CARE OF A NORMAL NEWBORN BABY
The vast majority of babies are normal. They are capable of going through the newborn period without too much trouble- crying, feeding, soiling, wetting, regurgitating, burping and hiccupping as and when required. However, in the highly artificial and mechanized world that we live in today, newborns are not left to lead their lives in peace. The medical profession gives technical names for perfectly normal activities. Parents get worked up thinking that every little unusual thing that their baby does is a sign of disease. We have tried to answer some Frequently Asked Questions (FAQs) by mothers- related to the care of normal newborn babies.
1.What is a normal baby?
If your baby was born with a weight of more than 2.5 kg, s/he has a normal birth weight. If his/her date of birth is within less than three weeks of the due date, then s/he has been born at full term. If your baby is a full-term, normal birth weight baby,who cried immediately after birth and had no major concerns dating back to pregnancy, then s/he is a normal baby.
2.Is it necessary to feed only mother’s milk in the first months of life?
Yes, it is absolutely necessary to feed only mother’s milk in the first six months of life. Breast milk contains everything that a baby requires during this period. Breast milk protects the baby against infections, allergies, asthma, dental cavities, obesity, high blood pressure and diabetes. Breastfeeding protects the mother against obesity, certain types of cancers and diabetes.
The composition of breast milk is so complex and it has so many “living components” (such as white blood cells and friendly bacteria) that no formula milk or animal milk can come anywhere close to it. The composition of breast milk is infant-specific, ie your breast milk is tailor-made for the requirements of your baby. There is simply no way that formula milk compositions can be modified to bring in this degree of individual specificity.
3. India is so hot in summer. Won’t my baby feel thirsty and won’t s/he require water?
No, your baby will not require water for the first six months of life. Breast milk itself contains a large amount of water which is enough for your baby. Several studies done in India and other hot countries have shown that babies who are fed water in addition to mother’s milk do worse than those were fed only mother’s milk. They have poorer weight gain and higher incidence of infections.
4. I am giving only mother’s milk to my baby. But in addition can’t I give honey or janam ghutti?
Exclusive breastfeeding means only mother’s milk and nothing else. A normal baby does not require anything else. Introducing unnecessary things that were not intended by Nature will only create problems, such as diarrhea, food poisoning and allergies. If honey, gripe water and janam ghutti were so important for a newborn baby, Mother Nature would have found some way to package these and send them to you along with the baby!
5. Mostly I give mother’s milk. However, once or twice at night I give a bottle feed after sterilizing the bottle thoroughly. Will even that small amount of bottle feed create a problem?
Firstly, a lot of mothers think they are sterilizing the bottle properly, but more often than not they miss a few steps. Sterilizing bottles is not an easy task- there are several nooks and crannies such as the hole of the nipple, the inside of the ring, the threading on the bottle and angulations within the bottle where germs can survive, if one is not meticulous about cleaning. Accidentally touching any part of the nipple or the inside of the ring/ cap/ bottle after sterilization renders the whole process of sterilization ineffective.
Secondly, even if the bottle is sterilized correctly, the occasional exposure to animal milk protein present in formula milk is sufficient to increase your baby’s risk of developing allergies, asthma and other non-infectious diseases.
6.I feel my baby is not getting enough milk. S/he is forever demanding milk.
A full-term baby should be fed on demand. This means that the frequency could be variable- every one to two hours at night when the little bundle of joy decides to stay awake, up to once every four hours during the day when your tiny tot insists on sleeping.
If you are experiencing one of the following, it means you are producing enough milk:
If your baby is experiencing the following, it means s/he is consuming enough milk:
7. My baby sleeps for most part of the day. Is there something wrong with him/her?
All newly born babies sleep for about 20 hours a day. Your baby may have appeared more alert on the first day, which is why you are concerned that s/he has started sleeping excessively from the second day onwards. This is normal. On the first day, babies are alert because of the adrenaline rush of the process of birth. After all, who would not be excited about being born?
Babies often tend to sleep more during the daytime and stay awake at night to feed (no, this is not a conspiracy on the part of babies to harass their mothers). There is a normal hormonal surge at night which results in greater milk production at night. Your baby staying awake at night is probably nature’s way of ensuring that s/he gets enough milk. Do not worry; your baby is not going to stay awake at nights forever. The day-night cycle gradually changes and normalizes within a few months.
8. My relatives advise me to avoid certain categories of foods, saying that it might harm my baby. What should I do?
As long as you are having hygienic, home-made food, it will not harm your baby. There is no scientific evidence that certain categories of foods, like daals or saags for instance, are harmful. On the contrary, excluding certain categories of foods would make your diet imbalanced and that would not be good either for you or your baby. The food that you eat gets digested completely and is broken down into the tinybuilding blocks of food. These are then absorbed through your intestines, converted into complex compounds in your body and sent via your bloodstream into your breast milk. It would be rather naive to imagine that a particular daalis going unchanged from your gut through your breast milk and is harming your baby. There are hundreds of components of food that you eat and a hundred little unusual activities that your baby would do from time to time (fussing, crying, passing stools, passing gas, regurgitating). It is very tempting to link something that you have eaten with a certain activity of the baby and to blame the food for it, without realizing that it is usually a chance phenomenon.
9. My baby passes stools only once in five days. My sister’s baby used to pass 6 to 8 stools per day. How can both be considered normal?
Surprisingly enough, the normal range of frequency of passing stools is extremely wide. Almost any figure starting from once in 5-7 days to once-a-day to 10 times per day is considered normal amongst babies. If your baby is not troubled by the stool frequency, if his/her stools contain no blood or mucus, if his/her tummy is not swollen up, if his/her vomit is not green in color, if s/he is otherwise happy and feeding well and gaining weight, it means you do not have to bother about your baby’s stool frequency. With passage of time it will gradually normalize to 1 to 3 stools per day by the end of infancy.
10. Soon after I feed milk to my baby, s/he brings out all the milk. I am exasperated.
Effortlessly throwing up milk soon after a feed is called regurgitation. Some amount of regurgitation is considered normal. The amount always appears large but is actually only a fraction of the milk consumed. If your baby is gaining weight appropriately, if s/he is not anemic, if the regurgitation is not accompanied by choking or wheezing, it tells you that this is not a disease that requires treatment. You should always burp your baby after giving a feed by gently patting his/her back. If you are concerned about his/her regurgitation, you can put your baby to sleep with the head end raised (with pillows) to about 30° and place him/her on the left-sided position. Your baby’s problem will settle on its own by one year of age.
11.How many clothes should I put on my baby?
At any given time of the year you should put one extra layer of clothing on your baby with respect to what an adult would require.
Prof Sourabh Dutta and
Newborn Unit,
Department of Pediatrics,
PGIMER