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Postpartum changes For Baby

The journey from your womb into the outside world was an interesting and tiring one for your baby. No matter how he was born, his head likely spent some time moulding (changing) to fit through your pelvis. He also did a lot of work to be able to come into your arms, including working with you to find the best way through your pelvis. He looks like a newborn, not quite like infants you may be used to seeing in photographs, but everything about his little body is there for a reason.

Adapting to life outside the womb
As soon as your baby is born she begins adapting to life outside your uterus. The world is a strange place – she is feeling air and cold on her skin and gravity on her body for the first time. She is also perceiving light and sounds in a very different way from the way she heard them in your uterus. She has more room to stretch her arms and legs and her body is in a new position. In addition to these strange sensations, her body is adapting to working for itself. Her lungs are working for the first time and supplying oxygen to her body. Her body temperature has to regulate itself, which is best done in her parent’s arms. She is wide-eyed and alert, taking in the strange new environment around her, being able to focus on things that are about 20-30 centimetres away. Most babies are interested in sucking within a few minutes after being born, and if left alone many of them can use their reflexes to crawl from their mother’s belly to her breast.
During the time after it is born your baby will be given an APGAR score (usually at one minute and five minutes after birth) which is a score out of ten to see how well she is doing (your midwife or doctor will assess her heart rate, respiration, muscle tone, reflexes and skin colour). The cord will be cut after (hopefully) letting it pulsate until it turns limp and white. This is painless for your baby and you.
After a few hours, your baby will probably fall fast asleep and you and your partner can also take the time to rest after the exciting and tiring experience of labour and birth. This is a good time to let your family members know that the baby has arrived. Your midwife or doctor will check on you and your baby every so often during this period.

Newborns in real life

First bath
Babies are not washed for at least the first day or two after birth. They are covered in protective vernix which is important for their skin in the first few days of life. After birth baby should be wiped (dried) of any blood or stool and placed on your body in skin to skin contact. This may seem messy but it is very important for the baby’s adaptation to life outside the womb. Baby’s first baths should just be quick rinses in water. Be mindful to keep her as warm as possible before and after
being removed from the bath. Wipe down all baby’s crevices and folds (under the neck, behind the knees and elbows). It’s helpful if your midwife can help you with baby’s first bath to show you how it’s done, and if your partner or another loved one can be with you too.

Umbilical cord
Right after birth your baby’s umbilical cord is plump and wet, with visible blood vessels roping through it. As it pulses it moves the baby’s blood from the placenta into his body and slowly becomes limper and whiter as it empties. Once it is limp and white it can be clamped with a plastic clamp and cut. Ideally there will be at least two or three inches of cord between the baby’s body and the clamp. Once the cord has dried out you can remove the clamp – this usually happens a day or two after birth. The cord should be kept as clean and dry as possible - wash your hands before touching it, fasten your baby’s diaper under the cord and if it gets dirty, wipe it with a cloth and let it dry thoroughly. If it gets wet when you bathe baby, dry it off gently and make sure it is dry and clean before you dress baby again. The cord will fall off by itself once it dries off sufficiently, usually within a week after birth. Once the umbilical cord falls off some residual blood or sticky yellow fluid may remain in the belly button - this is normal. If the cord or the belly button become foul smelling, puss starts to form or there is more than a drop or two of bright red blood, call your midwife or doctor.

Your baby’s head is large and after vaginal birth is cone-shaped (it will take on a rounder shape a few hours after birth). Her face may have blotches or bruises after labour and birth; these will go away within a few days. Her skull has two soft spots, one at the top and one at the back, which allowed her head to mould to fit through your pelvis. Be gentle with her head, especially when washing or brushing her hair. Her neck needs extra support to hold her heavy head for the first few
months of life, so always keep your hand near it.

Baby’s breathing is faster than adult breathing and your baby may make grunting sounds when sleeping. This usually stops about a month or two after birth, when the baby’s breathing also becomes slower.

Hormonal swelling
Due to the effects of its mother’s hormones, your baby may have swollen genitals or swollen breasts for the first few days after birth. Little girls might experience some light vaginal bleeding.

Sucking blister
Intense sucking sometimes causes a small white blister or callus to form in the centre of baby’s upper lip. This is painless, doesn’t need any treatment and goes away over a few weeks.

Baby’s skin is usually red, blotchy and flaky for the first few days postpartum. This doesn’t require any treatment and will go away by itself.

Changing diapers
Baby’s first stools are sticky and black, called meconium. This is a protective substance in the intestines that the baby sheds after birth. After the second day of life, stools will turn dark green and transition to a watery mustard yellow brown colour over the first week. When changing diapers, “clean what is seen” but be careful to clean the areas behind a boy’s scrotum and around a girl’s labia majora and minora.

Meeting weight and height milestones
Initial measurements can be wrong (e.g. not read properly or recorded incorrectly). Fluids given to you by IV during labour and birth increase a baby’s weight. As he eliminates these fluids through urine, it may seem that he has lost a lot of weight after birth. Babies lose about 10% of their weight in the first three to five days of life, and it’s important to watch for the moment when they reach their lowest weight and begin gaining again. Their lowest weight after birth is the one we need to keep as a baseline. But by the time baby is four weeks old she must have gained a minimum of about 500 grams, ideally more. More information on this can be found in the section on breastfeeding.

Growing is not a race to see whose baby grows faster. Every baby grows at its own pace.

Babies don’t use language but they do communicate. Making sucking movements with his lips, sucking on his fists or fingers or moving his head as if he is looking for the breast (the rooting reflex) are ways baby is trying to tell you he is hungry. If he is crying, he is urgently seeking your attention - either you missed his feeding cues and he is very hungry, he is wet or soiled, is tired, is in pain or just needs to feel safe in the arms of a loved one. Responding to your baby’s cues before they become
frantic cries makes it easier to meet his needs and calm him down but also teaches him learn to trust that his needs will be met. With time you will figure out why he is crying at a given time, but until then a good rule is to offer the breast whenever he is upset or crying or to try rocking him in a sling or carrier. Carrying baby and responding to his cues will teach him to communicate his needs and be confident that they will be met. Meeting a baby’s needs does not spoil him – he doesn’t need to be “toughened up” or taught lessons – he needs to be loved and cared for.

Spitting up
It is normal for baby to spit up after eating - the muscle at the top of her stomach is immature and cannot always keep milk down. This usually stops around six months of age, when the muscle is better developed. Until then, you can try and reduce spitting up by keeping baby upright for a few minutes after a feed. Not all babies need to be burped after a feed and if your baby doesn’t burp you don’t need to worry. If she prefers a burp, help her by keeping her upright for a few minutes after a feed.
Things change, fast - once you figure things out, babies change everything around on you. Routines change, needs and sleep patterns flip-flop. This is a normal part of parenting, your baby is growing and her needs are changing. She’s not doing this to drive you crazy, she’s dealing with her own growing as well as she can. Be flexible and adapt to changes.