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Buttock care tips

This is something that you will do at least 4 000 times for each baby you have, so it is worth doing it well! Good buttock care at each nappy change will prevent painful, unsightly rashes. These tips will keep your baby’s buttocks as smooth as they should be:

•Change soiled nappies promptly.

•If at home, wash Baby’s buttocks in the basin or a bowl with sufficient water and a gentle soap at every change.

•Avoid cleaning with cotton wool and oil.

•Do not routinely wipe Baby’s buttocks down with a moist flannel.

•Pre-soaped wipes should only be used for convenience when away from home – choose baby-sensitive ones.

•Once cleaned, leave Baby to play without a nappy for ten minutes to allow the area to dry well.

•If Baby has a sensitive skin or a rash in this area, expose the buttocks to five to ten minutes of direct non-midday sun each day to speed healing.

•If Baby has a bad rash, moisten a rooibos teabag with two teaspoons boiling water, allow to cool, place on the affected area. Leave on until the next change, as rooibos has skin-healing properties.

•Stubborn rashes often indicate a thrush infection, and this should be treated with an antifungal cream or homeopathic Calendula Tablets.

•Choosing a good quality disposable nappy helps ensure fewer problems with rashes and irritations.

How many nappies will Baby need in the early weeks?

Remember babies’ sizes vary so rather don’t buy too many disposable nappies in one size until you see how your baby grows.

•In the first six weeks of life, especially if breastfeeding, almost every nappy is soiled and a baby can easily need between six and ten nappies a day.

•From six to twelve weeks this should settle at about six nappies a day (breast babies will be soiling a lot less by this stage, sometimes only one nappy a week, because breastmilk is so perfectly digested).

•After three months, right up to six months, five to six nappies a day will be fine unless there is a tummy bug doing the rounds.

•From six months, five nappies a day is usually sufficient.

•After one year, as few as four a day until off nappies altogether.

TOWELLING NAPPY FOLDING TECHNIQUE

Breast babies’ bowel action

Breastfed babies’ bowel actions in the early months, before any supplemented milk is given or solids are introduced, have a typical pattern. For the first few days after birth meconium stools are passed – this is a sticky dark green/black substance that has filled the intestines while the baby was in the womb. Almost every nappy will be soiled with this, sometimes more, sometimes less, as the early mother’s milk, called colostrum, has a laxative effect to help clear the system of this sticky stool. Over the first three days, the colour gradually changes to become lighter and soon it will be the usual mustard colour of a normal breastmilk stool. Meconium is best cleaned with cotton wool balls dipped in baby oil.

Once breastfeeding is established, from about three days after birth, a typical stool is mustard-coloured, the consistency of a soft paste, almost without any odour and certainly not at all unpleasant smelling. A normal stool contains little whitish ‘seeds’. Almost every nappy will be soiled, sometimes just a smear, sometimes a huge amount. This is not diarrhoea and is no cause for concern. The digestive system is just maturing and this will soon settle. Frequent stools continue for about six to eight weeks. Thereafter, if the baby is still exclusively breastfed, stools will become far less frequent, sometimes occurring as seldom as once in seven to ten days. If the stool is still soft, this is not constipation. A constipated stool is always hard, dry and irregular.

Parents are often convinced their babies must be badly constipated in this phase as it seems so unlikely that a baby can pass a stool so seldom and still be healthy. Remember, though, that breastmilk contains very little waste matter and so there is little to pass through the colon. Babies often seem to be in discomfort when not passing a stool more regularly, but take into consideration that they are very aware of their digestive systems and make very dramatic faces from the rumblings on the inside! This does not mean that they are in pain – you will soon be able to tell the difference, so enjoy this unexpected benefit of breastfeeding!

There are some variations of this normal pattern that parents might need to know more about:

•It is normal for a newborn baby’s stool to contain a little blood sometimes. This is usually just a reaction to the mother’s hormones and will soon settle. You need only see a doctor if bleeding is substantial or persists.

•Baby’s stool might also reflect mom’s diet and medicines. Iron supplements and green veggies can cause green stools.

•Babies with allergy tendencies often react to dairy and grain products and other commonly allergenic foods by passing mucus with their stools. This can range from just a little to quite a lot of frothy mucus. If this occurs, nursing mothers should avoid these products.

•If the baby has been on medication, the stool may also change, mostly becoming looser.

•If the stool of an exclusively breastfed baby is malodorous and he is very windy or crampy, evaluate your diet carefully and make the necessary changes. If the problem still persists, see the doctor.

•Should your baby become jaundiced, you will notice that his urine stains the nappy a darker colour than that to which you have become accustomed. This is simply the pigment called bilirubin, which the kidneys are helping to excrete, and is not a cause for concern.

•When Mom takes an iron supplement, her baby’s stools may be tinged a green-brown and tend to be far firmer or even a bit constipated.

Formula babies’ bowel action

Formula-fed babies’ stools are usually brown and pasty, and are mostly passed once to twice daily. However a small baby will seldom demonstrate a pattern to its bowel action, apart from the motion accompanying feeding. In time you might detect a pattern, but a regular excretory routine cannot be forced. Green tinges can be due to iron added to the formula milk powder and are not a cause for concern unless accompanied by constipation.

The following deviations need attention:

•Constipation is quite common if the formula milk does not agree with Baby. These stools are pellet-like and painful to pass. At times a little diarrhoea-like stool might seep past the constipated stool, and should not fool one.

•Should you notice rather substantial quantities of mucus in the stool, it might be an indication that your child is sensitive to the formula. Alternatively, it might be a passing symptom of an, as yet, immature bowel. Should it persist and seem to cause discomfort in your baby, consult your practitioner.

•Some babies’ stools are passed explosively, others almost unnoticeably. Formula adjustments are sometimes required, but only if you see that your baby is uncomfortable. Homeopathic remedies like Rescue Digest and the tissue salt Mag phos may also provide distinct relief, as can massaging Baby’s lower abdomen and back.

•Green, watery stools are a definite cause for concern and if they persist after one or two episodes, have your practitioner check your baby. This is especially true if accompanied by fever and if your baby is disinclined to feed.

The best way to clean a baby after a soiled nappy is simply to wipe off most of the pasty matter and then dunk the baby’s buttocks in a basin of warm water and clean with baby soap.