Two medications are given to all babies shortly after birth.
Vitamin K injection
Babies are not born with enough vitamin K. Vitamin K is needed to prevent bleeding problems. All babies receive an injection of vitamin K shortly after birth. The injection is given in the baby’s thigh. You can breastfeed or hold your baby while it is given.
Credit of This Content: Ontario
Antibiotic eye ointment
In Ontario, all babies currently receive antibiotic eye ointment in each eye after birth. This is done to prevent an eye infection that can lead to blindness. This infection is caused by gonorrhea or Chlamydia. The Canadian Paediatric Society has issued a position statement that may change this practice in the future.
Babies are screened for several conditions after 24 hours of life.
Newborn Screening
When your baby is approximately 24 hours old, a small blood sample is taken to screen for some serious diseases. You will be contacted by your health care provider in the unlikely event that the screen is positive for any of the diseases. A positive result does not mean your baby definitely has a specific disease. It means that more testing is needed. Serious health problems can be prevented or reduced if treatment is started early.
Jaundice Screen
Your baby may be tested for jaundice with a blood test or a monitor placed on the forehead. Jaundice is the buildup of bilirubin that happens when extra red blood cells are broken down after birth. It can make your baby’s skin and eyes look yellow. Breastfeeding your baby often can help prevent a buildup of bilirubin. Extremely high levels of bilirubin can affect a baby’s brain. If your baby’s bilirubin level is high, your baby may need to be placed under phototherapy lights that help break down the bilirubin.
Hearing screening
The Ontario Infant Hearing Program provides free screening of all newborns for hearing problems. Ask your health care provider where and when the hearing test will occur. Early detection and treatment of hearing problems is important to help ensure that your baby will develop speech, language, and social skills.
Change your baby whenever his or her diaper is wet or soiled.
Your baby may need a diaper change eight to 10 times a day, no matter if you are using cloth or disposable diapers. A good time to check the diaper is before and after feedings. It makes the baby alert for feedings and ensures that your baby is comfortable. To change your baby’s diaper:
Wash your hands before and after changing the diaper.
Keep one hand on your baby at all times. Never leave your baby unattended.
Wipe from front to back using a clean, wet, and warm washcloth or unscented baby wipe.
For baby girls: Gently clean between the outer folds of the labia. There is no need to clean inside the vagina.
For baby boys: Be sure to clean underneath the scrotum where stool can collect in the skin folds. You do not need to pull the foreskin back when cleaning the penis.
Allow the diaper area to air dry. Using baby powder to keep the diaper area dry is not safe for newborns as it can get into their lungs.
Contact your health care provider if your baby has a diaper rash that does not go away in a few days. Your baby may have a yeast infection or other condition and may need a medicated cream prescribed by your health care provider.
Talk to your health care provider if you are thinking about circumcision for your baby boy.
Circumcision of baby boys is a surgical procedure that removes the layer of skin called the foreskin that covers the head of the penis. It is usually done during the first few days after birth. Circumcision is not a medically necessary procedure and routine circumcision is currently not recommended by the Canadian Paediatric Society. Some parents choose to have it done for cultural, religious, or social reasons. If you are considering a circumcision for your baby boy, discuss this with your health care provider. Circumcision is not covered under the Ontario Health Insurance Plan so you will need to pay for the procedure. Ask your health care provider about how to care for your baby after the procedure.
Bathe your baby every few days. Wipe your baby’s hands, face, neck, and diaper area every day.
Babies do not need to be bathed every day. Bathing too often can cause your baby’s skin to dry out. Bathe your baby every two to three days or as needed. Your baby can have a full bath even if the cord stump has not fallen off; just pat it dry after the bath. Some bathing tips to keep in mind:
If you give your baby a bath right after feeding, your baby may spit up.
Choose an area that is safe and easy to bathe your baby (baby bathtub, sink, or basin).
Bath water should be warm, not hot. Test the temperature with your wrist or elbow.
Stay with your baby. Always keep at least one hand on your baby at all times.
Wash your baby’s eyes and face first with warm water, no soap.
Never put your baby’s face under the water.
Use mild soap to wash your baby’s body, from cleanest to dirtiest, cleaning the diaper area last.
After bathing, gently dry your baby with a towel making sure to dry the skin folds.
You will also need to:
Trim your baby’s nails once they grow beyond the skin. The nails can be cut with blunt scissors when your baby is sleeping or after feeding when his or her hands might be still.
Clean your baby’s gums twice a day. Gently wipe your baby’s gums from back to front with a soft, clean, damp cloth or a piece of gauze (wrapped around your finger) to remove any leftover milk.
Your baby will go through many changes in the first week after birth.
These are some of the things that you can watch for as you get to know your baby.
Your baby may have swollen genitals at birth due to your hormones in their body.
Breasts in both baby girls and boys may be larger than normal and may leak a small amount of milk. Newborn girls can also have a small amount of bleeding or white discharge from their vagina. All of these are normal and will disappear in a few days.
The stump of your baby’s umbilical cord will dry up and fall off by itself one to three weeks after birth. Keep the cord stump clean and dry to prevent infection. You do not need to put anything on it to keep it clean. Fold the diaper below the cord stump to keep it dry until it falls off. If the skin around the cord stump becomes red or swollen, smells bad, or has pus coming from it, the cord stump may be infected. Call your health care provider if that happens.
You may notice tiny hairs on your baby or a white cream (vernix) on your baby’s skin. These protected your baby while in the womb. You do not need to remove the vernix.
Your baby may get a scaly or flaky scalp known as cradle cap. It usually does not need to be treated, but you can ask your health care provider.
You may notice dark spots on the buttocks of your baby or a rash on your baby. These skin changes are normal and will go away with time. Talk with your health care provider if you are concerned about your baby’s skin.
Your baby’s stool will change from black or dark-green meconium to brown, green, or yellow by the fourth day. After that, it should be soft, seedy, and yellow.
Dress your baby according to the temperature.
It is important not to overheat your baby. Your baby generally will be comfortable with the same layers of clothing that you are wearing. Babies lose a lot of heat through their heads. Depending on the season, a hat may be worn when outdoors. However, your baby should not wear a hat while sleeping as it could slip down over the face and mouth. See the Newborn Safety file for information about keeping your baby safe while sleeping.
Have your baby vaccinated as recommended by your health care provider to protect your baby’s health.
Vaccines cause the body to produce antibodies that will protect your baby from diseases and even death. Your baby needs to be vaccinated at several times to be fully protected. You can breastfeed your baby while the injection is given to minimize pain. Your baby’s first vaccine is given at 2 months of age. See the immunization schedule for more information on when you will need to book vaccination appointments with your health care provider. The vaccines used in Canada are safe and do not cause autism.
Babies can get sick quickly. If you are concerned about your baby, take your baby to see a health care provider.
If your baby seems sick, check his or her temperature. The best way to check your baby’s temperature is by gently placing a clean thermometer in the opening of their bum. The next best way to check a baby’s temperature is underneath their armpit. If your baby has a temperature greater than 38.0° C (100.4° F) when taken in the bum, this is a fever. If your baby has a temperature greater than 37.3° C (99.1° F) underneath the armpit, this a fever. Take your baby to see a health care provider right away if your baby:
Has a fever.
Appears jaundiced or yellow in colour.
Has a rash, especially in and around the diaper area that does not go away.
Feeds poorly or will not feed.
Has a dry mouth, lips, or tongue.
Normally has regular bowel movements but suddenly stops.
Is passing less urine or has dark yellow urine.
Vomits more than twice in one day.
Has diarrhea.
Has black or bloody stool that is not meconium.
Has grey or chalk-coloured stool.
Has a cough that won’t go away.
Is hard to wake or seems very weak.
Has lips or ear lobes that are blue or grey.
Has difficulty breathing or breathes very quickly.
Is shaking and not responding to you (having a seizure).
Shows any other signs that he or she may be sick.
Learn the cues that mean your baby is tired.
If a baby becomes overtired, he or she can have difficulty falling asleep. Cues that show your baby is tired can include:
Yawning
Quietness or a loss of interest.
Crying or fussiness.
Rubbing of the eyes.
To help your baby sleep well, it can be helpful if you:
Create a bedtime routine.
Avoid stimulating your baby too much before going to sleep.
Place your baby to sleep in his or her crib, cradle, or bassinet in a room that is dimly lit.
Change your baby’s position to prevent your baby from developing a flat head.
Your baby spends a lot of time on his or her back as this is the safest way to put your baby to sleep. To prevent a flat head from forming, you can:
Switch the end of the crib where you place your baby’s head each day. Your baby will naturally look towards the door.
Alternate the location of a mobile for your baby to look at when in the crib.
Avoid having your baby in a car seat or stroller for long periods of time when possible.
Have supervised tummy time when your baby is awake Do this for 10 to 15 minutes three times a day. It helps if you get on the floor face-to-face with your baby and use this as play time.
Healthy babies cry as a way to express their needs and communicate.
Your baby will cry to let you know when he needs something. Sometimes your baby might cry for no reason at all. Crying is normal newborn behaviour. To soothe your baby, try:
Feeding your baby.
Changing your baby’s diaper if wet or soiled.
Burping your baby.
Changing your baby’s position or giving your baby a gentle rub on the back.
Cuddling and comforting your baby by holding your baby skin-to-skin.
Checking that your baby isn’t under-dressed or over-dressed.
Talking and singing to your baby or playing soothing background music for your baby.
Gently rocking your baby, using a baby swing, or going for a car ride.
Taking your baby for a walk in a stroller.
Giving your baby a warm bath and massage.
Never shake or hit your baby. See the Newborn Safety file for information on coping with a crying baby.
You are your baby’s most important connection to the world.
Healthy emotional bonding and attachment establish positive relationships. Attachment develops as you respond sensitively and consistently to your baby’s needs. Babies need to know they can rely on you to respond to their needs.
Nurture, comfort, and respond to your baby. Show your baby that he or she can trust you for care and comfort.
Skin-to-skin contact (placing your baby, wearing only a diaper, chest-to-chest against your body and then covering you both with a light blanket) is a great way to establish an emotional bond between you and your baby. It can help with breastfeeding as well. Parents can place their baby skin-to-skin right after birth.
Building a secure and trusting relationship with your baby will promote healthy brain development.
Plan daily face-to-face time with your baby to cuddle and tummy time to play and engage with your baby.
Be sure to spend lots of time with your baby. Talk soothingly, sing songs, and look into your baby’s eyes.
Listen to your baby and watch for cues to understand your baby’s behaviour.
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