Debi Pearl

NEWBORN CARE

It can be difficult for a new parent to know when a baby is sick. Medical professionals field so many questions from mothers of newborns that they often treat concerns as nothing more than just new-mama nerves. Mothers can begin to doubt whether or not to trust their instincts.

 

The good news is that there are tangible and objective measures of a baby's health.

 

THE FIRST WEEK

During the first week of life a baby should nurse at least 8 times a day for more than 15 minutes at each feeding. You should be able to hear the baby swallowing milk. Baby's first sticky-black stool -- called meconium  -- should pass. You should see it progress from greenish-black to a brown soft play-dough consistency. By the fourth or fifth day, this will appear yellow. During the first two days of life, a child should begin to have wet diapers. At first this will be 2 or 3 per day and increase in number by the week's end.

 

That first week will also give you clues if a baby isn't doing well. If a baby has no desire to nurse, has a weak suck, feeds less than 8 times per day and can't manage to feed for at least 15 minutes, these are reasons for concern. If a baby falls asleep before nursing for 15 minutes, makes a clicking sound when nursing, and has dimpled cheeks when sucking, these are also indications that there is some difficulty. When the baby's diapers don't show stools progressing as they should and you don't see wet diapers within 48 hours after birth, there is something out of the ordinary. More than 2 days of these symptoms indicate that you should seek medical help.

 

THE FIRST MONTH

The signs that your baby is healthy will be pretty much the same throughout the next month. For weeks 2 through 4, the baby will continue to nurse at least eight times a day and have 2 to 4 yellow bowel movements per day. Wet diapers will likely occur between six to eight times per day with clear, not yellow, urine. The suck will strengthen and you should see milk and continue to hear swallowing during feedings. The baby should increase in weight and alertness.

 

However, in this 2nd to 4th week, you should make a note of anything that is out of the ordinary such as a baby not eating at least 8 times per day, infrequent or small stools, too few wet diapers, or if the urine becomes bright yellow. Measure your baby's length and weight; these should increase. Should the baby have a weak or tired sucking reflex, if you can't hear swallowing, if the baby becomes sluggish, slow to respond or refuses to sleep between feedings, these are all indications that something is not right. Should you observe these behaviors for a couple of days in a row, seek out a health care provider.

 

WEEKS 5 TO 10

In the second month of life, a baby might reduce the number of feedings to seven times per day. This is because he is growing and can take in more milk. Again, you will notice a change in bowel movements to either several small stools per day or a large one as infrequently as every couple of days. This is normal for a breastfed baby as the body is able to assimilate much of mama's milk with little waste. Six to eight wet diapers will continue daily, but check to be sure there isn't a concentrated yellow color. Along with increasing alertness, you should continue to see a strong suck, milk dribbles, and hear an audible swallowing at feeding time.

 

During the 5 to 10 week mark a baby that doesn't nurse at least seven times a day and produce the right amount of wet diapers (without dark yellow color) should be watched carefully. Make a note if your child stops gaining weight or doesn't grow in length. Weak, tired sucking without an audible swallow indicates the baby is not getting proper nourishment. Should the baby become sluggish, slow to respond and be unable to sleep between feedings, seek medical assistance in rectifying this problem. Two consecutive days of these behaviors indicate something is wrong.

 

KEEPING TRACK

 

This way, should anything seem out of the ordinary, you can refer to your notes and present them to a doctor if needed. This is also a good way for a new mama to bond with her baby. You may be too tired to figure out why your baby is crying, but a quick check of your notes will tell you if it's been too long since he ate (hunger) or if he hasn't had a bowel movement that day (constipation). In turn, you begin to interpret your baby's cries and what they mean. This goes a LONG ways towards helping a new mama learn to trust her instincts when it comes to her baby.

 

The BEST advice for new mamas, however, comes from not-so-new mamas. Enjoy these first few weeks to their fullest. Don't worry about filling your day with anything more than getting to know this new little one. Too soon, they are no longer little.