The first six weeks: what to expect for your baby

The first weeks with a newborn are often a blur of feeds, nappies, first-timers’ nerves, and of course crying – probably from all of you.

Margaret Hanahoe is assistant director of Midwifery at Dublin's National Maternity Hospital, and set up the hospital's first Community Midwife Domino (Domiciliary Care In and Out of Hospital) programme. "These first six weeks can be quite a shock for parents. Nothing quite prepares you for a baby who constantly needs your attention," she says.

“Having a little advance information, however, can make things easier, because what can seem strange and unusual to a new parent is actually normal. For instance, it’s reassuring to know that sleeping newborns make lots of noises – particularly if they are trying to clear out mucous. Or that the second and third nights after birth can be very difficult because babies may want to feed all the time, even those being bottle-fed.

“ It’s also good to be aware that babies can get a range of spots and rashes in the first weeks,” says Hanahoe, “or may look cross-eyed occasionally, or may posset [regurgitate a little milk] after feeding.”

Even changing those first nappies can be nerve-wracking for many parents. “It will soon be a doddle,” assures Hanahoe. “A few tips: Change after feeds, not before, as babies often perform mid-feed. Keep the nappy folded below the umbilical cord stump until it falls off after about two weeks. Make sure you leave boys with their penis down before you close the nappy, to prevent urine leaking up on to the umbilical cord area.”

As you get accustomed to handling your baby it can be reassuring to know it is not necessary to bathe them daily. “A baby only needs to have a full bath once a week,” says Hanahoe. “However, keep the bottom – and umbilical cord area – clean at every nappy change, and wash the face, neck and hands (and any folds of skin on the arms and legs) daily with just a sponge wet with warm water.”

Even putting your baby to bed can be a worry for new parents. “Knowing you have removed all the risk factors for Sudden Infant Death Syndrome can be very reassuring,”says Hanahoe. “ The cot should not have bumper pads or contain pillows or toys. Put your baby to sleep on their back, with feet near the foot of the bed, so they cannot wriggle under blankets. Be careful not to overheat. The right temperature for a baby’s room is between 16 and 20 degrees. Cellular blankets [blankets with holes in them] are best as they allow air to circulate.”

And then there’s the crying!

“If your baby keeps crying and doesn’t want to be fed or changed, he may just want some body contact,” suggests Hanahoe. “Try curling up together bare tummy to bare tummy. A lot of babies, though not all, also like to be swaddled to feel secure, as it reminds them of being snug in the womb. Ask your midwife to show you how. Walking while holding him – or wearing him in a sling – can also be soothing. Distraction, even at this young age, also works. Sing and talk to him, nod your head, stick out your tongue.”

Parents whose babies have colic may experience hours of non-stop crying on a daily basis. “Seek advice and support,” advises Hanahoe “and bring in friends and family to give you regular breaks.”

Another major cause of crying in babies is reflux, when milk and stomach acids flow back up into the oesophagus after feeding. “Many babies with reflux vomit after feeds,” says Hanahoe, “Others will not, but they will usually dislike being laid flat, will wake frequently, and will often start crying about an hour after feeding or show signs of discomfort. Seek medical advice, as unlike colic which just eventually goes away, reflux can usually be treated successfully.”

Any concerns you have about your baby’s health in these weeks should be brought to your doctor or public health nurse, advises Hanahoe. “Always remember that no matter how inexperienced, you know your baby best. If you feel that he is not ‘right’, then you are probably correct.”

And what about that elusive “routine” that most parents expect to be established by the end of the first six weeks? “As the weeks pass your baby will become more settled,” says Hanahoe. “Most babies will fall naturally into a regular pattern of eating and sleeping for longer periods without waking. Start a bedtime routine as early as possible, so that baby gets the idea that this is time to sleep. Try not to let baby fall asleep at the breast or on the bottle. Put him down in his cot while still awake, even if very drowsy, and don’t play with your baby at night while feeding or changing.”

Louise Ní Chríodáin