First-time parents tend to be unfamiliar with breastfeeding and are unaware of the warning signs that may indicate that something is not quite right when it comes to feeding their children. It is necessary to be attentive to the possible warning signs in the baby in order to act quickly and thus avoid situations that may compromise breastfeeding or the well-being of the newborn.
The first week with your baby is very exciting, but it can also be a huge challenge, especially if you have never experienced before. Read our tips on nursing newborn baby to get you started in the best way possible.
The Importance of the First Hour
After delivery, the baby should be placed on his mother’s breast to allow him to reach for the breast and take a first shot of colostrum . After that first feeding, babies often fall into torpor that can last for hours and that recovers them from the effort of labor. In the event that this first feeding has not occurred, it is important to help ensure that this encounter occurs as soon as possible, since sometimes babies who have not breastfed as soon as they are born often wake up from torpor, disoriented and can be clumsy and with difficulties in initiating lactation.
Lack of bowel movements
Weight is the most useful way to know if the baby is growing and breastfeeding is effective, but in the absence of this information, we can use the stools to assess the state of the baby, since these will give us important clues about their physical state.
Babies with exclusive breastfeeding should gradually increase the number of urinations and bowel movements as they grow. The table that accompanies this text is therefore only for babies fed with breast milk. Babies given artificial milk during their hospital stay can change their bowel pattern and make fewer bowel movements.
From the fifth day of life, the ideal would be a mustard-colored stool and the volume of a tablespoon after each feeding. Babies under one month of age exclusively breastfed should have bowel movements each day, specifically a minimum of two.
If there are no stools, find out if:
- Has the baby had artificial milk?
- How many stools have you made in the last 24h?
If you have not had any formula, you are 5 days old or more and you are not pooping, you should increase the frequency and quantity of the feedings or supplement with expressed breast milk or artificial milk.
Does not wet diapers
The baby’s urination should be light yellow, straw colored, and the baby’s urine should not leave dark signs on the diaper, as this is the first sign that the urine is concentrated, which in turn indicates that the baby does not receive a correct supply of water through milk. If clear and abundant urine indicates good hydration.
Sometimes parents do not know if the baby has urinated, since current diapers have great absorption power, so it is necessary to open the diapers and check if the gel beads inside are swollen.
What if there are stains on the diaper?
The urates, are pinkish spots that appear on the diaper, are normal if they appear in the first days of life, and are due to the concentration of the urine of the newborn, but if they appear after the fifth day of delivery, they indicate dehydration.
If a baby does not wet diapers, it is important to check their general condition:
- Fontanelle status: If the fontanelle is sunken it indicates dehydration.
- The mouth must be moist: if it is dry it indicates dehydration.
- The sign of the fold: if we press the skin and it does not return to its normal state, the baby is dehydrated.
It is vitally important to act immediately in the latter case and offer delayed milk to the baby, whether maternal or artificial, and if it is not possible to administer milk, we will give him water and transfer the baby to a hospital center as soon as possible.
Breastfeeding works on demand, but special attention must be paid to babies who are premature, sick or who do not gain weight. In these babies, breastfeeding cannot work on demand and it is the parents’ job to set the demand for the first few days until babies regain weight, are stronger, and are able to wake up and show signs of hunger.
There are certain babies that we call beautiful sleepers that despite being healthy babies and normally at term are not able to wake up to suck. These babies sleep and show no signs of hunger, which would lead to excessive weight loss if their parents did not intervene by waking them up every few hours.
In these babies it is necessary to mark a feeding demand: every two hours of day and every three hours of night.
In the event that the mother is not able to breastfeed directly, milk can be expressed and offered to the baby with different techniques : finger-syringe, glass, spoon …
When the baby is able to wake up and ask for himself, the parents no longer need to mark the demand.
Vomiting and regurgitation
Both vomiting and regurgitation are very frequent situations in babies. Although it may seem that it is the same, because in both cases there is expulsion of stomach contents through the mouth, they are two different processes, with their own causes and implications.
Regurgitation: is the simple reflux of the food that the baby has just ingested, from the stomach to the mouth, without effort, and in a small amount. It is very common in babies in the first months of life, usually up to 7 months and it is not important, since over time it is solved. There is no impact on the baby’s weight or physical well-being. It is also common for them to regurgitate and that immediately afterwards they want to breastfeed normally again.
Vomiting: is the forced and sudden expulsion of the gastrointestinal content through the mouth; therefore, it involves effort and is usually much larger than regurgitation.
In a newborn (less than one month) who presents with repeated, projective, food-related vomiting and after all feedings, an entity called hypertrophic pyloric stenosis must be ruled out. In this case there is a blockage in the valve that empties the stomach, so the baby cannot feed properly.
Virtually half of all newborns suffer from jaundice to one degree or another. What must be observed is at what time it is produced in order to assess whether it is physiological or pathological.
Physiological Jaundice: The physiological jaundice is not a disease, it is a temporary condition due to unborn babies have more red blood cells to better get the oxygen that happens to his mother through the placenta. Right after birth the baby begins to breathe on its own and no longer needs all of those red blood cells. These must be removed in some way. Bilirubin, a by-product of the breakdown of these blood cells, is eliminated through the liver, which makes it reach the baby’s digestive tract and from there it passes into the stool.
But there is a difficulty, the baby’s liver is immature and cannot work as fast and therefore bilirubin can accumulate.
Late Jaundice: The late jaundice is considered pathological.
It appears during the second week of life and can be extended until the baby is between 1 and 2 months old, affecting a very small percentage of children between 2% and 33%.
Does not gain weight
Babies typically have between 7 and 10% post-birth weight loss. This loss is habitual and occurs in part due to the expulsion of meconium, although the current conditions in which breastfeeding begins in hospitals may also influence, since when the conditions of birth are modified, with physiological and respected deliveries and early initiation of breastfeeding with correct grip, weight loss is much less.
At most from the fifth day of life, babies should regain the weight they have lost and have regained it completely around the fifteenth day of life.
Babies who do not gain weight should be evaluated as soon as possible in order to detect the situation that prevents them from gaining weight:
- Mama enough? Between 8 to 12 times a day
- Is the milk transfer correct? Check the nutritive suction in one or more shots
- Is the mother’s milk supply correct? Check production and rule out hypogalactia if necessary .
- Is the baby healthy? Sometimes small infections occur that can compromise the baby’s weight gain.
If the baby does not gain the necessary weight, it must be supplemented with breast or artificial milk. In no case should you receive the so-called vegetable milks that are not indicated for infant feeding since it does not have the same nutritional qualities as breast or artificial milk.
Logically, once the cause of the low weight gain has been detected, the appropriate solution will have to be addressed. Meanwhile, to obtain a rapid supply of milk or to rule out true hypogalactia, it may be useful to use the powerful extraction technique .