Caring for Your Newborn
First Few Hours
Allow yourself some relaxed, non-feeding time in a quiet, unhurried environment to get acquainted with your baby. Too often a parent reacts to a baby’s expression by trying to fix it, feeding, shushing, swaddling, jiggling a crying baby, instead of offering empathy and an attentive ear. Babies have only one way of communicating—crying—and if every time they attempt to talk we try to shut them down, they will get the wrong message. Infants, especially those born naturally (drug-free), tend to be more alert and active in the first few hours after birth than in subsequent hours. During this time the baby tends to have her eyes open, is gazing about, has strong sucking reflexes, and cries more. If you are delivering at the hospital you often hear the nurses say things like “It’s good for the lungs for a baby to cry,” while parents immediately, and instinctively want to quiet baby down. Both reasoning for those responses have good explanations, nurses rejoice at hearing a baby cry for it means that he/she is breathing properly, and mom immediately connects crying with distress. Often all baby wants to do is tell the birth story, so encourage your baby to “talk” and let him feel your empathy for the story.
Touch is the most completely developed sense at birth, and skin to skin massaging, caressing, cuddling, and stroking your infant are the best ways to begin your communication with her. She also knows daddy’s (or your partner’s) voice well and can really marvel at hearing it from outside the womb. You’ll see that not only will she recognize it, but if she has to be separated from the mother for any reason, daddy’s voice would immediately sooth her and reassure her.
Newborns see you and are capable of visual fixation for short periods of time. Their clearest vision is about eight to twelve inches away from breast to mothers’ eyes. Studies have shown that newborns do distinguish the form of a human face from other forms. As soon as he or she is born and placed on the mother’s chest, a baby will spend some marvelous quality time locking eyes with mom, exploring her face, listening to her voice, smelling her scent and rejoicing in her touch.
A crying baby is a form of communication between a baby and mother. Babies usually cry when they are hungry, tired, wet, have to burp, are bored, or are just lonely. A mother will quickly learn what her baby is trying to tell her. Responding to a baby’s crying will not spoil a child; it simply builds a trusting relationship between the child and mother.
In my work as a postpartum doula, I notice that sometimes when babies cry they just need to tell you something. Of course I encourage to always attending to a baby crying; in fact I am not a big supporter of anyone who tells you to let you baby cry to self-soothe or sleep on her own. But when I respond to a baby who is crying instead of shushing or bouncing him on a ball to quickly quiet him, I instead approach the crib or chair and simply empathize. I say something like, “I hear you, I am here, tell me more. Did you wake up scared? You seem very upset, tell me how you feel?” Invariably the baby hears and feels empathy and calms down even before I pick him up. The cry changes its pitch and quality. Sometimes I envision the baby saying to himself, “Wow, finally someone is listening!”
By empathizing we give respect and acknowledgement to the baby’s feelings. Sometimes babies cry when they want to tell you the stories of their birth, or they want to tell you they just had a scary dream. Maybe they just want to let you know that when they fall asleep on your breast and then wake up in the crib alone, they get scared. When you pick up a crying baby with words such as, “Don’t cry, there is nothing wrong. Shush,” it is denying his feelings. Think about it, how would you feel if your loved one used these words when you were crying? Of course sometimes babies are simply hungry, have a dirty diaper, are overtired, or need to be burped, but once you have checked that their bodily needs are met, allow them to tell you their thoughts and feelings. If this crying happens in the middle of the night it is okay to give yourself a time limit; you can tell your child “I hear you, I’ll listen to what you have to say for awhile, then we’ll go back to sleep.” After you have allowed the baby to express himself, go ahead and use the gentle shushing, swaddling, and all the other techniques to help your baby go back to sleep.
Sleep is an essential routine for a newborn baby. Babies sleep more than they do anything else. It is normal for a baby to sleep sixteen to twenty hours a day. Mothers should rest and take it easy while their baby sleeps.
During the first days of life, nails may be long and adhered to the skin high on the nail. Trim nails frequently with blunt-edged small scissors or file with an emery board to prevent scratching. Cut nails straight across.
Bathing your baby is a great opportunity for daddy (or partners) to bond with the baby. Be sure that the room is warm and without a draft. A sponge bath is given until the cord has fallen off; after the cord falls off, tub baths may be given. I encourage daddy to get into the tub and share the bath with his baby. The bath can be given in a basin, small tub, or kitchen sink. Testing the water temperature is essential; it should not feel hot or cold. When you place your hand in it should feel room temperature. A full bath with soap and shampoo is suggested to two to three times a week. But babies love floating in water, so as long as you don’t use soap all the time, you can even bathe your baby every night and make it part of the night time ritual. However, it is a good idea to wash the face and behind the ears, neck, hands, and bottom on a daily basis. I prefer soaps that have no fragrance and are organic. It might be more expensive but staying away from any artificial color or chemicals goes a long way in the well being of your child.
Bowel movements and urine
A baby’s diaper should be changed when the baby is wet or soiled. After each bowel movement or wetting, wash and pat dry. For girls, separate the folds and gently wash area from front to back, using a clean area of washcloth with each swipe until thoroughly clean. For boys, wash penis, creases, and folds near the scrotum. Do not push back the foreskin of the uncircumcised baby.
Your newborn girl’s genitals have been exposed to many hormones in the uterus. Among other things, these hormones may have:
- Made the outside of the vagina (“labia majora” and the “clitoris”) a little swollen and prominent.
- Caused a thick, milky discharge in the vagina.
Most dramatically, at two or three days of age, your daughter may have a little bit of bleeding from her vagina. This is perfectly normal and caused by the withdrawal of the hormones she was exposed to in the womb. It will be her first and last menstrual period for another decade or so.
If you see a pink spot in the front of your newborn boy’s diaper, don’t become alarmed thinking it’s blood in the urine. Uric acid crystals in the urine dry on the diaper to form a salmon pink powder. If you scrape it with your finger nail you can see that it is powdery. It is absolutely harmless and nothing to worry about; however, if you see it in every diaper it could mean that your newborn’s urine is very concentrated which could happen if he isn’t getting enough fluids.
The first bowel movement is a sticky greenish black substance (meconium). Try putting some grape seed oil (found anywhere oils are sold) in your newborn’s bottom before diapering so that the sticky meconium can be easily cleaned. Once mother’s milk comes in, the color of the waste changes to yellow, green, brown etc.
Expect one wet diaper on day one, two on day two, three on day three etc., increasing to 5–6 by one week. Urine should be pale and mild smelling. Remember that at first baby urine can be so well absorbed in your advanced technological diaper that it might be hard to see if he actually has peed. You can either switch to cloth diaper for a few days to make sure he pees, or simply place a Kleenex inside the diaper to see if it gets wet.
If baby is gaining well on mom’s milk alone, then baby is getting enough. A 5–10 percent weight loss during the first week after birth is normal. Baby should regain birth weight by two weeks.
Feeding—Breastfeeding is Best-feeding
Frequent nursing encourages good milk supply and reduces engorgement. Aim for nursing at least 10–12 times per day (twenty-four hours). Do not put your baby on a schedule; skin-to-skin contact is very important in the first weeks for milk production and bonding. Be patient: milk will come and you have enough. Trust that your body knows what to do. Your milk should start to “come in” (increase in quantity and change from colostrum to mature milk) between days two and five. This is probably the area that causes most distress in breastfeeding mothers. Best is to look at the baby, not the clock or the scale. If your baby is happy, responsive, loud, pees and poops enough, you have enough milk. If you have any concerns about breastfeeding, hire a lactation consultant or go to your local La Leche League, or visit KellyMom, another great source of info on breastfeeding. Also, your postpartum doula can help you with breastfeeding if you are not having a serious problem and simply need information and/or encouragement.
Nurse at the first signs of hunger (stirring, rooting, hands in mouth)—don’t wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy—wake baby to nurse if two hours (during the day) or a four-hour sleep time (at night) has passed without nursing. Once baby has established a good weight gain pattern and you do not swaddle the baby, you can stop waking baby and nurse on baby’s cues alone. If you opt to swaddle during the night (because your baby is particularly fussy) do wake your newborn every three hours to feed, even at night.