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Looking at Your Newborn: What's Normal (for Parents)

When their little one comes into the world, new parents might be surprised by their baby's appearance. Instead of the picture-perfect cherub, babies often look bluish, are covered with blood and cream-cheesy glop, and look like they've just been in a fist-fight.

The features that may make a normal newborn look strange are temporary. After all, babies develop while immersed in fluid, folded up in an increasingly cramped space inside the uterus. Then in most deliveries, they're pushed through a narrow, bone-walled birth canal.

When you'll get to first see and touch your newborn may depend on the type of delivery, your condition, and the condition of your baby. Following an uncomplicated vaginal delivery, you should be able to hold your baby within minutes.

What Should We Expect?

In most cases, infants seem to be in a state of quiet alertness during the first hour or so after delivery. It's a great time for you and your newborn to get acquainted and begin the bonding process. And it's OK if circumstances prevent you from meeting your infant right away — you'll have plenty of quality time together soon.

Posture

During the first several weeks, you'll notice that much of the time your baby will tend to keep his or her fists clenched, elbows bent, hips and knees flexed, and arms and legs held close to the front of his or her body. This position is similar to the fetal position during the last months of pregnancy. Infants who are born prematurely may display several differences in their posture, appearance, activity, and behavior compared with full-term newborns.

Primitive Reflexes

Infants are born with a number of instinctual responses to stimuli, such as light or touch, known as primitive reflexes, which gradually disappear as the baby matures. These reflexes include the:

  • sucking reflex, which triggers an infant to forcibly suck on any object put in the mouth
  • grasp reflex, which causes a newborn to tightly close the fingers when pressure is applied to the inside of the infant's hand by a finger or other object
  • Moro reflex, or startle response, which causes an infant to suddenly throw the arms out to the sides and then quickly bring them back toward the middle of the body whenever the baby has been startled by a loud noise, bright light, strong smell, sudden movement, or other stimulus

Also, due to the immaturity of their developing nervous systems, newborns' arms, legs, and chins may tremble or shake, particularly when they're crying or agitated.

Sleeping and Breathing

In the first weeks, infants usually spend most of their time sleeping. Newborns whose mothers received certain types of pain medications or anesthesia during labor or delivery can be especially sleepy during the first day or two of life.

Many new parents become concerned about their newborn's breathing pattern, particularly with the increased attention to sudden infant death syndrome (SIDS) in recent years. But rest assured that it's normal for newborns to breathe somewhat irregularly.

When infants are awake, their breathing rate may vary widely, sometimes exceeding 60 breaths per minute, particularly when they're excited or following a bout of crying. Also common are periods during which they stop breathing for about 5 to 10 seconds and then start up again on their own. Known as periodic breathing, it's more likely during sleep and is normal. However, if your baby turns blue or stops breathing for longer stretches of time, it's considered an emergency and you should contact your child's doctor immediately or go to the emergency room.

Although talking won't come until much later, your newborn will produce a symphony of noises — especially high-pitched squeaks — in addition to the obligatory crying. Sneezing and hiccups are common and are not signs of infection, allergies, or digestive problems.

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Head

Because an infant's head is usually the first part through the birth canal, it can be affected by the delivery process. A newborn's skull is made of several separate bones (which will eventually fuse together) to allow the large head to be squeezed through the narrow birth canal without injury to mother or baby.

The heads of infants born by vaginal delivery often show some degree of molding, which is when the skull bones shift and overlap, making the top of the head look elongated, stretched out, or even pointed at birth. This sometimes bizarre appearance will go away over the next several days as the skull bones move into a more rounded configuration. The heads of babies born by cesarean section or breech (buttocks or feet first) delivery usually don't show molding.

Because of the separation of your newborn's skull bones, you'll be able to feel (go ahead, you won't harm anything) two fontanels, or soft spots, on the top of the head. The larger one, located toward the front of the head, is diamond-shaped and usually about 1 to 3 inches wide. A smaller, triangle-shaped fontanel is found farther back on the head, where a beanie might be worn.

Don't be alarmed if you see the fontanels bulge out when your infant cries or strains, or if they seem to move up and down in time with the baby's heartbeat. This is perfectly normal. The fontanels will eventually disappear as the skull bones close together — usually in about 12 to 18 months for the front fontanel and in about 6 months for the one in back.

In addition to looking elongated, a newborn's head may have a lump or two as a result of the trauma of delivery. Caput succedaneum is a circular swelling and bruising of the scalp usually seen on top of the head toward the back, which is the part of the scalp most often leading the way through the birth canal. This will fade over a few days.

A cephalohematoma is a collection of blood that has seeped under the outer covering membrane of one of the skull bones. This is usually caused during birth by the pressure of the head against the mother's pelvic bones. The lump is confined to one side of the top of the baby's head and, in contrast to caput succedaneum, may take a week or two to disappear. The breakdown of the blood collected in a cephalohematoma may cause these infants to become somewhat more jaundiced than others during the first week of life.

It's important to remember that both caput succedaneum and cephalohematoma occur due to trauma outside of the skull — neither indicates that there has been any injury to the infant's brain.

Face

A newborn's face may look quite puffy due to fluid accumulation and the rough trip through the birth canal. The infant's facial appearance often changes significantly during the first few days as the baby gets rid of the extra fluid and the trauma of delivery eases. That's why the photos you take of your baby later on at home usually look a lot different than those "new arrival" nursery shots.

In some cases, a newborn's facial features can be quite distorted as a result of positioning in the uterus and the squeeze through the birth canal. Not to worry — that folded ear, flattened nose, or crooked jaw usually comes back into place over time.

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Eyes

A few minutes after birth, most infants open their eyes and start to look around at their environment. Newborns can see, but they probably don't focus well at first, which is why their eyes may seem out of line or crossed at times during the first 2 to 3 months. Because of the puffiness of their eyelids, some infants may not be able to open their eyes wide right away.

When holding your newborn, you can encourage eye opening by taking advantage of your baby's "doll's eye" reflex, which is a tendency to open the eyes more when held in an upright position.

Parents are sometimes startled to see that the white part of one or both of their newborn's eyes appears blood-red. Called subconjunctival hemorrhage, this occurs when blood leaks under the covering of the eyeball due to the trauma of delivery. It's a harmless condition similar to a skin bruise that goes away after several days, and it generally doesn't indicate that there has been any damage to the infant's eyes.

Parents are often curious to know what color eyes their infant will have. If a baby's eyes are brown at birth, they will remain so. This is the case for most black and Asian infants. Most white infants are born with bluish-gray eyes, but the pigmentation of the iris (the colored part of the eye) may progressively darken, usually not reaching its permanent color until about 3 to 6 months of age.

Ears

A newborn's ears, as well as other features, may be distorted by the position they were in while inside the uterus. Because the baby hasn't yet developed the thick cartilage that gives firm shape to an older child's ears, it isn't unusual for newborns to come out with temporarily folded or otherwise misshapen ears. Small tags of skin or pits (shallow holes) in the skin on the side of the face just in front of the ear are also common. Usually, these skin tags can be easily removed (talk to your doctor).

Nose

Because newborns tend to breathe through their noses and their nasal passages are narrow, small amounts of nasal fluid or mucus can cause them to breathe noisily or sound congested even when they don't have a cold or other problem. Talk with your doctor about the use of saltwater nose drops and a bulb syringe to help clear the nasal passages if necessary.

Sneezing is also common in newborns. This is a normal reflex and isn't due to an infection, allergies, or other problems.

Mouth

When your newborn opens his or her mouth to yawn or cry, you may notice some small white spots on the roof of the mouth, usually near the center. These small collections of cells are called Epstein's pearls and, along with fluid-filled cysts sometimes present on the gums, will disappear during the first few weeks.

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Neck

Yes ... it's there. Normally the neck looks short in newborns because it tends to get lost in the chubby cheeks and folds of skin.

Chest

Because an infant's chest wall is thin, you may easily feel or observe your baby's upper chest move with each heartbeat. This is normal and isn't a cause for concern.

Also, both male and female newborns can have breast enlargement. This is due to the female hormone estrogen passed to the fetus from the mother during pregnancy. You may feel firm, disc-shaped lumps of tissue beneath the nipples and, occasionally, a small amount of milky fluid (called "witch's milk" in folklore) may be released from the nipples. The breast enlargement almost always disappears during the first few weeks. Despite what some parents believe, you shouldn't squeeze the breast tissue — it will not make the breasts shrink any faster than they will on their own.

Arms and Legs

Following birth, full-term newborns tend to assume a posture similar to what their position in the cramped uterus had been: arms and legs flexed and held close to their bodies. The hands are usually tightly closed, and it may be difficult for you to open them up because touching or placing an object in the palms triggers a strong grasp reflex.

Fingernails

Infants' fingernails can be long enough at birth to scratch their skin as they bring their hands to their faces. If this is the case, you can carefully trim your baby's nails with a pair of small scissors.

Sometimes parents are concerned about the curved appearance of their newborn's feet and legs. But if you recall the usual position of the fetus in the womb during the final months of pregnancy — hips flexed and knees bent with the legs and feet crossed tightly up against the abdomen — it's no surprise that a newborn's legs and feet tend to curve inward.

You can usually move your newborn's legs and feet into a "walking" position; and this will happen naturally as a baby begins to bear weight, walk, and grow through the first 2 to 3 years of life.

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Abdomen

It's normal for a baby's abdomen (belly) to appear somewhat full and rounded. When your baby cries or strains, you may also note that the skin over the central area of the abdomen may protrude between the strips of muscle tissue making up the abdominal wall on either side. This almost always disappears during the next several months as a baby grows.

Many parents are concerned about the appearance and care of their infant's umbilical cord. The cord contains three blood vessels (two arteries and a vein) encased in a jelly-like substance. Following delivery, the cord is clamped or tied off before it's cut to separate the infant from the placenta. The umbilical stump is then simply allowed to wither and drop off, which usually happens in about 10 days to 3 weeks.

You may be instructed to swab the area with alcohol periodically or wash it with soap and water if the stump becomes dirty or sticky to help prevent infection until the cord falls off and the stump dries up. The baby's navel area shouldn't be submerged in water during bathing until this occurs. The withering cord will go through color changes, from yellow to brown or black — this is normal. You should consult your baby's doctor if the navel area becomes red or if a foul odor or discharge develops.

Umbilical (navel) hernias are common in newborns, particularly in infants of African heritage. A hole in the wall of the abdomen at the site of the umbilical cord/future navel allows the baby's intestine to protrude through when he or she cries or strains, causing the overlying skin to bulge outward. These hernias are generally harmless and aren't painful to the infant. Most close on their own during the first few years, but a simple surgical procedure can fix the hernia if it doesn't close by itself. Home remedies for umbilical hernias that have been tried through the years, such as strapping and taping coins over the area, should not be attempted. These techniques are ineffective and may result in skin infections or other injuries.

Genitalia

The genitalia (sexual organs) of both male and female infants may appear relatively large and swollen at birth. Why? It's due to several factors, including exposure to hormones produced by both the mother and the fetus, bruising and swelling of the genital tissues related to birth trauma, and the natural course of development of the genitalia.

In girls, the outer lips of the vagina (labia majora) may appear puffy at birth. The skin of the labia may be either smooth or somewhat wrinkled. Sometimes, a small piece of pink tissue may protrude between the labia — this is a hymenal tag and it's of no significance; it will eventually recede into the labia as the genitals grow.

Due to the effects of maternal hormones, most newborn girls will have a vaginal discharge of mucus and perhaps some blood that lasts for a few days. This "mini-period" is normal menstrual-type bleeding from the infant's uterus that occurs as the estrogen passed to the infant by the mother begins to disappear. Although it's much more common in boys, swelling in the groin of an infant girl can indicate the presence of an inguinal (groin) hernia.

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Hydrocele

In boys, the scrotum (the sack containing the testicles) often looks swollen. This is usually due to a hydrocele, a collection of fluid in the scrotum of infant boys that usually disappears during the first 3 to 6 months. You should call your doctor about swelling or bulging in your son's scrotum or groin that lasts beyond 3 to 6 months or that seems to come and go. This may indicate an inguinal hernia, which usually requires surgical treatment.

The testicles of newborn boys may be difficult to feel in the swollen scrotum. Muscles attached to the testicles pull them up into the groin briskly when the genital area is touched or exposed to a cool environment. Infant boys also normally experience frequent penile erections, often just before they urinate.

More than 95% of newborns pee within the first 24 hours. If your baby is delivered in a hospital, nursery personnel will want to know if this happens while your infant is with you. If a newborn doesn't urinate for what seems like a while at first, it may be that he or she urinated immediately after birth while still in the delivery room. With all the activity going on, that first urination may not have been noticed.

Circumcision Care

If your infant son was circumcised, it usually takes between 7 to 10 days for the penis to heal. Until it does, the tip may seem raw or yellowish in color. Although this is normal, certain other symptoms are not. Call your child's doctor right away if you notice persistent bleeding, redness around the tip of the penis that gets worse after 3 days, fever, signs of infection (such as the presence of pus-filled blisters), and not urinating normally within 6 to 8 hours after the circumcision.

With both circumcised and uncircumcised penises, no cotton swabs, astringents, or any special bath products are needed — simple soap and warm water every time you bathe your baby will do the trick.

No special washing precautions are needed for newly circumcised babies, other than to be gentle, as your baby may have some mild discomfort after the circumcision. If your son has a bandage on his incision, you might need to apply a new one whenever you change his diaper for a day or two after the procedure (put petroleum jelly on the bandage so it won't stick to his skin).

Doctors often also recommend putting a dab of petroleum jelly on the baby's penis or on the front of the diaper to alleviate any potential discomfort caused by friction against the diaper. How you take care of your baby's penis may also vary depending on the type of circumcision procedure the doctor performs. Be sure to discuss what after-care will be needed.

If your baby boy wasn't circumcised, be sure to never forcibly pull back the foreskin to clean beneath it. Instead, gently tense it against the tip of the penis and wash off any smegma (the whitish "beads" of dead skin cells mixed with the body's natural oil). Over time, the foreskin will retract on its own so that it can be pulled away from the glans toward the abdomen. This happens at different times for different boys, but most can retract their foreskins by the time they're 5 years old.

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Skin

There's little doubt about the origin of the expression "still wet behind the ears," used to describe someone new or inexperienced. Newborns are covered with various fluids at delivery, including amniotic fluid and often some blood (the mother's, not the baby's). Nurses or other personnel attending the birth will promptly begin drying the infant to avoid a drop in the baby's body temperature that will occur if moisture on the skin evaporates rapidly.

Newborns are also coated with a thick, pasty, white material called vernix caseosa (made up of the fetus' shed skin cells and skin gland secretions), most of which will be washed off during the baby's first bath.

The hue and color patterns of a newborn's skin may be startling to some parents. Mottling of the skin, a lacy pattern of small reddish and pale areas, is common because of the normal instability of the blood circulation at the skin's surface. For similar reasons, acrocyanosis, or blueness of the skin of the hands and feet and the area surrounding the lips, is often present, especially if the infant is in a cool environment.

When bearing down to cry or having a bowel movement, an infant's skin temporarily may appear beet-red or bluish-purple. Red marks, scratches, bruises, and petechiae (tiny specks of blood that have leaked from small blood vessels in the skin) are all common on the face and other body parts. They're caused by the trauma of squeezing through the birth canal. These will heal and disappear during the first week or two of life.

Fine, soft hair, called lanugo, may be on a newborn's face, shoulders, and back. Most of this hair is usually shed in the uterus before the baby is delivered; for this reason, lanugo is more often seen on babies born prematurely. In any case, this hair will disappear in a few weeks.

The top layer of a newborn's skin will flake off during the first week or two. This is normal and doesn't require any special skin care. Peeling skin may be present at birth in some infants, particularly those who are born past their due date.

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Birthmarks

Not all babies come with a birthmark. However, pink or red areas, sometimes called salmon patches, are common and generally disappear within the first year. Most frequently found on the back of the neck or on the bridge of the nose, eyelids, or brow (hence the fanciful nicknames "stork bite" and "angel kiss"), they can occur anywhere on the skin, especially in light-skinned infants.

Mongolian spots, flat patches of slate-blue or blue-green color that resemble ink stains on the back, buttocks, or elsewhere on the skin, are found in more than half of black, Native American, and Asian infants and less often in white babies. These spots are of no significance and almost always fade or disappear within a few years.

Strawberry or capillary hemangiomas are raised red marks caused by collections of widened blood vessels in the skin. These may appear pale at birth, then become red and enlarge during the first months of life. Then, they usually shrink and disappear without treatment within the first 6 years.

Port-wine stains, which are large, flat, reddish-purple birthmarks, won't disappear on their own. As a child gets older, cosmetic appearance concerns may require the attention of a dermatologist.

Cafe-au-lait spots, so called because of their "coffee with milk" light-brown color, are present on the skin of some infants. These may deepen in color (or may first appear) as the child grows older. They're usually of no concern unless they're large or there are six or more spots on the body, which may indicate the presence of certain medical conditions.

Common brown or black moles, known as pigmented nevi, also can be present at birth or appear (or get darker) as a child gets older. Larger moles or those with an unusual appearance should be brought to a doctor's attention because some may require removal.

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Rashes

Several harmless skin rashes and conditions may be present at birth or appear during the first few weeks. Tiny, flat, yellow or white spots on the nose and chin, called milia, are caused by the collection of secretions in skin glands and will disappear within the first few weeks.

Miliaria — small, raised, red bumps that often have a white or yellow "head" — is sometimes called infant acne because of its appearance. Although miliaria often occurs on the face and can appear on large areas of the body, it's a harmless condition that will go away within the first several weeks with normal skin care.

Despite the frightening sound of its medical name, erythema toxicum is a harmless newborn rash consisting of red blotches with pale or yellowish bumps at the center, which can resemble hives. This rash usually blossoms during the first day or two after birth and disappears within a week.

Pustular melanosis, a rash present at birth, is characterized by dark brown bumps or blisters scattered over the neck, back, arms, legs, and palms, which disappear without treatment.

Also, it isn't unusual to see infants born with sucking blisters on the fingers, hands, or arms because the fetus can suck while still in the uterus.

Newborn jaundice, a yellowish discoloration of the skin and white parts of the eyes, is a common condition that normally doesn't appear until the second or third day after birth and disappears within 1 to 2 weeks. Jaundice is caused by the accumulation of bilirubin (a waste product produced by the normal breakdown of red blood cells) in the blood, skin, and other tissues due to the temporary inability of the newborn's immature liver to clear this substance from the body effectively.

Although some jaundice is normal, if an infant becomes jaundiced earlier than expected or the bilirubin level is higher than normal, the doctor will follow the baby very closely.

Getting to Know Your Little One

The first days and weeks of a newborn's life are a time of great wonder and delight for most new parents. However, being responsible for this tiny creature can be scary, particularly if you're not familiar with how a newborn looks and behaves.

If you feel anxious or uncertain about any part of caring for your baby, don't hesitate to call your doctor, other health care professionals, or family or friends who have had experience caring for a newborn.

Your Child's Checkup: Newborn (for Parents)

Reviewed by: Elana Pearl Ben-Joseph, MD

en español La revisión de su hijo: Recién nacido

What to Expect

In the hospital, the doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on a growth chart.

2. Ask questions, address any concerns, and offer advice on taking care of your baby:

Feeding. Breast milk is the best nutrition for infants, but store-bought formula also can provide the nutrients they need. Newborns should be fed when they're hungry, which is about every 1 to 3 hours. Your doctor or nurse may watch as you breastfeed and offer help with any problems. Formula-fed newborns take about 1–1½ ounces (30–45 ml) at each feeding. Burp your baby midway through a feeding and at the end. As they grow, babies start to eat more at each feeding, so will need fewer feedings over time.

Peeing and pooping. A breastfed baby may have only 1 or 2 wet diapers a day until the mother's milk comes in. Expect about 6 wet diapers by 3–5 days of age for all babies. Newborns may have just 1 poopy diaper a day at first. Poop is dark and tarry the first few days, then becomes soft or loose and greenish-yellow by about 3–4 days. Newborns typically have several poopy diapers a day if breastfed and fewer if formula-fed.

Sleeping. A newborn may sleep 14 to 17 hours or more in 24 hours, waking up often (day and night) to breastfeed or take a bottle. Breastfed babies usually wake to eat every 1 to 3 hours, while formula-fed babies may sleep longer, waking every 2 to 4 hours to eat (formula takes longer to digest so babies feel fuller longer). Newborns should not sleep more than 4 hours between feedings until they have good weight gain, usually within the first few weeks. After that, it's OK if a baby sleeps for longer stretches.

Developing. Newborn babies should:

  • pay attention to faces or bright objects 8–12 inches (20–30 cm) away
  • respond to sound — they may turn to a parent's voice, quiet down, blink, startle, or cry
  • hold their arms and legs in a flexed position
  • have strong newborn reflexes, such as:
    • rooting and sucking: turns toward, then sucks breast/bottle nipple
    • grasp: tightly grabs hold of a finger placed within the palm
    • fencer's pose: straightens arm when head is turned to that side and bends opposite arm
    • Moro reflex (startle response): throws out arms and legs, then curls them in when startled

3. Do an exam with your baby undressed while you are present. This will include an eye exam, listening to your baby's heart; feeling pulses; inspecting the umbilical cord; and checking the back, hips, and feet.

4. Do screening tests. Your baby's heel will be pricked for a small amount of blood to test for some kinds of harmful diseases. Your baby will also get a hearing test and have their oxygen levels checked before leaving the hospital.

5. Give first immunizations. While in the hospital, your baby should have their first immunizations. Immunizations can protect infants from serious childhood illnesses, so it's important that your baby get them on time. Immunization schedules can vary, so talk to your doctor about what to expect.

Looking Ahead

Here are some things to keep in mind until your baby's next routine checkup in a few days:

Feeding
  1. If you breastfeed:
    • Help your baby latch on correctly: mouth opened wide, tongue down, with as much of the breast in the mouth as possible.
    • Don't use a bottle or pacifier until nursing is going well.
    • Breastfeed whenever your baby is hungry. Pay attention to signs that your baby is full, such as turning away from the nipple and closing the mouth.
    • Continue to take a prenatal vitamin or multivitamin daily.
  2. If you formula-feed:
    • Give your baby iron-fortified formula.
    • Follow the formula package's instructions when making and storing bottles. Don’t add extra water to your baby’s formula.
    • Don't prop bottles or put your baby to bed with a bottle.
    • Give a bottle whenever your baby is hungry. Pay attention to signs that your baby is full, such as turning away from the bottle and closing the mouth.
Routine Care
  1. Wash your hands before handling the baby and avoid people who may be sick.
  2. Hold your baby and be attentive to their needs. You can't spoil a newborn.
  3. Keep the diaper below the umbilical cord so the stump can dry. The umbilical cord usually falls off in 10–14 days.
  4. For circumcised boys, put petroleum jelly on the penis or diaper's front.
  5. Girls may have vaginal discharge that may include a small amount of blood during the first week of life. This is nothing to worry about.
  6. Give sponge baths until the umbilical cord falls off and a boy's circumcision heals. Make sure the water isn't too hot — test it with your wrist first.
  7. Use fragrance-free soaps and lotions.
  8. Call your baby's doctor if your infant has a fever of 100.4ºF (38ºC) or higher, taken in your baby’s bottom. Call the doctor if your baby is acting sick, isn't eating, isn't peeing or pooping, isn't latching on or sucking well when nursing, doesn't seem satisfied after breastfeeding, looks yellow, or has increasing redness or pus around the umbilical cord or circumcision. Do not give any medicine without talking to the doctor first.
  9. It's common for new moms to feel tired and overwhelmed at times. But if these feelings are intense, or you feel sad, moody, or anxious, call your doctor.
  10. Talk to your doctor if you're worried about your living situation. Do you have the things that you need to take care of your baby? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.
Safety
  1. To reduce the risk of sudden infant death syndrome (SIDS):
    • o Always place your baby to sleep on a firm, flat mattress on their back, and not on the stomach or side, in a crib or bassinet without any crib bumpers, blankets, quilts, pillows, or plush toys.
    • Breastfeed your baby, if possible.
    • Let your baby sleep in your room in a bassinet or crib next to the bed until your baby's first birthday, or for at least 6 months, when the risk of SIDS is highest.
    • Avoid overheating by keeping the room temperature comfortable. Dress your baby for the room temperature and don't overbundle. Don't cover your baby's head while they're sleeping. Watch for signs of overheating, such as sweating or feeling hot to the touch.
    • Consider putting your baby to sleep sucking on a pacifier. If your baby rejects the pacifier, don't force it. If the pacifier falls out during sleep, you don't have to replace it. If you're breastfeeding, wait until breastfeeding is established before introducing the pacifier.
    • Don’t let your baby fall asleep on a product that isn’t specifically designed for sleeping babies, such as a sitting device (like a car seat), a feeding pillow (like the Boppy pillow), or an infant lounger (like the Dock-a-Tot, Podster, and Bummzie).
    • Don’t use products or devices that claim to lower the risk of SIDS, such as sleep positioners (like wedges or incliners) or monitors that can detect a baby’s heart rate and breathing pattern. No known products can actually do this.
    • Make sure that all sleep surfaces and products you use to help your baby sleep have been approved by the U.S. Consumer Product Safety Commission (CPSC) and meet federal safety standards.
  2. Don't smoke or use e-cigarettes. Don't let anyone smoke or vape around your baby.
  3. Always put your baby in a rear-facing car seat in the back seat. Never leave your baby alone in a car.
  4. While your baby is awake, don't leave your little one unattended, especially on high surfaces or in the bath.
  5. Never shake your baby — it can cause bleeding in the brain and even death. If you are ever worried that you will hurt your baby, put your baby in the crib or bassinet for a few minutes. Call a friend, relative, or your health care provider for help.
  6. Avoid sun exposure by keeping your baby covered and in the shade when possible. Sunscreens are not recommended for infants younger than 6 months. However, you may use a small amount of sunscreen on an infant younger than 6 months if shade and clothing don't offer enough protection.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.

Reviewed by: Elana Pearl Ben-Joseph, MD

Date reviewed: July 2022

Top 15 Handbooks for Young Parents – News – IQ Research and Education Portal – National Research University Higher School of Economics

RESEARCH AUTHORS:

Zhanna Chernova , Professor of the Department of Sociology at the National Research University Higher School of Economics in St. Petersburg.

Larisa Shpakovskaya , Associate Professor, Department of Sociology, National Research University Higher School of Economics in St. Petersburg.

Books about early childhood assign different roles to parents. In some manuals, young mothers and fathers are just "students" who must follow the recommendations of "teachers" - experts. In other books, the "monopoly" on knowledge about the child is divided equally between parents and childhood specialists. The third type of books absolutizes parents and does not favor experts. At the same time, all books contain useful advice and serve as a good guide for young families.

Zhanna Chernova and Larisa Shpakovskaya studied which books about early childhood (up to three years*) are the most popular and how parental competence is understood in them. The results of the study are published in the article “Professionalization of parenting: between expert and ordinary knowledge” (Journal of Social Policy Research, No. 4, 2016).

Parents become professionals

In modern society, parenthood is perceived almost like a profession. As in any business, it has its own special set of competencies, the process of learning them, and even control by specialists. This "professionalization" is influenced both by the social institutions associated with childhood and by the families themselves.

  • Parents are persistently "educated" by all concerned: the state, pediatricians, psychologists, teachers, mass media and manufacturers of children's goods. Requirements for families are growing, new standards of parental care are being formed.

The old "formula" of maternal care - "clean, fed, shod, dressed" - has long been supplemented with new components. Among them are the "early intellectual development" of the child, his "psycho-emotional comfort" and "creative development". All this requires a lot of effort and time from parents, but it pays off with interest.

  • Young families themselves also want to know more about the right way to raise their children (see Parents actively educate themselves, Parenting becomes a profession). This is evidenced by their activity in Internet forums on childhood, the fashion for a variety of "schools for moms and dads", joint activities with children (kids clubs, for example) and a high demand for children's goods / services.

Childhood forums and blogs are especially revealing: they reflect everything that parents have learned on the topic. Articles, oral advice from experts, videos, and books about childhood are discussed.

The authors of the study studied websites and forums for parents (littleone.ru, eva.ru, chado.spb.ru, babyforum.ru and many others) and determined which books are most often mentioned and recommended by their registered members. Other sources of data on the most read literature were conversations with parents (urban educated middle class, 100 interviews in 2010-2014) and a survey of St. Petersburg bookstore salespeople.

Landmarks for neophytes

In the course of their research, Zhanna Chernova and Larisa Shpakovskaya identified fifteen books on childhood that were bought most often**. Some have already become classics for new parents. So, modern moms and dads still read the bestseller of the famous American pediatrician Benjamin Spock "The Child and Care for Him" ​​(first published in the USA in 1946). The advice of the famous Soviet educators Boris and Lena Nikitin is also popular (the first books were published in the 1960s; the works have been republished more than once and translated into at least ten languages).

The most read books on childhood tell about babies from "A" to "Z". Here and physical development (with specific indicators of growth, weight, skills of the child by a certain age), and the treatment of diseases, and educational games for children, and recipes for children's cuisine, and the psychological problems of parents and kids.

However, the authors of books see the parental role differently. And they differentiate the competencies of families and experts in different ways. In some books, parental experience is absolutized. Close contact with the child, intuition and parental love will help to find the right solution, they say. Other experts, on the contrary, insist on the need to "obey" specialists. Still others offer a compromise: the parent studies the opinion of experts, but makes the decision himself, taking into account the specific situation.

Experience plus intuition
  • Ludmila Petranovskaya. "Secret support. Attachment in a child's life.
  • Irina Mlodik. "A book for imperfect parents, or Life on a free topic."
  • Boris and Lena Nikitin. "We and our children."
  • William and Martha Sears. "Your baby from birth to two years."

Main parenting competencies: love for the baby and developing your own parenting style that is optimal for the family. The goal of professionalization: a happy childhood and parenthood.

Pros: benefits teach neophyte parents to believe in themselves, develop intuition.

Controversial moment: "dictation" of parental experience.

Presentation style: confidential story, dialogue with the reader on an equal footing.

Distinguishing marks: close emotional and physical contact with the child - for example, breastfeeding, carrying the child in a sling, co-sleeping.

The authors of such books are opponents of dogmas in regard to the upbringing and care of the child. The argument is simple: babies differ in their psychophysiological characteristics, and the situations in families are different. The home environment, the involvement of the child in household chores and maternal love, according to Boris and Lena Nikitin, are more important than expert advice.

The books are addressed primarily to young mothers. Behind them is recognized "biological", natural knowledge about children. “Surprisingly, by nature itself, a young mother has already been given enough knowledge, skills, wisdom, love to take care of her baby,” writes Irina Mlodik. Close contact with the child increases this knowledge, develops parental intuition: the mother feels her baby better.

Expert opinion
  • Lyubov Pavlova. "A Practical Encyclopedia of Early Development: Years to Three".
  • Mikhail Fedotov. Encyclopedia of early child development. First year of life.
  • Georgy Bolotovsky, Alexander Tsaregorodtsev. "Three Major Years: A Book for Parents".
  • Ludmila Sokolova, Nadezhda Andreeva. "This amazing baby."
  • Valentina Alexandrova. "Encyclopedia of the Young Mother".
  • Sergei Zaitsev. "A book for young mothers".

Key parental competencies: competent care of the child, training in proper care. The purpose of professionalization: the health and comfort of children.

Pros: Parents receive the most important knowledge about caring for a baby. Information is given on indicators of child development, and the range of recommendations is quite wide: from hygiene to dietetics.

Disputable moment: absolutization of medical knowledge, parental experience is taken out of brackets.

Presentation style: monologue guide. The authors of the books “offer an objective picture of the development of the child, thereby claiming the absolute truth of speaking about parenthood and childhood,” Chernova and Shpakovskaya explain.

Special features: Evaluation of all changes in the child in terms of health/illness.

Young parents, according to the authors of these books, are incompetent in matters of care. They need professional advice. After all, already from the first days of life, the child needs to create the right conditions, establish a competent (in terms of hygiene and health) life.

That is why the information in such books is extremely specific. So, the guide of pediatricians Georgy Bolotovsky and Alexander Tsaregorodtsev begins with the words: “To care for a newborn, you need cotton swabs and cotton swabs, gauze wipes, baby cream, powder, baby oil, two pipettes ...”. It is necessary to constantly monitor the physical condition of the child and, in case of any doubt, consult a doctor, the authors of the books are convinced.

Common sense based on knowledge
  • Mikhail and Nadezhda Telepov. “Education of parents. Questions for reflection.
  • Evgeny Komarovsky. The health of the child and the common sense of his relatives.
  • Benjamin Spock. "Child and Care".
  • Elena Pervushina. Handbook for a young mother. Educational activities for kids.
  • Ekaterina Murashova. "Your obscure child. Psychological prescriptions for parents.

Core parenting competencies: love for the child and the ability to think critically - adapt expert prescriptions to the person and situation. The purpose of professionalization: the health of the child, psychological comfort for the whole family.

Pros: balanced position. Parents are given a guide - medical information. At the same time, it is recognized that mothers and fathers must make independent decisions, taking into account all specific circumstances.

Controversial point: the need for a critical attitude of parents to very different information - both to ordinary stereotypes (which is quite understandable), and to the advice of experienced doctors.

Presentation style: instructions and imperatives alternate with confidence.

Special features: abundance of cases from practice.

Bookmakers give parents the freedom to decide. “The author does not aim to strictly regulate the actions of mom or dad,” writes Dr. Komarovsky. After all, sometimes expert advice is hard to put into practice. Then the common sense of parents helps, their ability to navigate the situation. This approach strengthens the position of parents when dealing with professionals, Zhanna Chernova and Larisa Shpakovskaya are convinced. "It allows mothers and fathers to be more autonomous in their choice of parenting model" and helps shape individual parenting style, the researchers conclude.

*Under three years of age selected in the study because babies need intensive parental care. On the other hand, during this period, parents are very actively involved in the course of things.

**Literature in the selection was published in 2000-2014.

See also:

Why grandmothers are replaced by nannies

Parents are actively engaged in self-education

Parenthood becomes a profession

Why children do not go to clubs and classes

Lyricist: Sobolevskaya Olga Vadimovna, February 10, 2017

All materials of the author

Literature children bookshelf

Caring for a newborn baby - a note to mom

During the first year of life, a child makes a giant leap in his physical and emotional development (just imagine that his brain grows 1.5 times!). But parents also learn a lot, especially if the baby is the first. “How to care for the ears, nose, eyes is, of course, very important, and we will definitely talk about it. But it is equally important to learn to feel your child, ”according to Yulia Viktorovna Andronnikova, pediatrician of the highest category, head of the pediatric department of the Center for Traditional Obstetrics and Family Medicine, this feeling of security and love will accompany the child all his life.

All children are different, their needs are different, and mom and dad will have to find their own way, relying on the opinions of specialists and their own intuition.

The only thing that can be said for sure is that extreme is always bad. And in the upbringing of children in the first place.

Breastfeeding

An important aspect of infant care is proper breastfeeding. This is “the core on which the whole care of the baby is wound. Breast sucking is the main interest of the baby in the first months of life, and in the future and for quite a long time - a priority interest. Breastfeeding helps to build the rhythm of life, help the baby in time, calm down, feed," says Lilia Valentinovna Kazakova, pediatrician of the Territory of Health and SM, AKEV breastfeeding consultant. Sucking activates the bowels. This will help to accustom to "planting" from early childhood. Just in case, let's make a reservation - breastfeeding is certainly good, but it is not a panacea and does not guarantee either good health or deeper affection. With other mother's efforts, "artificials" can easily catch up, or even overtake "babies" in all respects.

Bathing, caring for the umbilical wound and skin

Baby's skin is thin and vulnerable, sweating and diaper rash quickly appear on it. Therefore, it is necessary to arrange air baths for the child (the optimum temperature in the room is 20-22 C, humidity is 55-60%). You can bathe daily - the first month for 2-3 minutes (water - about 37 C). Then gradually increasing the time (up to 10 minutes) and lowering the temperature (by 1-2 C). It is better to use baby soap / foam less often - once a week, not more often.

"Never bathe your baby on an empty stomach." This is not a swimmer's training, but a relaxing and hygienic procedure. The kid should be calm and contented with life," reminds L. V. Kazakova. When taking it out of the water, wrap it in a large towel and immediately breastfeed (eat). He sucks, dries, calms down, and after 10-15 minutes you will calmly do everything you need. Use only sterile water to treat the remaining umbilical cord (other solutions may interfere with the natural healing process). After rinsing, dry thoroughly with a clean towel (not cotton! To avoid leaving fibers on the navel).

Hygiene for girls and boys

“The first and most important thing for a newborn girl is not to injure her genitals by mechanically removing the lubricant (she will go away on her own over time). Rinse with warm water (use soap once every 3-4 days), and then be sure to moisturize (distribute 1 drop of oil over the entire washed surface),” Galina Vladimirovna Ovsyannikova, an obstetrician-gynecologist of the Health Territory, advises washing from front to back (for this it is more convenient keep your daughter upside down). For signs of inflammation, take chamomile baths, and for more severe redness, treat with Miramistin. Another important - exclusively "female" - nuance of hygiene: "Immediately after birth, a neonatologist-pediatrician should look at the genital gap. Mom needs to be constantly monitored until 5-6 years old so that she does not overgrow (once every 3-4 days).

For boys, pediatricians recommend washing the genitals only from the outside (up to adolescence): during the day, if necessary, wipe with wet baby wipes, and in the evening, while bathing, wash with warm water from the outside and do not climb anywhere else (closing foreskin and smegma are the best natural defense against bacteria)! As for phimosis, up to 3 years is the norm, and a variant of the norm almost until adolescence.

Eye Care

The eyes of a newborn do not require special care. Everything that accumulates on the surface of the baby's eye is removed on its own when the baby blinks. In the morning, in the corners of the eyes, you can see the mucus accumulated during the night - this is also the norm. Rinse the eyelashes / eyelids of the baby with boiled water, wiping with a cotton swab from the outer corner to the inner.

The cause of profuse discharge from the eyes of a newborn may be dacryocystitis, blockage of the nasolacrimal canal. "Proper massage allows you to cope with this disease by the age of 2 months." Massage is simple, but it will be better if a specialist shows it. Also, ophthalmologist Anastasia Borisovna Petukhova recalls that the first examination by an ophthalmologist is immediately after birth, while still in the maternity hospital, and the second is at the age of 1 month: “It is a mistake to think that nothing can be done if the child is still very small. For example, a congenital cataract is operated on at the age of 2-3 months, while later surgical treatment may not be as effective.”

Nose and ear care

Yes, they can and should be cleaned. But the main thing is not to overdo it, warns the otolaryngologist, homeopath and mother of three children Ekaterina Vladislavovna Polinskaya: “You only need to clean the auricle (by no means the ear canal!) After bathing the child.” A small child still does not know how to blow his nose himself (he will learn this by the age of 2-3), so you can instill drops in him in the morning and in the evening based on isotonic sodium chloride solution. Children under one year of age do not need to use sprays - the auditory tube is still short and wide, this can provoke a rapid reflux of infection from the nasal cavity. The same applies to instillation of breast milk into the nose. “This is physiologically unreasonable and blocks the mucociliary clearance of the nasal cavity. Yes, milk contains proteins, fats and carbohydrates, as well as protective antibodies that are necessary for the baby. But they must still act through the oral cavity, ”explains the doctor.

Fundamentals of Fundamentals

Not all advances that make life easier for older people benefit the younger generation. Due to the constant use of diapers, pediatrician Yulia Viktorovna Andronnikova warns, the child may have difficulties with the formation of toilet skills, in the "diaper" he does not feel "bottom", does not realize that he is pissing - he does not have the necessary feeling of discomfort for this. Instead of disposable diapers, pay attention to "reusable" cloth diapers - they help to form the necessary skills much faster and are more physiological. The next important task for parents of babies up to a year, according to Yulia Viktorovna, is to teach them to chew and swallow correctly! “Our children drink and eat everything puree until almost 3-4 years old! This has a bad effect on chewing skills, diet. Does not "teach" the stomach to work normally. And finally, you need to organize a sleep schedule. “Unfortunately, modern children often live in a mode that is convenient for their parents: late bedtime, late rising. Whereas all the hormones necessary for the growth and proper formation of internal organs work precisely in sleep, moreover, from nine in the evening. Hug, kiss and rejoice... Together!

And finally, the most important thing. The mental development of the baby, the development of different parts of the brain, and, therefore, different sensory organs, depend on the external impressions that he receives in the first year of life. “Without the proper experience of one-on-one communication with a caring adult, the orbito-frontal cortex is unlikely to be sufficiently developed.

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