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. It’s enough to make a mama doubt her own instincts.
The good news is that there are tangible and objective measures of a baby’s health.
WEEK ONE
A baby should nurse a minimum of eight times each day for a period of at least a quarter of an hour each session during the first week of life. Listen and you should hear the baby swallowing milk. Muconium, baby’s first black sticky stool, will pass. This will transition from a black-green color to a brown doughey consistency. By the fourth or fifth day, this will appear yellow. Wet diapers will appear by the second day. The number of wet diapers will increase to two or three each day be the end of the week.
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. It is outside of a healthy range if the baby’s stools haven’t changed and there is no urination two days after the birth. If these symptoms are observed for two days in a row, seek medical assistance.
THE FIRST MONTH
A healthy baby will continue to have healthy signs for the next month. Each day a healthy baby will nurse for eight sessions and produce 2-4 yellow bowel movements. Wet diapers will likely occur between six to eight times per day with clear, not yellow, urine. The suck will strengthen, and you should see milk and continue to hear swallowing during feedings. Your baby’s alertness will increase as well as his size.
However, in this 2nd to 4th week, you should make a note of anything that is out of the ordinary such as a baby not eating at least 8 times per day, infrequent or small stools, too few wet diapers, or if the urine becomes bright yellow. 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. Should you observe these behaviors for a couple of days in a row, seek out a health care provider.
WEEKS FIVE THROUGH TEN
In the second month of life, a baby might reduce the number of feedings to seven times per day. This is because he is growing and can take in more milk. 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. In breastfed babies, this is normal because the body assimilates much of the milk with little waste. Check the wet diapers to make sure the urine isn’t bright yellow; there should be six to eight wet diapers daily. Along with increasing alertness, you should continue to see a strong suck, milk dribbles, and hear an audible swallowing 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. Weak, tired sucking without an audible swallow indicates the baby is not getting proper 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.
HOW TO KEEP UP WITH IT ALL
Remembering how often and when a baby ate can be a challenge when you are well-rested. It can be overwhelming to expect a new mother to know this with reduced sleep. One solution is to keep a pencil and a notebook near the sleeping baby. At each feeding or changing, jot down the time and any other notes. An example might be: “2:00 a.m., Nursed 20 minutes, wet diaper/clear, bm – greenish yellow.” It may help you to start a new page each day with the date written at the top.
Your detailed list will be of great value to you and your doctor should your little one become ill. This is also a good bonding tool for a new mama. You may be too tired to figure out why your baby is crying, but a quick check of your notes will tell you if it’s been too long since he ate (hunger) or if he hasn’t had a bowel movement that day (constipation). In turn, you begin to interpret your baby’s cries and what they mean. 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. Enjoy these first few weeks to their fullest. Don’t worry about filling your day with anything more than getting to know this new little one. They aren’t little for long.
Interested in more child training tips? No Greater Joy is a ministry dedicated to helping parents bring up children they enjoy. They have written a bestseller called To Train Up A Child that has helped thousands.
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