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The Newborn Period or “Survival Mode”

This article encompasses 20+ years of observations as a practicing pediatrician to enlighten new parents on the “survival period” of the first few weeks of life shared with a newborn. It is best not to have expectations during this time since all newborns are different, yet the majority displays some very common characteristics.

First and foremost – newborns do NOT know a day/night schedule; after all, they have lived in a world of complete darkness for the previous 9 (or fewer) months. They will not and cannot be put on a schedule these first few weeks – everything is on demand! The best you can do to facilitate this transition is to wake your infant during the day after 2-2 ½ hours of napping to feed as regularly as possible and allow 3-4 hours at night. The goal is to feed AT LEAST 8 times in a full 24 hours or 8-12 times which on the average is every 2-3 hours. The more you awaken the infant during the day to feed more frequently, eventually they will learn a day/night schedule. When they wake, feed them but do not wait for them to wake themselves. Infants enter a very sleepy phase a few hours after birth and will sleep up to 16-20 hours in 24 hours so waking them to eat is a necessity.

Until your newborn is gaining weight well along with gaining body fat, feeding is on demand. Somewhere between 10-12 lbs., a schedule will begin to evolve and the nights will become better and more consistent, but don’t expect to really schedule your infant until 6-8 weeks and remember, you are in charge of this.

Stooling is a messy subject! Newborns who stool frequently in the hospital usually slow after discharge if being breast fed due to low intake volume until mother’s milk arrives (typically 3-5 days after birth). It is ok if after several stools a day early on that a day or two is missed while awaiting milk production. Once meconium is cleared, infants should have soft to loose stools daily but this is not always the case. Stooling every other day or every couple of days is usually fine as long as it can be passed easily and is loose. Small balls of poop are considered constipation, even if passed daily.

Newborns seem to sleep best when being held – they all do this and “play possum” when you lay them down. They feel best against your body warmth feeling the vibration of your heart; however, this is not a safe sleep position for them unless you are fully awake. Realize this is a transition and WILL get better, in the meantime, get in the habit of laying them in their bassinette or crib for naps and night sleeping. Watch for cues of tiredness such as rubbing the face or mild fussiness and get in the habit of laying your baby down at these times.

All newborns will have hiccups, sneezes and faster breathing than older children. In fact, they have an irregular pattern of breathing called “periodic breathing” because they will actually stop up to 15 seconds, then start again with faster, shallow breaths, then slower then stop and breathe as many as 40-60 times in a full minute. Any concerns about an infant’s breathing should be discussed with your doctor but realize the rate and pattern are much different than that of an adult. Making funny noises with each breath or frequent coughing is not normal and should be addressed.

It’s a crying shame that cries are the only way newborns can communicate! Crying does not always imply something is wrong; it is simply all they can do to tell us if they are tired, hungry, wet, bored, in pain or simply letting off steam. In time you, as the parent, will be able to discern the meaning of different cries, but for now simply tend to their crying by giving them attention – holding, rocking, changing, feeding and hope that one of these does the trick! Any prolonged (2 hours or more), inconsolable crying may be a sign that something is wrong and your infant should be seen.

Pacifiers are exactly that! They pacify and soothe an infant because sucking is what they do best! These can be a very helpful tool to use in the first few months of life but get rid of them while you are in charge – by 4-6 months – since by then they have served their purpose.

Welcome to parenthood and do your best to enjoy these exhausting weeks but realize that “this too shall pass” and, with time, all will improve and become less work and more fun! Hang in there and enjoy the gift of parenthood!

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