1st Weeks at Home

Preventing Fatigue and Exhaustion:

For many parents, the first weeks at home with a new baby are often challenging. You may feel overworked, maybe even overwhelmed. Inadequate sleep may leave you fatigued. Caring for a baby can be a lonely and stressful responsibility. You may wonder if you will ever catch up on your sleep or work. The solution is asking for help. No one should be expected to care for a young baby alone.

Every baby awakens several times a night. One very good way to avoid sleep deprivation is to know the total amount of sleep you need per day and to get that sleep in bits and pieces. Go to bed earlier in the evening after your baby’s final feeding of the day. When your baby naps, you rest or nap. While you are napping silence the phone and put up a sign on the door saying MOTHER AND BABY SLEEPING. If your total sleep remains inadequate, ask a relative for help or hire a babysitter. If you don’t take care of yourself, you won’t be able to take care of your baby.

The Postpartum Blues

More than half of women experience postpartum blues on the third or fourth day after delivery. The symptoms can include tearfulness, tiredness, sadness, and difficulty thinking clearly. These temporary feelings are likely caused by the sudden changes in hormones brought on by birth. The full impact of being totally responsible for a dependent newborn can also contribute to feeling overwhelmed. Many mothers may feel let down or guilty about these symptoms because they have been led to believe they should be overjoyed about caring for their newborn. Usually, these symptoms clear in 1 to 3 weeks as hormone levels return to normal and the family develops routines and a sense of control over life.

If you are experiencing these symptoms, there are several ways to cope. Acknowledge your feelings. Discuss them with your partner or a close friend.  Don’t try to suppress negative feelings or act like everything is perfect.  Get adequate rest and help with the day to day tasks of newborn care. Stay in contact with friends and plan activities outside the house—take baby for a walk, go to lunch with a friend, even run an errand.  Take baby with you or leave them with your partner,  a trusted friend or family member. If you don’t feel better by the time your baby is 1 month old, see your healthcare provider.  Many mothers find counseling and medication very helpful. If the blues are making it impossible for you to care for yourself and your baby, get help as soon as possible.

Helpers: Relatives, Friends, Sitters

Everyone needs extra help during the first few weeks with a new baby.  Family members such as grandparents, sisters, aunts and uncles can be a great help.  Good friends also often come to the rescue if asked. You may also consider hiring a post partum doula.  Look at organizations such as DONA or CAPPA or ask your OB, midwife or pediatrician for a doula recommendation. You may also consider hiring a mother’s helper – whether a teenager or adult – someone to come by to help with household chores, childcare for other children or baby care while you nap.  Clarify that your role is looking after your baby. Your helper’s role is to shop, cook, houseclean, and wash clothes and dishes. If your newborn has a medical problem that requires special care, ask for home visits by a public health nurse.

The Partner’s Role

If able, your partner may also want to take time off from work to be home after baby is born. Many partners find it helpful to use vacation time to go back for a shortened week or shorter days for a time, even if it means taking off fewer full days right after birth.

Both parents will find their own way of interacting with baby – feeding, changing, bathing, holding.  At times the non-birthing parent may feel left out or may take a little time to feel confident in their parenting skills.  Many parents find that the best way through these feelings is simply practice!

Visitors

Only close friends and relatives should visit you during your first month at home. They should not visit if they are sick. To avoid the spread of RSV or other illnesses, gently remind visitors to avoid kissing baby on the hands or face.  To prevent unannounced visitors, the parents can put up a sign saying MOTHER AND BABY SLEEPING. NO VISITORS. PLEASE CALL FIRST. Friends without children may not understand your needs. During visits the visitor should also pay special attention to older siblings.

Feeding Your Baby

Much of your time during the early months of life is spent loving and feeding your baby. All babies lose a few ounces during the first few days after birth, up to about 7% of the birth weight (usually about 8 ounces for a 7 pound birth weight). Most babies are back to birth weight by about 10-14 days of age.  After that infants gain approximately an ounce per day during the early months.

A baby’s stomach size changes over the first week and so does the amount they are able to eat.  You’ll see this reflected in their stool.  During the first few days, baby’s stomach is the size of a marble and can hold 1/2 to 1 oz.  Baby will have 1-2 dark, black stools a day during this time.  By 3-5 days of age, baby’s stomach is the size of a ping pong ball and can hold 1-2 oz.  Baby will have 2-4 greenish stools during this time.  After day five, baby’s stomach is about the size of a large egg and can hold 2-3 oz.  Baby will have 3-5 yellow-brown stools during this time.   Breastfed babies tend to have more frequent and looser stools than bottle fed babies.  This is normal and doesn’t mean anything is wrong.

If your baby is eating 8-12 times per day (every 2-3 hrs or so), seems satisfied after feeding, and is having enough wet and dirty diapers, then you can feel confident that your baby is getting what he needs.  Some babies may need to be woken up to eat every three hours until they have regained their birth weight.  After that they are often able to set their own pattern.

Dealing with Crying

Crying babies need to be held. They need someone with a soothing voice and a soothing touch. You can’t spoil your baby during the early months of life. Many babies may need swaddling for comfort.

Sleep Position

Remember to place your baby in his crib on his back. As of 1992, this is the sleep position recommended by the American Academy of Pediatrics for healthy babies. The back (supine) position greatly reduces the risk of Sudden Infant Death Syndrome (crib death).

Taking Your Baby Outdoors

You can take your baby outdoors at any age. You already took your baby outside when you left the hospital, and you will be going outside again when you take him or her for the two-day or two-week checkup.

Dress the baby with as many layers of clothing as an adult would wear for the outdoor temperature. A common mistake is overdressing a baby in summer. In winter, a baby needs a hat because he or she often doesn’t have much hair to protect against heat loss. Cold air or winds do not cause ear infections or pneumonia.

The skin of babies is more sensitive to the sun than the skin of older children. Keep sun exposure to small amounts (10 to 15 minutes at a time). Protect your baby’s skin from sunburn with longer clothing and a bonnet.

Medical Checkup on the Third or Fourth Day of Life

Most newborns and their moms will be discharged from the hospital 48 hrs after birth for a vaginal birth and 4 days after birth for a cesarean birth.  We recommend a checkup two days after coming home to see how well baby is feeding, urinating, producing stools, maintaining weight, and breathing.   We recommend a checkup 24 hrs after a home birth.

The Two-Week Medical Checkup

At this check up, your child’s healthcare provider will be able to judge how well your baby is growing from his or her height, weight, and head circumference.

Try to develop a habit of jotting down questions about your child’s health or behavior at home. Bring this list with you to office visits to discuss with your healthcare provider. Most physicians welcome the opportunity to address your agenda, especially if your questions are not easily answered by reading or talking with other mothers.

If at all possible, both parents should go to these visits. Most physicians prefer to get to know both parents during a checkup rather than during the crisis of an acute illness.

If you think your newborn starts to look or act sick between the routine visits, be sure to call your child’s healthcare provider for help.