Pregnancy week by week

Baby

Toddler

First few weeks


There is something very special and exciting about being alone for the first time with your new baby, but it’s natural to feel a bit anxious too. There is so much to learn, especially in the first few weeks, and the responsibility may seem overwhelming. This section gives you all the basic information you will need to cope with and enjoy the early days with your baby.

First nappies

A baby’s first motion is called meconium. It looks like tar, greenish-black and sticky. This changes soon to brightly coloured yellowish poo if your baby is breast fed, and greyish green if your baby is formula fed. Meconium is the remnant of the amniotic fluid that your baby swallowed when still inside you. Your baby will have wet nappies from the very first day.

Breast fed babies have very soft, sometimes quite liquid stools; babies on formula have stools which tend to be firmer. All babies should have several wet nappies every day. If your baby’s nappies are dry for several hours, talk to your doctor. It may be a sign that she is dehydrated, constipated or ill.

Eye
 
Your baby’s range of focus is about an arm’s length, perfectly matched at gazing at your face while you hold her; she may turn her head just to look at you. New babies may have slight squint, which will disappear as they learn to focus their eyes. The tear ducts in a newborn are small and not fully formed at birth. Tears are usually not produced with crying until the baby is 1 to 2 months old.
Some babies have bright red spot in the eye referred to as “Sub conjunctival haemorrhage”. It is caused by a sudden increase in pressure in the eye as the baby passes through the birth canal. Since the blood is usually absorbed within 7 to 10 days, you can be reassured that the red spot is temporary and not a cause for worry.

Picking up and holding your baby



Your new baby will seem small and fragile, and you may be nervous about picking her up. There are a number of different ways to hold your newborn baby safely. As you gain confidence, you will enjoy finding positions in which you both feel comfortable.

To pick up your newborn baby, start by sliding one hand underneath your baby’s head. Your hand should cover part of her neck as well as her head. Take your other hand and slide it underneath your baby’s bottom. Both your hands should now be under your baby, supporting both the head and her bottom as you lift her. Gently lift your baby towards your chest. Slide the hand behind her head around her body to cradle her. Pull her close to your chest and support her head and neck in the crook of your elbow. Always support your baby’s head so that it doesn’t fall back or roll forwards. Her neck muscles take time to develop, but she will gradually be able to hold her head upright and look around.

Another position babies enjoy is nestled close to you with her head resting against your shoulder. One of your hands should support your baby’s head and the other her bottom. This is a great position for winding, and also helps your baby drift off to sleep.

No matter which way you carry your baby, always keep her head and neck supported while you hold her, whether it’s close against you or upright. Hold your baby securely- if you feel confident, she will, too. Don’t move your baby from one position to another very suddenly, so keep movements smooth and gentle.

Warning

You must never shake a baby. A newborn baby’s head is quite heavy and her back and neck muscles are not strong enough to hold her head up unaided. Shaking moves the head back and forward very quickly and with great force. This can tear tiny blood vessels in the baby’s brain, possibly leading to fits, brain damage or even death. Don’t play games of swinging through the air until she is a toddler. Your baby will hate it and it could hurt her very badly.

Skin  
 

Your baby may have yellow or white spots on the face and nose called milia. These will fade during the first two weeks. She may have pearly white spots in the mouth called Epstein pearls. Around 70% of newborns have these and disappear within a couple of weeks. Your baby may have white tipped spots with red blotchy surround on her skin. This is called erythema toxicum. Around 30% of term babies will have this rash, which is thought to be the result of babies developing some immunity to the external environment.

Swaddling 


Many babies are soothed by being wrapped closely. This is called “swaddling”. It is a tried-and-tested method for soothing newborns. It can help a baby settle by making her feel safe and secure. Use thin material rather than a blanket so that she doesn’t get too hot, and keep her head covered. Once babies are a month old, they don’t like being bundled up so much, and will probably kick off the covers. Don’t put a “swaddled” baby asleep in a cot or your bed.

Constipation check  
 
Babies often cry and grimace when they poo. This is normal and doesn’t mean they are constipated. Exclusively breast fed babies are rarely constipated. Formula fed babies can suffer from constipation. If stools are hard, like small marbles, you may need to give cooled, boiled water to avoid constipation, especially in hot weather. If your baby’s stool suddenly change in colour, or smell different from what you are used to, and your baby seems unwell, consult your doctor.

Engorgement 
 
As your body starts to produce milk, you may find that your breast become suddenly large and uncomfortable, or even painful. Your breasts are engorged. If you are breast feeding, encourage your baby to feed to ease the pressure. If your baby cannot feed because the area around the nipple is swollen, gently massage some of the milk out yourself. Warm your breasts first, with a warm flannel, as this will make the milk flow more easily. Your “supply and demand” system will control your milk production; engorgement won’t continue when baby-led feeding is practiced! To read more about feeding, see our section on breast feeding.
If you are bottle feeding, avoid expressing, wear a supportive bra and take pain relief if you need it.

Wind    


Wind is air that your baby has swallowed. Babies swallow it when they feed, cry and yawn. And once it’s gone in....it’s got to come out somewhere. It becomes a  problem when an air bubble gets trapped in an uncomfortable place. Try feeding your baby in a more upright position to cut down the amount of air she might be taking in with her milk. It may also help to hold your baby upright against your shoulder or propped forward on your lap after a feed. Gently rub your baby’s back so that any trapped air can find its way up and out.

Jaundice

A little jaundice is common in newborns for the first 3 to 5 days of life. The yellow colour of jaundice starts at the head and gradually moves downward. This happens because the baby’s liver is not working fast enough to cope with the normal by- products of broken down red blood cells. As the baby’s liver matures, it starts to break down bilirubin and the jaundice gradually disappears in one to two weeks time. However, in up to 5-6% of babies, bilirubin levels are high enough to require treatment. Phototherapy is a very effective way of controlling the level of jaundice. Many babies at this time seem sleepy and not interested in feeding, but it can help to wake and feed him as often as you can.

If your baby’s bilirubin is above normal in the hospital but not high enough to require treatment-your doctor may schedule you for a follow up bilirubin test. It is very important to have the testing done. If high bilirubin levels are not treated, some babies may suffer neurological damage. Hence, it is also important to notify your baby’s doctor if you notice your baby becoming more yellow or getting lethargic or eating poorly as these can all be signs of a high bilirubin level. Prompt treatment is important to prevent permanent injury in a newborn.

When to contact your doctor

•    If the feeding is reduced, i.e. if baby has taken half to 2/3 of the usual time at the breast.

•    If baby becomes yellow within the first 2 days, or increasing yellow after this.

•    If the baby has vomited at least half a feed or more or if the vomit is green in colour.

•    If the baby has had less wet nappies than usual

•    If the baby has blood mixed with the stools

•    If the baby’s cry has changed and you cannot settle her by the usual methods.

Contact your doctor immediately if your baby is drowsy, floppy, less alert when awake, has a bulging “soft spot”, does not respond to your voice, appears pale, sweaty or feels hot or cold to touch.

As parents, you are aware of your baby’s behaviour, activity and appearance. Should you feel something is not right, you should discuss your concerns with your doctor.


 

 



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