What to Expect the First Year (51 page)

“I'm not sure how many layers I need to put on my baby when I go out with him.”

Once a baby's natural thermostat is properly set (within the first few days of life), he doesn't need to be dressed any more warmly than you dress yourself. So, in general (unless you're the type of person who's always warmer or colder than everyone else), choose clothing for him that's smaller and cuter, but not heavier, than what you're wearing. If you're comfy in a t-shirt, your baby will be, too. If you're chilly enough for a sweater, your baby will need one as well. Jacket for you? Jacket for your baby.

Still unsure if you've bundled your little bundle just right? Don't check his hands for confirmation. A baby's hands
and feet are usually cooler than the rest of his body, because of his immature circulatory system. You'll get a more accurate reading of his comfort by checking the nape of his neck or his arms or trunk (whichever is easiest to reach under his clothing) with the back of your hand. Too cool? Add a layer. Too warm? Peel one off. If he seems extremely cold to the touch, or dangerously overheated,
click here
.

Don't take the fact that your baby sneezes a few times to mean he's cold either—he may sneeze in reaction to sunlight or because he needs to clear his nose. But do listen to your baby. Babies will usually tell you that they're too cold (the same way they tell you most everything else) by fussing or crying. When you get this message (or if you're just not sure whether you've dressed him appropriately), run that temperature check with your hand and adjust as needed.

The one part of a baby that needs extra protection in all kinds of weather is his head—partly because a lot of heat is lost from an uncovered head (especially a baby's head, which is disproportionately large for his body), and partly because many babies don't have much protection in the way of hair. On even marginally cool days, a hat is a good idea for a baby under a year old. In hot, sunny weather, a hat with a brim will protect baby's head, face, and eyes—but even with this protection (plus sunscreen), exposure to full sun should be brief.

A young baby also needs extra protection from heat loss when he's sleeping. In deep sleep, his heat-producing mechanism slows down, so in cooler weather, bring along an extra blanket or covering for his daytime nap in the stroller. If he sleeps in a cool room at night, a toasty blanket sleeper or sleep sack will help him stay warm (quilts and comforters are unsafe coverings for a sleeping baby). Don't, however, put a hat on baby when you put him to sleep indoors, since it could lead to overheating. Ditto for overbundling, particularly when baby is sleeping (do the nape of the neck check again).

When it comes to dressing baby in cold weather, the layered look is not only fashionable, it's sensible. Several light layers of clothing retain body heat more efficiently than one heavy layer, and the outer layers can be peeled off as needed when you walk into an overheated store or board a stuffy bus, or if the weather takes a sudden turn for the warmer.

“Everybody wants to touch our son—the cashier at the pharmacy, perfect strangers in the elevator, random people in line at the ATM. I'm always worried about germs.”

There's nothing that cries out to be squeezed more than a new baby. Baby cheeks, fingers, chins, toes—they're all irresistible. And yet resist is just what you'd like others (especially others who are strangers) to do when it comes to your newborn.

Understandably you're touchy about all that uninvited touching—and legitimately concerned about your baby being on the receiving end of so many germs. After all, a very young infant is more susceptible to infection because his immune system is still relatively immature and he hasn't had a chance to build up immunities. So, for now at least, politely ask strangers to look but not to touch—particularly when it comes to baby's hands, which usually end up in his mouth. You can always blame it on the doctor: “The pediatrician said not to let anyone outside the family touch him yet.” As for friends and family, ask them to wash their hands before picking up baby, at least for the first month (keep hand sanitizer handy so they can use it before you hand over your baby). Anyone with sniffles or coughs should stay away. And skin-to-skin contact should obviously be avoided with anyone who has a rash or open sores.

No matter what you do or say, expect that every once in a while your baby will have some physical contact with strangers. So if a friendly neighbor tests your child's grasp on his finger before you can stop the transaction, just pull out a diaper wipe and discreetly wash off baby's hands. And be sure to wash your own hands after spending time outdoors and before handling your baby. Germs from outsiders (and from door handles or shopping carts) can easily be spread from your hands to your baby.

As your baby gets older, it will not only be safe to lift the hygiene bubble—it'll be smart. Your little one will need to be exposed to a variety of garden-variety germs in order to start building up immunities to those common in your community. So after the first 6 to 8 weeks, plan to loosen up a little and let the germs fall where they may.

“My baby seems to have little whiteheads all over his face. Will scrubbing help clear them?”

Though you may be surprised—and a little bummed—to find a sprinkling of tiny whiteheads on your sweetie's face where you expected to see baby-soft skin, these blemishes, called milia, are very common (affecting about half of all newborns), temporary, and definitely not a sign of pimple problems to come. Milia, which occur when small flakes of dead skin become trapped in tiny pockets on the surface of your little one's skin, tend to accumulate around the nose and chin, but occasionally show up on the trunk, arms, and legs, and even on the penis. The best treatment? Absolutely no treatment at all. As tempting as it may be to squeeze, scrub, or treat milia, don't. They'll disappear spontaneously, often within a few weeks but sometimes not for a few months or more, leaving your son's skin clear and smooth—that is, unless he comes up against another common baby complexion challenge: infant acne (see the next question).

“I thought babies were supposed to have beautiful skin. But my 2-week-old girl seems to be breaking out in a terrible case of acne.”

Does your baby have more pimples than an eighth grader? Just when she seems ready for her close-up—head rounding out nicely, eyes less puffy and squinty—here comes infant acne. This pimply preview of puberty, which affects about 40 percent of all newborns, usually begins at 2 to 3 weeks (right about the time you were going to schedule that first formal portrait) and can often last until baby is 4 to 6 months old. And believe it or not, as with adolescent acne, hormones are believed to be mainly to blame.

In the case of newborns, however, it's not their own hormones that are probably prompting the pimple problems, but mom's—which are still circulating in their systems. These maternal hormones stimulate baby's sluggish oil glands, causing pimples to pop up. Another reason for infant acne is that the pores of newborns aren't completely developed, making them easy targets for infiltration by dirt and the blossoming of blemishes.

Infant acne isn't the same as newborn milia—the acne is made up of red pimples, while milia are tiny whiteheads. They both, however, call for the same treatment: absolutely none—that is, beyond patience (though some suggest that dabbing the affected area with breast milk can help speed the healing process—and there's no reason not to try that at home if you're breastfeeding). Don't squeeze, pick, scrub with soap, slather with lotions, or otherwise treat your newborn's acne. Just wash it with water two or three times daily, pat it dry gently, and it will eventually clear, leaving no lasting marks—and that beautiful baby skin you've been waiting for in its place. And just in case you're already worrying about your little one's middle school yearbook photos, know that infant acne doesn't predict future pimple problems.

“My baby suddenly turned two colors—reddish blue from the waist down and pale from the waist up. What's wrong with her?”

Watching your baby turn color before your eyes can be unsettling, to say the least. But there's nothing to worry about when a newborn suddenly takes on a two-tone appearance, either side to side or top to bottom. As a result of her immature circulatory system, blood has simply pooled on half of your baby's body. Turn her gently upside down (or over, if the color
difference is side by side) momentarily, and normal color will be restored.

You may also notice that your baby's hands and feet appear bluish, even though the rest of her body is pinkish. This, too, is due to immature circulation and usually disappears by the end of the first week.

“Sometimes when I'm changing my new baby, I notice his skin seems to be mottled all over. Why?”

Purplish (sometimes more red, sometimes more blue—it depends on the color of your baby's skin) mottling of a tiny baby's skin when he's chilled, crying, or even (in some babies) all the time isn't unusual. These transient changes are yet another sign of an immature circulatory system, visible through baby's still very thin skin. He should outgrow this colorful phenomenon in a few months. In the meantime, when it occurs, check the nape of his neck or his midsection to see if he is too cool. If so, add a layer of clothing or raise the thermostat. If not, just relax and wait for the mottling to disappear, as it probably will in a few minutes.

“My baby doesn't seem to react much to noises. She sleeps right through the dog's barking and my older son's tantrums. Could her hearing be impaired?”

It's probably not that your baby doesn't hear the dog barking or her brother screaming, but that she's used to these sounds. Although she saw the world for the first time when she exited the womb, it wasn't the first time she heard it. Many sounds—from the music you played, to the honking horns and screeching sirens on the street, even to the whir of the blender if you were an expectant fan of smoothies—penetrated the walls of her peaceful uterine home, and she became accustomed to them.

Most babies will react to loud noise—in early infancy by startling, at about 3 months by blinking, at about 4 months by turning toward it. But those sounds that have already become a part of the background of a baby's existence may elicit no response—or one so subtle, you might miss it, like a change in her position or activity.

Still concerned about your baby's hearing? Try this little test: Clap your hands behind her head and see if she startles. If she does, you know she can hear. If she doesn't, try again
later—children (even newborns) have a wonderful way of ignoring or blocking out their environment at will, and she may have been doing just that. A repeat test may trigger the response you're looking for. If it doesn't, try to observe other ways in which your baby may react to sound: Is she calmed or does she otherwise respond to the soothing sounds of your voice, even when she isn't looking directly at you? Does she respond to singing or music in any way? Does she startle when exposed to an unfamiliar loud noise?
If your baby seems never to respond to sound, check in with the doctor. Most newborns are screened routinely for hearing problems before leaving the hospital (
click here
), so it's likely that yours was screened and found to be fine—but it's always best to ask if you're not sure whether your baby was screened or what the results were. The earlier hearing deficit is diagnosed and treated, the better the long-range outcome.