Helpful Newborn Tips from a Pediatrician

Parents can sometimes feel overwhelmed with inadequacy once they are home with their baby. Unfortunately, we can’t bring the nurses home with us, so we asked Dr. James Ross, a Tulsa pediatrician, to answer some common questions about newborns and newborn care. Here are his top tips regarding newborn care.

Sleeping

Newborns sleep a lot. In fact, they sleep more than they are awake in a 24-hour day. However, they don’t sleep or stay awake for long stretches at a time. It varies, but on average, a newborn will sleep a total of 14-18 hours in a 24-hour time frame. Every parent prays their child will sleep through the night as soon as possible, but there is much variability here, depending on the baby and parenting (sleep training) approaches. Newborns will eat around the clock. Some babies will maybe get a 3-4 hour stretch at a time. I have seen babies start sleeping through the night (a 5-6 hour stretch) as early as 2 months, but most will take longer. Honestly, it is rare before 4-6 months.

Developing a routine and schedule can be helpful to get them used to falling asleep at desired times. The sooner a parent can help a baby learn to fall back to sleep (self-soothe) on their own, the easier the transition will be.

Eating

Newborns eat all the time. Breastfed newborns will eat every 2-3 hours and nurse anywhere from 15-30 minutes at a time (anywhere from 10-20 minutes per breast). The first few weeks of life, babies should be fed on demand. As they get older, they will nurse less often and won’t take as long to feed. Bottle-fed newborns can go a little longer stretch, like every 3-4 hours or so. In the first two days of life, they often take in 1/2-1 ounce per feeding, then start taking in about 1-2 ounces per feeding. By 2 weeks of age, they can increase to 2-3 ounces per feeding.

Babies typically let you know when they are hungry or when they have had enough. If babies are fed too much, they often can spit up excessively. As long as they are making wet and dirty diapers and growing, you know they are getting what they need. A little spit-up is common, but spitting up large amounts after every feed or projectile vomiting can be a sign of an underlying problem, and your baby should be checked out by their doctor.

Crying

Babies cry for different reasons, but it is their way of communicating with us to make their needs known. Crying is normal. Parents can begin to differentiate their baby’s cries. For example, when they are hungry, when they have a wet or dirty diaper, are gassy/colicky or when they are overstimulated. When the baby is crying for an excessively longer time than is normal for them, is inconsolable, has a change in the quality or sound of the cry, or if the baby has other symptoms associated with the crying such as poor feeding, decreased activity, fever or cough, then it would be advisable to call your doctor.

Pooping

Babies should have at least 6-8 wet diapers per day. The way a newborn baby’s stool looks will depend on if they are breast- or bottle-fed.  All brand-new babies have the dark greenish-black and tarry meconium stools in the first 24 hours. The newborn stools then begin to look different after 24 hours when the meconium has passed. We call these transitional stools, and they can look dark, greenish-yellow, loose and seedy.

After 3-4 days or so, the stool will vary based on breast or bottle feeding.  Breastfed babies will often have stools that are mustard looking, loose or watery appearing and have a seedy texture. Formula-fed babies can vary more but their stools are usually more formed, but still soft, and colors range from yellow to brown or brownish-green.

Bathing

Bathing a newborn is often a very sweet experience. I recommend sponge bathing until the umbilical cord falls off and is healed, which can take 1-3 weeks or so. I also recommend sponge bathing for at least one week after a circumcision as well to allow time for healing. Babies don’t need to be bathed every single day. Too many baths can dry out a baby’s skin. So, I recommend tub baths about 2-3 times a week in the first year of life.