Caring for a Newborn

While your child is a baby, have them sleep lying face up, on a firm flat surface. The adults and the baby sleep in the same room, but not in the same bed. Put no pillows, quilts, bumpers, stuffed toys or head-shaping pillows in the bed. Inclined cradles and baby seats are only for sitting, not for sleeping in as a bed. In the United States alone, about 3500 babies die in their sleep every year.

The baby should get the first dose of hepatitis B vaccine within 24 hours after birth. Of people infected with hepatitis B in infancy and early childhood, about 95% go on to chronic hepatitis. The great majority of those infected only as adults get better on their own. So the earlier this dose is given, the more good it does. If the mother is positive for hepatitis B surface antigen, the baby also needs hepatitis B immune globulin at the same time.

Vaccines in the national immunization program are free from start to finish, and vaccination units cannot charge for them. When a child enters childcare or school, the vaccination certificate is checked, and missed doses will be found and made up. If one is missed, make up only the doses not yet completed; there is no need to start over, and the series can be continued even with a different manufacturer. Eczema, hives, allergic rhinitis and asthma, as long as the condition is stable, and newborn jaundice as well: with any of these the child can be vaccinated normally.

Start breastfeeding within the first hour after birth. For the first 6 months give only breast milk, not even water. Once the baby is 6 months old, add complementary foods, with iron-rich animal foods every day, and keep breastfeeding to age 2 or longer. If there isn't enough breast milk or you can't breastfeed, use formula, and don't blame yourself. What you feed matters far less for the child's safety than sleep position.

Powdered formula is not sterile and may carry a bacterium called Cronobacter sakazakii. Once a newborn is infected, the reported death rate is between four and eight in ten. When mixing, first pour the hot water into the bottle, wait until the water has cooled to about 73.8 ℃, then add the powder. At that point the milk is still above 70 ℃, which can kill this bacterium down to less than one hundred-thousandth of what was there. Let it cool before feeding, and pour out what's left.

If your child is under 1, don't feed them honey. Honey water, honey stirred into complementary food and pastries containing honey all count. Honey may carry the bacteria that cause botulism. The bacteria in an adult's gut can keep it in check; a baby's cannot. The same reasoning applies to homemade pickles and fermented foods.

Newborns have very little vitamin K stored in their bodies. Without a supplement they may bleed, and the late-appearing kind is often bleeding inside the brain. In places where this shot is not given widely, 478 of every 100,000 newborns have this kind of bleeding. Getting the shot is estimated to cut that by more than 78%. Regular hospitals in China give it routinely; if the baby is born at home or at an unregulated facility, ask whether it has been given.

If the baby is under 3 months old and their temperature reaches 38 ℃, go straight to the hospital. Don't watch them at home, and don't give fever medicine first and then wait and see. At this age, even a serious bacterial infection may show up only as a fever. So “they seem in fairly good spirits” cannot be a reason to wait at home. For a baby less than 8 days old, not even the guideline covers them, so go right away all the more.

A baby's head is big and the neck has no strength. Shaking hard can make the baby bleed inside the brain and inside the eyes; it can kill them, or leave them disabled for life. Gentle rocking to get them to sleep doesn't count; what is dangerous is violent, out-of-control shaking. When you are close to losing your temper, put the baby back in the crib and walk away for a few minutes; letting them cry for a while is safer than holding them and shaking.

No official body has ever ranked “which brand is best.” Only two things can be checked: the product quality spot-check notices of the State Administration for Market Regulation, and regulators' investigations of specific incidents. Expensive does not mean safe, and imported does not mean up to standard. Buy a small pack first and try it for a week, see whether the baby gets diaper rash or marks from tightness, and stock up only if they suit.

Strollers, cribs, swaddle blankets and toys are all used only for a short time, and there are plenty secondhand. First ask to borrow; if you can't borrow, buy secondhand; only if that doesn't work, buy new. This usually saves a thousand yuan or more. Don't buy car seats or mattresses secondhand; the damage a car seat takes in a crash cannot be seen with the eye. For big expenses such as postpartum confinement centers and early-education classes, cool down for 24 hours before deciding.

Among babies with severe eczema or an egg allergy who ate peanuts regularly starting at 4 to 11 months, only 1.9% had a peanut allergy at age 5, compared with 13.7% of those who avoided peanuts completely. For children who already had some reaction on a skin test, it was 10.6% among those who ate peanuts and 35.3% among those who avoided them. Take the child to a doctor before you start. Never give whole peanuts; they can choke the airway.

More than eight in ten newborns turn a little yellow, and in most it fades on its own. If the baby turns yellow less than 24 hours after birth, or keeps getting more yellow, is sleepier than usual and can't be woken, won't feed, or is floppy or stiff, go to the hospital the same day. Pale stools may mean biliary atresia, and also need to be checked as soon as possible. Bilirubin that is too high can damage the brain and leave a lifelong disability.

Vitamin B12 is found almost only in meat, eggs and dairy. If the mother eats fully vegan and takes no supplement, her milk will be short of it, and problems in the baby mostly appear at 4 to 8 months of age: the baby doesn't grow and falls behind in development, and if it drags on, the nerve damage may not be reversible. The baby's complementary foods should include animal foods every day.