Newborn Care in the First Two Weeks
by the Neonatal Nurse Practitioners of Veterans Memorial Medical Center
There are many areas of newborn care that can be challenging to both first time and experienced mothers. Some of the main areas of concern are feeding, cord care, jaundice, crying or colic, and sleeping problems.
Parents often wonder how to tell if their baby is getting enough to eat. There are several ways parents can evaluate adequate intake. Your baby should act hungry and demand to eat every two to three hours, with one longer night interval. With each feeding your baby should have a wet diaper. Urine should be clear, not dark. For approximately the first month a well-nourished, breast-fed infant will pass a soft, yellow, curdy bowel movement six or more times each day. Bottle-fed infants may pass stool as infrequently as every three days. Whenever you doubt the adequacy of your baby’s intake of milk, it is always best to check your baby’s weight at the doctor’s office.
Formula feeding is safe and healthy. Ready-to-feed formula must not be mixed with water, or your baby will not get enough calories. Concentrated formula should be mixed in a 1:1 ratio with water. After the first couple of weeks infants consume about a quart of formula per day. If the type of formula you are using is upsetting your baby’s digestive system he may vomit frequently, cry excessively, have chronic congestion, excess gas, diarrhea, constipation, or a rash. If any of these symptoms are present consult your pediatrician about changing the formula.
All babies develop in head to toe progression. What’s important to know is that all babies develop at different rates. By the end of the second month your baby should smile in response to your smile, follow an object and vocalize in ways other than crying. He may even be able to hold his head steady when held upright. Your pediatrician will evaluate your baby’s development at each monthly visit.
Average infants, in the first month of life, sleep anywhere between ten and twenty-three hours per day. Helping your baby sleep may be fostered by the following points:
Take the extra steps to make baby comfortable before putting him down (full belly, burp, clean, dry diaper).
Wrap (swaddle) securely. This reduces the chance of the baby’s own movements disturbing him.
Maintain warmth. Chilliness will wake the baby from a light sleep. Cold can present a dangerous situation for infants. Keep the environment slightly warmer than comfortable for an adult.
Back to Sleep. Today experts believe the back (supine) position is the safest. Some studies show a 50% reduction in SIDS (Sudden Infant Death) rates with babies who are placed on their backs to sleep. The American Academy of Pediatrics recommends the back or side sleeping position for all healthy, full term babies.
Colic and its causes remain a mystery in spite of numerous theories that abound. The bottom line is there is little to do for a baby suffering from colic.
Your helplessness, in combination with the fact that these daily screaming periods occur at the time of day when you are exhausted and in need of some peaceful adult time together makes colic one of the most challenging hurdles for parents to cope with. Most reassuring is that colic does no permanent harm and the certainty that it won’t last forever.
The skin of many babies becomes slightly yellow by the second or third day of life due to newborn jaundice and is usually gone by 7 – 10 days. Most babies require no treatment but some will need to spend some time under a special ultraviolet light. Call your doctor or nurse practitioner if you notice the skin becoming more yellow or if the whites of the eyes become yellow.
The umbilical cord turns black a few days after birth and will fall off between 1 – 4 weeks of life. Keep the area clean by using alcohol on sterile cotton balls. Keep it exposed to air and do not give the baby a tub bath until it falls off. Do not pull it off, even if it is hanging by a thin piece of tissue. Call the physician or nurse practitioner if you ever notice a circle of redness on the skin around the area, or if it has a foul odor.
Editorial provided by the Neonatal Nurse Practitioners of Mid State Medical Center in Connecticut. Mid State Medical Center has a staff of three Neonatal Nurse Practitioners: Jeanne Franza, BS,APRN,NNP; Michelle Goldberg, BSN,APRN,NNP; Karen McGuiness, MSN,APRN,NNP.