Bringing your baby home from hospital is a huge milestone for parents. All those months of preparing , packing your bags, planning your take home outfits all lead up to that very special moment when you bring baby home. But what happens now? How do you care for baby? How do you know what’s normal and how to adjust to life with a new born baby? If only babies came with manuals! Then the fourth trimester would be so much easier.
The newborn period can be incredibly overwhelming and it’s a huge time of adjustment, for both you and your baby. Whilst each baby is different and will follow their own journey, it’s good to know what to expect in those first few weeks at home. After all, all babies do is sleep, poop, eat and repeat right? Wrong! As a mother and a paediatrician, I have summarised what’s normal for your baby in those first few weeks of life.
Newborn feeding and weight loss
Your new-born baby has a very tiny tummy, almost the size of their palm, and this means they will feed little and often. Some babies may nurse every 1.5-2h, whilst others may go 3h between feeds. The amount your baby needs will increase as they get older. Most babies will lose weight once you bring them home and this is normal. Usually, a community midwife will weigh your baby regularly in the first two weeks of life. It is normal to lose up to 10% of their birth weight in the first few weeks of life and most babies are back to their birth weight by 2 weeks of life.
It’s really important that your baby feeds regularly and if baby is falling asleep regularly, having difficulties in feeding or is losing weight, seek advice from either your midwife or your doctor.
Jaundice is a common condition that causes yellowing of the skin and eyes in babies and occurs in the first few weeks of life. Almost 60% of all babies will at some point be jaundiced in the first few weeks. This happens because your baby’s liver is immature and also because your baby has too many red blood cells at birth, which breakdown and release a substance called bilirubin. In the first few days and weeks your baby’s liver starts working better and can get rid of most of this bilirubin. For some babies, this doesn’t happen and they develop jaundice.
For most babies, jaundice appears around 2-3 days of life and disappears by 2 weeks. Babies that are breastfed are sometimes jaundiced for a longer period.
Yellowing of the skin, eyes, palms of hands and soles of feet is the most common sign. This is harder to spot in darker skinned babies. Your baby may also be sleepier than normal, feed less and have pale poo.
There are many types of jaundice and it is impossible to tell by looking at your baby which type it is. High levels of bilirubin can cause brain damage and this is why it is important to seek help from either your midwife/HV or a Paediatrician early.
Jaundice that develops within the first 24h of birth ALWAYS needs a doctors review so its straight to A&E if you’ve already left the hospital.
All babies cry. So the first thing to remember when your little one is wailing in the wee hours of the morning is that, you are not alone. Most parents I see always have the same story – their little one slept and was such a ‘good baby’ and then around day 4 or 5, the crying begins. In they walk to A and E, red eyed, sleepy and at wits end. By about two weeks of age, most newborns will cry 2-3hours a day! That’s a lot of crying! It usually gets worse around week 6-8 of life and then eases off. As you get to know your baby, it will get easier to figure out why your baby’s crying; hunger? Nappy change? Need burping? Sleepy? Over stimulated etc. Just remember that crying is a normal newborn right of passage but that if you’re worried, you can speak to you health visitor or your baby’s Doctor.
Posseting and Vomiting
All babies posset and vomit at some point in those early weeks. Some bring up milk after every feed, whilst others only a handful of times. This is sometimes called spitting up. If your baby does this a lot, it may be a sign that they need burping more often than other babies, for example, in between each breast or halfway through a feed. Some babies are easy and burp themselves whilst others needs a little more back rubbing and gentle patting.
If your baby brings up a lot of feed, or seems uncomfortable after feeds or arches their back, they may have reflux. All babies experience an element of reflux because of the large volume of liquid feeds and lying flat a lot. It usually gets better as babies learn head control, learn to sit up and go onto solid food.
In some cases, reflux can be one of the first sings of cows’ milk protein allergy and needs discussion with a doctor before you make any changes to your diet of your baby’s milk. Please remember, if your baby is losing weight, is very uncomfortable or has forceful vomits, it’s time to see a doctor. Whatever the cause of the posseting or vomiting, keep plenty of muslins nearby!
Infection and Immunity
When you are in your final trimester of pregnancy, you pass a lot of great antibodies to your baby through the placenta! Once baby is born, this passive immunity given to it by mummy starts to decrease in the first few weeks of life. If you are breastfeeding, you also boost your baby’s immunity as breastmilk contains some great natural antibodies for babies. However, newborn immune systems doesn’t mature until around 2-3months of life. This means that newborns are at greater risk of becoming very unwell with infections.
You can help your baby stay healthy by limiting visitors, asking people to wash their hands before touching baby and avoiding very crowded spaces and also getting your baby vaccinated! It’s also important to not let anyone kiss baby if they have a cold sore. This is because they can become very unwell.
If you notice any of the following signs in your baby, it’s time to seek urgent medical help:
- A fever > 38C in your baby
- Problems in breathing
- A blueish lip or skin colour
- Less than 3 wet nappies in 24h
- Very sleepy baby that doesn’t wake for feeds
These are just some of the things you can expect with your newborn in the first few weeks of life! It may be challenging at first but things will get easier as you get to know your baby. If you find that you are struggling or feeling low, it’s important to ask for help and to speak to your midwife, health visitor or doctor. Whilst knowing what to expect may make things a bit easier in those first few weeks it’s important to know that each baby takes their own time with many things and if you’re feeling like it’s all a bit too much, please ask for help.
If you have any questions about what I’ve written here then please do not hesitate to contact me on via m bloss profile.