What do babies need during their first few weeks and what to expect as a new mum?

Congratulations on the birth of your beautiful baby! Over the next few weeks, you will remain busy  looking after and getting used to the new member in your family. At the same time, don’t forget to take good care of yourself too. Here are a few things that you may want to know about your newborn in order to ease your journey.

Feeding

Breastfeeding is best for your baby. The first milk, colostrum, is produced in small volumes, but is nutrient rich and supports the baby’s immune system and helps to develop many organ functions. After 2-4 days, milk will be produced in larger volumes. Majority of babies don’t require additional formula top-ups. Babies need more frequent feeds in the first few days of life, every 2-3 hours, followed by 3-4 hourly or longer as they grow older. Good weight gain, changing stool colour, increase in urine frequency and sleeping well between feeds are signs that your baby is feeding adequately.

Stools:

Babies usually pass dark green, sticky stools, called meconium, within 48 hours of birth. Premature babies may take much longer. Following meconium, breast milk fed babies usually pass light green and then mustardy yellow stools. The stool frequency changes with time, breast fed babies passing stools every 4-5 days or so after two weeks of age.

Breathing:

Babies normally breathe faster than older children and adults. A phase of shallow and then rapid breathing is common whilst asleep. Hiccups, nasal congestion and sneezing can be normal in the newborn period.

Sleep safety:

Newborns sleep for the majority of their time, averaging 16-20 hours of sleep a day. Always put your baby to sleep on his/her back. Avoid overheating, exposure to cigarette smoke and do not cover the head and face. Never sleep with the baby on a sofa or armchair; put them to sleep in their own cot. Keep pillows, toys, wires or cords away.

Newborn baby skin:

Babies are born with a creamy secretion on their skin which acts as a natural moisturizer. Gentle washing every 2-3 days may be sufficient so as to not deplete the fat barrier from the skin. Wet wiping may be adequate for smaller babies. Minimize exposure to cold after baths and avoid contact with irritant chemicals in the first year of life.

Rashes:

Newborns commonly get a number of benign skin rashes. Erythema toxicum neonatorum is the commonest of these. It appears as red blotches with white tops (“flea-bitten” appearance) that appear soon after birth and fade over 5-7 days. No treatment is required, and the rash is not associated with any other symptoms.

Umbilical cord:

The cord usually separates by 7-10 days of life. Keep it dry and exposed to air, outside the nappy area by folding the nappy down. Clean with water if required, avoid applying any chemicals or antibiotics as that may delay cord separation. Redness of skin around the cord or pus like discharge may indicate cord infection and medical attention should be sought.

Intestinal colic:

This happens usually by 2-3 weeks of age. The exact cause is not known but it is thought to be a phase in the adaptation and development of the baby’s gut. It is self-resolving and causes no harm to the baby. Overfeeding during episodes of colic should be avoided and may lead to milk reflux. There is no specific treatment for colic. Gentle rocking, burping, bathing, massage and anti-colic remedies may help.

Medical care and screening:

You may be offered the following as part of routine care of your newborn:

  • Vaccines – BCG and Hepatitis B
  • Vitamin K
  • Heel prick test for newborn screening
  • Hearing screen
  • Transcutaneous bilirubin checkYou will receive information about future follow up and vaccines at the time of discharge from the postnatal ward.

When to seek medical attention/advice:

Seek medical attention if your newborn baby experiences fever, fast or laboured breathing, new onset feeding difficulty, frequent vomiting, lethargy, pallor or blue episodes.

Good luck and I hope you enjoy your beautiful baby and parent journey!

Dr. Roopali Soni

Consultant Neonatologist,

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