FIRST DAY HOME
It is amazing how most babies instantly transform from being beautiful, quiet, perfect infants in the hospital to demanding and crying babies the second they arrive home. It is true, however, that babies become more alert and hungrier 24-48 hours after birth. The first few days are a major adjustment for babies and parents alike. This can be a difficult time, but it is also a time to finally settle down and start to get acquainted with one another. You will find your baby loves to be handled. Babies are comforted by gentle, firm handling and prefer to be wrapped snuggly in a light blanket and cuddled. WHAT IS NORMAL?
Let’s face it. Babies are STRANGE. They burp, sneeze, spit up, pass gas, make faces, grunt and cross their eyes on a daily basis. All these things are NORMAL for them. They can turn red in the face and make horrible sounds in the process of having a perfectly loose stool and this WON’T mean they are constipated!
Your baby’s head may have undergone some “molding” during the birth process. It may look a little lopsided and have some bruising. The skull bones may also overlap slightly. This is all normal and gradually goes away in a few days. All babies have “soft spots” where the skull bones come together. The biggest one is on top of the head in the front. This area may even pulsate, which is normal. It is not a tender area and may be washed thoroughly.
Your baby’s eyes may have some swelling or discharge in the first day or two after birth due to irritation from the antibiotic ointment placed in the eyes at birth to prevent infection. Any discharge should be rinsed away with water and a clean washcloth. If the discharge doesn’t clear within a few days, call the office during office hours. Many babies have tear ducts that don’t function well in the first few months of life. These babies collect mucus in their eyes until the tear ducts start to drain. This is NOT an infection. Treatment involves keeping the eyes rinsed with warm water and massaging the tear ducts. This technique can be demonstrated in the office. Contact our office during regular hours if your infant has persistent eye drainage. We usually treat this problem conservatively as 90% resolve by 12 months of age.
After the first few days, your baby will begin to open his eyes more and look around. Babies can’t focus well or follow moving objects at birth. However, they can see short distances and like bright colors. Over the first 2 months, they begin to focus better and begin to track moving objects. They may occasionally look cross-eyed and this is not a cause for concern unless it persists longer than 4 months.
Your baby’s nose may become congested with mucus, particularly in the first few weeks after birth. Use a bulb syringe with a plastic tip to clear the mucous. If the congestion isn’t relieved with your baby’s spontaneously sneezing or with the use of the bulb syringe, you may use saline nose drops. These can be purchased over-the-counter at any pharmacy (Ocean Spray, Ayr, etc.) or you can make up your own by mixing ¼ teaspoon of table salt in 4 ounces of tap water. Use 2-3 drops in one nostril, then suction after a few seconds. Repeat, other side. If the stuffiness doesn’t interfere with your child’s breathing or feeding, try not to let it bother you. Some babies sound stuffier than others. Simply propping up your baby in an infant seat may help. Persistent congestion is often related to exposure to cigarette smoke or wood heat.
Many babies have nipples that appear raised and swollen. They may even have a milky discharge. This is due to hormonal changes and will normally subside in 3-4 months. Don’t squeeze or rub medication on the nipples, as it will only irritate them.
The genitals of both boys and girls may be swollen at birth. Girls commonly have a white discharge with some blood streaks from the vagina for up to 1-2 weeks after delivery. Boys often have a swollen scrotum, which usually contains fluid (a hydrocele); this normally resolves on its own during the first few months of life. However, If the swelling comes and goes or worsens, it may indicate a hernia. Call the office if this occurs.
Most babies have bowed legs or feet after birth. This is not a cause for alarm and almost never requires treatment. It is usually due to how they were “packaged” while in the womb and straightens out in due time. If you are able to passively move your baby’s legs or feet into a neutral position, they will get there on their own eventually.
Your baby’s umbilical cord will drop off at some point during the first 2-3 weeks of life. It is normal for there to be a few drops of blood when this happens and there may be some drainage intermittently for several days. Clean the area with alcohol when you notice blood or discharge. If the area develops red streaks on the skin or a foul odor, call the office. If your baby appears to have an “outie” or protruding umbilicus after the cord is off, no special treatment is needed. (See section on “Umbilical Hernias”)
Sudden movements, bumps and noises produce startle reflexes (jerky movements, throwing arms and legs out wildly). Babies also jerk or twitch for no apparent reason, even while asleep. Gentle, firm handling and calm, reassuring voices are easily sensed by your baby. As your comfort and confidence levels increase day by day, your baby will also be more calm and will overreact less often.
Newborn babies often have a rather irregular breathing pattern while sleeping. You will notice breathing may vary over 10 to 20 seconds from being very shallow and quiet, increasing in intensity to being deep and strong. This is called periodic breathing. Babies also appear to "sigh" and "catch their breath”. They occasionally sound "rattly", especially during or after feedings. This is due to secretions above their airway and the babies will not act bothered by this. It will only bother us parents, as we would like to have them "clear their throats”, but they don't! This is normal.