Cathy Joanne Nurkala, BSN, RN, CPCE, CLC discusses newborn care.
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Caring for a Newborn
Featured Speaker:
Cathy Joanne Nurkala, BSN, RN, CPCE, CLC
Cathy Nurkala, BSN, RN, CPCE, CLC is a certified professional childbirth education and a certified lactation counselor. She began working for BayCare in 1992 and has been a childbirth educator at St. Joseph’s Women’s Hospital since 1993. In fact, Ms. Nurkala was actually born at St. Joseph’s Hospital when it was located in Ybor City! Ms. Nurkala has her bachelor’s degree in psychology and her Bachelor’s in Nursing, both from Florida State University. Transcription:
Caring for a Newborn
Introduction: Here's another edition of the BayCare Health System’s podcast series, BayCare HealthChat with Melanie Cole.
Melanie Cole: Bringing home a new baby is one of the most exciting times of your life, but it can also be daunting. Here to tell us about newborn care is Cathy Nurkala. She's a Registered Nurse and Certified Childbirth Educator at BayCare. Cathy, I'm so glad to have you with us. This is such a great topic. I loved my little babies. What's the first thing you want parents to know about those first few days and nights with baby?
Cathy Nurkala: Well, one thing I wanted parents to know a little bit about is about their appearance because many new parents are surprised the first time they see their baby because newborns can look very different than what they were expecting. A newborn's head can be cone shaped for the first few days and weeks. Also, their eyes may be bluishy gray or brown, and that eye color can actually change. Sometimes it can take up to 12 months to know the baby's permanent eye color. Also a newborn's eyes might look crossed or they might move in an uncoordinated manner. And this usually disappears as the baby's eye muscles strengthen and their vision improves. Also babies, newborns their skin is usually covered with a white creamy substance called vernix and soft hair called lanugo. And I do want parents to know that that vernix and Lanugo does disappear soon after birth.
Also babies they might look pale with bluish hands and feet and that's normal too. The baby's hands and feet will pink up and also dry skin, pearly white bumps on their face, which are called milia and a newborn rash can be common. And also birth marks too can also be present. And birth marks will usually fade over time too. And if the parents do have any questions about their baby's appearance, they do want to discuss them with the pediatrician. Also, another thing that parents need to know about new babies is that they do communicate to us through cues and through crying. And it's important that parents respond to those cues and cries so that the baby can trust that their needs will be met. And when the baby cries, you know, of course it could mean that the baby might be hungry or need to be burped or too hot or too cold, can be bored or over stimulated or tired or lonely, need a diaper change. And of course for newborn cues you know sucking on their fingers, opening their mouth, sticking out their tongue, making sucking movements and sounds that can be a cue to indicate for instance, that the baby's hungry.
And when it comes to babies, a lot of parents kind of wonder, you know, will they spoil the baby, you know if they pick the baby up and respond to their cues and cries and you actually can’t spoil the baby. And when babies cry, sometimes they can cry and parents won't know why the baby's crying. And in that case, they just want to make sure that they should focus just on comforting the baby. And some comforting techniques could be holding the baby in their arms and gently, you know, rocking and swaying with the baby. Also talking and singing softly to the baby, making shushing sounds, maybe taking the baby for a walk, using a safe front carrier or a stroller, swaddling the baby in a blanket or a swaddle sack. And sometimes crying can frustrate parents. They want to make sure that they do if they are getting a little frustrated with the crying that they shouldn't be afraid to call someone to help like maybe call a family member friend or a parent hotline. Also, if they're by themselves, they can always put the baby in a safe place like the bassinet or crib and just walk away until they are calm and then go back in and tend to the baby. But parents want to make sure they never shake, hit, or throw their baby. And if the baby's crying a lot, they might even want to talk to the baby's pediatrician to rule out maybe a medical condition that might be making the baby cry.
Host: Wow. These are such great tips for new parents and it really can be such a daunting time. One of the most scary things for any new parents are the sleep cycles. How often should babies nap? How long should they be expected to sleep at night, whether they're formula fed or breast fed. What do you want to tell parents about those sleep cycles, which are really one of the most daunting aspects of new baby?
Cathy Nurkala: Well, one thing about newborns is they can sleep a lot. Usually they sleep about 16 to 18 hours per day, but they don't sleep for long stretches at a time, like we adults do. You know, babies usually sleep in one to three hour periods, but some of the periods can be as short as like 15 minutes and newborns, they don't really know the difference between night and day. So they will wake up for nighttime feedings. And these nighttime feedings are important because newborns, they do have very small stomachs and also their developing brains need energy, so they do need to be fed often. So they do need to be fed. Have some nighttime feedings too. Now as babies get older though over the next few months, you know, they will sleep more at night and also have some naps during the day too. One thing they can do to help their baby sleep is to make sure that they avoid a lot of stimulation during night feedings and diaper changes. You know, they want to save play time for daytime. And also it can help to have a bedtime routine of maybe three or four relaxing activities they can do before putting the baby to bed and that can, you know, kind of help wind down the baby. Another thing too is that we want to make sure when it comes to sleeping that babies are sleeping safely and the American Academy of Pediatrics recommends that babies sleep on their backs in a safety approved bassinet or crib with nothing in it, but the baby.
So the parents don't need to have any soft objects, toys, loose bedding, bumper pads, wedges, sleep positioners in the bassinet or crib. And again, babies also can sleep in like with a onesie and a sleeper with feet or a sleep sack. They don't need a hat when they're sleeping. The American Academy of Pediatrics recommends that babies sleep in their own bassinet or crib in the parents' room for at least the first six months and ideally for the first year. And the American Academy of Pediatrics does not recommend co-sleeping so that the baby needs to sleep in the parent's room, but the baby needs to be in their own crib or bassinet. Also they want to make sure that the room is at a comfortable temperature. Also for sleep. Sleeping babies can sleep with a pacifier after breastfeeding if well established. But if the baby will not take a pacifier, parents don't want to force one on the baby. Also, if the pacifier falls out while they're sleeping, they don't have to try to put it back in. They always want to keep their baby away from cigarette and cigar smoke from vapor. Also to breastfeed as long as possible and to make sure that they take the baby to all their well baby checkups.
Host: Wow. Another great list of really good advice. So give us some diapering tips. First of all, a lot of parents want to know about cord care and what they're supposed to do as far as taking care of that cord until it drops off and if the baby's been circumcised, how do they care for that as they're changing diapers?
Cathy Nurkala: Well, when it comes to changing diapers, which the parents are going to be doing a lot of because babies can go through a lot of diapers. What they want to do is for the cord they just want to make sure that they keep it clean and dry and the baby's cord stump will actually naturally fall off in about one to two weeks after the birth. And when it does fall off, they might see a little blood as it falls off cause it kind of, it's kind of like a scab falling off. But they want to make sure though that they don't use any alcohol wipes on the cord stump and that they don't pick at the cord stump, you know, let it naturally fall off. And they do want to notify the pediatrician at the skin around the cord stump is red or swollen if there's puss oozing from the stump and if the stump hasn't fallen off after three weeks, but for diapers, what they'll want to do is make sure when they put the diaper on in the front to fold it under the cord stump so that the diapers not going to irritate the cord stump. And dress the baby in loose clothing too, can help so that the clothing's not rubbing against the cord.
And when it comes to circumcision, if parents have questions about circumcision, it's good for them to actually talk to their obstetrician or the pediatrician. But when they're changing the diaper, when the baby's circumcised, the parents will be given instructions on how to care for the circumcision. And it takes about a week to two weeks to heal. But if they decide not to circumcise their son when they're changing the diaper or giving the baby a bath, they don't want to retract the foreskin from the tip of the penis cause it could tear. So they just want to wipe the penis. And when it comes to changing diapers once the cord stump has fallen off and the belly button is healed, then they can put the diaper over the healed belly button. And another thing too is when they're changing diapers they always want to make sure they wipe from front to back so that, especially for a daughter so that they're not wiping any stool over the sterile opening that their daughter urinates from. So always wipe from front to back. Having a son too when they put the diaper on, they want to make sure his penis is pointing downwards in the diaper so he doesn't end up with a wet shirt.
Host: Well that has happened to many of us. I am sure. So before we wrap up, you've been giving us such great advice. Now what about tummy time? When can that begin and wrap it up with your best advice for parents who are nervous, they brought home their newborn. It's so exciting. What do you want them to know?
Cathy Nurkala: Well, when it comes to tummy time, the good time to do it is when the baby's in a quiet alert state. Cause that's where the baby's going to be awake. And they're calm and their body's relaxed eyes bright and open looking at their parents. When they do tummy time, they can start it from the beginning while they still have the cord stump. And their belly button is healing. They can do it on their chest. And then once the cord stump has fallen off and their belly button is healed, then they could do tummy time on a blanket on the floor and tummy time is great because it'll actually help strengthen the baby's neck muscles and shoulder muscles. It promotes their motor skills and also prevents them from developing a flat spot on the back of the baby's head. And when they do tummy time it should always be supervised and the baby's awake and if the baby falls asleep or is fussing a lot, then the tummy time is over. And they could do tummy time a few times a day. And when it comes to parenting, one thing that parents just want to enjoy you know, being new parents. Parenting is kind of, you know, it's a lot of fun to take care of a new baby and get to know their baby and interact with their baby. And when it comes to taking care of a baby some of it will be trial and error. A little on the job training, but it'll be one of the most wonderful experiences they ever had.
Host: Well, it certainly is, and I can attest to that. It is just a wonderful time. It can be a little stressful and parents, you just take care of yourselves, have people help you and sleep when you can. Thank you so much, Cathy, for joining us today and sharing your great advice. And that concludes this episode of BayCare's HealthChat. To learn more about BayCare's maternity services, please visit BayCareMaternity.org, for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.
Caring for a Newborn
Introduction: Here's another edition of the BayCare Health System’s podcast series, BayCare HealthChat with Melanie Cole.
Melanie Cole: Bringing home a new baby is one of the most exciting times of your life, but it can also be daunting. Here to tell us about newborn care is Cathy Nurkala. She's a Registered Nurse and Certified Childbirth Educator at BayCare. Cathy, I'm so glad to have you with us. This is such a great topic. I loved my little babies. What's the first thing you want parents to know about those first few days and nights with baby?
Cathy Nurkala: Well, one thing I wanted parents to know a little bit about is about their appearance because many new parents are surprised the first time they see their baby because newborns can look very different than what they were expecting. A newborn's head can be cone shaped for the first few days and weeks. Also, their eyes may be bluishy gray or brown, and that eye color can actually change. Sometimes it can take up to 12 months to know the baby's permanent eye color. Also a newborn's eyes might look crossed or they might move in an uncoordinated manner. And this usually disappears as the baby's eye muscles strengthen and their vision improves. Also babies, newborns their skin is usually covered with a white creamy substance called vernix and soft hair called lanugo. And I do want parents to know that that vernix and Lanugo does disappear soon after birth.
Also babies they might look pale with bluish hands and feet and that's normal too. The baby's hands and feet will pink up and also dry skin, pearly white bumps on their face, which are called milia and a newborn rash can be common. And also birth marks too can also be present. And birth marks will usually fade over time too. And if the parents do have any questions about their baby's appearance, they do want to discuss them with the pediatrician. Also, another thing that parents need to know about new babies is that they do communicate to us through cues and through crying. And it's important that parents respond to those cues and cries so that the baby can trust that their needs will be met. And when the baby cries, you know, of course it could mean that the baby might be hungry or need to be burped or too hot or too cold, can be bored or over stimulated or tired or lonely, need a diaper change. And of course for newborn cues you know sucking on their fingers, opening their mouth, sticking out their tongue, making sucking movements and sounds that can be a cue to indicate for instance, that the baby's hungry.
And when it comes to babies, a lot of parents kind of wonder, you know, will they spoil the baby, you know if they pick the baby up and respond to their cues and cries and you actually can’t spoil the baby. And when babies cry, sometimes they can cry and parents won't know why the baby's crying. And in that case, they just want to make sure that they should focus just on comforting the baby. And some comforting techniques could be holding the baby in their arms and gently, you know, rocking and swaying with the baby. Also talking and singing softly to the baby, making shushing sounds, maybe taking the baby for a walk, using a safe front carrier or a stroller, swaddling the baby in a blanket or a swaddle sack. And sometimes crying can frustrate parents. They want to make sure that they do if they are getting a little frustrated with the crying that they shouldn't be afraid to call someone to help like maybe call a family member friend or a parent hotline. Also, if they're by themselves, they can always put the baby in a safe place like the bassinet or crib and just walk away until they are calm and then go back in and tend to the baby. But parents want to make sure they never shake, hit, or throw their baby. And if the baby's crying a lot, they might even want to talk to the baby's pediatrician to rule out maybe a medical condition that might be making the baby cry.
Host: Wow. These are such great tips for new parents and it really can be such a daunting time. One of the most scary things for any new parents are the sleep cycles. How often should babies nap? How long should they be expected to sleep at night, whether they're formula fed or breast fed. What do you want to tell parents about those sleep cycles, which are really one of the most daunting aspects of new baby?
Cathy Nurkala: Well, one thing about newborns is they can sleep a lot. Usually they sleep about 16 to 18 hours per day, but they don't sleep for long stretches at a time, like we adults do. You know, babies usually sleep in one to three hour periods, but some of the periods can be as short as like 15 minutes and newborns, they don't really know the difference between night and day. So they will wake up for nighttime feedings. And these nighttime feedings are important because newborns, they do have very small stomachs and also their developing brains need energy, so they do need to be fed often. So they do need to be fed. Have some nighttime feedings too. Now as babies get older though over the next few months, you know, they will sleep more at night and also have some naps during the day too. One thing they can do to help their baby sleep is to make sure that they avoid a lot of stimulation during night feedings and diaper changes. You know, they want to save play time for daytime. And also it can help to have a bedtime routine of maybe three or four relaxing activities they can do before putting the baby to bed and that can, you know, kind of help wind down the baby. Another thing too is that we want to make sure when it comes to sleeping that babies are sleeping safely and the American Academy of Pediatrics recommends that babies sleep on their backs in a safety approved bassinet or crib with nothing in it, but the baby.
So the parents don't need to have any soft objects, toys, loose bedding, bumper pads, wedges, sleep positioners in the bassinet or crib. And again, babies also can sleep in like with a onesie and a sleeper with feet or a sleep sack. They don't need a hat when they're sleeping. The American Academy of Pediatrics recommends that babies sleep in their own bassinet or crib in the parents' room for at least the first six months and ideally for the first year. And the American Academy of Pediatrics does not recommend co-sleeping so that the baby needs to sleep in the parent's room, but the baby needs to be in their own crib or bassinet. Also they want to make sure that the room is at a comfortable temperature. Also for sleep. Sleeping babies can sleep with a pacifier after breastfeeding if well established. But if the baby will not take a pacifier, parents don't want to force one on the baby. Also, if the pacifier falls out while they're sleeping, they don't have to try to put it back in. They always want to keep their baby away from cigarette and cigar smoke from vapor. Also to breastfeed as long as possible and to make sure that they take the baby to all their well baby checkups.
Host: Wow. Another great list of really good advice. So give us some diapering tips. First of all, a lot of parents want to know about cord care and what they're supposed to do as far as taking care of that cord until it drops off and if the baby's been circumcised, how do they care for that as they're changing diapers?
Cathy Nurkala: Well, when it comes to changing diapers, which the parents are going to be doing a lot of because babies can go through a lot of diapers. What they want to do is for the cord they just want to make sure that they keep it clean and dry and the baby's cord stump will actually naturally fall off in about one to two weeks after the birth. And when it does fall off, they might see a little blood as it falls off cause it kind of, it's kind of like a scab falling off. But they want to make sure though that they don't use any alcohol wipes on the cord stump and that they don't pick at the cord stump, you know, let it naturally fall off. And they do want to notify the pediatrician at the skin around the cord stump is red or swollen if there's puss oozing from the stump and if the stump hasn't fallen off after three weeks, but for diapers, what they'll want to do is make sure when they put the diaper on in the front to fold it under the cord stump so that the diapers not going to irritate the cord stump. And dress the baby in loose clothing too, can help so that the clothing's not rubbing against the cord.
And when it comes to circumcision, if parents have questions about circumcision, it's good for them to actually talk to their obstetrician or the pediatrician. But when they're changing the diaper, when the baby's circumcised, the parents will be given instructions on how to care for the circumcision. And it takes about a week to two weeks to heal. But if they decide not to circumcise their son when they're changing the diaper or giving the baby a bath, they don't want to retract the foreskin from the tip of the penis cause it could tear. So they just want to wipe the penis. And when it comes to changing diapers once the cord stump has fallen off and the belly button is healed, then they can put the diaper over the healed belly button. And another thing too is when they're changing diapers they always want to make sure they wipe from front to back so that, especially for a daughter so that they're not wiping any stool over the sterile opening that their daughter urinates from. So always wipe from front to back. Having a son too when they put the diaper on, they want to make sure his penis is pointing downwards in the diaper so he doesn't end up with a wet shirt.
Host: Well that has happened to many of us. I am sure. So before we wrap up, you've been giving us such great advice. Now what about tummy time? When can that begin and wrap it up with your best advice for parents who are nervous, they brought home their newborn. It's so exciting. What do you want them to know?
Cathy Nurkala: Well, when it comes to tummy time, the good time to do it is when the baby's in a quiet alert state. Cause that's where the baby's going to be awake. And they're calm and their body's relaxed eyes bright and open looking at their parents. When they do tummy time, they can start it from the beginning while they still have the cord stump. And their belly button is healing. They can do it on their chest. And then once the cord stump has fallen off and their belly button is healed, then they could do tummy time on a blanket on the floor and tummy time is great because it'll actually help strengthen the baby's neck muscles and shoulder muscles. It promotes their motor skills and also prevents them from developing a flat spot on the back of the baby's head. And when they do tummy time it should always be supervised and the baby's awake and if the baby falls asleep or is fussing a lot, then the tummy time is over. And they could do tummy time a few times a day. And when it comes to parenting, one thing that parents just want to enjoy you know, being new parents. Parenting is kind of, you know, it's a lot of fun to take care of a new baby and get to know their baby and interact with their baby. And when it comes to taking care of a baby some of it will be trial and error. A little on the job training, but it'll be one of the most wonderful experiences they ever had.
Host: Well, it certainly is, and I can attest to that. It is just a wonderful time. It can be a little stressful and parents, you just take care of yourselves, have people help you and sleep when you can. Thank you so much, Cathy, for joining us today and sharing your great advice. And that concludes this episode of BayCare's HealthChat. To learn more about BayCare's maternity services, please visit BayCareMaternity.org, for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.