1. INFANT CARE TECHNIQUES

2. How should baby be held?...
The baby’s head is large in proportion to the rest of its body. Because the baby’s 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, baby’s head could fall back, causing a case of whiplash!
This traditional cradle hold uses both arms of the caregiver, and supports both baby’s neck and back.

3. 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.

4. Sleeping habits... AGE SLEEP REQUIRED 1 week old
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.

5. 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.

6. 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 tepid…not 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.

7. 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.

8. 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.

9. 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.

10. Propped bottles...
In this busy world today, parents and caregivers may be tempted to prop baby’s bottle on a pillow and go on to other things during feeding time. Don’t 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.

11. Nurturing is important to growth, development, and thriving.
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.

12. 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, cow’s 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!

13. 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 infant’s back with the heel of your hand.

14. 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 baby’s skin slightly yellow or orange.

15. Milia... DO NOT SQUEEZE! DO NOT SQUEEZE!
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 mother’s 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 mother’s 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.

16. 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: Baby’s 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 birth…and 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.

17. 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.

18. 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.

19. Cradle cap is actually a form of dry skin, often due to a lack of circulation in the scalp since baby’s 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...

20. 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.

21. 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.

22. 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 baby’s 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 “witch’s milk”
Residual hormones...
Breast enlargement

23. Skin care... 2. NO ARTIFICIAL COLORS 3. NO ARTIFICIAL ODORS
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 baby’s 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.

24. 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.

25. Begin and end diaper change by washing hands in hot, soapy water.
Diaper changes...
Your baby's diaper should be very wet about eight times in 12 hours.
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 baby’s 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 baby’s legs and clean bottom.

26. Step 7: Place top half of diaper under baby’s 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

27. 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.

28. 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.

29. Diaper rash is caused by moisture, chafing and acid in soiled diapers
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 Moist Warm

30. 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.

31. 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 water…they 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 baby’s chest. Bathing every other day is adequate. The “football hold” illustrated at the left is recommended.

32. Checking bath water temperature...
Dip your elbow in the water to check the temperature of baby’s 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 water…not 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.

33. 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.

34. 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).

35. 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 baby’s blankets and clothing soft, it is sometimes overused. If baby doesn’t 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.

36. Taking baby's temperature...
Baby is fussy and crying. You suspect they may be sick. An adult’s internal “thermostat” is very sophisticated and will control their temperature quite well. It doesn’t 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 baby’s 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.

37. Hand on forehead: Touching the forehead is somewhat reliable for detecting fevers over 102°F (38.9°C) 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.

38. Digital electronic pacifier thermometers
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 it’s 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 0.5°F is added to the digital reading. They take approximately 3 minutes to reach a steady state. An added advantage is their low cost.

39. 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.

40. Glass thermometers: This type of thermometer has been the standard since 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.

41. 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.

42. 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.

43. What to do for baby's fever...
Loosen tight clothing
Check the nape of baby’s neck; if it is moist baby may be too hot; remove some clothing and/or adjust room thermostat
Give fluids
Tepid water sponge bath
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...

44. How high is too high?... 106 degrees rectal 105 degrees oral
It’s time to call a doctor when baby’s temperature is too high. Be prepared to tell the doctor:
1. child’s age in months
2. the method you used to take the temperature
3. the actual thermometer reading
4. what medications or precautions you’ve already taken to relieve the fever.
106 degrees rectal
105 degrees oral
104 degrees axillary
High, prolonged fevers are associated with encephalitis…and infection in the lining of the brain that causes brain damage.

45. 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.

46. By definition, colic is when baby cries for 3 hours or more a day, for more than 3 days of a week.
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 can’t 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 don’t 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 baby’s stools to be black in color!
Look carefully at baby’s 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 baby’s 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 it’s crib is almost unbearable.
Couples/marriages are often crippled by blame, rage, and guilt after the loss of a baby to SIDS.

53. WHEN YOU CAN’T TAKE IT ANYMORE… WALK AWAY!
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, ,400 children are shaken in America each year, for whom treatment is sought. Of these, % 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 CAN’T 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 baby’s gums just as it they had teeth. This cleans and increases circulation in the gumline. Healthy gums…healthy 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 baby’s 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
Toast
NO MILK OR MILK PRODUCTS FOR 3 DAYS!

59. Diarrhea itself is NOT life threatening
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 baby’s 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 baby’s clothes with those from the rest of the family. Chemicals from adult deodorants, colognes, hair sprays, etc. could transfer to baby’s clothes in the washing process.
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.
Rinse twice, to make sure all soap residue is removed. It can cause rashes.
Wash diapers separately.
Use oxygen bleaches, not chlorine bleach.
Avoid the use of fabric softener.

63. INFANT CARE TECHNIQUES
THE END