Jill's Guide to Newborn Care

Jill Fain Lehman

Copyright 1995, Jill Fain Lehman. All rights reserved.

1. Introduction

    Why is my baby crying? Why can't I get anything done? When will I get my
    life back? Why is my baby still crying? When did I last take a shower? How
    many days have I been wearing this shirt? Won't this kid ever shut up? When
    will she sleep through the night? Why does she eat so often? Is her head
    supposed to look like that? It's quiet in here, why isn't the baby crying?

Answering questions like these is the purpose of any good reference on newborn care. Go buy one. Jill's Guide is here to offer you insight and advice on all those questions nobody else answers1. For example:

Just what does newborn mean, anyway?

Like so many words in English, this term is ambiguous and its exact definition debated by experts. Certainly it refers to the smallest size of children's clothing (usually labelled 0-11 pounds although the notion of a 0-pound baby seems inconvenient at best). However, you are likely to find that your child outgrows newborn clothes long before she outgrows newborn behavior. That being said, we might be tempted to define newborn on behavioral grounds. We refrain from doing this because it is likely to give the reader the misguided impression that there is something predictable about newborn behavior. Instead, we adopt the empirically-validated R. V. Lehman metric, which places your child in the newborn period from birth through her first 100 days. We suggest (strongly) that you mark the hundredth day on your calendar. During times of high stress, a simple method for reassuring yourself that calmer moments will eventually prevail is to count the number of days remaining in this period (although this method tends to be somewhat less comforting if done too often on the same day).

Knowing how long your child will be a newborn is not the same as knowing how to live through the newborn period with grace and style. In the sections that follow, we will explore landmark events for you, your spouse and your newborn, more or less in the order you will experience them. Unless inappropriate, comments and suggestions are offered to both parents, irrespective of gender. Who actually does what, and how often, you'll have to work out for yourselves.

2. The Hospital Stay


Here is the most important thing to do while you are in the hospital: sleep. Elsewhere you will no doubt have read about the importance of bonding with your child in the first days of life. Indeed, in the first hours both you and your baby will be wide awake and ready to chat (well, you'll chat, she'll just try to look attentive). Once the adrenaline dissipates, however, heed my words and move on to power snoozing because this is the last chance you'll have for uninterrupted sleep for a long, long time. If you're breastfeeding, hospital staff will wake you to nurse (also to check your blood pressure, take your temperature and pound on your uterus). Don't feel you have to play with the baby after she's eaten, even if she's awake. Go back to sleep...eventually she will too.

When you reach the point that you just can't get your body back to sleep, it is time to entertain visitors and move on to your next activity: recounting the birth experience. The importance of this step in the process of coming to grips with parenthood cannot be overestimated. As a rational being you have to come to terms with what was essentially an irrational, overwhelmingly physical experience. Human memory is a lousy mechanism for recalling physical pleasure and pain. This, of course, explains why people have more than one child. So, despite the fact that this is one of the most memorable experiences of your life, you'll find that you're already forgetting aspects of it. By recounting the event rather more often than is usually considered polite, you build up a mental representation that will persist over time. It is this reconstructed memory that you will treasure, relive, and, ultimately, use to induce guilt in your child when she is an adolescent.

There are a small number of other activities you should be prepared for once visitors begin to appear: receiving gifts, acknowledging the terrific job you did, and responding to insensitive comments about your baby's size, shape, weight, ears, etc. This is also the time to indulge in smiling beatifically, as it is one of the few times in your life people will not find it annoying.


Here is the most important thing to do while your wife and child are in the hospital: sleep. True, you didn't work as hard as she did during the birth. Nevertheless, the baby is coming home to both of you. Sleep now, for she may never hold her peace.

When you can no longer sleep, consider that this is the last chance to purchase those few things you must have in the house before the baby comes home: q-tips and isopropyl for cleaning the cord, a rectal thermometer, infant aceteminophin, ipecac, pedialyte (so-called not because it replaces electrolytes in dehydrated children but because it is the favorite, or "lite," advice of many pediatricians to any and every problem mentioned during call-in hours), diaper rash ointment, newborn diapers, cloth diapers (see Section 4.2), and nail scissors. For many of these objects, having them on hand is not actually as important as not not having them on hand. In the former case they will prove unnecessary, while in the latter case you will surely need them, and usually at 2 a.m.

3. Coming Home

After a few short days the time comes to take your baby home. A feeling of panic arises. Anticipating those early days with your baby, you thought you wanted time alone with just her and your spouse, free from the interference and advice of an older generation. You were wrong. Luckily, you now remember that someone, probably your mother or mother-in-law, has summarily ignored your wishes and is waiting at home to help. Panic recedes. Then you realize that she will eventually want to resume her own life. Panic resurfaces. Remain calm, this is why there is 1-800-ASK-JILL. Our lines are always open. If you were to call right at this moment, here's what our experienced staff would tell you:

     You are panicked largely because you have just had a baby. You are not 
     your usual energetic self. In fact, you have never felt quite this 
     horrible, and in so many places. Without the kind nurses to cajole, rock,
     and cuddle your screaming infant while you sleep, things are only going to 
     get worse. Here is what you can expect: for the next week or so you will 
     feel like the walking dead; in the following few weeks you will feel like 
     the walking wounded; during the remainder of the newborn period, you will 
     feel merely as if you are sleep walking. This is normal. 

Let's review:

Week Energy Level
1-2 walking dead
2-4 walking wounded
4-100 days sleep walking

Now, aren't you glad your mother or mother-in-law didn't listen? Aren't you getting tired of the phrase mother or mother-in-law? Right. From now on we will refer, instead, to your support person. A support person is anyone who doesn't have to be coherent the morning after being up with the baby all night. Note that if he or she is going to be going to work every day, your spouse, who may be supportive, clearly does not qualify as your support person.

Not suprisingly, here is the most important thing to do while there is a support person in the house: sleep. Let your support person cook, clean, market, run up and down stairs, and generally do everything you loathe doing anyway. Whatever energy you have, expend on the baby, slowly acquiring and refining the skills outlined in the next section. Remember, one day (soon) the three of you will be on your own.

4. Caring for your newborn

If you are like most couples one of you will take primary responsibility for the baby. In getting smoothly through the remainder of the newborn period, if not the remainder of your child-rearing years, here is the most important thing for you, the primary caregiver, to learn: there is more than one right way to do things. Assuming that your new family includes two adults, there are, at least some of the time, two sets of hands, four shoulders, and two nervous systems to bear the load. So, unless you want to do it all yourself for the next eighteen years, refrain from correcting your spouse in all but the most egregious circumstances. Wincing is also ill-advised. As a practical suggestion, if you find the words ``not like that'' about to come out of your mouth, stop, then ask yourself if what you are seeing can actually cause the baby harm. If not, shut up. If you feel you must say something, a gentle, ``I find that doing it this way seems to work'' may be considered helpful rather than hostile.

In addition to understanding that there is more than one right way to do things, you must keep in mind that no right way is right for very long. Your newborn changes constantly. What calmed her yesterday will, quite suddenly and for no apparent reason, start her crying today. Thus, the following information is intended as suggestive rather than prescriptive; finding what works for your baby is the whole adventure.

4.1 Eating

For all practical purposes newborns have a single goal: growing up to be babies. To accomplish this they must eat continually and, therefore, often at inopportune times. There are two schools of thought associated with feeding the newborn: on-demand and on-schedule. Unless your baby knows how to tell time, we at 1-800-ASK-JILL strongly suggest you acquiesce gracefully on demand. Although either method will leave you exhausted in the first few weeks, it seems to us that an enormous amount of unnecessary screaming and crying is generally endured by parents who tell themselves, ``She can't possibly be hungry, it hasn't been four hours yet.''

In addition to deciding whether you will feed on-demand or on-schedule, you must decide if you will feed by breast or bottle. Just as there are general guides to newborn care, there are many books written about breastfeeding. These books, not to mention lactation consultants and acolytes from the La Leche League, will all give you the same message: breastfeeding is natural, easy, and the best source of nourishment for your baby. To which Jill's Guide replies: two out of three ain't bad. Here are two important things they will not tell you:

  1. There is nothing inherently easy about nursing, either for you or your baby. Although she has certain reflexes to help (i.e. the rooting reflex), it is essentially a learned behavior for both of you. As a general rule, all learning takes time and engenders a certain amount of frustration.
  2. Unfortunately, it seems as if the issue of whether to nurse (and how long to nurse) has become the female equivalent of comparing penis size2. You are not a failure as a mother if you choose not to nurse or if you start out nursing and decide it's not for you.
If you choose to nurse

You will have a much harder time nursing successfully if you also choose on-schedule feeding. You must be willing to let the biology of supply-and-demand work itself out. When feedings do start to seem regularly spaced, remember that this is just your child's way of lulling you into a false sense of security before ambushing you with a growth spurt.

You will probably experience an extremely unattractive interval at the beginning in which your nipples become sore and cracked and possibly bloody. Don't panic, this is a pretty short-lived stage, albeit one they rarely tell you about. If you keep nursing, they will eventually heal. In the interim, soaking them in hot, salty water will help. So will changing the baby's position while nursing (assuming she's willing to go along with it).

If you choose to bottle-feed

Before trying to go to sleep, pour and refrigerate one more than the number of bottles you think you'll need during the night. This allows you to cultivate the ability to stumble downstairs, grab a bottle, and get back to the baby before she wakes the entire house, while simultaneously minimizing the number of times you end up cleaning four or five ounces of formula off the kitchen floor after she's gone back to sleep.

Despite dire warnings by manufacturers, there's nothing wrong with heating a bottle in the microwave as long as you don't heat it with the nipple on and remember to give it a few gentle shakes (to distribute the heat throughout the liquid) before feeding.

There's also nothing wrong with giving your baby room-temperature formula. Indeed, a bottle that feels warm to the touch seems cozy and nurturing until you are stuck in traffic somewhere with a screaming, hungry child, a cold bottle, and no way to warm it but body heat.

You have two choices viz travelling with a bottle-fed baby. First, you can rely on powdered formula and the availability of water in most places (except on airplanes). The problem with powdered formula is that it never seems to mix right with room temperature water, often resulting in a clogged nipple and a screaming, frustrated child (especially on airplanes). 1-800-ASK-JILL offers the following alternative: make up your bottle ahead of time and wrap it with a small ice pack in disposable diapers (the diapers act as modest insulation and absorb the moisture given off as the ice pack and bottle sweat). Specifically, place the bottle and ice pack in a single diaper and secure them using the diaper's tapes. Then, place a second diaper over the first diaper so that the closed portion of the second diaper covers the open portion of the first diaper, and secure as before.

As in most complex systems, input inevitably leads to output. The general reference alluded to in the opening paragraph will tell you everything you need to know about the color, consistency, and frequency of the contents of your newborn's diapers. What it does not tell you is covered in the next section.

4.2 Diapering

Well before you change that first diaper, you will need to decide which kind of diapers to use. The choice to use cloth or disposables is a personal one, based on economic, ecological, and epidermal concerns. If you choose disposables, however, it is still worth investing in a dozen or more of those thick, double-stitched cloth diapers. They will easily handle the usual quantities of drool and other fluids, and have even been known to successfully absorb an entire bottle of regurgitated soy formula before the stain could set.

Once the need for diapers becomes real, it is generally the case that at least one parent will manifest a near-phobic aversion to the diapering act itself. Get over it. There are many diaper-related records your child may break (e.g., most diapers used in a one-hour period, most outfit changes in a single day due to leaks, longest/shortest recorded period between dirty diapers, etc.) but being potty-trained in the first 100 days is not one of them.

Having resigned yourself to the act of changing diapers, you will still be completely unprepared for the percentage of your time devoted to talking about this topic. How often the diaper has been changed, when it was last changed, what was in it, when you expect it to be changed next, whether it needs to be changed now and who's going to change it, are all questions that will be asked and answered over and over during the day. Note that friends without children may react negatively to this sudden downturn in the intellectual content of your conversation.

About the same time you notice that diapering has become a dominant conversational theme, you also realize the incredible importance of choosing wisely the words you use to refer to the relevant biological functions and their by-products. In making your choice keep in mind that you will be talking about this topic in front of three distinct audiences: your spouse and family, others with whom you are less intimate, and your child. Although you may be quite comfortable employing the base vernacular with your immediate family, the remaining audiences usually require that you employ euphemism. Consider the options carefully before committing to a particular vocabulary; you will live with this choice for years to come. For example, you may find that clinical terms, while acceptable in polite company, never feel quite right when discussing this topic with your child. For some reason still unexplained by psycholinguists, Is Charlie having a bowel movement? actually feels less natural than Is Charlie making a poopy didy?, when talking to a straining, red-faced newborn.

Although we have adopted the generic she in this text, when it comes to diapers a word or two specific to boys is needed. In either sex, the feel of a cold wipe against the skin is often enough to start things flowing. Assuming her clothing is pushed out of the way, a girl who begins to pee in mid-diaper change presents no problems. Changing a boy, however, is fraught with peril. The available data indicates about a 50-50 chance that one of you will end up peed upon. The odds increase dramatically that you will be the victim if (a) you are wearing silk, or (b) you are in a hurry and have just showered. The odds increase in the baby's favor if (a) it is 3 a.m., (b) he is lying on a really good piece of furniture, particularly if it is white, or (c) you forgot to bring an extra outfit to change him into.

It is an untestable but interesting hypothesis that if diapers had existed throughout human evolution, we would never have lost our prehensile tail (advantage being conferred on those who could club a wooly mammoth with one hand while using the other plus the tail to change a wriggling infant at the same time). To compensate, here is a simple trick for avoiding danger when the (disposable) diaper you are about to remove is only wet. First, undo the tabs and fold them back on themselves so they will not stick to the baby, his clothes, or the changing surface when you are ready to remove the diaper. Now, leaving the wet diaper in place, push a clean, flattened diaper directly under it. Next, pull the front of the wet diaper away from the baby and give a couple of quick wipes, being careful to keep part of the wipe over the penis (if he begins to pee now, just let the front of the wet diaper fall back in place). Once you have wiped, use one hand to quickly pull the wet diaper out from under him and the other hand to quickly pull the front of the clean diaper up and into place. Congratulate yourself as you fasten the tabs.

The trick if the diaper is also soiled or if you are using cloth, is to take a spare cloth diaper and place it over his penis while you clean him up. This is not guaranteed to work as he will often move around and dislodge it while both your hands are otherwise occupied, but it will work at least some of the time. Yes, of course you can use the cloth diaper trick in the case of a wet disposable, but you tend to run out of cloth diapers much more quickly and, let's face it, the maneuver itself is not nearly as impressive.

Keeping your baby contentedly well-fed and dry will facilitate her second favorite activity, discussed in the next section.

4.3 Sleeping

By this, of course, we mean hers, not yours. Sleeping is actually less problematic than other people's endless complaining would have you believe. The great thing about infants is that when they're tired they sleep. This is in distinct contrast to the horrible thing about toddlers (and some adults), i.e., when they're tired they keep themselves awake and whine. Why, then, do so many complain about their infants' sleeping habits? Two reasons. First, newborns sleep on the schedule that is best for them, not you. Since they insist on eating frequently, they wake up frequently, usually just as you've fallen asleep.

The second reason for complaint is that although your baby will go to sleep when tired, she will not simply say ``goodnight'' and pad off down the hall on her own. She needs your help in making the transition to sleep, and will ask for it (loudly). Now the attentive reader may have noticed that a tacit principle behind the advice given in this guide is the minimization of screaming and crying on the part of the infant (leading, we believe, to a minimum of screaming and crying on the part of the adult). We acknowledge that it is possible to let your newborn cry herself to sleep. Rush Limbaugh's mother did just that. So did Newt Gingrich's. 'Nough said.

Assuming a more proactive attitude, the problem remains: how to help your baby to sleep? Rhythmic motion usually works best: walking, rocking, driving in a car, dancing the tango (avoid dipping). Once you feel the baby's body relaxing you can consider the timing of putting her down. Some babies, once drowsy, will simply drift off to sleep on their own, while others must be OLAL3 before you can lay them in a crib or bassinet. In achieving the transition from your arms to the crib, however, try to place her with her head resting lightly against the bumper. This has the same comforting effect on her that ramming into your ribcage or bladder did during pregnancy.

The peacefulness that permeates a house in which an innocent child is sleeping is not entirely without its own problems. At various (unpredictable) points your newborn will nap with a vengeance, sleeping significantly longer than her previous behavior would predict. You and your spouse will turn to each other with worried expressions and say things like, ``Do you think she's allright?,'' and ``Maybe one of us should go check on her,'' and ``Maybe we should wake her, or she won't sleep tonight.'' At times like these it is important to remember one simple rule: never wake a sleeping baby. If you wake her up she will simply fuss at you until you help her back to sleep. Since at this stage there is little causal relationship between how long she sleeps in the afternoon and how long she screams at night, enduring her wrath now is no hedge against a repeat performance at 2:00 a.m.

Indeed, as it is extremely unlikely that your newborn will sleep through any of her first one hundred nights, a short word about night feedings is in order. Your goal here is to get both of you back to sleep as quickly as possible. The easiest way to do this is with a little simple behavioral conditioning: since daytime feedings are usually done where there is light, noise, conversation and play, keep night feedings quiet, calm and in the dark (you'll need a small nightlight in the her room, with just enough light to ensure you feed and diaper the appropriate ends).

So much for the easy stuff. Your child's next most prevalent behavior has neither the obvious benefits of growth nor the endearing attributes of innocence.

4.4 Crying

There are essentially 5 reasons why newborns cry, each with its own remedy. The following list ranks them by likelihood and so, in an impressive feat of organization, provides both a smoothly flowing narrative and a coherent plan of action for dealing with this behavior (just start at the top of the list and try each in turn):

  1. Hunger is by far the most prevalent reason for crying. Even when you are firmly convinced that she couldn't possibly be hungry because she just ate an hour ago, she's probably hungry. About the only time you can be absolutely certain she's not hungry is when she is rejecting the breast or bottle outright by pushing it out of her mouth. Of course, the remedy for this one is easy: feed her.

  2. Discomfort is the next most prevalent reason. Discomfort may be internal (e.g. gas) or external (e.g. a wet diaper). If she just ate or has been sucking on something (a pacifier, her fist, the cat), burp her. If she is wet, change her. If she is in pain -- and believe me you'll know when it's pain -- remove the offending object, hold her close, and speak softly and soothingly until she calms down.

  3. Tiredness/Overstimulation. Infants are trying to get a grip on the world. This is not an easy chore and most of them can manage it only in small doses. The line between merry interaction and overstimulation is a thin one. If she's turning her eyes away when you talk to her or try to engage her in play, if her movements seem even jerkier and more uncoordinated than usual, she's probably hit the limit. Watery eyes, and bopping herself in the head with her tightly clenched little fist are also good indicators. The solution? Get out of her face. Sometimes this is enough, but sometimes you need to help her minimize the stimulation she's creating for herself. Swaddling may help (although some babies outgrow that pretty quickly). Ditto strategies outlined in the previous section for helping her sleep.

  4. She's a baby. Look, sometimes babies just cry. No particular reason, they just cry (admit it, you've had days like that, too). Although this is probably the least likely reason for crying in a newborn, it is also the most difficult one to deal with. The whole key to coping with crying, especially extended crying, is to stay calm. The more upset and out of control you feel, the more frantic she's going to get. So, while you can stand it, hold her close and try to comfort her. But when the moment comes that you can't stand it anymore, here are three things to try: (1) earplugs (you'd be surprised how cutting out the high frequency component makes the sound less grating), (2) a time-out (for you, of course, time-outs for her don't come until later. Put her down someplace safe and just go into another room and leave her alone until you can get calm. You may find she falls asleep once your frustration isn't feeding hers.), (3) lie down on the bed next to her, give in and cry and wail right along with her (she'll never tell).

5. Buying for your newborn

The arrival of your infant carries with it the implicit promise of conspicuous consumption. Every surface, drawer, cabinet, nook and cranny is a potential location for an ever-expanding amount of babyphernalia. Some of this stuff is actually necessary and some is not, although Jill's Guide does not presume to distinguish the categories too sharply. Below, we address some of the finer points of acquiring and maintaining the primitive components of clutter.


There is only one fundamental rule to remember about newborn clothing: return it or wash it. In the return category we have both articles falling outside your personal aesthetic preferences, and one piece outfits without crotch snaps. People who manufacture infant one-piece clothing without crotch snaps are evil and must be destroyed. Nevertheless, it is highly likely that someone will give you an otherwise adorable one-piece, snapless outfit. Since you adore it you will wash it (see below). Sometime after you have washed it and can no longer return it, you will actually use it to dress your child. Then you will discover that the one thing infants hate more than having their diaper changed is having to be completely undressed to have their diaper changed. Especially in the middle of the night.

The reason you must wash new clothing immediately is that the true size of the clothing (after washing) generally bears absolutely no relation to the age, length or weight listed on the label. By washing it immediately, you ensure that you will get the full 4 1/2 days of use for each article before your baby outgrows it.


By this, of course, we mean yours, not hers. For the first month or two the things with the most amusement value for your baby are your face and voice (and, on the rare occasions she can get it to her mouth, her fist). The stuffed animals, rattles, black and white developmental toys, musical bears, rocking horses, and cloth books are there to make you feel as though you're doing something concrete to entertain and educate your newborn during those seemingly endless periods when she's not asleep and you want to be. Some of these items have been known to keep sleep-deprived parents amused for hours. So if something amuses you, keep it out and play with it all you want (as long as you leave it in a room that could conceivably have been occupied by the baby, your secret is safe). As for the rest, you may as well put it in a box until she's old enough to grasp.


While stuff is a fairly straightforward, catch-all term, stuff you need, is a more elusive category. Moreover, the vagaries of personal taste tend to dominate here. Nevertheless, we at Jill's Guide do have our opinions, to wit:

Things you probably need: a baby monitor (allows you to be awakened from a deep sleep by your newborn's slightest twitch), another baby monitor (keeps you from having to continually move the one you have around the house), a child's tape player (portable, indestructible once the child is older, and a hedge against having your CD-changer full of children's music which you are too tired to take out to listen to your own), a baby swing (some newborns don't like them, but for those who do, they're invaluable), a cool-steam humidifier, and an extra bumper for the crib (imagine pulling a recalcitrant boa constrictor out of the dryer).

Things you probably don't need: a warmer for baby wipes, a ``friendly'' rectal thermometer, a bedside bottle warmer, an odor-free diaper disposal system (you feed in your child's dirty diapers which are then extruded in the evocative form of hermetically sealed sausage links), a bottled water adapter (fits between the neck of the water bottle and a standard baby bottle collar so she can sip her Perrier direct), an automatic crib rocker (Magic Fingers technology for your child), a rainbow box (musical and non-musical versions available), or a teddy bear with built-in womb sounds (inextricably linked to species-confusion in later development).

Things you think you need, but don't: a computer. In particular, refrain from creating a spreadsheet program to track baby expenses as a simple rule of thumb will suffice: the size of your disposable income is inversely related to the size of her disposables4.

Things you definately need, but didn't think of: a battery recharger.

6. Conclusions

Well, that's pretty much it. Given the length of this document and the amount of free time new parents have to read, you should have reached this section at just about the hundredth day. The end of the newborn stage is bittersweet. She no longer screams as often or as inconsolably, but you can no longer walk her effortlessly for hours when she needs to be calmed. She is no longer quite so fragile looking, but she no longer nestles so cozily in the crook of your neck when sleeping. She no longer eats and sleeps at unpredictable times, but she's no longer satisfied just by eating and sleeping. While it's true that in some ways the very hardest part is over when your newborn graduates to baby, don't feel complacent, there are still many challenges ahead (tantrums, potty training, and adolescence to name just a few).

And as parting advice for those moments when you truly feel down to the bottom of your soul that you just can't do this, remember: you have to, you're a parent now5.


1 All right, if you insist: She's probably hungry; Because you just had a baby; You won't; She's probably hungry; On average? the day before yesterday; Since your last shower; Yes, but then you'll wonder why; Long before you do; Because she's a baby; Yes; See? I told you. Stop worrying and go to sleep.

2 Many thanks to P. L. Lehman for this profound insight.

3Out Like a Light.

4 On the other hand, if you are doing the nursery anyway, there's no time like the present to install wiring for Internet access.

5Jean Fain.