Written by Monali Bordoloi and published on 22 July 2021.
Are you a new mom with an endless list of questions for your paediatrician? If so, this article should answer some of your common queries. Time to clear your doubts by looking at some FAQs.
We understand you. It is easy to get overwhelmed when there is an overload of information from friends, family and the Internet. From well-meaning relatives to neighbourhood aunties, everyone seems to have unsolicited advice for your baby. As you're learning to adjust to your new life with your little one, you also have lots of questions - from feeding to diapering to nighttime routine, everything is new and intimidating. Even if your questions are silly for some, they are important to you. And you will do everything you can within your power for the well-being of your little bundle of joy. To help you in your quest to be an informed parent, and clear all your doubts, we have teamed up with the renowned paediatrician, Dr Jitender Nagpal. He has answers to all your common queries, that are FAQs from new moms on newborn care.
Why is my child active during the night and sleeps through the day? How to get her to sleep through the night?
When the baby is in the amniotic fluid (the protective liquid covering the baby in the womb), she is gently rocked when the mother walks around. This rocking motion is soothing and puts her to sleep. As soon as the mother stops moving, the baby starts to kick. That is the reason why a pregnant woman feels most of the fetal movements right about her bedtime. This behaviour continues into the post-delivery period, and the baby is likely to be active when the mother is about to sleep. However, this pattern will change in a couple of months. Initially, she may be awake for 2 to 3 hours a day. After a month or two, she will become more alert and will be awake for 4 to 5 hours.
To help your infant sleep through the night, you can try to keep her awake during the day, with activities like bathing, light massaging and spending time outdoors. On the other hand, if you try to put your infant to sleep during the day, like the way many parents tend to do in order to finish their work, she is going to stay up at night, messing up her sleep cycle. Remember, it is important to let your baby have her own schedule during the first month. But after that, you can try and be smarter.
Do I need to bathe my baby daily? How to keep him hygienic and clean?
We recommend bathing your newborn daily, especially during summer time. Using soap and water is alright, but do stay away from creams or moisturisers. They offer no help except for their artificial fragrance. Also, bathe your baby after giving an oil massage.
Should I wake up my newborn to feed him or wait for his cues for hunger?
This is another common FAQ from new moms. To answer this question, it is better to 'feed your newborn on demand', which means that you should feed her when she cries for milk. Generally, you can look for your little one's cues, but in certain situations, you can be proactive. In the first 48 hours, you can feed her when you can. If your newborn is less than 2.5 kg or over 3.7 kg, you have to be more attentive. It is highly recommended that new moms feed according to the baby's demand instead of going by the clock. Try and stick to the cues of your little one as often as possible.
Why my infant throws up everything that he drinks or eats?
For babies under six months, it is normal to spit up a bit of milk. This is quite common, and you don't have to worry. But also, babies don't normally throw up everything they eat or drink. If that is happening to your baby on a frequent or regular basis, he needs to be checked by a doctor.
With issues like throwing up, it is important to look at the age of the baby. For an infant younger than 6 months, there is a chance that the milk might backflow, which is called reflux. This happens because he is always lying down. A small amount of reflux is quite common in babies. This is normal and harmless.
Eventually, babies will be able to sit by the time they are six or seven months old. By then, the reflux should go away. If he suffers reflux after this point, you need to look at the pattern of his weight gain. On the other hand, if he is gaining weight appropriately, throwing up a little bit of food is fine. If your little one is not gaining weight appropriately, then your paediatrician will have to investigate further.
How often do I need to sterilise my child's teether/pacifier and feeding bottles?
Ideally, you should sterilise your child's pacifiers and feeding bottles before every use. However, we don't usually advise using pacifiers because it is really difficult to keep them hygienic.
My newborn's stool is black in colour? Why does the texture and colour of the stool change as the child grows?
The texture and colour of your newborn's stool tend to change with age. Your newborn's first stool will be black in colour. By the third or fourth day, it could become greenish colour. Then, it becomes yellow, and later, it becomes watery yellow with some granular matter in between. Hence, after the first week, a normal breastfed newborn should have watery stools with yellow granular matter.
These stools also change in frequency. Initially, your child may pass stool 2 to 3 times a day. Between the seventh and tenth day, the frequency of stools can be as high as 15 to 20 times. This is called transitional diarrhea, and there is no need to panic. In effect, every breastfed baby goes through this particular pattern and does not need any treatment.
My newborn pees so frequently, is it normal?
For any newborn baby, it is normal to pee very frequently - even as high as 12 to 16 times a day. So, be prepared to change diapers. A newborn who pees frequently is not usually a medical concern. However, if she is not peeing or if the quantity is low even after feeding, it could be a cause for concern.
My newborn does not pee much. Should I be worried?
After the first 48 hours of life, your newborn should be passing urine at least five times every 24 hours. If not, then it is possible that she is not being fed adequately.
How long should I breastfeed? When can I stop?
The duration of breastfeeding needs to be on demand, just like the interval of feeding. Since every mother-child pair is unique, the duration of feeding differs from child to child. It also depends on the mother's milk flow and the baby's suckling reflex.
Most babies on average feed for 15 to 20 minutes. If an infant is continuously feeding or is unexplainably hungry after 30 or 40 minutes of feeding, it is a cause for concern. The baby might not actually be getting enough milk or there could be issues with the breastfeeding technique.
How often in a day should I breastfeed? Whenever the baby cries or should I follow a feeding routine?
Routine feeding or feeding by the clock is not recommended. The frequency of feeding should be decided by your newborn's demand, which is expressed through hunger cues. This pattern of feeding on demand may occur in phases. Your baby may want to feed every 30 to 45 minutes for a period of time. Then, it may change to every 3 or 4 hours. This variability is called 'phasic feeding', but this is not something you should worry about. On average, mothers successfully breastfeed babies between 12 to 14 times in 24 hours. But that does not mean that your child will follow a scheduled routine.
How can I tell if my baby is getting enough feed?
This is one of the most common concern among mothers. We usually determine whether an infant is getting enough feed based on two things. The first indication we look for is whether the baby is passing urine more than 5 or 6 times in 24 hours, after the first 48 hours of his life. Secondly, we see whether the weight loss or weight gain pattern is appropriate for the baby's age. Your baby's feeding time, interval or frequency is not the right yardstick to measure your baby's diet. Many times, these questions only add to unnecessary anxiety. There is nothing to worry if your child is feeding and passing urine regularly.
Some say it is good to hold and carry the baby often, while others advise against it, as the baby would get used to being carried all the time. What should I do?
This is a psychological question, which has been studied and tested. It has been found that babies who are picked up at first cry tend to be more stable emotionally. As they grow and cross their one-year milestone, they are found to be less irritable and fussy. So, there is no medical reason behind not picking up your little one when she needs your time and attention.
Why does my baby have a huge pulsating soft patch on his head?
This soft patch is called anterior fontanelle, which is basically a gap between the bones. As your baby's brain is still growing, the bones are not yet solidified or fused. This gap is necessary to allow the brain to continue to grow in size, which will happen for the first two years of your baby's life. As she grows older, her brain's growth slows down, and the gap closes. The bones usually fuse by the time your child is 18 months old.
Why does my newborn cry so much?
Your newborn cries so much because it is the only way of communication he knows. If your baby is hungry, wet, uncomfortable, wants to be picked up, or feels anything for that matter, the only way for him to communicate with you is by crying. The onus of deciphering the reason for crying, unfortunately, rests with the parents. You need to follow a step-by-step approach by checking whether the baby is wet, hungry, feeling too hot or cold, or if there are other discomforts.
Why is my newborn losing his birth weight?
Every baby loses around 7 to 10 percent of its weight within the first week and usually regains its birth weight between 7 to 10 days of life. Since the baby was soaked in amniotic fluid in the womb, she has all the extra water weight at birth. She loses this extra weight in the first few days when she is exposed in the air. This weight loss is expected and normal. We start to monitor your baby's weight closely after the first week. However, it is essential to keep a close eye on the babies who lose too much weight.
Should I vaccinate my kid as per the vaccination chart been given by a doctor?
Yes, of course. There are various charts available, but the most commonly used one is published by the Indian Academy of Paediatrics, an expert body on vaccination guidelines. The chart recommends the best available vaccines for public use. There is also a government chart, which is slightly different. This chart focuses mostly on affordable vaccines. As a thumb rule, your doctor's chart will advise you on what is best for your kid.
Dr Jitender Nagpal is a Consultant and Head of Pediatrics, Sitaram Bhartia Institute of Science & Research, Delhi.