Monday, November 25, 2013

Your Healthy Newborn - First Days at Home

So you came home with your baby. Whether it is the first-born or not, it's always an exhilarating experience and an opportunity to learn new things everyday.

Your baby probably already had the first Hepatitis B vaccine and the newborn screen at the hospital. Also, he or she already passed the hearing test. Congratulations! This article reviews what you need to know about your newborns developmental milestone, feedings, elimination, and safety.

There are some essential things to know when you bring your neonate home. First of all, per the hospital's recommendations, set up a follow-up appointment with your baby's health care provider (usually 3-4 days post delivery). It is important to evaluate your infant, i.e. check the weight, listen to the heart, etc. Also, you may have questions that need to be answered: prepare a list before the visit so that nothing gets forgotten! Most health care providers like when patients come to the appointment well prepared. It helps us address all of your needs!

Below, I outlined some important things to know about your baby from the very first day.


Your baby should respond to noise. For example, she should startle at the sound of a slamming door or a barking dog. By one month of age, she should be able to distinguish between the mom's voice and voices of other people. However, some babies have this ability from the very first days after birth. Your baby's vision is intact, but right now she can best see objects and faces placed 8-12 inches away from her face. Also, she does not like bright lights. Babies like to open their eyes in dim light by the adult standards.


During the first few weeks, don't worry about schedules: your baby should eat on demand, on average every 2-4 hours. However, babies experience rapid growth spurts from time to time, and during those times they may be hungry every 1-2 hours. Just play it by ear. Also, keep in mind that your baby's stomach is very small (about the size of her fist), so it can't hold more than a couple of ounces at the time. If you feed your infant formula and notice excessive spit ups, decrease the amount of the formula but feed your baby a little more often. Don't let more than four hours pass between feedings. You do not want you baby get frustrated with hunger and make the feeding experience unpleasant. At any time, your breastfed or formula fed baby spits up excessively, talk to your health care provider. She may suggest a formula change or, on rare occasions, medication.


A healthy newborn should pass the first bowel movement (BM) within 36 hours after being born. After establishing a healthy BM pattern, your baby may go to the bathroom once or a few times a day, or every other day, or so. One thing to keep in minds is that not everybody has a BM every day! As long as you infant is comfortable between BMs and they do not look like pebbles, there is no reason for concern. Also, keep in mind that breast milk has much less waste than formula. Therefore, your baby may have less frequent and malodorous BMs than a formula-fed infant.
Urination is a good indication of hydration. A few days old baby should have at least 4-5 wet diapers and work her way up to more than 6 a day!


The safest sleeping position for your baby is on her back. It decreases the chance of SIDS (Sudden Infant Death Syndrome) (See Box 1). Co-sleeping of infants and parents is no longer recommended. Such sleeping arrangements create an unsafe environment for the baby who can suffocate on bedding or be crushed by a sleeping adult. Every baby should sleep in her own bassinet or crib. Smoking should not be allowed around your baby as well. Cigarette smoke exposure not only increases the risk of SIDS, but it also increases your baby's susceptibility to catching upper respiratory tract infections.

Practice measuring your baby's temperature. Should the temperature be 100F or above, undress the infant and let her cool off. Small babies overheat easily! After 15 minutes, check the temperature again. If the temperature is still 100F or above, your baby needs to be examined by a health care provider right away. That is true until the infant is 3 month old, because until then the immune system does not know how to work efficiently and fever may be a sign of a serious illness.

The series on newborns will cover in the future issues topics, such as jaundice of the newborn, the senses, primitive reflexes, six states of consciousness breastfeeding, reactions of older siblings to the newborn, postpartum depression, and infant's social development. If there are other topics that you would like to read about, email me at

Box 1. Sudden Infant Death Syndrome (SIDS)

SIDS is a sudden and unpredictable death of a seemingly healthy infant younger than 12 months of age. The diagnosis comes only after other causes of death are ruled out. You can take steps to reduce your baby's risk of SIDS by placing her to sleep on her back even though she might prefer to sleep on her belly! Make sure that the mattress in her crib is firm! Also, offering a pacifier to your infants (only if she does not reject it!) may decrease the risk of SIDS. Avoid cigarette smoke exposure and do not overdress your infant as overheating may contribute to SIDS.

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