Newborn Care

Each day of the hospital stay, a pediatrician will stop by to see how you and your baby are doing. We’ll answer any questions you may have. We also will ensure that your baby completed these steps in newborn care:

• Routine newborn screenings, including hearing tests
• First immunization (hepatitis B vaccine) before leaving the hospital
• Any further care or testing, as needed

Cochran Newborn Service

You may have chosen a pediatrician for your baby who doesn’t provide newborn care at BIDMC, or perhaps you didn’t have a chance to choose a pediatrician before your baby’s birth. Neither of these situations will adversely affect your baby’s care right after birth. We are happy to offer the Cochran Newborn Service during your baby’s hospital stay.

Cochran Newborn Service doctors are pediatricians who specialize in newborn care. They are available to care for your newborn during their stay in the hospital nursery. Within 24 hours of birth, one of our pediatricians will examine your baby.

Your baby will have these standard screening tests while in the hospital:

• Blood tests to check blood sugar levels
• Jaundice and bilirubin screenings
• Pulse oximetry screening for congenital (present at birth) heart diseases
• Routine vision and hearing screenings
• Tests for infections

We offer the first course of standard immunizations for babies while in the hospital:

We offer the option of circumcision for male babies before hospital discharge. Circumcision is a personal, family choice that may be influenced by many factors. Only you can decide if it’s the right choice for your baby.

We perform circumcision in our nursery. Complications from circumcision are rare. Risks include hemorrhage (excessive bleeding), infection, and injury to the penis, scrotum (sac that holds the testes) or urethra (tube that urine passes through). There’s also a small chance that you won’t be pleased with the cosmetic result, which could require a revision of the circumcision when your baby is older.

When you and your baby leave the hospital, the Cochran Newborn Service will provide you and/or your pediatrician with a summary of your baby’s hospital stay. If there are any unusual circumstances or concerns for your baby, we’ll contact your pediatrician directly to discuss them.

Choosing a Pediatrician

Here are some things to consider when your family is choosing a pediatrician:

• Type of practice: solo, partnership or group practice
• Hospital affiliation
• Credentials, such as board certifications
• Office location and hours 
• Office staff and atmosphere
• Wait time and appointment availability
• Emergency, after-hours care protocol
• Financial considerations and insurance
• Care and childrearing philosophy

Once you find a pediatrician that interests you, call their office to see if they offer a courtesy prenatal interview. That allows you to meet the pediatrician and visit the office during your pregnancy. If the pediatrician doesn’t offer it free of charge, call your insurance provider to see if they cover a prenatal visit. When you and your baby leave the hospital, the Cochran Newborn Service will provide you and/or your pediatrician with a summary of your baby’s hospital stay. If there are any unusual circumstances or concerns for your baby, we’ll contact your pediatrician directly to discuss them.

BIDMC offers ongoing care and support after you and your baby go home. We offer a variety of classes and support groups on topics such as newborn care and breastfeeding. The Parent Connection provides support and mentorship for new parents.

When to Call Your Pediatrician

Call your health care provider immediately if your baby:

• Is very yellow
• Is hard to wake up
• Is very fussy or has a high-pitched cry
• Is not feeding 8 or more times in 24 hours
• Does not make enough wet diapers or diapers with stool
• Has a temp of 100.4 or higher
• Breathes more than 60 times per minute (awake or asleep)
• Doesn’t seem to see objects in front of their face by one month old
• Doesn’t startle or jump with loud noises, such as a door slamming or dog barking

Tips on How to Take Care of Your Child at Home

Umbilical Cord Care: Your baby’s umbilical cord stump has a clamp on it for a day or two as a precaution against the slight chance of bleeding. When the care team removes the clamp, the cord stump begins to dry up naturally. As it begins to separate, a little mucous and blood appear at the edges. Keep the stump dry until it falls off in two to three weeks. No wiping is necessary. Do not put any type of ointment, creams or a bandage on the cord.

It’s fine to give your baby a sponge bath or a tub bath as long as the cord is kept as dry as possible. While it is still attached, it is a good idea to keep the diaper folded below it so the air can dry out the stump. If your baby's bowel movement gets on the cord, wash it with warm water and pat dry.

If the skin around the stump becomes red and swollen, is draining any type of fluid, smells bad, or has not fallen off by the third week of life, call your baby’s pediatrician. This may be a sign of infection. Gently clean the area only with warm water until it heals within 7-10 days.

Care of a Baby’s Vagina: Caring for your baby girl’s vagina is easy. Wipe away any vaginal discharge, always wiping toward the anus, from front to back. You can safely clean the folds of the labia and the most external part of your baby’s vagina, but you shouldn’t perform any deeper cleansing. 

Care of a Circumcised Penis: Generally, we perform a circumcision the day after delivery. Afterward, the doctor puts gauze coated with petroleum jelly around the tip of the penis. The petroleum jelly keeps the healing tip of the penis from sticking to the diaper. The gauze will fall off or the care team will remove it later that day. 

Continue to apply a generous amount of petroleum jelly to the tip of the penis for one to two days while it heals. You may notice mild bleeding and some yellow or white creamy material on the tip of the penis. It will be swollen and dark red in color. Within 24 hours of circumcision, the penis will be covered with a crusty discharge for about 7 days. Both of these are normal as long as they are not excessive and there is no swelling of the penis itself. Gently clean the area with warm water only until it heals within 7-10 days.

Care of an Uncircumcised Penis: Wash the outside of the penis with soap and water, just like the rest of the body. Do not try to pull the foreskin back from the tip of the penis. 

In time — perhaps three or four years — the foreskin will loosen naturally to the point where it can be pulled back over the tip of the penis. Parents should teach their child to wash his penis as part of his daily routine, including under the foreskin after it has begun to retract. 

Newborn Eye Care: Most babies’ eyes are puffy during the first several days. They may have some mucous discharge. Usually, the puffiness will disappear in a day or two, and the discharge within a week. While the discharge is there, clean the eyes by wiping from the inside corner to the outside. Use a cotton ball or part of a soft washcloth for each eye. Use a new cotton ball or different part of the washcloth for each eye.

You need to seek medical advice only if the whites of your baby’s eyes become red or yellow (which can be a sign of jaundice) or if the discharge persists for more than a week. 

Newborn Fingernail Care: Babies have very soft nails that are difficult to cut. Their fingertips are very delicate for the first few weeks, and scissors or clippers may produce cuts. You can smooth the fingernails using an emery board (nail file). 

After your baby becomes a month old, you can use nail clippers or cuticle scissors to carefully clip the nails. To make it easier, try to do this while they are asleep. Do not bite your baby’s nails to make them shorter. This old way of cutting the nails causes infections. 

Newborn Hair Loss: Very often, baby hairs fall out during the first three to four months. Do not be alarmed if this happens. Your baby’s permanent hair will eventually grow in, though it may take a year or more. 

Taking Your Baby’s Temperature: A baby has a fever if the temperature is greater than 100.3°F. They are cold if the temperature is below 97.5°F. There are two ways you can take your baby’s temperature. A rectal temperature is more accurate, but an axillary temperature (in the armpit) is easier to take and more comfortable for the baby. 

Axillary Method 

We recommend using a digital thermometer. Place the thermometer with the bulb end in the baby’s armpit. Hold the baby’s arm against their side so the end is well covered by skin. Be sure that no clothing is in contact with the bulb end of the thermometer. Hold in place until the digital thermometer shows the final reading, usually indicated with a beep. 

Rectal Method 

To take a rectal temperature using a digital thermometer, grease the tip with petroleum jelly or lubricant. Slide the tip into the baby’s anus, three quarters of an inch at most. If you meet any resistance, do not push hard. Once you have the thermometer inside, hold the thermometer near the tip end, leave it in until the thermometer indicates the final reading. 

Remove the thermometer and clean it well. For sanitary reasons, once you use the thermometer to take a rectal temperature, do not use if for any other method of temperature taking, even after a cleaning.