The First Month

Max is just over a month old and for first tie mothers I know just how hard it can be to get your head around the many new changes, challenges and appointments that come with a new baby. The first month with a new baby is really exciting. It’s the time to get to know your new baby and rediscover family life.

What is happening with you:

If this is your first baby you will probably be feeling very clueless – but don’t worry, you aren’t the only one! Having a new baby is not at all what you can ever expect. But don’t worry, in the first month he/she wont do much more than eat, sleep and cry which means that other than coping with a lack of sleep, it should be pretty straight forward!

Start interacting with you baby by talking to him/her on a daily basis. This will help with speech language and brain development, and he/she will just love to hear your voice.

If you don’t fee like you have bonded with your baby straight away, try not to worry. Some mothers don’t bond with their baby straight away, you don’t have to look into his/her eyes and fall in love straight away, it can take time. Just concentrate on his/her physical well-being and your own physical recovery and the bonding will happen in its own time.

Baby Blues & Postnatal Depression

In the early days and weeks after birth you may feel a bit down with the baby blues. Most new mums experience this and its most likely due to the hormones, new mum anxiety and exhaustion. Feeding struggles, a dufficult birth and lacking in emotional support can also be contributing factors. The blues should pass pretty soon so try tot to get too caught up in this down feeling and just get as much rest as possible.

Try not to get the baby blues confused with full on post natal depression. Postnatal depression tends to come on a bit later and lasts a lot longer as well as causing serious mental health issues.

  • Postnatal depression is a type of depression many parents feel after having a baby.
  • It affects more than 1 in every 10 women within a year of giving birth.
  • It can affect partners and father but this is less common
  • Seek help as soon as possible if you think you or aomebody else is depressed

Post Traumatic Stress Disorder

This is another psychological condition that may strike now and it is basically birth trauma. This form of post traumatic stress disorder affects a small number of mums after a difficult birth. Talk about your experience with a supportive partner, family member or friend in order to help deal with the problem, and if none of these options are available to you many hospitals offer help and advice.

What Is Happening With Your New Baby:

Newborn babies often arrive with unexpected features, this could be from the trauma of birth or else their own personal distinguishing features like a birth mark.

A birthmark is a coloured mark on or just below the skin. Some birthmarks tend to fade with time whereas others are just another distinguishing characteristics there to stay.

Nipples and genitals may be swollen caused by your hormones crossing the placenta. If you have a baby boy and one or both of his testicles haven’t dropped down expect your health visitor or go to keep an eye on this becaus if they don’t drop later in some cases a small op may be required.

Some babies are born with a lot of hair where’s others don’t have any. Regardless, it is likely to change in amount and colour. A hairy body is also normal as this is just the remains of the coating keeping baby cost during pregnancy called lanugo.

When the umbilical cord is cut at birth it will leave an umbilical stump. You can expect this to shrivel and drop off in the next few weeks. Remember to keep it clean and dry. When bathing your newborn keep the belly out of the water to avoid infection. If it starts to look sore or is weeping a lot you will need to show a health professional.

Dry, blotchy and spotty skin is also very common in newborns. Babies have very sensitive skin which increases the chance of blotches or spots. Milk spots or milia is also common and these are just small white spots that are harmless.

Jaundice is a yellowish tinge to the skin and your midwife will want to keep an eye on this – even tough when its mild it it not a concern.

A new baby’s head is often misshapen, squashed or elongated and this is from the labour and moving down the birth canal. This will be more noticeable or worsened if you had an assisted birth with forceps or ventouse – this can also leave marks or swelling which will only be temporary. There is also a delicate soft spot called a fontanelle which is located at the top of the baby’s head and this will close up over time.

New babies cant control the eye muscles; so therefore having the look of very squinty eyes. They may also have eye gunk like crusty sleep which is easily washed away with warm water. You should let your midwife or health visitor know if you notice your baby to have a yellow tinge to the eyes ad this could indicate jaundice.

What Is Jaundice?

Jaundice is very common and normally harmless in new babies. it is where the skin and whites or the eyes appear to have a yellowish tinge. Other signs of jaundice are: yellow tinge on the palm of the hands or soles of the feet, dark yellow urine (urine should be colourless) and pale coloured poo (poo should be yellow or orange.

Jaundice usually develops two to three days after birth and should clear up without treatment around two weeks after birth. Seek medical attention if a baby develops jaundice after this time.

Sleeping

You will most likely be very surprised with just how little sleep you can continue to function with in this first month. You will find that your baby sleeps loads, just without a pattern. The average amount of sleep for a newborn is 16 out of the 24 hours in a day but this does vary widely. The easiest thing is to just go with the flow. Babies wake regularly through the day and night because they don’t yet have a functioning body clock. They need frequent feeds in order to keep hunger at bay so don’t be surprised if he/she is up at least four times a night at first. Don’t worry, you will get used to it and wont notice it as much. let baby sleep whenever they want and the easiest way to do this whilst piece of mind and so you know their safe is with a Moses basket with handles so you can take baby wherever you go. Get rest whenever you can whilst baby sleeps. another good way so you can continue with your house routine and cleaning is a sling – baby is always close to you and you can carry on with everything you need to do. Keep lights low for nighttime feeds so you aren’t stimulating baby to fully awake, this should make it far easier for him/her to fall back to sleep after their feed/nappy change. Also speak softly and keep noise levels low. Use a nightlight that emits a soft light all night long to aid you with this. Most babies don’t like the dark so keeping a nightlight on all night in the bedroom is a good idea.

You can start to sleep train with your baby when he/she is 3 weeks old. When baby awakens in the night, do not feed him/her straight away as this will induce the thinking that waking in the night means they will be rewarded. Hold off feeding for 5-10 minutes or whatever you are comfortable with, and distract him/her by changing their nappy first.

Sudden Infant Death Syndrome (SIDS)

You should always be thinking about encouraging safe sleeping with a newborn as to reduce the risk of SIDS. Sudden infant death syndrome – also known as cot death – is the sudden and unexplained death of a child under a year in age. For a death to be classed as SIDS, it is required to be totally unexplained even after an autopsy. SIDS usually occurs during sleeping.

  • Make sure the room is at the correct temperature for a baby i.e. not too hot or too cold by using a GroEgg or other type of thermometer
  • Always put baby to sleep on their back
  • Don’t put any additional blankets or toys in the crib
  • If using a blanket, keep it tucked tightly under their armpits
  • Put baby to sleep with his/her feet touching the end of crib so they cannot wriggle down under the blanket
  • Don’t smoke whilst pregnant
  • Don’t allow smoking around your baby
  • Swaddle your baby
  • Don’t put baby down to sleep on his/her side
  • Have baby sleep in your room
  • Do not share a bed with your baby
  • Make sure crib mattress is firm and tight fitting
  • Don’t overdress baby
  • Keep sleeping baby away from heat source

Feeding

Whichever way you decide to feed your baby it must be the right choice for you. Breast may be best in some cases as they say but this isn’t true for everyone so don’t be made to feel bad for not bottle feeding or judged.

If you chose to breastfeed make sure you get plenty of help and support from midwives before leaving the hospital and if you’re struggling there are always plenty of support groups you can attend afterwards.

When bottle feeding be sure to follow all of the hygiene and safety guidelines.

Newborn Screening Tests

In the first 6-8 weeks after birth your baby will be offered some screening tests. This is important as it allows medical professionals to find hidden conditions after a baby is born. most babies are healthy and wont have any of the conditions these tests are designed to find but for those who do finding it early is hugely beneficial. although you can decline if you wish. Screening tests are fast and really simple and wont harm your baby.

The Physical Examination:

The physical examination of your baby is carried out within 72 hours of birth and then again at 6 to 8 weeks of age as some conditions develop over time. This is to check the eyes, heart, hips and testicles for boys. The first examination is usually carried out in the hospital before you go home and other times it may be done at home or GP surgery and can be done by either a doctor, midwife, nurse or health visitor.

The examination may be slightly uncomfortable for your baby but wont cause him/her any pain and the aim is to spot any early problems in order to get them sorted as soon as possible. Any problems found during the examination and they will refer your baby for more tests.

The second physical examination is usually done at the GP surgery and this will need booking nearer the time and usually takes place at around 6/8 weeks of age.

What the examination includes:

  • Will ask parents some questions about how baby is feeding, alertness and general welbeing
  • baby will need to be undressed for part of the examination
  • Check look and movement of the eyes
  • listen to baby’s heart and check the sounds
  • check hip joints
  • check boys testicles are in the right place

What examination checks for:

  • Eyes – check  the appearance and movement whilst looking for cataracts (a clouding of the transparent lens on the inside of the eye) Roughly 2-3 out of 10,000 babies are born with an eye problem that requires treatment. The examination does not tell how well your baby can or cannot see.
  • Heart – This is done by observation, listening to the heartbeat and feeling baby’s pulses. This mainly looks for a heart murmur (an extra or unusual sound when the heart beats and this is from disturbed blood flow through the heart. If a murmur is detected it is normally common and nothing to worry about. About 1 in 200 babies have a heart problem that needs treatment.
  • Hips – Some babies hipjoints are not formed properly and this is known as DDH Developmental Dysplasia of the Hip. If untreated this can cause a lim or joint problems. About 1-2 in 1,000 babies have DDH in need of treatment.
  • Testicles – Boys testicles are checked to ensure that they are in the right place. The testicles form inside the baby’s body during pregnancy and some don’t drop down until a few months after birth. Around 1 in 100 baby boys have only partially descended testicles or not at all, and this needs treating as soon as possible to avoid problems later on in life including reduced fertility.

The examination and screening in not compulsory, but it is strongly recommended to make sure your baby is in the best health possible.

The health professional carrying out the tests will give you the results straight away, and if further tests are needed this will be discussed with you there and then. Any results will be recorded in your baby’s red book/personal health record. Keep this safe and take it along anytime your baby has a visit with a health professional.

Hearing Screening Test

  • This is done soon after your baby is born
  • If you gave birth in hospital you may be offered the screening before you’re discharged, otherwise it will be done at home or in a surgery within the first few weeks.
  • This helps to identify babies who have permanent hearing loss as soon as possible and parents are able to get the support they need straight away.
  • 1-2 in every 1000 babies are born with permanent hearing loss in one or both ears.
  • For babies whom have spent more that 48 hours in intensive care, this increases to around 1 in every 100 babies.
  • Permanent hearing loss can significantly affect a baby’s development so finding out early means you can prepare which gives children a better chance of developing language, speech and communication skills.
  • If you are not offered a screening test, ask your health visitor or GP to arrange an appointment.
  • The test only takes a few minutes – a small soft-tipped ear piece is placed in your baby’s ear and gentle clicking sounds are played – when the ear receives the sound the inner part (cochlea) responds. This can be picked up by the screening equipment.
  • It is not always possible to get a clear response front he first test – This happens with a lot of babies and  doesn’t always mean your baby has permanent hearing loss and could mean either your baby was unsettled, there was background noise or the baby has fluid or a temporary blockage in the ear – You will be offered a second test if this should occur.
  • The tests wont harm your baby in any way
  • This test is not compulsory but highly recommended, and if you do refuse you will be given checklists i order to help to check on your baby’s hearing as they grow older
  • You will be given the response straight away.
  • The test doesn’t pick up all types of permanent hearing loss, children can sill develop permanent hearing loss later in life. if you have any concerns tell your health visitor or GP.
  • Your baby will be referred to a hearing specialist if the test results do not show a clear response in one or both ears
  • A hearing specialist will see you within a month of your baby’s hearing test and it is very important for you to attend this in case your baby does have permanent hearing problems. The appointment will usually take one to two hours. Feeding baby beforehand will help him/her to settle during the actual examination.
  • The tests will neither hurt nor be uncomfortable for your baby and you will stay with them the entire time, as well as a partner, friend or relative.
  • The test is similar to the first ones you baby had but this one gives a more detailed overview of baby’s hearing.
  • The audiologist will explain when the results mean and whether further tests are necessary.

Heel Prick/Newborn Blood Spot Test

This test checks for 9 rare but serious health conditions which include Sickle cell disease, Cystic Fibrosis, Congenital Hypothyroidism, Inherited Metabolic Diseases (PKU, MCADD, MSUD, IVA, GA1 & HCU). It is important to tell your health professional if there is any family history of any of these.

The test involves taking a small sample of baby’s blood to screen it for any of there conditions. When baby is about 5 days old a midwife will collect the sample by pricking baby’s heel and squeezing out a few drops of blood onto a spot card which then gets sent off for testing. The test may be uncomfortable for your baby and he/she may cry but is is over very quickly and some cuddles and a feed afterwards will settle baby. Sometimes a second sample is needed but this doesn’t necessary mean there is something wrong. Amelia had to have a second test done because the midwife that did her first one didn’t do it correctly and they couldn’t accurately process it.

There are large benefits of screening for any babies that do have any of these conditions and early diagnosis and treatment can improve their health and prevent severe disability and even death. You can expect to get the results either via a letter of from a health professional when your baby is 6-8 weeks old and the results should be recorded in the red book/personal child health record. You will be contacted sooner if the screening results come back positive for any of the tested conditions.

Development

A keepsake box and/or book are both lovely ways to document your baby’s first years and special moments.

Things to include:

  • Hospital name tags
  • A first outfit or coming home outfit
  • New baby congratulations cards
  • Birth announcement cards
  • A lock of hair
  • Homemade thankyou card
  • Welcome home/new baby balloon
  • Umbilical cord stump

In your baby’s first month they are learning and developing rapidly. You will need to give your newborn’s head plenty of support as neck muscles are still developing. He/she will be getting stronger everyday and may be able to lift his/her head when held upright or when laying on his/her back for a short time only.

Hearing and vision are improving and this means baby is becoming more expressive. Respond to coos and gurgles to encourage developing communitcation ksills. Talking and singing to your baby will help to develop these skills further

By the end of te first month he/she will begin to show that they recognise their parents. The reactions to mummy and daddy will be different to strangers

  • can track a moving object
  • recognise mum and dad
  • more vocal – will coo and gurgle
  • jump at loud noises
  • soothed y th e sound of your voice
  • turn toowards bright light
  • focus on your face
  • rooting – turn towards and try to such anything placed by their cheek
  • grasp a finger

Promote development by massaging as it will help sleep and boosts motor skills may aid cognitive development.

No matter how difficult the first month may be, enjoy it. Those sleepless nights wont last forever.

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