First days at home with your baby

First days at home with your baby

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You've probably heard that all a newborn baby does is eat, poop, cry, and sleep. Sounds simple, right? It may become simple, but chances are it won't seem that way at first. Knowing what to expect from your newborn will make your first days home together a little less overwhelming.

To help map out what's in store after the big homecoming, we turned to pediatricians and mothers Laura Jana and Jennifer Shu, who literally wrote the book on the topic. The third edition of their book Heading Home With Your Newborn: From Birth to Reality was released in May 2015 by the American Academy of Pediatrics.

What to expect: Newborn feeding

Because their stomachs are so tiny, newborns need to eat small amounts frequently – about 1 to 3 ounces at a time. Some want to nurse or have a bottle every two to three hours, and others will be hungry even more often.

While some babies announce their hunger with strong cries, others give more subtle cues such as sucking on their hands, smacking their lips, or rooting (when a baby purses her lips and turns her head toward the breast or bottle).

In their first few days, newborns typically lose about 7 percent of their body weight. Although this is normal, you'll want to feed your baby every two hours or so until she's back at her birth weight.

Newborns are sleepy, so you may need to wake your baby up to feed and give her gentle encouragement to stay awake while eating. Try undressing your baby down to the diaper, rubbing her head or back, or talking to her. The goal is for your baby to be back to her birth weight at her two-week checkup.

What to expect: Newborn burps, hiccups, and spit-ups

Some newborns need to be burped frequently, while others burp on their own and need very little assistance from you. If your baby is fussy or seems uncomfortable during or after a feeding, that's a cue to burp her.

You can also burp your baby when you switch breasts, after every 2 or 3 ounces, every 10 to 15 minutes of feeding, or when your baby's finished eating. After a day or two of feedings, you'll find a pattern that works for your little one.

No need to whack your baby's back – a gentle circular motion or soft pats will bring up the bubbles. There are several burping positions to try, including holding your baby with her head resting on your shoulder, sitting her upright on your lap with the fingers of one hand supporting her chest and chin, or laying your baby tummy-down across your lap.

Don't be alarmed by hiccups or spit-up. Hiccups are normal for new babies and don't cause them discomfort. Likewise, spitting up during and after feedings – whether in just small amounts or what may seem like the entire feeding – is normal.

If your baby's spitting up seems excessive, or if she also arches her back or cries, she may have a type of reflux. Read more about the difference between reflux, which is normal and improves with your baby's head control, and gastroesophageal reflux disease, or GERD, which requires treatment. Whatever the cause, keep a burp cloth handy.

What to expect: Newborn pee and poop

A breastfed newborn will have at least five wet diapers a day. A formula-fed baby may have even more than that – up to 10 per day.

There's also a large range for what's considered a "normal" number of bowel movements. Breastfed babies tend to poop more than formula-fed ones because formula takes a bit longer to digest. But the regularity of breastfed babies can vary widely: Some go as seldom as once every four or more days to as often as once per feeding. Formula-fed babies typically poop a few times a day, but it can range from one poop every other day to several poops per day.

Keep track of your baby's pee and poop schedule because the doctor may ask about her urine and bowel movements at the first checkup.

The very first bowel movements – called meconium – usually happen within the first day or two after birth (often while you're still at the hospital. These first poops are black and have an almost tar-like consistency. The ones that follow won't look much like grown-up poop either. From a breastfed baby, be prepared for seedy poops that are greenish, light brown, or, mustard-yellow. A formula-fed baby's poops tend to be pastier and vary in color. Call the doctor if there are whitish mucus or streaks or flecks of red in your baby's stool because this can indicate a problem. (Red flecks can indicate there's blood in your baby's stool.)

The consistency of normal poop also ranges from very soft to watery, with breastfed babies having looser poop. This can easily be confused with diarrhea. Basically you want to keep an eye out for a change from your baby's usual pattern or consistency – which is admittedly hard when your baby is first creating a pattern. When in doubt, check with your doctor.

"If you're confused, just remember this," says Jennifer Shu. "Whether we're talking about pooping, eating, sleeping, or crying, every baby is different. Normal is actually a big range. What matters most are sudden changes – and that's when you should contact your doctor."

See our complete baby poop slideshow for a visual guide to what you might find in your baby's diaper.

What to expect: Newborn crying

There's no getting around this one: Your newborn will cry. How often, how hard, and how long is entirely variable and will change over time, says Laura Jana.

For the first few days, many newborns are remarkably quiet and sleepy. But by two weeks old, a typical newborn will cry about two hours a day. (Crying usually increases until about six to eight weeks of age, then starts to taper off.)

Over time, it'll get easier to figure out why your baby's crying. At this point, run through the most likely culprits – soiled diaper, hungry, overtired, uncomfortable – and you'll probably find the source. If not, another reason for early fussiness can be overstimulation. Some infants get fussy when they're amidst too much commotion or activity.

There will be times, however, when your baby cries with no clear cause, and you'll need to figure out what soothes your baby. Remember: There's no such thing as spoiling a newborn, so respond to her cries with attention and affection.

If being unable to always quickly or accurately figure out why your baby is crying makes you feel helpless, frustrated, or incompetent, try to be less critical of yourself. "Every new mother has been there, even the 'experts'," says Shu. "There will be times when your baby's needs are obvious, but there will also be times when you're just not sure about anything!"

What to expect: Newborn sleep

Your newborn's tiny tummy will likely keep her from dozing more than a few hours at a time before she wakes up to eat. All the short naps will add up, though – your newborn will sleep about 16 to 18 hours total each day. You may want to track when and where your baby sleeps, to identify patterns and answer any questions from your baby's doctor.

Luckily, newborns have the amazing ability to fall asleep pretty much anywhere – in the car seat, baby carrier, bassinet, or in your arms. Many newborns prefer the snug fit of a car seat or baby carrier to their crib for sleeping, because the close confines remind them of your womb.

That's why so many new babies love being swaddled, too. Being snugly wrapped up mimics the environment your baby is used to and keeps a reflexive jerk of an arm or leg from waking her up.

No matter when or where your baby sleeps, always put her on her back and remove all loose blankets, as well as bumpers, pillows, quilts, and toys to reduce the risk of sudden infant death syndrome (SIDS). Also, never leave a snoozing baby unattended on a couch or bed as the risk of rolling or falling is always present, even if your baby can't roll on her own yet.

Once your baby is asleep, don't be surprised if you hear her making strange noises. If it sounds like your baby has a cold, it's probably because babies are natural nose breathers. Since she can't clear her nasal passages by herself yet, you can use a bulb syringe to clear them for her, which may make it easier for her to breathe and sleep – and even eat.

What to expect: Newborn breathing

Another newborn habit is periodic breathing. Your baby may breathe quickly, pause for a few seconds, then start breathing again. Although normal, it can be unnerving.

However, the following signs aren't normal and warrant an immediate call to your baby's doctor:

  • Grunting
  • Flaring of the nostrils
  • Chest retractions (sucking in the skin above the collarbone, between the ribs, or below the ribs)
  • Breathing that's consistently fast
  • Wheezing from her chest (rather than her nose or throat, which is a sign of garden-variety congestion and stuffiness)
  • Heavy, noisy breathing (audible wheezes, whistling sounds, or crackly sounds during inhalation and exhalation)
  • Pausing more than 10 to 15 seconds between breaths

See more signs you should call the doctor for your newborn.

What to expect: Newborn bathing

Keeping your baby clean in the first couple of days is pretty basic. For now, you won't need the baby bathtub. While your baby's umbilical cord stump is still hanging on, follow your baby's doctor's advice on bathing your baby – most hospitals advise against immersing the stump in water. Sponge baths are enough to keep a newborn clean for the first week or two. In fact, too much bathing could dry out your baby's skin.

Use a warm, damp washcloth or unscented wipes to gently wipe around neck folds and other areas where breast milk, formula, or moisture might accumulate, finishing with the genitals. If you notice any redness or irritation in the diaper area, a swipe of diaper cream or petroleum jelly should squelch it.

Don't be surprised if your newborn's skin doesn't look like the perfect baby skin in the commercials – that will come later. Many newborns have a range of minor skin irritations, such as newborn rash, cradle cap, peeling, or general dryness after emerging from their nine-month bath in amniotic fluid. You may even spot some shoulder and back hair – it usually falls out within a week or two.

Read more about baby body care.

What you really need: Newborn clothes

Cute outfits will probably take a back seat to ease and comfort at first – after all, you want clothes that are easy to change, and that work well for your baby's many naps. Many parents use some combination of T-shirts, one-piece bodysuits, and footed pajamas, plus a swaddling blanket or a sleep sack in cold weather or at night.

If your newborn dislikes having clothes pulled over her head or her umbilical cord stump is sensitive, kimono-style one-piece outfits that snap at the sides can come in handy. For warmth, most hospitals send newborns home with a hat, but unless it's quite chilly, a cap is optional.

Use your common sense as well as your own internal thermostat to gauge how many layers to put on your baby. Many people adhere to the age-old "what you're wearing plus one layer" rule. When in doubt, add a light blanket or hat – you can always remove it if your baby feels warm.

Read more about dressing your infant in the first six weeks.

What you really need: Newborn gear

During your pregnancy, you may have amassed a small mountain of baby gear. For now, you won't use much of it. You need a safe place for your baby to sleep and of course you'll need a properly installed car seat for the ride home. Extras such as bouncy seats, activity mats, toys, and other baby gear will come in handy eventually, but don't worry about them this week. Your newborn's needs right now are both all-consuming and surprisingly simple.

Check out our handy list of mom and baby gear for the first six weeks to see what's most useful when you bring your baby home.

What to expect: Your transition home

Bringing home a baby is a life-altering change, and you shouldn't expect to adapt to it the moment you walk through the door. In fact, it may take anywhere from a few days to a few months to get your bearings. While you're navigating this huge adjustment, remember to cut yourself some slack and let go of your ideas about how things "should" be.

Your body is dealing with fluctuating hormone levels, healing from giving birth, and is seriously sleep-deprived. Your mind is adjusting to this new stage of life. You may laugh, cry, be frustrated, get excited, and feel a myriad of emotions within mere hours – or minutes. And you'll probably find that caring for a newborn – simple as those needs are – takes up an astonishing amount of time, making it hard to fit in even the basics for yourself.

About 70 to 80 percent of new mothers experience the "baby blues" during the hormonal roller coaster that is the first few weeks after delivery. Luckily, the baby blues are short-lived, generally fading within two weeks. All parents should be aware of them, though, and of the signs of postpartum depression (PPD).

Compared to the baby blues, PPD lasts longer and is more severe. PPD affects 1 in 10 women – and new dads as well. Getting treatment is important for both you and your baby, so if you have symptoms of PPD, talk to your partner or someone close to you for support and discuss your symptoms with your doctor.

One way to combat the baby blues is to carve out tiny bits of time to tend to yourself, and enlist family, friends, or hired help to handle chores and errands. Don't be shy about asking your friends and family to help stock the fridge, bring meals, or run a load of laundry.

While your baby sleeps, use the time to take a nap, grab a shower, or just spend a few minutes looking at a magazine or zoning out. Anything you can do to recharge your batteries between feeding, burping, changing, and cuddling will help.

What to expect: Your body

Your body is also going through major physical changes. About 72 hours after giving birth, your milk will come in. Often, this coincides with your first day at home. Until now you've been producing the coveted, antibody-rich colostrum, which is usually yellower than breast milk.

You'll know when the real deal comes in because your breasts become noticeably fuller, firmer, and heavier. This is when engorgement can happen.

While many people assume breastfeeding comes naturally, it's not uncommon to hit some bumps in the road – especially early on. "Even if you were coached by a lactation consultant or nurse at the hospital, you may need more help after you head home," says board-certified lactation consultant and childbirth educator Sabrina Easterling.

A lactation consultant or support group can be invaluable for troubleshooting problems and getting adequate assistance in these first few days. With help, you'll start to learn the finer points – from getting the perfect latch to finding your favorite hold.

Breastfeeding can make your nipples really sore. Try different positions to prevent aching and cracking. Washing your breasts with water, applying pure lanolin cream after breastfeeding (the cream does not need to be removed before feeding), using drops of expressed breast milk as a nipple moisturizer, or even icing your breasts can help.

If you're not sure whether your baby's hungry, pay attention to whether she actually swallows when you offer her your breast. If she's self-soothing rather than nursing, try offering her own thumb for comfort to give your nipples a rest.

If you've decided not to breastfeed, get advice from your doctor or a lactation consultant about the best way to suppress lactation. "Once you ramp up production, many women are surprised to find that it can be tough to shut it down without discomfort," Easterling says.

While you stop lactating, you'll experience engorgement pain. The discomfort should peak about three to five days after giving birth and then taper off. To deal with the temporary pain, try over-the-counter pain relievers, ice packs, and a supportive bra. A decongestant can also help speed up the process, as it dries out body tissues.

If you had a vaginal delivery, you'll probably be quite sore. If you had a tear or an episiotomy, it may be extra painful. Apply a cloth-covered ice pack to the area to reduce swelling. Some women swear by witch hazel pads for reducing inflammation, too.

When you go to the bathroom, use a squirt water bottle instead of wiping, which can be painful. Many women experience severe constipation after delivery, and stool softeners can help. Also, for about six weeks after delivery you'll probably need to wear a full-size sanitary napkin to absorb the flow of blood called lochia, which ranges in color from red to yellow to white.

A c-section is major abdominal surgery, and if you had one, you'll need someone to help you with almost everything for at least a week – from basic household tasks to picking up your baby for feeding and diaper changes. In fact, many doctors advise their patients not to pick up anything heavier than the baby until they get the doctor's all-clear at the first postpartum check-up.

You'll probably leave the hospital with some form of pain medication, and it's a good idea to track what medicine you take and when. Been-there-done-that moms concur: Take what you need, and don't feel the need to be brave and go without.

Call your doctor if you notice blood or pus seeping from the incision, as that could indicate infection or a blood clot. As with those who've had a vaginal delivery, you'll want to avoid straining on the toilet, and you may need to take a stool softener for at least the first bowel movement or two.

One of the most shocking things about your post-baby body might be the one thing that didn't change: You probably will still look pregnant. If so, don't fret, it typically takes weeks – or months – for your body (especially your belly) to fully recover. In the meantime, it's perfectly normal to keep wearing maternity clothes after giving birth.

Read more about recovering from childbirth

Watch the video: 1 DAY OLD NEWBORNS FIRST DAY HOME. Aaryn Williams (May 2022).


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