Your first weeks home with a newborn can be awkward and scary. Here's what to expect and how you can stay sane.
Plenty has been written on just how to make it through the first few disorienting weeks at home with a newborn. The problem is, at the center of that maelstrom, who has the time to read all of it? This pull-out postpartum survival guide culls from our favorite experts tried-and-true tips on how to make the best of this challenging rite of passage.
At the hospital, your baby is examined by the pediatrician, who will explain to you any obvious curiosities (for example, birthmarks or a pointy head shape). After you get home, your baby may produce some unexpected sights and sounds; most are normal.
The umbilical cord: The stump of the cord may seem very black and unwieldy for such a tiny infant. This is OK; it will disengage within three weeks. Until then, keep it clean (fold diapers down clear of it), dry (give only sponge baths until it falls off), and dab the base with alcohol twice a day.
The spit up: Not to worry, just keep lots of cloth diapers at the ready. Two effective ways to diminish returns, offered by the American Academy of Pediatrics' (AAP) Caring for Your Baby and Young Child (Bantam Books), are to burp your baby every three to five minutes during feedings, and to place the baby in an upright position in an infant seat or stroller right after feeding her. Or just do what comes naturally: Hold her.
The color poopoo: In the very beginning, it's blackish green, and then it approximates certain shades of green, yellow or brown—and it can be runny, pasty, seedy or curdy. An early breastfeeding bonus: Baby's poop usually doesn't smell at all.
Baby's breath: You won't believe how you'll crane to hear your baby respire. Any fewer than 60 breaths per minute is normal, as are pauses of about six seconds, according to Barton D. Schmitt, M.D., in Your Child's Health (Bantam Books). Take note of any wheezing or rapid breathing, since this could indicate a respiratory problem. New research shows that sleeping with your baby will help her regulate her own breathing, possibly reducing the risk of sudden infant death syndrome (SIDS).
Getting through the night: Since their tiny tummies cannot hold much milk, newborns must be fed often, which is one reason they wake so frequently. Still, you can begin the process of getting the whole household on the same schedule.
- Establish a routine early on: Bathe, dress, play and stroll around the block at about the same time every day.
- Place your baby in his crib while he's drowsy. This way he learns to fall asleep on his own and associates the crib with bedtime.
- Swaddle him. An unswaddled baby's own movements may startle and awaken him. In Your Baby & Child (Knopf), Penelope Leach writes: "At night you want him so securely wrapped that he will not wake even during the normal periods of light sleep." Keep him faceup to reduce risk of SIDS.
- "Keep night feedings as sleepy and brief as possible," Leach also suggests. "When he cries, go to him immediately so he has no time to get into a wakeful misery. Don't play or talk while you feed him." Bring him to bed with you if you want to fall back to sleep quickly.
- Newborns often sleep for four hours at a stretch and a total of 16 hours or more a day. As for how quiet the house should be while baby sleeps, Leach says the following: "A sleeping baby need not mean a hushed household. Ordinary sounds and activities will not disturb him at this early age.
However, if everybody creeps about and talks in whispers while he is asleep, there may come a time when he cannot sleep unless they do. It is therefore important to let him sleep through whatever sound level is normal for your household so that he does not come to expect a quietness that will make all your lives misery."
Bathing: Bathing a newborn can be a challenge. You can do it either by holding her in a big bowl or plastic tub or by wetting a washcloth and washing her on her changing table. Here are some other tips:
- Baby needs a full bath only about once or twice a week, but she needs to be "topped and tailed" (a Penelope Leach term) every day. This means washing the baby's head, face and bottom.
- Make sure she's been fed (but not right before the bath), that the room is warm and that you have everything at the ready (you can't leave her for even a nanosecond to retrieve something you've forgotten).
- Supporting her head, start washing Baby from the top down, using a soft cloth and tap water or mild soap specially made for babies.
- Shampoo the scalp first (only once or twice a week), shielding the water from Baby's eyes.
- Be sure to wash her face well. Left around the mouth, milk and spit-up may cause a rash. Wash eyelids and under the chin.
- Moving down, be sure to get in all those nooks and crannies.
- Rinse baby well and pat her dry with a towel.
Calming a crying baby: Crying is the only means an infant has to communicate. Your quandary: What is she telling you? Check her out. Is she hungry? Too cold or hot? Is her bedding or clothing tangled? Is her diaper dirty? Are the lights too bright, noises too loud? Is a burping in order? Is she ill? If you've run this gauntlet and put things right and she's still inconsolable:
- Experiment to discover the most comforting way for her to be rocked (side to side, back and forth), spoken to and sung to.
- Pat or rub her back.
- Walk the floor with her.
- Offer a finger, breast or pacifier to suck on.
- Swaddle her.
All babies have their fussy period during the day (for many it's between 6 and 10 p.m.); at a certain point there is nothing you can do. Although trying to calm a distressed infant can be exasperating, always respond to the cry. "You cannot spoil a young baby by giving him attention; and if you answer his calls for help, he'll cry less overall," suggests the AAP.
What to do for yourself: To help you get through this period, you owe it to yourself to:
- Get enough sleep. Yeah, right, you're probably thinking. However, "the way to avoid sleep deprivation," proposes Schmitt, "is to know the total amount of sleep you need per day and to get that sleep in bits and pieces. When your baby naps, you must also nap."
- Take breaks. Take a walk, no matter how short; run your own errands to get away. Of course, this involves asking your spouse, other family members or friends for help.
- Get Dad into the picture. Allow him to care for the baby so that you get time alone.
- Accept that progress is incremental. Break projects into smaller tasks.
- Wear a snug-fitting, nonpendulous front baby carrier so you can work while holding Baby. Being close to you is familiar; she'll love the sounds and sensations and maybe even nap.
Early visitors: Respiratory syncytial virus (RSV) is on the rise, especially among newborns and can be dangerous because it causes inflammation of the small breathing tubes of the lungs, possibly leading to pneumonia and future respiratory problems.
Symptoms begin as a runny nose, a low-grade fever and a cough that worsens, and can be accompanied by wheezing. In some cases, hospitalization may be necessary. Most prevalent from late fall to early spring months, it can still appear at any time. Monica Saad, M.D., F.A.A.P., suggests the following preventive measures:
- Do not allow an excessive number of visitors to see your newborn until one month after you've brought her home.
- Family members and visitors should wash hands upon arriving at your home.
- Consider keeping siblings at home for a few days if a lot of children in the day-care center or school they attend have colds.
- Keep babies away from anyone who has the flu or flulike symptoms.
Breastfeeding: Just after delivery, you will probably receive hands-on intensive training on feeding from hospital nurses. Once home, though, you're pretty much on your own. If you choose to breastfeed, you strengthen your baby's immunity to disease, and for every ounce you feed your baby, you burn 20 calories. You many want to attend a breastfeeding class offered at a local hospital or an obstetrics-gynecology office. Kittie Frantz, R.N., C.P.N.P., pediatric nurse practitioner and author of the video series Breastfeeding Techniques That Work! (Geddes Productions), offers these secrets to successful breastfeeding:
- Be prepared: During the first few weeks, many babies nurse more at night. Bring him to bed with you to take the edge off sleep deprivation.
- Nurse often—the more you nurse, the sooner your milk comes in. If you nurse at least eight times a day, you reduce the likelihood of painfully engorged breasts.
- Sometimes engorgement feels like your breasts have the flu: They're hot, achy, swollen. This pain may be due to mastitis, an inflammation within the breast, which is usually caused by a plugged milk duct or two. If this happens to you, apply a washcloth run under hot water to the breasts; gently massage the area; nurse frequently. If you continue to experience discomfort or have a fever, call your doctor.
- If it hurts to nurse because your nipples are sore, this could be, says Frantz, because "the baby is latching on wrong. Get help from a lactation consultant." You can also contact your local La Leche League chapter. Call (800) LA LECHE, or check out its website (lalecheleague.org).
- Above all, don't give up. Nursing may be natural, but it's a learned art.
Benefits: The health benefits of nursing are numerous: A baby's suckling triggers the mother's uterus to tighten, reducing uterine bleeding and returning it to its previous shape more quickly.
"Babies who are breastfed have fewer infections, especially diarrhea and allergies, during the first year of life than babies who are fed formula," writes Schmitt. Even breastfeeding for just a few months can be beneficial for your baby. Breast milk is free, convenient, sterile, always available and provides Baby with a balanced, easily digestible diet.
Nursing positions: Penelope Leach offers this advice for getting your baby in the best position to nurse.
- Cradle the baby in the crook of your arm so that her well-supported head is above the level of her stomach.
- Don't hold her head forcibly toward you. She must be able to turn away for a rest.
- Leave her outside hand free—she'll soon enjoy stroking the breast as part of active feeding rather than passively being fed. Make eye contact.
Stay hydrated: It's important to drink plenty of fluids during the period you nurse. The following tips are from the book What to Expect the First Year (Workman Publishing) by Arlene Eisenberg, Heidi E. Murkoff and Sandee E. Hathaway, B.S.N.
- Drink at least 8 cups of fluid a day. Good choices are water, fruit and vegetable juices, milk and soups.
- Excessive fluids—more than 12 cups a day if you're nursing one child—can actually inhibit breast-milk production.
Bottle-feeding: If you're bottle-feeding, try these tips:
- Wash your hands thoroughly, and make sure bottles, nipples and measuring spoons are spanking clean. Measure powdered formula and sterilized water exactly.
- Don't reuse leftover formula.
- Experiment with different types of nipples. Boil new bottles and nipples before use.
- Never microwave your baby's formula. Instead, warm it slowly by placing it in a pan of water on the stove.