When to Page in the Postpartum (Baby)
If you have general concerns regarding care of a healthy baby, please leave a voice mail on our non-urgent
line 905-723-6088 for a midwife from your team to call you back. If you are concerned that your baby is
unwell, contact your midwife immediately. This information may help to answer some questions you have
regarding what is normal for a newborn.
Elimination:
Babies should pass urine at least once in the first 24 hours, two times on day 2, three times on day 3 and by
day 4 should be numerous and produce fairly heavy diapers. A few days after the birth you may notice a
reddish-orange powder or crystals in the diaper. These are called urates and can be normal as the milk is slowly
coming in, but it may also be a sign of mild dehydration. Let a midwife know if they appear.
Bowel movements start out as sticky, very dark green or black tar-like stool called meconium. This can be hard to
wash off baby’s skin, but a little olive oil or petroleum jelly applied to the baby’s bottom after each diaper change
should help with wiping it away. The stool will change in colour and consistency over the first 3 to 4 days, becoming
a greenish or brownish colour and then changing to a bright mustard yellow loose stool for breast/chest fed babies,
and a hummus consistency and colour for formula fed babies by about day 4. Green stool after day 4 may be an
indication that your baby is getting more foremilk (the start of a feed like “a drink of water”) and less hind milk
(the fatty milk that is essential to weight gain and healthy growth). Feeding baby on one side longer so it is emptied
during a feed should rectify the issue. Green stool is more common on hot spells in the summer when baby instinctively
knows to take in more fluid (foremilk) to protect themselves from dehydration in the heat. Rarely, green stool can be
an indication of infection so if your baby has green stool, and has a fever or is disinterested in feeding or appears
unwell please take your baby to your doctor , a walk-in clinic or if appropriate, the hospital, for care.
Umbilical Cord:
It is not necessary to clean the cord with rubbing alcohol, and in fact using alcohol prolongs the time
it takes for the cord to fall off. Clean the area with water when you bathe the baby, keep the area dry between baths,
and fold the diaper away from the cord. This should help the cord fall of in 5 to 8 days. In the process of falling off,
the cord may become smelly and small amounts of dried blood may appear on the baby’s clothes or diaper. This is
normal and not a cause for concern. If the cord develops a green discharge or the area around the umbilical cord
becomes very red or swollen call a midwife.
Eyes:
A newborn baby can see things 8 to 10 inches away and prefers to focus on faces. The eyes usually appear dark grey
or blue and while muscles in the eyes are still developing can appear crossed at times. Babies rarely produce tears
in the days after birth. The eyes may develop a clear, crusty discharge. This is common and warm clear water is the
best way to clean a baby’s eyes. Breastmilk expressed into a sterile teaspoon and poured into the eyes may also
help with the discharge. It can be helpful to take a clean warm damp cloth to wipe away the discharge. If the eyes
become red and inflamed or have a green discharge call a midwife.
Bathing:
Many parents feel nervous about bathing their newborn. You can bathe baby in the sink, a specially purchased
baby tub or even in the bathtub with a parent. The water should be warm and babies are happier to be immersed in
the tub of water (keeping ears above the water surface) where they stay warmer, rather than a sponge bath. It is perfectly
fine for the umbilical cord to get wet in the bath. Babies do not need to be bathed right away nor do they need a bath
every day. How often you bathe your baby is up to you.
Dressing:
Babies need comfortable, soft, easily cleaned clothes to wear. Cotton clothing is best for babies as it is the least
irritating and easily cleaned. They need to wear the same amount of clothes as you are wearing plus one extra layer
such as a sweater or light blanket. It is common for babies to be overdressed or over bundled with blankets. To
determine if you baby is warm enough always check under their clothes at their chest or upper back. A baby’s hands
and feet are usually cooler than the rest of their body due to poor circulation in the first weeks and is not a good indication
that your baby is too cold or too warm.
Temperature:
If your baby feels warm, you should take their temperature with a digital thermometer under the armpit.
Ear thermometers are not recommended for newborns, as they can give inaccurate readings at this age.
A temperature greater than 37.5 C or 100F under the armpit can be concerning. If the baby has been bundled in
blankets and the temperature is close to these numbers try unwrapping the baby and retake the temperature in
30 minutes. If the temperature does not go down or if the baby was not over bundled, have the baby seen by a
doctor or in hospital. If the baby has no interest in eating, or is very sleepy with no periods of wakefulness over
several hours your baby may need to be seen by your doctor or at the hospital.
