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What are babies like?

Many parents these days have not had much experience with babies when their first baby comes along. If you are one of these parents you will probably find you have lots of questions about this new person in your family who is so small and helpless. The best way to get to know what babies are like is to watch and learn from your own baby. Babies grow and learn faster than at any other stage of life, so what they do will be continually changing. Take time to enjoy with your baby the new things she is learning and doing. If you have any questions about your baby, ask for help or information. You will probably find that many other parents have exactly the same question. Here are some of the things you might want to know about your baby.

WHAT ARE BABIES LIKE?

• Babies do some things "automatically" - without knowing they are doing them and these are called reflexes. For example if something is put in their mouths they suck on it (sucking reflex), if they are startled or upset they fling their arms out and throw their heads back (startle reflex), and if something is put in their hands they hold on tight (grasp reflex). If your baby grasps your hair or necklace in the early weeks when the grasp reflex is strong, don't pull away as this will make him hold on tighter. Instead, relax and stroke the outside of his fingers - this will make him uncurl his fingers and let go.
• Babies' heads can sometimes be uneven in shape after the birth or because of the way they sleep. This is nothing to worry about and goes away as they grow.
• The "soft spot" or fontanelle on the baby's head is there so the baby's head can change shape so it can more easily fit through the birth passage when he is being born. The bones will join together in the first year or so. The skin over the soft spot is strong and you cannot hurt babies by touching the spot or by washing or brushing their heads. Sometimes the fontanelle swells when the baby is crying and goes flat when the crying stops.
• Some babies have sticky eyes due to a blocked tear duct. Ask your doctor how to manage this. It is not serious and almost always gets better without treatment.
• Some babies have little white lumps like tiny pearls in their mouth, especially on the gums (called Epstein's Pearls). These are normal and go away when the baby grows. They are not teeth.
• Babies are often born with puffy genitals and breasts (sometimes even milk coming from the breasts). This is from the mother's hormones and is not a problem for boys or girls. They will change size back to "normal" in a few days or weeks.
• Babies sometimes get a lump (or hernia) underneath their belly button (umbilicus). It may swell if the baby is crying. This is a small gap in the tummy muscle and will nearly always go away in time. It does not need treatment and does not cause health problems. If they have a lump in the groin area (it may come and go, or stay there all the time) this could be an inguinal hernia which does need to be treated. See your doctor.
• Lots of babies have hiccups after feeds. This is normal.
• Some babies spill a little milk (bring it back up) after feeds. If they are growing well and happy this is nothing to worry about. If your baby is bringing up milk in big spurts you need to see your doctor. If the baby is not putting on weight or is miserable a lot of the time, talk to your doctor or child health nurse about it.
• Pink wee -A little light pink stain from urine on the nappy is not uncommon and is nothing to worry about. It is more likely in boys because their stream of wee (urine) is more likely to be all in the same place on the nappy (diaper). If it is red or leaves a brown stain, that is, if it looks at all like blood or your baby seems unwell and is not feeding normally you need to have it checked by a doctor. Sometimes there can be small "crystals" on the inner surface of a disposable nappy. These come from the inside of the nappy, not from the baby.
• Very young breastfed babies do several poos a day. Even if they seem to be pushing hard to get it out, the poo is usually very soft. After a few weeks they may only have a poo every few days and it will still be soft. All this is normal.
• Bottle fed babies might have firmer poos. If the poos seem very hard try putting a teaspoon of brown sugar in a little boiled water before a feed (once or twice). Don't keep doing this after the poos are soft again.
• You can play with a very young baby
• Many babies cry for up to 3 hours a day in the early weeks. Most babies like being held and comforted. Some babies still cry when they are being held.

BABY'S SKIN AND HAIR

• Most babies have spots on their faces and often on other parts of the body in the first few weeks. These can look like acne - red spots with white centres. They are not acne and they do not need any treatment. They seem to be a reaction to the skin being in the air rather than in the womb (uterus) as it was before they were born. Sometimes the spots come when the baby gets hot or has been lying on that side. If they go away within half an hour or so they are probably this kind of spot.
• If the spots last for more than a week or so, it may be a very common skin infection with a yeast called pityrosporum folliculitis. This is very easy to treat using a ketoconozole product. Check with your doctor or chemist. The rash will clear without treatment but it can take a couple of months to do so.
• Cradle cap is crusty scales on the head. You can rub it with olive oil or vaseline to soften it one evening and wash it off the next day. Gently lift off the scales with a fine-toothed comb or fingernail then wash off the vaseline. If it is really bad and does not improve ask your doctor about it.
• A new baby's skin can be very dry and look to be peeling in the first few weeks. This is normal and not a problem. You can rub in a little sorbolene or almond oil if you like.

Remember that every baby is different. While babies usually follow similar patterns with their development your baby might do things faster or slower or differently from other babies and this is usually fine. If your baby is doing things much more slowly or not doing some things at all, it is a good idea to check with your doctor to make sure that all is going well. Here are some of the things your baby will probably be able to do.

• By 4 weeks he will stare at you, and can watch you as you move around in front of him.
• By 6 or 7 weeks he can smile at you when you smile at him.
• By two months he can hold up his head when you are holding him upright and lift his head up if he is lying on his tummy.
• By three months he will enjoy hitting toys that make a noise and he can hold a rattle for a short time.
• By four months he may be able to roll from his front to his back, but it will take another couple of months or more before he can roll from his back to his front.
• By seven months he will be sitting up and might be starting to crawl. He will listen to you and start to make sounds as though he is "talking" to you.
• By nine months many babies can pull themselves up to stand, some babies take longer. It takes another two or three months or so before he can stand without holding onto something and then a few more weeks before he can actually walk.
• By twelve months babies will listen to what you say, 'talk' to you in their own language and may say one or two clear words - probably one of them will be "No!" Your baby will be able to hold something with his thumb and forefinger and to play little games like wave goodbye and "pat-a-cake". Some babies can walk by this age, but for most it will take another month or more.

WHAT CAN BABY SEE, HEAR, TASTE AND FEEL?

• Although babies can see when they are born it takes a few months before they can see as clearly as older people. Babies can see clearly objects about 25 cms from their eyes and especially like to look at their mother's face while feeding. They do not see colours very well at first but soon begin to like colours, especially bright colours. Babies eyes may change colour and you may not know what colour their eyes will be for several months. Many babies look as if they might have a squint (look cross-eyed) sometimes. If it happens most of the time or is still happening often as your baby gets towards 6 months, see your doctor.
• Newborn babies can hear lots of different sounds but they can't yet understand what they are hearing. Even very young babies will turn their heads to sounds, especially the sounds of people's voices. They soon learn to know their own parents' voices. Many babies like high voices (this might be why people often talk to babies in a higher voice). It is very important to talk and sing to your baby. Listen to your baby's noises and sounds and copy them. When you copy your baby it is like saying "I can hear you" and is the start of teaching your baby to talk.
• Gentle, caring touch is very important so babies feel loved and cared for. They are sensitive to touch from the time they are born and can feel pain. (Babies also react to pain and touch before birth).
• Babies can tell different tastes such as salty, sweet, sour and bitter tastes. They do not need salt or sugar on their foods when they start eating solids and they learn to like the tastes they are given.
• Babies can smell from the time they are born and sometimes turn their heads away or "make a face" if there is a smell or taste they don't like.

FUSED LABIA

The labia (the folds of skin on either side of the opening of the vagina) are often stuck together in baby girls.

• They always separate by late childhood, when the levels of oestrogen in the body start to rise at the beginning of puberty.
• For some girls, they may need to be separated at a younger age if the girl has an infection of the skin around the labia, or a bladder infection.
• Sometimes the labia can be gently pulled apart, but this may be painful, and they may join back again if the surfaces are 'raw'.
• Putting cream, which contains oestrogen, onto the skin around the labia causes them to come apart in at least half of the girls, and this is usually tried as the first treatment.
• If the join is strong, and does not separate with oestrogen cream, and there are health problems, the girl may need an anaesthetic so that the labia can be separated. If she is not having problems, no treatment is necessary.
• Check with your doctor if you are worried.

BABY'S TEETH

• Babies usually start to get their teeth at about 6 months and usually have all their baby teeth by the time they are three.
• Some don't have any until they are a year old and occasionally a baby is born with a tooth.
• You can clean baby's teeth gently with a soft cloth as soon as they come through.
• If there is pain with teething you can give them something firm to bite on e.g. cold teething ring or dummy.
• Some babies prefer mushy food while teething because it needs less chewing, others prefer something to chew.
• Rusks can be useful. If there is a lot of pain sometimes a teething gel or paracetamol can help.
• Your baby's teeth can be damaged by too much sucking on a bottle of milk or any sweet drink such as fruit juice. This can cause early tooth decay. If your baby needs something to suck on between feeds (as long as she is not hungry), put cool water in the bottle or give her a dummy without any sweetener (such as honey) on it. It is best not to let babies go to sleep while sucking on a bottle.

HEAD SHAPE

A baby's brain develops normally even when the bones at the back of the skull are flattened by lying a baby on his back for sleep.

• For most babies, as soon as they start to move around more, for example spending more time sitting, crawling and standing, normal growth of the bones and the brain fills out that flatter spot, so that the head appears a more 'normal' shape.
• -Children's heads continue to grow larger for several years even though most of the increase in size happens before they turn one year old. There will be several years for the head shape to gradually change.
• Some babies go on having a flatter than average back of their heads, but it may be that this is more due to the shape that is usual for their family, rather than just due to the way the baby sleeps. Maybe that baby was going to have a flat back of his head no matter how much time he spend lying on his back.
• Although Child and Youth Health strongly recommend putting a baby to sleep on her back, we also recommend putting a baby on her tummy for play from an early age. Making sure that she spends some time most days without pressure on the back of her head may keep the shape more rounded, but it also may not make a difference.

Note: If a baby's head is very unusually shaped or it is growing in an unusual way (such as staying much smaller than expected) you need to check with your doctor.

LOOKING AFTER THE PENIS

• For most male babies and many young boys the foreskin is attached to the glans ( tip of the penis).
• Forcing it away from the glans may cause damage to the tip of the penis or the foreskin - so it is best not to force back an infant's foreskin.
• Like every other part of the body the tip of the penis and underneath the foreskin should be cleaned regularly once foreskin moves easily.
• Boys should learn how to wash their penis and scrotum (balls), as they are taught to wash other parts of their body.
• Don't use soap when washing foreskins because it can irritate the skin.
• With time and use the foreskin moves back more easily, and boys should be encouraged to wash under the foreskin every time they bath or shower,

The white stuff (smegma) under the foreskin is natural and does not cause health problems - it simply needs to be washed away regularly.

CARING FOR YOUR BABY

Babies need to be kept clean, comfortable, warm (but not too hot) and fed. They need to sleep when they are tired, be fed when they are hungry and have someone to play with them and cuddle them when they are alert and awake. Other topics about caring for your baby are listed in Other Related Topics.

Bathing baby
It isn't necessary to bath your baby every day if she does not like it. You can wash baby's face and bottom when you need to without a bath. Find out the time when your baby enjoys the bath most. It will usually not be when she is very hungry. Between feeds at a time when your baby is unsettled, a bath may help her feel better and help her to go off to sleep. She will probably enjoy it most when she is calm after a feed.

If your baby seems scared by the feeling of going into the bath water, try wrapping her in a cloth nappy or towel. Put her into the bath while wrapped, then let the wrap float away.

IMMUNISATION

Immunisation is a very safe way to protect babies from some very serious illnesses. Don't forget to find out about immunisation to help protect your baby from infectious diseases. Ask your doctor or child health nurse. The first immunisations are due when your baby is two months old.

Note: This topic gives some practical suggestions and information about health and illness. It is important to see your doctor if you are worried about your child's health as information about a particular illness may not exactly fit your child.