Registering the Birth

The baby's birth must be registered within six weeks from the date of birth at the nearest registry office. The address will be in the telephone book under the name of your local authority. Also, look under 'Registration of birth, deaths and marriages'. If you are married, you or the father can register the birth. If you are not married, you must go yourself, and if you want the fathers name to appear on the birth certificate he must go with you.

If you live in a different district from the one where your baby was born, the registrar will take details from you and then send them to the district where the birth took place. You will then be sent the birth certificate. You cannot claim benefits or register your baby with a doctor until you have a birth certificate and a National Health Service number which will be issued at the same time.

Crying

All babies cry. It's their way of saying that something isn't right. Sometimes you'll be able to find the reason for your baby's distress and deal with it. At other times all you can do is try to comfort or distract your baby. If it's not obvious why your baby is crying, think of possible reasons. Could it be:

• hunger?
• wet or dirty nappy?
• wind?
• colic?
• feeling hot, cold or uncomfortable?
• feeling tired and unable to sleep?
• feeling lonely and wanting company?
• feeling bored and wanting to play?

It could be none of these things. Perhaps your baby simply feels overwhelmed and a bit frightened by all the new sights, sounds and sensations in the early weeks of life and needs time to adjust. Holding your baby close and talking in a soothing voice or singing softly will be reassuring.

Movement often helps to calm down crying. Gently sway or rock your baby or take your baby for a walk in the pram or baby carrier or even for a ride in a car. Sucking can also be comforting. You can put your baby to your breast or give your baby a dummy if you wish. But if you do, make sure it is sterilised.

Do not dip the dummy in honey or sugar to make your baby suck - he or she will suck anyway. Using sugar will only encourage a craving for sweet things which are harmful to children's teeth.

Some babies do cry more than others and it's not really clear why. Don't blame yourself or your baby if he or she cries a lot. It can be very exhausting so try to get rest when you can. Share soothing your baby with your partner. You could ask a friend or relative to take over for an hour from time to time, just to give you a break. If there's no one to turn to and you feel your patience is running out, leave your baby in the cot, put on some music to drown the noise, and go into another room for a few minutes. Make yourself a cup of tea, telephone a friend or find some other way to unwind. You'll cope better if you do.

Never shake your baby. Shaking makes a baby's head move violently. It can cause bleeding and damage the brain. Put the baby down safely in a cot or pram and calm yourself; don't be angry with the baby. If you feel you're having difficulties in coping with your baby's crying, talk to your midwife or health visitor. Or contact CRY-SIS, who will put you in touch with other parents who've been in the same situation.

If your baby's crying sounds different or unusual, it may be the first sign of illness, particularly if the baby isn't feeding well or won't be comforted. If you think your baby is ill, contact your doctor immediately. In an emergency, if you cannot contact your doctor, take your baby to the nearest hospital Accident and Emergency Department.

 

Sleeping

The amount babies sleep, even when they are very small, varies a lot. During the early weeks some babies sleep for most of the time between feeds. Others will be wide awake. As they grow older they begin to develop a pattern of waking and sleeping which changes as time goes by. Some babies need more sleep than others and at different times.

You'll gradually begin to recognise when your baby is ready for sleep and is likely to settle. Some babies settle better after a warm bath. Most sleep after a good feed. A baby who wants to sleep isn't likely to be disturbed by ordinary household noises, so there's no need to keep your whole home quiet while your baby sleeps. It will help you if your baby can get used to sleeping through a certain amount of noise.

See below for advice on sleeping positions.

Reducing the risk of Cot Death

Sadly, we don't yet know why some babies die suddenly and for no apparent reason from what is called cot death or Sudden Infant Death Syndrome (SIDS). This section lists, in detail, all the advice we now have for reducing the risk of cot death as well as other dangers such as suffocation. There are three ways in which you can reduce the risk:

• always put babies to sleep on their backs;
• avoid dressing your baby too warmly or overheating the room;
• do not smoke or allow others to smoke near your baby or the room your baby sleeps in.

A safe place to sleep

Babies should always be put to sleep on their backs unless there is clear medical advice to do something different. Babies sleeping on their backs are not more likely to choke, and the risk of cot death is greatly increased for babies sleeping on their fronts. Keep your baby's head uncovered and place your baby in the 'feet to foot' position to prevent your baby wriggling under the covers. Make the cot so that the covers reach no higher than your baby's shoulders.

Ask your doctor or midwife for the leaflet, "Reduce the risk of cot death, published by the Department of Health and Foundation for Study of Infant Death (FSID)".

The right temperature

Small babies are not very good at controlling their own temperature. It's just as important to avoid getting too hot as it is to avoid getting chilled. Overheating is known to be a factor in cot death. Remember:

• if the room is warm enough for you to be comfortable wearing light clothing (16-20°C) then it is the right temperature for your baby;
• give your baby one light layer of clothing (or bedding) more than you are wearing. If the room is too hot for you, keep your baby's clothes or bed-covering light;
• don't use duvets (quilts) until your baby is a year old - they get too hot;
• keep your baby's head uncovered when inside (unless it's very cold) as babies need to lose heat from their heads and faces;
• never use a hot water bottle or electric blanket as babies have delicate skin which can scald easily;
• ill or feverish babies do not need any extra bedding - in fact, they usually need less;
• there has been some advice suggesting that it is unwise to have your baby in bed with you - there is no clear evidence of risk, but it would be wise not to have your baby in your bed if you have been drinking alcohol or have taken drugs which can cause drowsiness, and to be careful not to get the baby too hot;
• babies chill easily if it's cold, so wrap them up well when you go out, but remember to take off the extra clothing when you come back inside, even if you have to wake your baby to do it;
• avoid plastic sheets or bumpers, ribbons and bits of string from mobiles anywhere near your baby, who could get entangled in them;
• make sure there's no gap between the cot mattress and the sides of the cot which your baby's body could slip through;
• remove any loose plastic covering from the mattress which could come off and smother your baby.

Clean air

Babies should not be exposed to tobacco smoke, either before birth or afterwards. If you, or anyone else who looks after your baby, smoke then don't smoke anywhere near the baby. Ask friends to smoke outside or before visiting you. It would be even better if everyone could make an effort to give up completely. Babies and young children who breathe in cigarette smoke are also more likely to get coughs, asthma and chest infections. For more advice on giving up smoking, look here.

Cot mattresses

There have been suggestions that toxic gases from fire-retardant materials found in some cot mattresses are another potential cause of cot death. However, a recent report examining this link found no evidence that cot mattresses contribute to cot death.

Following the advice given above will help to reduce the risk of cot death.

If your baby seems at all unwell, seek medical advice early and quickly.

Do remember that cot death is rare. Don't let worrying about cot death spoil the first precious months you have with your baby.

Nappies

Babies need their nappies changed fairly often, otherwise they become sore. Unless your baby is sleeping peacefully, always change a wet or dirty nappy and change your baby before or after each feed, whichever you prefer.

Organise the place where you change your baby so that everything you need is handy (more information here). If you're using terry nappies, your midwife or your friends can show you different ways of folding them. Experiment to find out which method is easiest and best for you.

Changing nappies

You need to clean your baby's bottom carefully each time you change a nappy to help prevent soreness.

• Take off the nappy. If it's dirty, wipe away the mess from your baby's bottom with tissues or cotton wool.
• Wash your baby's bottom and genitals with cotton wool and warm water and dry thoroughly. Or use baby lotion. For girls, wipe the bottom from front to back, away from the vagina so that germs won't infect the vagina or bladder. For boys, gently clean the foreskin of the penis, but don't pull it back; clean under the penis and the scrotum.
• You may want to use a cream such as zinc and castor oil cream which forms a waterproof coating to help protect the skin. Or you can just leave the skin clean and dry, especially with disposable nappies since cream may prevent them absorbing urine so well.
• Don't use baby powder as it can cause choking.
• If you're using a terry nappy, fold it and put a nappy liner inside, if you wish. Pin the corners of the nappy together with a proper nappy pin or clip which won't spring open.
• If you use disposable nappies, be very careful not to get cream on the tabs or they won't stick down.
• Put on, or tie on, the plastic pants, if you're using a terrynappy.
• Wash your hands.

Nappy hygiene

Disposable nappies

• If the nappy is dirty, flush the contents down the toilet. Roll up the nappy and re-tape it securely. Put it into a plastic bag kept only for this purpose. Fasten the bag and put it outside in your bin each day.

Terry nappies

• If the nappy is dirty, flush the contents down the toilet and rinse off the nappy in the flushing water.
• Have a plastic bucket (with a lid) ready filled with water and the right amount of nappy sanitising powder. Follow the instructions on the packet. Make sure you keep the nappy powder out of reach of small children.
• Put the dirty nappy to soak in the bucket.
• Wash each day's nappies in very hot water. Don't use enzyme(bio) washing powders as these may irritate your baby's skin. Rinse very thoroughly. Don't use fabric conditioners as they may also irritate the skin.

Nappy rash

Most babies get soreness or a nappy rash at some time, but some have extra sensitive skins. If you notice redness or spots, clean your baby very carefully and change nappies more frequently. Better still, give your baby time without a nappy and let the air get to the skin (keep a spare nappy handy to mop up).

You will soon see the rash start to get better.

If your baby does have a rash, ask your midwife or health visitor about it. They may advise you to use a protective cream. If the rash seems to be painful and won't go away, see your health visitor or GP.

 

Babies' stools

Immediately after birth, and for the first few days, your baby is likely to pass a sticky black-green substance. This is called meconium and it is the waste that has collected in the bowels during the time spent in the womb. As your baby begins to digest milk, the stools will change, probably becoming more yellow or orange. The colours can be quite bright. Breastfed babies have quite runny stools. Bottle-fed babies' stools are firmer and smell more.

Babies vary a lot in how often they pass stools. Some have a bowel movement at or around each feed; some can go for several days without having a movement. Either can be normal.

Most small babies strain and go red in the face, or even cry, when passing a stool. This is normal and doesn't mean they are constipated so long as the stools are soft. If you are worried that your baby may be constipated, mention this to your midwife or health visitor.

What you find in your baby's nappies will probably vary from day to day and usually there is no need to worry about how runny the stools are, for example. But if you notice a marked change of any kind in your baby's bowel movements, such as the stools becoming very frequent and watery or particularly smelly or if they change colour to become green, white or creamy, for example, then you should get advice from your doctor, midwife or health visitor. See Babies with jaundice after two weeks).

Washing and Bathing

You don't need to bath your baby every day but you should wash your baby's face, neck, hands and bottom carefully each day. You can do this on your lap or on a changing mat. Choose a time when your baby is awake and contented and make sure the room is warm. You'll need a bowl of warm water, some cotton wool, a towel and a fresh nappy.

1. Take off your baby's clothes except for the vest and nappy. Wrap the baby in a towel.
2. Gently wipe round each eye, from the nose side outwards, using a fresh piece of cotton wool for each eye.
3. Using fresh, moist cotton wool again, wipe out each ear but don't clean inside the ears.
4. Wash the rest of your baby's face and neck with moist cotton wool and gently dry. Wash and dry your baby's hands in the same way.
5. Take off the nappy and wash your baby's genitals, again with cotton wool and warm water. Dry very carefully and put on a fresh nappy. In the first week or so, you should also clean round the navel each day. Your midwife will show you how.

Bathing

Bath your baby two or three times a week, or more often if your baby enjoys it. Don't bath straight after a feed or when your baby is hungry or sleepy. Make sure the room is warm and that you have everything you need ready in advance.

1. Check that the water is not too hot, just comfortably warm to your wrist or elbow.
2. Undress your baby, except for a nappy, and wrap snugly in a towel. Wash your baby's face with cotton wool and water as described above. Don't use soap on your baby's face.
3. Wash your baby's hair with baby soap or liquid, supporting the head over the baby bath or basin. Rinse carefully.
4. If you're using baby soap, unwrap your baby and soap all over, still on your lap so you have a firm grip. Take the nappy off at the last minute. If you're using baby bath liquid add it to the water at this stage.
5. Put your baby gently into the water. Using one hand for support, gently swish the water to wash your baby without splashing the face. You should never leave your baby alone in the water even for a few seconds.
6L . ift your baby out and pat dry with the towel. Dry carefully in all the creases. If your baby's skin is dry, gently massage in some baby oil. Your baby may enjoy this anyway.

Never leave your baby alone in the bath.

If your baby seems frightened of the bath and cries, it may help to try bathing together. You may like to do this anyway. Make sure the water is only warm, not hot, and don't add anything to the water unless it's baby bath liquid.

Sunshine

In warm, sunny weather, always protect your baby from direct sunlight with a sunhat or sunshade. Never leave your baby in a place where he or she could become overheated.

Remember too that a baby's skin burns easily, even in sun that would not affect your own. Use a high protection sunblock (at least protection factor 15+) to help protect your baby's skin from the sun.

Illness

It's sometimes difficult to tell at first when a baby is ill but you may have a funny feeling that things aren't quite right. If you're at all worried, ask for help. You are not fussing. It's far better to be on the safe side, particularly with a very small baby. Trust your own judgement. You know your baby best.

Very urgent problems

Sometimes there are more obvious signs that your baby is not well. Contact your doctor at once if your baby:

• makes jerky movements - this is a fit or convulsion;
• turns blue or very pale;
• has quick, difficult or grunting breathing, or unusual periods of breathing, for example if your baby breathes with pauses of over 20 seconds between breaths;
• is very hard to wake, or unusually drowsy, or doesn't seem to know you;
• develops a rash of red spots which do not fade and lose colour (blanch) when they are pressed. (See the 'Glass Test'.) This may be the rash of meningococcal septicaemia - an infection in the blood. There may not be any other symptoms.

Your baby may need treatment very quickly. If you can't get hold of your GP at once, dial 999 for an ambulance or take your baby to the Accident and Emergency Department of your nearest hospital as quickly as possible.

Problems that could be serious

• If your baby has a hoarse cough with noisy breathing, is wheezing, or cannot breathe through the nose.
• If your baby is unusually hot, cold or floppy.
• If your baby cries in an unusual way or for an unusually long time or seems to be in pain.
• If you notice any bleeding from the stump of the cord or from the nose, or any bruising.
• If your baby keeps refusing feeds.
• If your baby keeps vomiting a substantial part of feeds or has frequent watery diarrhoea. Vomiting and diarrhoea together may mean your baby is losing too much fluid and this may need prompt treatment.
• If your baby develops jaundice (looks yellow) when he or she is over a week old, or has jaundice which continues for over two weeks after birth.

If you have seen your GP and your baby is not getting better or seems to be getting worse, tell your GP again the same day. If you become very worried and can't get hold of your GP or your GP can't get to you quickly enough, dial 999 for an ambulance or take your baby to the Accident and Emergency Department of the nearest hospital.

 

Where to get advice

Everyone needs advice or reassurance at some time or other when they are caring for a young baby, even if it's just to make sure that they are doing the right thing. Some problems just need talking over with someone. It's always better to ask for help than worry on your own. Do talk to your midwife or health visitor. As you grow more confident, you'll begin to trust your own judgement more. You will be able to decide which advice makes most sense for you and your baby and which suggestions you can safely ignore.

You will also want to talk to friends, relations or other mothers in a similar situation. You'll meet other mothers when you start taking your baby to the Child Health Clinic. Your health visitor will explain where this is and when you should go. The health visitor can also tell you about any mother and baby groups in the area. Or your local branch of the National Childbirth Trust or MAMA (Meet-A-MumAssociation) may be able to put you in touch with other mothers nearby.

Enjoying your baby

So far we have only talked about the things that have to be done to keep your baby warm, fed and safe. In the first weeks those things can grow to fill all the available time, but of course they're only a tiny part of what it means to be a parent. Every second that your baby is awake he or she is learning from you. Learning about what it feels like to be touched gently, about the sound of your voice and your very special smell, about what the world is like and whether it is a safe place to be and, above all, what it feels like to love and be loved.