The First 28 Days of New Born Care!

By Medical Expert Team

Nov 11 , 2020 | 8 min read

The birth of a baby is an exhilarating time for most new parents. It is a time for celebration, joy, and learning, particularly for first-time parents. It is also when the mother and child require a great deal of medical attention and family support.

Most neonates are highly fragile and vulnerable in the first 28 days following birth. While over 70% of infant deaths occur within the first 24 hours of birth, statistics from UNICEF reveal that over 2 million newborns die within the first seven days of birth each year. This means that newborn baby care during the first 28 days is critical in the survival and health of your baby.

Hence, Dr. A.P. Mehta, Senior Consultant – Neonatology, says that the first 7 days of life are the most crucial for a baby’s survival.

What should be the steps ahead?

Few things that you have to consider:

Birth Place: You need to ensure that an adequate neonatal intensive care facility is available so that in the case of any emergency one does not have to run to other healthcare facilities.

Neonatal transfer carries a lot of risk to the baby and shifting them in the utero (Mother is shifted to NICU before the birth of the baby) has scientifically proven to be beneficial in terms of survival and development of neonate.
During Birth or after birth “initiation of respiration” is a critical step and may require a pediatrician’s help. It is required that a doctor who is trained in neonatal resuscitation is present as he/she may be able to keep the baby warm, rule out any birth defect and initiate birth feeding activity.
During the hospital stay, a mother should be encouraged for breastfeeding to avoid any prelacteal feeds. On-demand, she should be able to put the baby on the breast after every 2-3 hours. Adequacy of feeding can be judged by urine output ie. 3-4 wet diapers every 24 hours.

Normally, a baby passes stool within 24 hours and urine within 48 hours of life. The baby is monitored for crying, temperature, feeding, jaundice, and any parental concern. Before the mother is discharged, she should be confident in breastfeeding, evaluate for jaundice, maintain temperature, and be vaccinated.
Finally, going home with a new baby is exciting but it can be scary too. It sometimes becomes difficult to cater to the needs of a newborn like frequent feeds, and diaper changes. Their room temperature should be in a range of 27 to 29*C so that they do not waste calories in maintaining their body temperature.

It is easy for a mother to judge her baby’s temperature by touching her hand and feet and comparing it with the abdomen. We can use an AC/cooler with a slow fan speed for maintenance of room temperature. Cold air blasts should not be directed towards the baby.

What can be the common Newborn Issues?

There can be multiple medical problems for newborns, which if left unattended can become serious. Dehydration can be one of the concerns for newborns that can be judged by significant weight loss. Full terms babies lose nearly 10% weight while preterm up to 15% weight during the first 7 to 10 days of life and regain birth weight again by 3-4 days. After that, they start gaining weight by 10-15gms/kgs/ a day.

Parents should also watch for signs of infection in their newborn that can be easily picked up from birth or other people handling the baby. You can witness signs of infection around the belly button or circumcised foreskin. Moreover, babies with infections often complain of poor sucking during breastfeeding, poor weight gain, and increasing irritability among several others.

There can be other health issues that are different for older children and adults like diaper rash, cradle crap, etc. Although most babies remain perfectly healthy after they are discharged from the hospital but it is important to watch out for signs of illness like jaundice, and infections. It is necessary to take the baby to the pediatrician for evaluation within a day or two of leaving the hospital.

Tips for Parents for Newborn care

The baby should be given only breast milk for the first six months of life.
Exclusive breastfeeding means nothing except breast-feeds not even water, gutters, gripe water, tonics, or any form of milk.
Babies need proper clothes, which cover them properly, especially the head, hands, and feet. They should not be overclothed as well.
Breastfed Babies pass watery stools after the first 3-4 days of life especially after every feed which is normal for them.
A baby, who is feeding well, will be passing urine at least 8-10 times a day sleeps for 3-4 hrs in between feeds.
Babies don't need any Kajal, Surma, Talcum powder, or daily bath. Bathing should be postponed for the first few days after birth. A good rule to follow is to delay bath till the umbilical cord falls.
Vaccination is the most cost-effective way of health for children.

Getting Help After the Birth of Baby

Planning the birthplace is one of the most essential steps in newborn baby care. The availability of neonatal intensive care facilities could be crucial to the survival of many newborns, particularly when it comes to high-risk pregnancies.

In recent times, doctors recommend shifting babies to the NICU in-utero. If pregnant mothers should be moved to the NICU before birthing, this helps save neonatal transfer time and helps keep the baby safe.

The initiation of respiration is the next step in getting help for your newborn. The newborn transitions from reliance on maternal cardiac, respiratory, thermal, and metabolic systems to self-sufficiency.
The baby usually takes its first breath within 10 seconds of delivery. The availability of trained medical professionals to assess this transition and provide intervention if the baby experiences problems is very important.

The first 28 days after birth is when the parents require the most support with newborn baby care. This includes medical support and support from family and caregivers as parents ease into the routine of handling the baby's needs.

Handling a Newborn Baby

One of the most important skills that a new parent should learn is handling the newborn. Neonates and infants are yet to develop a robust immune system. This makes them vulnerable to infections. Here are a few tips for handling a newborn -

Wash/sanitize your hands before handling the baby
Always support the head and neck while picking up or carrying the baby
Never shake the baby. Hold securely and gently sway to soothe the baby.
In the first 28 days, your baby is not ready to play. Avoid bouncing or jiggling the baby.

Before you leave the hospital, a nurse or doctor may help you learn the correct way to swaddle, wrap, clean, and carry the infant as part of the newborn baby care routine.

Feeding and Burping Your Newborn Baby

Doctors recommend that mothers must exclusively breastfeed babies for the first six months. This means that they should not be given water, gripe water, or other foods.

The baby must be fed on-demand every 2-3 hours. New mothers are usually encouraged to breastfeed during the hospital stay. However, breastfeeding may not come naturally to many mothers. This is not something to be embarrassed about. You may wish to consult a lactation specialist and get help.

After every feed, the baby must be burped. Hold the baby against your chest, or hold the baby sitting up on your lap and gently pat the back with a flat palm.

All About Diapering Your Baby

A newborn baby usually passes stool within the first 24 hours and urine within 48 hours of birthing. After this, an adequately fed baby should wet 3-4 diapers a day. As the baby grows, you may need about ten diapers a day.

Keep the baby clean with water and a gentle washcloth or wipes. Use a diaper rash cream when necessary. Talk to your baby's paediatrician about signs of skin conditions like diaper rash, cradle cap etc., as part of routine newborn baby care.

Umbilical Cord Care for New-born

Before leaving the hospital, learn more about caring for the baby's umbilical cord. The dried cord falls off between 10 days and three weeks. Hold off wetting the baby or bathing it till the cord stump falls off. If the cord turns red, gives off an odour, or bleeds, you must seek medical attention.

Bathing Basics for New-borns

You may want to enlist the help of a doula to learn the basics of bathing a newborn. Avoid using soap or harsh shampoo for the first few weeks.

Ensure that you support the baby's neck and head when you wash the body with a washcloth and a mild cleanser after the umbilical cord stump has healed.

Bonding and Soothing with New-born Baby

The first few days after baby birth are wonderful when most parents learn to soothe, swaddle, and bond with the baby. Be very gentle with the infant in these first few days. Most babies benefit from skin-to-skin contact with the infant.

Sleeping Basics for Babies

Newborn babies sleep between 2and 4 hours at a time. This means you may need to wake up multiple times at night to feed or change them.
It is important to place the babies on their backs when you place them in the crib. This reduces the risk of sudden infant death syndrome.
It is good to remove pillows, stuffed animals, and blankets from the crib.
Regulate the temperature between 27 C and 29 C to keep the baby warm and comfortable.

You may want to talk to your paediatrician and learn more about newborn baby care, including –

Expected weight gain in the first month
Vaccination schedule for the newborn
Newborn reflexes and warning signs to look out for
Follow up visits to the paediatrician
Maternal diet to optimize lactation
Tracking dirty diapers and looking out for signs of abnormal poop
Signs of colic and tips to help relieve colic
Signs of illnesses like jaundice or infections

The paediatricians at Max Hospital recommend bringing the baby for an evaluation within a day or two of being discharged from the hospital.

Read More FAQs on New Born Care