Wondering if that newborn cough is normal? What about the color of your baby's poop? Newborn parenting can be full of questions, but fortunately, we're here to help with some expert insight.
We've rounded up pediatricians' advice on nerve-racking-but-normal newborn health problems. Here are the top 10 things your doctor wants you to know, from when to worry about a newborn cough to how to evaluate that weird neck rash.
1. A Newborn Cough Can be Normal
Newborns cough and sneeze for the same reasons we do: to clear their nasal passages of something irritating, such as dust, or to move mucus or saliva out of their throats.
"Coughing and sneezing are the only ways babies have of clearing their airways—of lint, spit-up, whatever," the late Suzanne Corrigan, MD, who was a spokesperson for the American Academy of Pediatrics and a pediatrician in Dallas told Parents. "It doesn't necessarily mean illness."
When might a newborn cough signal a problem? Call a doctor if your baby has any of the following with a cough:
If your newborn is having any difficulty breathingIf your baby is displaying retractions (a sign of respiratory distress in babies when the skin is pulled in near the ribs when they breathe)If the cough is accompanied by congestion or feverIf the cough interferes with your baby's eating or sleeping
It's also very important to be aware of a newborn's cough during RSV season—roughly from October through April—as the virus can be very dangerous in newborns because their airways are so small.
If your baby is ever having any trouble breathing, you should call 911 or go to the hospital.
How To Decode Your Baby's Cough
2. Your Newborn Might Lose Weight
Newborns typically lose about 10% of their body weight by day three of life. Breastfed babies may lose a little more than bottle-fed babies because mature breast milk doesn't usually “come in” until three to five days after giving birth.
Why do newborns lose weight? Because babies are often sleepy from going through labor and delivery, feeding isn't always high on their list of priorities. What's more, they're shedding some of the fluids they were born with, which can lighten their load. But don't panic, because the weight loss is normal and expected.
"Babies enter the world with enough fluid on board to get them through the first three to five days, whether they feed or not," noted Dr. Corrigan. "By a week, they'll have started gaining weight again," adds Miriam Bar-on, MD, a former professor of pediatrics at Loyola University Stritch School of Medicine, in Chicago.
If your baby hasn't regained their birth weight by their two-week checkup, or they lose more than 10% of their body weight in those first few days, your doctor may suggest a strategy such as supplementing with formula if breastfeeding.
3. Your Instincts Do Matter
When you become a parent, everyone from your mother to the mailman will be giving you advice. Though they might have more experience than you in the child-rearing department, don't discount your own hunches. After all, you rock, bathe, cuddle, diaper, calm, and feed this baby every day. Who could know them better than you do?
“Your own intuition will get you through a lot of situations,” says Gwen Wurm, MD, MPH, director of community pediatrics at the University of Miami School of Medicine. “Most parents have a sixth sense about what their child needs. I'm not suggesting that you ignore the symptoms of illness, but if you think everything looks fine, then it probably is.”
The opposite can also be true: if you feel something is wrong, you're always justified in talking to your baby's doctors about your concerns. Advocating for your family's health is an important skill for parents.
It's also worth acknowledging that all parents are different and if you aren't feeling any “intuition” or struggle with anxiety, it can be hard to distinguish what's “intuition” and what's a worry. That's perfectly normal too and it's one reason that it's important to build a team of health care providers you trust to help guide you. And don't be afraid to talk to your baby's doctor about your concerns, no matter how big or how small.
4. Many Newborns Develop Rashes
A newborn's skin may be soft, but it's often not clear. Baby acne—which typically erupts in the first few days to weeks of life—is common and usually nothing to worry about. “It happens when the mother's estrogen is still circulating in the baby's body, and it will go away on its own,” explained Dr. Corrigan.
The same goes for milia, which are tiny white pimples on the face caused by blocked oil glands. Milia occur in about half of all newborns and disappear on their own in about a month.
Another common newborn skin condition is erythema toxicum, which is small white or yellowish bumps surrounded by red, blotchy skin. Erythema toxicum tends to "freak everybody out," said Dr. Corrigan, but she reassures parents it's nothing to worry about. "We usually see it in babies under 10 days old. We don't know what causes it, but it generally lasts three to five days and means nothing," she explained.
Lastly, parents may encounter seborrheic dermatitis (cradle cap), which can cause scaly, flaking skin on your baby's scalp, eyebrows, behind their ears, and on their neck. Again, no treatment is necessary—just cleanse with a mild, hypoallergenic soap.
While many types of newborn skin rashes are normal, call a doctor if your baby has:
A rash with a feverA rash with oozing or bleeding skinA rash that doesn't improve on its own5 Common Baby Skin Care Issues and What To Do About Them
5. Spit-Up Is Common
You no sooner finish feeding your baby than boom—they're wearing the meal. What's going on? Spit-up is common in newborns because the muscle that closes the opening to the stomach is sometimes floppy and underdeveloped, allowing formula or breast milk to come right back up. But don't worry that your baby will go hungry.
“Spill out a tablespoon of fluid, which is half an ounce, on the counter,” suggests Dr. Bar-on. “See what a mess it makes?” In other words, the mess looks worse than it is. Add in the mucus that also gets regurgitated and what a baby spits up is going to look even more menacing.
To help stop spit-ups if you're bottle-feeding, feed your baby in a semi-upright position and tilt the bottle so that they swallow milk (not air) from the nipple. Whether feeding from the breast or a bottle, burp them several times and keep them upright for a few minutes after feeding them.
6. There's a Wide Range of Normal Newborn Poop
When it comes to newborn bowel movements, what's normal depends on the baby and their diet. Newborn babies who are fed human milk often poop loose, yellowy, mustard-like stools—sometimes as often as with every feeding. Formula-fed babies, on the other hand, usually have stools with a thicker texture and may poop only two or three times a day. No matter their food source, it's common for newborns to poop after eating. “Newborns often have an active gastro-colic reflex,” explains Dr. Bar-on. “Eating relaxes the reflex, which makes them poop.”
"Breastfed babies can have a stool with every feeding, every other day, or even every four days and then have a big blowout," added Dr. Corrigan. "All are normal. And [formula-fed] babies can poop three to four times a day, then twice a day, and then just once a day. As their digestive systems mature, they tend to have fewer stools."
Although it's not common in very young babies, many parents wonder how they can tell if their baby is constipated. Don't rely on the grunting sounds they make when passing a stool—they're just creating pressure to help their bowels evacuate. Instead, you'll want to examine your baby's poop to see if it appears hard and dry.
"It's not the number of stools that makes you see the doctor, it's the consistency," explains Chitra Reddy, MD, an assistant professor of pediatrics at the University of Medicine and Dentistry of New Jersey in Newark. If their stools are hard several times in a row, they're probably constipated.
Also, call your doctor if your baby's poop is more watery than usual or is tinged with blood. “These could be signs of an infection or a formula intolerance,” notes Dr. Reddy.
7. Newborn Belly Buttons Don't Need Special Care
Doctors used to advise parents to regularly clean their baby's umbilical cord stump with alcohol wipes, but updated guidelines recommend a hands-off approach. In other words, there's nothing special you need to do to your baby's belly button other than keep it clean and dry.
Any remaining umbilical cord should fall off within two weeks of your baby's birth, but it could be sooner. Let your doctor know if the cord hasn't fallen off after four weeks or if you notice any excess bleeding or foul-smelling drainage from the cord. Never pull on the cord either, as that could lead to bleeding.
8. Doctors Don't Mind Phone Calls
Sometimes, middle-of-the-night calls to the doctor are warranted—and no one knows this better than pediatricians themselves. "Most of us are parents too," said Dr. Corrigan. "We know what it's like to be up with a sick child in the middle of the night. We know you can't schedule emergencies."
Don't fret about bothering the doctor. If something's wrong, they want to hear from you. And if you call with a basic question (like how to bathe your baby or how to tell if they've eaten enough, for instance) during office hours, chances are you'll speak with a nurse or other knowledgeable person who can give you the information you need.
"Use your common sense and do what feels right," says Dr. Bar-on. "If you have questions, call."
9. Babies Can Cry (A Lot)
Many pediatricians say you can count on about three hours of crying a day with a newborn—from whimpering to full-blown wailing.
"Crying is the only way a baby has to communicate—that [they're] hungry or annoyed or afraid or tired, among other things," said Dr. Corrigan. "Each of those cries will probably have a different tone, and it will take you a while to sort them all out."
So if crying is normal, how can you tell when it indicates a problem? Look for these signs:
A cry that sounds different than normal: “The crying will seem different in some way,” says Gwen Wurm, MD, a pediatrician in Florida. A newborn in distress may have cries that sound more shrill than usual or are persistent or uncontrollable.A cry that doesn't stop with calming efforts: If it's easy to calm your baby down, the crying may not signal anything serious.A cry that lasts longer than three hours a day: Crying that lasts more than three hours, more than three days a week that occurs for more than three weeks is often associated with colic and may require extra support.
Again, however, follow your instincts here. If your baby seems like they are in pain or they are crying more than three hours per day, it never hurts to ask your doctor if anything else may be going on.
10. Parents Need Sleep Too
What new parent doesn't check their sleeping baby's breathing—not once, not twice, but several times a night? But a cradle watch will only make you more exhausted.
“There's no proof that being hypervigilant will prevent something like sudden infant death syndrome,” notes Dr. Wurm. “In fact, there's little evidence that even apnea monitors (electronic devices that observe breathing) prevent SIDS unless there's a medical reason to use one.”
Instead of staying up all night to watch your baby's breathing, focus on following safe sleep guidelines:
Put your baby to sleep on their back in a separate crib or bassinet.Use a firm mattress with no loose sheets.Make sure there is nothing in the crib; remove blankets, pillows, bumpers, and stuffed animals.Don't over-bundle your baby.Don't smoke in the home.
“There are concrete things you can do to decrease the risk of SIDS,” says Dr. Wurm. But watching your baby's every breath isn't one of them and getting enough sleep will help you be the best parent you can be too.
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