$Unique_ID{PAR00010}
$Pretitle{}
$Title{Medical Advice:  The Normal Newborn Baby}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Normal Newborn Baby Newborns Babies appearance appearances ROUTINE
TESTS test phenylketonuria PKU congenital hypothyroidism SUPPLIES EQUIPMENT
Clothes Diapers Skin cleanser Bed Mattress Toys Car restraints FEEDING BURPING
SPITTING UP PACIFIER PACIFIERS BREAST-FEEDING BOTTLE-FEEDING CRY crying cries
EXPECTATION EXPECTATIONS}
$Log{
Baby Car Seat*0001002.tif}

Your Child:  A Medical Guide


The Normal Newborn Baby


     Every baby is different.  Although this section is especially intended
for first-time parents, anyone who has a new baby may find a "refresher
course" useful.  If you expect your second baby to be just like your first,
you may be in for a surprise.
     One thing that is easy to forget is how tiny even the healthiest,
heftiest baby really is.  A newborn usually is only 18 to 21 inches long,
stretched out.  And very young babies often keep their legs in the prebirth,
folded-up position for several months, which makes them seem even smaller.
The baby was in that position for many months before birth, and it takes a
while to get used to an uncramped environment.
     Remember that at birth the baby has left a warm, dark, still, safe
environment; been pushed through a narrow birth canal; and been suddenly
thrust into light, noise, and a new degree of independence.  It's a difficult
adjustment to make, even more difficult than the adjustment you must make as
new parents.
     There are some things about a new baby's appearance that may worry you if
you're not prepared.  For instance, it is perfectly normal for a newborn baby
to be born with a bluish tinge to the skin (which soon turns to pinkish-red),
with a slightly lopsided head, and with soft spots, called fontanelles, above
the forehead and at the top of the head.  It is also quite common for a new
baby to have jaundice, which gives a yellowish color to the skin and the
whites of the eyes.
     Although the baby went through a period of incredible growth and
development before birth, the newborn still has a lot of growing and
developing to do.  Many bones are still unformed; they are made of tough,
elastic tissue called cartilage that will gradually harden into bone.  The
legs are often bowed and shorter than you might expect when you compare them
with the arms.  The head may seem too big for the body.  The baby's face may
seem abnormally plump in the cheeks and flat in the nose.  The eyes will not
move together well and may seem to be crossed.  The genitals, especially on a
boy, may seem abnormally large.
     Be reassured that in a few months your baby will begin to look more
"normal."  Movements of the limbs, eyes, and neck will become more controlled
as muscles develop, and the face will become more alert and expressive.

ROUTINE TESTS FOR A NEWBORN BABY

     Certain tests are done on each new baby to check for abnormalities.  Many
minor problems can be taken care of before the baby leaves the hospital.
Others can be treated by the parents at home.  Some problems that appear at
birth must be detected early so that they can be corrected before they become
serious.
     One test that is required in all states is a screening test on samples of
the baby's blood and urine to check for phenylketonuria (PKU).  This rare
disorder can cause brain damage and mental retardation.  If it is detected
right away, however, changes can be made in the baby's diet to prevent such
damage.
     Also done routinely is a blood test for congenital hypothyroidism (a
disorder of the thyroid gland that causes abnormalities of mental and physical
development.)  Other tests may be done as well, depending on the hospital
routine and your doctor's recommendations.

SPECIAL SUPPLIES AND EQUIPMENT

     Before you bring your baby home, you will want to have everything you
need on hand.

     Clothes

     A newborn baby usually needs only diapers and soft nightgowns for
sleeping and extra sheets or blankets.  Overdressing a baby can cause heat
rash.  Babies spit up on and otherwise dirty their clothes, sometimes many
times a day, so be sure you have plenty.  You don't want to spend all your
time washing.

     Diapers

     Diapers can be made of reusable cloth or disposable paper.  The initial
cost of new cloth diapers may be high, but they can be used for many years.
Paper diapers cost more in the long run.  Many parents use paper diapers for
the first few weeks, for convenience in the initial adjustment period, and
then switch to cloth when a routine has been established.

     Skin cleanser

     Many doctors recommend using just a mild soap and water to keep your baby
clean.  Do not use oils, lotions, or powders; clear water is best.  A baby's
skin can be very sensitive, and scented products can be irritating.  Some
babies are allergic to certain lotions and creams.

     Bed

     You can use a cradle or bassinet for a new baby, but your baby will soon
outgrow it.  A crib will work just as well and be useful for a longer time,
making it a better investment.  Choose a crib with one side that drops, so
that you can easily reach the baby.  Make sure the catch is out of the baby's
reach; it won't be long before the child is standing up in bed.  Also, be sure
that the rails are close enough together that the baby's head won't fit
through them; they should be no more than 2 3/8 inches apart.

     Mattress

     The mattress should be firm and covered with a plastic or vinyl mattress
protector and a regular fitted crib sheet.  Make sure that the mattress is not
too small for the crib; the edge of the mattress should be no more than half
an inch from the side of the crib all around (otherwise, the baby might get
wedged between the mattress and the side of the crib).

     Toys

     Babies like toys that are brightly colored.  Soft toys are safest in the
early months.  Avoid sharp edges.  Remember that soon everything will go into
the baby's mouth, so be sure that toys are safe and washable.  Mobiles and
music boxes are interesting and stimulating, but be sure they are either out
of reach or safe for the baby to touch.

     Car restraints

     No baby should ever ride in a car unless he is protected by a car seat
with a sturdy harness system and a shell made of molded plastic or a
combination of molded plastic and steel tubing.  A car seat that adapts to fit
both infants and toddlers may be your best investment, and one that allows the
child to recline is more comfortable for a napping child than an upright
model.

COMING HOME

     When you come home from the hospital with a new baby, a period of
adjustment begins for all concerned.  It may take several weeks, or even
several months, for the mother to recover from the physical stress of labor
and delivery.  At the same time, the new baby is completely dependent on the
parents for food, shelter, and comfort.  To accommodate the mother's physical
tiredness and the baby's constant needs, you may have to review what is most
important to you as a family.  For example, keeping the house spotless may
have to take second place to caring for the baby and allowing the mother to
get the extra rest she needs.  Household jobs may have to be reassigned so
that the mother can devote more time to the baby.
     Your social schedule may have to change as well.  You may find that your
preferences have changed, and you would rather stay home with the baby than go
to a party or a movie.  This certainly does not mean you must--or should--give
up going out or never do the things you enjoy.  It only means that your
priorities will probably change when you have an infant in your household.

FEEDING

     In the first months of life, eating is a major concern of your baby.
This activity will take up a lot of your time and a lot of your energy.  But
whether you breast-feed or bottle-feed your baby, feeding time is a time of
closeness.  You are giving the baby nourishment and thus meeting your child's
most basic need.  At the same time, you are holding and cuddling the baby, and
he or she is getting to know your touch and your voice.
     Whether you are breast-feeding or bottle-feeding, remember that your
baby's appetite is generally a reliable measure of how much he or she needs to
eat.  A characteristic, demanding cry will let you know when the baby is
hungry.  After a few weeks or months, you'll probably be able to identify that
hunger cry.

BURPING THE BABY

     As the baby nurses, from the bottle or the breast, air is swallowed along
with the milk.  Burping the baby helps to expel excess air and prevent
discomfort.  Interrupt the feeding once in the middle for a burp, and also
burp the baby after a feeding.  Expelling extra air in the middle of the meal
ensures that the baby's stomach will not fill up with air.
     To burp an infant, put the baby over your shoulder, sit the baby up on
your lap, or place the baby face down across your lap.  Pat or rub the baby's
back gently until you hear a good, solid burp.  Some babies prefer one
position, while others need to be moved around until they burp.  If burping is
difficult, experiment with different positions and combinations of patting and
rubbing.  Some babies will protest the interruption of the meal, but burp them
anyway at mid-meal.  They will get more nourishment, and your life will be
easier.

SPITTING UP

     Many babies spit up either as they are being burped or a little while
after a feeding.  This is normal.  Check with your doctor if the baby is
spitting up large amounts, is having projectile vomiting (forceful, explosive
vomiting), or does not appear to be gaining weight.  Also consult your doctor
if the baby is spitting up and seems hungry all the time, or becomes limp and
not alert.
     To reduce spitting up, try burping the baby more often during a feeding
or changing the feeding position slightly so that the baby is more upright.
It may help to have the baby rest quietly in an infant seat for a few minutes
after feeding, rather than laying the baby down or encouraging active playing.

THE PACIFIER

     Babies need to suck for a certain amount of time each day.  If your baby
acts hungry but takes only a small amount of food, he or she probably just
needed to suck.  If this happens consistently, a pacifier may be a great help.
It meets the baby's need to suck but spares you the inconvenience of trying to
feed a baby who really isn't hungry.  After about six months (this may
vary--all babies are different), the baby will no longer need extra sucking.
Then you can take away the pacifier.

BREAST-FEEDING

     Many doctors today recommend breast-feeding, if it is possible, for a
number of reasons.  First, breast milk is thought to pass on to the baby some
of the mother's own resistance to infections.  Second, many babies develop
allergies to infant formulas, but it is rare for a baby to be allergic to his
mother's milk.  Third, breast-feeding is generally more convenient than
bottle-feeding, requiring no sterilizing, mixing, or refrigeration.  Fourth,
the experience of breast-feeding is emotionally satisfying for both mother and
baby.
     You can give the baby an occasional bottle or give one feeding a day by
bottle, if you choose.  This can give the mother a chance to be away from the
baby sometimes or to sleep through the night while the father gives a feeding.
The breasts can be emptied with a breast pump if they become uncomfortably
full.

BOTTLE-FEEDING

     If you are bottle-feeding, you must have clean water and refrigeration
available.  Be sure to clean the top of the can before you open it, and follow
the directions carefully when you're preparing the formula.  Some formulas are
concentrated, so you must add water.  Others are "ready to feed," and if you
dilute this type the baby will not get enough nourishment.
     Bottles and nipples must be cleaned and sterilized through the baby's
fourth month.  After that, only the nipples must be sterile.  To sterilize,
clean the nipples with soap and water, making sure that the hole in the top is
not clogged with dried formula.  Then boil them in water for 15 minutes.
Bottles should be cleaned first and then sterilized.  After four months, the
bottles can be washed in hot water or in a dishwasher.
     Hold and rock the baby when you're bottle-feeding.  Do not prop the
bottle up and leave the baby alone to eat.  Human contact is important to the
baby's development, so don't rush the feeding time.  However, try not to spend
more than 30 to 45 minutes on each feeding.

WHY BABIES CRY

     It's normal for babies to cry.  It is, after all, their only way of
letting you know that they need something.  At first it may be difficult to
figure out what the baby needs.  In a newborn, though, there are only a few
things a cry can signify--hunger, needing a diaper change, and needing to be
held and comforted.  As the baby grows up, he or she will find more reasons to
complain--for example, boredom, frustration, loneliness, fear,
overstimulation, and tiredness.
     Sometimes you and your baby can get into a crying cycle.  When the baby
cries, you get anxious and nervous.  The more the baby cries, the worse you
feel, and nothing you do seems to help quiet the baby.  It sometimes seems
that the baby senses your feelings and responds by crying even more.  If you
find yourself getting into these cycles, talk about it with an experienced
parent or your doctor, who may be able to suggest a solution.
     Occasionally, a baby will cry because he or she is in pain.  Check to see
if you can figure out what is causing the pain.  A sick baby may cry but will
usually also have some other symptom of illness, such as a fever, diarrhea, or
a runny nose.  Generally, a healthy baby will have a strong, loud cry.  If
your baby's cry becomes weak, contact your doctor right away.

WHAT TO EXPECT OF YOUR BABY

     For about the first month of life (longer if the baby was born
prematurely and is catching up), the baby will do little besides eat, sleep,
and dirty his diapers.  An infant has a small stomach and can't eat very much
at a time, so feeding the baby the usual six to ten times a day is likely to
be the biggest demand the baby makes on you.  The rest of the time, the baby
will probably sleep, and you may be able to catch up on your sleep too.
     Babies develop at different rates, so the following description of a
baby's development is only a guide.  It will give you a general idea of what
changes to expect in your baby over the first year or so of life.  Many
parents keep a baby book in which they note these events.  But whether you
record the baby's progress or not, it's fun to see a tiny infant who does
nothing but eat and sleep develop into a person.  Beware, though, of making
comparisons between your child and your relatives' or neighbors' babies.
Remember that each baby is unique.  If a child is slow to talk or stand up, it
doesn't mean that he or she is less intelligent than a cousin or a neighbor's
child.  However, if your child lags far behind other children of the same age,
check with your doctor.  Basically, here is what you can expect from your
baby:

  -  At six weeks, the baby may be awake and playful, without crying, for half
     an hour after each feeding.  This is about the time when you can expect
     the first spontaneous smiles.
  -  At three months, the baby will follow the movement of a favorite toy
     dangled in front of his or her eyes.
  -  At four months, the baby will learn to roll over from front to back.  At
     five months, he will be able to roll from back to front.
  -  Between the ages of four and six months, the baby will learn to lift his
     or her head and shoulders, and by about six months will have enough
     muscle control to balance in a sitting position without support.
  -  Most babies begin to make simple, recognizable sounds (such as "Dada" and
     "Mama") at about eight months of age.  This is also the stage at which
     they may try to use a spoon for the first time.
  -  At nine months, most babies can get to a sitting position from lying down
     and can pull up to a stand and walk holding onto furniture and walls.
     The baby may begin to crawl, but some babies skip crawling altogether.
     This is the time to "childproof" your home and put harmful items out of
     reach.
  -  At about a year old, the baby may be able to stand up for a few seconds
     and may be taking a few steps alone.  Fortunately, this is also the time
     when a baby begins to understand a few simple commands, like "Stop!" and
     "Don't touch!"  In most cases, it will be a few more months before the
     baby is walking.  By this time, your child will be eating only three to
     four times a day.

     As your baby develops, her attention span and interests will also
broaden.  A very small baby may watch a mobile for a few minutes, but then
fall asleep or cry.  As the child learns how to use her arms and legs, she
discovers the ability to make things move.  The baby learns to grab for
things, too.  Her eyes begin to focus better, so she can see more things.
Still, a toy may hold a baby's interest for only five minutes before she needs
to look at something different.  As you play with your baby, you can see how
long a game remains satisfying.  The complexities of the game and the time it
holds the child's attention will gradually increase.