You'll be changing a lot of diapers (an average of 10 a day!), so it's important to learn the drill early on.

With today's modern disposables, it can be nearly impossible to tell by touch if your baby's diaper is wet, so plan on changing her after every feeding at first as well as after every bowel movement. While her cord is attached, use the notch-cutout diapers (or fold down a regular one), and be sure to daub the stump with a wet cotton ball or swab when you change her. Here are a few more helpful diapering tips:

Wipes may be used whenever you change a diaper, but they're especially handy when the diaper's messy. If you wish, apply ointment or petroleum jelly to prevent diaper rash before you put on a clean diaper. Wrap the clean diaper around your baby firmly and fasten the tabs in front. If your baby's skin is red around the diaper when you change it, it's either fastened too tightly or your baby is ready for the next biggest size.

And when it comes to taking care of your baby's umbilical cord, keep these guidelines in mind:

Take care of your baby's umbilical cord stump until it falls off on its own (usually 10 days to three weeks after your baby's birth). Daubing the stump with a clean, wet cotton ball or swab at every diaperchange is usually sufficient, but you can use rubbing alcohol if your health care provider advises it. Pay special attention to the area at the base of the cord, nearest to the belly button. Wipe gently but thoroughly to clean out any moist debris that may have collected there. Be sure to allow air to reach the cord stump use a notched diaper (or fold down the edge of a regular diaper) and avoid tight clothing around your baby's stomach.

FYI: If you start to experience frequent leaks, it may be time to move up to the next biggest diaper size. Read more about diapering and cord care from Dr. Anthony J. Mancini. By Linda Jonides R.N., C.P.N.P.
Meet our authors

"I have worked as a pediatric nurse practitioner (P.N.P.) for over 30 years," says Linda Jonides. "I continue to thoroughly enjoy forming new relationships with parents and newborns and working with them through infancy, childhood, and adolescence."

Linda Jonides is a pediatric nurse practitioner in a private pediatric practice in Ann Arbor, Michigan. She received her Diploma in Nursing and Certificate as a Pediatric Nurse Practitioner from The Johns Hopkins Hospital. She is a past recipient of the Michigan PNP of the Year Award. She has a B.S. in Nursing from Eastern Michigan University. She has published articles and lectured on childhood obesity, infant colic, role of the P.N.P., growth and development issues, and infectious diseases. She was an author of "Clinical Insights Column," published biannually in the Journal of Pediatric Health Carefor nine years. Jonides is past president of NAPNAP. Currently, she is a steering group work member of NAPNAP's HEAT (healthy eating and activity together) project. One outcome of this group's work is the clinical practice guideline, "Identifying and Preventing Overweight in Childhood," that was published as a supplement to the March/April '06 issue of the Journal of Pediatric Health Care. Ms. Jonides has been married to John, a university professor, since 1971.

Today, accidental injuries are the leading cause of death in children under 5. Injuries used to be called accidents because they seemed unpredictable and unavoidable. Now we know that accidents are not random but instead follow distinct patterns involving changes in the child, the circumstance that causes the injury, and the environment in which the injury occurs. These three componentsthe child, the circumstance, and the environmentare elements to examine. Prevention should focus on objects and surroundings because no matter how closely a child is watched, some accidents will happen. This is a new perspective: We used to think we could prevent accidents just by watching a child more closely. If an emergency occurs in a situation you considered safe, it offers a chance to learn something new about safetyonce your child is out of harms way and recovered, that is! What Is a True Emergency? Animal Bites

Burns Scrapes and Cuts Poisoning Head Bumps

What Is a True Emergency? Its a situation in which you believe a severe injury or illness threatens your childs life or may cause permanent harm. In these cases, which may involve unconsciousness, serious breathing trouble, and bleeding that you cant stop, a child needs to go to the emergency room for medical treatment immediately. Discuss with your pediatrician in advance what you should do, where you should go, or whom you should call in such a case. Be sure to post all critical phone numbers near every phone, and always let babysitters know where this information is and what to do with it. Some injuries can be helped initially by proper treatment by you, and minor ones can be managed completely at home. Others will need some professional attention in addition to steps you take yourself. Youll be able to evaluate what to do first with the information provided below. Animal Bites If an animal bite causes bleeding, apply firm and continuous pressure to the area for five minutes, or until the blood flow stops. Wash the wound gently with plenty of soap and water, then call your healthcare provider. Whenever an animal bite breaks the skin, even if it appears minor, its important to be sure about your childs immunization statusthat is, find out if shes been adequately immunized against tetanus from DPT shots and if she might need protection against rabies. Both diseases can be spread by animal bites, so discuss the situation with your healthcare provider. Tell him if the attack animal is known to you and whether its health status can be checked. Bites from wild animals such as squirrels, raccoons, or rats always need to be evaluated. Burns Causes of burns in children include excessive exposure to sun, electrical or

chemical contact, scalding by hot liquids, or contact with fire. All can cause permanent injury and scarring to the skin. Heres what to do in case of such burns:

Soak the burn in cool water as quickly as possible. Do not use ice. Remove any clothing from the burned area. If clothes are stuck to the skin, cut them away from the area as carefully as possible. You can also soak them off with clean, cold, wet cloths. Dont cover the wound unless its oozing. A small burn that is red or covered with blisters will dry out. If it is oozing, you can cover it with a sterile gauze pad, which is one of the supplies you should always have in your medicine cabinet. Call your healthcare provider for blistered burns or for burns that are white or black, which means the burn is deep. If the burn is larger than a saucer or involves the face or hands, call right away. Do not put butter, grease, or powder on a burn. These are not remedies and can actually make the injury worse. If redness or pain continues for more than a few hours, consult your healthcare provider. All electrical burns and burns of the hands, mouth, or genitals should receive medical attention as soon as possible. Be aware that sunburns that blister are second-degree burns. They need medical evaluation, pain relief, and careful protection the rest of the season. Scrapes and Cuts In most cases, good treatment requires just gentle, thorough cleansing of the area. Plenty of reassurance and perhaps a kiss on the injured area do wonders for your child, so dont skimp on them. Most scrapes in young children are abrasions, where the outer layers of skin have literally been scraped off. If its a large abrasion, the area may appear to be quite bloody, although the amount of blood lost is usually very small. Clean the area thoroughly because dirt left on the skin can lead to infection. Rinse the area first with water to flush away any debris, then wash as vigorously as possible with soap and warm water. Iodine and other antiseptic solutions generally have little protective value, and they can add to the pain and discomfort. Most abrasions scab over quickly, and this is the best natural remedy. Scrapes that are large or oozing or are still open should be covered with a sterile dressing, which you can obtain at any drug store. Apply an antibiotic ointment to protect the surface until the scab forms. Change the dressing daily or more often if it gets dirty or wet. Dressings are usually needed for only two to three days, until a firm scab has formed. A cut or laceration is a wound that breaks through the skin into the tissues beneath. There is likely to be bleeding, and damage to nerves and tendons is possible.

When your child gets a cut, do the following:

Apply pressure with a clean cloth over the site for five minutes. If bleeding hasnt stopped or has started again after five minutes of continuous pressure, reapply pressure and seek medical attention. Stay calm. This is often easier said than done, but youll make better decisions if you keep your cool, and your child will be less frightened. Seek medical advice if the laceration is deep (completely through the skin to the muscle or tendon beneath) or more than half an inch long. These cuts are more likely to damage nerves and tendons and more often need stitches, which ideally should be placed within eight hours of injury. So dont delay getting your child to the doctor if the cut is deep or wide. Check for movement around the cut: Fingers should still bend; toes should be able to curl. If not, a tendon may be cut, and you should see a healthcare provider right away. If its not a deep cut, wash the wound with warm water and examine it carefully to make sure its clean; then cover it with a sterile dressing. Pull a Band-Aid across the cut at a right angle to keep the two sides together. Dont hesitate to check with your doctor if youre unsure about treatment.

Poisoning Call 1-800-222-1222 (the U.S. Poison Center) right away if there is any chance your child has been poisoned. Suspect poisoning if you find your child with an open or empty container of any toxic substance, especially if he is acting strangely in any way. Other signs of possible poisoning include the following:

unexplained stains on clothing burns on the lips or mouth unusual drooling unusual breath odors unexplained nausea or vomiting abdominal cramps without fever difficulty breathing sudden behavior changes convulsions unconsciousness Take the poisonous substance away from your child, but keep the container or material for identification purposes. If he is vomiting and you are unsure what was ingested, catch some vomit in a container to bring to the doctor. Always call your local poison-control center with any suspicion of poisoning. Poison-control centers

are staffed 24 hours a day and can provide immediate information and guidance. If you are sure the situation is serious, or if your child is very groggy or unconscious, seek medical attention immediately, particularly if you are near an emergency facility. If its a long drive, get advice from the poison-control center or your health care provider before you start out. Dont make your child vomit unless you have been told to do so. In some cases vomiting may be dangerous. Products such as cleansers or dishwasher detergent can burn the throat, and vomiting can increase the damage. Head Bumps Generally, for a head injury to be serious, a child must fall more than four feet, be thrown a distance, land on something with a sharp edge, or be purposely hit with something by a large person. If a child suffers a concussion, she will lose consciousness, if only for a few seconds. Shell be confused and unable to tell you who and where she is, and she wont remember how she was injured. All kids with concussions need to see a doctor right away and be observed for a period of time. For more on what to look for and how to handle serious head injuries, click here. Every child is bound to have some kind of accident at some time, so dont feel guilty when it happens. Do learn how you can help prevent accidents and, in their event, how to handle them calmly, efficiently, and safely. Click here for a list of supplies to have in your medicine cabinet to be ready for any emergency.

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