Newborn Care
7/6/2020
A guide to the first few weeks with your newborn
Is this normal?
You are home from the hospital. You have waited 9 long months to meet your child.
But your dishwasher came with a better instruction manual than your baby! It’s hard not to question everything your baby is doing and if you are doing the right thing. What about that noise the baby is making? And the poops, should there be seeds in my infant’s stool? And why is my baby shedding skin like a snake?
Newborns are wonderful…and hard!
Newborns are weird. Often these things they do seem scary but mostly are all normal. These weird but normal things include:
• Snoring or sounding congested when sleeping
• A leg that frequently shakes
• Quivering lips
• Body hair on back, arms, and even ears
• Acne on face and chest
• Scooped toenails
• Hair loss (which can happen slowly or suddenly)
• Enlarged breast tissue (even on boy babies)
• Vaginal bleeding and vaginal discharge
• Preferring their legs curled up and arms curled in
• Legs that appear bowlegged
• Eyes that cross when trying to focus
• Fontanelle (the soft spot on top of their head) that may pulse
• Skin that is peeling or cracked especially on feet and hands
• An umbilical cord that may have bloody discharge or an odor to it
• Feet and hands that turn blue and feel cold
Feedings
Breastfed or formula fed your baby is going to eat frequently!
Babies come out ready to eat and have a first feed within an hour of birth. If you choose to breastfeed, this first milk is colostrum and is an important early food and immune booster. Your body provides colostrum in a small concentrated amount. After 2-5 days of colostrum feeds, breast milk will increase in volume and change from the gold color of colostrum to a white milk. This will happen as early as day 2 if this is not your first baby, Breastfeeding is a perfect meal that has nutrients, growth factors, and immune cells not found in any other food! Babies who are nursing will feed upwards of 12 times a day! Often this can lead to sore nipples and tired parents! Nipple creams as well as working on positioning and latch can help reduce nipple soreness.
If the pain does not improve or you need assistance nursing, Lactation Consultants are available at Anna Jacques Hospital. This service is available even if you did not deliver at AJH. AJH also coordinates a Lactation Group for nursing moms. Nursing moms need to make sure to rest, hydrate and feed themselves! You are recovering from birth and making all your babies nutrition. Nursing babies will stool 8-10 times a day but that slows by 6-8 weeks and they may even skip a day while they are gaining weight rapidly. If your baby is taking more than 50% of their food as breastmilk, they should be started on a daily Vitamin D supplement. Vitamin D drops can be found at any pharmacy.
Although breast milk is our first choice for babies, sometimes a baby needs to be formula fed. There are many formulas on the market all of which are highly regulated by the FDA and safe for your baby. Make sure all bottles are sterilized and the water you use to mix the formula is safe. Formula-fed babies stool frequently but sometimes reduce to once a day in the first few weeks. If your baby is taking more than 50% of their food as breastmilk, they should be started on a daily Vitamin D supplement. Vitamin D drops can be found at any pharmacy.
All babies lose weight initially. After a few days they should eat enough to gain 0.5-1 ounce EVERY day! That is fast growth! Most babies are back at their birthweight by 10-14 days. If you baby is gaining weight slower, please call us so we can discuss how to increase volume of feeds and consider setting up a consult with a Lactation Consultant.
Sleep
Is my baby sleeping enough? Why won’t they sleep at night?
Newborn babies sleep upwards of 16-17 hours a day but in small increments of time, generally 1-2 hours before they wake up for a feed. They often start off sleepy during the day but wide awake and wanting to be held at night. This is very common. You can help gently encourage your baby onto a more day/night schedule by changing the way you provider care to your baby and the baby’s environment. During the day, smile and interact with your baby during diaper changes, keep the room bright, do not try to reduce noise (your baby will sleep right through it, even the vacuum). At nighttime, keep talking and playful interaction to a minimum, do not expose your baby to blue light (from a phone or TV), and after feed try to immediately put your baby back to sleep. That is easier said than done! You may need to comfort your baby and soothe them to sleep. This will improve as your baby gets older and generally by 1-2 months your baby has a more normal day/night schedule.
Babies are safest sleeping on their back in a separate safe sleeping space such as a bassinet or crib. These sleeping spaces should be in your bedroom to make it easier to feed and comfort your baby. The sleeping space should be free of loose blankets, stuffed animals, or bumpers. The mattress should be firm.
My baby cries…a lot!
Newborns cry. And it seems like they cry a lot. This is their main way to communicate with you and the world. These early days are hard as you learn about who your baby is, what they like, and what soothes them. Babies have a range of behavior even as newborns. They can be alert and active, sometimes watchful, and sometimes cranky. To help soothe your baby you can try a number of techniques. Most of these try to make your baby feel like they are back in the womb! After trying a feed or diaper change, you can swaddle, hold them close on your chest, sway, pat their bottom, bounce, sing or dance. You can also try going for a walk or a giving a warm bath. These crying periods peak between 3-6 weeks and then improve as your baby matures.
The newborn days are a wonderful time for you to bond with your baby and settle in as a family. It is a time to learn about your baby and your new role as parents. These days are hard and involve trial and error to see what works for you and your baby. Having supportive partners and family can be a huge help. You also have our support and we are available to answer any questions you may have about your newborn.
Children’s Health Care of Newburyport, Massachusetts and Haverhill, Massachusetts is a pediatric healthcare practice providing care for families across the North Shore, Merrimack Valley, southern New Hampshire, and the Seacoast regions. The Children’s Health Care team includes pediatricians and pediatric nurse practitioners who provide comprehensive pediatric health care for children, including newborns, toddlers, school aged children, adolescents, and young adults. Our child-centered and family-focused approach covers preventative and urgent care, immunizations, and specialist referrals. Our services include an on-site pediatric nutritionist, special needs care coordinator, and social workers. We also have walk-in appointments available at all of our locations for acute sick visits. Please visit chcmass.com where you will find information about our pediatric doctors, nurse practitioners, as well as our hours and services.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.