02.20. APPENDIX 02 - SOME ADVICE FOR NEW MOTHERS

APPENDIX TWO - SOME ADVICE FOR NEW MOTHERS CARE OF THE INFANT The immediate care of the newborn, just after birth, will be supervised by the doctor or midwife.

You should then take your baby for a medical check-up once every month. The doctor will advise you about immunisations etc. Your baby will sleep most of the time during the first month. His wants are few - sleep, warmth, comfort, and food.

Sleep

During the first month, the baby may be awake only for its feeds. As he grows older, he will be awake for longer periods.

Provide him with a quiet, well ventilated room (without any draught) to sleep in. Keep him under a mosquito net to protect him from flies and mosquitoes etc.

There is no need to rock him to sleep as this will become a habit that may become difficult to break, later on. Your baby may feel more comfortable if he is made to lie on his stomach. This will save him from choking himself in case he vomits, and will also relieve him of any colics. His head too will thus have a good shape and won’t be flattened. But you should check him frequently, whenever he is sleeping on his stomach.

Warmth and Comfort

Remember that a baby doesn’t have an efficient temperature-controlling mechanism in his body, like an adult has. So don’t over-dress him in the hot season. A thin cotton dress diaper will be sufficient.

Woollen clothes can also irritate a baby’s skin. So when using woollen clothes in winter, make sure that you use cotton underclothes as well. To check whether your baby is warm enough, you should feel his hands and feet and see whether they are cold or chilly. When using a cap, ensure that it is of some knitted material so that the baby can breathe, even if the cap falls over his face. When your baby awakes, check that he is not uncomfortable with wet diapers. Diapers should be washed well, rinsed thoroughly and dried in the sun. Particles of soap on them can irritate the baby’s skin. If possible, try and boil all diapers once a week.

Bathing The Baby

Very hot baths can be harmful for a baby. Keep a separate soap and towel for your baby. Wash him in warm water and try and give him an oil-rub every time you bathe him. Avoid exposing the baby’s body to anything that will suddenly cool it, and ensure that no water enters his nose, mouth and ears.

Clean out visible secretions in his nose and ears, but never put anything into them that could cause injury. If the nose is blocked, it can be cleaned with something soft like a thin wick made out of soft cotton cloth. The ear can also be cleaned in a similar way.

Care should also be taken over the umbilical cord, till the navel has healed completely. Until then, you should keep it dry, applying a clean dressing over it and a light, soft bandage round his abdomen in that area.

If the baby is even slightly ill, it is better to give it a sponge bath rather than giving it a regular bath and thus exposing it to chill.

Feeding

There is actually no substitute for breast-milk! It is the best milk your baby can have. There are antibodies in breast-milk that can protect your baby from many infections. Breast-fed babies thrive well, are more satisfied, have a greater feeling of security and also do not get bowel-infections as easily as bottle-fed babies. In the beginning, feed your baby every three to four hours between 6 a.m. and midnight. After the first month, you may find that your baby prefers to sleep through the night. You can then omit the night-feed. But don’t let him starve if he is hungry and cries at night. A nursing mother should have a good diet herself, including vitamins and iron tablets. She should also take sufficient rest every day. She should avoid hot spicy foods, chocolates, laxatives, sedatives, aspirin and other drugs, as these can be passed on to the baby through the milk, and may harm him. The breasts should be washed before and after feeds. You should never allow your breasts to be engorged with milk, lest an abscess begin to form there.

Bottle-Feeds

If you have sufficient breast-milk, you need not start your baby on bottle-feeds until he is 6 to 9 months old. Fresh cow’s milk, if used, should be boiled well. Baby-milk-powder is usually fresh and free from germs. But always check the date of expiry on the tin before buying milk-powder. Drinking water should also be boiled. For every kilogram of body-weight, a baby usually needs about 125 millilitres of fresh milk and 75 millilitres of water every day. So for a 3-kilogram baby, the daily formula would be about 400 ml. of fresh milk and 200 ml. of water, with two tablespoons of sugar. This can be divided into five feeds during the day. (If you are using baby-milk-powder, follow the instructions on the outside of the tin). As the baby grows older he will need more milk and less water. In summer, or whenever the baby has diarrhoea or a fever, you should add more water to his feeds. In tropical countries like India, where germs multiply easily, the feeding-bottle and its nipples should be boiled well. Otherwise the baby can easily get diarrhoea or some other infection. The bottles should be boiled for at least ten minutes, and its nipples boiled separately in mild salt water. Make sure you don’t touch the inside of a sterilised bottle or the inner portion of a sterilised nipple.

Check and see that the milk is not too hot, before giving it to your baby, lest he burn his tongue!

After the first month you can start giving him vitamin drops and fruit juices as well. Make sure that fruit juices are well strained.

General Precautions

People with colds and infections should not be allowed to come near your baby. If you yourself have a cold, you can wear a mask or cover your nose and mouth when feeding him.

Here are some thing that you should report to a doctor:

1. Any discharge from the baby’s eyes. (Remember that babies have no tears for the first three months).

2. Any rashes on his skin.

3. Jaundice. Physiological jaundice may occur in many infants on the third day, but it will usually clear up in a week. If it persists it should be reported.

4. The area around the baby’s nipples may sometimes be swollen and excrete a yellow fluid. This is normal in many infants, but if they get infected and form an abcess then they should be reported.

5. Any foul smell or pus from the navel.

6. Bleeding from any site - mouth, navel, skin, rectum or vagina.

7. Any frequent, watery, foul-smelling stools. (Babies normally have three to four bowel-movements daily for the first three months.)

8. If the baby is not growing properly. (An average baby should double his birth-weight in about five months, and triple it in about a year.)