Most babies sleep for 1-4 hours at a time with ½-2 hours wake time in between; usually not sleeping more than 5-6 hours at night until 3 months of age. Every baby has different sleep needs and their pattern may also vary from day to day. Your baby should sleep in a safety approved crib or bassinet and not in an adult’s bed due to safety concerns. It is normal for your baby to move around quite a bit and make noises during sleep.
Pee and Poop
After the first few days, your baby should have wet diapers every 3-4 hours. If your baby goes longer than 6-8 hours without a wet diaper it could be a sign of early dehydration; ensure your baby is taking feedings frequently and call for advice if this problem persists. Your baby’s bowel movements should gradually change from black meconium, to green-black, to green-yellow, to yellow over the course of 3-5 days. Breastfed babies’ stools may be looser and more frequent (8-10 times a day) as compared to formula-fed babies’ stools. At around 6-8 weeks of age your baby may have less frequent stools and even skip 1-3 days in between. Straining and crying with passing bowel movements is very normal for many babies, as their tummy muscles are not very strong yet. The pattern, frequency, and color may also vary day to day.
A bath once every few days is fine, with sponge baths needed until a few days after the umbilical stump falls off. Avoid soaps and liquid washes on your baby except a very small amount of Dove soap. Baby washes may cause your baby to have drier skin.
Umbilical Cord Care
Cleanse the umbilical cord stump with Q-tips and alcohol 2-3 times a day, gently lifting it up as necessary. Do this for 1-2 days after it falls off as well. Your baby may cry when you do this but know that it is dead skin and this care should not cause pain. Keep the area dry and clean. Call if the area around the navel becomes red, oozes with pus, or constantly drains fluid. Most umbilical cords will come off between 1 and 4 weeks of age. Call for an appointment if the cord is still attached at 6 weeks of age.
If your baby is healthy and of average weight, they need to wear a similar amount and type of clothing as you would, with perhaps a light, extra layer. The only difference would be in cold weather, your baby may need to wear a hat to prevent heat loss due to their proportionately larger head size.
Your baby’s skin will probably be dry and flaky in the first 2-3 weeks; like other organs in the body it is immature and doesn’t function optimally yet. This should improve over time. If there are very dry, cracked areas you may use a very small amount of Aquaphor or Vaseline 2-3 times a day. Many babies get mild rashes such as erythema toxicum, heat rash, and acne which are harmless. Contact the office for advice if you are worried about a rash. You will need to trim your baby’s nails to avoid your baby from scratching his skin. This may be easier to do while your baby is asleep and can be done with either a nail file or baby clippers
Circumcision/ Non-Circumcised Care
If your baby has been circumcised you will need to help protect the penis until if fully heals. For the first 1-2 days keep petroleum gauze on your baby’s penis and simply clean the area gently with warm water when necessary without vigorous cleaning. After that you can keep a thin layer of Vaseline on the tip of the penis until it no longer looks red and tender. You may notice a thin yellow film form; this is usually not pus, but simply healing tissue formation. If your baby has had a “plastibell” type of circumcision, this plastic piece should gradually fall off by 7-8 days of age. Call if you note increasing swelling, bleeding or redness, or if urination seems abnormal. If your baby has not been circumcised you simply need to keep the glans clean and very gently retract the foreskin only enough to clean appropriately. If you provide very gentle, not forceful traction, the foreskin will gradually be able to be retracted back fully by 5-10 years of age or sooner.
Crying and Other Things Babies Do
Babies cry for many different reasons; it is their way of communicating. Hold, comfort, rock, talk to your baby to try to calm them. Call the office if the crying is excessive or if you are distressed by your baby’s crying. Crying usually peeks at about 6 weeks of age and then lessens. Most babies have brief periods of fussiness throughout the day. As your baby gets older, you may be able to distinguish different cries: hunger vs. pain vs. tired, for example. Most babies have reflexes in the first few weeks that you will see and hear, such as: hiccups, yawning, sneezing, noisy breathing, passing gas, and startling. These are all normal, but if you feel concerned that they are not normal, please call to get advice.
It is okay to take your baby out for a ride in the car or go for a walk in a stroller; belted in properly, dressed appropriately for the weather, protected from the sun, and avoiding anyone with an illness. Be sure that everyone in contact with your baby uses good hand washing.
It is normal to feel tired, stressed, and a little overwhelmed in the first few weeks given the physical and emotional effects of childbirth and everyday life challenges. Use your helpers and get as much rest as possible. If you feel down, unhappy, unable to caring for your new baby, don’t hesitate to call your doctor’s office for help. Postpartum depression is very real and should never be ignored.