Newborn nurseries are magical places. Wonderful people care for new babies and their nervous mothers. Before the pair go home to experience new life together, nursery nurses are able to teach a number of essential tasks to make the first few months go well. They teach mothers how to feed, and bathe their infant. Mothers learn how to monitor for signs of illness in a baby. With these important functions to teach it is no wonder that nurses don’t cover less important worries that new mothers have. Fortunately, that is where I come in. As a pediatrician I get to teach new mothers about their babies too. And in the first visit with me, mothers are often perplexed about many simple things that we as practitioners in medicine take for granted. Over the years I have made a list of worries other than feeding that mothers have at their first check up at two weeks of age. Here they are.
1. How do I stop his hiccups?
Many mothers experience hiccups in their babies even before birth. But it is more disturbing to us to see a baby’s little body shake with hiccups. Fortunately, we don’t have to do anything about them. Hiccups occur as a natural reflex. This reflex tends to subside as babies grow. It may be hard to watch. But remember, babies aren’t bothered by hiccups. We are, but they are not. Just leave them be. They’ll be fine.
2. My baby sneezes and coughs. Is she sick?
Oh, those immature reflexes! They haunt babies for months. Sneezes and coughs are also reflexes that are a bit hyper in babies. These, too, will decrease in frequency over the first several months.
3. My child sounds congested.
Congestion is not a reflex. Congestion is a blockage in the nose that makes it hard for babies to breathe. But babies often sound congested without even having any blockage. Why is this? Babies have narrow nasal passages with loose mucus membranes. Air moving through a narrow space makes a noise. In musical instruments air makes a pretty sound. In babies’ noses, air makes a congested noise as it moves along those vibrating mucus membranes. So a parent only needs to be concerned about congestion they see – not a congested noise they hear. With congestion you see, a few drops of saline solution usually helps clear their little noses.
4. My baby is fussy and hard to console sometimes.
All babies have fussy periods. These occur with more frequency and for longer periods of time at six weeks of age. Babies usually settle down and are less fussy at three months of age. Even though it goes away, that doesn’t make it easy to deal with while it is happening. Keep your baby close, support his belly and have extra people around to help out. That’s how to get through the fussy baby times.
5. My baby has so much gas! Is that normal?
Whether your baby is fussy with gas or not, it is normal for babies to be gassy. It is a natural process for our bowels to develop a flora of bacteria that creates gas in their bowel. Only a small percent of babies have fussiness caused by this gas.
6. What about this green poop he has?
Stool color changes with time even when the baby’s diet does not. Nursing babies progress from brown muconium stools to yellow watery stools to yellow seedy stools to green stools. Bottle fed babies change more rapidly through these color stools and end up with the typical brown stool faster than nursing babies. It might be hard for a pregnant woman to imagine being concerned about the color of poop. But…you will see. It is amazing how much talk there is about poop once you have the baby.
7. Besides pooping the only other things my baby does is eat, sleep and pee! And he sleeps a lot! When will he wake up and interact a little?
For the first few weeks after birth most babies just eat, sleep, pee, and poop. This can be surprising to parents who expect an expressive baby. Many parents start longing for more interaction. It becomes difficult to be at the service of an infant and get little of the warm and fuzzy things in return. The interactive time will come. By two months of age babies are usually focusing on parent’s faces and smiling back at them.
8. Well, before two months what is my baby seeing?
It is hard for babies to tell us what they are seeing. However, physicians have studied the visual preferences babies have in the first few months of life. At first babies prefer sharp contrasts between light and dark objects. This is likely due to the fact that the color interpreting cone cells of the eye develop over the first month or so. After the first month babies prefer to look at oval objects similar to the general shapes of faces. This leads to the focusing on particular faces by two months of age. By four months babies will be able to see across a room. And by six months any stray object that you didn’t see such as a small toy or a bit of fuzz will be picked up and thrust into their mouths.
9. When do they stop burping, gagging and spitting up?
Babies are messy little creatures. They drink and gulp their meals. Belch frequently. They gag on almost anything at the beginning. And often spit up or throw up what seems like half their meals. It sounds awful but is quite natural. Since most of their food is liquid and taken in by sucking, burping is a natural consequence of this form of feeding. If babies didn’t burp they could become more bloated and more gassy. Burps will come if they need to. Not all babies burp after all feedings. Spitting up happens with burping. It is of no consequence so long as the baby gains weight on the amount of food they keep down. And gagging is helpful for babies to protect themselves from aspirating their liquid food. Due to a baby’s gag reflex, it is rare for any baby to actually aspirate food into their lungs. So even though these issues are messy, they help our babies stay healthy. They do become less frequent after nine months of age.
10. My baby breathes in a funny way. Sometimes she even stops breathing for a second. Is that okay?
Babies do breathe in a funny way. They can breathe ten times rapidly, then take a deep breath and not breathe for five seconds. If we traced newborn breathing patterns on paper we would have nothing but squiggly lines. Their breathing patterns smooth out and become more regular at three to four months of age. Until then, their irregular respirations can startle parents until they recognize how normal their baby’s abnormal breathing is.
These are the most common normal body habits of babies that disturb new parents. Some of these cause real fear and concern for first time moms and dads. Having some knowledge about these nuances of newborns can help parents relax. And that is good for parents, good for baby and good for the new family. It would be nice to hear about all these issues in the newborn nursery but it would just be too much to handle at that special time. Having some reference for these issues after you go home is more appropriate. So it is with that in mind that this was written for expectant parents.
I hope you can relax and enjoy your new baby.