ALL ABOUT BABY
first hours to first week
how they look, reflexes
newborn babies head to toe
what to expect: feeding, output
sleep, feeding, out, weight gain
skin to skin, nail care, swaddling, safesleeping
They go from taking their first breath (sometimes through vigorous crying) to calming down with their first cuddle. They’ll be taking things in for the first time.
Around 20 to 30 mins later their instincts will give in and you might find them smacking their lips and sucking sounds. They’re ready to eat!
Babies are then quite active for the next hour or two to practice feeding for the first time because they drift off for a well deserved nap.
HOW THEY LOOK
Cone-head: They might have a cone head, especially if you laboured for a while. The bones of their skull have been created to shift and slide and overlap to fit through the pelvis. This molding of their head is normal and will shift back in 24 hours or so.
Caput (Swelling on the head): Some babies have a bump on their heads caused by swelling from the pressure of birth. This usually goes down in 24 hours or so.
Lanugo (baby hair): You might find your baby covered all over with this soft, downy hair. This is normal from their development in utero. They will start to lose it in the coming weeks.
Startle Reflex: Babies have a reflex where they shake and jitter, especially when being put down. They are not cold! Babies actually cannot shiver yet. This is their startle reflex and is completely normal. It is sporadic without pattern, and not continuous.
Feet Reflexes: If you press into your baby’s feet, their toes will curl in a reflex only newborns have. If you gently caress the outside of their foot from the heel up, their toes will curl out. There is nothing important to note about this, just that it’s pretty cute!
Stepping Reflex: If you put your arm like a board behind your baby’s feet, they will instinctively kick and propel themselves forward. This is a stepping reflex, and theorized to help them move down the birth canal!
Sucking Reflex: If you put a clean pinky finger, with the pad of the finger up, in their mouths, they will begin to suck as their sucking reflex activates. If you insert your finger deeper into their mouth, you’ll notice that at the back the hard palate roof of their mouth becomes soft - this is where you want the nipple to be during breastfeeding.
First day babies are sleepier. It’s their recovery day, too.
They will ask to feed every 3 to 4 hours. As long as they don’t sleep too much longer than 4 hours, there shouldn’t be a need to wake a healthy baby for feeds. You can simply take their cues and look for the signs of feeding.
Pees Expected: Just 1, if they peed at birth, then done!
Some diapers are designed with the little strip indicator that turns blue if the baby has peed. This may not be as useful the first few days because the pees are very small. Instead, try putting a tissue into the diaper to detect the pees. Also, for baby girls, check the line at the back, the front doesn’t always change colour!
Poos Expected: Just 1! We’re just looking for 1 of each to make sure all the systems work!
First poos are called meconium. They are black and tarry and sticky.
Babies breathe irregularly. It can be scary if you haven’t been warned. They breathe sporadically, taking a few quick breaths and leaving some pauses.
What to look out for:
FAST breathing with no pauses, it might sound like they are panting
Laboured breathing - this means they are making a lot of effort to breathe
In-drawing - the muscles under their ribs are pulling in with every breath
Nasal flaring - as they breathe in their nostrils are flaring wide to inhale more oxygen
Babies turn pink quite quickly after their first breath is taken.
However, their hands and feet can remain quite pale or even blue the first 24 hours. This is their body prioritizing blood flow to their brain, heart, and main organs. When they are exerting themselves, for example when crying or breastfeeding, this colour difference in the extremities become more apparent - don’t be alarmed.
Sometimes the skin around their mouth can also be more pale in colour. But their lips should always be pink.
What you should see:
Pink face and chest
What to look out for:
Paleness or blueness in the face, chest, or lips, especially paired with laboured breathing.
Peeling: Your baby’s skin will start to peel the first week, you may see it even at birth, especially if they were born past their due date. This is not because their skin is dry, but simply them losing their newborn skin that was developed in a complete water environment as they adjust to air.
Baby Rash: Most babies develop a rash of small red spots all over their body. They appear sporadically and disappear quickly. There is no known reason or cause of this, but another normal transition from womb life to earth life.
Milia (white -heads): Almost all babies will have these prominent little white heads on their noses. It’s normal from the pregnancy hormones. Just leave them alone and resist the urge to squeeze!
Baby Acne: Baby acne is very common and starts to appear the first week or two. It is their body reacting to the withdrawal of all the pregnancy hormones that are passing through their body.
Babies can have lots of mucous the first day, especially if you didn’t push for very long or had a c-section. The process of coming through the birth canal squishes some of this fluid from their lungs.
You might see your baby:
This is all normal. You can help them get rid of this mucous by gently rubbing their back and holding them upright or face down over your arm.
Breast Buds: regardless of your baby’s sex, they might have some swollen breasts! This is just from the pregnancy hormones and is completely normal. Occasionally some babies also have a little milk coming from their nipples! Again, completely normal.
Swollen Genitalia: your baby’s private area might also be swollen from the pregnancy hormones. It’s also normal
Pseudo-menses: Baby girls can have some vaginal discharge or even a little bit of blood (called a pseudo-menses). Can you guess why? Yes, it’s their bodies adjusting to the withdrawal of the pregnancy hormones.
Uric Acid Crystals: Baby boys can have very dark pees that look pinkish, orange-red, like blood. This is from uric acid crystals in their urine because the first few pees are very concentrated. Also normal.
The second day, the baby will be quite different from the sweet angel you met the day before.
Clusterfeeding is the phenomenon where your baby becomes a feeding-machine. They will ask for the breast almost non-stop over a few hour stretch. Normally, at night. Babies clusterfeed to bring your milk in, and at later time points, to increase your milk supply if they are having growth spurts.
What to do: Offer the baby the breast as often as they want.
What to do for sleep protection: Offer the baby the breast every time, and make sure they have a good latch, and are feeding effectively. This means continuous sucking and swallowing with a deep latch. If they have had a good feed for 15 to 20 minutes and you find that they are just “nibbling” at the breast or using it as a soother, you can decide to take them off to give yourself a break. In this time, your partner or you can hold them baby and soothe them or give them your pinky finger to suck on. (We recommend letting them suck on your finger instead of a soother the first few weeks to avoid artificial nipples).
Pees Expected: 2
Poos Expected: : 2, it might still be meconium but starting to get brown or green as baby starts to digest milk
Day three comes with more of a rhythm as your milk comes in and your baby feels satisfied.
Newborns feed every 2-3 hours for 15-20 mins at a time.
Note: Feeds are times from the beginning of one to the beginning of the next. This means when we say babies should feed every 2-3 hours, this includes the actual time it takes for the to have a feed. This does mean the expected "break time" is 1-2 hours.
Pees Expected: 3 pees
Poos Expected: 3 poos
Their poos will start to be mustardy yellow on day 3 as they are receiving more breast milk. Some seedy grains in their poo is completely normal as they are undigested fat curds.
About 60% of babies will experience newborn jaundice. This means their skin looks yellow. You might see it in the white of their eyes, their gums, or their faces.
What causes this jaundice? Jaundice is caused by a substance called bilirubin. Billirubin is a waste product that comes from the breakdown of red blood cells. Babies have more red blood cells than normal to give them enough oxygen in utero. When they are born, they break down all the extra red blood cells they don’t need. However, their livers are also immature and unable to process it all. Thus, the extra bilirubin causes their skin to have a yellow hue.
Some communities check the bilirubin levels routinely for every baby with a blood test, and some will check when there is concern.
What to look for:
Your baby’s behaviour - they should be waking every 2-3 hours by themselves
Output - meeting or exceeding the minimum expected pees and poos daily. They should have large, heavy pees.
Drinking - effective drinking at the breast
How to help them with jaundice:
Lots of feeding - bilirubin is excreted in their poos
Sunlight - sunlight helps breakdown the bilirubin in their skin
Sign to look out for:
Extra sleepy baby - not waking for their usual feeds, sleeping more than 1 stretch of sleep longer than 4 hours.
Not enough pees and poos
Lazy feeding and sleepy at the breasts
If you see the above signs with a jaundiced baby, call your care provider and try to increase feeding.
FIRST WEEK OVERVIEW
New babies’ biggest task is eating.
Newborns don’t have enough energy to play yet, and so they are mostly eating, pooping, and sleeping.
Newborns typically sleep ONE longer stretch of sleep in 24 hours, around 4 hours or so. The rest of the time they wake to feed every 2-3 hours. They should not be having multiple stretches of 4+ hours of sleep.
If this is happening, wake your baby to feed. If they are consistently sleepy, does not feed actively at the breast, and having minimal pees and poos, contact your care provider.
Newborns feed between 8 to 12 times a day. Depending on your milk supply and how effectively your baby feeds at the breast they may be on the lower or higher end of the spectrum.
Also remember, you can’t overfeed a breastfed baby! The muscles they need to use to breastfeed are a lot more exhaustive than drinking from a bottle. Your body is also not a machine - the baby does not get milk with every suck but instead has to work to stimulate your body for milk to be let down.
The first week we expect the minimum number of pees and poos to go up by 1 each day:
Day 1 - 1 pee and 1 poo
Day 2 - 2 pees and poos
Day 3 - 3 pees and poos
Day 4 - 4 pees and poo
Day 5 and beyond - >5 pees each day, with varying number of poos
Baby's first pees are very small as they have not received much milk yet. Slowly, we expect full heavy diapers as a sign of a well hydrated baby. The number of poos vary more greatly, and is less important. Breastfed babies sometimes have less poos as breast milk is better digested.
Newborn babies lose weight the first few days. This is normal.
Your milk is not in yet, and sometimes interventions such as an IV can contribute to some water weight in the baby. They have enough reserve for this expected weight loss. Starting by day 3-5 as your milk comes in, we expect the baby to start gaining. We expect babies to regain their birth weight by 2 weeks of age.
The following is just for your interest, and some information that you can use to guide and advocate for yourself. If you have more questions, we are more than happy to assist you in a private consultation.
Normal weight loss: up to 10% of their birth weight
Normal weight gain: Around 15-30 g a day. There is no upper limit!
Skin to skin: Lots of skin to skin contact and being near your baby is beneficial for their development and your recovery. Being near you helps babies regulate their temperature, breathing, and heartbeat.
Nail Care: You might notice your baby has quite long nails, and they might start to scratch themselves. This is okay. Their skin heals VERY rapidly, and their nails are very fine causing superficial scratches. However, if you are concerned by this, you can carefully use a baby nail clipper to clip their nails, or you can bite them off. The second way might be less intimidating and you have more awareness to not clip their skin. You can also use baby mitts, although we recommend leaving baby's hands free as it allows them to explore and aids in their neurodevelopment.
Swaddling: - hands out or in: It is a personal preference if you want to swaddle your baby. It is also a personal preference and dependent on the baby if they prefer to have their hands wrapped or tucked in. Keep in mind that the baby uses their hands as feed cues, when they start to wave or suck. It also aids the baby’s neurodevelopment when they touch their face and body.
Safe Sleeping: - The public health standard in many western nations is in the same room, different bed. This is the safest. There are lots of benefits for babies being in the same room as the parents and makes night care a bit easier. It is a personal decision if you’d like to co-sleep with your baby. A side crib that attaches to the adult bed is a safe arrangement that doesn’t disrupt the baby-parent bond.
A note on baby sleep setups: firmer surfaces are recommended with a clutter-free space (no toys or blankets near their face). Pillows are not needed and blankets should pull up to shoulder level.
A Friendly Note:
Every birther should walk away from their birth feeling like a superhuman.
Sometimes things don't go according to plan. Yet at times even when everything goes perfectly well, the sheer intensity and shock of birth can leave one feeling overwhelmed.
For these reasons, we offer special birth debriefing services in our Private Consultations.
This is especially for anyone who feels that they have a had a traumatic experience, would like to debrief with a clarity of mind to gain more insight on their birth management, and to find closure and strength in their experience.