Resources
New Baby Care
Postpartum Panic Prevention
New Baby Care
Congratulations on your new baby! Even though some baby books will state that they are “manuals”, babies don’t actually come with them! There are some great books out there you can use as reference guides and as you learn more about your baby you will grow to recognize changes. We are there to help you in the early days at postpartum home visits and then at our clinic check-ups. We can answer your questions and help you as you transition into becoming parents.
| Normal | |
| Behavior | Deep sleep, light sleep, drowsy, quiet alert, active alert, cryingSleeps about 16 hrs/day, 2-3 hrs at a time |
| Feeding | Every 2-4 hrs: 8-12 times per dayUsually, at least 20 minutes is advisedCluster feeding, followed by longer interval |
| Elimination | Until milk comes in: One wet diaper for every day postpartum (e.g. day 2, two wet diapers); meconium stools.After milk comes in: 6-8 wet diapers/day; liquid yellow, green or brown stools, with curdsBottlefeeding: 6-8 wet diapers; poops are more formed, smelly and fewer |
| Skin color | Acrocyanosis (blue feet and hands) on first dayMay mottle with cold, cryingVernix and lanugo may be presentMilia (white spots)Baby “acne”Birthmarks may appear within first weekMild jaundice after 24hrs |
| Respiratory patterns | Rate 30-60/minObligate nose breathersMay be irregular or periodicApnea up to 20 seconds |
| Weight gain/loss | Loss of 5-8% considered averageRegained birth weight by 14-21 daysAverage weight gain of ½ – 2 oz per week after milk in |
| Temperature | 36.3 to 37.5 |
Temperature
Between 36.3 to 37.5C is normal. If the baby’s temperature is over 37.5, take off a layer of clothing and re-check in 30 minutes.
If the temperature is less than 36.3, place the baby skin-to-skin with you and cover both of you, or wrap the baby in a blanket warmed in the dryer, and re-check in 30 minutes.
Respirations
Irregular, shallow breathing is normal for a newborn. They will even stop breathing for up to 20 seconds at a time. Normal ranges are 40-70 per minute for the first 24 hours, and 30-60 thereafter.
Babies make all kinds of faces and noises, most of which are endearing and normal. They may blow bubbles or cough up mucous for the first few days. If you see flaring nostrils, grunting with each expiration, or the baby’s chest pulls in sharply between the ribs when they breathes: these are signs that the baby is having to work hard to breathe and should be reported to your midwife.
Colour
Regardless of ethnicity, all newborns are born several shades lighter than what their skin tone will become and many babies have pink-toned skin at birth. It is not uncommon for the baby’s hands and feet to be blue during the first day. If it happens after the first day it may mean that they are cold.
Skin care
Sponge baths or tub baths are okay, although not necessary, right from birth. Research has shown that babies who are not bathed for the first 2-3 days find the breast easier which makes breastfeeding more successful. When you do start bathing, it may be easiest for a parent (or anyone) to get in the tub, then have someone hand them the baby.
- Use water to clean eyes and face
- Use mild soap to wash hair and body
- Use non-petroleum-based oil or lotion (olive oil works well) daily for dry or peeling baby, or if the environment is very dry
Babies’ skin is influenced for several weeks by the maternal hormones passed through the placenta. This can cause small red “acne” which usually is on the face or trunk, and disappears quickly.
Cord care
The cord usually falls off within the first few days or weeks.
- Keep the cord dry and clean, placing the diaper, diaper wrap and plastic pants below the cord
- If desired, clean the cord daily, or when it is soiled, with warm water, then let it dry thoroughly. This will delay the cord falling, since it washes off the necrotizing bacteria, but will cut down on odor (for the same reason).
Problems to report include a large halo of redness around the cord area (some redness is normal due to irritation from diapers, etc), or excessive bleeding when the cord falls off (more than just a smudge on the baby’s outfit).
Elimination
Healthy, term babies are built to lose some weight after birth before the milk comes in. This allows them time to take in the highly concentrated antibodies in the mother’s colostrum before they get the higher volume and hydration of breastmilk. Sometimes they get dehydrated enough that their urine forms crystals. These are called urate crystals and are pinky-orange. More common in male babies, they are often mistaken for blood in the diaper.
Problems to report
Temperature >37.5C
Temperature <36.3
Skin color changes to pale, grey or bluish
Difficulty breathing: nasal flaring, grunting, retraction of sternum
Apnea (not breathing) >20 seconds and mouth and central body bluish – call 911
Lethargic or difficult to arouse
Extremely irritable
Excessive, high-pitched crying
Blisters, boils, pustules or other unusual rash
Red halo or bleeding cord area
Urate crystals after first 48 hrs
Jaundice that appears in first 24 hours, extends into extremities, or rapidly increases
If circumcised: if there is discharge or the penis becomes increasingly red or swollen