Normal Newborn Behavior
What to Expect From Baby's First Days
Your baby is finally coming home with you after many long months of anticipation and planning! Now you are thinking what will baby be doing for the first few days and weeks and what is normal newborn behavior?
Bringing home your new baby will be one of the happiest days of your life but once you get home there may not be anyone right there to ask what is normal and when is cause for concern. If you are ever worried the best thing to do is to call you pediatrician’s office. Most offices have weekend hours and coverage overnight so you can always speak to someone who can answer your questions. Pediatric offices are used to many normal newborn questions so do not be shy to ask. Chances are if you have a question, someone else before you has also had the same concern.
Feeding
All babies lose weight in the first week of life so do not worry when your baby is not putting on weight right from the start. Babies are all born with extra fluid and they need to lose that extra fluid first and then they become hungry and start feeding much more regularly.
If you are breastfeeding, you can expect that baby will want to go to the breast right after delivery and then will probably be pretty sleepy for the next 24 hours, so you might only get 2-3 nursing sessions in during that first day. This is normal and should not cause you to get nervous. While you are in the hospital take the time to meet with the nurses and lactation consultants, if necessary, to learn tips about nursing. When you go home your milk will likely not be in yet as for first time mom’s your milk comes in on day 5 or 6. Before this, you will have colostrum (or first milk) and then transitional milk, which is very important as well for your baby’s immune system.
Once your milk starts to come in, you can expect your baby to nurse between 8 and 12 times a day. Most breastfed babies do a 3-4 hour stretch where they cluster feed—feeding every hour or so—often in the evening time before getting ready to sleep a longer stretch—say 3 hours. Generally, breastfed babies will want to eat every 1.5 hours to 3 hours. Feed your baby based on her cues, not on the clock, if possible. You will be meeting with your pediatrician 2-3 days after you head home so you can check in on weight gain, latch position and feeding schedule then as well.
If you are formula feeding, most formula fed babies fall into a more typical pattern of eating 3 ounces every 2.5-3 hours. Similarly to breastfed babies, formula fed babies will also lose weight in the first few days and won’t be up to their normal feeding schedule until several days old as well.
Sleeping
Most newborn (within the first month) babies sleep between 18 and 20 hours a day. This seems like a lot of time but, since they often sleep in short stretches it can be hard to get any good rest for yourself. An important mantra is mom should sleep when the baby sleeps. If you spend the baby’s nap returning phone calls and writing thank-you notes you will soon get very exhausted. These things can often wait until baby’s sleep patterns are better established, so for now try to rest when your baby sleeps.
Often the bulk of sleep can be during the daytime hours and baby is up and alert at night. This day/night reversal is very normal and with some gentle coaching baby should be able to flip over to a more conventional diurnal schedule in no time. At night time try to encourage low lights, minimal stimulation and efficient feedings, while during the daytime turn music and lights on and consider having baby sleep in a swing or seat with family around. Your baby has been experiencing all these sounds around her throughout the pregnancy so noise is often calming and soothing.
Swaddling can be an effective way to calm baby and remind her of being in the womb and can be quite useful in combination with rocking to put babies to sleep. During the newborn period you don’t have to worry about the baby self-soothing or putting herself to sleep on her own—for the moment sway and swing with her and lull her to sleep if you like. Encouraging babies to sleep on their own usually doesn’t come into play for at least another 2-3 months.
Babies will move when they sleep and will flutter their eyes as well. Babies also have periodic breathing—a period of irregular breathing where they breathe quickly and then more slowly for seconds at a time. This is normal. If your baby has color changes with this, such as turning blue/grey or if your baby has a period where she stops breathing completely for more than 10 seconds you will want to be in touch with your doctor immediately as they may be experiencing apnea.
Activity Level
Since your baby is sleeping most of the day this leaves only a few moments here and there for alert time. We do expect your baby to be alert in small spurts—10-20 minutes—perhaps before a feed or after a diaper change. You can anticipate that your baby will start to follow your face and the sound of your voice after the first couple of weeks. She can also grab your finger when you place it in her hand. Vision is not very well developed so unless you are within 18 inches of her face, she likely cannot see you very well and even then, in the first weeks she can see only in black and white and mostly shadows. Over the next 2 months, vision develops very quickly and she will be able to see across the room and by 6-8 weeks even smile back at you! Also, baby will slowly start to gain more head control so keep working on tummy time to strengthen those neck muscles.
Diapers
You will likely be going home on day 2 if you had a vaginal delivery or day 4 for a c-section delivery. Usually you can expect the same number of diapers of urine for every day old your newborn is. So, if you baby is 3 days old, expect at least 3 wet diapers of urine and so forth until babies usually plateau at 5-6 wet diapers at least a day. If your baby has small crystals in her diaper-called uric acid crystals—this may be a sign of dehydration or dryness for the baby. Many babies experience this as mother’s milk is still coming in but you will want to mention this to your pediatrician and check in on baby’s weight.
Once your baby has her first bowel movement, which usually occurs in the first 24 hours, then stool will change over from dark and thick tarry black (meconium) to green (transitional stool) to yellow and seedy by day 5- 6 for breast milk fed babies. Formula fed babies will end up with beige and slightly more solid stools than breast fed babies. Any shade of green/brown/yellow is normal. The time to call you doctor is if you see blood in the stool or if the stool is rock hard like rabbit pellets.
Frequency of bowel movements has great variety from baby to baby. Some breastfed babies have a bowel movement after every feed (some can go 12 times a day) and some go as infrequently as once a week. Formula fed babies tend to have a bowel movement at least every other day but usually twice a day in the first weeks.
Straining and turning red and squirmy before trying to have a bowel movement is normal behavior. Babies don’t have their gastrointestinal system coordinated quite yet and have very little in the way of abdominal muscles to assist in producing a bowel movement. Your little dear may get worked up and red and gassy and you might open the diaper and find nothing—don’t despair this is all part of the learning process!
Crying and Other Behaviors
All babies cry—it is their way of telling us they need or want something—diaper change, food, to be held, too cold, too hot, have gas, need to be burped or are over stimulated. Figuring out what is the problem is often the tricky part—start with offering food, changing the diaper and then go from there. Try to keep a cool head and have family or friends available if you need help. This is a learning process for both of you. Should you feel as if you have tried everything and your baby still seems inconsolable you may want to check in with your doctor.
Babies have all sorts of interesting reflexes and most are very normal. Sneezing, hiccupping, startling (also called the Moro response when babies throw their arms and legs up and shake them in response to a loud noise), rooting—or turning mouth to one side and trying to suck—are all normal. If you are not sure if it is normal consider taking a video of the behavior to show your pediatrician.
Over the course of the next few weeks you will learn your baby’s likes and dislikes and you will become and expert at understanding your baby. Many people will have advice from their own experiences and remember that each baby is different so if one way doesn’t work for your baby, try a different approach and just remember this is the beginning of a wonderful experience.