Baby - the care and feeding of your

A few practical matters concerning the care and feeding of your baby

During your baby’s admittance we have involved you as much as possible in the care of and feeding of your baby. However, you may have questions when you are back home. That is why we have made this information brochure for you, in which the most frequent questions are discussed. When you receive this brochure, we kindly request you to read it. Should you still have any questions, during admittance or at discharge, do not hesitate to ask them.

Use of hot water bottles

• Depending on the weight and/or temperature, give 1 or 2 hot water bottles.
• Fill the bottles with boiled water.
• When the bottle is filled, close it tightly and put it down. Check the bottle for leakage.
• Wrap in a hot water bottle bag and always put the bottle with the opening facing downward between or on the blanket(s). Preferably at the foot or otherwise when using two bottles, one at the foot and one at the side.
• We advise against using cherry stone pillows. These are not warmed evenly in the microwave and in case of leakage all the hot stones are spread throughout the cot.

Taking the temperature

• In the hospital, the temperature is taken 4 times per day, every 6 hours. At home, depending on your baby’s weight, this may be done 2 to 3 times per day during the first week and then when necessary.
• When you take the temperature, it is important that you insert the thermometer properly to avoid an incorrect result.
• When the temperature is 36.7° C or lower, you may give 1 or 2 bottles, depending on the baby’s weight.
• When the temperature is 36.8° C or higher, you need not give a hot water bottle.
• If the baby is very warm, temperature above 37.5°C, you may put on some lighter clothes or use one less blanket in the cot.

Temperature at home

• For larger baby’s around 18-20° C
• For smaller baby’s around 20-22° C
• When bathing the baby it is recommended to heat the room additionally or use an extra source of heat.

Bathing the baby/nursing the navel
In the hospital, the bath is usually taken in the morning but you may also choose another time in consultation. It is usually not necessary to bathe the baby every day but if you like it, it is no problem. The umbilical clamp may be removed if the umbilical button has completely shrunk. If the navel does not shrink properly or is dirty, it may be cleaned with a gauze and some alcohol.

The cot at home/what is the safest way for a baby to sleep?

• In the incubator the baby is often nursed lying on the tummy in order to stimulate the breathing and the digestion. The baby is then hooked up to the monitor, allowing the heartbeat and breathing to be checked continuously.
• At home, it is safest for the baby to sleep lying on its back. When lying on its side, the baby may easily roll on to the tummy after a few weeks. Never put your baby to sleep lying on its tummy.
• A good cot has a solid base with a firm mattress. Do not use head protectors or pillows in the bed, as these hinder the air circulation around the baby. The use of duvets for children younger than 2 is advised against. Use 1 or 2 cotton blankets depending on the season.
• Make up the bed in a way that the baby’s feet are quite close to the feet of the bed and have the blankets reach to the shoulders. This way, the baby can never completely disappear beneath the blankets and the head remains free.

Breastfeeding/expressing milk
Breastfeeding is a process that mother and child have to learn. The nurse will provide information on this and he/she will assist you. When your baby may go home you have often already made some progress in the breastfeeding process. At home you may continue in the way you were taught at the hospital.

At the hospital, we weigh your baby before and after feeding to see how much additional feeding the baby needs. As long as your baby does not yet drink sufficiently from the breast, it is wise to express your breast milk and to weigh your baby before and after the feed. By expressing the milk, your milk production will be stimulated. After the feed, give the amount of expressed milk you were advised by the paediatrician. You may hire scales and a breast pump at the home care shop.

If you have the impression that your baby is drinking sufficiently from the breast, you may stop the weighing before and after the feed and weigh the baby naked at a fixed time for a few days. When the   baby grows sufficiently (100 - 150 grams per week), you may return the scales. Watch carefully that your baby has a properly wet nappy and during the first weeks a few dirty nappies per day. If your baby is satisfied and gains enough weight you can be assured that the breastfeeding is going well. In case of questions on breastfeeding: www.borstvoeding.nl

Bottle-feeding
If you still do not have enough breast milk or if you have decided to give artificial feeding, it is wise to continue the feeding your baby was given at the hospital. The nurse will advise you on this. You will also be advised on the number of feeds you have to give and on increasing the feeds in the period after discharge.

Check-up by paediatrician/child health centre
If necessary, the baby has to come for a check-up 2 to 3 weeks after discharge to the paediatrician at the Outpatient Clinic. When you go home with your baby the child health centre will subsequently contact you; if not, please contact them yourself.

Going outside with the baby
If your baby does not yet weigh 3000 grams, we advise you to go outside as little as possible.

We hope that your child’s admittance was to your satisfaction and that we have made a positive contribution to the care of your baby.

Telephone numbers

If you have questions:	Willem-Alexander ward	+31 (0)70 - 312 41 05
Making an appointment:	Paediatrics Outpatient Clinic	+31 (0)70 - 312 41 16

edition: April 2011/469