Growth and Development, Newborn
Common Concerns
Although you may feel prepared for your baby, the reality of the constant care a newborn needs can shock many parents. A newborn affects your life in ways that simply can't be anticipated. It is only through experience that parents can fully understand the impact of these new responsibilities and how your expected roles change. It is normal to shift frequently between feeling confident and ecstatic one minute, and drained, scared, and unsure the next.
When you realize that your baby is physically completely dependent on you, you may worry whether you are giving your baby the best care. Common issues in this first month include:
- Umbilical cord care. Basic care of your baby's umbilical cord is keeping it clean and dry. Gently clean the umbilical cord stump and the surrounding skin at least one time a day and as needed during diaper changes or baths. Gently pat the area dry with a soft cloth. The stump should fall off within a couple of weeks, although sometimes it takes longer.
- Your newborn's sleepiness. Especially in the first few days after birth, your baby may seem to be in a distant world, only pausing long enough in this one to wake you up for a little snack or a diaper change. Your baby will become gradually more alert throughout the month. By the end of the first month, your baby will likely begin developing sleeping and eating patterns. In general, your baby will likely have periods where he or she is awake for 2 or 3 hours straight. Around 3 months of age, the patterns will become more predictable.
- Your exhaustion and sleep deprivation. Although newborns sleep a lot, they also wake up a lot for brief periods and need feeding, diapering, and attention. Nights of long, restorative sleep can seem a foggy memory to parents. This may be especially true for mothers, who start with a deficit after the physical exertion of and recovery from giving birth. Be sure to ask for help when you need it. Don't hesitate to ask a family member, friend, or neighbor to help you with daily tasks, such as laundry, cleaning, or making meals. This can help you to nap while your baby sleeps instead of doing chores.
- Worry over whether your baby is getting enough to eat. This is especially a common concern among breast-feeding mothers. As long as your baby feeds regularly (every 1 to 3 hours in the first few weeks, then 2 to 4 hours over the next few weeks), he or she should be fine. Sometimes you may need to wake a sleepy baby to eat. Look for signs that your baby is getting enough breast milk, such as wetting about 6 to 8 cloth diapers—or 4 to 6 disposable diapers—and having at least 1 or 2 bowel movements in a 24-hour period. During well-child checkups, the doctor will monitor your baby's weight gain and growth.
- Newborn jaundice. Many babies get jaundice (also called hyperbilirubinemia) in their first few days of life. Jaundice is a condition in which the skin and the whites of a baby's eyes appear yellow because of a buildup of bilirubin in the blood. Bilirubin is a yellow-brown substance produced by the breakdown of red blood cells. Although jaundice should be monitored, it most often does not require medical treatment. Usually, increasing the number of feedings helps reduce jaundice. Phototherapy, in which a baby is placed under special lights or fiber-optic blankets, may be used if bilirubin levels are too high. Keep your baby's well-child appointments with your doctor, or call anytime if you are concerned about jaundice or your baby's skin. For more information, see the topics Jaundice in Newborns and Newborn Rashes and Skin Conditions.
- A misshapen head. Immediately after birth, especially after lengthy vaginal deliveries, your baby's head may look misshapen. This is normal, and your baby's head will most likely take on a more normal shape within a few days to weeks after delivery. But in rare instances, a misshapen head can be a sign of an abnormal condition, such as craniosynostosis. After your baby is born and during your baby's well-child checkups, your doctor will monitor your baby's head shape and skull growth. If you are concerned that your newborn's head has not returned to a normal shape within several weeks of delivery, talk with your doctor. For more information, see the topic Craniosynostosis.
It is also normal to question your feelings for your baby. A bond doesn't necessarily happen the moment you set eyes on your child. But you will develop stronger feelings and love for your baby every day. For some parents, it takes time to develop this bond, especially when the baby's physical demands take a great deal of time and energy. Talk to your doctor if you do not feel that you are bonding with your baby in the first week or two.
Also keep in mind:
- Your baby will soon be able to engage with you. But this first month, your baby may seem to be in a semi-conscious state. Sleeping and eating are a newborn's main activities. He or she will gradually emerge from this groggy state, and you can rest assured that your loving care will be rewarded with interaction very soon.
- Gradually within the first month, your newborn will begin to look more "baby-like." Although many parents don't like to admit it, even to themselves, it is common to feel disappointed that their baby isn't as cute as they had hoped. If you feel this way, don't despair. Labor and delivery takes its toll on your baby's appearance. He or she may have an odd-shaped head, swollen or squinty eyes, blotchy skin, and a flattened nose in the first few weeks. Soon, these irregularities will fade away and your baby will start to develop more normal-looking features.
- Your baby may have a birthmark that is noticed at birth or within this first month. Most birthmarks need no treatment. They often fade as a child grows older. But sometimes a birthmark needs treatment or close monitoring. Talk to your doctor if you have concerns. For more information, see the topic Birthmarks.
Although you will go through some major adjustments to this new little person in your life, your baby's first month is also a period of amazing growth and change. Treasure these first weeks as you gradually introduce your baby to the world.
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| Author: | Debby Golonka, MPH | Last Updated: March 19, 2009 |
| Medical Review: |
Michael J. Sexton, MD - Pediatrics
Kimberly Dow, MD, FRCPC - Neonatology |
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