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on the upcoming birth of your baby!

Now the baby is almost here and you and your partner may be feeling a bit

overwhelmed and asking…

“Now what do we do?”

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There may be an intense sense of…

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Whatever your immediatefeelings are at that moment…

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It is alright!

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Trust yourself!

You will instinctively learn about your baby as your baby will learn

about you. Stop to enjoy this…

Journey through Parenthood!

Realistic Expectations

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• Intense love

• Totally overwhelmed

• A sense of responsibility

• Anxiety

• A sense of protection

• Jealousy

• A sense of exclusion

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Find special time for just you and your baby.

New Dads or Partners May Feel…

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Have Realistic Expectations forYourself and Your Baby.

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This is a time of transition!

Remember…

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Preparing for Your New Baby

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The transitionof becoming a family affects

you and your partner on many different levels.

Becoming a New Family

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You may feel exhausted and think you cannot make it through another day.

Physically

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You may find yourself with a new group of friends. They can be a wonderful support system for you and your partner.SAMPLE

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Emotionally

You may be overwhelmed by the love and connection you feel for your new little one. In the beginning, your baby will

demand most of your time and attention, as well as your partner’s. That is all part of being new parents.SAMPLE

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Your new little one will have an impact on you financially.It is surprising how much you can save just by putting away a

small amount each month!

Financially

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It is hard just to be a new parent. When you are a single

parent, it is an additional strain. Being the full time

caregiver can be exhausting and lonely. Please remember,

your baby can read your emotions. If you are

confident and happy, then your infant will be more

relaxed in his environment.

Single Parents

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Finding a Healthcare

Provider for Your Baby

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Look for a Healthcare Provider early on for your baby.

• This information will be needed by the nursing staff when you go to the hospital.

• Your hospital may offer a physician referral specialist to help you.

• Set an appointment for a face to face meeting before you choose.

• Feel good with the choice you make for your baby’s care!

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Some questions to ask when interviewing a healthcare provider…

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• What is the cost of well-baby visit and is my insurance accepted?

• Are there evening hours available?

• Are there call hours for new moms who have questions?

• Is there a lactation consultant on staff?

• Will I be supported by the healthcare team if I choose to breastfeed?

• Do you have a separate room for sick children?

• May I bring my baby in for weight checks?SAMPLE

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• The average newborn weighs approximately 7½ pounds at birth.

• Infants typically lose 5 to 8% of their birth weight in the first few days of life before they start to gain.

• Most regain their birth weight by day 10.

• Double it by the 6th month.

• Triple it by 1 year.

Weight Loss and Gain

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Regular office visits are Important!

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Your Baby’s Care at Birth

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• Wipe baby off with clean towel to keep him from getting cold.

• Stimulate baby to cry.

• Place the baby on your chest for skin-to-skin contact.

Once your baby is delivered, your healthcare provider will…

Your Baby’s Immediate Care

The Miracle of Birth

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Apgar Score

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The Apgar Score is an assessment tool used forevaluating a newborn’s life outside the womb.

AREA SCORED SCORE OF 0 SCORE OF 1 SCORE OF 2

Skin Color Blue in color Body pink, feet and hands blue Baby is pink

Heart Rate Absent Under 100 beats/minutes More than 100/minutes

Breathing Absent Slow or irregular Good or crying

Muscle Tone Limp Some tone Actively moving

Reflex Response None Grimace Sneezing or coughing

The Apgar Score WILL NOT determine howhealthy a baby will be as he grows up.SAMPLE

Reflexes Present at Birth

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Moro Reflex

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Often called the “startle reflex”, this can be one of the scariest for new parents. This is a natural, healthy

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Rooting Reflex

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This response is a feeding cue. This response helps the baby search for the

breast so that he can eat.SAMPLE

Sucking Reflex

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When the roof of the baby’s mouth is touched, the baby will begin to suck.SAMPLE

Grasp Reflex

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This reflex is a guard against falling and thought to enable the baby to hang on to his mother.SAMPLE

Step Reflex

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This reflex is present at birth, disappears and then comes back when your child is ready for

those first real steps.SAMPLE

Tonic Neck Reflex

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Often called the “fencing position”, this reflex occurs when you lie your baby on his back.SAMPLE

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You will be amazed at the resilience of your new baby. All the reflexes that you notice:

…are part of your baby’s built-in survival responses at birth.SAMPLE

Physical Assessment

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A quick physical assessmentof your baby will be done atthe time of birth, such as birth weight, head circumference and length. These are known as “vital statistics”.

A more thorough exam willbe done by the healthcare provider you have chosen for your infant at a later date.

Head Circumference

Birth Weight

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Naturally made in thegut and needed forclotting of the blood,this injection is given in your baby’s thigh. Newborns lack the necessary bacteria that produce Vitamin K.

Vitamin K Injection

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Eye Prophylaxis

A medicated ointment or drops will be applied to your baby’s eyes within 2 hours after birth to protect him from contracting bacterial infections during birth, such as Chlamydia or Gonorrhea.SAMPLE

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Identification

After the birth, you and your baby will be given identification bracelets to wear.SAMPLE

Becoming Acquainted with Your Baby

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Years ago, babies wouldspend the majority of their hospital stay in the newborn nursery. Today, parents,as well as the healthcareteam, know how important itis for babies to stay with their families as much as possible.

Family Centered Maternity Care

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Rooming-in

A part of family centered maternity care consists of “rooming-in” or “rooming-together”. This is when the new

mother and her partner keep the baby in the room with them at all times.SAMPLE

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SecuritySome safety tips for rooming together:

• Call for help anytime.

• Remember to NEVER leave your baby unattended or alone for any reason.

• Pull the emergency cord or push the button if you feel a nurse is needed immediately.

• Wheel the crib to the restroom door to see and hear your newborn.

• Keep the baby close to your hospital bed-the furthest point away from the doorway.

• Do not give your baby to anyone you do not know or who has not properly identified themselves.

Your hospital will have special security procedures in place that are there to protect your baby. Please make sure

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Newborn Screening

Newborn screeningis a simple bloodtest used to identify many life-threatening genetic illnesses.

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Metabolic screening is an essential preventive health measure. It tests for developmental, genetic and metabolic disorders in the newborn. Certain conditions may not be apparent immediately after birth.

If identified early, many of these rare conditions can be treated before they cause serious health problems in your child. Each state requires screening, but the specific test performed may vary. Some disorders are more common in some states, making these screenings even more important.

Metabolic Screening

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Hearing Screening

It is recommended that all newborns be screened for hearing loss. Hearing loss is the most common congenital disorder in newborns, 20 times more prevalent than Phenylketonuria (PKU).

Talk with your healthcare provider and the facility where you are going to deliver about this important screening.

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Pulse Oximetry Screening for Congenital Heart Disease

• Pulse oximetry is a simple, non-invasive procedure. • Measures how much oxygen is in your baby’s blood.• Effective in screening for some congenital heart diseases in

newborns. • A device is placed on the baby’s hand and foot with a sticky strip

and a small red light, or probe.• The probe is attached to a wire that connects to a special monitor

measuring the baby’s oxygen level in the blood and pulse rate. • The test takes a few minutes to perform while the baby is still,

quiet and warm.

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Birth Certificate• It is required that every birth is

registered in the county and state in which baby is born.

• You can indicate if you would like a Social Security Card for your baby at this time.

• Your hospital or birth center will register the birth certificate and the original is kept in state or county offices.

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Caring for Your Premature Baby

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Premature Babies

Premature babies are born before their bodies and organ systems have completely matured. They may need help with breathing, feeding, staying warm and fighting infections.

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NICUNeonatal Intensive Care Unit

To help make the birth of a premature baby easier, your healthcare team will work with the parents and other family members to help them understand what is happening and

how they can be involved in the care of the infant.

Rooming-in will not be an option, as the baby will be

under 24-hour supervision in the NICU.

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Factors with mom:• Toxemia of pregnancy• Chronic medical illnesses• Infections• Illegal drug use• Problems with the growing uterus• Inability of the cervix to stay closed

during pregnancy

Factors involving the pregnancy:• Abnormal or decreased function

of the placenta• Placenta previa• Placental abruption• Premature rupture of membranes• Polyhydramnios

Factors involving the baby:• Multiple gestation (twins, triplets

or more)• Inappropriate growth• Fetal testing results

Factors Contributing to Premature Birth

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Kangaroo Care

Kangaroo Care is skin-to-skin contact. It is beneficial and therapeutic for both you and your baby. Even dads and

partners can take part in this special bonding.

Photo by K. Schrock and courtesy of Hamot Medical Center

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• Thin, shiny, pink or red skin

• Veins visible through skin

• Very little body fat

• Little scalp hair

• May have lots of lanugo (soft body hair)

• Weak cry

• Weak body tone

• Genitals may be small and underdeveloped

Characteristics of a Premature BabyMost Common Characteristics

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Some Premature Babies May be Very Sleepy. Here are some tips to keep your baby awake for feeding:

• Undress to diaper

• Skin-to-skin contact

• Tickle feet

• Rub back

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Support for Parents of Premature Babies

Do not be afraid to ask your healthcare team about being a part of your baby’s care; such as feeding, bathing and diapering.

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Newborn Appearance and Characteristics

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What will my baby look like?

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You and your partner have spent all these months wondering, dreaming and talking about what your

baby will look like.

What is amazing is how your newborn’s appearance maychange even in the first hour after birth.

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Vernix

Thick, white, cheesy coating that protects the baby’s skin.

Newborns may be gray or purple until they take their first breath and start to cry.

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Dry Skin

The protective vernix will start to slough off around 38 weeks.

If your baby is born after his due date, then he may have dry, wrinkly skin.

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Lanugo

Lanugo is the fine hair some babies may be born with. Especially those who were born before their due date. Your baby will not grow up hairy! You’ll notice that in a

couple of weeks it will start to slough off.

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Eyes

Facts about your baby’s eyes:• Your baby’s eyes are typically gray-blue in

color. May take 9 months to a year before true color is known.

• Even though a baby cries, there are no tears and they may not be present for up to 3 months of age.

• In the first few weeks after birth, your baby’s eyes may appear crusty.

• Red spots (broken blood vessels) may form in the whites of your baby’s eyes due to the birth process. They produce NO long-lasting effects to your baby’s sight.SAMPLE

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The Shape of Your Baby’s Head at Birth.

A newborn’s head may seem misshapen immediately after birth. This will change. The head will go back to a normal shape in a relatively short period of time.SAMPLE

Soft Spot

A soft spot on top of the baby’s head causes many new parents a sense of uneasiness. The skull of the newborn is made up of bony plates. These plates join together to form the skull, which protects the brain. The points where the plates join together are called sutures or suture lines. At birth, the spaces where the suture lines come together are called fontanels. There are two which are noticeable at birth. The anterior soft spot is the larger of the two and is located on the top of the head. The other is located in the back of the head.

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Fetal Head Molding

The fontanels are designed for the bones of the baby’s skull to be flexible and movable making the birth of the baby possible. Your baby’s head needs to mold, or change shape, to accommodate the birth canal and your pelvis.

The fontanels allow for growth of the skull during an infant’s first year. Fontanels gradually become fixed and close becoming solid bony areas. The average time for the anterior fontanel to close is 18 months.

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Milia

Milia are small, white, pimple-like bumpsand are immature oil glands.SAMPLE

Mongolian Spots

Mongolian spots are flat birthmarks commonly found on African-American, Asian, Hispanic and Native American babies. They usually will fade after the 1st year of life.

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Jaundice

Jaundice is the yellow coloring of a baby’s skin and eyes due to bilirubin build-up.

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If you see yellow skinand possibly yellow eyes

in your newborn, call your healthcare provider for instructions right away!

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Phototherapy (or bilirubin light)

• This special lighting helps to lower the bilirubin build-up.

• The baby’s eyesare covered.

• The baby’s skin is exposed.

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Getting to Know Your Newborn

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Newborn Senses

Your newborn enters this world with all senses functioning… sight, sound, touch, taste and smell.

Your insight to this little one starts from the moment you hold him in your arms.SAMPLE

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Crossed Eyes

The muscles in your baby’s eyes are not fully developed. Often a baby will appear to be cross-eyed and this can give new parents a scare.Do not worry! Over time, the muscles will develop properly.

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What Your Baby Sees

• At birth, your baby can see 12 to 14 inches.

• He can determine between light and dark.

• He is aware of movement.

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What Your Baby Hears

Your baby was listening to your heartbeat in the womb and quite often will recognize mother’s voice as well as dad’s voice

at birth. Many babies will turn their head towards a voice, although eye contact may not be coordinated with listening

quite yet. Just know that he is studying your voice.

It is amazing that this little one can be so observant!

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What Your Baby Tastes

• Your baby’s taste buds are developing in the womb.

• He prefers sweet tastes over bitter.

• He will show a strong preference to breastmilk.

Make sure you put your baby to the breast the first hour after birth, or as soon as possible.

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The brain’s olfactory (smell) center forms early in the womb, just as the sense of taste does. The two are closely

intertwined. This is another reason it is important to get baby to the breast as soon as possible.

What Your Baby Smells

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Touch is vital for brain development. Hold him, cuddle him, keep him warm and give him lots of kisses! You CANNOT spoil him!

Touch

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• Sneezing

• Hiccupping

• Chin Trembling

• Straining during bowel movement

• Irregular breathing patterns

• Noises during sleep

• Fussy time

Infant Behavior

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Babies Love Routine

For example, if you like to bathe him in the morning, then stick to that routine. It lets your baby know what to expect

and allows him to become more comfortable with his environment.

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Bath time is a wonderful time for the baby to learn your touch. This is also a great time to assess your infant’s skin, rashes, healing of the umbilical area and the overall general appearance of your baby.

Bathing and Care

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Supplies Needed

• Washcloths

• Warm tap water

• Cotton balls

• Towel

• Diapers, cloth or disposable

• Baby shampoo

• Baby soap

Getting Started

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• Bathe the baby before a feeding.

• Pick a comfortable place for you to bathe the baby. Choose an area that is draft free.

• Make sure all bath supplies are in reach.

• Lay the baby on a towel and undress.

Steps to help you bathe your baby…

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• With a clean corner of the washcloth, wash from the inner aspect to the outer.

• Repeat with the other eye.

• Wash baby’s face with warm, clean water.

• Do not use a cotton swab to clean the ears, eyes or nose.

Start with the Eyes

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• Make sure you get intoall the nooks and crannies.

• Check the umbilical cord for proper healing.

• Wash area with warm water.

• Never insert a cotton swab up your baby’s nose or into his ear.

Washing The Baby’s Body

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Washing Your Baby’s Hair

• Save a little clean water for the hair.

• Wrap the baby in a towel and hold him in the “football hold.”

• Use only small amount of shampoo.

• Make sure you wash the entire scalp for stimulation and proper circulation to promote healthy scalp.

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• At birth, a clamp is placed on the cord.

• You will be instructed at dischargehow to care for the cord.

• Keep the area clean.

• Roll down the diaper under thehealing cord.

• It may take 7 to 10 days forthe stump to fall off.

Umbilical Cord Care

Call your healthcare provider if the skin around the navel gets red or irritated, if there is a foul smell or a greenish

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It is important for you to check with your healthcare provider on how to take care of your baby’s umbilical cord. You may be instructed to use

nothing at all!

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Taking Your Baby’s Temperature

According to the American Academy of Pediatrics, it is important to keep the following guidelines in mind when taking your child’s temperature unless your healthcare provider has given you other specific instructions.

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• For children younger than 3 years, a rectal digital thermometer gives the best reading. Lubricate the tip with petroleum jelly or a water-soluble lubricant and insert it a half inch. (Diaper-changing position is ideal.) DO NOT insert it too far. Hold the thermometer in place loosely with 2 fingers, keeping your hand cupped around your baby’s bottom. Keep it there for about 1 minute or until the temperature registers or beeps.

• For children older than 3 months, underarm (axillary) temperature may be taken, but it will not be as accurate as a rectal reading.

• For children 4 or 5 years old, temperature may be taken with an oral digital thermometer.

For more information go to: www.healthychildren.org/English/health-issues conditions/fever/pages/default.aspx

CAUTION: Never use a mercury thermometer to take your child’s temperature. If you have a mercury thermometer in your home,

remove it to prevent accidental exposure to this toxin.

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How to DiaperYour Baby

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• If your baby is soiled, gently wipe off as much as you can.

• Always wipe front to back.

• When cleaning, make sure to get into all the folds and crevices.

Taking Off a Soiled Diaper

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• Lay the diaper under the baby.

• Bring the front of the diaper up, covering your baby and overlapping on the sides.

• To fasten the diaper, pull the tabs and stick to the front of both sides of the diaper.

Putting a Clean Diaper On

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Tips on Preventing and Treating Diaper Rash

• Check diaper frequently and change as soon as it is soiled or wet.

• Use warm water (never hot) to clean your baby’s bottom during diaper changes.

• If the baby has a soiled diaper and you need to use more than warm water use very mild soap.

• Make sure your baby’s diaper area is fully dry before applying another diaper.

• Ask your healthcare provider what protective ointments may be used to protect your baby’s skin.

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Circumcision and Care

Removal of the foreskin that covers the tip of the penis.

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Normal healing timeis 7 to 10 days.

Vaseline gauze helps to keep the healing penis from

sticking to the diaper.

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When to Call Your Healthcare Provider…

• If the circumcision does not stop bleeding.

• If there is not a wet diaper within 6 to 8 hours after the procedure is performed.

• If the redness and swelling around the tip of the penis does not go away or becomes worse.

• If there is a foul smell or heavy discharge coming from the area.

• If there is oozing from the site.

• If your baby is running a fever.

• If a Plastibell device is used and does not fall off in 10 to 12 days.SAMPLE

First Tub Bath

• Baby bathtub

• Changing mat

• Baby bath towel

• Cotton balls

• Baby soap

• Baby shampoo

• Diapers

• Clean clothes

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Supplies needed…

Your healthcare team may not want you to use any lotions the first few weeks. Suggestions will be given to you at discharge from the hospital as to the best

products to use for your infant.SAMPLE

Instructions for Tub Bathing…

• Put the tub on a flat, sturdy surface.

• Make sure the room is draft free and warm.

• Place 2 inches of water in the tub and test it with your elbow before placing the baby into it (water should feel warm to touch).

• Kneel, sit or stand to bathe your baby, but be comfortable.

• Once everything is ready, bring your baby to the tub area and undress.

• Make sure you have a good grip while washing him.

• It should take 2 to 3 minutes for a complete tub bath.

• Place him in a warm towel when done with bath.

• Wash your baby’s hair outside of the tub.

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Never leave your baby in the tub alone or turn your back. It only takes a second for a baby to drownSAMPLE

Bath time is a wonderful time foryour baby to learn your touch.

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This is also a great time to assess for rashes, healing of the umbilical area and the overall general appearance of your baby.SAMPLE

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Infant Massage

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• Develops a sense of security and connection.

• Important for physical growth and development.

• Important for brain development.

• Wonderful for learning social skills.

• Beneficial for total overall well-being of the newborn.

Benefits for Baby...

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Infant massageis a common child care

practice in many parts of the world, especially Africa and Asia.

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Your Baby’sCommunication

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What Your Baby’s Cry Means

Crying plays an important role. Research has shown that a newborn may spend anywhere from 1 to 5 hours

throughout the day crying.

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I am hungry!

I am too cold or too hot!

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Causes of Crying

I am bored!

Change my diaper!

I need tobe held!

I don’t feel well!

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• Most babies wake up and cry to make you aware that they are hungry.

• There are “quiet babies” and you must be aware of their hunger cues, such as mild fussiness or hand to mouth sucking.

• These cues are their messages to you that they are hungry.SAMPLE

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Have you ever heard a baby crying so hard and watching the parents trying everything to quiet them… feeding, walking, rocking and talking… and nothing seems to help? This is called overstimulation.

Overstimulation

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Signs of Overstimulation

If you think your baby is over stimulated, it is so important to take them to a quiet place where there is no hustle and bustle, lights and noise. They just need rest, sleep and quiet!

• Shrill cry • Arched back• Face grimace• Frowning• Clenched fists• Inconsolable• Irritability• Stiff and extended arms• Turning away from eye contact

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Colic

• Continuous cryingfor 3 or more hours a day.

• Usually seems to start at 1 to 3 weeks of age.

• The reason is truly unknown.

• It is always important to consult your healthcare provider.

What is Colic?

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Coping Skills for Parents with a Colicky Baby

• Ask for what you need… this does not mean you are a failure as a parent.

• Arrange personal “time-outs” for yourself.

• Have family and friends available for help when you need it.

• Sleep when your baby sleeps.

• Take a breath before picking up your crying child.

• Make sure you are calm.

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1. Swaddling

2. Side/Stomach Position

3. Shushing Sounds

4. Swinging

5. Sucking

Soothing Your Baby

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How to Swaddle Correctly

• To swaddle, spread the blanket out flat with 1 corner folded down.

• Lay your baby face-up on the blanket with his head above the folded corner.

• Straighten the left arm, wrap the left corner of the blanket over the body and tuck it between the right arm and the right side of the body.

• Tuck the right arm down and fold the right corner of the blanket over the body and under the left side.

• Fold or twist the bottom of the blanket loosely and tuck it under 1 side of the baby.

• Make sure his hips can move and that the blanket is not too tight. You should be able to get at least 2 or 3 fingers between the baby’s chest and the blanket.SAMPLE

The American Academy of Pediatrics (AAP) says that when swaddling is done correctly, it can be an effective technique to help calm infants and promote sleep. It is also important to know the risks of swaddling.

• It may decrease a baby’s arousal so that it is harder for the baby to wake up. Decreased arousal in newborns can be a problem and may cause an increased risk for SIDS.

• The blanket could come unwrapped and cover your baby’s face which could increase the risk of suffocation.

• It can increase the chance your baby will overheat.

• In order to allow healthy hip development when your baby is swaddled, his legs should be able to bend up and out at the hips. He should not be wrapped so his legs are straight and unable to bend or move. When your baby’s legs can move freely, the hip joints can develop naturally.

It is recommended that swaddling be stopped by approximately 2 months of age, before the baby is able to roll.SAMPLE

There are many benefits to swaddling and you may be shown many different ways. Remember that in order to allow healthy hip development when your

baby is swaddled, his legs should be able to bend up and out at the hips. He should not be wrapped so his legs are straight and unable to bend or move. When your baby’s legs can move freely, the hip joints can

develop naturally.

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• Rocking is the best way.

• “Wear” your baby in a sling or other front carrier.

• Swaddle your baby, making sure to use a large enough blanket.

• Take a walk outside or a ride in the car.

• Produce “white noise” by running a fan or vacuum.

• Sing or hum to your baby.

Techniques to Soothe a Crying Baby

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NEVER SHAKE Your Baby!

REMEMBER… no matter how tired, angry or beside yourself you feel, NEVER SHAKE or toss YOUR BABY into the air. Any of these can cause brain damage, blindness or even worse, death. Always protect your baby’s head

from any jerking movements.

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IF YOU THINK YOUR BABY HAS BEEN SHAKEN…

GO TO THE EMERGENCY ROOM.

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Grandparents

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Grandparents can bean invaluable resource. Make the most of their help!

Take a Break! Grandparents are usually delighted to take over for an afternoon. This allows them to bond with their grandchild and gives you

and your partner time to nurture your relationship.

Watching your parents dote on your baby and being involved may give you a whole new appreciation for them.

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Not only is a new baby a huge adjustment for mom, partner and baby, but also for your other children.

Some suggestions for a smooth transition…

Siblings

• Let them choose a special gift for the new baby.

• Read books to them about their new role as a big brother or sister.

• Allow siblings to help you take care of the new baby.

• Let them talk openly about their feelings.SAMPLE

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Growth and Development

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• Yawning

• Fussing

• Rubbing eyes

• Looking away

Be aware of signs that will tell you that your baby is ready to sleep:

Sleep Patterns

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Ways you can “play” with your baby…

Play is important for your newborn. He learns through your playful voice tones. Your face is his first and favorite toy the first

weeks of life.

• Sing• Cuddle• Read

• Listen to music• Dance• Love him

Play

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“Tummy Time”

• Strength

• Hand use

• Balance

• Eye-hand coordination

• The ability to roll over (belly to back is the first way most babies roll over)

Tummy time helps with…

Make sure that tummy time with your infant is a timewhen he is awake. He must be supervised!SAMPLE

Keep a diary or write in your baby book when you notice different milestones that your baby is achieving. Documentation of these events will be so special to share with your child as he gets older. It also helps your healthcare provider know that your child is developing properly.

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What to Expect the First Few Months

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Recognizes your face

Follows objects briefly

Raises his head when on belly

Lays quietly and listens intently to your voice

Turns head toward direction of sound

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Vocalizes sounds

Likes to look at black and white or colorful patterns

Holds head up for short periods of time

Gurgles and coos responsively

Follows objects intently

Smiles spontaneouslySAMPLE

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Likes to look at black and white or colorful patterns

Can laugh and smile

Some babies may roll over

Holds head steady

Movements become smoother

May watch and play with hands

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Feeding Your Newborn

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Breastfeeding

Studies prove that breastmilk provides optimal health and benefits the newborn for as long as you choose to breastfeed.

Exclusive Breastfeeding

UNICEF and the World Health Organization (WHO) recommend exclusive breastfeeding for the first 6 months of a baby’s life. This

is based on scientific evidence that shows benefits for infant survival and proper growth and development. Breastmilk provides

all the nutrients that an infant needs during the first 6 months. Exclusive breastfeeding may also reduce infant deaths caused by

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The connection of the unwrapped baby lying directly on your skin is called skin-to-skin contact and can provide you and your baby time to get to know each other. This initial snuggling also has very important health benefits.

Skin to Skin Connection

Your touch is how you communicate with your child.How many times have you had someone hold your hand or give you a

hug and you automatically had a sense of peace and comfort? The science of touch, which is one of our 5 senses, is real and has been proven

as an important part of bonding at birth and beyond.

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• Stable and normal skintemperature.

• Stable and normal heart rate and blood pressure.

• Stable blood sugar.

In addition, the baby will:

• Cry less.

• Latch-on the breast better.

• Exclusively breastfeed longer.

Skin-to-skin contact immediately after birth has these positive effects on a newborn:

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It is important for you to talk with your healthcare provider about your desire for skin-to-skin contact

immediately after birth. You may also want to include this information in your birth plan if you intend to write one. You should also remind your birth team when you are in labor that you would like skin-to-skin connection,

barring any unforeseen complications.

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Benefits for Baby

Benefits for Mother

Benefits for Both Mother and Baby

• Easily digested.• Perfectly matched nutrition.• Filled with antibodies that protect against

infection.

• Convenient.• Economical.• Helpful with the process of the uterus

returning to its normal size.

• A beautiful and intimate way a mother can bond with her baby.

• Contributes to a very special and loving relationship.

Benefits of Breastfeeding

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Anatomy of the Breast

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Physiology of the Breast

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The hormone that stimulates the milk gland cells within the breast to begin producing milk.

Prolactin

This hormone causes the cells around the milk glands to contract and squeeze the milk down the milk ducts and out the nipple. This response is known as the “milk ejection reflex”.

Oxytocin

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Milk Ejection Reflex, also known as “let-down”

The sensations you may or may not notice are as follows:

• Tingling sensation

• Warm upper body sensation

• Feeling your breasts become full

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ColostrumCommonly called “Liquid Gold”

• Colostrum is the “first milk”

• Very high in protein

• Easily digested

• Serves as a laxative to help clear intestinal tract

• Beneficial in loosening mucus

• Coats the stomach and intestinesand protects against invading organisms

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• Support

• Confidence

• Reassurance

• Peace of Mind

Lactation consultants provide…

A Lactation Consultant is a professional who is trained to help mothers who want to breastfeed their babies.

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Preparation for Breastfeeding

Helpful suggestions:

• Education is the best preparation.

• If leaking colostrum, you may want to purchase breast pads.

• Have someone knowledgeable about nursing bras help you with the purchase of a bra that fits well.

• Be careful about underwire bras. The wires may place pressure on the ducts and cause a blockage of milk, if not properly fit.

• You may find that you will need to buy a bra that is 1 to 2 cup sizes larger toward the end of your pregnancy, although wearing a bra is not necessary.SAMPLE

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Supply and Demand

To increase your supply of breastmilk, you need to increase stimulation at the breast by breastfeeding or pumping if necessary.

Milk production is regulated by supply and demand. The concept is… the more milk that is removed, the more milk that is made.

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If you are having concerns about breastfeeding, contact your birth center and ask if they provide a breastfeeding support group that

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You must hold and position the baby close to you.

Breastfeeding RelationshipA good breastfeeding relationship takes time. Readiness is important. Before you begin breastfeeding follow the 3 C’s.

Have pillows all around you in a comfortable chair for support and elevate your legs.

Holding your baby skin-to-skin is very helpful to calm your baby in the early days after birth.

CALM

COMFORTABLE

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Breastfeeding: When and How

• It is best to begin breastfeeding within the first hour after birth.

• Have your lactation consultant watch you latch the baby on so you can feel comfortable with breastfeeding after going home.

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Breastfeeding Positions

There are different positions to hold your baby while breastfeeding. Using these different positions prevent the same

pressure points on your nipples and help with more even breast-draining throughout the day.

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Cradle Cross-Cradle

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Laid-Back Position or Baby-Led Latch

In this position, you are encouraging your own, as well as your baby’s natural instincts.

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Clutch Hold

In the beginning, you may find that one positionbecomes most comfortable for you and your baby. As mentioned earlier, remember to alternate positions.

Side-Lying

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• Lip smacking

• Mouth opening

• Hand to mouth

Some babies do not cry when they are hungry, so stay attentive to the cues.

Early Feeding Cues

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Proper Positioning for Correct Latch-On

• Decide on a comfortable position for you and your baby.

• His nose should align withyour nipple.

• Support and hold your breast away from the areola.

• Place your nipple above baby’s upper lip – this will promote the rooting response.

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• Wait until he opens wide.

• Do not let him latch juston your nipple!

• Remember that correct latch-on is a learned response.

• Be patient with yourselfand your baby!

Proper Positioning for Correct Latch-On

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• As he opens wide, make sure your nipple is pointing to the roof of his mouth.

• Pull him on your breast quickly and gently.

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Proper Positioning for Correct Latch-On

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• Sucking on tongue or lips during sleep.

• Fussing or fidgeting while sleeping.

• Turning head from side to side.

Other Signs of a Good Latch-On

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Signs of Being Full

• Self-detaches.

• Sucking less vigorously.

• Relaxes the body.

• Opens his fists.

• Relaxes the forehead.

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• Do not pull the baby off your breast. This will traumatize your nipples and lead them to becoming sore.

• Removing your baby from the breast is known as “breaking suction.” Slide finger into the corner of your baby’s mouth to break suction.

Break Suction

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Signs of a Good Latch

• All of the nipple and as much of the areola as possible are in baby’s mouth.

• Lips flanged or turned out.

• Tongue over lower gum.

• Baby stays on breast.

• Listen and watch for milktransfer or swallowing.

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Sometimes babies will not burp if they did not get a lot of air in their stomach when feeding.

• Over the shoulder.

• Lying belly down across your lap.

• Sitting in your lap and chin well supported.

Effective Ways of Burping:

Burping

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Making Sure Your Baby is Receiving the Feedings He Needs to Grow and Thrive

Once breastfeeding is established, the best way to ensure a good milk supply is by allowing your baby to feed on cue.

• Babies need and naturally request at least 8 to 12 feedings in a 24-hour period.

• In the early sleepy days, babies may tend not to request feedings often enough.

• Nurse until baby shows signs of being full.

• Offer both breasts each feeding for stimulation of milk production.SAMPLE

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• Baby eating at least 8 to 12 times every 24 hours.

• Baby wetting diapers: 1 diaper in the first 24 hours after birth. 2 on the second day of life. 3 on the third day of life. 6 to 8 wet diapers of urine that is yellow in color once milk is in

greater supply.

• Baby will be passing meconium for the first 1 to 2 days.

• Stool changing to mustard color, runny and seedy in texture once the milk is in greater supply.

Is My Baby Getting Enough To Eat?

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Growth Spurts

The common name for your baby’s need to breastfeed more is “growth spurts” and is your baby’s way of increasing your milk supply so that he can grow.

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• Baby will want to eat more frequently than usual.

• This is your baby’s way of regulating your milk supply.

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Weight gain is an important clue to your healthcare provider that the baby is feeding properly and getting enough to eat.

Most doctor’s offices will allow you to bring the baby in for aweight check. Sometimes that is all you need to make you

feel better!

Weight Gain

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• Audible swallowing – actually hearing the milk being swallowed.

• Breast feels less full after feeding.

• Baby is satisfied – falls away from the breast at the end of feeding. This is called “self-detachment”.

Other Positive Signs

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• Increased blood flow.

• Swelling of surrounding tissue.

• Accumulation of milk.

Engorgement

Time of Awareness

Your breasts may become heavier and swollen 3 to 4 days postpartum.

This is due to:

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Effective Treatment Measures for Engorgement

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• Breastfeed frequently.

• Manually express or pump out milk to soften areola and nipple (the baby cannot latch-on if it is too hard).

• Apply cold compresses to breasts before or after nursing to relieve the swelling and soothe discomfort.

• Wear a sleep bra even at night but make sure it is not too tight.

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• When returning to work.

• To collect breastmilk for a premature baby.

• If the baby is temporarily unable to feed.

• To provide a supply of milk if mom is away.

• To relieve engorgement.

Expressing BreastmilkExpressing breastmilk can be done manually with your hands or with a special pump designed to remove breastmilk.

The following may be some reasons why a breastfeeding mother may choose or need to express her milk.

Skipping a feedingwill slow down or stop milk production.

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• Sore NipplesExpect some tenderness by the second to third day - shouldrelieve by day 7 to 10.

• Cracked NipplesUsually due to improper positioning and latch-on ortraumatic removal from the breast.

• Blocked DuctsPea-sized or larger lumps felt under the skin and in the substance of the breast and are sore to the touch.

• MastitisBreast infection due to blocked ducts, which become inflamed.

Common Nipple Concerns When Breastfeeding

Contact your healthcare provider if you have any of these symptoms.

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• A nursing mother needs an additional 500 calories per day. Breastmilk gets the calories it needs for production from the fat accumulated during pregnancy.

• If you do not properly eat from the beginning of your pregnancy, you will find yourself being very fatigued. The baby gets what he needs… you are the one who suffers!

• Drink at least 6 to 8 glasses of fluids per day to prevent constipation. Your body takes water from your system to make breastmilk.

Dietary Requirements for the Mother

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• When storing breastmilk, label and date the container to ensure your baby is receiving breastmilk that is not outdated.

• Store in 2 to 4 ounce amounts to cut down on waste.

• NEVER microwave or boil breastmilk. This could cause “hot spots” due to uneven distribution of heat.

Storage of Breastmilk

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You may find that depending on which study or resource book you read, these storage tips may vary. Please ask your lactation consultant or healthcare provider for the best storage guidelines and recommendations.

Freshly Expressed Breastmilk Storage Guidelines (For Healthy, Full-Term Babies)

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• Are my breasts are too small?

• How can my partner find me the least bit attractive?

• Will my breasts leak all the time?

• Can I breastfeed if I have had breast surgery?

• Can I breastfeed if I am taking certain medications?

Breastfeeding Questions

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A Note to Dad or Partner

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There is no doubt that the role of the dad or partner is extremely important and an essential part in a new mother’s success with breastfeeding. There are ways you can become an important part in daily routines as well. Such as, diapering, bathing and cuddling.

Your role as caregiver to your new baby is a big addition to your life. Even though the first few weeks are overwhelming, you will find a growing excitement and joy with your new little one. Keep in mind, communication with each other is so important in allaying fears and negative feelings and makes this time special.SAMPLE

Going Back to Work

There are great breast pumps on the market today that may help support your decision to continue to breastfeed!

Hints for breastfeeding mothers:

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• Discuss your needs with your employer.

• Organize your day to incorporate regular pumping sessions.

• Wear comfortable clothes with easy access for pumping.

• Find a place to store your breastmilk.

• Take healthy snacks and drink plenty of water.

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Early FeedingsFirst 24 Hours

• Many babies are sleepy in the first 24 hours after birth and in recovery mode from the birth. Be attentive to feeding cues.

• Healthy term newborns are born with sufficient fluid stores, therefore they do not need anything other than your breastmilk, unless there is a medical problem.

• Unwrap the baby and remove the hat and hand covers and place him skin-to-skin on your chest or next to your breast to help wake the baby.

• Once the baby is positioned, a blanket over the baby will prevent chill while the mother’s body keeps the baby’s temperature stable.

• You may need to continue with some “gentle” stimulation to keep your baby nursing, such as stroking his legs, feet and back.

• Some babies will wake easily when you unwrap them or change their diaper.

• A newborn’s sleep cycle is about 45 minutes to an hour so try again then or anytime he shows feeding cues.

• Unrestricted feeding in the first 24 hours is important as the baby is learning how to breastfeed and is establishing your milk supply.

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First 24 to 48 Hours of Age

• Babies during this period begin to be more awake and alert and breastfeed better.

• Offer the breast anytime the baby starts exhibiting feeding cues.

• Attempt to nurse your baby at least 8 times in 24 hours. Many babies will breastfeed 10 to 12 times in a 24-hour period.

• Allow baby to breastfeed as long as they desire.

• Allow your baby to self detach from the breast unless you become uncomfortable and need to change position.

• After long periods of sleep some babies will go through a “marathon nursing phase” where they want to nurse “all the time” and cannot be put down. This is a good sign as the baby is allowed to stimulate the mother’s body to establish an adequate milk supply. It is NOT because you do not have enough milk.

• If your baby does fall asleep during this frequent feeding phase, you can usually get a break from nursing if your baby is held or cuddled.

• Your little one has realized that he is no longer in the warm comfortable environment of your womb. The most comforting place to your baby is at your breast.

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48 to 72 Hours of Age

• This is the time that your milk will begin transitioning from colostrum to mature milk.

• The breast will become heavier and fuller over the next few days as the volume increases.

• Milk volume is related to frequency and duration of feeds as well as the effectiveness of the baby at the breast.

• You should be hearing more swallows from the baby at this time.

• Do all pacifying at the breast. Continue to avoid pacifiers or artificial nipples until your baby is nursing reliably and gaining weight.

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For the first few weeks it is important for you to track the

baby’s feeding times, wet diapers and stools in a 24 hour period.

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Taking Care of You

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The intensity of feelings after having a child cannot be compared to any other life experience.

Do not feel bad about accepting help from neighbors and family. This will give you some much needed “me” time.

Realistic Expectations

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The New Mother

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Baby Blues

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The arrival of a baby is like no other experience in life. As a new mother you may feel…

• Joy

• Fear

• Confusion

• Exhaustion

• Love

The intensity of feelings after having a child cannot be compared to any other life experience. During the first few days after giving you birth you may experience “baby blues”. With this you may encounter impatience, irritability or crying. These feelings generally come and go quickly.SAMPLE

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Perinatal Mood and Anxiety Disorders

According to Postpartum Support International, as many as 1 in 8 women may experience emotional symptoms known as perinatal mood and anxiety disorders. Symptoms can appear any time during pregnancy and the first 12 months after giving birth.

Postpartum depression is the most well-known of these conditions. Many signs of the “blues” are present, but they are more severe or intense. SAMPLE

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Perinatal Mood and Anxiety DisordersPlease contact your healthcare provider immediately, if you think you have any of these signs or symptoms:

• Trouble sleeping or sleeping too much.

• Changes in appetite.

• Feeling irritable, angry or nervous.

• Low energy.

• Feeling exhausted.

• Feeling guilty or worthless.

• Feeling hopeless.

• Crying unconditionally.

• Feelings of being a bad mother.

• Trouble concentrating.

• Not enjoying life as much as in the past.

• Lack of interest in the baby.

• Lack of interest in friends and family.

• Lack of interest in sex.

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The New Father or PartnerThere are many things you can do to be a part of your baby’s everyday routine…

• Take turns getting up in the middle of the night to feed your baby.

• Be involved in bath time.

• Take your baby for a walk. This will give mom some “alone time.”

• You need personal time too. Together you can work out a schedule that benefits both of you.

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Take Time for Yourselves

It may be hard to find time to spend together as a couple.

Here are some suggestions for nurturing your relationship…

• Set time aside for a weekly get-away.

• Your parents may be thrilled to watch their grandchild so you can get-away.

• Have someone help with chores around the house.

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• Have meals in the freezer for those evenings you have run out of time to cook.

• Ask a friend to watch your baby while you take a shower, do laundry or nap.

• When you are feeding your baby, make sure it is uninterrupted time.

• Learn to say “no” if you are not up for a visit.

• It is OK to take time for yourself away from your baby.

Parenting Tips

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Baby Basics

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Getting Ready at Home

• One-piece outfits or body suits with snaps in the crotch (5 to 7).

• One-piece nightgowns or stretch suits (5 to 7).

• Socks and booties (2).

• Cotton undershirts (5 to 7).

• Sweater or jacket for outdoors or if it is cool inside (1).

• Sun hat and/or warm hat to conserve body heat and shield baby from the sun (2).

• Mittens for baby’s hands to keep him from scratching himself (1 to 2).

The following are items you’ll need once the baby is born...

Clothes

Baby Gear

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• Diaper pail.

• 10-11 disposable diapers a day.

• Diaper wipes.

• Baby monitor.

• Sling for baby.

• Front carrier for baby.

• Bulb syringe.

• Brush and comb.

• Nail scissors or file.

Miscellaneous

Diapers

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Bassinet or Cradle

• A wide and sturdy bottomso that it will not tip over.

• All surfaces are smooth(no staples, nails or other hardware that would hurt an infant).

• A firm mattress that fits snugly.

• If there are legs, make surethey lock so they do notcollapse while in use.

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Furniture

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• Do not use antique or old cribs with decorative cutouts or lead paint.

• The space between the slats should be no more than 2 ⅜ inches apart.

• Corner posts should be the same height as end panels.

• Top rails in their raised position should be 26” above mattress support at its lowest position.

• When your child can pull himself up to standing position, set and keep mattress at its lowest position.

• Stop using crib once the height of the top rails is less than ¾ of the child’s height.

Crib Safety

In your state, safety advocates may recommend you do not use bumper pads. If you choose to use them, make sure they fit snugly to cover the entire inside frame of the crib and tie or snap in place.SAMPLE

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• Teething rails that are damaged should be fixed, replaced or removed immediately.

• Remove mobiles and crib gyms when your baby is 5 months old or when he begins to push up onto his hands and knees or when he can pull himself up.

• Keep the crib clear of plastic sheets, pillows and large stuffed animals or toys. Your baby can suffocate on them.

Crib Accessories

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• Do not place crib next to window.

• Have smoke detectors installed in your home.

• Lead paint is a health hazard - be careful about used cribs and painted toys.

• Make sure all your baby items are safe!

Crib Environment

If you think your child has taken in leaded paint or soil, or you need help with identifying or removing lead paint, call the National Safety Council’s National Lead

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Changing tables offer an easy place to change your baby’s diaper. NEVER leave the baby on the table unattended. Look for a changing table that has drawers for you to easily access clothes and diapers so you do not have to turn your back to your baby for a moment.

Changing Table

Rocking chairs can be so comfortable for you and comforting for your baby. Look for a chair with arms wide enough so you will be comfortable holding and feeding your baby.

Rocking Chair or Glider

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• The mesh is less than a ¼ of an inch insize, so baby fingers or buttons on clothes cannot get caught.

• The mesh does not have tears, holes or loose threads that could trap a baby.

• The mesh is securely fastened to the top rail and bottom of crib or playpen floor.

• Make sure that the top rail cover has no tears or holes.

There are mesh-sided cribs or playpens, so look for the following before using one…

Playpen

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• A wide base so there is no chance of tipping.

• The seat belt and strap attach securely to the frames.

• A seat belt buckle that is easy to use, so that you will use it!

• Brakes that securely lock the wheels.

• Make sure the basket on the back is low and directly over the back wheels for stability, which prevents tipping.

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Strollers or Carriages

With so many strollers and carriages on the market how do you choose the best one for your baby?Here are some guidelines…

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Car Seat Guidelines

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Every state requires that infants and children ride buckled up. It is your responsibility to know the proper installation of your baby’s car seat.

Proper Installation of Your Baby’s Car Seat

It is a good idea to practice installing and adjusting the car seat before the birth of your baby. If you have trouble at first, you have time to practice and get the proper

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• An infant in a rear-facing seat should not be used in front of an active airbag.

• The safest place is in the middle of the back seat (depending on the car).

• The American Academy of Pediatrics (AAP) recommends that children should ride in rear-facing child safety seats as long as possible. New research indicates toddlers are more than 5 times safer, according to the AAP, riding rear-facing in a convertible car safety seat until they reach the maximum height and weight recommendation for that particular model, or at least to the age of 2.

Infant-only seats may come with more than one harness slot. They allow room for your baby to grow. In the rear-facing position, the harness usually should

be in the slots at or below your baby’s shoulders. Check the car safety seat manufacturer’s instructions to be sure.SAMPLE

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What are the basic guidelines for proper safety seat use?

• Tightly install child seat in back facing the rear.

• Infant car seat should be at a 45 degree angle.SAMPLE

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• Harness straps/slots at or below shoulder.

• Harness should be snug. You should only be able to fit one finger between your child and the harness.

What are the basic guidelines for proper safety seat use?

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Are You Using a Second-Hand Car Safety Seat?

• Is too old - look on the label for the date it was made.

• Was in a crash, even if it looks fine.

• Does not have a label with the date, seat name and model number.

• Does not come with instructions.

• Has any cracks in the frame of the seat.

• Is missing parts.

Do not use a car safety seat that…

Double-Check Everything!

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• To find out call the manufacturer or the Auto Safety Hot Line at 1-888-327-4236.

• If the infant car seat has been recalled, follow the instructions to fix it or return it.

• Another good resource is the NHTSA or www.nhtsa.gov.

• Get a registration card for future recall notices for your model.

• Send in your registration card.

Has Your Car Safety Seat Been Recalled?

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Know the history of a hand-me-down! Even if there was a car crashat 5 miles per hour, a child car seat should not be used again.SAMPLE

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Be a good example to your children…

…always buckle up!SAMPLE

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Keeping YourBaby Safe

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The best way to relax and enjoy these early months with your baby is to anticipate any risks ahead of time and take certain precautions.

Safety Measures

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• You should have at least 2 working smoke detectors.

• Have a working fire extinguisher.

• Have cover plates for electrical outlets.

• Secure all cabinet doors with latches.

• Place screen or safety rails on fireplaces.

• Do not allow any small objects in or around baby’s sleeping area.

• Keep buckets up and toilet seats down.

A Personal Home Safety Checklist

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It is a good idea to have a few sets of EMERGENCY NUMBERS. Some suggestions on where to place them…

• On your refrigerator.

• In your diaper bag.

• Near phones.

• In your car.

• Give to family and friends.

• Give to caregivers and neighbors.

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• SIDS is the sudden death of an infant under the age of one, which remains unexplained.

• To reduce the risk of SIDS, place your healthy infant on his back to sleep.

• Studies show that there is a decrease in SIDS deaths due to parents understanding this important information.

Sudden Unexpected Infant Death (SUID), Sudden Infant Death Syndrome (SIDS) and Safe Sleeping Environment

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• Place your baby on his back to sleep at nighttime and naptime.

• Place your baby on a firm mattress in a safety-approved crib.

• Remove fluffy, soft or loose bedding from the sleep area, such as pillows, quilts, comforters, crib bumpers and stuffed toys.

• Keep your baby’s head and face uncovered during sleep.

• Do not smoke before or after the birth of your baby and do not let others smoke around your baby.

• Do not have more than one baby per crib.

Always keep the following points in mind for your infant:

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Keep the following points in mind…• Devices designed to maintain sleep position or to reduce the risk of

rebreathing are not recommended since many have not been tested sufficiently for safety. None have been shown to reduce the risk of SIDS.

• Babies should be allowed supervised “tummy time” during awake periods to promote shoulder and muscle development and avoid flat spots on the back of the head.

• Keep your baby’s sleep area close to, but separate from, where you and others sleep. Your baby should not sleep in an armchair, bed, or couch with adults or other children.

• Consider using a pacifier at naptime and bedtime. For breastfeeding infants, delay pacifier introduction until the baby is one month old.

• Share all of these important tips with babysitters, grandparents and other caregivers.

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Baby’s Warning Signs and Reportable Symptoms

Even experienced parents may feel worried as they adjust to a new baby’s habits, needs and personality. It is important to remember that most of the common physical problems that occur during a given 24 hours with baby are normal situations or problems with simple answers.

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• Blue lip color call 911.

• Blue or pale colored skin.

• Yellow skin or eyes.

• Patches of white in baby’s mouth.

• Eating poorly or refuses to eat.

• No stool for 48 hours and less than 6 wet diapers a day.

• Redness, drainage or foul odor from the umbilical cord.

• Does not urinate within 6-8 hours of circumcision.

• Fever of 100.4°F degree temperature or more.

Call your healthcare professional if any of the following symptoms of illness occur…

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• Difficulty breathing.

• If your baby has a congested cough, running eyes or running nose.

• Repeated vomiting or several refused feedings in a row.

• Listlessness.

• Crying excessively with no known cause.

• An unusual or severe rash (other than prickly heat).

• Frequent bowel movements with excess fluid, mucus or foul odor.

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When to call your baby’s healthcare provider or lactation consultant

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• Blue lip color is a 911 call!

• If your baby is not effectively nursing at least 8 to 12 feedings a day.

• If your baby has less than 4 wet diapersin a 24-hour period in the first week of life,and less than 6 wet diapers in a 24-hourperiod after he is 7 days old.

• If your baby is not stooling 3 to 4 times a dayonce your milk is in greater supply.

• If your baby refuses to eat for 6 to 8 hours.

• If your baby experiences drastic behavior changes such as increased irritability, excessive crying without a cause, extreme sleepiness or floppy arms and legs.

If you feel your baby needs immediate medical

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Infant CPR

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(under one year of age)

The thought of having to do CPR on your baby is very frightening. However, there is nothing worse than not

knowing what to do in case of such an emergency.

It is highly recommended that you take an Infant CPR class. If not offered as part of your Childbirth Education class, call your

local American Heart Association, American Red Cross or go online to find a schedule of classes close to you.

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When considering CPR, remember C-A-B:

C= Circulation

A = Airway

B= Breathing

Breaking it down to these letters makes it easyto remember what to do if faced with this emergency. Infant

CPR is a little different from adult and child CPR, but the concept is the same.

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Check to make sure the baby is conscious and breathing.

1. If your baby is not conscious, try to arouse him. NEVER shake your baby! Instead, try tapping the bottom of his feet or rubbing his back. Babies do not like this and will usually respond quickly.

2. If you are alone and there is no response (crying or stirring), begin giving compressions. If someone is with you, have them call 911 at this time. Begin compressions by placing 2 fingers in the center of his chest, 1 finger width below the nipple line. Compress at least 1/3 the depth of the chest (approximately 1 1/2 inches) to get the heart to pump blood for CIRCULATION.SAMPLE

96

3. Do 30 compressions, at a rate of 100 per minute, and then briefly check the AIRWAY. Do this by placing the baby on a hard surface (NOT the crib) and tilt his head back in a neutral position. Do not tilt the baby’s head back too far because you will block the airway.

4. If the baby is not BREATHING, cover the baby’s nose and mouth with your mouth and gently puff 2 times. Look to make sure the chest is rising when you give the puffs of air. A baby’s lungs are smaller than an adult’s, so remember to give only puffs of air, not full breaths.

Infant CPR

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5. Continue to do 30 compressions to 2 puffs of air. It should take 2 minutes to do 5 cycles.

6. If you are alone, and have not done so, notify 911 at this time.

7. Continue CPR until help arrives.

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Infant CPR

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The instructions DO NOT take the place of a class where you are

trained and given time to practice these skills on a mannequin.

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Infant Choking

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(under one year of age)

Choking can be scary… IF IT HAPPENS! Little ones tend to put anything they can get their hands on into their

mouths. If a small object gets lodged in the windpipe and your baby cannot cough, breathe or cry, it is

important to dislodge it as soon as possible.

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The following will help you understand how to help your baby if he is awake (responsive) and choking:

1. Place your baby face down along your arm. Support the head by holding his jaw. Make sure his head is lower than his body.

2. With the heel of your hand,deliver 5 quick back slapsbetween the shoulder blades.

3. Turn the baby over onto your other arm. Your baby is now facing up.

Infant Choking

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4. While supporting the head and body, deliver 5 downward chest thrusts using 2 fingers positioned a finger width below the nipple line. Make sure his head is lower than his body.

5. If you do not dislodge the object, repeat with 5 back slaps and 5 chest thrusts until the object is dislodged or the infant becomes unresponsive.

Infant Choking

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6. If the infant becomes unresponsive, begin CPRas outlined on pages 96-97.

7. Between giving puffs of air, look into the baby’s mouth to see if the object is visible. If the object is not seen, do not attempt a blind finger sweep. Continue with CPR.

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Remember, only use finger sweep if you can see the object in the baby’s mouth.

Infant Choking

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Yell out for help and direct someone to dial 911.

If you are alone, dial 911 after2 minutes of trying to

clear his airway.

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Shaken Baby Syndrome or Abusive Head Trauma

Shaken Baby Syndrome or SBSis when a baby is “shaken” forcefully.

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REMEMBER – NEVER THROW OR SHAKE YOUR BABY NO MATTER WHAT!

• Take a breath.

• Close your eyes and count to 10.

• Put the baby down in his crib and leave for a few minutes to gain composure.

• Ask a friend, neighbor or family member to take over for a while.

• Give yourself a “timeout”.

• Do not pick the baby up until you feel calm.

• If you feel he is ill, call your healthcare provider right away or take him to the hospital.

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If you or a caregiver has violently shaken your baby because of frustration or anger, the most important step you can take is to seek medical

attention IMMEDIATELY.

Do not let fear, shame or embarrassment keep you from doing the right thing. Getting the

necessary and proper treatment without delay may save your child’s life.

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Parenting is a process that requires you to constantly learn. You will discover new skills and insights along the way. Please know that you will make mistakes and stumble from time to time. You are only human, but trust your instincts!

At the end of the day, it comes down to love. Your love for this precious life will guide you in making the right decisions.

Take pleasure in parenthood and ENJOY YOUR JOURNEY!

Conclusion

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SAMPLEBenefits of Breastfeeding Baby Warning Signs Car Seat Safety

Correct Latch Is Baby Getting Enoughto Eat

Jaundice

New Dads and Partners

Newborn Screening Soothing-Calming a Fussy Baby

Umbilical Cord Care