Baby Boot Camp: How to Navigate the Newborn Period
You made it through nine months and childbirth—now what? Week one will be an endless merry-go-round of sleeping, eating and changing diapers, made even crazier by your postbirth exhaustion and new-parent anxiety. And since you won’t have a drill instructor on hand to bark orders at you, we thought we’d give you some expert pointers to help get you through it.
Start a bedtime routine ASAP
There’s no time like day one to start fostering healthy newborn sleep patterns. Babies learn quickly about life’s routines and what to expect next, so if you do a feeding, then rock and sing to baby, then put him in the crib (or whatever your routine is like), he’ll gradually learn that this series of events signal bedtime. Instead of holding baby until he conks out, put him to bed while he’s drowsy but still awake. That way he’s more likely to equate the bassinet or crib with sleeping.
Make day and night drastically different
If you want to get something resembling a good night’s sleep in the near future, make it your mission to help baby learn to distinguish day from night. This means exposing her to noises and, well, daylight during the day and keeping nighttime about quiet and darkness. When baby wakes at night, make your encounter all business: Feed her, burp her, change her and put her back in the crib. Save conversation and playtime for daytime.
Let baby sleep in your room
Invest in a bassinet designed for co-sleeping—or wheel in the crib—so baby can sleep by your bedside in the early weeks. Not only does keeping baby in your room (but not in your bed) decrease his risk of SIDS, it also makes getting used to middle-of-the-night feedings less stressful, since you’ll barely have to leave your bed. (Bottle feeding? Consider storing some supplies right in your room.)
Keep baby comfy
New parents have the tendency to over-bundle baby. As a rule of thumb, put baby in one extra layer than what you’re comfortable in. So if you’re fine in a T-shirt in your house, put baby in a lightweight onesie with a swaddled blanket. Look to baby for cues: If her hands feel cold, her head looks sweaty or she develops heat rash, dress her up or down accordingly. Babies tend to feel a little warmer. Try to get in lots of skin-to-skin bonding time in the hospital and the days after so you start learning what baby’s normal body temperature feels like.
Let go of perfection
Baby isn’t going to keep a predictable schedule anytime soon, so don’t expect him to. Instead, follow the tried-and-true “sleep when baby sleeps” advice. That means forgetting about the sink full of dirty dishes and taking a nap — because you never know when you’ll get your next opportunity. Rest is definitely more important than cleaning in these first few weeks.
Keep a mental checklist
The period when babies cry more than any other time, known as the period of purple crying, kicks in at two weeks and can last until three to four months. So depending on baby, she may not be as vocal as you were expecting that first week. If she’s crying and you don’t know how to make her stop, don’t freak out. It takes a while to get to know what baby needs, and until you do, simply rely on trial and error. First, start with the basics. Could she be hungry or have a dirty diaper? Try feeding or changing her. Once you’ve ruled those out, consider her comfort level. Is she hot? Cold? Does she just need something soothing? Adjust the thermostat or her clothing, hold her close and rock her, or play music or white noise until something starts to work. It’s okay—and totally normal—if you’re not able to read baby like a book right away.
Frequent crying or fussing can be stressful, but take comfort in knowing the crying itself doesn’t hurt baby. And because it’s too much to deal with every single cry yourself—especially in those first few weeks home when you’re exhausted and overwhelmed—remember to accept help from your partner and others as much as possible so you get a break. If you suspect something’s wrong (you’ve got those mom instincts now!), take baby to the pediatrician. She could have a chronic condition, such as reflux or a protein allergy, both of which are treatable, and babies usually grow out of them—whew!
Input and Output
Read baby’s signals
So how much are you supposed to feed baby, anyhow? If you’re nursing, it’s hard to tell, since you won’t have bottles with ounce markings to gauge baby’s input. But luckily, babies seem to know when they’ve had enough. No matter how you’re feeding baby, he should seem drowsily content right after eating, and in that first week as well as the next few, he’ll probably fall asleep for two or three hours once he’s full (hello, milk coma!). Be careful though—some babies want to suck on something, whether they’re hungry or not. If sucking on a finger or pacifier calms baby, then he doesn’t need to eat any more.
Do diaper checks
The other indicator that baby is eating enough is her output, so keep track of those diapers (your doctor might ask for specific numbers at checkups). In the first four days newborns may only pee two to four times a day, but then they should start to wet about 6 to 12 diapers daily. As for newborn poop, the number isn’t so straightforward. Baby should poop at least once in the first 24 hours, but if not, 98 percent of babies poop by the second day. From then on baby could soil five or more diapers a day (especially if you breastfeed), or she could go up to 7 to 10 days without a dirty diaper and be perfectly healthy (as long as she’s not showing signs of discomfort). Just beware of hard, pellet-like poop; it could be a sign baby is constipated.
Know your colors
In baby’s first couple of days, he’ll have a black stool known as meconium—that’s a product of all the stuff he “ate” in utero. After that, for an exclusively breastfed baby, it will get lighter brown before turning yellow with a seedy look to it. But no matter how you feed baby, his poop could be yellow, brown or green—all of which are totally normal. If it’s red, black (beyond those first couple days) or white, though, it could mean there’s a problem, so notify baby’s pediatrician if you see any of those weird colors.
Keep an eye on weight
Bet you didn’t know baby will likely lose up to 10 percent of her birth weight in the first three to seven days. Well, it’s true and it’s totally normal—she’s just shedding some of that fluid retained from the womb, plus she’s burning more calories now that she’s free to move around. After that, she should be gaining about half a pound a week. Your pediatrician will help you measure and track her progress and alert you if her weight gain or loss is a cause for concern.
Like we mentioned before, baby doesn’t know how to follow a clock. Sure, there are newborns who are perfectly fine eating every three hours on the dot. If yours is one of those, lucky you! Others might be hungry closer to every two hours, or “cluster feed,” meaning they want what seems like back-to-back feedings. (This tends to be common in the evening, so be prepared.) Seeing how some babies take as long as 45 minutes for a feeding, you might have days where you feel like all you’ve done is feed your baby. That’s totally normal. And on those days, remember: That’s a very important thing to have accomplished!
Bathing and Belly Button
Protect the umbilical cord
Baby’s immune system kicks in as soon as that umbilical cord is clamped, and this is the first chance the body has to heal a wound. Treat baby’s belly button with care until the cord shrivels up and falls off in about one to two weeks. Keep it dry and let it breathe: Look for newborn diapers with a notch cut out for the belly button, or just fold the diaper down and away from the navel, and dress baby in looser fitting clothes, like kimono-style onesies or baby tees. As the stump dries it might snag on baby’s clothes. If that happens, you can put a small piece of dry gauze over it for protection. Although infections of the umbilicus are rare, call the doctor if the wound gets very red or swollen, is actively bleeding, smells foul or if pus oozes out.
Stick to sponge baths
Since the umbilical cord can’t get wet, you won’t want to submerge baby in a full bath until the stump falls off. Clean baby’s face, neck, hands and diaper area at least once a day with warm water (no soap) and a soft cloth like the ones the hospital sends you home with. If baby’s navel looks sticky or moist, gently clean the skin (not the cord) around it with a slightly damp cotton ball.
Keeping Baby Healthy
Confirm your first doc appointment
Before you leave the hospital, ask when to follow up with your pediatrician. If baby is at risk for jaundice or losing too much weight, your doctor will let you know and want you to follow up within 72 hours or so. Healthy babies should see their pediatrician at least one time before the end of that first week.
Avoid large crowds
A newborn’s immune system has a lot of developing to do, so something as run-of-the-mill as a fever could land them in the ER. So you’ll want to avoid letting baby get passed around a crowded room of people. That doesn’t mean that you have to be antisocial, though. In the first few weeks, have family and friends come see you in small groups or individually rather than going to a large party. Ask anyone who holds baby to wash their hands first, and politely ask sick people to postpone their visit. Feeling cooped up? If the weather’s nice it’s okay to take baby out for a little fresh air and a short walk around the neighborhood as long as he’s bundled accordingly and you steer clear of crowded areas or people who might try to touch him.
Get yourself immunized
You, your partner and anyone else who will care for baby should make sure they’re up to date on vaccinations. Particularly important are the Tdap vaccine, which helps prevent whooping cough, and the seasonal flu vaccine. If baby’s inner circle isn’t sick, she’s much less likely to catch something. Baby won’t get her first set of shots until around her two-month birthday, which will give her immune system a bit of a boost against some communicable diseases.
Watch for changes
The first few weeks will be spent getting to know baby’s signals, habits, likes and dislikes, and nobody will know him better than you and your partner. If something veers from his usual pattern (for example, he’s normally a vigorous eater and then suddenly doesn’t want to feed), it’s time to check in with the doctor. Other red flags: forceful vomiting, rectal fever above 100.4 degrees Fahrenheit or below 96.4, coughing, diarrhea, jaundice or breathing problems.
The Bump Expert: Cheryl Wu, MD, pediatrician at LaGuardia Place Pediatrics In New York City
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