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    Your Baby's Health

    Once you and your baby are home from the hospital, call your baby's health care provider as soon as possible for an appointment for his/her first check-up. The first check-up is a good time to ask questions and generally see that you are doing a fine job as a new parent.

    It is important to feel comfortable communicating with your baby's health care provider as you will have frequent contact throughout your baby's childhood.

    The topics covered here provide guidelines to aid you in maintaining your newborn's health:

    Temperature/Fever  |  Taking Your Baby's Temperature  |  When to Call Your Baby's Healthcare Provider  |  Infant Safety  |  Lead Poisoning  |  Sleeping Positions  |  Sudden Infant Death Syndrome (SIDS)


    Temperature/Fever

    You do not need to take your baby's temperature routinely. Do it only when you suspect your baby is sick. Overdressing, or too hot an environment (i.e. room, car, etc.) can cause an elevated temperature. If the baby is overdressed, remove some clothing and retake the temperature in 30 minutes.

    Take your baby's temperature if:

    • Baby is especially irritable


    • Baby's skin is hot, or there is excessive sweating or a rash


    • Baby's complexion is either very pale or flushed


    • Baby's breathing is unusually fast, slow or especially noisy


    • Baby has a runny nose, is sneezing or coughing


    • Baby's appetite is poor; refused more than one feeding


    • Baby rubs his/her ear(s), rolls head or screams sharply


    • Baby is vomiting, or has diarrhea, or the stool has an unusual color or odor (if there is diarrhea, take an axillary temperature, which is under the armpit.

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    Taking Your Baby's Temperature

    Usually, it is recommended that a baby's temperature be taken under the armpit (axillary). However, your baby's health care provider may ask you to take a rectal temperature as well. Inform your baby's health care provider which way you took the baby's temperature. It is recommended to not use an ear thermometer on newborn babies as it can give an inaccurate reading due to the ear canals being wet. You can use this method when the baby is about 3 months old. An electronic digital thermometer is very accurate.

    For all thermometers, follow the directions that come with the thermometer.

    Taking an Axillary Temperature(Under the Arm)

    • Before taking your baby's axillary temperature, make sure the area under the arm is dry. Insert the end of the thermometer under your baby's arm and hold his/her arm snugly against his body.


    • Wait five minutes or until the electronic thermometer "beeps" before removing.
    Normal axillary temperature ranges from 36.5 to 37.2 degrees Celsius (97.6 to 99.4 degrees Fahrenheit).

    Taking A Rectal Temperature
    • Coat the end of the thermometer with petroleum jelly (such as Vaseline.


    • Gently insert the thermometer into the baby's rectum, no further than 1/2 inch.


    • Hold the thermometer in place until it beeps.
    Normal rectal temperature is 37.9 degrees Celsius (100.2 degrees Fahrenheit or less

    Normal temperature ranges are the American Academy of Pediatrics recommended ranges. It is recommended that you discuss this with your baby's health care provider.

    Rectal Temperature – Normal 100.2°F or Less



    Maintenance of Thermometer
    • After use, clean the thermometer in warm (not hot), soapy water and wipe with rubbing alcohol.


    • Store the thermometer in a plastic container to prevent breakage.

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    When to Call Your Baby's Healthcare Provider

    Sometimes it is difficult to know when to call your health care provider. Following is a list of symptoms for which he/she should be contacted. Never hesitate to call your health care provider if you are worried about your baby's health.

    • Behavior (marked change): Unusual irritability, excessive sleepiness, general restlessness, lethargy


    • Bowel movements (frequency varies depending on baby's age and whether breast or bottle feeding): Blood or mucus present; foul odor; excessively loose, watery stools; or, in general, a sudden change in the number of stools


    • Breathing difficulties: Flaring nostrils, wheezing


    • Circumcision: Swollen, bleeding, unusual discharge


    • Diaper rash: Rash that does not heal, looks excessively red or raw, or is accompanied by thrush (white patches)


    • Eyes: Excessive tearing, swelling, redness or discharge


    • Feedings: Loss of appetite for a couple of feedings


    • Fever: If you suspect an increased temperature, take the baby's temperature.Call your health care provider if axillary temperature is greater than 99°F (37°C) or rectal temperature is greater than 100.4°F (38°C).


    • Mouth: White patches on the roof and sides of the mouth and/or on tongue (thrush)


    • Nose: Stuffy (particularly when having difficulty sleeping or feeding), or runny — note color and consistency


    • Skin: Hot, moist, perspiring, blotchy, pustular rash, dehydrated, yellow color


    • Umbilical cord (Small amount of bleeding is routine): Swelling, foul-smelling, drainage, excessive bleeding, redness of the surrounding skin


    • Urination: Change in color, odor or frequency


    • Vomiting: Frequent and excessive; projectile

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    Infant Safety

    Accidents

    • Most accidents that involve newborns in the home involve falls. Be sure your baby is not left alone on high surfaces unless proper barriers are in place, which prevent your baby from rolling off. The safest places for a newborn when not being held in arms are in a crib, with the sides up, and no pillows or toys inside, or on the floor. Never leave your baby alone on the changing table or counter top! Keep a hand on your baby at all times.


    • Keep toys, stuffed animals and pillows out of crib


    • Use gates/barriers to keep your baby away from dangerous areas such as stairs.


    • Do not leave your baby alone with pets until they have adjusted to each other.
    Car Safety
    • A common cause of death in babies and small children is car accidents. Most of these deaths can be prevented with the proper use of car safety seats. California State law requires all children under age six (regardless of weight) or weighing less than 60 pounds (regardless of age) to be restrained in a federally approved car seat. Set a good example for your children by wearing your own seat belt. The police or Highway Patrol may issue citations if you do not comply. Never hold your baby while riding in a car, even for a short ride.


    • Read all car seat instructions before installing.


    • Starting with the trip home from the hospital, the baby should always be placed in an approved car safety seat.


    • Use only a federally approved, dynamically tested car seat. Do not use light weight infant carriers, travel beds, backpack carriers, etc. as car seats.


    • For infants under 20 pounds, the car seat must be placed facing the back of the car.


    • Whenever possible, place the infant car seat in the middle of the back seat.


    • When the infant is over 20 pounds, do not use an infant carrier type car seat.


    • Check to be sure that the seat belt is fastened tightly. You may need to use a special device called a Locking Clip to tighten the seat belt. Check with your car seat manufacturer if you are unsure.


    • A 3 to 5 point harness on the car seat is recommended.


    • Cover a vinyl car seat to protect baby's skin. (Vinyl seats may become hot enough to burn a child in summer and they are cold in winter.)


    • Be consistent. Use the car seat every time. Make sure every ride is a safe ride.
    Choking
    • Be sure to keep all small items that could cause your baby to choke out of his/her reach. Be particularly careful with small toys that belong to older siblings. Never feed a baby hard pieces of food as they may cause choking.


    • Avoid toys with cords. Never put the baby's pacifier on a cord.


    • Do not use a homemade pacifier; one piece commercially made pacifiers are recommended.


    • Keep cradle gyms high out of your baby's reach.


    • Keep small toys that might be suitable for an older child away from the baby to avoid choking.


    • Keep balloon strings and curtain cords out of reach of young children. Latex rubber balloons are not recommended for children under five years of age. Mylar balloons are safer for younger children.
    Drowning
    • Drowning is the second most common cause of accidental death of children. Especially at risk are children under the age of four as it takes only an inch of water and a few moments for a child to drown. Children can drown in a bathtub, toilet bowl, or a pail of water.


    • When bathing an infant, plan ahead to avoid interruptions.


    • Never leave a young child unattended in the tub. If you must leave, take the baby with you.


    • Never leave a young child alone outdoors, especially if there is a pool, spa, pond, or even a bucket of water.
    Crib Safety
    • Place baby on back when sleeping. Do not place the baby face down.


    • If you are using an older model crib, be aware that it may have unsafe, wider spaces between the slats. Be sure the crib slats are no more than 2 and 3/8" apart to prevent the baby's head from getting caught.


    • Be sure the mattress fits snugly against the sides and edges of the crib.


    • Use bumper pads that fit snugly and trim ties to prevent choking.


    • Check to see there are no sharp edges or cracked, chipped paints.


    • Do not use paint containing lead for baby furniture. Find out more about lead poisoning.


    • Keep pillows, large floppy toys and stuffed animals that could smother a baby out of the crib.


    • Never put a baby to sleep on a soft surface (i.e. pillow, cushion, bean bag chair or water bed).


    • Never use plastic bags from cleaners on a crib mattress.


    • Keep the mattress in the lowest position and the side rails up and locked when the baby is in the crib.


    • When the rail is in the low position, keep one hand on the baby at all times.


    • Do not string toys across crib opening.
    Burns

    To avoid burns:
    • Do not smoke or drink hot substances (such as coffee) while carrying your baby.


    • Install smoke alarms in your home and establish a schedule of changing the batteries.


    • Turn your hot water heater down to 120°F to prevent accidental scalding while bathing.


    • Use flame-retardant sleepwear for your baby.


    • A baby needs to be protected from direct sun; a sunscreen lotion specially made for babies should be used when taking infants on outings. Always have your baby wear a hat as well.


    • Keep electrical cords out of reach.


    • Use safety caps on electrical sockets.


    • When cooking, turn pot handles away from the front of the stove.
    Playpens
    • A wooden playpen should have slats no more than 2 and 3/8" apart.


    • Buttons on the baby's clothing should be larger than the netting holes on mesh playpens to prevent a button being caught, which could choke the baby.


    • Check to see there are no sharp edges, especially on the hinges. Check that the playpen is sturdy.


    • Keep the sides up when your baby is in the playpen.


    • Provide close supervision
    High Chair
    • Always secure the safety strap. Be sure there is a strap between the baby's legs as well as a waist strap to prevent the baby from slipping out.


    • Check for sharp edges and rough surfaces.


    • Keep high chair away from stoves, electrical cords, and other areas where the infant could be hurt.
    Strollers
    • Check for stability and sharp or rough edges.


    • If you use a folding stroller, be sure all parts are firmly locked into position before placing the baby in the stroller.
    Walkers
    • Walkers have a very high incidence of unintentional injury and should not be used.


    • Studies have shown that walkers can be a safety problem and may interfere with proper muscular development for standing and walking.
    Changing Area
    • Never leave your baby alone on a counter or changing table. Keep one hand on the baby at all times
    • .

    • Keep sharp objects such as diaper pins, nail scissors and glass thermometers out of your baby's reach.


    • Rubbing alcohol, powders, lotions and creams should all be kept out of your baby's reach.


    • Powder, perfume or talcum is not recommended for use around infants
    Poisoning
    • Put the Poison Control Center telephone number next to your telephone.


    • Keep Syrup of Ipecac on hand.


    • Place household chemicals in higher cabinets out of reach.


    • Use child resistant caps on any medicines. Never tell children their medicine is "candy".


    • Keep indoor plants out of reach as many are poisonous if eaten.

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    Lead Poisoning

    Children between the ages of 6 months to 6 years are at a high risk of lead poisoning. Lead poisoning is an illness caused by swallowing or breathing lead. Children in this age group will put their hands and other things in their mouths. Their bodies absorb lead more easily than adult's do and lead can do more damage to children because their brain, organs and bones are still developing.

    Lead is found in:

    • Paint


    • Soil


    • Glaze


    • Folk medicines (greta, azarcon, alarcon, Maria Luisa, paylooah)


    • Some cosmetics


    • Vinyl mini-blinds made in Asia and Mexico


    • The workplace (i.e. machine and auto repair shops)


    • Imported foods in lead-soldered cans


    • Water coming through bronze or copper pipes in plumbing
    Lead-based paint is the most common source of lead poisoning in children. Painted surfaces crumble into household dust which clings to objects children may put into their mouths. This is the most common way the lead gets into a child. Some young children may eat paint that is peeling or chipping. Houses built before 1950 are very likely to contain lead paint. House paint today has very low levels of lead (since 1978).

    The only way to know if children have lead poisoning is to have a blood lead test. Discuss the need for a blood lead test for your children with your doctor. Contact your local public health department for more information regarding lead poisoning and what you can do to prevent it.

    Additional information on Lead Poisoning may be found in our Health Information section.

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    Sleeping Positions

    New research has shown that the safest position for sleeping babies is lying on their backs. Therefore, always place your baby on his or her back. Be careful of pets, such as cats, which may wander into the crib. Consider using a safety net over the crib.

    It is recommended that every baby spend a certain amount of "tummy time" while awake and observed to develop muscular strength for crawling and walking. If you have any questions about your baby's sleep position or health, please talk with your baby's health care provider.

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    Sudden Infant Death Syndrome (SIDS)

    SIDS is defined as the sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation. Although physicians and scientists do not know what causes SIDS, they have determined that there are some things parents can do to reduce their baby's risk of SIDS.

    1. Put your baby to sleep on his back.


    2. Breastfeed your baby.


    3. Maintain a smoke-free zone around your baby.


    4. Use a firm mattress for your baby's crib.


    5. Don't use fluffy blankets, sheepskin or waterbeds.


    6. Do not place pillows or stuffed toys in the crib.


    7. Keep your baby's sleep areas warm, but not overheated. (Keep it at a temperature comfortable for you.)
    Once you have done what you can to reduce your baby's risk of SIDS, do not let the fear of SIDS spoil your joy and enjoyment of having a new baby.

    For more information about SIDS, contact:
    SIDS Alliance
    1314 Bedford Ave.,Suite 210
    Baltimore, MD 21208
    800-221-SIDS

    For more information about the importance of placing your baby on his back to sleep, call or write:
    "Back to Sleep"
    1-800-505-CRIB, or P.O. Box 29111, Washington, D.C. 20040

    Read more about Sudden Infant Death Syndrome.

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