The first few weeks, part one
Author's note: this is part one of a two part story on normal newborn behavior. Read part two, featuring tips for mothers who choose to breastfeed, here.
You just brought your newborn home from the hospital. It’s a stressful but exciting time. At the front of your mind: what behavior in the first few weeks is normal? Or what behavior should prompt a call to a health care provider? Heather Ludwig, an international board-certified lactation consultant at OSF HealthCare, has some tips.
- Eyes: Ludwig says babies are still getting used to using their eyes in the womb. So, when outside, eyes closed does not always mean the baby is asleep.
“If they’re moving or their mouth is making movements, that’s a sign of alertness,” Ludwig says, adding that newborns should be woken up and offered the breast or another feeding opportunity every couple hours.
- Sleep: Ludwig says for the first couple months, babies do not have their days and nights figured out. They’re 24- hours-a-day humans. They have tiny stomachs and want to eat frequently. Frequent feeding helps them develop their circadian rhythm, but it may mean sleepless nights for parents.
“Find ways to make it work for your family,” Ludwig advises. “Trade off who’s taking a nap and who’s taking care of the baby. I also encourage everyone to use a baby wrap or carrier. They’re happiest snuggled on your chest.
“It will get better, I promise,” Ludwig adds with a laugh.
Find ways to make it work for your family, Trade off who’s taking a nap and who’s taking care of the baby. I also encourage everyone to use a baby wrap or carrier. They’re happiest snuggled on your chest. It will get better, I promise.
- Coping: Gone are the days of letting your baby “cry it out.”
“For babies that cry for a long time, it increases the stress level in their body,” Ludwig explains. “Cortisol is a hormone related to stress. Babies that have high levels of cortisol don’t grow as well as they could have.”
Instead, hold and comfort your baby when they cry. Ludwig says newborns want and need this comfort just like an adult wants a hug when stressed.
Ludwig says babies may also come to the mother’s breast for comfort, as if it’s a pacifier.
“A baby has a busy day. Maybe they went to the doctor and had a lot of stimulation. Many times, in the evening they’ll have a fussy period. Sometimes people call it the witching hour. They like to come and nurse frequently because it’s comforting.”
Ludwig even recommends waiting to give your baby a pacifier for the first time until you’re in a good feeding routine. That’s so you don’t miss any opportunities to feed your baby. If your baby wants to come to the breast or otherwise be fed, offer that first. Save the pacifier for times when you can’t feed, like a car ride.
- Skin: Ludwig says babies are born with a waxy coating on their skin that eventually is wiped off or absorbed in. This is called vernix, and it’s what protects them in the womb. They may also develop raised spots on their skin, called baby acne, due to the release of hormones. Their fingers and toes may appear blue or purple as their body figures out blood circulation. All normal, she says, and they will go away on their own. But if your baby turns completely blue or purple or isn’t breathing, call 9-1-1 immediately.
Babies may also scratch themselves. They love to touch their face. Ludwig says the marks usually heal quickly on their own. Mom can also put a dab of breast milk on the scratch to help healing.
- Bowel movements: Here’s a word for new parents to add to their vocabulary: meconium. That describes your baby’s first bowel movement, which is usually thick, sticky and dark-colored. Ludwig says this is the fecal matter that the baby was holding while inside mom. It contains a compound called bilirubin, which Ludwig says comes from normal cell breakdown. The substance needs to be expelled from a baby’s body to reduce the risk of jaundice and other issues. Also, breast milk has a natural laxative effect. That means expect a lot of bowel movements in the first few days if you’re breastfeeding.
“Eventually, [the fecal matter] will start to brown up and become yellow,” Ludwig says. “Poop from an exclusive breast milk diet kind of looks like cottage cheese with mustard. There’s not a whole lot. It’s a little runny.”
If your baby’s bowel movements contain blood or mucus, that’s the time to call a doctor.
- Weight: Ludwig says babies will lose weight in the first few days. It’s a byproduct of the frequent bowel movements. A lot of fecal matter is going out, and a smaller amount of breast milk or formula is going in. Ludwig says a typical loss is five to seven percent of the baby’s body weight. A 10% or above loss would be cause for concern.
Weight loss stops as the baby starts to eat more. After 10 to 14 days, Ludwig says a baby should be back to their birth weight.
Learn more
Read more about how to care for your newborn on the OSF HealthCare website.