Early Health Problems
Your baby should do fine after he goes home if he got a clean bill of health in the hospital. Most of the more common problems that can affect a newborn are easy to uncover while he is still in the hospital, including severe infections, pneumonia, respiratory distress syndrome, and major heart defects.
Still, especially with early discharges, your baby could be born with a problem and not start to show symptoms until after you get home. And then there are problems that don't even begin until after a few days of life. Knowing what to look for should ease your worries and help you recognize when your baby might be having a problem that requires a visit to your pediatrician.
The first few weeks of breastfeeding can be difficult, especially for new parents. Afterward, once a mom has a good milk supply and the baby has learned to latch on and suck well, things go much more smoothly.
During those first few days and weeks, though, moms might struggle with nipple soreness, a baby who doesn't latch on well or who has a poor suck, and other problems. At these times, instead of just giving a bottle of formula, you should get help.
Getting help is easy if you have friends or family members who have already breastfed successfully. If not, look to your pediatrician or a lactation consultant for some expert advice. It may not be easy, but most breastfeeding problems can be overcome with the right help. It's likely that after you receive help, your baby will soon be breastfeeding without further problems.
Signs that your baby is not breastfeeding effectively might include:
Wanting to breastfeed fewer than eight to twelve times in a twenty-four-hour period
Having fewer than two yellow-green stools by three to four days after birth (these follow the black, tarry meconium stools he will have the first two days) or fewer than three to four loose yellow stools by day five to seven
Having fewer than six full, wet diapers by day five to seven, although urinating less frequently is common until mom's milk comes in
Losing more than 5 to 10 percent of his birth weight in the first week
Persistent nipple or breast pain for the mother
Remember that letting your baby breastfeed frequently, at least eight to twelve times a day, is the best way to help mom establish a good milk supply and encourage effective breastfeeding.
Problems with Formula
Although people often think of feeding problems as being limited to those babies who are breastfeeding, formula-fed babies can have problems too. One of the biggest problems is simply not tolerating the formula, which might lead to your having to change to a different type. This means if you are giving your baby a cow's-milk-based formula, you might have to switch to a soy or elemental formula.
Because the different brands of the same variety of formula, such as Enfamil Premium Lipil and Similac Advance, have the same protein (cow's milk) and sugar (lactose), changing from one to another is usually not helpful when your baby has a real formula intolerance.
Many of the things that parents interpret as problems with food — such as the baby having gas, spitting up frequently, or having loose stools — are actually normal reactions. Although changing the kind of formula your baby drinks is not usually harmful, it can lead to increased anxiety if you think something is wrong. That is why it is usually a good idea to talk to your pediatrician before changing formula.
Another problem that formula-fed babies can have is simply not eating enough or eating slowly. After the first few days of life, most babies will drink about two to three ounces of formula every three to four hours. Talk to your pediatrician if your baby is drinking much less than that or regularly going longer than three to four hours without wanting to eat.
Poor Weight Gain
It is expected that a baby will lose weight during his first week of life. This upsets many parents who were happy with their healthy seven or eight pound baby and who don't like to see him drop even an ounce. However, your baby will almost certainly lose at least 5 to 10 percent of his birth weight during the first week. This weight loss is mostly because newborns lose excessive fluid they are born with and because at first they can't eat enough to keep up with their caloric needs.
A greater weight loss can be a problem, though. Or it might indicate a problem if your baby loses weight too rapidly. If your baby is already down 5 or 7 percent after just one or two days, then by the end of the week the loss might be well over 10 percent. These babies should be closely monitored every day or two to make sure that they don't continue to lose weight.
After the weight loss of the first week, your baby should start to gain some weight. You can expect a baby who is feeding well to gain at least one half to one ounce each day, so that by the two-week checkup, the baby is back up to his birth weight. Continuing to lose weight or not getting back up to birth weight by two weeks can indicate a problem, especially with feeding, and should be investigated by your pediatrician.
Developing jaundice, which is a yellowish discoloration to the skin, is very common in newborns. This jaundice typically develops on the baby's second or third day, so it may not be seen in the hospital. Jaundice that develops within twenty-four hours of your baby's birth, or which rapidly gets worse, can be a sign of a more serious problem than the typical “physiological jaundice” that most babies have.
Jaundice usually starts on your baby's face and eyes and then spreads down his body as it gets worse. You should notify your pediatrician if the jaundice seems to be spreading quickly or has already reached your baby's arms and legs. Although many babies with jaundice are simply observed until it goes away on its own, some babies require blood testing and treatment with phototherapy and special lights. Because so many people are aware of this problem, jaundice rarely gets to a high enough level to cause serious or permanent problems anymore.
Babies who have very high levels of jaundice can develop kernicterus, a form of brain damage. Although rare, the effects of kernicterus can be severe, with mental retardation, cerebral palsy, and hearing loss.
Although sickness in babies is usually discovered because they are having trouble feeding, other signs to look for include rapid breathing, excessive crying, a swollen abdomen, fever, excessive sleepiness, and persistent vomiting. However, occasional crying, vomiting, and even short periods of rapid breathing, called periodic breathing, can be normal.
One problem is recognizing whether or not something is excessive. If your new baby is sleeping for sixteen and a half hours a day, is that excessive? It sounds like a lot, but is actually average for a baby in the first week of life.
It can be hard to recognize when young infants are sick, so if you think there is something wrong with your baby, be sure to call your pediatrician. When your child's health is at stake, it's always better to be safe than sorry.