Week 1: First Week of Your Baby
Week 1 – How big is your baby this first week?
The information we provide in this section each week is based on average expected growth for a baby. Growth changes we cite here are based on a full-term baby weighing 7 pounds who is 20 inches long. Your baby may grow a little more or a little less in a given week. If your baby is born small, growth may be less than what we indicate. The same holds true if your baby is large; her growth may be faster or she may gain more weight. There’s also a difference in size (and sometimes the rate of growth) between boys and girls.
The object of providing this information is to help you determine if your baby is growing and gaining weight at a steady pace. It’s important to remember that if your baby is born prematurely, her weight gain and growth may be delayed for a time but usually catches up.
Baby Care and Equipment
Umbilical-Cord Care
Almost every baby goes home from the hospital with a stump of umbilical cord still attached. It takes from 7 to 10 days for it to heal and fall off. Until then, keep the area clean and dry to promote healing.
You don’t have much to do in the way of care. When you change baby’s diaper, wipe the cord with a cotton ball dipped in alcohol. Fold down the diaper top so it will not rub against the stump. Change baby as soon as she is wet to reduce irritation further.
Penis Care for Circumcised and Uncircumcised Boys
Circumcision. As parents, you may decide to have your son circumcised, which means the foreskin of his penis is removed by a surgical technique. This is usually done in the hospital, unless it is part of your religious observance and done in a religious ceremony a short time after your baby leaves the hospital. You will be shown how to care for the circumcision while you are in the hospital.
Care. After the circumcision, you may notice your son’s penis is a little red, and there may be a yellow secretion. Both are signs the incision is healing. Keep the area clean; put a little petroleum jelly on the tip of the penis each time you change his diaper.
The incision should heal within a week; however, if you notice swelling or sores, call your doctor. He or she may suggest using mild antibiotic gels on the spot or advise you to clean the area more often. Sometimes ice or a cold pack is used, but do this only when directed to do so by your doctor.
Care when no circumcision is performed. If your son is not circumcised, gently pull back the foreskin of his penis each time you change his diaper. Using warm water and mild baby soap, wash the area thoroughly.
Feeding Your Baby
Feeding your baby is one of the most important things you do for her. You’ll know when she’s hungry; she’ll exhibit definite signs of hunger, including fussing, putting her hands in her mouth and turning her head and opening her mouth when her cheek is touched.
How often to feed. Most newborns eat every 3 to 4 hours, although some feed as often as every 2 hours. You may feed at regular intervals to help your baby get on a schedule. Or you may decide to let your baby set her own schedule—some babies need to eat more often than others. At times a baby needs to feed more often than usual, such as during periods of growth.
A baby is usually the best judge of how much she needs at each feeding. She’ll usually turn away from the nipple (mother or bottle) when she’s full.
It’s a good idea to burp your baby after each feeding. Some babies need to be burped during a feeding.
Spitting up. Babies frequently spit up some breast milk or formula after a feeding. It’s common in the early months because the muscle at the top of the stomach is not fully developed. When a baby spits up enough to propel the stomach contents several inches, it is called vomiting. If your baby vomits after a feeding, don’t feed her again immediately. Her tummy may be upset. Wait until the next feeding.
Breast or bottle? Many believe that breastfeeding is the best way to feed baby. Breast milk contains every nutrient a baby needs, and it’s easily digested. Research has found that breastfed babies have lower rates of infection because of the immunological content of breast milk. Breastfeeding provides the baby a sense of security and the mother a sense of self-esteem.
If there are reasons you cannot or choose not to breastfeed your baby, be assured she will do well on formula. It won’t harm her if you don’t breastfeed. No mother should feel guilty if she doesn’t breastfeed her baby. An infant can still get all the love, attention and nutrition she needs if breastfeeding is not possible.
Picking Up and Handling Baby
If you’re like most first-time parents, the thought of handling your baby fills you with trepidation. She’s such a tiny, delicate being! You want to pick her up correctly, and you don’t want to drop her. Rest easy—she’s not as fragile as you think. There are ways to handle her so you’ll both feel confident.
What to do. Always support her head with your hand or arm, and keep an arm or hand under her back. You may hold her close or a little more loosely. Use smooth motions when moving her, and always protect her head with your arm or hand.
When you hold her or if you wear her in a sling or front carrier, do so only when you are doing something that could not harm her. Never cook over a hot stove or handle hot or caustic liquids while holding baby.
Diapering Baby
Changing your baby’s diapers is a necessary task you’ll do thousands of times. Once you get the hang of it, you’ll be able to do it quickly and efficiently. Men are capable of learning this skill also! Change baby’s diapers whenever she’s wet or soiled to prevent irritation and diaper rash. A newborn wets between six and 10 times a day. Bowel movements are more variable. Some babies poop two or three times a day, others only every few days. Whether your baby is breastfed or bottle-fed may also make a difference in her bowel movements.
You don’t need to clean baby with baby wipes if she has only a wet diaper. Urine is germ-free; using a baby wipe every time you change her could irritate her skin, if possible, let her “air out” (go without a diaper for a while) between diaper changes. It helps reduce the risk of diaper rash.
Dressing Your Baby
Dressing baby is a challenging task for a new parent. It’s not like dressing a baby doll—baby dolls don’t wiggle and squirm! We know a few tricks to help make your first attempts a little easier. Our best advice is to take it slow, and don’t get frustrated. With practice, you’ll soon be an expert.
Tops. After you’ve diapered baby, put on her undershirt. Hold the shirt neck open with your thumbs, and slip it over her head. Reach into the end of one sleeve, grasp her hand and gently pull it through. Adjust the body of the shirt once you’ve got both arms in.
Bottoms and “onesies.” When you put her pants on, first reach through the bottom leg opening and grasp one foot. Slide it through the opening, then do the same for her other foot. Once both feet are through the leg openings, pull pants up to her waist. If you’re putting on overalls, we’ve found sliding them on from the bottom works best. Adjust them, snap the legs, then hook the straps.
With a sleeper or one-piece outfit that opens down the front, lay it down on the changing table, then lay baby on top of it. Slide baby’s arms, one at a time, through the sleeves, adjust, then slip baby’s feet through the openings. When everything’s in place, snap the snaps or zip up.
Keep the room warm. When changing your newborn, keep the room warm. A small baby gets cold quite quickly when undressed.
Swaddling Your Infant
Before her birth, your baby was in a pretty tight environment, with little room to move. When she’s born, the lack of confinement may make her feel a little insecure. Swaddling, wrapping her snugly in a soft blanket, may help if she seems discontented. It may help make her feel secure and comforted. (See the box on page 8.)
Milestones This First Week
During the first year of life, your baby grows and changes according to stages of development. These are the four most important developmental categories:
Motor development. This refers to your baby’s ability to control voluntary body movements. Your baby’s large and small muscle groups develop dramatically this first year. At this time she moves very little, yet by the end of 72 months, she will be walking or ready
to walk!
Language development. Development of language includes her speech, and also her attempts to listen and to understand language around her.
Mental development. As your baby’s brain grows, her thinking skills develop.
Social development. Social skills she learns help your baby relate to the world around her.
As the weeks and months pass, your baby will move from one learning task to another, and her focus will shift. Don’t worry if she seems to be slow in one area for a while; it’s her overall development you are concerned with.
At birth, your baby’s brain is not fully developed, and a great deal of growth must still occur. A baby’s brain grows most rapidly from the last trimester of pregnancy through the first 3 months of life.
Baby’s Sight
From the moment your newborn opens her eyes after birth, she can see her world, although it is a bit fuzzy. She is nearsighted, and her best field of vision is about 8 to 12 inches away from her. She will stare at objects placed in this range of her vision. She can also tell the difference between a human face and other objects— she prefers faces. (If the baby is smiling at you at this point, it’s probably gas.)
A Newborn’s Hearing
Your baby hears most noises in the first few weeks as echoes, not distinct sounds. However, she hears voices; she recognizes her mother’s voice at or shortly after birth and will soon recognize the voices of other people around her. Speak to her often, about everything, and you will help her develop her hearing and begin to relate to language. A baby can’t learn to talk or begin to understand the subtle nuances of language if she doesn’t hear a lot of conversation.
Other Newborn Development
Calming baby. Soothing a fussy baby takes experimentation on your part. After all, you don’t know each other very well yet, so you may need to try different tactics to help her settle. You may find your baby calms when she is swaddled. {See the discussion above.) Swaddling helps her feel secure and may help her focus. Rocking and patting her or offering her a pacifier are other options. Some babies calm down when they listen to monotonous “white” sounds, such as a vacuum cleaner running. Try different things when baby needs to be comforted.
When you snuggle or feed your baby, your skin-to-skin contact makes her feel secure and safe. It also provides gentle stimulation. Offer her this contact as much as possible.
Early reflexes. Two reflex actions you may notice in baby right now are the rooting reflex and reflexive smiling. When your baby roots, she is searching for food. She will open her mouth and turn her head toward that side if you stroke her cheek. When your baby is sleeping or drowsy, you may notice her smiling. She’s in a dream state—her eyes may be moving at the same time. Enjoy watching her. It’s a beautiful sight—soon she’ll be smiling at you!
What’s Happening This First Week?
Changes You May See in Baby
Incredible as it may seem, infants often enjoy a growth spurt soon after birth. At 7 to 10 days after birth, your baby may grow in length. When you take her for her first checkup, she may have grown more than you realized.
Your baby’s heart rate is faster than yours; her heart beats between 100 and 150 beats a minute. When she yawns, hiccups or has a bowel movement, her heart rate may decrease. She also breathes quite rapidly—up to 50 breaths a minute. This is normal.
When she cries, you may not see tears. A newborn’s tear ducts are not yet mature enough to produce tears. This will change soon.
Some babies don’t like to cuddle; it’s normal. If she stiffens and arches her back when you hold her close, hold her with her back to you. This may be better for her.
Baby and Sleep
You’ll notice your baby sleeps at least 18 hours a day in these first weeks. She’ll slip between waking and sleeping with little regard for day or night and will eat every 2 to 4 hours. She won’t sleep longer at night and be awake more during the day for another 6 to 8 weeks. Exposing her to daylight during the day and putting her in a dark room at night to sleep helps establish this pattern.
“Back is better.” A relative, friend or someone else may advise you to put baby on her tummy so she’ll sleep better. We now know that “back is better.” Put your baby to sleep on her back every time you put her down. Why?
Research has shown that with a healthy, full-term baby, sleeping on her back lowers the chance she will have problems, especially with sudden infant death syndrome (SIDS). (See the discussion of SIDS in Week 8.) Research also shows that a normal baby doesn’t usually have problems choking or aspirating vomit if she spits up while lying on her back because she has a well-developed gag reflex. Some babies sleep better on their stomachs, but don’t be tempted to put your baby to bed on her tummy.
Exceptions. Exceptions to the sleep-on-back rule include premature babies who have breathing problems, babies with certain upper-airway problems, babies with birth defects of the nose, throat or mouth, and babies with swallowing or vomiting problems. If your baby experiences any of these, discuss the situation with her doctor.
What Baby’s Crying Can Mean
Crying is one of the few ways your baby has to communicate with you. It’s her way of telling you she’s uncomfortable, hungry or needs attention. As you get to know your baby better, you’ll be able to understand what her crying means.
Don’t worry about picking her up when she cries—you won’t spoil her. You’ll be building a stronger bond with her. You are teaching her that you will take care of her, and she will feel secure with you.
It may seem like baby cries a lot, but on average, she cries only about 4 hours out of every day this first week. By the second week, she’ll only be crying about 2-1/2 hours a day, and by week 3, it’ll be down to about an hour and a half. For ways to comfort a fussy baby, see the discussion in Week 4.
Cradle Cap
What it is. Cradle cap is a yellow or brown waxy buildup on baby’s head. Also called seborrheic dermatitis of the scalp, it is common among newborns and infants. It usually occurs from 1 to 12 weeks following birth; half of all infants get it. If your baby has cradle cap, you’ll notice patches of scaly skin on the scalp. They may also appear in other areas of the face or at the hairline. It’s not painful or itchy, but it looks bad. This form of dermatitis is usually treated by your physician with a corticosteroid lotion. It’s OK to use a soft brush to remove skin patches gently after rubbing the scalp with lotion.
When to call the doctor. There should be no signs of infection on the scalp. Call the doctor if the area shows signs of oozing or pus, if the cradle cap fails to respond to the measures listed above, if the skin becomes red or scaly, or if the area becomes inflamed. If there are signs of inflammation or redness on other parts of the body, it could indicate another problem, so be sure to call your pediatrician.
Jaundice
What it is. Two to 5 days after birth, your baby may show signs of jaundice, also called hyperbilirubinemia. Symptoms include a yellow appearance of the skin (caused by excessive amounts of bilirubin, a breakdown product of blood cells), which is often first seen in the face. The whites of the eyes may also appear yellow. The yellowness of the skin spreads to the rest of the body. Even the nail beds may appear yellow; pinch the fingernail gently and release to check for yellow discoloration. Your healthcare practitioner will test the baby’s blood to determine the level of bilirubin in your baby’s system.
To date, determining the bilirubin level in your baby’s blood involved doing a blood test. The test could be uncomfortable for baby and her parents because it had to be done repeatedly. However, a new test has been developed that doesn’t involve pricking baby with a needle. Called the Colormate LTc BiliTest, a handheld device is used to measure the yellow tinge of baby’s skin. The test is 95% accurate, and results are available in minutes. If your newborn must be tested for jaundice, ask if this test is available.
What to do. Mild jaundice is not serious; follow your doctor’s advice. Bili lights, also called phototherapy, may be used. Jhese ultraviolet lights breakdown bilirubin, making it possible for it to be passed from your baby’s bloodstream. It also helps improve the condition if baby is feeding well because bilirubin is excreted in her bowel movements.
When to call the doctor. Call your doctor if your baby appears to be getting more yellow, or if she is not feeding well. Your pediatrician wants to know if your baby experiences any problems.
Vaginal Discharge in Girls
What it is. After birth, your baby girl may have a vaginal discharge that is clear or white. This is caused by the excessive hormones in her body from her mother. It is rarely a problem.
What to do. To take care of it, gently clean the vaginal area. It should disappear soon.
When to call the doctor. Call your baby’s doctor if the discharge seems excessive or if the color is yellow or green.
Toys and Play This First Week
This first week of life is the beginning of a wonderful time of games and play you and your child will share for years to come. As you get to know your baby better, games and opportunities for fun will begin to present themselves naturally. You’ll make a game out of something ordinary, and it will be a special time for you both.
Help Stimulate Her Vision
To stimulate her vision, hold boldly patterned objects within 8 to 12 inches of baby, and let her look at them. At present, she prefers bold patterns and the contrast of black and white. She will also enjoy looking at pictures of people’s faces. Cut out some large pictures from a magazine to hold in front of her. Let her gaze at them as long as she is interested. When she begins to squirm or look away, it’s time to end the game.
Keep Talking to Her
Begin your journey of play and interaction with words and music. Talk to baby as often as you can; just hearing your voice is what matters. Sing to her—even if you can’t carry a tune! Tell her what you’re doing and what’s going on. Play soothing music for her when she’s fussy; it may help settle her.
You’ll probably have lots of visitors who want to meet your baby. They’ll probably want to hold him. That’s OK. However, be respectful of baby’s needs. If he’s sleeping, don’t get him up and
pass him around. Let people look while you let baby sleep.