Having a newborn can be an exciting yet somewhat scary time, especially for first-time parents. While there’s no official guide that tells you what to do when you bring baby home from hospital, there are a few key areas new parents should focus on according to Johns Hopkins All Children’s experts—eating, sleeping and pooping.
Feeding Your Newborn
If your newborn is crying, opening his or her mouth for a consistent period of time or sucking on a hand, chances are they are ready to eat. Breastfeeding for the first year of life is optimal for babies, but can sometimes be challenging for new moms. Your pediatrician is a great resource to give you tips for successful breastfeeding. Working with a lactation consultant can help you with proper feeding positions that work for you and baby, as well as other helpful breastfeeding tips. Talk to your hospital and insurance provider for options that are available to you.
Most newborns will take about 1 to 3 ounces during each feeding. Whether you breastfeed or formula feed, the baby should be eating every three to four hours for the first couple of months. Don’t forget to burp the baby to help expel gas, by gently patting or rubbing their back.
“Babies will continue to suck on a bottle long past when they are full. It’s important to limit the amount you give in feeding from a bottle to prevent spit ups or reflux,” says Rachel Dawkins, M.D., medical director of the Pediatric and Adolescent Medicine Program at Johns Hopkins All Children’s Hospital. “My usual rule of thumb is the number of months old the baby is plus 2 is the max amount (in ounces) of formula/breastmilk you should give from a bottle per feeding.”
Babies are typically calm after feeding and may even go to sleep. They should make multiple wet diapers a day and after the first week or two, they will start gaining weight. If you’re concerned with or see any signs of dehydration, talk to your pediatrician immediately to ensure your newborn is getting proper nutrition.
Baby’s Sleep Patterns and Safety
Sleep is one of the first things new parents sacrifice for themselves when their newborn arrives, and many wonder, “When will my baby sleep through the night?” By three to four months old, most babies should be sleeping through the night. However, newborns need to eat every couple of hours, so you will want to quickly establish a sleep schedule and try to stick to it. Try jotting down feeding times and sleep times so you can have a consistent routine and plan ahead for when baby should rest.
To ensure safe sleep and reduce the risk for sudden infant death syndrome (SIDS), it’s important to place babies on their back in their own crib for the first year. Be sure the crib has tightly fitted sheets and does not include bumpers. Avoid putting anything inside the crib that could suffocate a baby, such as pillows, blankets or stuffed animals.
Even with today’s high-tech night vision video monitors, many new parents may still worry and check on newborns after they go to sleep to see if they are still breathing. If you see the chest slightly moving up and down, hear light breaths and see the coloring is normal, they should be just fine. While uncommon, heavy or consistent rapid breathing, lack of movement in the chest area and other inconsistencies in breathing can be a cause for concern. If you notice any of these, contact your pediatrician, or in an emergency, dial 911, then start the basics of infant CPR from the American Heart Association by:
- Tapping baby’s foot to check for movement
- Beginning chest compressions—place two fingers below the nipple line and start 30 compressions
- Open the airway and administer two breaths for every 30 compressions by tilting the baby’s head back slightly and watching for the chest to rise
- Continue CPR until the baby is resuscitated or until emergency help arrives
“It is important for every parent to know what to look for if their baby is in distress or not breathing adequately,” says Jen Arnold, M.D., M.Sc., FAAP, medical director of simulation at Johns Hopkins All Children’s Hospital. “Typically, babies, unlike adults, are in need of CPR because of respiratory not cardiac reasons. Taking a CPR class is an important step for preparing for the birth of a child to learn when your baby might need help and how to react. Being prepared for an emergency that could require CPR such as choking, drowning, SIDS (sudden infant death syndrome) is priceless and being prepared for the worst case scenario is critical.”
Baby Bowel Movements, a.k.a. Poop
It may be gross to talk about at first, but one of the most common questions pediatricians offices get may be related to poop. Parents constantly worry about what’s normal, what’s not and when to call the doctor. Every baby is different and so are their diets, so some newborns have bowel movements multiple times of day, while others may poop every couple of days. Over a week or so, try to monitor what’s typical for your baby. You can also use the below as a guide of when to call the doctor about poop:
- What’s normal?
- Soft stools
- Stools of varying color including, brown, green or yellow
- Seedy stools
- What’s not Normal?
- Hard, ball like stools
- Pale yellow, chalky gray or white stools
- Bloody stool
- Black or tar like stool (except meconium—a newborn’s first stool—which shouldn’t last more than their first week of life)
“Remember that no question is too silly to ask your pediatrician,” Dawkins says. “I would much rather my new parents contact the office with concerns rather than spending hours worrying or reading disreputable websites.”
Talk to your pediatrician about any challenges or issues you or baby may be having, but after the first couple of months pass, most new parents can become pros at feeding, changing diapers and ensuring their infant is sleeping properly.
Check out more advice for new moms and learn more about the Pediatric and Adolescent Medicine Program at Johns Hopkins All Children’s Hospital. Visit HopkinsAllChildrens.org/parenting for more tips on safe sleep, breastfeeding and other questions about babies and toddler health.