The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Miscellaneous Newborn Care

See also:

• Transient Tachypnea of the Newborn - TTN

Subsections on this page:

• Resources
• Vitamin A Supplementation at Birth
• In-Home Followup Newborn Care
• Chiropractic Care for Babies and Children
• Bathing Baby
• Learning Baby's Language
• Warming Baby/Skin-to-Skin Contact
• Newborn Hearing Screening
• Proposed Screening for Heart Problem - LQTS
• Blood Typing with Eldon Cards
• SIDS/Baby Safety
• Dry Baby Skin
• Eczema
• Newborn Rashes and Skin Infections
• Newborn Urinary Tract Infections/Ear Infections/Eye Infections
• Umbilical Hernia
• Grunting in Infants during First Few Weeks
• Breastmilk for Eye Infection
• Newborn Care at Six-Week Postpartum Exam
• Vaccinations
• Natural Baby Wipes
• Cradle Cap
• Baby Calming - Happiest Baby on the Block
• GERD - Gastroesophageal Reflux
• Self-Calming
• Colic
• Natural Infant Hygiene aka Elimination Communication
• Other Miscellaneous Newborn

Resources

HIDDEN CARCINOGENS IN BABY CARE PRODUCTS - The Organic Consumers Asosciation and Cancer Prevention Coalition joined together last week to inform consumers of these dangers while providing information about safe alternatives.

drgreene.com - caring for the next generation - Lots of answers to lots of questions.

Neonates in the Emergency Department - a comprehensive guide

I have used "Physical Assessment of The Newborn" by Ellen Tappero and Mary Ellen Honeyfield for years and been very satisfied.

I like that book too, but another book I have found very helpful is a little paperback, "Primary Care of the Newborn" by Henry M. Seidel, Beryl J. Rosenstein and Ambadas Pathak.   I like this book because it goes beyond examining the newborn and noting abnormalities.  It also discussed labs and treatments for certain conditions.  I have found this very helpful when discussing unusual problem with the parents.  Not that I make the diagnosis, but it gives us some basis for understanding and anticipating recommended treatments.

Evidence-based practices for the fetal to newborn transition.
Mercer JS, Erickson-Owens DA, Graves B, Haley MM.
J Midwifery Womens Health. 2007 May-Jun;52(3):262-72.

Many common care practices during labor, birth, and the immediate postpartum period impact the fetal to neonatal transition, including medication used during labor, suctioning protocols, strategies to prevent heat loss, umbilical cord clamping, and use of 100% oxygen for resuscitation. Many of the care practices used to assess and manage a newborn immediately after birth have not proven efficacious. No definitive outcomes have been obtained from studies on maternal analgesia effects on the newborn. Although immediate cord clamping is common practice, recent evidence from large randomized, controlled trials suggests that delayed cord clamping may protect the infant against anemia. Skin-to-skin care of the newborn after birth is recommended as the mainstay of newborn thermoregulation and care. Routine suctioning of infants at birth was not been found to be beneficial. Neither amnioinfusion, suctioning of meconium-stained babies after the birth of the head, nor intubation and suctioning of vigorous infants prevents meconium aspiration syndrome. The use of 100% oxygen at birth to resuscitate a newborn causes increased oxidative stress and does not appear to offer benefits over room air. This review of evidence on newborn care practices reveals that more often than not, less intervention is better. The recommendations support a gentle, physiologic birth and family-centered care of the newborn.

Introduction - The transition from fetus to newborn is a normal physiologic and developmental process -- one that has occurred since the beginning of the human race. Many hospital routines that are used to assess and manage newborns immediately after birth developed because of convenience, expediency, or habit, and have never been validated. Some practices are so ingrained that older traditional practices, such as providing skin-to-skin care or delaying cord clamping, must be considered "experimental" in current studies.[1] However, recent research is beginning to identify some older practices that should not have been abandoned and some current practices that should be stopped. In order to achieve a gentle, physiologic birth and family-centered care of the newborn, practices that might interfere with maternal and newborn bonding need to be closely scrutinized. This article examines the evidence about practices related to the newborn transition, including the effects of various drugs used labor, umbilical cord clamping, thermoregulation, suctioning, and resuscitation of the newborn.

Vitamin A Supplementation at Birth

http:

Vitamin A Reduces Newborn Deaths

It is known that vitamin A deficiency can lead to increased deaths in infants under 6 months of age. Researchers found that giving infants two doses of vitamin A (24,000 IU each dose) within 48 hours of birth significantly reduced early infant mortality. Newborn infants who received vitamin A had a 22 percent to 23 percent reduction in mortality during the first six months of life.

Researchers are uncertain why infants benefit from receiving a large dose of vitamin A shortly after birth, but suggest vitamin A may provide a stimulus to rapid maturation of both gut and lung lining. This matured lining may be more resistant to invasion by pathogens or may be able to clear such organisms more efficiently. [British Medical Journal August 2, 2003;327:254]

Well, stop and think  about this. Colostrum is *heavy* in vitamin A, 89 retinol equivalents per 100 ml.  It also has 364 mg of IgA in every 100 ml.

Breeders of animals know that if the baby animal doesn't get colostrum in the first hour, they "may as well knock it in the head" because it so much more likely to die and not do as well. Animal researchers have found that this is because the animal's lining to the intestines have larger holes for the first few hours.  This allows the nutrients and large immunoglobins to get directly into the system.  Of course, no one is going to do that kind of research on babies (please God, make that so).  But it stands to reason if the other mammals are like that, we are, too.

They said they gave the vitamin A in the first 48 hours.  I suspect it may have been even earlier.  They don't say whether or not the babes got colostrum and, if so, at what timing and for how long.

I think of colostrum (now called early breastmilk) as a sealant for the intestinal lining.  It makes sense that if the intestinal lining isn't sealed properly afer birth, it will be easier for germs to get into the bloodstream through the digestive tract.  This is especially dangerous to babies born in the germ-heavy institutional environments such as hospitals or hospital-based "birth centers".

In-Home Followup Newborn Care

See: Medical Necessity of In-Home Newborn Followup

Chiropractic Care for Babies and Children

See also: For Parents - How to Get the Best Care/How to Find Chiropractors

International Chiropractic Pediatric Association and referral directory.

Upper Cervical Trauma and the Birth Process by Peter N. Fysh.

Chiropractic for Children from the The World Chiropractic Alliance.

Chiropractic care for children from Family Forum Online

Bathing Baby

See also: Skin Flora
See also: Care of the Intact Penis

Neonatal Skin: Back to Nature? - Leaving vernix on the newborn's skin is better for baby.

"Dr. Hoath and his colleagues at the Skin Sciences Institute, Cincinnati Children's Hospital Medical Center, have been studying the composition and properties of vernix and its role in adaptation of the neonate to the extrauterine, or dry, environment. Their research suggests that rather than being a soil, vernix is a natural skin cleanser. It may also be an anti-infective, an anti-oxidant, a moisturizer, and a wound-healing agent. Perhaps instead of rubbing vernix off of the newborn infant's skin, we should be rubbing it in![2]"

"World Health Organization guidelines for newborn care specify that vernix should not be removed from the skin of newborn infants and bathing should be delayed for at least 6 hours after birth."

After the baby's skin is colonized with the parents' skin flora, and breastfeeding is well established, you'll find it much easier to bathe baby using the beautifully designed Tummy Tub.

It's not always easy to find, but in 2007, it's available from Countless Kisses in Canada.

The effect of bather and location of first bath on maintaining thermal stability in newborns.
Medves JM, O'Brien B.
J Obstet Gynecol Neonatal Nurs. 2004 Mar-Apr;33(2):175-82.

"Heat loss experienced by newborns during bathing is significant and is not associated with who bathes the newborn or where the bath takes place."

"Bathing of the newborn baby soon after birth causes a drop in temperature and is not necessary.

If cultural tradition demands bathing, this should not be carried out before 6 hours after birth and preferably the second or third day of life. The newborn should be healthy and its temperature normal.

Priscilla Dunstan's gift - from the Oprah Winfrey Show.  You can order directly from their web site.

Mom unlocks baby talk - Australian says she's unlocked the mystery to five sounds made by all babies [11/30/06]

An Australian mom claims to have discovered the holy grail of infant development ­ a universal baby language spoken by all newborns the world over.

She believes it's composed of five distinct sounds: Neh, Owh, Heh, Eairh, Eh, meaning, I'm hungry; I'm sleepy; I'm experiencing discomfort (also known as "change my diaper already"); I have lower gas pain and I need to burp.

The sounds aren't randomly produced; they arise from a reflex to a physical need, says Priscilla Dunstan, 32, adding she made her discovery after reaching wit's end with her own crying infant son in 1998.

For example, the "Neh" sound is created when a baby gets hungry and cries through the sucking reflex, which pushes the tongue against the roof of the mouth. The "Eh" (I need to burp) sound is made when there's an air bubble trapped in baby's chest.

Warming Baby/Skin-to-Skin Contact

In a Swedish study of eighty hypothermic newborns, 40 were placed in incubators and 40 were held skin-to-skin by their mothers. After four hours, 90 percent of the infants who had skin-to-skin contact had reached a normal body temperature while only 60 percent of the infants placed in incubators had done so. After 24 hours, temperatures of the incubated infants were slightly higher than those of the held infants, suggesting that incubated infants run a risk of becoming too warm and developing heat stress. Skin-to-skin contact also stabilizes heart and respiratory functions, according to the researchers. -The Lancet 1998, 352:1115

Randomised study of skin-to-skin versus incubator care for rewarming low-risk hypothermic neonates.
Christensson K, Bhat GJ, Amadi BC, Eriksson B, Hojer B.
Lancet. 1998 Oct 3;352(9134):1115.

Thermal protection of the newborn: a practical guide (from the World Health Organization - WHO)

Care in Normal Birth: A Practical Guide Report (from the World Health Organization - WHO) says:

Immediately after the birth the baby has to be dried with warm towels or cloths, while being placed on the mother's abdomen or in her arms. The baby's condition is assessed and the existence of a clear airway is ensured (if necessary) simultaneously. Maintaining the body temperature of the baby is important; newborn babies exposed to cold delivery rooms may experience marked drops in body temperature, and concurrent metabolic problems. A fall in infant temperature can be reduced by skin-to-skin contact between baby and mother.

Early skin-to skin contact between mother and baby is important for several other reasons. Psychologically it stimulates mother and baby to get acquainted with each other. After birth babies are colonized by bacteria; it is advantageous that they come into contact with their mothers' skin bacteria, and that they are not colonized by bacteria from caregivers or from a hospital. All these advantages are difficult to prove, but nevertheless they seem plausible. Early suckling/breast-feeding should be encouraged, within the first hour after birth (WHO/UNICEF 1989).

Kangaroo Care and Skin-To-Skin Contact

This section has been moved to Kangaroo Mother Care / Immediate Newborn Care

Newborn Hearing Screening

Tune in to Newborn Hearing Screening discusses the impact of undetected hearing loss in infants and children and presents recommendations for achieving the national Healthy People 2010 goal of hearing screening of 100% of newborns by age 1 month.

Early Hearing Detection & Intervention Information & Resource Center from National Center for Hearing Assessment & Management (NCHAM)

Newborn Hearing Screening Technologies

Infants Tested for Hearing Loss --- United States, 1999--2001 - CDC report - "Benchmarks for the key components of the EHDI process include hearing screening before age 1 month, diagnostic audiologic evaluation before age 3 months for infants who do not pass the screening, and enrollment of infants identified with HL in early intervention services before age 6 months."

I agree that if a hearing screening done early in life has significant potential benefits and no risks, then it's a great idea.  However, I am concerned that there are risks involved in any procedure which separates a newborn from the mother.  The baby's mother serves as the baby's immune system and food source, and separating them naturally involves infection risks and potential harm to the breastfeeding relationship.  Like the class newborn screen for metabolic disorders, it is done while the newborn is in the hospital for convenience factors, not because that is the best time to do the screen.  I'd prefer to see the initial screen done around 3 weeks, when it is more reliable and less disruptive to a newborn's health.

Proposed Screening for Heart Problem - LQTS

Test advised for newborns to detect heart problem

[7/12/06] LONDON (Reuters) - Babies should be given a simple, non-invasive test when they are about a month old to check for a life-threatening heart problem, Italian researchers said on Thursday. . . .

The electrocardiogram (ECG) test could prevent deaths from an hereditary illness known as long QT syndrome (LQTS) -- a heart problem than can cause sudden, unexplained death.  It can be treated with medication.

"In a study of 45,000 children, the test found signs of the disorder in almost one in 1,000 children."

Blood Typing with Eldon Cards

DOES ANYONE OUT THERE USE ELDON CARDS? Do you like them? How do they work? Do they type blood group AND Rh factor? Are they expensive? Do you use them on every birth or just with Rh- mom births? Can they be exposed to cold or heat and still work OK (Trunk of car through winter/summer)? What is their shelf life? Can they be trusted?

I had a client who ordered the Eldon Cards for their own personal use. She wanted to test the types of her kids. She is neg and her husband pos. She knew blood types for herself, husband, and one of the kids. The cards showed their types accurately and she was very happy with them. They did seem pretty expensive but nothing like what the lab costs.

I use them and love them. For the first few, we double tested, sending one sample to the lab and doing the other sample on the card. The results were the same, so now we just use the Eldon cards. We collect cord blood in a purple top tubes and test it when things settle down. It shows both the type and Rh, and is very easily to perform. I usually only test babies who's moms are neg or if I am concerned about an ABO incompatibility. My equipment stays in the car year round. I have had no problems with temperature affecting the cards (although they are room temperature when I do the test).

They have about a 1 year shelf life and cost about $16 for a pack of five, or $4 each. I will warn you that the expiration date is written British style i.e., 23/1/97. I was concerned when I got the cards (in January, 96) because the exp. date was 4/12/96. What I now know is Dec. 4, 1996.

I collect cord blood in a 10cc syringe and then place a drop on each test probe. Never had a wrong result yet. The needle from the syringe makes a perfect drop.

sounds OK.... But I would encourage everyone to follow the directions explicitly with no variations! There might be a simple process, than the one recommended. but I wouldn't advise fiddling with it.

I've had some European clients tell me their blood type is "A2" or "B3".  Apparently, there are subgroups of the A and B proteins.

SIDS/Baby Safety

SIDS May Be Linked to  Infection

Baby Bedding & SIDS - Do crib mattresses cause infant deaths?

Natural Baby Crib Mattress

Its origin is a mystery. How the Wisconsin babies got it is another. It's the first time the virus has been found in the United States and raises the question of the role of germs in crib death. Whether it killed the babies isn't clear, but both were sick before they died.

Crib death, sudden infant death syndrome and SIDS are terms for unexplained deaths in children less than a year old. About 2,200 occur in the United States each year.

After the virus was detected in the dead babies, it was identified at the federal Centers for Disease Control and Prevention. Doctors now hope for research into whether it's a factor in SIDS.

From Primates to Late Nights: One Researcher’s Path to Sleep Studies - Interview with James McKenna, Ph.D.,  Professor of Anthropology and Director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame.

This is an excellent article about the way in which co-sleeping helps to regulate the baby's physiological functions and reduces the SIDS risk.

Sleeping Position in SIDS Identified

Risk Factors which lead to suddent infant death - from a family medicine site in the UK

Here's the PVC industry's rebuttal to the allegations that PVC fumes cause SIDS.

I have no evidence that this is based on any real scientific research, but it might be worth checking into:

Cot Life 2000 - How to prevent cot death (crib death, SIDS)

"The danger of cot death can be eliminated by ensuring that babies sleep on mattresses and underbedding known to be free from the elements phosphorus, arsenic and antimony. The BabeSafe range of mattresses complies with this requirement."

The Cot Life Society UK

CDC's MMWR Weekly Report --- Preview / First Paragraphs

Sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality in the United States. In 1992, the American Academy of Pediatrics (AAP) recommended that all healthy babies be put to sleep either on their back or side to reduce the risk for SIDS. In 1994, a national "Back to Sleep" education campaign was initiated to encourage the public and health-care providers to put babies to sleep on their back or side. In November 1996, the AAP modified its policy to preferentially recommend putting infants on their back because of the lower risk for SIDS associated with this position relative to the side position. To assess adherence to recommendations for infant sleeping position, CDC analyzed population-based data on the usual infant sleeping position for 1996 births by race from 10 states participating in the Pregnancy Risk Assessment Monitoring System (PRAMS). This report summarizes the results of that analysis and indicates that infant sleeping position varied by state and race.

I just did a humongo lit search on SIDS for a class presentation (lost a grandson to it almost 4 years ago), and here's a very brief summary of what I would recommend from what I read. There is no simple way to prevent it, because it looks like a whole complex of processes may be responsible. Most of these are things you already know to do:

1. Don't smoke or use addictive drugs during pregnancy. The more you do, the higher the risk.
2. Correct anemia problems during pregnancy, esp. in smokers. The lower the crit, the higher the risk.
3. Use good nutrition to reduce low birth weight, which is also a risk (prematurity is not, surprisingly).
4. All babies should sleep on their sides unless they have serious medical problems. Several countries have reduced their SIDS rates 60-70% with this change alone. (Back sleeping has been linked to aspiration.)
5. Breastfeed your baby.
6. Do not give cold remedies to babies, or any other drug that makes them sleepy.
7. Be careful not to restrain (tightly wrap) or overheat babies, esp. when they sleep. The room should be comfortable for you, babies should sleep with hats off, take those snowsuits off when you come indoors or into a heated car.
8. Though New Zealand now recommends against co-sleeping, my own review suggested that things such as co-sleeping and breastfeeding that tend to keep the baby from very deep sleep for long periods is probably a good thing.
9. As much as possible, try to maintain a regular routine for your baby. There is some evidence of increased risk on weekends and holidays.
10. Have your baby in the spring. The risk in January is twice what it is in July (in the northern hemisphere, opposite in the southern), and peaks at 12 weeks of age (even in preemies).

Family Bedroom Reduces SIDS Rates

Family Bed Prevents SIDS

Family Bed Doesn't Reduce SIDS Incidence

Sharing a bed with your baby from UNICEF

Baby safety tips from the Consumer Product Safety Commission

Dry Baby Skin

I have searched everywhere for some evidence regarding management of dry skin. I can't find any. I know that many women use oils - almond etc. But, is this evidence based? What impact do the oils have on the defense mechanisms a neonate's skin has against infection?

Skincare for the newborn: exploring the potential harm of manufactured products. [full-text article]
Trotter S.
RCM Midwives. 2002 Nov;5(11):376-8.

Many midwives routinely bath newborns using baby bath products believing these products are mild and suitable for delicate skins. This paper asks midwives to reconsider their role in the promotion of manufactured skincare products.

What can be done to keep babies' skin healthy?
Atherton D, Mills K.
RCM Midwives. 2004 Jul;7(7):288-90.

Jojoba oil is the best to use on a new baby's skin as it has the closest ph level to the skin's natural ph level.  I would never use anything petroleum based!!!  While it does lubricate the skin it does not nourish the skin. The most important thing is to use cold pressed oil - not just vegetable oil like from the supermarket because this is chemically processed whereas cold pressed oils are pure.

In view of DOH advice about avoiding nut products until your early twenties, I now avoid advising nut based oil.  I suggest a patch test of any product to be used on babies' skin - as I would do for any product I use on my own

I've only recently started studying holistic therapy but as far as I'm aware sunflower oil is a safe base oil for children as well as almond, peach kernel oil and light olive oil (extra virgin should be eaten by us mummies).  Sunflower oil provides a light protective barrier and doesn't smell.  The best time to apply oils is after a bath and massaging a baby will help with sleep, colic, help bonding and is great for postpartum depression.

In our trust, we recommend avoiding the nut oils because of the potential for causing allergies, especially peanut oil, but even almond oil.

For preterm infants with compromised skin barriers, sunflower see oil provides effective protection against nosocomial infection.  However, this is irrelevant to the term baby who is at home.

Note that this study mentions AquaPhor is a petroleum-based ointment, and I wouldn't use it on my baby's skin!

Effect of topical treatment with skin barrier-enhancing emollients on nosocomial infections in preterm infants in Bangladesh: a randomised controlled trial.
Darmstadt GL, Saha SK, Ahmed AS, Chowdhury MA, Law PA, Ahmed S, Alam MA, Black RE, Santosham M.
Lancet. 2005 Mar 19;365(9464):1039-45.

Eczema

Eczema is commonly caused by food allergies, either what the child is eating or drinking, or the mother if baby is breastfed.  It's usually the thing that we love the most, eat frequently and have cravings for (wouldn't ya know it!).  Start with eliminating one thing, give it a week or two to see if there are any changes or improvement in the skin, and then eliminate another (this is known as an elimination diet).  Doing it one item at a time will help you clearly determine what the offending factor is so that it can be eliminated.  The eczema should then clear up on its own.

I found that this 100% natural creme called " cleared up my kids eczema wonderfully.  They used to call it children's healing cream and it is from Canada although I found a similar product out of Texas which was identical ingredients but was more expensive. Bottom line is this is an overly fragrant but wonderful natural product which actually did cure up some severe eczema in me and my 2 sons.

Eczema is part of the annoying triad: eczema-allergies-asthma, so it is a possibility that your 3 months old is allergic to something. The question is . What? Using lotion will not solve the problem but it will increase the time between outbreaks.

When you pick a lotion, find something heavier rather than lighter. The more "liquid' it is, the less moisturizing it is. I know it sounds counter intuitive... But there it is. Sometimes I do a 1-2 with the lotions. I use something more liquid at first when I am very irritated, then I put a second coat with a more moisturizing lotion which is usually harder to rub in.

If you use a lotion, it will get into the skin easier when the skin is still humid from the bath, than if it is dry.

If I were in your shoes, here is what I would do.

I would go and see an homeopath and tackle the underlying problem.

I'd get rid of every product you use that is scented or colored.  I'd get a soapless soap (like eucerin's soap) and see if that makes a difference.

If you can, use natural fibers on the area which are affected. I have noticed on my own skin that the synthetic fibers almost rub my skin the wrong way and will create patches of eczema.

I would do double rinse on all laundry that will touch the baby skin. BTW, laundry detergents can be big culprits. I had a boyfriend who switched from Tide to 7th generation which is supposed to be better. Well, he was covered with eczema until he figured it out and switched back..;)

I would use a lotion after every bath on the entire body of the baby.

I have tried the following lotions:
- vaseline: good moisturizer but well, very greasy. It is a hit and miss for me.
- eucerin: the lotion is not very moisturizing, the cream is. Warning: contains nut oils, which are allergens. - Egyptian miracle cream (I think that it is what it is called), you can get it at whole foods. It is olive oil based. I had good results with that, so did a friend of mine. Both of our children have/had eczema. - shea butter. Very moisturizing, but hard to rub on irritated skin. - bag balm. Works wonders on the butt area. Lanolin based. If the baby is not allergic to wool, that could be a winner. It is very moisturizing, and will stay on the skin. It is extremely greasy. For area which are covered, t is fantastic. Does not work that well on hands.

As I said earlier, keeping the baby's skin hydrated will reduce the chance of outbreaks.  I am trying to make it part of the night routine. Bath. Then massage. My daughter loves it. Now if only I could think of it for myself..;)

Newborn Rashes and Skin Infections

See also: Laundry Issues since delicate newborn skin may react to dry cleaning fluid or even ordinary household laundry products.

Neonatal Dermatology

Differential Diagnosis Tool

Common rashes:

ERYTHEMA TOXICUM NEONATORUM

They have a complete section on Neonatal Dermatology.

Erythema toxicum must be distinguished from more serious vesiculopustular eruptions of the newborn including staphylococcal pustulosis, (another staph photo), herpes simplex, varicella, (another varicella photo), candidiasis, and listeriosis.

Transient neonatal pustular melanosis looks a lot like herpes.

Diaper Dermatitis

The Normal Flora of Humans is a helpful adjunctive site.

If a baby has inflammation centered around the anus, consider that this is probably a "gut reaction" to something the baby is "eating", which really means to something the breastfeeding mother is eating.  This is often citrus or vitamin C supplements.  Some babies will react to any fruit juices or just non-organic fruit juices.  So, it may be best for the breastfeeding mother to back off all fruit juices for a few days to see if the baby's rash gets better; if it does, try gradually adding organic apple juice and gradually expand to other juices until the rash returns - thus you've identified the culprit.

Medline plus has good images of Erythema toxicum neonatorum.

Differential Diagnosis of Rash Illness.

Diaper Rash Care and Management [Medscape registration is free]

Childhood Skin Rashes from © American Institute for Preventive Medicine

A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis.
Atherton DJ.
Curr Med Res Opin. 2004 May;20(5):645-9.

 Irritant diaper dermatitis (IDD) is a form of contact dermatitis occurring in the diaper area as a consequence of disruption of the barrier function of the skin through prolonged contact with faeces and urine. Despite advances in diaper technology, it is a condition that still occurs regularly in young children. To combat this, barrier preparations can be used to protect the skin by coating the surface of the skin and/or by supplying lipids that can penetrate the intercellular spaces of the stratum corneum. In this review, the pathophysiology of IDD is outlined and its prevention and treatment are discussed, with particular reference to the role of emollients.

Great article on Skin Lesions in Newborns

Find the latest Neonatal Dermatology sites from Alta Vista

Natren produces a probiotic product designed specifically for infants. Life Start is made with Bifidobacterium infantis - the beneficial bacteria which is most necessary during infancy.  This can be beneficial for newborn thrush, newborn diarhea or diaper rash.

Newborn Urinary Tract Infections/Ear Infections/Eye Infections

Newborn Fever May Be Urinary Tract Infection

Antibiotics not best for ear infections - journal

Ear Aches/Ear Infections

The pain in the ear infec. with the acidophilus will stop right when you put it in. I guess I didn't make myself very clear on that. It will do the same for the sore throat. I do like your recipe though, it is similar to my garlic oil recipe sounds like.

Quick Recipe for Garlic Oil for Ear Infections

Umbilical Hernia

The baby is about 6 weeks old and has an umbilical hernia that has become increasingly noticeable in the last couple of weeks. It's now a good 1.5 cm in diameter and sticks out quite impressively when the baby is crying.

Last I heard...leave them alone for 5 years....if not resolved, then surgery.

I had an umbilical hernia. My elder son has one too. Mine went by the time I was two, he is 6.5 and it shows no signs of going away. When he's big (i.e., 16) he can decide what he wants to do about it.

One of my daughters had a baby with a giant umbilical hernia -- it actually looked like a penis coming out of her stomach. Rather awful to look at... and her pediatrician told her to just leave it alone. Now at 7 months, my granddaughter's belly button looks quite normal.

Hi, my son who is now 17 had one about that size. It got worse before it got better. We did nothing. The peds said we could put a belt on it if it made us feel better, but that it probably wouldn't make a difference, so I didn't bother. I think that they wait until age 5 or 6 to do surgery, unless there are symptoms of incarceration (extremely rare!). Now an inguinal hernia is a different cup of tea entirely

Grunting in Infants during First Few Weeks

New parents have a 5-week newborn who grunts loudly while sleeping and when she needs a bm, nothing else going on, just keeping these new parents awake at night.  Any ideas?

I had a full term baby who grunted like that.  The pediatrician said that the cartilage in the trachea was not fully developed, and every time baby inhaled and nursed, the trachea would partially collapse.  He grew out of it, several months later.  Maybe this is a later stage of the same problem. It was an uncommon but normal variant of baby physiology

One of our newborns made was grunting; it sounded like he was trying to sing or something.  The pediatrician said it sounds like a 'soft' airway - the cartilage in the trachea can remain quite soft for a while, and sometimes that causes that sound - there's nothing to be done but wait for him to grow. He says if it gets worse, or starts distressing him, we'll take another look, but he should be fine.

I wonder if there is a form of Tracheal Laryngeal Malacia which would be heard only during sleep or with BMs.  Last year one of mine was diagnosed with it, but he was breathing noisily (stridor) all the time. He has outgrown it now (the usual outcome).  It is simply unusually soft cartilage supporting the windpipe that tends to partially collapse, though ordinarily baby is still able to maintain adequate oxygenation.  It is not seen immediately at the birth, but starts several days or weeks later.

I also had a baby with tracheal malacia who had a apneic episode at about 4 weeks old that required hospitalization but after that was observed at home with an apneic monitor.  Similar sx -- episodic grunting with one episode that was a doozy!

Breastmilk for Eye Infection

I recently had a mum whom I referred to a pediatrician for a check-up for two vessel cord. (otherwise healthy) While there, he noted that the baby had "conjuctivitis" and prescribed antibiotic drops. Well, this is a welfare mum, who didn't have a drug card for baby yet, so she asked me if I could give her more erythromycin ointment. I looked at the eye, I thought, sticky eye, no real conjuctivitis, (eye was not red, or inflamed, no fever of baby etc.) I suggested tear duct massage and breastmilk in the eye.

We have always been told in LLL that drops of breastmilk help clear up the sticky eye thing that happens with babies. Sorry - not getting real Technical. Basically it is the secretory IgA antibodies that are in breastmilk that help clear the gunk from the babies eye. Maybe reminding him these antibodies are there, in abundance in the early weeks especially, will remind him of how helpful it can be

Paraphrased from the Womanly Art of breastfeeding Pg.348-356:

Breastmilk IS living tissue - with live antibodies, live white blood cells and active macrophages, all of which have significant roles in fighting foreign protein (bacteria and viruses). This is why fresh BM makes such great nose drops and eye drops incidentally.

Breastmilk as an Antibiotic

"The sensitivity of Staphylococcus aureus to term colostrum was 50 per cent and to mature milk 0. Coliform organisms had a sensitivity of 57 per cent to colostrum and 28 per cent to mature milk."

Breastmilk Usage

Newborn Care at Six-Week Postpartum Exam

In Ontario the midwife is the primary caregiver for mom and baby until 6 wks.

Baby, wt, measurements, listen to heart, exam abd for masses, check hips (important as birth exam can be false dt maternal hormones) Also assess for developmental changes, i.e. smiling, head control etc.

Vaccinations

The subsection on Vaccinations has been moved to its own page.

Natural Baby Wipes

I cut up a couple of old receiving blankets into little squares with pinking shears (or hem) and put them into one of those little square Tupperware sandwich containers with a little water and mild soap. Instant, portable baby wipes, than I would just throw the little squares in with my cloth diapers to wash.

One of my babes had famously delicate skin -- sensitive to everything: and I didn't dare use packaged diaper wipes on him. In an old health care book I discovered how to make oil soap. I put it in a carrying bottle with a strong flip top, and simply used it like diaper wipes, pouring a little on a rag or tissue when needed. Cleans well, no rinsing, always available, and leaves the skin soft.

The recipe is simple, I don't think the portions are crucial, (at least I played around with them quite a bit). Mix about a cup of oil (almond, or other good stable oil) into a container, with several tablespoons of anhydrous lanolin, (an egg whip works well to mix), then pour into a good pop top or squeeze bottle.

You can also use vegetable shortening, or even zinc oxide cream as the thickener...Use more or less till you get the right consistency -- like a thick lotion. This may sound odd, but all soap is simply oil or fat with an alkalizing agent added... this is just primitive, back to basics, soap.

PS You can add calendula (either oil or tincture) to the mix... or other "healing'" herbs.

Cradle Cap

One of my clients was inspired to try using breastmilk for cradle cap, and she said it worked beautifully and was a lot less messy than the oils.

We used warmed olive oil on DD both for dry skin and cradle cap (left on overnight for cradle cap).  Her cradle cap had been really bad but cleared within 2 days and made her skin lovely.

Use burt's bees apricot baby oil, and scrub it into the scalp with a scrub brush, then use some shampoo and scrub, then rub the oil on again and leave it.  I have NEVER seen cradle cap go away so fast as when I used this method!  I spent days picking off flakes (okay, I would even use tweezers, that's how obsessive I was, LOL) and after doing the oil scrub twice, no more cradle cap.

Make sure you are using a soap that isn't animal based (like ivory and such) because it doesn't wash off well. Dr Bronners baby soap is great stuff to wash with and a bargain for how much you use.

There are various types of Cradle Cap Oil available online.

Weleda baby soap with calendula got rid of mine

Baby Calming - Happiest Baby on the Block

What do people think about the Karp book/video - "Happiest Baby on the Block"?

If this is the one about "shh-ing" the baby by swaddling and rapid movements, Roberta Scaer (A Good Birth, A Safe Birth) has seen the video and thinks the babies aren't calming. They are shutting down in response to trauma the way they do after, say, circumcision. There is also a group for "shaken baby syndrome" that has extreme concern about his technique. Karp openly acknowledges their opposition and says that his technique poses no threat if the parents are gentle in their movements.

I find the "shushing" too loud and too harsh, especially for just-born babies who may still have a little bit of headache from the birth!

I'll admit I have mixed feelings about Karp's recommendations, mostly because I sometimes see them implemented in an overly enthusiastic, almost aggressive manner.  And because some parents try these techniques on a just-born baby, whose discomfort may be a "birth hangover" and who will be caused further pain by very active movement.

AND . . . the API just came out with a positive review.

AND . . . I just had a seven-month visit with parents who have been doing this from the start, and their baby sure seems like the happiest baby on the block, not like one who's been continually shut down.

I don't know much about Roberta Scaer's qualifications, other than her excellent book.  Is she a specialist in perinatal psychology?  Does anyone know what APPPAH thinks about all this?  I just searched their web pages and didn't find anything about Karp; I'll check with a specialist friend and see what she knows about this.

This book is frequently discussed in my mom/baby groups.  As with ALL parenting options, a little common sense goes a long way.  My biggest gripe with the techniques is the frequent use of a pacifier - often before parents are SURE b/f is going well 1st.  Other than that, I have never seen a "jiggle" hard enough to put me in fear of "shaken baby syndrome" for the baby of anyone using this technique.  I also like that the parents are a part of the solution, as opposed to the "cry it out" methods of Ezzo, etc etc etc, in which parents remove themselves from the picture and hope to goodness they all live through the "cure."

GERD - Gastroesophageal Reflux

See also: Gut Flora and Colic

Treating Reflux (GERD) in Infants from Randall Neustaedter OMD

GER: WHAT IT IS; WHAT TO DO; FAQ's from Dr. Sears

Reflux (GERS) - There is a lot of misinformation about Gastroesophageal Reflux out there. Here are some of the better articles.

The Amby Baby! Motion Bed may help.

The PEP Reflux Reducer (from Physician Engineered Products) holds baby in the recommended 30 degree    head-up/face down position after meals.  As I like to say . . . no shortage of creativity!

GERD from the Archive of Newsletter Articles by Randall Neustaedter OMD

One of my very astute moms noticed that when she was around 4-6 months postpartum, dairy would cause her babies to spit up more.

I had a baby with a good deal of reflux, sometimes projectile.  It didn't bother her at all, except that she would then be hungry again real soon after losing her milk w/in minutes of drinking it!  I became VERY CAREFUL about burping her after feedings:

first, burp the baby more often than usual--even before s/he is finished on one side.

second, burp the baby VERY GENTLY: for my daughter, all I would do is sit her up, with one hand on back and one in front, trying to keep her back straight without putting too much pressure on her gut (weight more on chest and chin).  I never patted her back to make the bubble rise, would just wait patiently for a minute or two, keeping her still and me relaxed.  She always burped gently but thoroughly in this position.

Once we got the hang of this, she pretty much stopped vomiting...and by the time she was a few months old, she stopped being so sensitive to bubbles in her tummy. It did make night nursing a bit more hassle; couldn't just nurse and roll over back to sleep.  Had to wake up enough to sit up to nurse, and then do the burping right, tho this was preferable to sleeping in the milk all over me and the sheets (as if my perpetual leaking wasn't wet enough).  And like I said, it worked itself out soon, and this girl is now 26 with never a digestive problem since. I think of this issue as part of some baby's development--not exactly a real valve issue, just stomach mechanics that are still learning how to do what they do.

We had a mom who went to a kinesiologist/chiropractor for something similar and the mom was diagnosed with food allergies. The baby  wasn't allergic, but the mom mal-processed the (in this case) wheat  which made her breastmilk irritating to her baby. Once she eliminated the allergen from her diet, her baby calmed down, ate well, and eliminated all other signs of reflux like the arching back and  dislike of sitting up.

I have DGST by Chirozyme (available from Chiropractors) or Therazyme from health food stores.  Same product.  Vegi based enzymes one capsule 2-3 times a day mixed with water.  Use an eye dropper or medicine baby spoon. Usually will not need after 6 weeks.  I have great results with this product.

One of my clients had a Russian mother-in-law who showed us this trick to resolve baby vomiting: she did this little trick that amounted to a gentle downward dip several times after each feeding - it stopped the vomiting flat.  Might be worth a try.

We were always taught as long as the baby is gaining weight and does not seem uncomfortable then leave it alone, just keep baby upright after meals for an hour or so and make sure to burp well. It is simply an immature sphincter and should improve as the baby gets older.

Self-Calming

One of my clients reported that her children held their upper ear when stressed or sleeping.  This may be a self-calming acupressure technique that you can teach your baby.

Colic

See also: Gut Flora and Colic

Note that the techniques of Elimination Communication may facilitate easier bowel movement.  In particular, if it is painful for a baby to poop, you can help them by holding their belly to gently increase internal abdominal pressure.

Research Says Massage May Help Infants Sleep More, Cry Less And Be Less Stressed

Excluding Allergenic Foods From Maternal Diet May Reduce Colic in Neonates  CME

For babies who need to be held tightly, they might benefit from the Cozy Cocoon - The Cozy Cocoon builds on the wisdom of ancient and indigenous cultures that understood the importance of swaddling newborns, and it infuses this wisdom with the knowledge of our own times to create the perfect answer for holding newborns close, with love and in freedom.

Fussy Baby - Help for infants who cry, scream or don't sleep

Natren produces a probiotic product designed specifically for infants. Life Start is made with Bifidobacterium infantis - the beneficial bacteria which is most prominent in infants.  This can be beneficial for newborn thrush, newborn diarhea or diaper rash.

BioFlora makes a product called Infantiflora, containing B. infantis, which can help with colic by improving newborn digestion.

Our culture tends to be very undereducated about the importance of sensible postpartum recovery.  Women bounce back much more quickly and easily when they are pampered for the first few weeks.  And new babies are less likely to have colic.

Here's a good book to read BEFORE baby comes, because you'll be too busy afterwards:

The Keys to Postnatal Rejuvenation

How to Avoid Colic, Avoid Postpartum Depression, Experience Deep & Profound Rejuvenation
"Many cultural traditions use the same principles after childbirth, the ones which statistically don't have problems. The language is the same - mothering the mothers with TLC, warmth, oiliness (internal and external), massage, simplicity, moisture, favoring sweet, sour and salty tastes, specific foods, freshly cooked (not raw) soupy foods, herbs, and of course rest - these are keywords to favor. The details even of these considerations are significantly more under guidance (and communication with/advice of your primary care provider is essential with pre-existing medical conditions)."

Here's some specific information about Happy Baby Tummies!

Garlic eases colic and helps to bring the milk in, too!

Miranda Castro has some good articles about colic.

You could try Colic-Ease

crying-babies.com - information about colic and baby-safe remedies

Probiotics Well Tolerated, Safe in Infant Formula (News CME) - Feb 2004 - In a randomized, double-blind, placebo-controlled trial, infants given probiotic-supplemented formula had a lower rate of colic and use of antibiotics. [Medscape registration is free]

The new Tummy Tub may be just the thing to help soothe your baby's colic.

TUMMY CALM is an EXTERNALLY applied, herbal oil that alleviates newborn colic/gas pains.

Rooibos tea is purported to relieve colic in infants.  [Search on the net for lots of sources.]

Several homeopathic remedies can be used effectively for colic. If your baby bends backwards or arches his or her back during a colic attack, give homeopathic Dioscorea as the label directs.

Infantile Colic - Chiropractic has been found to be effective for infantile colic!  Randomized controlled trial shows that manipulation is more effective than drugs

Chiropractic Found Effective for Infantile Colic

Colic

Crying & Colic - How To Help Your Baby To Stop Crying - from the Web page for the book, Pregnancy & Childbirth Tips

Some parents swear by the modern version of Gripe Water, containing ginger and fennel to ease nausea and pain due to gas and stomach upsets.  It is also available from Cascade.

I've heard of a new tea that is supposed to be a terrific anti-spasmodic to treat colic.  It's called rooibus - it's a South African tea, and apparently it works wonders.  It seems to be available mostly on the Internet.  [NOTE - This is only hearsay, and it wasn't even clear whether the tea was for the breastfeeding mother or the baby to take!  Please check with your healthcare provider first.]

Colic

Colic Relief and Chinese Pediatric Massage

Natural Infant Hygiene aka Elimination Communication

Elimination communication revives how humans evolved caring for their newborns without diapers. - By TINA KELLEY, 10/9/05, NYTimes

Most important, they say, is an increased emotional bond with the baby, forged by the need for the parent to pick up on subtle signs and act on them quickly. Proponents of the practice use the phrase "elimination communication."

"It is enhancing that interaction and closeness, the intimacy between baby and mother," said Thomas Ball, a psychologist in California who is helping develop a documentary about the technique.

The American Academy of Pediatrics, in its current "Toilet Training" pamphlet, says children have no control over bladder or bowel movements when they are younger than a year and little control for six months afterwards.  [Ed.: I've had a number of parents tell me that their babies would cry until they were taken to the diaper changing table, which was the closest they could come to "the correct place" to eliminate.  This shows a significant control over bladder and bowel function.  This statement about lack of control may be true of babies who were drugged at birth and so still under narcotic influence for the first few weeks of their lives as their immature livers process out the toxins.]

Dr. Mark Wolraich, author of the academy''s Guide to Toilet Training: "The risk is, if it's not working and the parents are frustrated, they're creating more negative interactions with their child." [Ed.: This is true of ALL parent-child interactions, including breastfeeding, bottle feeding, diapering and even playing.]

DiaperFreeBaby is a network of free support groups promoting a natural approach of responding to babies' elimination needs.

My Journey to Elimination Communication - Hannah tells the story of her "late start" with ds and EC'ing her second since birth.

Mothering, Mindfulness and a Baby’s Bottom by Sarah J Buckley, MD. May 2001

or a similar article, Mothering, Mindfulness and a Baby's Bottom, by Sarah J. Buckley, MD, from the section on Mothering - Care of the Newborn at Women of Spirit

Joining Elimination Communication: Babies Without Diapers at SmartGroups.com

The following group may be defunct?
Elimination Communication E-Mail List - http:

Infant Potty Training Web Ring! - Infant potty training is about a method of toilet training that involves close communication with your baby. The best time to start is in early infancy. The three big winners are baby, parent(s) and the environment.

DIAPER FREE! The Gentle Wisdom of Natural Infant Hygiene by Ingrid Bauer - website and book.

Elimination Communication Station

Trickle Treatby Laurie Boucke - this is a surprisingly comprehensive book on the subject, providing lots of information and some really helpful personal narratives.

More On Potty Training Babies by Laurie Boucke - "As hard as  it is for Westerners to believe, the process of infant potty training is a very simple and cozy one, used in many countries around the world."

Going Diaperless! - An Introduction to an Effective and Enjoyable Toilet-learning Method From Infancy

I am completely overcome with awe and admiration and hope at what I've read about Elimination Communication.  I was first introduced to the concept while reading The Magical Child by Joseph Chilton Pearce, but I assumed this was something that could happen only in another place or another time.  Now I've had the good fortune of being introduced to the reality of EC here and now.

I am just blown away.  I am agog.  I feel like a blithering idiot.

When I first read about EC in The Magical Child, I interpreted the communication as a sort of psychic phenomenon, as I do believe that mothers and babies share a richer communication channel than most human beings.  Then, after hearing about EC earlier in the evening, I spent some time poking around the web and came across the Go Organic, Baby! site and the Elimination Communication Station:

Whoa!  Reality Check!  Is a mother's ability to know when her baby is hungry a psychic phenomenon?  I feel like such an idiot for having been so blind all these years.  I am so overwhelmed with the beauty and sensitivity of the above web page in particular (I haven't had a chance to read the rest, yet).  I feel so blessed to have had my eyes opened today.

P.S.  I'm copying this to Mothering Magazine - I would love to see them do a short piece on the subject.  Maybe other folks on this list would want to drop them a line, too?

Many of us have gone through the same experience of having felt blind for not seeing baby's signals all these years. I only discovered this method in time to use with my third child.

About  Mothering Magazine - For 10-15 years, Mothering has rejected this method, each time with a different excuse. Let's hope they have a change of heart. As far as I know, the hostess of this site (who also set up the other one you visited) may be the only one yet to have managed to get this topic mentioned in Mothering -- via a Letter to the editor.

I believe this whole diaperless thing is just one small step to making a Whole person.

I can't say how much I agree with this - the experience of a totally naked baby is VERY different for the baby and the parents.  A diaper basically anesthetizes the child's genitals and butt - they're not touched, they feel uncomfortable in a wet diaper, they're cut off.  And parents treat the diapered baby as if the genitals are not sensitive areas (holding baby straddled over arm etc.) without the baby getting any normal casual touch on butt or belly either.

Another issue is little boys with intact foreskins.  My son could retract his foreskin by 25 mos or so - really early for an american boy.  He won't have problems with adhesions or retraction - and this is because he could GET TO his penis when ever he wanted (which of course is often LOL).  I have read so many stories of mothers with intact boys whose foreskins are partially adhered and causing urine to spray embarrassingly, or erections to be uncomfortable....and since western dr's know zip about the intact penis, of course they recommend CUTTING THE FORESKIN OFF.

Other Miscellaneous Newborn

Introducing Baby to Pets

Friends for life....new babies and pets DO mix !

 Introducing Your Pet and New Baby from the Humane Society

Newborn Fingernails

Some of my clients introduced me to the use of a fingernail smoothing block, available at beauty supply stores.  They said sometimes they used it along the ridge of the nails and sometimes they used it across the nail, depending on which seemed to work better in the moment.

Baby Breasts

I have seen it. Breasts got pretty dang big, peaked out at about three weeks or so and were pretty much gone by 6 weeks.

Neonatology Teaching Files, Outlines, and Guidelines from neonatology.org