You and your baby! Mercy Care. Always There. AZ-11-11-18

Mercy Care. Always There.
You and your baby!
Member Services
602-263-3000 or 1-800-624-3879
Hearing Impaired (TTY/TDD) 1-866-602-1982
Mercy Care Plan
4350 E. Cotton Center Blvd., Building D
Phoenix, AZ 85040
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**You will be assigned a PCP. Your PCP is named in your welcome letter.
This handbook has been revised as of September, 2011. Contract services are funded in part under contract with the
state of Arizona. Mercy Care Plan follows federal and state laws that apply under the contract with AHCCCS.
Your pregnancy will not be
like anyone else’s in the
world. Yes, you will have
many things in common with
other women who have had
babies. But did you know that
every pregnancy is special?
It is important to treat this
pregnancy as special, even
if you have been pregnant
Mercy Care Plan
We want to help you feel good about having a baby. A pregnancy lasts
about nine months (or 40 weeks). It is counted from the first day of your
last period. Your pregnancy is divided into three parts called trimesters.
• The First Trimester is months 1-3, or weeks 1-12.
• The Second Trimester is months 4-6, or weeks 13-27.
• The Third Trimester is months 7-9, or weeks 28-40.
We are here to answer any questions you may have about our services. If
you do not have a way to get to the doctor for your appointment, we can
help. Before you call Mercy Care Plan for a ride, make sure you have a set
appointment with your doctor. As soon as you have that, call us right away
to learn about setting up a ride. If you wait until the last minute to call for a
ride, we may not be able to help you.
Right now, growing a healthy
baby is your most important
job. To give your baby the best
possible start in life, you must
take care of yourself.
You need to:
Eat well
Get enough rest
Stay fit
Not smoke
Not drink alcohol
Not take drugs
You need to take care of
yourself all the time, every
day. This guide has important
information about doing what
is right to give your baby every
chance to be born healthy.
Your pregnancy
This guide will give you
information about your
pregnancy and your baby. If
you have any questions, ask
your doctor. Follow what your
doctor tells you.
Health care while you are pregnant
Your pregnancy
Be sure you get good medical care while you are pregnant. Visit your doctor as soon as you find out you are
pregnant. You may feel great, but only your doctor can make sure you are healthy.
10 Tips for a healthy pregnancy
1. Choose a healthy life even before you get pregnant.
2. Select a health-care provider (doctor) who makes you feel
3. Start taking care of your baby before giving birth (this is called
prenatal care). Know what services are available. There are many
good programs available to you during your pregnancy as well as after.
4. Let your doctors know what medicines you are taking. Avoid alcohol,
cigarettes and drugs. Check with your doctor before using any
medicines. This includes over-the-counter medicines.
5. Rest when your body gets tired. Your body is working overtime.
6. Stay physically active. Check with your doctor about activities that are
best for you during pregnancy.
7. Make time for yourself. Ask for help to make sure you feel your best.
8. Learn as much as you can about labor and delivery. Start thinking
about breastfeeding, childcare and choosing a pediatrician (a doctor
for babies and children).
9. Know the early warning signs of premature labor and the importance
of calling your doctor.
10. During your pregnancy, talk to your doctor about family planning
choices that will work best for you after you have your baby.
At your doctor visit, you will get a
physical checkup. All pregnant
women get their blood drawn
at the first visit. Your blood is
checked for any problems. Your
doctor will decide what tests
should be done during your
pregnancy and when they will be
HIV/AIDS testing and
We encourage every pregnant
woman to get tested for HIV. This
is the virus that causes AIDS.
Check with your doctor about how
to get this test. If you test positive
for HIV, your doctor can help you
with counseling services.
Choosing baby’s doctor
Doctor visits
Your baby will need his or her own doctor. This is not the doctor who
you see during your pregnancy.
Be sure to follow your doctor’s
advice about how often you
should be seen. The following
is an example of a common
schedule during pregnancy:
To pick a doctor for your baby, you can:
• Call Mercy Care Plan for a list of doctors near you who can take
new patients.
• Pick the same doctor you had for your other children.
• Ask your doctor for names.
Always call Mercy Care Plan to let us know which doctor you picked.
We need this name by the time you are seven months pregnant.
If we do not hear from you, we will pick a doctor for your baby. We
will send you a letter with the name, address and phone number of the
Exams and testing
during pregnancy
• Weeks 4-28
Visit at least every four weeks.
• Weeks 29-36
Visit at least every two weeks.
• Weeks 37-40
Visit at least every week.
Your pregnancy
Taking care of
For your health and to give
your baby the very best start
in life, do the following every
day during your pregnancy:
• Eat well
• Drink lots of water
• Check with your doctor
before taking any
• Exercise
• Get enough sleep
• Keep your doctor visits
Safety for you and your baby at
Are you safe at home? Being abused will hurt both you and your unborn
baby. This is a time when you should be happy and safe.
Abuse can be:
• Physical (hit, kicked, punched, bitten, etc.)
• Mental/emotional (such as always being put down by your partner, or
not being allowed to go anywhere without him)
• Sexual (forced to have sex)
Safe housing
If you are not safe at home, please tell your doctor, or let us help you get
into a “safe house.” A safe house is a place where you can go and no one
can find you to hurt you. For information about a safe house near you,
please contact Member Services. There is help.
If someone is hurting you, you may also call the
• National Domestic Violence Hotline at 1-800-799-7233, or the
• AZ Coalition Against Domestic Violence at 1-800-782-6400.
Do not smoke, take drugs or
drink alcohol.
Just for teens
Teen moms have special needs.
There are many special programs
to help teen moms get ready for
the changes in their lives. We
have a case management team to
help teen moms who have health
problems or who need special
programs and services. Call Mercy
Care Plan Member Services for
more information.
The case manager can either
give you a list or connect you with
special programs and services,
• Schools for pregnant and
parenting teens
• Parenting services
• Adoption services
• Support groups
• Maternity and children’s clothing
• Job services
• Paternity information
• And much more
Eating right
Eating right when you are pregnant
is the best thing to do. You can get
help from WIC at 1-800-252-5942.
Your doctor also will give you
information about eating right. Be
sure to follow that information.
Prenatal care
Here are some other helpful tips:
• Drink at least six to eight glasses
of water every day.
• Eat healthy snacks and meals.
Instead of eating three big meals
a day, try eating five or six small
meals and snacks that include:
✽ Fruit and fruit juice
✽ Cheese
✽ Vegetables
✽ Yogurt
✽ Wellcooked (baked or
grilled) meats, poultry and
✽ Watch out for highcalorie,
highfat foods.
• Stay away from foods with
“empty” value, such as:
Gaining the right
amount of weight
Your doctor will tell you how
much weight to gain during
this pregnancy. Most women
gain about 25 to 35 pounds.
Gaining too much or too little
weight can be bad for you or
your baby. The extra weight is:
7 1/2 pounds
1 1/2 pounds
Uterus (womb)
2 pounds
Amniotic fluid
(bag of water)
2 pounds
1 pound
Extra blood
3 pounds
Tissue and fluid 3 pounds
Your reserves
5 pounds
25 pounds
✽ Donuts, cake, cookies,
candy, ice cream and chips
✽ Burgers and fries
✽ Fried foods
✽ “Fast foods”
• Stay away from foods that could
make you or your baby sick,
such as:
✽ Raw fish, raw shellfish,
and some other fish like
swordfish, shark and king
✽ Undercooked meat and
✽ Raw or undercooked eggs
✽ Soft cheeses
✽ Cheeses not made in the
United States
✽ Unpasteurized milk and
foods made from it
✽ Unpasteurized juices
✽ Raw sprouts (i.e., alfalfa
You don’t have to stop all
physical activity because you
are pregnant, but you may have
to change the type of physical
activity that you usually do. Be
sure to talk to your doctor about
what physical activity is safe for
you to do. For example, ask
your doctor if it is safe for you to
take a walk every day.
Medicines during pregnancy
Your doctor will help you get your vitamins and folic acid. Be sure to take
these while you are pregnant. Your body needs this extra help now.
There are some medicines that are OK to take while you are pregnant,
but there are others that can cause harm. Always check with your
doctor before taking any medicines, even over-the-counter medicines or
Aches and pains
You may have many aches and pains during your
pregnancy. Many women experience the following
aches, pains and other side effects during each
trimester. These are normal.
First trimester (Up to 12 weeks)
Ask your doctor how many hours of sleep
you should get each night now that you
are pregnant. You may feel very tired and
may need more sleep than you’re used to,
especially in the first three months of your
Dental health
It’s important to take care of your teeth and
gums. Regular dental services are covered
for members under the age of 21 years.
Call Mercy Care Plan Member Services
for help on where to get dental care at
low or no cost. Mercy Care Plan Member
Services can be reached at 602-263-3000,
1-800-624-3879 or TTY 1-866-602-1982.
Before you take any medicines or get X-rays,
let your dentist know that you are pregnant.
Your dentist may want to check with your
doctor before giving you any medicines.
Prenatal care
Getting enough sleep
• You may feel tired and sleepy all the time.
• You may have an upset stomach. This is called
“morning sickness” but can happen at any time of
the day.
• You may have sore breasts that may be very
• You may find that you have to go to the bathroom
to urinate (pee) more often.
• You may be irritable, moody, cranky or cry easily.
• You may have other feelings. You may be afraid,
or you may be very happy.
Second trimester (13-27 weeks)
• You may have a discharge from your breasts, and
they may itch.
• Your changing hormones may make you sweat.
• You may have mood swings.
• You may feel mild aches and pains in your sides as
the baby grows.
• Your belly may have stretch marks and itch a lot.
• You may have heartburn as well as morning
Third trimester (28-40 weeks)
• You may need to urinate (pee) a lot because the
baby is pressing on your bladder.
• Your hands and ankles may swell a little.
• You may have backaches.
• You may get constipated.
• You may get hemorrhoids.
• You may have aches and pains in your sides as
the baby grows and stretches your muscles and
Warning signs
Some signs are NOT NORMAL. Call your doctor right
away if you have any of these problems:
First trimester
Symptoms & discomforts
• Vomiting that lasts more than two days or you are
unable to keep fluid down
• Pain or burning when you urinate
• Pain or itching in your vaginal area
• Unusual vaginal discharge
• Bleeding or fluid leaking from your vagina
• Fever (temperature) over 100° or you have chills or
flu-like symptoms
• You are in an accident
• You are hit, kicked or abused in any way by anyone
Second trimester
Same as the First Trimester plus:
• Any signs of labor
• Cramping that doesn’t go away after a few minutes
• Swelling in your face
• A bad headache that doesn’t go away after eating or
• You see spots, stars or your vision is blurred
Third trimester
Same as the First and Second Trimesters plus:
• Sudden swelling in your hands and feet when you
get up in the morning
• Your baby’s movements change in any way from
• Your baby is not moving
Watch for signs of labor
Call your doctor immediately if you have ANY of
these. Don’t wait for them to go away!
• Discharge, blood or water leaking from the
• Low, dull backache
• Feel like you’re going to start your period
(period-like cramping)
• Pelvic pressure (like the baby is pushing down)
• Stomach cramps (you may or may not have
diarrhea with this)
• Contractions that last for awhile
Having your baby too early
Here are a few things to know
about premature birth:
The following situations put you at risk of having your
baby too soon. If you:
• Do not take care of your health while you are
pregnant or do not get health care until late in your
• Have poor eating habits
• Have tooth and gum disease
• Smoke
• Drink alcohol
• Take drugs
• Have infections
• Are going to have twins, triplets or more in this
• Are under 17 or over 35 years of age
• Delivered a preterm baby in another pregnancy
• Are in a high-stress situation
• The earlier the baby comes, the more danger there
is to the baby.
• Premature babies can be very sick and can spend
most of their first year of life in the hospital.
• Premature babies may need special care throughout
their whole lives.
• You can help give your baby a healthy start in life!
Get early care, and be sure to keep your health-care
Babies born too early (premature babies) can have
many problems right from the start. In fact, early birth
is the main reason for newborn baby death. A baby is
considered premature when born before 37 weeks.
What you can do to help
• Get good health care while you are pregnant, and
keep all your appointments.
• Be alert for signs of early labor.
• Eat healthy.
• Follow your doctor’s advice about what you should
• Quit smoking.
• Stay away from drugs and alcohol.
• Make sure your teeth and gums are healthy.
Sypmtoms & discomforts
For more information about premature babies,
go to the March of Dimes website at:
Baby’s growth and development
Inside your womb
First trimester
1st month
Your baby’s heart is beating, and all the important organs
are beginning to work.
2nd month
Your baby is the size of a grape; all the organs are
formed, and the baby can move its arms, legs, fingers
and toes.
3rd month
Your baby weighs about an ounce and is about four
inches long.
Second trimester
4th month
Your baby has eyelashes and eyebrows, and kicks, turns
and moves a lot, but you can’t feel it yet. Your baby
weighs about five ounces and is six to seven inches long.
5th month
Your baby grows really fast, is now 12 inches long, and
weighs 1/2 to one pound. Soon you will feel your baby
6th month
Your baby starts to open and close his/her eyes. Your
baby weighs one to one and a half pounds and is about
14 inches long.
Third trimester
7th month
Your baby is very active and even sucks his/her thumb.
The baby can hear and often responds to touches (that’s
why so many women rub their tummies)! Your baby
weighs about three pounds now and is 15 inches long.
8th month
Your baby’s organs are working well, but he isn’t ready to
be born yet, because the lungs are not ready to breathe
on their own. Your baby’s moving may slow down
because there isn’t much room in there! But please call
your doctor if you don’t feel the baby move for a day.
Your baby now weighs about five to six pounds and is
about 18 inches long.
9th month
Time is getting closer, and the baby is getting ready to
be born. Your baby is now saving up a lot of energy for
the big day and is ready to come any time. Your baby
now weighs between six and nine pounds and is 19 to
21 inches long.
Getting ready
Inside your womb
You will need to have
everything ready ahead of time.
Have your things packed and
ready for the hospital. Your
doctor may have a list of things
you will need.
• Be sure you have a car seat
for the baby. The hospital
will not let the baby go home
without one.
• If you have other children, let
them know you will soon be
going to the hospital to have
the new baby.
• Make plans for someone to
watch your children when
it’s time for you to go to the
Labor and delivery
Your doctor will let you know
what to do when you go into
labor. Here is some helpful
If it is more than three weeks
before your due date:
Call your doctor right away if
you have four contractions in
one hour (even if they don’t
cause pain).
Childbirth classes
We make it easy for you to go to
childbirth classes. Just call the
hospital where you will have your
baby to find out about when the
classes are. Plan to take childbirth
classes starting about week 30
of your pregnancy. Classes often
meet once a week for about six
weeks. Some hospitals have
classes in Spanish too.
You don’t have to worry about the
costs for the classes. Classes
are available to Mercy Care Plan
members at no cost. Mercy Care
Plan will help with a ride to your
childbirth classes if you can’t find
Do you have questions? For
more information, call Mercy
Care Member Services at
602-263-3000, 1-800-624-3879
or TTY 1-866-602-1982. .
If you are near your due date:
• Call your doctor when you
have contractions every five
to seven minutes for one
• Call your doctor right away
if your water breaks or is
leaking (or if you’re not
• Call your doctor if your
contractions get stronger
and more frequent when you
are walking.
Your new baby is here!
This part of the guide will help answer some of your questions about your new baby. If you have questions, talk to
your baby’s doctor. We will refer to the baby as “he” throughout this book, even though your baby may be a girl.
After the baby is born
Your newborn baby
Call your doctor right away if:
• You have heavy bleeding or large clots that
continue two to three days after you have your
• Your bleeding goes away and comes back
heavy or with clots.
• Your discharge develops a bad smell or gets
• You develop a fever and abdominal pain.
• You have breast pain and any redness in any
area of one or both breasts.
Your health after your baby
is born
You will need to see your doctor six weeks after you
have your baby. This is a very important visit. Call
the first week after you have your baby to make this
appointment. If you are not already on some kind of
family planning, this can be set up at this visit. If you
had a C-section, you may need to go the doctor before
six weeks is up.
Your body will go through many changes after
having a baby. It is common to cry or feel sad
- even if you think there is no reason to feel this
Many women have some sort of baby blues after
having the baby. Having these feelings does not
mean you are a bad parent.
This lasts only about two weeks. If you do get
the baby blues, try to have your family and friends
around to help. Also, get as much rest as you
can. Call your doctor right away if:
• Your sad feelings are more than you can take
or last longer than the first two weeks.
• You can’t take care of yourself or do not feel
like eating.
• You can’t take care of your baby or have
strange or unusual thoughts about yourself or
your baby.
• You start to think something bad will happen to
your baby or you feel you will hurt your baby.
If you have a history of depression, let your doctor
know. This may add to the chances of you having
postpartum depression (baby blues that do not go
away after two weeks or are severe).
What to expect from your baby
Baby’s eyes
Your baby sees objects best when
you hold them about eight to 15
inches away from his eyes. Babies
like looking at faces, bright lights,
colorful objects, and black and
white patterns. Some examples of
these are a picture of a black and
white bear, a red ball or a yellow
smiley face.
Baby’s ears
Your baby hears sounds. It is
common to raise the pitch of your
voice and “baby talk” to your baby.
Babies hear higher tones best.
Your baby likes to hear the sound of
your voice. Hold your child against
your chest so he can hear your
Baby’s sleep
Babies need a lot of sleep. When
sleepy, your baby’s eyes will start
to blink. If there is a loud sound,
baby’s body may jerk. Babies in
a deep sleep breathe evenly and
do not wake up easily. When your
baby sleeps more lightly, breathing
may be less even. His eyes may
move under the closed eyelids.
Baby’s mouth may make a sucking
Many babies wake up slowly. It may
take a little while for him to be ready
to eat or play. You can talk softly to
your baby. Try holding him gently to
give him time to wake up.
Baby’s learning
When awake, your baby will be
moving about and learning about
the world. Your baby will look at
your face. He will listen to the
sound of your voice. At first, babies
are only able to do this for one
to two minutes at a time. As he
gets older, he will be able to focus
Your baby needs to use the muscles
in his back and neck. Lay your
baby on a clean blanket on his
tummy when he is awake and an
adult is watching. You can put a
bright colored soft toy where your
baby can see it. As your baby gets
older, he will start to use his hands
to reach for toys. Your baby may
also move around when lying on his
Your baby will try to make himself
feel better when he is tired. Putting
his hand to his mouth is one way
he does this. Give your baby time
to relax. Hold your baby close and
rock him gently.
Baby’s reflexes
New babies have many automatic
reactions (reflexes). These reflexes
show how well his brain, nerves
and muscles are working. Reflexes
go away as your baby grows and
changes. A few examples of
reflexes your newborn will show are:
• Grasp reflex - Your newborn will
hold on tightly to your finger.
• Startle reflex - Loud sounds will
startle your baby. His arms and
legs will straighten suddenly.
• Rooting reflex - If you stroke your
baby’s cheek, he will turn his
head and open his mouth.
• Crawl reflex - When your baby is
on his tummy, he will move his
arms and legs like he is trying to
• Sucking reflex - You baby will
suck on anything that is placed
in his mouth.
Your newborn baby
Your baby is amazing! All children grow and change at their own rate. If you question the way your baby is
growing, ask your baby’s doctor.
Baby’s growth and development
1 Week
9 Months
1 Month
12 Months
• Liftheadforashorttimewhenlyingdown
• Sleepthreetofourhoursatatime;stayawakeone
• Watchyourfaceasitmovesfromsidetoside
• Becomfortedbybeingheldortalkedto
2 Months
15 Months
• Abletocontrolhisheadwhenheldupright
Your baby’s development
18 Months
Whenlyingontummy,willraiseupperbodyonhands •
Your baby is a
special person.
Your baby will be
different from other
babies. Listen to
your baby. Watch
his face and body.
Your baby will let
you know if he
needs something or
has a problem.
Childcare basics
Taking care
of your baby
Never shake your baby.
Shaking is not safe even if
it is done in fun and not anger.
Shaking can hurt a baby’s neck
and brain. Rough bouncing or
swinging also could hurt
your baby.
How to hold your
Your baby will have very weak
muscles in his neck. His head
is heavy and hard for him to
control. To stop neck or head
injuries, keep your hand or
arm under his head. You can
hold him up to your shoulder,
cradle him in one arm or hold
him under your arm, like a
When to
feed your baby
It is best to feed your baby when
he is hungry, not at a set time.
If you had more than one baby,
you may have to feed them on
more of a set time. Breast milk
is the BEST baby food. It may
protect your baby from illnesses.
Your baby will get added help in
growing if you can breast-feed,
even for a short time.
How to breast-feed your baby
Remember, both you and your baby are new at breast-feeding. It may not
be easy. Sometimes problems start after you your take baby home. If you
have problems breast-feeding your baby, ask for help right away. Don’t just
stop breast-feeding. Before the problem becomes big, call your doctor’s
office or the hospital where your baby was born. You can also call La
Leche League USA at 1-877-4-LALECHE (1-877-452-5324).
Breast-feeding babies often eat every one to three hours. Your baby’s
hunger will change from week to week. Sometimes when growth is
fast, your baby needs to eat more often. Feed him when he shows
signs of hunger.
Childcare basics
How to feed your baby
with a bottle
Bottle-fed babies may only be
hungry every three to four hours.
Your baby’s hunger will change as
he grows.
It is important to hold your baby
when you feed him.
Hold your baby in your arms against
your chest. Put the nipple into your
baby’s mouth. Tip the bottom of
the bottle up so the nipple is full of
formula and not air.
Check with your baby’s doctor
about which kind of formula to use.
Be sure to follow information when
you mix liquid with powder or liquid
concentrate. If you use too much
or too little water, the formula could
cause health problems and hurt the
growth of your baby. This could
even be very dangerous.
Here are a few important tips about
bottle feeding:
• Bottles should be clean for each
• Don’t heat bottles in a microwave
oven. Formula heats unevenly.
It can burn your baby even if the
bottle is not hot.
Boil and cool water, or use
bottled water for your baby, if
you are not sure how clean the
tap water is.
Check how hot the formula is by
putting a few drops on the inside
of your arm. If it burns, it is too
hot for your baby.
Formula should flow from the
nipple in slow drops. Babies can
choke if formula is flowing too
When your baby is a newborn,
he will not drink a full bottle. If
you only mix a few ounces in the
bottle at a time, you won’t waste
as much.
It is not good for your baby to be
forced to finish every bottle.
Throw out what your baby does
not use at each feeding.
How to know if your baby is
getting enough to eat
New moms often worry if their baby
is getting enough to eat. You can
be sure your baby is eating enough
if he:
• Has six or more wet diapers
every 24 hours and soft bowel
movements (poop or stool)
• Has a weight gain after the first
week - sometimes babies lose
some weight the first few days
• Gets sleepy or calm after eating
and burping
How to burp your baby
Babies often swallow air when they
are nursing or drinking from a bottle.
Burping helps to get rid of the
swallowed air so that your baby’s
tummy can hold more milk. Burping
also helps to reduce spitting up and
upset tummies. Try to burp your
baby in the middle of a feeding and
at the end.
You can hold the baby upright
on your shoulder. You can also
lay him on his tummy across your
knees. You can hold him in a
sitting position on your lap. You
need to lightly pat or rub his back.
Sometimes some milk or formula
comes up when a baby burps. Use
a burp cloth to cover your clothes.
• Wash the diaper area and under the chin, arms and
around the legs.
• Dry these areas well to stop skin rashes.
The doctor or nurse at the hospital will tell you how to
take care of your baby’s cord.
• Never try to pull the cord off.
• The cord will fall off by itself in seven to 14 days.
• Keep the cord clean. Dry by folding the top of
diapers down below it.
• Call your baby’s doctor if the skin around the cord
gets red or bleeds any more than one or two drops
of blood.
• Binding the belly button (or taping coins on the cord)
will not keep your baby’s belly button from sticking
• Do not put any type of covering over the cord, such
as a bandage, because it will keep the cord from
drying and falling out.
After the belly button is okay, you can bathe your baby
in a small tub or sink with only two to three inches of
warm water. Bath water should be warm to your touch,
not hot.
How to wash your baby
• The first days after birth use a sponge to wash your
• It will help keep the cord dry.
• If you keep your baby’s cord, genitals and face
clean, he only needs a bath every few days.
Before washing your baby, get all the things you need.
Have a washcloth, gentle soap, towels, clean clothes
and a diaper. Start washing your baby’s face and neck.
Wash the diaper area last. Always hold onto babies
in or around water. A child can drown quickly. Never
leave a child alone in water.
How to dress your baby
Unless your baby weighs less than 4 ½ pounds, he
only needs to wear a little more clothing than you do.
Too many clothes and blankets can make your baby too
Protect your baby’s skin from the sun. For the first few
weeks, it is best to keep your baby inside. Baby’s skin
sunburns very easily. Stay away from the sun and keep
baby in the shade or lightly covered. Use sunscreen for
older babies and children when they go outside.
Childcare basics
How to care for the umbilical cord
(belly button)
Childcare basics
Baby’s bowel
The first few poops after birth
are thick, dark green and sticky
and are called meconium. After
the first few green poops, a new
baby has yellow poop. The way
your baby’s poop looks depends
on if he is fed breast milk or
Breast-milk-fed babies:
• Have yellow, lumpy and liquid
poop, the color of mustard
• May have up to 10 dirty
diapers every day in the first
• May have only one poop each
day or one every few days
• Have dirty diapers that do not
smell bad
Formula-fed babies:
• Have poop that is a little
• Have poop that looks like
yellowish peanut butter
• Usually have dirty diapers one
or two times a day
If your baby is not able to have a
bowel movement (poop):
• If he’s been unable to poop
for several days or his poop
is hard and dry, he may not
be getting enough liquid.
Contact your baby’s doctor
right away about this problem.
• Your baby also needs more
liquids if he is throwing up or
has a fever. If your baby is
throwing up or has a fever,
contact the baby’s doctor
right away.
Diapering your baby
The rule for cleaning a baby is to wash from the clean areas to the dirtier
areas. Always wipe baby’s bottom from the front to the back. This
keeps germs out of your baby’s openings.
• Use a clean baby wipe or a clean part of a washcloth for each wipe.
• If your baby is a girl, use a clean wet wipe or washcloth and wipe from
front toward the back to clean any poop that may have collected in the
folds of skin around her vagina.
• If your baby is a boy, the foreskin on the penis may not loosen until
about three years of age. Don’t try to pull the skin covering back.
If your baby is circumcised
Check with your doctor about how to take care of the penis after the
circumcision. Drip warm water gently over the end of the penis to clean
it with every diaper change. Put diapers on loosely. Don’t lay baby
on his tummy until he has healed. It takes about two weeks to heal.
Circumcisions are not covered by AHCCCS - you will need to pay for this.
What is diaper rash?
Diaper rash is red and may have small bumps. It shows up on the baby’s
skin usually around the area covered by a diaper. There are different
causes of diaper rash:
• Wet or dirty diapers against the baby’s skin
• Reaction to the soap used to wash cloth diapers
• Reaction to disposable diapers
• A new food in your baby’s diet
How to take care of diaper rash
Change diapers more often.
• Use a diaper rash cream when you change the baby.
• Let your baby go without a diaper for some time each day.
• Check with your doctor if diaper rash does not go away within a few
days or if it becomes worse.
How to stop diaper rash
• Change your baby’s diaper after every poop.
• Change your baby’s diapers often when they are wet.
• Wash the diaper area with a soft, wet cloth. Dry the area before
putting on a clean diaper.
• Leave your baby’s bottom bare for a while each day. The air helps
stop diaper rash.
Baby teeth start to come in during
the first year of your baby’s life.
Taking caring of your baby’s teeth
is important because they help your
baby to:
• Talk well.
• Eat well.
• Think well of themselves.
• Keep their next set of teeth in line.
Dental or gum disease is catching.
Mom’s dental health can affect
baby’s teeth. When mom brushes
her teeth, it helps to get rid of the
germs in her mouth.
• Don’t share anything that will get
saliva from mom’s mouth into
baby’s mouth.
How to put your
baby to bed
You can lay the baby on his tummy to
play. Always place your baby on his
back to sleep. Babies put on their
backs to sleep have less chance of
Sudden Infant Death (SIDS).
• SIDS is the sudden and
unexplained death of an infant.
• SIDS is sometimes known as crib
• The death happens quickly and
silently during sleep.
• SIDS is the number one cause of
death in babies from one month
to one year of age.
After years of study, scientists still
cannot find a reason for SIDS.
These are some things that you can
do to help stop SIDS:
• Place your baby on his back to
• Mom and baby should not eat
from the same spoon.
• Mom should not chew food to
feed to the baby.
Other ways to protect your baby’s
teeth are:
• Don’t put baby to bed with a
• Limit snacks that will stick to
baby teeth, like crackers or
• Have your baby’s teeth checked
often by a dentist, doctor or
• Get any cavities taken care of.
• Clean your baby’s teeth and
gums with a damp cloth or a soft
• Children need help brushing their
teeth until about age seven.
• Don’t give your baby juice.
• Do this when the baby is put
down for a nap or to bed for the
• If your baby rolls over on his own,
don’t try to force him to stay on
his back.
• Do put your baby in different
positions while he is awake.
Putting your baby on his tummy to
play helps his neck and shoulder
muscles get stronger.
• Keep your baby away from
cigarette smoke. Smoking
near babies may cause health
problems for babies, including
• Breast-feeding your baby may
also help to cut the chance of
• Put your baby to sleep on a
firm surface. Do not use fluffy
blankets, pillows, stuffed animals,
waterbeds, sheepskins or other
soft bedding in his crib.
The baby’s teeth start to appear
around four to seven months. The
first teeth to show are usually the
two bottom front teeth. There are
some signs where you can tell your
baby is teething:
• Bulging gums
• Drooling
• Fussing
• Night waking
• Biting
While your baby is teething, your
baby may also have:
• A rash caused by drool.
• Watery poop.
• Cough.
• Low-grade fever.
Some help for teething includes
anything cold or teething gels.
• Talk to your baby’s doctor about
other steps you can take to cut
the chance SIDS.
Additional information is available
in English and Spanish online at or by calling
New babies sleep most of the time.
They are awake for short periods.
When your baby is tired, he will let
you know. He will get fussy, turn
away and stop wanting to play.
Baby’s waking and sleeping patterns
will be very different from yours.
New mothers should take
a nap whenever the baby is
sleeping. Babies often get
days and nights mixed up.
When a baby sleeps, it may
be the only time mom has a
chance to get her rest. Don’t
forget to take care of yourself.
Childcare basics
How to keep
your baby’s
teeth healthy
What to do when your baby cries
Babies ask for help by crying. Crying is the way that a baby tells you things. He could be hungry, tired, lonely or
sick or could have a wet diaper. Crying may also help a tired baby feel better. Listen and you will soon know your
baby’s different cries.
Some babies are “fussy” the same time every day, often at night. Some babies have colic and cry really hard into
the night. The good news is that most babies no longer have colic by three months of age.
A few ways to help a fussy baby feel better:
• Change wet or dirty diapers.
• Hold your baby; try different positions that provide
support to his tummy.
• Let your baby suck on your clean finger or on a
clean pacifier.
• Try to feed your baby.
• Swaddle your baby by wrapping a blanket around
him tightly.
• Hold your baby close to your chest and softly
rock him.
Why babies cry
What to do if your baby keeps
If you cannot calm your baby or he is acting different
check his temperature. Call his doctor right away if he:
• Has a fever.
• Is not acting normally.
• Cannot be calmed.
If your baby cries a lot and seems to have lots of gas,
he may have an upset tummy. Something he ate may
be causing him pain. Breast-feeding mothers may
have to give up foods that upset their baby’s tummies.
Sometimes bottle-fed babies need to have a different
formula. Talk to the baby’s doctor about this.
• Talk to your baby face to face; use low, rhythmic
• Reduce noise and lights in the room.
• Put your baby in a carriage or baby carrying pack,
and walk with him inside or outside.
• Take your baby for a car ride.
• Put your baby in his crib and let him cry. Be patient.
He may just need to cry a few minutes before he
can sleep.
Sometimes your child will need to see the doctor
sooner than his next checkup. If your baby is
sick and has a fever, call the doctor’s office right
away. Ask to bring your child in that day. If your
child gets sick after-hours or on a weekend, call
the doctor’s office anyway. An answering service
will make sure your doctor gets your message.
The doctor office will call you back to tell you
what to do. Be sure your phone accepts all calls.
Otherwise, the doctor may not be able to reach
It may be best to put your baby in his crib if you get
angry or upset when he cries. He may need to cry for
a short time.
Things to do:
• Check that your baby’s needs have been taken
care of.
• Make sure your baby is not sick.
• Find a trusted adult who will take care of your baby
if you get very upset with him. Parents Anonymous
is a group that has a hotline you can call when you
need someone to help you deal with your anger.
You should always follow the information from your doctor. Family and friends
mean well, but your doctor is best for medical information.
Right after birth, your baby will be checked. Your baby needs to be checked
again by the doctor within two to five days after you bring your baby home.
Your baby must see his doctor for checkups many times the first year of life. This
is because babies grow and change so much during their first year. The doctor
will weigh your baby. She will measure his length and head size. She will check
your baby from head to toe. Your baby also will get immunizations (shots). The
doctor can sometimes find problems you cannot see. Early care can keep many
problems from becoming worse.
List of well-child visits (this is the same as the EPSDT visits) during the first two
2 to 5 days
2 to 4 weeks
2 Months
4 Months
6 Months
9 Months
12 Months (1 Year)
15 Months
18 Months
24 Months (2 Years)
Well Child
(EPSDT) Visits
Shots Needed
Check with doctor
No (If child is up to date)
Check with doctor
No (If child is up to date)
More information about well-child checkups and baby shots can be found in your
member handbook.
Vaccines (shots) can protect your child from many diseases. After some shots,
your baby may be fussy or have a low fever for a few days. Check with your
baby’s doctor to see if you should give your baby any medicine after shots. Call
the doctor if your baby’s fever goes above 103.
If your baby misses a well-child visit (this is the same as an EPSDT visit), it is
important to go to the doctor soon for the shots. Shots can be given even if
your baby has a cold. If your child has a fever, cold, watery poops (diarrhea) or
is taking antibiotics, shots can still work. Shots will not make your child sick.
Missing shots can make your baby sick.
Take your baby’s shot record with you to every checkup. Take good care of the
shot record. Your child will need to show this record every year to start school.
What to expect
after shots
Some children have
minor side effects after
baby shots:
• A mild fever
• A sore where the
shot was given
It is unusual for a child
to have a bad reaction
to a shot. The side
effects of baby shots
are small and worth
it if they stop serious
Sometimes parents
forget and their child
is late on baby shots.
Shots protect babies for
life. It’s never too late
to catch up! Ask your
baby’s doctor about
catch up shots.
Keep the record of your
baby’s shots in a safe
spot. Parents need to
keep a record of their
child’s shots. Make
sure all baby shots are
listed in the LIFETIME
RECORD given to you
by your baby’s doctor.
Keeping good records
will make sure your
child gets the shots he
needs. Remember to
take this record to each
well-child visit (this is
the same as an EPSDT
Health care basics
Health care for your baby
When your
baby is sick
• Takeyourbaby’stemperatureifyou
rightaway if your baby’s temperature
• Writedownwhatthenumberis,how
• Writedownwhatyouseethatmakes
• Makenotesaboutyourbaby’sskin
• Write down if he is crying.
• Noteifheisthrowinguporhas
Baby and fever
When to call the doctor or clinic
• Atemperatureunder97.8orover100.4degrees
• Vomitingthatshootstwoorthreefeetoutofhismouth
• Vomitingthatcontinuesformorethansixhours
• Tummyfeelsveryswollenandtight
• Twoormoretimesofgreen,waterydiarrheaormorethan
• Notwantingtoeattwofeedingsinarow
Health care basics
• Dischargeorbleedingfromanyopenings,exceptfromthe
• Coughingorchokingwhilefeeding(Makesurethatthe
• Cryingmorethanonetofourhoursaday
• Skinthatlooksverypaleorbluish,exceptbaby’shands
• Jaundice,ayellowtinttotheskin,thatstartsorgetsworse
• Infectionsaroundthecordorcircumcisedpenisthatisred
Your baby’s doctor
After your baby becomes a member of the health plan, you will get a letter with the name of your baby’s doctor.
Call your baby’s doctor for the first visit before leaving the hospital. Most healthy babies are sent home within 48
hours after being born. New babies should be seen by their own doctor two days after being sent home.
You will have questions about your baby’s health and care. It’s hard to remember the things you want to ask.
Write down your questions when you think of them. Be sure to take your member ID, your baby’s shot record and
your questions with you to the visits.
If your baby’s doctor feels that your baby is too sick to wait, he may tell
you to take your baby to a care clinic. Care clinics are open longer hours
and on weekends. Call Member Services to help find a care clinic by your
For increased sleepiness with little movement or a floppy body, call 911
instead of the doctor’s office
If your baby is not able to be soothed, no matter what you do, he may be
sick. Check his temperature. If you take it rectally and it is over 100.4
degrees Fahrenheit (38 degrees Celsius), he could have an infection.
Contact your baby’s doctor.
Health care basics
Care clinics
Call the doctor if
your baby is not acting
or looking normal. You will
soon learn what is normal
for your baby. It is always
best to talk with your
baby’s doctor if you
are worried.
Tips to help keep baby safe
Health care basics
• Everyonewhotouchesyour
• Makesureusedorhand‑me‑
• Neverleavesmallobjectsor
• Neverleaveyourbabyaloneon
• Neverleavehouseholdcleaners,
• Neverleaveyourchildalonenear
• Keeplidsdownontoiletseats
• Donotleaveoutbucketsor
• Protectyourbabyfromelectrical
• Don’tletyourbabyplaywith
• Useacarseat.Neverholdyour
NEVER,EVER• Allbabiesshouldrideinacar
SHAKEABABY! seatinthebackseat.
Shakingmaycause • Neverplaceababyin
• Installyourcarseat
• Neverleaveyourbaby
• Neverleaveyourbabyaloneina
Keepbabiesawayfromanimals. • Don’tplacethebabyinacar
• Protectyourbabyagainstburns.
✽ Whenholdingyourbaby,
✽ Testbathwaterwithyour
✽ Turndownyourhotwater
When to use the emergency room (ER)
A true emergency is when you
believe a severe injury or illness is
threatening your child’s life or may
cause permanent harm. In these
cases, a child needs emergency
medical treatment.
Discuss with your child’s pediatrician
in advance what you should do in
case of a true emergency.
Call your doctor first for advice
instead of going to the emergency
room, unless there is a life- or
limb-threatening problem.
Emergencies can result from illness
or injury. In cases of emergency,
your child may show any of the
following signs:
• Acting strangely or becoming
more withdrawn and less alert
• Unconsciousness or no response
when you talk to your child
• Rhythmic jerking and/or loss of
consciousness (a seizure)
• Increasing effort or trouble with
• Skin or lips that look blue, purple
or gray
• Neck stiffness or a rash with
• Increasing or severe persistent
• A cut that is large or deep, or
involves the head, chest or
• Bleeding that does not stop
after applying pressure for five
• A burn that is large and/or
involves the hands, feet, groin,
chest or face
This might be from:
• A bad fall
• A deep cut
• An electric shock
• An object stuck in the nose, ear
or eye
• An animal or human bite
• Hitting his head - he might seem
confused, or cannot stay awake
or is throwing up
If your baby does not have a
Take your baby to the ER if: medical emergency and you go to
• You think he has a medical
• His life is in danger
• He is really sick. These are
some symptoms you might see:
✽ A high fever
When to call 911
Call 911 if you think the baby’s life is in danger.
Do not hang up. Hold for the operator to give you
instructions. Have your address taped near your
phone. It is easy to forget your address when you
are scared or excited.
Call 911 right away if your baby has any of the
following problems:
• Trouble breathing
• Breathing very fast (more than 60 breaths per
• Breathing very heavy with nose flaring or upper
stomach area under breast bone sucking in with
✽ Vomiting in a newborn
✽ The baby is wheezing or
making a high-pitched noise
when breathing
✽ A blue or pale tinge to the
baby’s skin
the ER, you may have to wait for
hours before a doctor sees your
baby. If your baby is sick but it
is not an emergency, your baby’s
doctor can give him the best care.
Call your doctor for advice on what
to do.
• Not breathing for more than 15 seconds
• Choking and is not able to suck air in - DO NOT
because this may push objects further into
baby’s throat
• Continued blueness of skin, especially around
the mouth
• You cannot wake the baby
• If your baby has a seizure
• If you or your baby is in immediate danger of
being hurt by any person in your home
Illness, injuries & accidents
What are the signs of an
Learn what to do in an emergency. Know what to
do for your baby. Most hospitals, fire departments,
the Red Cross and the American Heart Association
have local CPR classes.
Local community resources
Below are some local community resources that can help you during your pregnancy and after your baby is born.
WIC (women, infants,
and children)
Community resources
Women, Infants, and Children
(WIC) provides food, breastfeeding education, and
information on healthy diet to
women who are pregnant, infants,
and children under five years old.
We have staff who can help you
get in touch with WIC shelters,
or other local agencies whose
help you may need while you are
AZ Department of
Health Services
150 N. 18th Avenue, Suite 310
Phoenix, AZ. 85007
The Nurse-Family Partnership is a
program for first-time mothers who
are less than 28 weeks pregnant in
North or South Phoenix or Tucson.
With the program, a registered
nurse will come to the home of a
pregnant member. The nurse will
help to make sure that the mother
has a healthy pregnancy, and there
is no cost to the member for this
North & South Phoenix
Nurse-Family Partnership
Southwest Human Development
2850 N. 24th St.
Phoenix, AZ 85008
Tucson Nurse-Family
1101 N. 4th Ave.
Tucson, AZ 85705
520-624-5600 ext. 506
Healthy families
This program helps mothers have
a healthy pregnancy and also
helps with child development,
nutrition, safety and other things.
A community health worker will go
to the pregnant member’s home to
give her information and help with
any concerns. The program starts
while the member is pregnant, and
can continue until the child is five
years old.
Maricopa County
150 W. Congress, Room 227
Tucson, AZ 85701
County map
Director’s Blog on
Prenatal Care
Cochise County
Graham County
Teen outreach
pregnancy services
Teen Outreach Pregnancy Services
(TOPS-is a program specific for
pregnant and parenting teens). The
nurses and social workers in this
program know the challenges that
teens face, and they can help to
make sure that the pregnant mother
and baby are both healthy. They
have classes about having a healthy
pregnancy, childbirth and parenting.
The classes are for teens only.
They can also help teen mothers
get the things they need for their
pregnancy and new baby. Members
enrolled with TOPS can earn
“TOPS Dollars” by attending events
and/or classes, community service
and good grades. “TOPS Dollars”
can then be traded for things like
maternity clothes, baby clothes
and baby items (cribs, strollers, car
seats, etc.).
West Valley:
10875 N. 85th Ave, Suite 8
Peoria, AZ 85345
East Valley:
931 E. Southern Ave. Suite 101
Mesa, AZ 85204
Tucson Area:
3024 E. Ft. Lowell Rd.
Tucson, AZ 85716
Child and family
Programs include:
• Child Care Resource & Referral,
parents can call and get a list of
child care centers.
• The Center for Adolescent
Parents where teen mothers can
earn their high school diploma or
GED while receiving free, on-site
child care.
• KIDLINE, where school-age
children can call a free hotline for
• KIDLINE also offers in-home
programs that teach parents
better coping skills.
700 W. Campbell, Suite 3
Phoenix, AZ 85013
2800 E. Broadway Blvd.
Tucson, AZ 85716
855 Cochise Avenue
Douglas, AZ 85607
999 E. Frye Blvd., Suite 222
Sierra Vista, AZ 85635
301-B E. 4th Street
Safford, AZ 85546
Community resources
Pima County