6 Things Your Pediatrician Wishes You Knew About Baby's First Days
Your new-parent learning curve is steep, but here's what experts wish you knew from the get-go.
You've taken the classes. You've read the books. You've Googled until your fingertips blistered. Surely, you have some idea of what to expect when your newborn arrives, right?
The reality is that while you may know the best car seat to buy (and how to install it!) or how to change a diaper, many parents are still uniformed about important health-related topics, says Ari Brown, M.D., a Parents advisor and co-author of Baby 411: Clear Answers & Smart Advice For Your Baby's First Year. There will always be plenty of uncertainty—it's just one of the joys of parenthood—but brushing up on these important health facts can help make navigating your baby's first precious days go that much more smoothly.
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1. Your baby is much more alert after the first 48 hours. While you're still in the hospital, your baby will be very sleepy. "After a vaginal delivery, you'll likely go home after 48 hours and suddenly your baby will wake up, realize he's left the womb, and be very hungry," Dr. Brown says. "It's often a real shocker for new parents because you've had a very placid baby at the hospital and suddenly your baby is awake and crying, but you no longer have the comfort of nurses and knowledgeable people around you."
2. Your baby's feedings may not be spaced three hours apart. You've probably read that your baby should eat about eight times within a 24-hour period. What many new parents don't know is that those eight feedings aren't always evenly spread throughout the day (and night). Instead, your baby may cluster feed. "This occurs when your baby feeds several times in a row with a few short breaks, and may then go a longer stretch before her next feeding," Dr. Brown says. It's way too early to worry about schedules yet—go ahead and feed your baby whenever she's hungry. "If you're breastfeeding, demand drives supply so making sure you get those eight feedings in per day, whenever they occur, will help establish and protect your supply," Dr. Brown adds.
3. A little jaundice is okay. It's not ideal for newborn photos, but it's not necessarily something to get super worried about either. "All newborns can get a little bit yellow in their face around 3-4 days of life," Dr. Brown says. "That's normal because the culprit, a yellow-pigmented body waste product called bilirubin, is not being effectively eliminated through the stool. Babies aren't eating very much during the first few days of life so they're not pooping very much." As a result, bilirubin can collect in the skin and cause it to become slightly yellow.
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This normally clears up as your baby starts eating and stooling more frequently—several times a day around 4 to 5 days of life. But concern is warranted if your baby starts looking yellow in the first day or two of life, is born prematurely, and/or becomes significantly jaundiced on other parts of his body—especially down to the legs and feet. "If your baby turns into a pumpkin between heading home from the hospital and his first newborn follow up appointment, you need to call your pediatrician to be seen sooner," Dr. Brown says, noting that treatment may be necessary. Adds pediatrician David L. Hill, M.D., author of Dad to Dad: Parenting Like a Pro: "There's a fine line between a mild amount of jaundice and higher levels that can be poisonous to the brain and require immediate treatment," he says. "Even experienced clinicians often need labs to know whether a baby's level of jaundice is dangerous. And premature babies and those who have lost more weight are at higher risk."
4. Babies are nocturnal. Unfair, but true: Babies tend to be super-sleepy during the day and ready to party when you want to crash. "Babies don't make melatonin for the first four weeks of life so they have no circadian rhythm and are often more wakeful at night," Dr. Brown says. Over time, this will work itself out. "You can help the process by keeping your house light and lively during the day and calm and quiet at night," Dr. Brown says. When your baby wakes up at night, try to keep the room as dark as possible while still being able to see for diaper changes and feedings.
5. Your baby will sneeze and hiccup a lot. Tiny baby sneezes are adorable, but can also make you concerned that your baby has allergies. Rest assured that most of the time, the achoos are completely normal. "Babies don't know how to blow their nose and still have amniotic fluid they need to clear from their airway," Dr. Brown says. You probably felt your baby hiccupping in utero, and that's likely to continue once he's on the outside, too. "Babies get over-stimulated very easily, which can cause a small spasm in their diaphragm and lead to hiccups," Dr. Brown says. Keep in mind that for babies, overstimulation can be something as simple as going from sleeping to waking or eating to not eating.
6. Your obsession with poop starts from day one. You will quickly become that parent who talks/thinks/dreams/Googles about poop all day long. "Many breastfeeding moms think their baby is having diarrhea, but it's supposed to be runny," Dr. Hill says. "The colon is fairly inefficient at removing water from the stool at that point. Breast milk also speeds transit through the intestines. It's a good thing, though. It's how their bodies get rid of bilirubin." You can also expect your baby's poop to change in color over the first few days. It starts out black (a tar-like poo called meconium), then brown, then green, then yellow. "I hear from a lot of parents who are worried that their infants' stools are green," says Dr. Hill. "I tell them that I'm happy with any of the earth tones."