It can be difficult for a new parent to know when a baby is sick. Health care workers are so used to requests for information that a parent's genuine concern can sometimes be treated too casually. It's enough to make a mama doubt her own instincts.
It will come as a relief to know that there IS a way to objectively measure a baby's health.
WEEK ONE
From the start, newborns will need to nurse for no less than 15 minutes, 8 times per day during the first week of life. A mama can hear her baby swallow milk during feeding. Baby's first bowel movement will be a black paste called muconium. This will transition from a black-green color to a brown doughey consistency. By day 4 or 5 the color will be yellow. During the first two days of life, a child should begin to have wet diapers. By the end of this week, the frequency of wet diapers will increase to 2 or 3 per day.
An ill baby will show definite physical signs of his condition. 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. Signs that something is wrong can include a clicking sound when the baby nurses, cheeks that pucker inward and dimple when the baby sucks, or the inability to stay awake for a full 15 minute feeding. When the baby's diapers don't show stools progressing as they should and you don't see wet diapers within 48 hours after birth, there is something out of the ordinary. Two days of these symptoms indicate that you should seek medical help.
THE FIRST FOUR WEEKS
The signs that your baby is healthy will be pretty much the same throughout the next 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 suck will strengthen, and you should see milk and continue to hear swallowing during feedings. Your baby will grow both in weight and alertness.
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. 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. As your little one grows, he can take larger feedings. Bowel movements will continue to change and will settle into a pattern of either several small stools in a day or a large bowel movement every 2 days. This isn't unusual in breastfed babies as they assimilate much of the milk. The wet diapers (6-8 per day) will continue in frequency, but check to be sure the urine isn't a yellow concentrate. Expect increased alertness, strengthened suck, audible swallows and a little milk dribbling at feeding time.
There may be reason for concern if a baby fails to produce the right amount of wet diapers without bright yellow color, or if the baby doesn't nurse at least seven times daily. Length and weight should increase for baby. 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. If you see these things for two days in a row, something is not right with your baby.
KEEPING TRACK
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 simple way to remedy this is to leave a notebook and pencil near the baby's sleeping area. Write down the time of each feeding and changing along with your notes. An example might be: “2:00 a.m., Nursed 20 minutes, wet diaper/clear, bm - greenish yellow." Start with a clean sheet each day. Write the date at the top of the page.
This way, should anything seem out of the ordinary, you can refer to your notes and present them to a doctor if needed. This is also a good bonding tool for a new mama. By looking over her list, even a weary mama can tell at a glance if the crying is due to hunger (too long between feedings) or constipation (hasn't moved his bowels). In turn, you begin to interpret your baby's cries and what they mean. This goes a LONG ways towards helping a new mama learn to trust her instincts when it comes to her baby.
Yet, BEST advice is often the most common advice, and it comes from the not-so-new mothers. 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. In a flash, they are no longer little.
If you're a new parent, you might like more tips on child training. No Greater Joy has written a best a bestseller called To To Train Up A Child that has helped thousands as well as publishing many articles on their website dedicated to helping parents bring up children they enjoy.
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