Your baby is finally here! As you hold him in your arms, here is what you need to know about your bundle of joy.
WORDS ANGEL DREWGUS
Before birth, a baby leads a somewhat sheltered life but, from the moment he is born, a new phase in his development starts. Your newborn is ready for the most important relationships of her life, those she will share with you and your partner. Allowing yourself time to look at, touch and get to know this tiny person you’ve created, will give your relationship the best possible start.
Some people may find that newborns have funny shaped heads at birth. This is due to the pressure on the head while the baby is being squeezed out of the birth canal and is termed molding. This usually resolves in a few days, explains Dr Christelle Tan, registrar, Department of Neonatal & Developmental Medicine, SGH.
A newborn’s skin colour may carry a tinge of yellow in the first few days of life due to jaundice which is a common occurrence. As long as the jaundice is monitored and within safe levels, it usually goes away after a week. Some babies have bluish-green patches over their buttocks or legs. These are called Mongolian spots. They are normal and will disappear with time.
Finally, in the first few days of life, some babies may have rashes called erythema toxicum. They look like red blotches. Some parents may get alarmed by it but there is nothing to worry about, advises Dr Tan, as they will go away in a few days.
Most newborns have sensitive skin and hence it may appear dry. Some babies born later than their expected due date can look like they have dry and scaly skin. This is normal. While you should bathe your baby once or twice a day, if you find that your child has dry skin, avoid frequent baths and avoid using hot water but just use warm water. Ensure the cleanser you use is mild, fragrance-free and soap free, making it suitable for sensitive skin. If you still find your baby’s skin to be dry, apply baby oil or lotion after bathing your baby or up to two to three times a day, says Dr Tan.
Height and Weight
Your baby’s height, weight, and head size are often charted during regular check-ups. The centile chart used is obtained from local data on the variation in sizes of healthy babies. In general, anywhere between the tenth centile and ninetieth centile is considered to be normal. Of course, there are healthy babies who lie outside of these ranges and often all that is required is more frequent monitoring.
Babies within the normal range of length and weight are less likely to have any major clinical problems. A drop in the centiles can be an early indicator of underlying medical conditions which may require further evaluation. This is why monitoring the growth of your child is very important, explains Dr Tan.
Routine care of the umbilical cord is all that is required. Cleaning the cord and the surrounding skin daily with warm water and drying it with a clean towel thereafter is usually all that is required. Try to avoid alcohol or any topical agent that can cause the skin to be very dry.
No additional care is needed unless there are other signs of infection like redness or swelling around the umbilical cord. If you notice the skin around the stump turning red, or if there is discharge coming from the umbilical stump, do seek medical advice. In general, most infants would have their umbilical cord fall off by the second week of life.
The heart rate of a newborn is much faster (almost 1.5 times faster) than that of an adult. A baby’s heart rate is considered slow if it goes below 90 beats/min and is considered high if it is above 160 beats/min.
A newborn’s breathing can vary throughout the day. In general, if your baby is taking deep breaths such that you can see his ribs clearly, or if your baby has to stop in between feeds in order to catch his breath, it would be considered abnormal.
The best way of measuring the temperature for your newborn is to use a thermometer placed in the armpit. A temperature equal to or more than 38 degrees celsius is considered fever. You should bring your baby to see a doctor if he has a fever, advises Dr Tan.
Just how often you should change your baby’s diaper varies between parental preferences. Some prefer to change their baby’s diaper once they detect any soiling of the diaper with urine or stool. Others prefer to wait for a heavy diaper before changing. In general, changing diapers about five to six times a day is common and the idea is mainly not to leave the baby’s stool or urine in contact with the skin for prolonged periods as that can lead to an increased risk of developing rashes, explains Dr Tan.
What to expect in your baby’s diaper?
Colourless or light-yellow coloured urine and poo. What is helpful to know is that the colour of a baby’s stool changes from green to yellow (transition) usually after three to five days of life. Pale coloured (off white) stools are abnormal and should be highlighted to your doctor immediately, advises Dr Tan.
Often, in the first few days of life, there can be pinkish stains on the diaper often mistaken for blood. These are urate crystals which are common in newborns. These crystals indicate that your baby needs more fluids (in the form of milk). It will become normal once your baby is well hydrated.
Occasionally, says Dr Tan, there may be some bleeding from the vaginal area of newborn baby girls in the first few days of life and that can be alarming to parents. This is associated with the withdrawal of maternal hormones in their bloodstream after birth, which is very normal.
Time for a Feed
So how often should your baby be taking feeds? It depends on how much your baby takes each time, as they may feed between a two- to four-hour gap.
Most babies will demonstrate hunger cues when they are due for a feed. These can be in the form of sucking on their fingers/hands, licking or smacking their lips and showing signs of searching for the breast when carried. Crying is often a late hunger cue and should be avoided as much as possible.
Is baby drinking enough?
Breastfeeding is best for babies. After the first week of birth, your baby should be drinking either breast milk or formula (60 to 90mls), sleep for two to three hours after a good feed, pass urine four to six times a day, have yellow or mustard coloured stool and gain 150-200 grams of weight per week. These are indicators that your baby is getting enough milk, explains Dr Pradeep Raut, a paediatrician & neonatologist, from Kinder Clinic, Parkway East Hospital.
If mothers experience any difficulty in latching on or if the baby seems unsettled after each feed, mothers are advised to seek help from a lactation consultant.
Let’s Talk Sleep
Generally, babies tend to sleep 14 to 16 hours per day until six months of age, explains Dr Raut. Thereafter, their average sleeping hours may reduce to 13.5hrs when they’re about a year old. However, babies should be able to self-awaken for their feed every three to four hours and it would be unusual for a baby to sleep past a feed to the next. If you find difficulty waking your baby when his feed is due, you should consult your doctor.
How many naps does your baby need to have? In the newborn period, babies do not have a sleep-wake cycle and will usually awaken for a feed every two to three hours. They fall asleep readily after a feed and hence your baby is likely to take an average of eight naps in a day.
Hush Now, Baby
Your baby will no doubt cry and they do so for many different reasons. Common reasons would include times when they feel uncomfortable especially with a soiled diaper, when they are hungry and due for a feed, or when they just want to be carried.
However, it is unusual for a baby to be crying continuously for more than three hours in a day or be inconsolable despite being fed adequately and all other sources of discomfort addressed. If this occurs, it would be advisable to see a doctor, advises Dr Tan.
I see a Smile!
Babies start smiling to themselves when they are sleeping during the first couple of weeks. These smiles are more of a reflex in the early days. A purposeful social smile in response to a familiar face usually develops around four to six weeks of age, explains Dr Raut.
Knowing, caring and loving are the keys to the whole human experience. There is no better confirmation than childhood, that every moment well spent is a useful preparation for life. At the end of the day, who your baby is now and who she turns out to be is not always totally within your control. All you can do is to allow nature and nurture to both play a part.