It can be difficult for a new parent to know when a baby is sick. Sometimes a parent's concerns can be treated as a casual inquiry by medical workers who are accustomed to soothing new-mother nervousness. Mothers can begin to doubt whether or not to trust their instincts.
Fortunately, even new parents can objectively measure their baby's health.
THE FIRST SEVEN DAYS
During the first week of life a baby should nurse at least 8 times a day for more than 15 minutes at each feeding. Listen and you should hear the baby swallowing milk. Muconium, baby's first black sticky stool, will pass. The texture and color will change from a blackish green to a brownie batter consistency. By day 4 or 5 the color will be yellow. Wet diapers will appear by the second day. By the end of this week, the frequency of wet diapers will increase to 2 or 3 per day.
A baby that is not doing well will also give hints to his condition during the first week. There is reason to be concerned if a baby has a weak sucking reflex, little or no desire to nurse and cannot sustain a feeding for at least 15 minutes, 8 times per day. Something is likely wrong if there is a clicking sound when a baby nurses, the cheeks dimple when the baby sucks, or the baby falls asleep before nursing for 15 minutes. If the pattern of stools don't progress and transition and there aren't wet diapers within two days of birth, this is not normal. If these symptoms are observed for two days in a row, seek medical assistance.
THE FIRST FOUR WEEKS
Signs of a healthy baby will be similar for the first month. The second to fourth week, babies continue to have two to four yellow stools and nurse eight times per day. Urine should be clear, not yellow, 6-8 times per day. The baby's suck will gain in strength; You should see some milk at feeding and hear your baby swallowing. The baby should increase in weight and alertness.
Continue to monitor anything out of the ordinary in weeks 2 to 4 - infrequent or bright yellow urination, stools that are small or too seldom, fewer than 8 feedings per day. Measure your baby's length and weight; these should increase. Should the baby have a weak or tired sucking reflex, if you can't hear swallowing, if the baby becomes sluggish, slow to respond or refuses to sleep between feedings, these are all indications that something is not right. These behaviors for two consecutive days mean you should seek medical assistance.
THE 5TH THROUGH THE 10TH WEEK
During this stage, the baby's feedings may go down to seven per day. This is due to your growing baby's ability to hold more food. Further changes may be noticed in bowel movements: they can either increase to several small stools per day, or one large one every third day. This isn't unusual in breastfed babies as they assimilate much of the milk. Six to eight wet diapers will continue daily, but check to be sure there isn't a concentrated yellow color. Expect increased alertness, strengthened suck, audible swallows and a little milk dribbling at feeding time.
During this 5th to 10th week you may have reason for concern if your baby doesn't nurse at least seven times per day or produce the right amount of wet (not bright yellow) diapers each day. Note carefully whether or not your baby is gaining weight and getting longer. Babies that can't be heard swallowing and have a weak suck are not likely to be getting enough nourishment. Seek medical assistance if your baby becomes lethargic, slow to respond or unable to sleep between nursing sessions. A couple of days in a row of these indicators mean that something is not well with your baby.
MONITORING YOUR BABY
Knowing when your baby last ate and how often can be complicated enough if you were operating on a full night's rest. Expecting a new, sleep-deprived mama to do this can be overwhelming. One solution is to keep a pencil and a notebook near the sleeping baby. Whenever mama feeds or changes the baby, note the time and what was done along with your observations. For example, you might write: "4:00 p.m., b-fed 15 min., wet diaper - clear, no poop" For clarity, you may want to start a new page each day with the date written at the top.
Should you need to confer with your doctor, you'll be able to reference your notes for detailed information. This is also a good way for a new mama to bond with her baby. Your weariness may make it difficult for your to identify the cause of your baby's crying, but your list will provide you with the information you need to know if it's been too long between feedings or bowel movements - identifying the cry as hunger or constipation. This tool helps a mama learn to identify the different cries of her newborn. This list will then encourage a mother to trust her instincts as she learns to identify her baby's different cries and meet those needs.
The BEST advice for new mamas, however, comes from not-so-new mamas. The first few weeks are to be enjoyed to their fullest. Other things can wait while you take the time to get to know your baby. In a flash, they are no longer little.
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