We’ve all been there- and some of you are there right now. In the thick of trying to decode a newborn (and yourself with the new bundle of joy). Until you’ve been faced with these question marks, it’s hard to know the answers. We thought that some wise words of advice from seasoned Dr. Hugh Gilgoff would help those of you who need a lifeline of knowledge. Enjoy!
~Rebecca Conroy, Former Editor of A Child Grows in Brooklyn
I think it’s harder than ever to feel confident about parenting a newborn. There are so many books and models out there, each one telling you to do something different. Most of us are having kids later, years after having success both at top academic institutions as well as within established careers. We were able to create a balance between work, family and maybe even a social life! We felt smart, confident, and perhaps even in control of our daily lives. We managed our balance of sleep, exercise and healthy eating… and then comes the newborn!
The hardest thing about newborns is that they have no schedule. For nine months in utero they were getting a continuous infusion of nutrients from mom, and they really never felt hunger. They didn’t have to digest any milk; mom took care of all of that! The changes that occur in a baby’s body during delivery and the days and weeks after are immense, and intense! Taking their first breaths, moments later drinking their first milk, and asking their intestines to digest and break down the milk into amino acids and fat and carbohydrates. There really was no day or night for them, and now comes all kinds of stimulation (and noises, and kisses)! It is a lot, and a lot for any new parent.
Making Sense of the Newborn Period
How then can we make sense of the newborn period and figure this thing out? How can we crack the code? How do we get them to be on a schedule – both for feeding and sleeping? Well, I’ll tell you the answer. After thirty years of working with kids, and after seeing ten thousand of these little ones – I will tell you the secret: you don’t!
The newborn period will usually last about two to three months for a full term, healthy baby. It’s not that they need to get to a certain weight- but rather they need to develop. To blossom and emerge. We need to be able to truly understand them – to read their cues – and only then do we have a shot at figuring them out and establishing a true pattern or schedule of sleeping and eating.
You’ll hear about feeding on demand, and whether you are nursing or giving formula (or both) that is honestly the right approach. We don’t want to miss their cues, and not feed a baby who is truly hungry. We want to meet all their needs, and immediately if possible. This may not be my advice on older kids, and some would say you could spoil even a nine month old! But the newborn can’t be spoiled – there can’t be any bad habit that you are starting with a brand new baby. So, the best approach is to watch their every cue, learn and love them, and feed them often. When in doubt, it is ok to offer milk (and as much as they want). A premature baby in the NICU will have to be monitored more carefully. But a full term, healthy baby will tell us when they are full. They will pull off the bottle or breast, suck with less vigor, or give us the easiest cue to read, and simply fall asleep for a few hours. This sleep proves they weren’t hungry, as hungry healthy babies will cry.
In the hospital you do hear advice about waking a baby, and feeding them every two and a half to three hours. This isn’t necessarily wrong advice, but once they prove that they are healthy, and regain their birth weight and have seen the pediatrician, I usually say, “don’t wake a sleeping baby, ever.” Healthy babies who have proven they can gain the appropriate amount of weight will not allow themselves to just get dehydrated or malnourished.
Of course a lot of issues will come up with nursing and achieving an efficient latch, and I take great care in that first visit to look for any tongue-tie, yeast infection, or supply issue that can interfere with nursing. Once we get to that smooth-sailing period (where nursing is natural and painless) and baby is gaining their weight, then we really should follow their lead and feed on demand.
Growth spurts and cluster feeds don’t come at the same time for each child, so don’t read the books as much as you read your child and their cues. When they do go through those growth spurts they will seem voracious, and most likely your supply will keep up without a problem. The growth percentiles are not the laws nor should they be a measure of overall health, and every baby is different indeed. A bigger child is not necessarily the healthier child, and it is just fine to have a petite child. There is nothing more reassuring than seeing a good growth velocity in the first few weeks and months (a good rate of rise) so I utilize the growth percentiles, but pay careful attention to the “bigger picture,” as well as in newborns.
Most babies get fussy or colicky in the first month, so expect a fuss and hope it doesn’t turn into full-on colic. We often need to check the weight to reassure us that the fussy baby isn’t the hungry baby, but following their pees and poops can also be a guide. Colic can be an intense phase, but most babies will power through it by three months of age.
By looking for the proper scheduling we assume we can always read their cues, and that is just so hard in the newborn period. If we were sure they weren’t hungry, then it would be easier. You can feed an older baby for comfort, but I would advise against that. The hard part is really knowing if they are hungry or just fussy in that first couple of months, as there are so many factors and variables all going on at the same time!
Once they get older and blossom and develop, things do get easier. They will talk with us in their own language and you’ll be able to read them better. You’ll see when they are truly hungry, or when they just want to be held. You’ll read the growth spurt versus the pre-teething oral sensations versus the sassy attitude that starts way too young!
But during that precious and trying newborn period, the best attitude might be just too buckle up and ride the waves. Look out for badness (fever, fast breathing or lethargy) and notice general patterns or flows, but try not to micromanage or over analyze each day when they are so young. We all do it (my wife and I went through it as well)! But, the harder we try to find the schedule in the newborn, the higher the stress level. The sooner we let it go, and allow them to take the lead (albeit on a very rocky road) the easier it will be for the entire family. So love your baby to death, and hang in there!
Dr. Gilgoff has been working with kids since 1986, and has been a pediatrician since 1996. He is available for same day sick visits, second opinions, well-child care and free prenatal consultations. More of his thoughts can be found at www.drgilgoff.com as well as the mountsinai.org website.
Also by Dr. Gilgoff:
https://www.achildgrows.com/2008/09/29/fever-jaundice-rash-spit-up-and-more-by-dr-gilgoff/