What to Expect the First Year (33 page)
Read What to Expect the First Year Online
Authors: Heidi Murkoff
You haven't even been a parent for 48 hours yet, and already you've been on the receiving end of so much conflicting advice (on everything from umbilical stump care to feeding) that your head's in a tailspin. The hospital staff tells you one thing (or maybe two things, if you count the day nurse and the night nurse), your sister (veteran of two newborns) has a completely different take, both clash with what you seem to recall baby's pediatrician telling you and what you just read on your message boardâand let's not even get started on your mother ⦠and your mother-in-law. So what's a confused new parent to doâand believe?
The fact is that the facts about baby careâat least, the most up-to-date factsâaren't easy to sort out, especially when everyone (and their mother) is telling you something different. Your best bet when all that contradicting counsel leaves you in doubt about how best to care for your newborn (or when you need a deciding vote you can count on): Stick with the doctor's advice.
Of course, in listening to others (even the pediatrician), don't forget that you've got another valuable resource you can trustâyour own instincts. Often parents, even the really green ones, do know bestâand usually, much more than they think they do.
“I'm afraid my baby is going to turn into a little blimp. Almost immediately after I put her down, she's up, crying to be fed again.”
Feed your newborn every time she cries, and baby blimpdom definitely could be on the horizon. After all, babies cry for many other reasons besides hunger, and it may be that you're misreading her signals by serving up a feed each time she fusses (see
box
). Sometimes, crying is a baby's way of unwinding for a few minutes before she falls asleep. Put her back to the breast or bottle, and you may not just be overfeeding her but also interrupting her efforts to settle down for a nap. Sometimes, crying after a feed may be a cry for companionshipâa signal that baby's in the mood for some socializing, not another meal. Sometimes, crying signals that baby is craving more sucking satisfaction than her meal provided, which means a paci may pacify herâor that she may be having trouble calming herself down, in which case a little rocking and a few soft lullabies may be just what she's fussing for. And sometimes, it's just a simple matter of gas (which more feeding would only compound). Bringing up the bubble may bring her the contentment she's craving.
If you've ruled out all of the above scenariosâas well as done a quick check for a dirty or uncomfortably wet diaperâand your baby's still crying, then consider that perhaps she really hasn't gotten enough to eat. Maybe she's settled into a snack-and-snooze habit, drifting off to sleep before she fully fills her belly, and then waking quickly for a second servingâin which case, the trick will be keeping her awake until she's finished the feed. Or maybe a growth spurt has temporarily sent her appetite into overdrive, and she's letting you know her needs (healthy babies, after all, usually know exactly how much feed they needâeven if their parents don't always).
Breastfed babies may feed more often, too, when they're trying to pump up mommy's milk supplyâand they usually succeed within a few days. But
if your baby is breastfeeding, seems chronically hungry, but doesn't seem to be thriving (she's not gaining weight fast enough or filling her diapers like she should), you may not be producing enough milk (
click here
).
Whether it's a breast or a bottle that will be your newborn's ticket to a full tummy, the guidelines that follow should help make the trip a smoother one:
Zero in on zen.
While you're both learning the ropes, you and your baby will have to focus on the feeding, and the fewer distractions from that job, the better. Turn off the TV (soft music is fine), let the phone go to voice mail at baby's mealtimes, and silence those texts and tweets. If you have other children, chances are you'll already be pretty proficient at feedingâthe challenge will be keeping your older ones and your new one happy at the same time. Try diverting the older sib set with some quiet activity, like coloring, that they can settle down with at your side, or take this opportunity to read them a story.
Make a change.
If your baby is relatively calm, you've got time for a change. A clean diaper will make for a more comfortable meal and less need for a change right afterâa definite plus if your baby has nodded off to Destination Dreamland. But don't change before middle-of-the-night feedings if baby's only damp (sopping's another story), since all that stimulation makes falling back to sleep more difficult, especially for infants who are mixing up their days and nights. Does your sleepyhead have trouble staying up for a whole feed? Then changing midfeed might provide just the jolt he or she needs to get that feed finished.
Wash up.
Even though you won't be doing the eating, it's your hands that should be washed with soap and water before your baby's meals.
Get comfy.
Aches and pains are an occupational hazard for new parents using unaccustomed muscles to tote growing babies around. Feeding baby in an awkward position will only compound the problem. So before putting baby to breast or bottle, be sure you're set up comfortably, with adequate support both for your back and neck and for the arm under baby.
Loosen up.
If your baby is tightly swaddled, unwrap that bundle so you can cuddle (preferably skin-to-skin) while you feed.
Cool down a fired-up baby.
A baby who's already worked up will have trouble settling down to the business of feeding, and even more trouble with the business of digesting. Try a soothing song or a little rocking first.
Sound reveille.
Some babies are sleepy at mealtimes, especially in the early days. If your little one is a dinner dozer, try the wake-up techniques
here
.
Break for a burp.
Midway through each feeding, make a routine of stopping for a burp. Burp, too, any time baby seems to want to quit feeding too soon or starts fussing at the nippleâit may be gas, not food, filling that little tummy. Bring up the bubble, and you're back in business.
Make contact.
Cuddle and caress your baby with your hands, your eyes, and your voice. Remember, meals should fill your baby's daily requirements not just for nutrients but for love and attention as well.
“Sometimes, especially when he's been crying, my baby's chin quivers.”
Though your baby's quivering chin may look like just another precious ploy to play the cute card, it's actually a sign that his nervous system is age-appropriately immature. As it matures, that quivering chin will disappearâbut that's okay, since he'll find plenty of other adorable ways to make you melt.
Sure, crying is a baby's only form of communicationâbut that doesn't mean you'll always know exactly what he or she is trying to say. Not to worry. This cheat sheet can help you figure out what those whimpers, wails, and shrieks really mean:
“I'm hungry.”
A short and low-pitched cry that rises and falls rhythmically and has a pleading quality to it (as in “Please, please feed me!”) usually means that baby's in the market for a meal. The hunger cry is often preceded by hunger cues, such as lip smacking, rooting, or finger sucking. Catch on to the clues, and you can often avoid the tears.
“I'm in pain.”
This cry begins suddenly (usually in response to something unexpectedly painfulâfor instance, the jab of a needle at shot time) and is loud (as in ear-piercing), panicked, and long (with each wail lasting as long as a few seconds), leaving the baby breathless. It's followed by a long pause (that's baby catching his or her breath, saving up for another chorus) and then repeated, long, high-pitched shrieks.
“I'm bored.”
This cry starts out as coos (as baby tries to get a good interaction going), then turns into fussing (when the attention he or she is craving isn't forthcoming), then builds to bursts of indignant crying (“Why are you ignoring me?”) alternating with whimpers (“C'mon, what's a baby got to do to get a cuddle around here?”). The boredom cry stops as soon as baby is picked up or played with.
“I'm overtired or uncomfortable.”
A whiny, nasal, continuous cry that builds in intensity is usually baby's signal that he or she has had enough (as in “Nap, please!” or “Clean diaper, pronto!” or “Can't you see I've had it with this infant seat?”).
“I'm sick.”
This cry is often weak and nasal sounding, with a lower pitch than the “pain” or “overtired” cryâas though baby just doesn't have the energy to pump up the volume. It's often accompanied by other signs of illness and changes in the baby's behavior (for example, listlessness, refusal to eat, fever, and/or diarrhea). There's no sadder cry in baby's repertoire or one that tugs harder at parental heartstrings than the “sick” cry.
“I'm worried that there's something wrong with my baby's nervous system. Even when she's sleeping, she'll suddenly seem to jump out of her skin.”
It's startling to parents, but startling is second nature for newbornsâone of many very normal (though seemingly peculiar) reflexes babies are born with (see
box
). Also known as the Moro reflex, the startle reflex occurs more frequently in some babies than in others, sometimes for no apparent reason, but most often in response to a loud noise, jolting, or a feeling of fallingâas when a newborn is picked up or placed down without enough support. Like many other reflexes, the Moro is probably a built-in survival mechanism designed to protect these newbornsâin this case, a primitive attempt to regain perceived loss of equilibrium. In a Moro, the baby typically stiffens her body, flings her arms up and out symmetrically, spreads her usually tightly clenched fists wide open, draws her knees up, then finally brings her arms, fists clenched once again, back to her body in an embracing gestureâall in a matter of seconds. She may also cry out.
While the sight of a startled baby often startles her parents, a doctor is more likely to be concerned if a baby doesn't exhibit this reflex. Newborns are routinely tested for startling, the presence of which is actually one reassuring sign that the neurological system is functioning well. You'll find that your baby will gradually startle less frequently and less dramatically, and that the reflex will disappear fully somewhere between 4 and 6 months. (Your baby may occasionally startle, of course, at any ageâjust as adults canâbut not with the same pattern of reactions.)
Sure, you're all about how to care for your baby right nowâbut chances are you have just as many questions about how to care for yourself. For answers on everything you might wonder (and worry) about during your 6-week recovery periodâfrom bloody discharge to hemorrhoids, hair loss to night sweats, exhaustion to depression, that first bowel movement to that first postpartum checkup to the first postpartum periodâcheck out Chapters 17 and 18 in
What to Expect When You're Expecting.
Mother Nature pulls out all the stops when it comes to newborn babies, providing them with a set of inborn reflexes designed to protect these vulnerable creatures and ensure their care (even if parental instincts have yet to kick in).
Some of these primitive behaviors are spontaneous, while others are responses to certain actions. Some seem intended to shield a baby from harm (such as when a baby swipes at something covering his or her face, a reflex that is meant to prevent suffocation). Others seem to guarantee that a baby will get fed (as when a hungry newborn roots for a nipple). And while many of the reflexes have obvious value as survival mechanisms, nature's intentions are more subtle in others. Take the fencing reflex. Though few newborns are challenged to a duel, it's theorized that they take this challenging stance while on their backs to prevent themselves from rolling away from their moms.
Newborn reflexes include:
Rooting reflex.
A newborn whose cheek is gently stroked will turn in the direction of the stimulus, mouth open and ready to feed. This reflex helps the baby locate the breast or bottle and secure a mealâsort of like a feeding GPS. Your baby will do this for 3 to 4 months, though rooting may persist long after that during sleep.
Sucking reflex.
A newborn will reflexively suck when something (for example, a nipple) touches the roof of his or her mouth. This reflex is present at birth and lasts until 2 to 4 months, when voluntary sucking takes over. Again, it's nature's way of making sure baby scores those feeds.
Startle, or Moro, reflex.
When startled by a sudden or loud noise, or a feeling of falling, the Moro reflex will cause the baby to extend the legs, arms, and fingers, arch the back, draw the head back, then draw the arms back, fists clenched, into the chest. Expect this reflex to last around 4 to 6 months.
Palmar grasping reflex.
Touch the palm of your baby's hand, and those tiny fingers will curl around and cling to your finger (or any object). An interesting bit of baby trivia: A newborn's grasp may be powerful enough to support his or her full body weight (but no need to test this out). Some more trivia: This reflex curls babies' feet and toes, too, when they're touched. You'll notice the firm grip lasting 3 to 6 months.
Babinski's, or plantar, reflex.
When the sole of a baby's foot is gently stroked from heel to toe, the baby's toes flare upward and the foot turns in. This reflex lasts between 6 months and 2 years, after which toes curl downward.
Walking, or stepping, reflex.
Held upright on a table or other flat surface, supported under the arms, a newborn may lift one leg and then the other, taking what seem to be “steps.” This “practice walking” reflex works best after the fourth day of life and usually lasts around 2 months. Endlessly entertaining to watch, but before you post your apparent prodigy's feats on 2 feet, keep in mind that this reflex doesn't predict early walking.
Tonic neck, or fencing, reflex.
Placed on the back, a young baby will assume a “fencing position,” head to one side, with the arm on that side extended and the opposite limbs flexed (see
illustration
). This “en garde” reflex (which may be a baby's way of being “on guard” on his back) may be present at birth or may not appear for at least 2 months, and it usually disappears at about 4 to 6 months (though it varies a lot).
Fencing reflex
For fun, or out of curiosity, you can try checking your baby for these reflexesâbut keep in mind that your results may vary and will probably be less reliable than those of a doctor or other expert. A baby's reflexes may be less pronounced, too, if he or she is hungry or tired. So try again another day, and if you still can't observe the reflexes, mention this to your baby's doctor, who probably has already tested your baby successfully for all newborn reflexes and will be happy to repeat the demonstrations for you at the next well-baby visit.