Baby and infant care – a guide for the first years of life

Baby & infant care: laying a strong foundation in the first 1 000 days

The first 1 000 days of a child’s life — from conception to age two — are among the most critical for long-term health and development. Nutrition, bonding, sleep, safety and healthcare during this period influence everything from immunity and brain growth to emotional resilience and overall wellbeing. South Africa’s diverse cultures, lifestyles, households and socioeconomic realities mean that parents follow different approaches to infant care. This guide provides evidence-based, accessible advice to support families across all communities.

Why early infant care matters

The early years shape:

• Brain development (rapid in the first two years)
• Growth and physical development
• Immunity
• Emotional bonding and security
• Language and learning foundations
• Long-term health outcomes

Supportive caregiving strengthens the bond between parent and child — contributing to better emotional and behavioural outcomes later in childhood.

1. Nutrition: the cornerstone of early development

Breastfeeding

The World Health Organization (WHO) and the South African Department of Health recommend exclusive breastfeeding for the first 6 months and continued breastfeeding up to 2 years and beyond, alongside solid foods. Breast milk provides optimal nutrition, protection from infections, immune-boosting antibodies, digestive comfort, and a stronger bond between mother and child. However, not all mothers can breastfeed — and that is okay. Formula feeding is a safe and nutritious alternative when used correctly.

Introducing solid foods (around 6 months)

Signs of readiness include the baby being able to sit with support, showing interest in food, loss of the tongue-thrust reflex, and being able to move food to the back of the mouth. Start with puréed vegetables (carrots, butternut, spinach), iron-rich foods (fortified cereal, lentils, beans, meats), soft fruits, and full-cream yoghurt. Avoid salt, sugar, honey (risk of botulism in babies under 1), and processed or spicy foods. South Africa’s Food-Based Dietary Guidelines are highly applicable to infant feeding — especially encouraging whole foods and vegetable diversity.

Hydration and fluids

Under 6 months: breast milk or formula only. From 6 months: small sips of clean, safe water. Avoid fruit juices, sweetened drinks, and flavoured waters as these contribute to early childhood decay and unhealthy weight gain.

2. Sleep and rest

Babies need significantly more sleep than adults. Typical sleep needs are 14–17 hours for newborns, 12–16 hours for infants (4–12 months), and 11–14 hours for toddlers (1–2 years).

Safe sleep practices

Place baby on their back for every sleep on a firm, flat mattress. Keep the sleeping area smoke-free and avoid loose blankets, pillows, or toys. Dress the baby in light clothing during hot seasons and use breathable fabrics. Load shedding can disrupt bedtime routines, so keep rechargeable night lights and fans accessible.

3. Hygiene & bathing

Bath your baby daily or every second day depending on climate and sensitivity. Change nappies frequently to prevent rashes and use fragrance-free products for sensitive skin. Keep nails short to avoid skin scratches. Good hygiene helps prevent infections — especially in warmer, humid regions.

4. Oral health from birth

Early oral care prevents early childhood caries, a major concern in South Africa.

Steps for good oral hygiene:

• Wipe gums with a soft, damp cloth after feeds
• Brush teeth as soon as they appear using a soft infant toothbrush
• Use a rice-grain amount of fluoride toothpaste
• Avoid giving bottles with juice or sweetened liquids
• Schedule the first dental visit by age one

5. Safety in the home environment

Preventing accidents

• Keep medicines, cleaning products, and chemicals locked away
• Use plug covers
• Secure furniture to prevent tipping
• Keep hot drinks out of reach
• Ensure safe sleep surfaces
• Check water temperature to avoid burns
• Cover sharp corners and edges

These steps are essential in busy South African households where multiple caregivers may be involved.

6. Emotional bonding and development

Secure attachment forms the foundation for a confident, emotionally resilient child.

Ways to strengthen bonding:

• Hold, cuddle, and talk to your baby
• Practise skin-to-skin contact
• Respond to cries promptly
• Sing, read, and play daily
• Maintain predictable daily routines

Babies thrive in environments where caregivers are affectionate and responsive.

7. Early learning and stimulation

Brain development is rapid in the first years.

Support learning by:

• Talking often
• Providing age-appropriate toys
• Reading picture books
• Practising tummy time
• Encouraging exploration

You do not need expensive toys — household items such as pots, containers and fabric textures are excellent stimulation.

8. Routine healthcare & immunisations

South Africa’s Road-to-Health Booklet (RtHB) provides clear guidance on:

• Growth monitoring
• Developmental milestones
• Vaccination schedule
• Nutrition support
• Illness alerts

Immunisations protect against serious diseases including measles, polio, whooping cough and pneumococcal infections. Attend clinic visits even when your child seems healthy — early detection prevents complications.

Common myths about baby & infant care

• Myth 1: Babies should drink water from birth. False - water can be dangerous before 6 months.
• Myth 2: Crawling is essential. Some babies skip crawling entirely, and that’s normal.
• Myth 3: Picking up a crying baby spoils them. Responding to cries builds trust and security.
• Myth 4: Teething causes severe illness. It may cause irritability but not high fevers or diarrhoea.
• Myth 5: Baby teeth don’t matter. Healthy baby teeth prevent future dental complications.

Frequently asked questions (FAQs)

Q: When should my baby start solids?
Around 6 months, once they show readiness cues.

Q: How often should my baby sleep?
Sleep needs change with age; follow age-appropriate guidelines.

Q: How can I help my baby during heatwaves?
Dress lightly, keep rooms ventilated, offer frequent feeds, and watch for dehydration.

Q: Are traditional remedies safe?
Some are, but always check ingredients and avoid anything untested or harmful.

Q: How do I know if my baby is developing well?
Monitor milestones and use your RtHB — or consult your clinic or paediatrician.

Practical baby & infant care checklist

• Breastfeed exclusively for 6 months (if possible)
• Start solids at 6 months
• Offer water only after 6 months
• Maintain safe sleep practices
• Practise daily bonding and play
• Brush baby teeth as soon as they appear
• Attend all clinic visits and follow the immunisation schedule

When to seek medical help

Seek urgent care if your baby:

• Has difficulty breathing
• Shows signs of dehydration
• Has a fever above 38°C (under 3 months)
• Refuses to feed
• Has persistent vomiting or diarrhoea
• Seems unusually sleepy or unresponsive
• Has a rash with fever
• Has seizures

Early intervention saves lives.

References

• WHO — Infant and Young Child Feeding Guidelines
• ADSA — >South African Position on Complementary Feeding
• South African Department of Health — Infant & Young Child Feeding Policy
• MSF - Road to Health Booklet

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