You are here

Your New Baby: A Troubleshooting Health Guide

The first few weeks with your baby are a lot like boot camp. You get next to no sleep, you find yourself frequently surrounded by screaming, and you worry that you'll do something wrong.

Your infant's a bit stressed too. She may feel as if she's made a wrong turn somewhere: Instead of swimming in warm comfort, she's suddenly sleeping on a cold, hard bed...surrounded by bars. Fortunately, a baby is sturdier than you think. (You are too, but that's another story.)

"Most infants are born without any complications," says Joshua Copel, M.D., chief of high-risk obstetrics at Yale New Haven Hospital, "and their immune systems are made stronger with maternal antibodies [infection-fighting proteins] passed on during pregnancy." And, as moms soon realize, the more you know about your baby, the more you can relax and enjoy. To help you get there just a little sooner, here's a no-worries guide to the most common newborn health concerns.

 

He sleeps a lot!

The average newborn snoozes for 16 to 18 hours a day, waking up every one to four hours for a feeding. He won't establish a pattern of sleeping during the night more than during the day for a month or more. If you're concerned that he's lethargic rather than simply sleepy, check his diapers. "A newborn should wet a minimum of six to eight diapers a day," says Claibourne Dungy, M.D., a pediatrician at Children's Hospital of Iowa, in Iowa City. "Anything less and he may be dehydrated." That can be self-perpetuating: "The less a baby eats, the less energy he has to eat."

Call the pediatrician if: your newborn sleeps for longer than six or eight hours at a stretch, is hard to rouse, skips more than three feedings, has difficulty latching on to the breast or bottle, or has a temperature below 97°F or above 100.4°F.

She Cries So Much!

"Ella had one of those bloodcurdling screams pretty much round the clock," says Kelly Sklar of Houston about her baby, now 4 months old. Most of the time, the problem was hunger. "Just about the only reason she cries now is if I'm a few minutes late with her bottle," says Sklar.

The average full-term infant needs to nurse every one and a half to two and a half hours, since breast milk empties rapidly from the stomach, while formula-fed infants eat about every three hours, says Maura Frank, M.D., an assistant professor of pediatrics at New York Presbyterian-Weill Cornell Medical Center, in New York City.

If after eating your baby arches her back, spits up a lot, or releases a high-pitched wail, she may be experiencing gastroesophageal reflux  -- painful heartburn. (Elevating the head of the crib about 30 degrees and burping her frequently may help comfort her.)

If it's not hunger (or heartburn), besides checking to see if your baby's diaper is wet, make sure it's not stuck to her bottom or too tight; if you're using cloth diapers, be sure the pin isn't touching her. Or undress her completely and do a top-to-bottom check; sometimes a strand of hair can get wrapped around her finger or toe and pinch.

Still crying? She might be extra sensitive to loud noises, vibrations, and changes in the room, such as lights being turned on or a window being opened. Many moms find that the best soother is a "mummy wrap": Turn off the TV and the phone's ringer, swaddle your baby in a blanket, and hold her close.

If nothing works, it might be colic, which affects 20 percent of babies. The cause isn't known, but the excessive fussiness usually starts between weeks two and four, peaks around week six, and subsides by the time the baby's 3 months old. So just hang in there.

"I'd set Ariana  -- she's eight years old now  -- in her bouncer on the dryer at times until she fell asleep," says Jennifer Ortiz of Lexington, Kentucky. Judith Matloff of New York City nestled her son, Anton, now 3, in her arms and swayed him along to some tapes of Angolan ballads. "They're slow and haunting, with a rhythm similar to a heartbeat. I guess that's why they soothed him."

Of course, you may have a baby who doesn't cry much at all. "Not every newborn is a crybaby, and that's normal too," says Dr. Dungy. "Some infants are able to soothe themselves."

Call the pediatrician if: she's spitting up excessively; the doctor may prescribe a baby-safe reflux medication. Also call if she cries uncontrollably, or if she's under 3 months of age and is running a temperature above 100°F (under the arm) or 100.4°F (in the ear or rectally).

Her Poop Looks Weird!

For the first few days after birth, your baby will pass meconium, a greenish-black sticky substance that filled her intestines while she was in the womb. For the next three to seven days, she'll have yellowish-orange bowel movements that may look like the inside of a cantaloupe  -- seedy, with a ring of water around them. "That first week, when our daughter's bowel movements went from black and tarry to clear and watery, we thought she had diarrhea," says Giselle Lederman of San Francisco. So she called the nurse at 3 a.m. "We learned it was just part of the transition."

After about a week and for about the next six months, the consistency and frequency of your baby's bowel movements will depend on whether she's breast- or formula-fed. While it's normal for an infant to have a bowel movement anywhere from once every couple of days to five or six times a day, breastfed infants tend to have them less often; breast milk is so readily digested that it leaves little bulk. Breastfed babies also tend to have soft, light-mustard-colored stools, while those of formula-fed infants are firmer and tan-colored.

If your infant's stools have become hard or she's straining, she may be constipated. Try giving a little extra water during the day; if you're mixing a formula from concentrate, make sure you're preparing it properly.

Call the pediatrician if: you see mucus or blood in her stool or if she starts having diarrhea (watery bowel movements after each feeding); it could signify a food allergy or an infection. Alert the doctor if your baby hasn't pooped during her first week or if her stools remain black and sticky.

Her Poop Looks Weird!

For the first few days after birth, your baby will pass meconium, a greenish-black sticky substance that filled her intestines while she was in the womb. For the next three to seven days, she'll have yellowish-orange bowel movements that may look like the inside of a cantaloupe  -- seedy, with a ring of water around them. "That first week, when our daughter's bowel movements went from black and tarry to clear and watery, we thought she had diarrhea," says Giselle Lederman of San Francisco. So she called the nurse at 3 a.m. "We learned it was just part of the transition."

After about a week and for about the next six months, the consistency and frequency of your baby's bowel movements will depend on whether she's breast- or formula-fed. While it's normal for an infant to have a bowel movement anywhere from once every couple of days to five or six times a day, breastfed infants tend to have them less often; breast milk is so readily digested that it leaves little bulk. Breastfed babies also tend to have soft, light-mustard-colored stools, while those of formula-fed infants are firmer and tan-colored.

If your infant's stools have become hard or she's straining, she may be constipated. Try giving a little extra water during the day; if you're mixing a formula from concentrate, make sure you're preparing it properly.

Call the pediatrician if: you see mucus or blood in her stool or if she starts having diarrhea (watery bowel movements after each feeding); it could signify a food allergy or an infection. Alert the doctor if your baby hasn't pooped during her first week or if her stools remain black and sticky.

She Holds Her Breath!

"When a baby is breathing and all of a sudden he stops, you get so nervous," says Allison Rafferty of San Francisco. "My son, Bobby, would stop for eight seconds at a time!"

It might seem like an eternity, but it's completely normal. "Periodic breathing is fine as long as it's for short periods of time, up to ten seconds, there's no color change in the baby, and she resumes breathing on her own," says Dr. Frank. "It happens because the portion of the brain that controls breathing hasn't fully developed in your baby."

Even better news is that there's no link between periodic breathing and the risk of sudden infant death syndrome (SIDS), says Dr. Frank.

Call the pediatrician if: she has difficulty breathing, her hands and feet start to turn blue, or she's running a temperature above 100.4°F; she might have an infection.

His Belly Button's Red and Looks Infected!

Go ahead and contemplate his navel, but don't worry about it. Infection is very rare, though you may notice small drops of blood on his diaper when the umbilical stump is healing or after the cord falls off. That's normal. "Emily's cord came off at the end of the first week, and the stump looked like the neck of a wine bottle with chipped paint on it  -- it was red and looked irritated," says Annie Eastman of Elmhurst, Illinois, whose daughter is now 10 months old. "But a week or two later, the scabbing disappeared."

The stump of the umbilical cord usually turns black and falls off during the first few weeks. Until then, give him a sponge bath only, but it's okay if the stump gets wet; just gently towel it dry. And no need to reach for rubbing alcohol. Studies show that if you use it on your baby's umbilical cord, the stump can take up to two days longer to fall off than with dry cord care.

Call the pediatrician if: the belly button oozes pus or leaves more than a dab of blood on the diaper. Also contact your doctor if the skin at the base of the stump turns red or is painful when you touch it. Your baby may have an infection that needs immediate medical attention.

She's Got Acne!

Newborns often break out in patches of pinhead-size pimples (white dots on a red base), especially on the face, chest, belly, or back. Her skin may be reacting to the maternal hormones that surged through her in the last few weeks of pregnancy and to the change from amniotic fluid to air.

The best solution: Do nothing. "It was so tempting to try to clean them or pop them, but my pediatrician told me just to leave them alone," says Dorothy Symister of Bronx, New York, whose daughter, Zinzi, is now 2 1/2 months old. It'll clear up within weeks or, at most, a month or two; creams or ointments will just irritate the skin.

If you discover red lesions on your baby's bottom, though, it's a form of diaper rash. To treat it, change her diapers more frequently and let your infant "air-dry" without a diaper for ten minutes or so between changes.

Call the pediatrician if: the pimples are bigger than a pinhead or if they blister, pus, or crust over; she could have a bacterial or fungal infection that requires medication.

He's Got Gunk In His Eyes!

While it's not pretty, yellow goop in the corner of his eyes doesn't necessarily mean they're infected. The chances of that are very low, since all newborns are given antibiotic eyedrops right after birth.

A much more likely culprit is a blocked tear duct, which is painless. If his eyes always look wet, that's another symptom of blockage. It can happen in one or both eyes and generally clears up on its own within a few weeks or months. To loosen the ducts, massage the bridge of his nose.

Call the pediatrician if: his eyes appear red, swollen, or filled with pus.

 

comments