It’s 2 am. Your first night home from the hospital. The baby is crying and you’re exhausted. Is she hungry, wet, tired…aaahhh! You’ve read all the must-have parenting books. You thought you were prepared. But nothing can ever completely prepare you for the crazy but exciting ride ahead. All parents have questions (lots of them!) the first few days at home with their newborn and here are some of the answers to get you started.
1. Why should I breastfeed my baby? Is it going to hurt?
Breastmilk is best! Mother’s milk provides immunity against bacteria and viruses, is easy for your baby to digest, is less expensive and requires no prep time. It is demanding because of the large time commitment required, but the benefits are well documented. Studies show that breastfed babies have fewer ear, respiratory tract, and diarrheal infections. They are also at lower risk for many childhood diseases including obesity. Breastfeeding also benefits mom by decreasing your risk of cancer and helping you get back to your prepregnancy shape.
Persistent pain during breastfeeding is not normal. Although breastfeeding is natural, it’s not always easy at first. It’s ok to ask for help from your pediatrician or lactation specialist. Improper latch on and vigorous or prolonged sucking can be painful and may lead to sore, cracked nipples. In the beginning, brief pain can occur while your infant latches on. Count to 10 and if the pain continues, remove the baby and reattach him so that the baby’s mouth covers as much of the areola (the dark brown area around your nipple) as possible. If the pain occurs during a feeding, switching breasts may help. If a burning or stabbing pain is experienced later in breastfeeding, call your physician because you might have an infection that needs treatment.
Most of your milk comes down in the first 5-10 minutes, so after 15-20 minutes on one side, take your baby off. You are not a pacifier! Prolonged sucking can dry out your nipples and cause soreness. Allow your nipples to air-dry after you feed your baby or shower. Then apply a lanolin cream. Wear a cotton bra or loose fitting top and remove plastic liners from your bra. Continue breastfeeding! Your baby will appreciate you for sticking it out through any discomfort.
2. How do I know if my baby is gaining enough weight?
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. Your pediatrician 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.
3. How do can I tell if my baby is hungry? How do I know if she is getting enough to eat?
During the first two weeks of life breastfed babies should feed 8-12 times a day, about 10 to 15 minutes on each breast. 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 your pediatrician. Don’t forget that many times a diaper has both urine and stool mixed together.
4. How do I know if my baby’s spit up is normal or worrisome?
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 your pediatrician 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.
5. My baby is yellow. My mom says it is jaundice. What does that mean?
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 off and the yellow in the skin will begin to resolve. You should let your pediatrician know if your baby begins to look yellow so the bilirubin level can be checked (a simple blood or skin test). Depending on the results your pediatrician will advise on treatment.