Babies normally lose up to 10% of their birth weight in the first few days after they are born. Then they start gaining weight and by two weeks should be back at birth weight. We will see your baby frequently after birth to make sure the weight gain is appropriate. After that, babies usually gain ½ to 1 ounce a day. Most babies double their birth weight by six months and triple it by one year.
During the first two weeks of life breastfed babies should feed 8-12 times a day, about 10 to 15 minutes on each breast. Formula fed babies should feed 6-10 times a day. Don’t wait until your baby is crying and upset to feed. This is actually a late sign of hunger and it may be harder to feed the baby if both of you are frustrated. Look for earlier, more subtle clues such as stirring from sleep, putting the fist in the mouth, turning the head if the cheek is stroked lightly, or sucking movements with the mouth. During the first few days it is best to feed your baby every 2 to 4 hours, even if you have to wake them up.
To tell if your baby is getting enough in, take a look (literally) at what comes out. The first two days your baby may only have a couple of wet and dirty diapers. The next few days he should have at least three of each. For the next few weeks, your baby should have at least 6 wet and 3 dirty diapers a day (although often they will have a dirty diaper after every feed). If your baby is having less, please call our office. Don’t forget that many times a diaper has both urine and stool mixed together.
All babies spit up—sometimes after every feed. There are two common causes: overfeeding and reflux. Reflux happens because the valve at the bottom of the esophagus (feeding tube) where it connects to the stomach is weak or relaxed. This allows the food to easily come back up. The valve tightens as the baby grows and the reflux usually resolves by about 1 year of age. As long as your baby is gaining weight and the spit up doesn’t bother him we usually don’t treat it medically. Things that do help are giving smaller, more frequent feeds as well as holding your baby upright for 15 to 20 minutes after a feed. Call our office if you notice blood in the spit up, greenish color, increase in frequency and intensity of the spit up, projectile or forceful spit up or if the baby’s belly looks swollen or feels hard.
Your mom is right. Jaundice occurs when babies have extra bilirubin in their system. Bilirubin is produced by the breakdown of red blood cells. This is often normal in newborns. The more your baby feeds and poops, the more bilirubin he will get rid of and the yellow in the skin will begin to resolve. You should let our office know if your baby begins to look yellow so the bilirubin level can be checked (a simple blood test).
You may think that poop should be brown, but babies produce a wide variety of colors! During the first 24 hours of life, it is thick, sticky, and brownish-black in color (meconium). After the first few days of life, the stools of breastfed babies lighten in color from black to brown to green to yellow and change consistency from sticky to seedy to cottage cheese like to looser. Formula fed babies usually have firmer stools that are light brown in color.
The cream you choose depends on the type of diaper rash your baby has. In the first week of life the rash is usually due to irritation from wetness. Barrier creams with Zinc Oxide are best, but even a thin layer of Vaseline works well on newborns. If your baby has a yeast rash (bright reddish pink and raised, often with little bumps surrounding) you will need a prescription medicine. Let your doctor check the rash and let you know which type of cream you need.
In the beginning your baby should wake up to feed about every 3 hours. To help her learn the difference between day and night, keep night feedings as calm and quiet as possible. As she gets older (around 3 or 4 months) you can start teaching her how to fall asleep on her own. Start by putting her down when she is awake. She will find her own method of soothing herself to get to sleep. If you always rock or feed her to sleep when she wakes up in the middle of the night she’ll need you to put her back to sleep. Around 4 months of age she no longer need to eat in the middle of the night, so don’t pick her up, hug her or feed her every time she cries. Don’t forget—your baby should always be put to bed on her back!
Our office recommends that for infants less than three months of age, you should contact our office any time your child’s temperature is greater than 100. In general, if your baby is not acting well, call our office whether there’s a fever or not.
If you baby is less than 3 months of age and irritable and or has a fever please contact our office. Between three and six months, for mild illness with or without fever, a parent may administer acetaminophen for a few days, but parents should seek medical attention for fever if it is high (104 or more), unexplained, or lasts more than three days.
We recommend that all healthy newborns be placed on their back to sleep in a safe, firm mattress with no stuffed animals, blankets or pillows. At about five months of age, the baby may learn to roll over. However, SIDS precautions should still be taken.