Belinda Joyce
During pregnancy, the focus is on the birth of your baby, which is very important but after that, you’ll have your baby to care for 24 hours a day and there is a lot to learn -you don’t really know what you need to know until you need to know it!
So, what do you need to know in the first 7 days of your baby’s life?
Breastfeeding:
We start with small amounts of colostrum a thick concentrated substance, which is available immediately after birth in small quantities, so the baby needs to feed often. If they are a sleepy newborn, we will ask you to wake them to feed as this assists the milk coming in and keeps your baby’s blood sugar up as well as stimulating the digestive system to help your baby start using their bowel and passing their early poos which are called meconium.
The milk usually ‘comes in‘ around day 2-5, many women will have a large supply, sometimes enough for 4 babies. This will gradually reduce, it can take a week or more depending on supply and demand which will help your body to figure out how much to produce for your baby.
I apologise in advance, but you will often get a lot of differing advice around breastfeeding in those first few days and weeks as it is changing and evolving every day and we are also watching your baby to see how they’re responding to the feeding and how they are gaining weight. Most new Mums will need some support around breastfeeding, it doesn’t come naturally for many Mums and Babies.
Weight Gain:
It is normal to lose up to 10% of birth weight, they are having very small feeds in the first few days as they drink the colostrum or small servings of formula. We expect that with good feeding they will start to gain weight quite quickly and get back up to their birth weight by 2 weeks of age.
If they lose more than 10% of their birth weight, they will need more frequent monitoring of weight and probably a feeding plan whether breast or bottle feeding. If breastfeeding a lactation consultant review would be helpful.
Wet Nappies:
On the first day of life, we are checking that your baby passes urine at least once, we will track this as it means everything is working properly.
On day 2 we expect 2 wet nappies, day 3, 3 wet nappies, day 4, 4 wet nappies, day 5 and from then we usually expect at least 5 heavy wet nappies a day. This goes hand in hand with breastfeeding, starting out with very little and then increasing over those days.
Monitoring this is important as milk/liquid is their only food source and what goes in has to come out. It also shows that your baby is starting to acclimatise to life outside the womb well.
You may see small amounts of stained orange/red rusty liquid in the nappy in the early days, these are called urates and are normal early on but after days 4-5, this may be a cause for concern as it can be a sign of dehydration, talk to your health professional about this. Female babies can occasionally pass a little blood from their vagina, almost a mini period that is caused by Mum’s hormones crossing to baby and will not last.
Dirty Nappies:
Your baby’s poos change dramatically in the first week of life. The first poo passed will be meconium, which has lined the baby’s digestive tract for some months, it’s black or dark brown or green, and it’s sticky and shiny. It sticks onto your baby’s bottom and is hard to get off, you will likely go through many wipes or wet washers to clean it off.
From day 2 or 3, you will start to see a transitional stool, milk starts being incorporated and it changes to more of a brown or khaki green colour, often finishing in a mustard yellow colour for most babies from then on, although some variation is normal as well especially if breastfed.
Many babies will poo with every feed from then on for some weeks or months. It is also normal for a breastfed baby to go up to 2 weeks between poos and it is not considered constipation although most babies are quite uncomfortable.
How your baby looks:
Immediately after birth many babies are purple or very dark red and this is often concerning to parents, but this will improve as they start breathing air they will ‘pink up’ and look more normal in colour.
Most are covered with vernix, a creamy white substance that has protected their skin in utero, this is beneficial to their skin. There is no reason to wash this off, it will wear off itself.
Most babies’ heads are moulded from the journey down the birth canal, cone shaped, or misshapen heads are common, and these will round out quite quickly over a few days. Many wear a beanie in the first few days and have this covered.
Swelling around the eyes and mild bruising to their face is sometimes present, if forceps were used, they may have marks on their cheeks, these usually heal and are gone within the first week or 2 of life.
Some babies are quite hairy and can have soft downy hair along the tops of their ears, on their forehead, shoulders and back. This will usually fall out over time.
Birthmarks are common, there are many different types, some they are born with and others that develop in the first few days of life. Ask your health professional what type your baby has.
Swollen genitals are common and will reduce over days and weeks, even breast tissue on both male and female babies is common and sometimes small amounts of milk can also be excreted.
Some jaundice or slightly yellow tinge to the skin is normal skin however it can be brighter and travel down the body past the belly button and then testing by a heal prick test is required and sometimes phototherapy (light) treatment is needed.
First Bath:
Most parents are surprised to hear that babies usually don’t enjoy their first few baths. They are used to being really well contained in their mum’s tummy and then in a swaddle, parents’ arms and so on. We then take their clothes off and their arms and legs are out there, they feel very cold, and they don’t feel safe.
Try to undress them as quickly as possible, plunging them into a warm bath can help. Put a wet washer over their body and keep wetting it with warm bath water. This helps them to feel more secure, it’s almost like covering them with a blanket. This often helps them to stop crying immediately.
They don’t need a bath every day, start with the face and end with the nappy area, no big rules are needed. It only needs to be short; they are not that dirty.
Try and make bath time fun, have everything out, and ready to go, and ask a midwife to help with the first bath to show you how to hold your baby safely. Once you get home you may want to do the first few baths with both parents available to help.
Baby Play:
I am often asked if I need to play with a newborn baby, there is no need for structured play. It should be fun, there’s nothing that needs to be incorporated, especially in the first week as you are just getting to know each other. Talk to them, give them lots of eye contact, smile and talk to them.
You’ll probably notice them responding to your facial expressions, they already know your voice from in utero, they’ve been listening to you talk for months now. Your voice and others that have been around them a lot such as a dad will be familiar, and comforting and they will love hearing you.
Their vision is best between eye and chest height, so cradle them so that they can see your face well or place them on their change table and talk to them.
Get to know them, take the pressure off anything being structured.
As you can see there are many changes in the first week which are good to be aware of, some may affect you and others won’t but having an idea of what is normal or at least common can be helpful.
Enjoy Your Baby
