A Doula's Guide to Newborn Care Basics
We love talking all about babies! One of our specialties is offering education surrounding newborn care. We do this in our postpartum doula training, in our group classes for expectant parents, and, organically and as needed, during 1:1 postpartum visits. This blog is an introduction to our top newborn care topics for postpartum doulas and aspiring postpartum doulas. We hope that it serves as an educational resource for you as you build your doula toolkit.
Each doula comes to our training with unique prior experience. For some of you, parts of this information may be old news, while for others this is all a whole new world. However you are arriving here, we hope that the resources we offer here can help you deepen your understanding of newborn care. These skills will come into handy while you are caring for baby during a postpartum shift, as well as in the education you provide for the families you are working with.
Newborn Care Basics
Diapering
The first step in diapering is preparing supplies. This includes a fresh diaper (or two), wipes, cream, and potentially a new outfit if baby had a blowout. As baby gets older, you may also need a distraction, such as a lovey or toy or song to help baby stay still during the change. What To Expect has a detailed guide that walks you through diaper changes. A few tips we like to point out include:
Help the family make a few diaper-changing stations in their home, especially during early postpartum.
On disposable diapers, the tabs start in the back.
If baby still has the stub of their umbilical cord, fold the top of the diaper down so it doesn’t cover the belly button.
Wipe from front to back.
For babies with penises, keep the genital area covered in case they start to pee.
Keep hand sanitizer at each station for easy use before and after changes.
Resources:
Swaddling
This video offers a great demo of safe hip swaddling, which is really important for babies under the age of six months. The Bump offers visuals that can be helpful as well. The goal is a secure wrap that helps baby feel snuggled and cozy (like they were in the womb). However, it’s important to ensure that baby has range of motion in their legs and hips, which helps prevent hip dysplasia.
Resources:
Feeding
As doulas, we are here to uplift each individual family’s feeding goals and needs. This can range from exclusive breastfeeding to exclusive pumping to triple feeding to exclusive formula feeding. The first important piece of information is to know that newborns need to eat every 2-3 hours or whenever they ask for the first several days of life. Then, baby should be eating ~8 feeds per day for the first three months.
Recognizing hunger cues is an important parenting skill. These include:
Licking lips
Sticking tongue out
Rooting
Hand to mouth repeatedly or sucking on things
Opening mouth or lip-smacking
Fussiness
Resources:
Soothing Baby
When (not if) baby is communicating by crying, there are a few steps you can follow to help them soothe and regulate. First, start with the basics: Does baby need a diaper change? Is it time to eat? And/or comfort feed? Does baby need to burp?
If baby is still not settled, other ideas for soothing them include the following: 1. Movement: rock baby or repurpose a birth ball; match your rhythm and pace to the intensity of baby's cries. 2. Noise: White noise via a machine, Spotify, shushing, etc. or try music! Sometimes dancing and singing does the trick, as you hit #1 and #2 at once. 3. Snuggle: A parent may try skin to skin or perhaps a swaddle. 4. Help with gas: Baby may benefit from some gentle abdominal massage, gas drops, or doing the bicycle. (By the way, some amount of gas is to be expected and is totally normal for a newborn.)
The 5 S’s, as branded by Harvey Karp is another shortlist of ideas to try. They are: Swaddle, Swing (or bounce), Side-lying (only for soothing, not for sleep), Sucking, and Shushing.
Resources:
Harvy Karp’s Happiest Baby on the Block video
Sleep
Studies about sleep rhythms are based on age. If the baby was born premature, then the family should use their estimated due date (EDD) to correctly figure out age. This is important to keep in mind when trying to determine what type of schedule the baby needs.
From newborn to eight weeks, these are some key ideas to know:
There is no sleep pattern and sleep happens when it does.
Parents cannot really influence sleep at this age.
Babies may be fussy in the late afternoon.
Many babies often experience day and night confusion.
That said, we encourage parents to work on sleep routines, which doulas can help initiate and model. Keep routines simple, predictable, and calming. This may include steps like swaddling, dimming lights, reading a book, and then rocking for a bit.
Resources:
Bathing
The World Health Organization (WHO) recommends delaying baby's first bath until 24 hours after birth, unless this is unacceptable for cultural reasons. Some people like to have baby bathed before they leave the hospital (if that’s where they birthed) while others prefer to wait days or weeks. This guide from healthychildren.org has a lot of helpful information about why families often delay baths, as well as how to bathe a baby. Families you are supporting may ask for assistance with their first few baths, so this is great information to have.
These are some of the crucial ideas we like to highlight:
You may stick to sponge baths until the umbilical cord is healed; although this is an American protocol, so know that many other folks skip this step.
Don’t bathe baby daily.
Use a cup to gently pour water on baby’s body.
Use an infant-safe tub. (Many have inserts or conversions that make newborns more secure until they get bigger.)
Place the infant tub on a taller surface like a kitchen counter so you don’t have to bend over.
Use soap in a pump, although use it sparingly, especially for the baby’s first few months of life.
Check the water temperature with the inner part of your wrist.
Know that it’s normal if baby is not enjoying their first baths (aka crying).
Resources:
Join Us for Postpartum Doula Training
ABG offers both online (self-paced) and in-person trainings for folks who are interested in becoming postpartum doulas. We’d love to be a part of your journey in offering crucial care and education to postpartum families. Learn more and sign up here!