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5 Big New-Mom Decisions

The foggy first weeks of motherhood are full of joy -- and confusion! Omaha pediatrician Laura Jana, M.D., coauthor of Heading Home With Your Newborn, helps you sort it all out. Relax and read on.

1. STUMP SOLUTIONS

Cleaning the umbilical-cord site used to mean applying rubbing alcohol at each diaper change. Fortunately, that's no longer necessary (so don't listen to grandma!). Recent research has shown that doing nothing is perfectly fine. The stump will fall off just as fast, usually in seven to ten days; there's also a smaller chance of infection with dry cord care. To reduce chafing, turn down the top part of your baby's diaper or use ones made with a cutout to accommodate the stump. And be sure to call your pediatrician if you notice any signs of infection, such as pus, odor, or a ring of redness around the stump. When it does drop off, wash the area with some baby cleanser. If there's any bleeding, dab a small amount of rubbing alcohol or antibiotic ointment on the site.

2. CIRCUMCISION CARE

If you opted to have this procedure done, you'll need to keep the penis clean while it heals. Apply a bit of petroleum jelly on the tip each time you change your little guy to prevent the circumcision site from sticking to his diaper. His penis will be red and you may see yellowish secretions (both are normal); it'll heal in about a week. If it takes longer, or you notice swelling, sores, or bleeding, call your pediatrician. Skipped circumcision? Your only task is to keep the tip of his penis and the foreskin ridge clean (but don't attempt to pull the foreskin back farther than it will easily go -- it'll retract on its own eventually).

3. JAUNDICE WATCH

This condition can cause high anxiety the first week at home. If you start seeing yellow -- that is, a yellowish tinge to your baby's skin and the whites of her eyes (regardless of race) -- you're not alone: Jaundice occurs in at least 50 percent of all new-borns, and though most cases are mild and quickly resolved, it can be serious if left untreated. What's happening: An excess of bilirubin has built up in your baby's body, thanks to her immature liver and digestive tract. Bilirubin is a normal product that occurs when old red blood cells break down and pass through the liver, intestines, and then out into your baby's diaper.

Most cases of jaundice peak three to five days after birth (preemies may peak a few days later) and go away on their own, with the help of those 24/7 feedings you'll be doing and your bambina's subsequent poopings; both will help the bilirubin to pass through her system. Here's how to check for it: Gently press down on your newborn's skin, then look to see if there's a yellowish tint on the spot underneath.

Your pediatrician will want to evaluate your baby if you see signs of jaundice. A simple blood stick, drawn from the heel, can determine her bilirubin levels; if they're on the high side, the doctor may recommend placing your baby under phototherapy lights to help break down the bilirubin. Discuss a plan of action with your physician, who will want to keep tabs on your baby's levels for the next few days.

4. BATHTIME

Splashing in the water will become one of the best times of the day -- after the cord stump falls off. Until then, give her a sponge bath, focusing on her diaper area, of course, as well as behind her ears and in the folds of fat around her neck where milk and drool collect, notes Dr. Jana. When it's time for a bath in an infant tub or the sink, follow these steps:

Line it up

Gather your supplies -- a little tub, a hooded towel, washcloths, baby soap, a dish of warm water, cotton balls, a diaper, and her clothes -- so you don't have to leave your babe alone in the bath, even for a second. It also helps to have an extra pair of hands at first -- wet babies are slippery, and you will no doubt be nervous!

Add padding

Line the tub with a washcloth or hand towel to make a comfy, nonslip spot, and then fill it with a few inches of warm water.

Provide child support

Prop up her head and neck with one hand and wash her with the other. Start with the face (ears, cheeks, eyelids), using the cotton balls dipped in the dish of water only; then take a washcloth with a little baby cleanser to her neck, belly, arms, and legs. Save the diaper area for the end.

Love those locks

Shampoo her tiny head last, so she doesn't get too cold. Wrap her up well and try to keep her covered up as you apply a moisturizer.

5. SKIN CARE

A luscious complexion is in your sweetie's future -- right after she gets over a few blemishes. These skin conditions are very common and, fortunately, very temporary:

Cradle cap

Flaky yellowish patches on the scalp, forehead, and behind the ears are the hallmarks of cradle cap (known medically as seborrheic dermatitis). Most cases resolve on their own, but you can speed things along by applying a little olive or baby oil to her scalp, then brushing off the scales gently with a soft-bristled baby brush or toothbrush. It's also fine to use a bit of dandruff shampoo (being careful not to get it in your baby's eyes); some doctors consider this approach to be most effective. Again, brush the scales away after shampooing.

Infant acne

You can thank your hormones for these premature pimples -- tiny white or yellow dots with a red base may be seen on her face, back, chest, or belly. Lotions and ointments may exacerbate the problem, so just wait for it to pass in a few weeks.

Milia and miliaria

Milia are little white spots seen on the forehead, nose, and cheeks; miliaria are similar -- a slightly bumpy rash of white, fluid-filled blisters. These breakouts are due to secretions from your baby's immature oil glands; just keep them clean and they'll clear in a few weeks.

Erythema toxicum

They sound scary, but there's nothing dangerous about these red splotches with yellowish-white bumps in the center (think bug bites). They usually erupt soon after birth, then disappear on their own in a week or so. Meanwhile, don't poke, prod, or try to pop them.

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