How to clean a newborn’s vagina

newborn-cleaningSome people recommend that parents ignore the whitish material that accumulates between the labia majora (outside vaginal lips) and labia minora (inside vaginal lips). I prefer that parents clean the area because otherwise poop can get mixed in with the discharge and irritate the baby’s skin.
However, cleaning this area often makes parents nervous. I recommend two things to make this easier. First, you don’t need to remove all of the goo at one time. Second, clean the area by gently wiping with a cotton washcloth in a downward direction. (I prefer washcloths to cotton balls because they have better traction.) Third, if you clean the area with each diaper change, less goo will accumulate and the whole process becomes simpler.

Why newborns poop when they’re nursing

african american mother with newbornThe first stool a baby has is a thick, green, gooey mess called meconium. (For the record, meconium consists of all the stuff babies swallow during his fetal life: skin cells, hair, and other material floating around in the amniotic fluid.) After passing a handful of these sticky poops, a baby has something we refer to as “transition stools.” These poops are runny, green, and foamy. In fact, if your baby has a transitional stool when his diaper is off, you may see it shoot 12 inches through the air! But rest assured, they’re not dangerous and will fade into memory in a couple of days.
When a person’s stomach fills with food, it triggers a reflex that stimulates peristalsis. (Peristalsis is the name for the rhythmic contraction of muscles that push food from the beginning of the gastrointestinal tract to the end.) This explains why adults and older kids often have a bowel movement after eating. However, this reflex is much more active in babies, which is why they often poop while nursing. But the poop that comes out when your baby eats is waste from the feeding that went in hours ago.

Is it normal for newborns to grunt or strain when they poop?

African-American-Mother-and-BabyIt’s hard to see your baby cry, especially when she’s pooping. Parents often assume that babies are constipated if they strain or cry when they poop. Although this is true in older children, babies commonly grunt and strain with defecation because of a reflex that causes them to push when fecal material enters the rectum. However, if this behavior concerns you, be sure to mention it to the doctor at the baby’s next checkup. In rare cases, a baby’s anal opening may be too tight or her anus may be in the wrong position. Although rare, these anatomic variations can make it more difficult to pass stool.

Does it hurt to wash your baby’s soft spot?

Pressing-Babys-Soft-SpotThe medical name for a baby’s soft spot is called the anterior fontanel. This is an opening between the bones of the skull that allows the cranium to grow. The fontanel is covered with a very tough membrane so you will not hurt it when you wash your baby’s hair. Although doctors would never recommend poking the fontanel, you can scrub it gently with a hairbrush like the rest of your baby’s scalp.

Do umbilical hernias need to be treated?

Umbilical-hernia-in-childUmbilical hernias are caused by a weakness in the ring of muscles that surround the belly button. Because of this weakness, abdominal fluid or intestinal contents can push on the skin covering the belly button causing a bulge. The bulge will be more noticeable if a baby is crying or if an older child is standing up.

Umbilical hernias are common and not serious. In the past, parents were told to bind the hernia so it would go away. This does not work and may create a rash on the baby’s abdomen. Fortunately, most resolve on their own by the time children start first grade. If they persist beyond this point, they may need to be repaired surgically.

Umbilical hernias rarely cause harm. Once in my 30-year career, a piece of intestinal fat got “stuck” in the hernia ring had to be fixed on an emergency basis. The way I knew something was wrong was because the area was red and the baby was crying. When I pressed on the hernia, instead of being easily pushed back in, it was hard and tender to touch.

Reassuring older kids that shots don’t hurt that much

Giving a shot to an older kidIt’s common for toddlers and young children to be afraid of shots. Although I never had to chase my own kids to get them to hold still for a shot, lots of parents have to do this. What I have frequently noticed, however, is that older kids almost always end up being surprised that the shot hurt less than they thought it would. Why does this happen?

Not only do we all have fears, but we also have a tendency to remember our fears when faced with similar experiences in the future. That’s why most people hate going to the dentist even if they’re getting a cleaning instead of having a cavity fixed.

Although young children experience pain when they get shots, older kids are usually not that bothered by the shot itself. However, older kids are often worried about shots because they remember the pain they had in the past.

You may be able to help in this situation if you remind your child that shots haven’t hurt much in the last few years. Another way to deal with this is to have kids write themselves a note after the shot. Then, the following year, you can show them the note, which reminds the child the shot didn’t hurt that much.

How to take a rectal temperature in newborns

Child-Rectal-ThermometerAfter a baby is born, hospital nurses take armpit temperatures. They do this for two reasons. First, they want to be sure a baby’s temperature doesn’t drop as she adjusts to being outside the uterus. Second, because the nurses take temperatures multiple times per day, they do it in a way that is quicker and less disruptive for the baby.

Once you take your baby home, you should take rectal temperatures if you’re concerned that the baby is sick or has a fever. The reason for this is because rectal temperatures are the most accurate way to check for fever, and a doctor’s diagnostic approach to fever is based on rectal temperatures. Pediatricians define fever in the first three months as a rectal temperature of 100.4 degrees or higher.

It’s much easier to take rectal temperatures on newborns than older infants. There are different ways to do this, but I prefer having a baby lying across my legs with her bottom facing up. I separate her buttocks with one hand and gently insert a lubricated digital thermometer with the other. I insert the tip about ½ inch and hold the thermometer in place with two fingers of the same hand I used to separate the baby’s buttocks. That way I don’t have to worry that the device will poke the baby if she wiggles or moves.