Baby First Week: What Should You expect ?

The baby first week is the most exciting and sometimes difficult time for the whole family. The parents get to be with their baby immediately after birth, if the mother and the baby are doing well. The new parents can hold and cuddle the baby, and the early interaction is said to help them bond with the newborn. If the mother intends to breastfeed the baby, she is encouraged to initiate the feeding as early as possible, even within the first 30 minutes after birth. Early feeding is beneficial to both the mother and the baby, as suckling releases a hormone called oxytocin which helps uterine contractions resulting in faster healing. It also stimulates milk production.

If the first few hours could not be spent with the baby due to some reason, the bonding can happen later also, when the parents are taught how to take care of the baby. The parents familiarize themselves with the different aspects of looking after the baby, such as changing the diapers, bathing, dressing up and feeding the baby, during the hospital stay of one or two days after the delivery. They also learn to understand the baby’s needs from its sounds and cues. For a normal delivery, the hospital stay does not usually extend beyond one or two days in the United States, though it may be longer in some other countries.

Bringing the baby home entails a lot of preparation. All the members of the household and their schedules have to adjust to the natural schedule of the new member. Tremendous lifestyle changes are necessary, if it is the first baby in the household. If older children are there, they should be well prepared and sensitized to the new arrival. Jealousy may be an issue, but giving them extra attention and involving them in the care of the newborn usually help. Special attention should be given to household pets also. Sometimes, it may be necessary to keep them away from the newborn during the initial period.

Umbilical Cord: A day after the birth, the plastic clip used for clamping the umbilical cord should be removed. Special care is taken to keep the stump clean as well as dry till it falls off. It usually falls off during the baby first week. If any discharge or swelling is noticed, the doctor should be informed as soon as possible, as it could be due to an infection which should be treated promptly.

Circumcision: There may be different reasons for circumcision. If the parents opt for circumcision either due to religious traditions or out of personal choice, the minor surgical procedure may be done before the baby is discharged from the hospital. The usual medical reason for conducting circumcision is urinary obstruction due to a tight foreskin. The lower rates of urinary tract infections, sexually transmitted diseases, and cancer of the penis, observed in circumcised males, are often cited as the benefits of circumcision. However, these are not sufficient medical grounds for circumcision, as the same benefits can be obtained by good hygiene practices. Complications such as infections or bleeding may occur in up to 2% of cases, but they are usually minor. Major complications like scarring or serious infections are rare, but not unheard of. The tip of the penis getting amputated accidentally is also a rare possibility. About 2% of babies who are not circumcised at birth may require the procedure later on.

 There are a few situations which preclude circumcision in the early days after birth. If the baby has not passed urine or if any abnormality with the penis is detected, circumcision is postponed. If the penis has any structural abnormality requiring plastic surgery, the foreskin can be used for the purpose. If the mother had been on anticoagulant drugs or aspirin during pregnancy, the effect of those drugs may cause excessive bleeding in the newborn. In such cases, circumcision is postponed till the effect wears off.

Skin: A skin rash may appear during the baby first week. It is usually found in places such as the back, arms, and legs, where the clothing rubs the body, but the face is rarely affected. No treatment is necessary as it usually disappears on its own. The rash is likely to become worse with the use of soaps, powders or lotions. When the weather is hot, dressing up the baby in plastic pants to prevent leakage also aggravates the rash. At the skin creases in the ankles and wrists, dryness as well as peeling of skin is normal.

Jaundice may appear after a day in babies who are born quite normal. The skin develops a yellow tinge due to the immature liver’s inability to process all the waste produced by the body. It is normal, and usually resolves without treatment as the liver function improves. If jaundice develops earlier, it is a cause of concern as it may be a sign of some serious disorder. The blood level of the bile pigment bilirubin is tested, and if it is found to be high, the baby is given phototherapy treatment. The baby is kept under special fluorescent lights called bilirubin lamps, with the whole body (without clothes) exposed to the light. The baby may have to remain in the hospital for one or two days more, for the treatment.

Urine and Bowel Movements: When the newborn urinates for the first time, the urine is very concentrated, containing urates. The diaper may look pink due to these chemicals. If the baby does not pass urine within 24 hours after birth, the reason is investigated. Usually baby boys are delayed in their first urination.

Newborns normally pass a substance called meconium in their first bowel movement. It is a greenish black substance, sticky like tar. It is essential that meconium is passed within a day after birth. If it is not passed, it is investigated immediately as a congenital defect, such as an intestinal block, could be the reason for the delay.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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