INFANT CARE TECHNIQUES

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INFANT CARE TECHNIQUES
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How should baby be held?...
The babys head is large in proportion to the
rest of its body. Because the babys neck muscles
are usually weak, it is important to support the
head for about the first three months. 
Young children need to sit down and have constant
assistance in attempting to hold a baby. If
unsupported, babys head could fall back, causing
a case of whiplash!
This traditional cradle hold uses both arms of
the caregiver, and supports both babys neck and
back.
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How should baby be dressed?...
Use the way you are dressed as your guide. In
general, baby needs the same number of clothing
layers as you have on. If you are wearing a
shirt and jacket, baby may need a top and
blanket. A hat may be an important accessory, to
prevent heat loss through the scalp or sunburn.
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Sleeping habits...
You can help your baby establish good sleeping
habits by developing a bedtime routine. Do not
try to minimize daytime noises, such as vacuums,
dishwashers, etc. Keep lights on and regular
noise levels. If you always rock your baby to
sleep, they will come to expect and rely on it.
AGE SLEEP REQUIRED
1 week old 17 hrs, including 4 naps
1 month 16 hrs, including 3 naps
3 month 15 hrs, including 3 naps
6 month 14.5 hrs, including 2 naps
9 month 14 hrs, including 2 naps
1 yr 13.5 hrs, including 2 naps
When baby wakes up at night, keep lights, noise,
and interaction at a minimum. Delay reaction
time to crying if baby has recently been fed and
changed, to see if they will go back to sleep on
their own.

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In an effort to reduce the number of children who
died from SIDS (crib death), physicians
encouraged parents to lay their babies on their
backs to sleep.
Back is best...
Unfortunately, the fontenals and skill plates are
not fully fused during infancy, and can shift.
This back to sleep philosophy can cause the
head to flatten in areas.
This head malformation, known as positional
molding, develops in babies who spend most of
their time on their backs in cribs, car seats or
infant seats. This is called positional molding.
The solution may be as simple as placing the baby
on its side or tummy when it's not sleeping to
relieve the constant pressure on the back of the
head. The direction the child is placed in the
crib should also be varied. In cases of extreme
deformity, special helmets can be customized for
wear such as the one shown in the picture at the
right.
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Checking the temperature of baby's bottle...
If feeding baby formula or preserved breast milk,
some babies prefer their milk and sometimes even
the nipple warmed. Test the temperature of the
milk by sprinkling a few drops on the back of the
hand or the inside of the wrist. It should be
tepidnot hot.
Use caution if using a microwave to heat the
bottle. The milk or formula is heated unevenly.
Shake before feeding. Warming milk is NOT
necessary, but once baby becomes accustomed to
it, they may refuse cold milk.
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Burping the baby...
As baby sucks, from a bottle even more so than
the breast, they swallow air. They try to burp,
but the feeling is new for them, and they
sometimes end up spitting up their entire lunch
in the effort. They could use some assistance
from the caregiver. You can place the child up
and over the shoulder to pat their back, but you
take a chance of spit-up trickling down your back.
Place baby in sitting position. Lean them
forward, supporting their chin and chest with
your hand. Pat their back in an upward motion.
You may want to squeeze the cheeks of their face
to open the mouth. Continue until you hear the
burp of air.
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Spitting up vs. vomiting...
In older children and adults, an elastic-like
muscle at the entry to the stomach closes like a
valve to prevent liquids from being pushed back
up. In babies, however, this valve or sphincter
isn't fully effective until between 6 and 12
months of age. Since it isn't fully developed
yet, the valve is easily pushed back by the
contents of the stomach - resulting in
regurgitation or spitting up. It often happens as
the result of overfeeding or because an air
bubble is swallowed during feeding.
Vomiting, unlike spitting up, is characterized
by the forceful expulsion of the contents of the
stomach. It is a symptom of gastrointestinal
distress and may indicate an illness. Vomiting
can quickly lead to dehydration.
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Feeding Schedule...
Proponents of breastfeeding encourage mothers to
feed their babies on demand, with no schedule
established. It provides baby with comfort as
well as nutrition.
If bottle feeding, whether it is with formula or
expressed breast milk, baby needs
one ounce per hour.
If they drink 4 ounces,
therefore, they can usually wait about 4 hours
before they eat again.
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Propped bottles...
In this busy world today, parents and caregivers
may be tempted to prop babys bottle on a pillow
and go on to other things during feeding time.
Dont do it!
Babies choke more often when bottles are propped.
They also fall asleep with milk in their mouth,
promoting gum disease and tooth decay. Milk runs
down the face and into the ears, causing more ear
infections.
Feeding time is nurturing time, and nurturing
means holding baby close, looking into their
eyes, giving them your attention and tender,
loving care.
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Failure to thrive...
Nurturing is important to growth, development,
and thriving.
A baby that simply receives satisfactory
physical care does not always thrive. The child
might be receiving enough nourishment, but does
not gain weight. The term for this condition is
failure to thrive. It may be indicative of an
illness, or lack of nurturing.
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Introducing baby foods...
Until baby has teeth and is able to chew food
well, they should eat only pureed food.
Pediatricians recommend starting with a bland
rice cereal, followed by oatmeal and then barley
cereals. Vegetables such as peas and carrots
come next, followed by fruits.
There are some foods that should be avoided for
the entire first year, as baby has or easily
develops allergies to them chocolate, citrus
fruits, peanut butter (it also presents a choking
hazard for children under 3), egg whites, honey
(may contain botulism food poisoning), wheat
products, cows milk
When starting baby on solid foods, introduce only
one new food every 3 days. If your baby has an
allergy to this food, you will be able to
pinpoint which food is a problem and avoid it.
Babies do not need a wide variety of foods in
their diet, and very bland foods are flavor-
packed for baby!
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Blue skin tones...

• While the color red is associated with most
  emergencies, with babies it is the color blue.
  Blue skin means
• Baby is very cold this shows up first on
  fingers and toes
• Baby is not getting oxygen this might show up
  first on the lips of the mouth or in the face

If baby displays brief episodes of turning blue
for no apparent reason, consult a physician!
In the event of choking, perform the Heimlich
Maneuver by placing the infant stomach- down
across your forearm. Give 5 thumps on the
infants back with the heel of your hand.
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Yellow skin discoloration...
While yellow skin in newborns is symptomatic of
jaundice, yellow skin tones in an older baby is
probably due to diet. Beta-carotene is the
orange pigment that gives carrots, sweet
potatoes, and other vegetables their
characteristic coloring.
Babies have a taste preference for sweets, and
carrots are one of the sweetest tasting baby
foods. For that reason baby eats larger
quantities of carrots than some other vegetables.
The higher levels of carotene in the diet can
actually turn a babys skin slightly yellow or
orange.
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Milia...
Mila are tiny white papules, actually plugged
sebaceous glands or oil ducts, located over nose,
cheek, and chin. They are caused by stimulation
from the mothers hormones, and will disappear in
a week or two.
Mila are tiny white papules, actually plugged
sebaceous glands or oil ducts, located over nose,
cheek, and chin. They are caused by stimulation
from the mothers hormones, and will disappear in
a week or two.
DO NOT SQUEEZE! Milia are NOT pimples, and
squeezing could result in permanent scarring.
DO NOT SQUEEZE! Milia are NOT pimples, and
squeezing could result in permanent scarring.
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The infant is learning about their new
environment through all 5 senses.especially
through the sense of taste. Everything goes into
the mouth, so it especially important to keep
small items away.
The 5 senses...
Taste Babys taste buds are immature. They
taste sour and bitter, but prefer sweet. They do
not taste salt for several months.
Hearing and smelling Both of these senses are
well developed at the time of birthand probably
have been since the 2nd trimester of prenatal
development.
Feeling/touch By the end of the 8th month of
prenatal development, nearly every part of the
body is sensitive to heat, cold, pressure, and
pain.
Sight Vision is the last of the senses to
develop. At birth, the infant can clearly focus
on objects within a distance of 8 12 inches.
The ability to see color develops over time,
beginning with the brightest and boldest colors.
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Hair care...
While many babies are born with a full head of
hair, others are nearly bald and stay that way
for up to a year.
Hair usually does not need to be shampooed daily
twice a week with a non-tearing product may be
sufficient. Soft baby brushes are available or
regular combs can be used gently.
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Hair loss...
Babies born with hair often lose it during the
first six months of life. This is because hair
alternates between two stages, a growing stage
and a resting stage, and in newborns, all of the
hair follicles enter the resting period at the
same time, causing them to fall out. This hair
loss is thought to be due to the natural drop in
a baby's hormone levels right after birth. (New
moms often lose hair for the same reason.)
A baby may also have bald patches on his scalp
from sleeping in the same position or rubbing his
head against the mattress. This may decrease as
he starts to move around more on his own, or if
you deliberately change the position your baby
sleeps in.Some babies not only lose their hair,
but also when their new hair comes in it's a
completely different color and texture.
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Cradle cap is actually a form of dry skin, often
due to a lack of circulation in the scalp since
babys head rests against mattress surfaces for
prolonged periods. It looks like white to yellow
flaking skin on the scalp. This is not an
infection and is not contagious. To help prevent
this, use a soft brush or a special scalp brush
to brush the scalp vigorously and daily in the
opposite direction the hair grows. To try to
dissolve existing scalp flakes, you can apply
mineral oil to the affected areas and leave it on
about 6 to 8 hours, followed by a thorough
washing and brushing.
Cradle cap...
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Before or shortly after the birth of a baby boy,
the parents make a decision about whether or not
to have him circumcised. A circumcision is the
surgical removal of the prepuce (foreskin) on the
penis.
Circumcision...
Circumcision is a religious requirement for males
in the Jewish and Muslim faiths, and may be
performed by a Rabbi rather than a physician.
Pros and cons to this procedure Pros -
scientific evidence exists that links poor
hygiene of the area under the foreskin to penile
cancer and AIDS secretions on the head of the
adult penis can dry under the foreskin, and if
not cleaned properly can lead to infection some
evidence of fewer urinary tract infections during
1st year of life Cons - removing the foreskin
leaves the head of the penis exposed, possibly
leading to desensitization and in turn to the
lack of sexual sensation and response some
physicians attribute this as a possible cause of
the increasing incidence of adult impotence.
Still others say it is simply mutilation.
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Penis care...
If your child has not been circumcised, his penis
requires no special care. Do not try to pull back
the foreskin of an infant to clean it. If your
child has been circumcised, his penis may be
wrapped in gauze after the operation. Each time
you change his diaper, apply fresh gauze dabbed
in petroleum jelly or other ointment, until the
penis is fully healed. This prevents the area
from sticking to the diaper. The petroleum jelly
also forms a moisture barrier, to keep urine out
of the area. Once the incision has healed (in
about 7-10 days), simply wash the penis with soap
and water.
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Many newborns, both boys and girls, seem to have
swollen breasts or genitals. They may even have a
milky discharge from their nipples. In newborn
girls, there's often a clear or whitish vaginal
discharge, that may be tinged with blood. This is
referred to as a mini-menstrual period. These
features are perfectly normal, and are caused by
mother's female hormones that cross the placenta
just before birth, and are still present in the
babys bloodstream. They will disappear within a
few weeks. In the meantime, don't try to squeeze
any discharge from the breasts, because this can
irritate them or cause infection. The secretion
is referred to as witchs milk
Residual hormones...
Breast enlargement
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Skin care...
The skin of a newborn baby is very sensitive,
particularly on the face and scalp. Applying
lotions or oils to the baby's skin is generally
not recommended because they can clog pores and
cause or aggravate rashes.
If babys skin is very dry, however, and a lotion
is needed, (which is especially true in overdue
babies) you should avoid some product
ingredients. Make sure the lotion contains
1. NO GREASE / OIL 2. NO ARTIFICIAL
COLORS 3. NO ARTIFICIAL ODORS
Keri Lotion is a popular brand of lotion
containing no oil or artificial colors and scents.
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Care of the umbilical stump...
Within about one to three weeks after birth, your
newborn's umbilical stump (where the cord was
attached at the navel) will turn black, dry out
and fall off.
If the stump is very moist, you can use rubbing
alcohol on a cotton swab to wipe around and under
the area one or more times a day. The alcohol
evaporates quickly, and causes drying. The baby
may cry, but it is because the evaporation causes
a cooling effect. It is cold, not burning.
Sponge bathe rather than tub bathe the baby, and
try to keep the diaper below the belly button
until the cord has completely healed.
Call the doctor if the belly button becomes red,
bleeds or smells bad.
The normal belly button is an innie, pulled
inward as the stump dries and falls off.
Outies are caused by a weak or split abdominal
muscle. This often corrects itself by age 2, but
could be repaired if desired for cosmetic reasons
at a later age.
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Your baby's diaper should be very wet about eight
times in 12 hours.
Diaper changes...
If the urine is dark and your baby has not wet
his diapers 6-8 times a day, he may not be
getting enough formula or breast milk.
Baby may have a bowel movement between every
diaper change, or as little as once every day or
so.
Begin and end diaper change by washing hands in
hot, soapy water.
Step 1 Unfasten the diaper Step 2 Use the
diaper to remove excess feces from skin place a
clean cloth or diaper over the genital area on
a boy baby to avoid a warm shower during
wetting Step 3 Hold babys bottom up by
gripping ankles and remove soiled diaper Step 4
Fold the dirty diaper in half, with the unsoiled
half up Step 5 Clean front of genital area with
damp washcloth or baby wipe wipe from front to
back on baby girl to avoid the introduction of
bacteria into vagina (causes infections) Step 6
Lift both of babys legs and clean bottom.
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Step 7 Place top half of diaper under babys
rear and bring bottom half up between legs a
moisture barrier cream can be used on the skin at
this point NO POWDER as it can be inhaled
and/or cause vaginal infections in girls Step 8
Fasten diaper securely

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Using cloth diapers...
Some babies have allergies to the materials in
disposable diapers.
Step 1 Lay diaper flat fold in left 1/3
toward center Step 2 Do the same fold with the
right 1/3 Step 3 Fold up bottom 1/3 this part
goes on the front of a boy and under the bottom
of a girl


When using diapers with pins instead of adhesive
tabs, place two fingers under the diaper fabric
to avoid giving your baby an accidental pinprick.
Insert the pin away from your baby's navel on
each side, and be sure not to push it through all
the layers of the inner fold of diaper, so you
don't stick yourself. (Here's a quick tip If you
stick the pins in a bar of soap first, they'll be
easier to push through the fabric.) Placing
plastic or rubber pants over the diaper during
wear will prevent leaks. Drop excess feces from
soiled diaper into toilet and soak diaper.
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The stools of the average newborn are very soft
and yellow, with little or no offensive odor.
Normal stools...
As soft foods are introduced into the diet, the
color and consistency of the stool changes. It
becomes tan and brown in color and is more formed
(takes shape). The smell becomes unpleasant.
For various reasons baby does not always digest
all the milk they eat. This undigested milk
shows up in the stools in the form of curds (much
like the curds in cottage cheese.
If the stools become filled with curds primarily,
baby may not be getting proper nutrition. This
warrants a call to the doctor.
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Diaper rash is caused by moisture, chafing and
acid in soiled diapers. Frequent diaper changes
may prevent the rash, but most newborns have
diaper rash periodically because their skin is
tender. To treat the rash, try to change the
baby's diaper as soon as it gets wet or soiled.
Apply a protective cream or ointment ,a moisture
barrier, with each diaper change, such as
Desitin, or vaseline... not powder!
Diaper rash...
The diapered area on baby presents perfect
conditions for growing the bacteria that causes
rashes 1. Dark 2. Moist 3. Warm
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Constipation...
Your child is not constipated if his or her
stools are soft and pass easily, even if it has
been a few days since the last bowel movement.
Constipation occurs when stools become hard and
are difficult to pass. It is not unusual for a
baby to turn red and strain while having a bowel
movement even when they are not constipated, so
do not use that as an indicator.
.
Never use artificial laxatives or stool softeners
without the orders of a physician. Babies easily
become dependent on these chemicals.
For natural relief Mix 1 tablespoon dark Karo
syrup in 4 ounces of water and feed from a
bottle.
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Bathing...
Supplies needed Washcloth or two, towel for
drying, large towel to place baby on, mild soap
and shampoo, clothes, diaper, basin or tub or
sink. The room temperature should be at about 75
degrees.
Babies do not cry at bath time because they are
afraid of waterthey developed in the womb in a
bag of water! They cry because they are cold and
feel insecure without a diaper and clothing. Try
placing a warm washcloth over the babys chest.
Bathing every other day is adequate. The
football hold illustrated at the left is
recommended.
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Checking bath water temperature...
Dip your elbow in the water to check the
temperature of babys bath. The water should be
nice and warm, but not hot. Over 4,000 children
a year are scalded in hot bath water.
Liquid crystal temperature displays on bathtub
toys monitor bath water temperatures.
Under no circumstances should baby ever be left
unattended in or around waternot even for just a
minute! Drowning and burns are two of the top
five causes of death in children under the age of
one year.
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The baby's nails may be softer and more pliable
than an adults, but they're sharp, and a newborn,
who has little control over his flailing limbs,
can easily end up scratching his own face. Longer
nails also easily become ingrown, and in turn,
infected. Little fingernails grow so fast you
may have to cut them as often as a few times a
week. Toenails require less-frequent trimming.
Trimming nails...
The best time to trim nails is while he's
sleeping, and after a recent bath when they are
still very soft.. Press the finger pad away from
the nail to avoid nicking the skin, keep a firm
hold on your child's hand as you clip, and cut
straight across. You can use a pair of baby
scissors or clippers made especially for this
purpose. If you do nick the skin at the tip of
the nail, you can expect it to bleed profusely
for quite a long period of time. A band aid is
not appropriate on an infant who sucks on their
fingers, so you simply apply pressure and hold
the area above the heart. It might be easier and
safer to use a nail file.
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Bulb Syringe...
A bulb syringe is used to clean your baby's nose
and mouth of formula or mucus. You may use it
when your baby spits up, has a stuffy nose or
sneezes (this is how he clears his nose).
To use, first squeeze the bulb until it is
collapsed. Place it in one nostril and quickly
release the bulb. This will bring the formula or
mucus into the bulb.
Remove the bulb syringe from the nose and squeeze
the bulb quickly into a tissue to get rid of this
material. Repeat for the other nostril (and
mouth, if necessary).
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Baby's stuffy nose...
Itchy, watery eyes and nose are hallmarks of an
allergy, as are repeated sneezing attacks and
itchy skin that lasts for weeks or months. Also,
the mucus coming out of your child's nose will
continue to run clear. Allergies aren't
associated with fever, and they tend to show up
in the spring, summer, and early fall.
When baby has a cold, they often run a low grade
fever. The mucus from the nose thickens and
turns yellow or green. Colds tend to show up
from December to April.
A common source of the stuffy nose is fabric
softener. In an effort to make all of babys
blankets and clothing soft, it is sometimes
overused. If baby doesnt appear to have a cold
or allergy, try cutting down or out the use of
fabric softeners. In the meantime, use a bulb
syringe to clear the nasal passages.
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Taking baby's temperature...
Baby is fussy and crying. You suspect they may be
sick. An adults internal thermostat is very
sophisticated and will control their temperature
quite well. It doesnt rise too quickly, or too
high easily. For a baby, however, that is not
the case. Any temperature over 99 degrees is
considered a fever, and that temperature can soar
quickly to high numbers.
The time and effort it takes to measure babys
temperature will depend on the type of
thermometer you are using. Thanks to
technological advances, many methods are now
available, some more accurate than others.
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Hand on forehead Touching the forehead is
somewhat reliable for detecting fevers over 102F
(38.9C) but tends to miss mild fevers. It might
simply be used as an indication of when you
should get out a thermometer.
Ear thermometers Many hospitals and medical
offices now take your child's temperature using
an infrared thermometer that reads the
temperature of the eardrum. In general, the
eardrum temperature provides a measurement that
is as accurate as the rectal temperature.
The biggest advantage of this thermometer is that
it measures temperatures in less than 2 seconds.
It also does not require cooperation by the child
and does not cause any discomfort. Ear
thermometers for use at home have been developed,
but they are expensive.
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Plastic strip thermometer These plastic strips
contain a heat-sensitive liquid crystal that
changes color to indicate the temperature. This
method is not very accurate. Place the strip on
the forehead and read it after 1 minute while it
is still in place. That is its true advantage a
strip can be applied and left on the forehead
while the child plays for continual monitoring.
They are inexpensive and disposable.
Digital electronic pacifier thermometers The new
electronic pacifier thermometers have a heat
sensor and are powered by a button battery. These
pacifiers let you measure oral temperature in
younger children. They are quite accurate if
0.5F is added to the digital reading. They take
approximately 3 minutes to reach a steady state.
An added advantage is their low cost.
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Digital electronic thermometers Digital
electronic thermometers measure temperatures with
a heat sensor and require a button battery. They
measure temperatures quickly, usually in less
than 30 seconds. The temperature is displayed in
numbers on a small screen. The same thermometer
can be used to take axillary, rectal, and oral
temperatures. (see slide on glass thermometers
for more instructions) Digital thermometers tend
to be more accurate than glass thermometers.
There are several varieties as pictured here and
some can be purchased for 10 or less.
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Glass thermometers This type of thermometer has
been the standard since 1870. These are the least
expensive thermometers, and are usually filled
with mercury. The mercury in the tube rises when
expanded by an increase in body temperature.
They have two disadvantages they measure
temperatures slowly and are often hard to read.
Glass thermometers come in two forms, oral with
a thin tip and rectal with a rounder tip. This
difference is not too important. If necessary, a
rectal thermometer can be used in the mouth as
long as the thermometer is cleaned with rubbing
alcohol. An oral thermometer can be used in the
rectum if you are extra careful with rectal
insertion. Both are very inexpensive.
The rectal thermometer with the more rounded tip.
The oral thermometer with the more elongated tip.
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To use the glass thermometer, first clean it with
cool, soapy water or rubbing alcohol. Gripping
the end opposite the bulb, shake the thermometer
down until it reads 95 degrees Fahrenheit or
less. You can measure the temperature on three
body locations
Oral Place the thermometer under the tongue and
close the mouth using the lips to hold the
thermometer tightly. The patient must breathe
through the nose. Leave the thermometer in the
mouth for 3 minutes.
Axillary (in the armpit) Place the thermometer
in the armpit, with the arm pressed against the
body for 5 minutes before reading. This is the
least accurate method for using a glass
thermometer. Reads 1 degree lower than actual
temperature!
Rectal For this method, use a rectal
thermometer. This method is recommended for
infants and small children who are not able to
hold a thermometer safely in their mouths.
Lubricate the bulb of the thermometer with a
petroleum jelly. Spread the buttocks, place your
fingers 1 inch from the bulb end, and insert the
bulb end of the thermometer about 1/2 to 1 inch
into the anal canal (or up to your fingers).
Remove the thermometer after 3 minutes. This
method is very accurate! It reads 1 degree
higher than actual temperature!
Read the thermometer by gripping the end opposite
the bulb so that the numbers are facing you. Roll
the thermometer back and forth between your
fingers until you see a silver or red reflection
in the column. Compare the end of the column with
the degree marking in the lines on the
thermometer. Clean and store.
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The Temporal Artery Scanner thermometer is
designed to measure the temperature of the skin
surface over the temporal artery, a major artery
of the head.Completely non-invasive, quick, and
accurate. It continually scans for the highest
temperature. It is the latest technology of
those discussed here, and the most expensive.
With so many choices of thermometers available,
the caregiver or parent must choose a method that
is affordable and meets their needs. A child
that is frequently ill might warrant the purchase
of a more expensive and easily - used product.
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1. Loosen tight clothing
2. Check the nape of babys neck if it is moist
   baby may be too hot remove some clothing and/or
   adjust room thermostat
3. Give fluids
4. Tepid water sponge bath
5. Give recommended dosage of acetaminophen
   (non-aspirin fever reducer/pain reliever) or
   ibuprophen medication

Fever is the body's normal and healthy reaction
to infection and other illnesses, minor and
serious. Fever is a symptom, not a disease. Some
babies run fevers frequently, even in response to
room temperature and too much clothing. Often
the importance of a fever can be determined only
when other symptoms are evaluated.
What to do for baby's fever...
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How high is too high?...
Its time to call a doctor when babys
temperature is too high. Be prepared to tell the
doctor
1. childs age in months 2. the method you used
to take the temperature 3. the actual
thermometer reading 4. what medications or
precautions youve already taken to relieve the
fever.
106 degrees rectal 105 degrees oral
104 degrees axillary
High, prolonged fevers are associated with
encephalitisand infection in the lining of the
brain that causes brain damage.
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Reye Syndrome...
Research has shown an association between the
development of Reye's Syndrome and the use of
aspirin for treating the symptoms of
influenza-like illnesses, chicken pox, colds,
etc. The U.S. Surgeon General, the Food and
Drug Administration, the Centers for Disease
Control and Prevention, and the American Academy
of Pediatrics  recommend that aspirin and
products containing aspirin (salicyate compounds)
not be given to children under 19 years of age
during episodes of fever-causing illnesses.
If your child shows symptoms of nausea, vomiting
or behavioral changes following a viral illness,
contact your doctor immediately Reye's syndrome
is a rare but serious illness that can affect the
blood, liver and brain of children and teenagers.
It can lead to permanent brain damage, and even
coma and death in one out of every 5 cases.
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By definition, colic is when baby cries for 3
hours or more a day, for more than 3 days of a
week.
Colic...
There is no cure for colic. The cause of colic
is debated by experts. Some believe it
accompanies an immature digestive system (they
get a tummy ache after eating), and others
believe it accompanies an immature nervous system
(inability to cope with all the stimuli of their
environment). Nearly 22 of all babies will
suffer from colic.
There is nothing you can do. When you cant take
anymore
The parents of a colicky baby feel frustrated,
isolated, stressed and helpless to do anything.
The condition seems to intensify toward evening
hours. It may last from 3 weeks up to 3 months,
but rarely beyond.
WALK AWAY!
47
Ear infections...
(otitis media)
Frequently caused by a virus and/or bacteria, and
typically occur in the aftermath of a cold.
Because a child's eustachian tube (the tube that
connects the middle ear to the back of the nose)
is very short and very narrow, it plugs up
easily. Moisture is trapped in the inner ear and
not allowed to drain properly. Three-quarters of
children will have at least one ear infection by
the time they reach age three. Ear infections are
not contagious.
Signs and symptoms Fussiness, irritability,
difficulty sleeping (lying down tends to increase
ear pain), difficulty eating (sucking and
swallowing can result in painful pressure changes
in the middle ear and feel like a sore throat),
difficulty hearing (baby stops responding to
certain types of sounds), fluid draining from
baby's ear, tugging or rubbing ears, fever and
cold symptoms. Note Pus coming from baby's ear
indicates that the eardrum has burst and requires
antibiotic treatment
48
Treatment of ear infections
Antibiotics are usually prescribed, but in the
case of repeated infections small plastic
spacer tubes may need to be inserted to hold
open the eustachian tube passageway. As the
child grows, so does the eustachian tube, and the
spacers fall out.

• Statistically, babies that have more frequent ear
  infections are those that
• Are exposed to cigarette smoke
• Have had one or more ear infections in the past
  (particularly if those infections occurred before
  his first birthday)
• Are formula-fed rather than breastfed
• Attend day care
• Were born prematurely or were a low-birthweight
  baby
• Are male
• Use pacifiers (they are a breeding ground for
  germs and encourage a constant sucking motion)

49
Anemia...
The most common type of anemia, especially in
infants and children, is iron-deficiency anemia.
Iron is a dietary mineral needed by the body to
make red blood cells. While white blood cells
are made to fight infection, the red blood cells
are necessary to carry oxygen to cells throughout
the body.
If you dont have enough red blood cells to carry
the oxygen your body needs, you are anemic. The
solution is to increase iron intake, so the body
can make additional red blood cells. Infants can
be given an iron supplement, or if formula-fed,
can be switched to an iron rich formula. Be
aware, iron supplements may cause babys stools
to be black in color!
Look carefully at babys outstretched palm. The
lines in the palm should be nice and pink. If
they are pale, it may be an early indication of
anemia.
50
Leading causes of death...
For children younger than one year of age, the
leading cause of unintentional injury-related
death is suffocation, followed by motor vehicle
occupant injury, choking, drowning, and fire /
burns.
As of April 11, 2002 any person who drives any
motor vehicle in Nebraska is required to ensure
that all children up to their 6th birthday ride
correctly secured in a child restraint system
which meets Federal Motor Vehicle Safety
Standards. Car seat belts are not adequate.
The highest rates of suffocation occur when
babies are in their cribs or sleeping with their
parents.
If an object is small enough to slide through a
toilet paper tube, it presents a choking hazard
to the infant.
Use rear-facing child safety seats for babies
under 1 year old and up to 20 pounds.
51
Sudden Infant Death Syndrome...
A healthy baby is put to bed and is later found
dead for no apparent reason. Sudden Infant Death
Syndrome (SIDS), also known as crib death,
strikes one out of 350 babies between one and six
months old.
What we know SIDS is the leading cause of death
in babies after 1 month of age. (falls under
suffocation category) More SIDS deaths happen in
colder months ( when babies are bundled up with
more blankets and clothing). Babies placed to
sleep on their stomachs are much more likely to
die of SIDS than babies placed on their backs to
sleep. African American babies are 2 times more
likely to die of SIDS than white babies.
To help hold baby in a back-sleeping position,
you can use a blanket. Place baby with his or
her feet at the foot of the crib. The blanket
should reach no higher than the babys chest, and
the ends of the blanket should be tucked under
the crib mattress.
52
Some physicians believe that Sudden Infant Death
Syndrome is associated with a sleep disorder
called sleep apnea. In this condition, the
person goes so soundly asleep and muscles are so
relaxed, that their airway actually closes off.
IF a good gasp reflex is present, they will
gasp and start breathing again. Many hospitals
monitor baby for this reflex before sending them
home after birth.
Parents have a great deal of difficulty facing
the death of any child, but to face the
unexplained death of a healthy and contented baby
sleeping in its crib is almost unbearable.
Couples/marriages are often crippled by blame,
rage, and guilt after the loss of a baby to SIDS.
53
Shaken baby syndrome...
Shaken Baby Syndrome (SBS) is the collection of
signs and symptoms resulting from the violent
shaking of an infant or small child. Frustration
and stress are the reasons some one shakes a
child. A crying child is reported to be the
number one reason why people have shaken a child.
When shaking occurs, the brain bounces within the
skull cavity, bruising the brain tissue. Swelling
and bleeding occur.
It is a potentially fatal form of child abuse.
Approximately 1,200 - 1,400 children are shaken
in America each year, for whom treatment is
sought. Of these, 25 -30 die as a result of
their injuries. The rest have lifelong
complications.
WITH 3 SHAKES, BABY BREAKS! 3 SHAKES IS
ALL IT TAKES! WHEN YOU CANT TAKE IT ANYMORE
WALK AWAY!
54
Some babies are born with a tooth, or get one
within a week or two after birth. These are
rootless, pre-baby teeth, and will fall out when
the baby teeth come in.
Milk tooth...
55
Cleaning baby's gums...
Begin daily mouth-cleaning at birth before teeth
appear. Wipe the roof of mouth and insides of
cheeks with a clean soft damp fabric cloth. Then
use this same cloth, wrapped around your finger,
to brush your babys gums just as it they had
teeth. This cleans and increases circulation in
the gumline. Healthy gumshealthy teeth. When the
first teeth appear, brush them gently with a
small, soft bristled toothbrush. Fluoride
toothpaste is not recommended for children under
age 3.
56
Teething...
Children typically begin to erupt a tooth between
the 6th and 8th month of life. Signs of teething
are drooling, irritability, gum swelling and
sensitivity, sleeping problems, refusing food,
the urge to bite on hard objects and possibly a
low grade fever. The discomfort that results from
teething is due to the pressure exerted on the
tissue in the mouth, called the periodontal
membrane, as the teeth erupt.
The front four (incisors)  teeth are usually the
first to appear. In some cases a bluish swelling
is visible shortly before the new tooth arrives. 
The chewing edge of these teeth may have three
small bumps which normally wear off with use. A
full set of primary teeth (20) is usually in
place by age three.
To relieve babys pain you can provide specially
designed toys for teething including ones to put
in the freezer, topical numbing medications, and
acetaminophen. No wooden objects. No ice cubes.
No toys in the freezer not designed for that
purpose.
57
Diarrhea...
The occurrence of loose, watery stools is called
diarrhea. While some babies have only one loose
stool others have many each day.
Baby's diarrhea may be caused by a
gastrointestinal infection, antibiotics, too much
fruit or juice in the diet, food poisoning, an
allergy to milk sugar (lactose), an enzyme
deficiency, and perhaps even teething due to
extra swallowing of saliva.
The first step in your course of action to treat
diarrhea is to eliminate all milk and milk
products from the diet for 3 days, as the lactose
in milk sometimes irritates the bowel. Babies on
liquid diets may be switched to electrolyte
solutions. Electrolyte drinks contain sodium and
potassium salts and are used to replenish the
body's water and electrolyte levels after
dehydration. Push these fluids.
Electrolyte solutions such as one marketed as
Pedialyte and sports drinks such as Gatorade can
help hydrate baby. They can live on these for 3
days and will like them since they are slightly
sweet.
58
3 day regimen to treat diarrhea...
COMMERICIALLY PREPARED OR HOMEMADE ELECTROLYTE
SOLUTION 2 quarts water 1 teaspoon baking soda
1 teaspoon salt 7 Tablespoons sugar 1 packet
Sugar-Free Kool-Aid 1/2 teaspoon salt substitute
(for potassium)
B.R.A.T. DIET Bananas Rice Cereal Applesauce Toas
t
NO MILK OR MILK PRODUCTS FOR 3 DAYS!
59
Diarrhea itself is NOT life threatening. It
causes dehydration, however, which IS a
life-threatening condition. Dehydration is the
loss of body fluids, needed for survival.
Dehydration...
SYMPTOMS OF DEHYDRATION 1. Dry mouth or thick
saliva 2. Small amounts of dark urine in
diaper 3. Dark circles around eyes 4. Baby may
be fussy, sleepy, not hungry, or difficult to
wake up 5. Skin on back of hand forms a tent
when pinched, and stays pinched up 6.
Fingernails appear to be growing (actually the
skin is shrinking back away from the nail
bed) 7. Soft spot (fontanel) on head sinks in
when baby is held upright or in sitting
position
Diarrhea is very acidic and can cause painful
rashes and skin irritants. Stop using baby wipes
temporarily. Consider swabbing the area with a
liquid antacid (such as Maalox) mixed with
cornstarch to a thin-paste consistency.
60
Cleaning baby's eyes...
Moisten a clean cotton ball with water. Gently
cleanse with a single swipe on each closed eye
from the inner corner to the outer corner. Dirt
or bacteria is easily transferred from one eye to
the other, so repeat the procedure in the second
eye with a clean cotton ball.
Tears are produced by the lacrimal gland located
in the upper outer portion of each eye. Tears
drain down and cascade over the eye, cleaning the
eye. Tears and debris then drain into the tear
ducts and down into the nasal passages located
near the inner portion of each eye. Tears will
accumulate and overflow onto the cheek if there
is an excessive amount of tears produced such as
in emotional crying, or if the duct is blocked.
61
Stimulating tear ducts...
With the invention of contact lenses came a
renewed interest in care of the eyes. Both the
quality and quantity of tears is important.
While cleaning each of babys eyes with a cotton
ball, you should gently massage the upper outer
corner of the eye. This encourages the
production of tears addressing the issue of
quantity.
A gentle massage in a circular motion at the
inner corner of each eye helps keep tear drainage
ducts clear of blockage that may be caused by
excessive crying or a cold.
62
Washing baby clothes...
Avoid washing babys clothes with those from the
rest of the family. Chemicals from adult
deodorants, colognes, hair sprays, etc. could
transfer to babys clothes in the washing process.

1. Use soap, not detergent. There are several brands
   available. Detergent can leave a harsh residue
   and can remove the fire-retardant that is used on
   baby clothing.
2. Rinse twice, to make sure all soap residue is
   removed. It can cause rashes.
3. Wash diapers separately.
4. Use oxygen bleaches, not chlorine bleach.
5. Avoid the use of fabric softener.

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INFANT CARE TECHNIQUES
THE END