in your diet if you are breastfeeding the child.

Warning

If your baby is colicky, be aware of other reasons for their crying. Contact your doctor if the child cries for a longer period of time than is usual, if they develop a fever or look sick. It is also important to monitor your own reactions. Dealing with a colicky baby can be stressful. Seek help from others to get a break and call for help right away if you start thinking about hurting the child.

Crib Safety

Crib safety is extremely important when placing a child in a crib. AAFP says the space between crib bars should never exceed 2-3/8 inches. That's because a wide space could let a baby slip through and possibly get trapped. Mattresses should fit directly against the sides of the crib. Mattresses should be protected with pads, never plastic. The Consumer Product Safety Commission recommends the following crib safety tips to ensure that babies under 24 months sleep safely:

  • Don't place a baby to sleep in an adult bed. The baby could become entrapped between the bed & wall, or in headboards, footboards or bed frames. Babies could also fall or suffocate in soft bedding.
  • Place babies to sleep in a crib that meets current safety standards and has a firm, tight-fitting mattress. If you use a portable crib or playpen, make sure it meets current safety standards. Use only the mattress or pad provided by the manufacturer.
  • Babies should be placed to sleep on their backs, not their stomachs. According to the Back to Sleep Campaign, babies sleeping on their stomachs seem to be more likely to succumb to SIDS (Sudden Infant Death Syndrome).
  • Don't place a baby to sleep on soft bedding. The baby could suffocate. Do not use soft bedding such as pillows and thick quilts and comforters for infants under 12 months old.
  • Be sure the crib is far enough away from any windows so that an infant cannot reach curtain or drapery cords. Babies have died of strangulation and suffocation after a cord became wrapped around their necks.

A healthcare professional can provide more information on crib safety, and on ways parents and other family members can get their baby off to a happy - and healthy - start.

Diaper Rash

Diaper rash is another one of those little problems you are going to face if you are a new parent. Just about every child gets diaper rash at some point. The American Academy of Pediatrics (AAP) estimates more than half of babies between 4 and 15 months develop a diaper rash in a two month period.

Causes of Diaper Rash

The two basic causes of diaper rash are irritation and moisture. The irritation occurs where the diaper rubs against the skin or is too tight. Chemicals in diapers, detergents used to wash diapers or wipes can cause irritation as well. Moisture in the diaper from soiling, that is left on too long or is trapped by plastic pants, is also a major culprit in diaper rash. Another type of diaper rash is caused by yeast infections. Children on antibiotics are more susceptible to yeast infections, according to AAP.

What to do

The best defense against diaper rash is to keep the baby's diaper area clean, cool and dry. AAP and the American Academy of Family Physicians (AAFP) suggest the following:

  • Change the diaper often.
  • Use plain water to clean the diaper area when you change your baby.
  • Allow the area to completely dry before putting on a new diaper. It is best to let the area air dry, avoid rubbing, just pat dry if you need to.
  • Use a zinc oxide ointment and petrolatum to protect the skin
  • Allow the child to go without a diaper for periods of time during the day, perhaps putting them down to sleep without a diaper. Be aware to change the cloth under them if they soil it while asleep. AAFP points out that many babies urinate right after falling asleep.
  • Avoid creams and lotions that contain chemicals such as boric acid, camphor, phenol, methyl salicylate or compound of benzoin tincture.
  • Avoid talcum powder; it has been linked to respiratory problems.

If the problem lasts more than a few days or the diaper rash gets worse, you should contact your doctor.

Cloth vs Disposable Diapers

There is some research that indicates children who wear disposable diapers have lower rates of diaper rash. But both the AAP and AAFP say the choice is yours. You can add a stay dry liner to cloth diapers to help. Also if you use cloth diapers, do not use softeners and other chemicals and use an extra rinse cycle to remove detergents. The key thing to remember however is to change whatever diapers you use, often.

Jaundice

Jaundice is a yellow discoloration of the skin, eyes and mucus membranes. Jaundice is a symptom of many different diseases and conditions. It is caused by the orange-yellow pigment called bilirubin. Bilirubin is formed when red blood cells break down. The liver extracts bilirubin from the blood and then puts it into the bile, a substance that helps with digestion. Most of the time bilirubin leaves the body in the stool. Problems with the liver, or problems that cause too many old red blood cells, can result in bilirubin not being filtered out of the blood. This results in jaundice.

Jaundice in Newborns

Many newborn babies have some jaundice. When they are a few days old, their skin slowly begins to turn yellow. The yellow color comes from the color of bilirubin. When red blood cells die, they break down and bilirubin is left. It is normal for some of the red blood cells to die everyday. The red blood cells break down and make bilirubin. In newborns, the liver may not be developed enough to get rid of so much bilirubin at once. So, if too many red blood cells die at the same time, the baby can become very yellow or may even look orange. The yellow color does not hurt the baby's skin, but the bilirubin goes to the brain as well as to the skin. When there is too much, a condition called kernicterus results. That can lead to brain damage, according to the National Center on Birth Defects and Developmental Disabilities (NCBDDD).

Newborn Screening

The newborn screening is one of the largest disease prevention programs in the country. Each year some 4 million babies have tiny amounts of their blood tested in newborn screening for genetic and metabolic diseases. According to the National Center for Environmental Health, approximately 3,000 babies are found to have severe disorders each year. As a result of newborn screening, they are treated and in many cases problems - such as mental retardation, illnesses and even death - are avoided or minimized.

A newborn screening test is done before the baby leaves the hospital. For most, the baby's heel is pricked to obtain a few drops of blood for the lab to analyze. A hearing test can also be performed.

The March of Dimes (MOD) recommends that newborn screening should be conducted for 29 disorders. Not all states, however, require newborn screening. You can ask your doctor or state health department which newborn screening test is required in your state.

SIDS

Sudden Infant Death Syndrome

Sudden Infant Death Syndrome, also known as SIDS, strikes fear into every parent. SIDS is a term used for any unexplained death of a child under a year of age. It's also been called crib death because that is where the child is often found. Even though the cause is unknown, there are some things that are known about SIDS. The National Institute for Child and Human Development (NICHD) says:

  • SIDS is the leading cause of death for babies over 1 month old.
  • Most SIDS death happen between the second and fourth month of life.
  • More SIDS deaths occur in colder months.
  • African American babies are twice as likely to die from SIDS as are white babies.
  • American Indian babies are nearly three times more likely to die from SIDS than are white babies.
  • Babies who sleep on their backs are less likely to die from SIDS than those who sleep on their stomachs.

Thrush

Thrush is a yeast infection caused by various species of microbes called Candida. According to the Centers for Disease Control and Prevention (CDC), it is a fungus, and one of the many little organisms found on our bodies. Most of the time they have no effect, but in young children and people with weakened immune systems, they can cause problems.

When Candida grows out of control in the mouth, it is called oral thrush or simply thrush.

Thrush appears as creamy white, curd-like patches on the tongue and the inside of the mouth. In babies, it can be differentiated from dried formula by the fact that the thrush cannot be scraped off with a tongue blade.

Many infants develop thrush because they got Candida from their mothers during childbirth. (Read about Childbirth) According to CDC, this can happen when the mother has a vaginal yeast infection. Babies can contract thrush orally from friends and relatives, too.