By Tanya Remer Altmann, MD, FAAP
In the hospital you have lots of help—nurses, lactation consultants and doctors—all at your beck and call. Then comes the time to take your little one home. You’ve read the “must-have” books, subscribed to parenting magazines and spent many evenings on the phone with your own mom. Think you’re prepared? Think again.
Here are a few important tips parents tell me they wish they had been told about the first few weeks at home with their newborn.
Everyone tells you that you won’t get much sleep, but it’s worse than you imagine. Realistically, you won’t get any in the first few weeks. In addition to needing to feed every few hours, babies don’t know the difference between day and night. So no matter what time he rests, you need to take advantage and nap too. You can also try to help him get on track by keeping nighttime feeds and changing as calm as possible and wake him after 4 hours of daytime sleep to feed. But as soon as your doctor says he’s gaining weight appropriately and it’s ok to let him sleep at night, don’t wake him up at night to feed and enjoy the extra sleep yourself.
Babies cry! When they’re not sleeping, eating or pooping, they’re crying! They cry when they are hungry, wet, cold, hurt, or just for no apparent reason at all. You will get to know her cries and what they mean. If she’s been fed, changed and checked to make sure nothing is hurting her, it’s ok to let her cry for a little while. Often it’s just her way of blowing of steam. So give her the chance to just let it all out. You can try swaddling, rocking or singing to her, it may help. If she is truly inconsolable, call your pediatrician.
We know that breast milk is the best nutrition for your infant and you should attempt to breastfeed your baby every 2-3 hours or when she seems hungry. What you may not know is that although breastfeeding is “natural”, most babies aren’t born experts. Breastfeeding takes patience and hard work initially, but keep at it. It’s worth it for your infant’s health as well as your own. And don’t be afraid to ask your pediatrician or a lactation consultant for help. It usually takes 4 or 5 days for your real milk to come in. Rest, water and a nutritious diet can help. Stress, lack of sleep, dehydration and not enough calories (or even low carb diets) can decrease your milk production.
While your infant may resemble you, his stool won’t look like yours. Babies poop a wide variety of colors, consistencies and frequency. During the first 24 hours of life, stools are thick, sticky, and brownish-black in color—called meconium. After the first few days of life, the stools of breast fed babies lighten in color from black to brown to green to yellow. They also change consistency from sticky to seedy to cottage cheese-like to looser. Formula fed babies may have firmer stools that are often light brown in color. Also, when babies poop they may strain so hard their face can turn bright red and that’s ok. And some babies may not stool for a day or two when they first come home from the hospital, while others will poop after every feed.
Your baby will most likely lose weight the first few days. Many newborns lose 10% of their birth weight after they are born and within the first week start gaining weight back and reach their birth weight by 2 weeks of age. Your pediatrician should plot and follow her growth at each office visit.
Who says that babies have soft, silky smooth skin? The truth is that most infants initially have dry, flaky skin that may start to peel after the first day. They also have a wide variety of skin rashes, bumps, spots and even acne. Don’t worry, having baby acne doesn’t mean more acne as a teen. Most are normal newborn skin conditions and will go away with time—no treatment needed. Your doctor can take a peak at the next exam.
Hiccups, sneezes and spit up…oh my!
You’ll think it is so cute the first time your baby hiccups, sneezes and even spits up a little. But then it continues and goes on and on and on. While these behaviors rarely bother the baby, they often really bother parents. Don’t worry. It’s all a normal part of infancy. As long as he is feeding and gaining weight normally, there is no need to be concerned.
By no means will this completely prepare you for life with your newborn. You will have questions every day, hour and minute you are home with your baby. Write them down as you think of them and take them with you to your infant’s check-ups. Don’t forget that you can always call your baby’s pediatrician if something is urgent or you’re unsure of what to do—that’s what we’re here for. After all, you can’t be prepared for everything.