Journey of first few weeks

Welcoming Your Newborn: The First Few Weeks

Becoming a parent is a whirlwind of emotions, and those initial weeks with your newborn are nothing short of magical. From the tiny fingers to the delicate coos, every moment is filled with wonder and joy. As you step into this new chapter, it's a blend of sleepless nights, adoring gazes, and a heart full of love.

The New Normal

The first weeks with your baby are an adjustment period. Your days now revolve around feeding, changing diapers, and lots of cuddles. Embrace the chaos, relish in the snuggles, and remember, it's okay not to have all the answers right away. Newborns spend their first weeks of life adapting to their new environment. Your newborn baby is learning a lot as you spend time together every day. Their brain is growing and developing as they see, hear, smell and touch things in the world around them.

Bodily changes

Your baby’s umbilical cord will gradually dry, become black and then fall off, usually within the first 10 days. Try to keep the umbilical cord clean and dry. If the area around the umbilical cord looks red or is sticky, let your midwife, GP or child and family health nurse know.

Any swelling around your baby’s face and eyes should go down within a few days. If your baby’s face or head has been bruised – for example, after a forceps birth – the bruising will disappear. Newborns with bruising are at risk of newborn jaundice.

Read the following article to know more about normal skin changes seen in newborn.

Feeding cues

1.Early Cues

Early signs of hunger are subtle. Watch for these cues to feed your baby:

· Rooting Reflex: Your baby turns their head and opens their mouth when you stroke their cheek or mouth.

· Sucking Motions: Babies might suck on their fists or fingers as a sign they're hungry.

2.Mid-Level Cues

As hunger intensifies, these cues become more evident:

· Increased Movement: Your baby may squirm or fuss more than usual.

· Lip Licking: You might notice your baby sticking their tongue out or licking their lips.

3.Late Cues

If the baby becomes too hungry, these cues are clearer:

· Crying: This is a late sign of hunger. Try to recognize earlier cues before your baby reaches this point.

· Agitation: Your baby might seem frantic or upset.

Sleep, or Lack Thereof

Let's talk about sleep! Newborns don't follow a schedule, and their sleep patterns are irregular. Be prepared for short naps and frequent wakings. It's all part of the journey. Rest when your baby sleeps, and don't worry about the household chores just yet.

· Initial Sleep Duration: Newborns experience their longest sleeping hours during the initial phase. However, the sleep duration varies significantly between infants, constituting a normal pattern.

· Hours of Sleep: Typically, newborns sleep between 16 to 22 hours per day, but this duration gradually lessens as they grow older.

· Feeding and Sleep: Newborns often wake up every 2–4 hours for feeding and return to sleep after feeding. It's advisable to feed the baby every 2–3 hours during the neonatal period.

· Developing Sleep Patterns: By 3–4 months, many babies establish a more structured sleep pattern, sleeping longer stretches during the night. Nevertheless, some infants might exhibit an opposite rhythm due to an underdeveloped circadian rhythm.

· Infant Sleep at Different Stages: Most babies, by late infancy, sleep for 4–6 hours in one go. Yet, some might continue waking up every 2–4 hours throughout the night, persisting even at 2 years of age.

· Sleep-Inducing Techniques: To help babies fall asleep, practices like swaddling, gentle rocking, and singing lullabies can be beneficial.

Face down or prone positioning for sleep is not advisable due to potential risk of accidental suffocation.

For the same reason, newborn baby should not be allowed to sleep on parents’ chest.

The newborn startle

· Sudden Startling Movements: Newborns often display sudden, reflexive movements, particularly when they're sleeping or in a serene state, responding to abrupt noise or movement.

· Startle Reflex: These instances of sudden activity, involving all limbs for a few seconds followed by calmness, are known as the "startle reflex." This reflex fades away as the baby grows.

· Moro's Reflex: A particular sequence of movements, the "Moro's reflex," can be elicited when a baby's head is swiftly lowered, such as during the process of putting them to sleep. It includes the opening of the baby's hands, followed by the extension and abduction of the upper limbs, embraced activity, and occasionally crying.

· Term Baby Movement: This sequence is more noticeable in babies born at term and usually vanishes by the time the infant reaches 3 months of age.

Variable respiration patterns

· Nasal Breathing Preference: Newborns primarily breathe through their nostrils rather than their mouths. It's a natural breathing tendency during their initial phase.

· Airway Vulnerability: Due to their smaller breathing pathways, infants are more susceptible to blockages. Their tiny air passages are prone to obstruction, requiring careful monitoring.

· Chest Movement: Infants display more prominent chest movements compared to older children. Their chests are pliable, mainly composed of cartilage, contributing to greater chest wall mobility.

· Respiratory Immaturity: Newborns possess an underdeveloped respiratory system, often exhibiting irregular breathing patterns. They tend to breathe rapidly and may pause briefly (<10 seconds) between breaths.

· Breathing Rate: A newborn's normal breathing rate ranges between 30–60 breaths per minute. This rate may slightly decrease during sleep and increase during periods of activity or wakefulness

Consult your doctor if:

 Persistent abnormal movement such as continuous twitching which does not disappear on restraining.

 Presence of starring look, abnormal cry especially, if associated with lethargy.

 Decreased feeding, feeling of not looking well, having sudden change in behavior from earlier times.

 Decreased movement of any body part, sudden paleness.

Stooling pattern

· Initial Stool Passage: Babies should ideally pass their first stool within the first 24 hours after birth.

· Frequency of Bowel Movements: Most infants typically have 6–8 bowel movements in a day, although this frequency can widely differ.

· Breastfed Babies: Especially in breastfed infants, passing a small amount of semi-solid stool post-feeding is common. This occurs as a baby's full stomach can stimulate the digestive system, resulting in frequent bowel movements.

· Variations in Stooling: Some babies might only pass stool once every 4–6 days. This reduced frequency isn't worrisome as long as it's the only symptom observed.

· Meconium and Subsequent Changes: The initial stool, known as "meconium," is thick, greenish-black, and sticky. Over the first few days, the stool changes from greenish-black to green, ultimately transitioning to yellow or yellowish-brown by the end of the first week.

· Breastfeeding and Stool Color: Babies on exclusive breastfeeding often pass more yellow stools compared to those on formula feeds

Bladder habits

· Early Urination: In the first 48 hours after birth, a newborn should pass their initial urine.

· Daily Frequency: After this period, it's common for babies to urinate about 6–8 times a day. Some infants may even urinate more frequently, reaching 12–15 times a day or possibly more.

· Urination and Feeding: Adequate urination serves as an indirect sign that the newborn is receiving enough milk, ensuring proper nourishment.

· Crying and Urination: It's typical for neonates to cry before urinating. The sensation of bladder stretching can cause discomfort, leading to crying. However, once the bladder empties, the baby often feels relaxed and calms down.

Please immediately consult a doctor:

 If decreased stool frequency is associated with either vomiting, tight abdomen, decreased activity or if baby is not feeding or looking well.

 If stool frequency is very much increased, and either urination is decreased, baby looks ill, lethargic or does not accept feeds.

 If there is decreased urine output, poor weight gain or ballooning of skin, while micturition in male babies, a doctor should be consulted to rule out urinary tract infection and other diseases.

Parenting Partnerships

If you have a partner, teamwork makes a world of difference. Share responsibilities, take turns, and support each other. Those moments of shared joy and tiredness strengthen your bond and make this beautiful journey even more special.

Self-Care for Parents

Remember to care for yourself amidst the baby care. Take short breaks, enjoy a hot meal, or catch a nap when possible. Self-care is not selfish; it's essential for being the best for your little one.

The Emotional Rollercoaster

Emotions can be all over the place. It's okay to feel overwhelmed, and it's normal to experience moments of uncertainty. Seek support from family, friends, or professionals if you're feeling too stressed or down.

Cherishing the Milestones

In these first few weeks, every little progress your baby makes is a milestone. The first smile, the first grip of your finger, these are the moments to treasure. Capture them, but don't forget to live in the moment.

Parenthood is a remarkable journey, and these first few weeks set the stage for an incredible adventure ahead.

REFERENCES: Standard Parental Guidelines by INDIAN ACADEMY OF PAEDIATRICS 2023