DAY 4

YOUR BABY

Your four-day-old already has the ability to distinguish the sounds of her native tongue from the intonations of Japanese, Chinese, or other languages. You can attribute this skill to all those months of listening to your voice in the womb.

Her skin will seem less mottled and red except when she’s crying. Her skin is much more vulnerable to sunburn than yours, so baby sunblock will be needed if you’re outdoors for more than a few minutes. You may discover what looks like whiteheads speckling your baby’s nose and forehead. They’re called milia, and they are caused by plugged oil glands. Some babies have an infant version of acne on their cheeks or forehead. Don’t touch the milia or acne bumps or try to squeeze them, since this could cause them to become infected. They will disappear on their own.

Newborns don’t sweat or shiver in the same way children or grownups do. If your baby is in a draft or feels cold, she may try to draw her body tighter into a little ball, but her body’s most comfortable right up next to yours with your chest serving as her radiant heater. Your baby has only a primitive thermostat for adapting to cold, drafts, and other temperature changes. At this age, an ambient room temperature of about 75° F is the most comfortable temperature for a clothed newborn. Pay attention to having the room warmer, or cover your baby with a blanket for undressing and diapering to help maintain her temperature.

Within a few weeks, your baby’s body will become more adept at heat production and temperature control. She will adjust to the ambient temperature in your home and won’t need to be kept any warmer (or cooler) than you, but you shouldn’t turn your furnace’s thermostat way down in the night; expose your baby to too much hot sun; allow your baby to become overheated by dressing her in too many layers of clothing, especially if she is running a fever; or allow the house to get too clammy from airconditioning. Make sure, too, not to place the crib in front of heating or air-conditioning vents or in a draft. If her room is very dry, an air humidifier may help (be careful not to place it near wooden furniture, as the moisture could ruin the finish).

Your baby’s diaper should be changed as soon as you discover it’s damp. Urine and bowel movements can irritate the skin and cause a rash if they stay in contact with it for too long. That said, experienced parents quickly learn not to wake up a baby just to do a diaper change. It’s better to let the baby sleep (and to get some sleep yourself), unless there’s a major stinky going on down below. (For more on changing diapers, see in 3. Your Baby Maintenance Guide.)

Over the next week, the stump of your baby’s umbilical cord will harden and turn dark. It will finally shrivel, separate, and fall off on its own. Meanwhile, fold your baby’s diaper below the stump to expose it to air. And instead of bathing your baby, gently wipe her down with a warm, soft washcloth while keeping her under a blanket to prevent chilling.

  Tip

Swabbing the baby’s umbilical stump with alcohol is no longer recommended. Studies have found that alcohol is readily absorbed by the baby’s skin and it can be toxic, especially when it becomes sealed under a bandage. Alcohol treatments have also been shown to prolong the stump’s falling off by one to two days.

Your dear Mr. Magoo

Your newborn won’t be able to see across the room very well, at least not at first. You’ve heard the term 20/20 vision. The first 20 in 20/20 refers to the distance in feet between your eye and the eye chart. The bottom number indicates the distance—20 feet away—at which people with normal eyesight can clearly read the eye chart. Having 20/20 vision is considered normal. Better vision would be 20/15, and worse vision 20/30 or higher. Someone with poor vision, say, 20/400, would need to be 1½ feet from the letters to read what a person with 20/20 vision could read at a distance of 20 feet. A newborn’s visual acuity is estimated to be 20/400, so the world is pretty blurry to her, except for your face or other things that are close up. In fact, if your baby were to apply for a driver’s license right now, she’d be turned away as legally blind. By month four, her vision will improve to 20/100, and by one year of age your baby’s acuity could be estimated as somewhere between 20/20 and 20/40, or nearly as sharp as normal adult vision.

Meanwhile, your baby’s brain has to grow and develop to coordinate her vision. Seeing is not just a matter of focus, but very much a matter of the brain’s ability to interpret the signals that enter in through the eyes, too. Right now, all the images that are arriving through your baby’s eyes only make limited sense to her. Later, when the higher functions of her brain have developed, a light-bulb will go off inside, and all the images will start to form patterns and make more sense.

YOU

When you were pregnant, though people may have offered to carry grocery bags for you, you probably said, “Thanks, but no thanks.” Now, that kind of help is exactly what you need. Somebody needs to do the dishes, pay the bills, wash the mountain of dirty clothes, and pick up the clutter before it swallows the house. And that person is NOT you. If your partner is making plans to go back to work, you may be thrown into isolation. Add to that stress and hormonal changes, and you could be very vulnerable to depression.

The truth is, often you have to ask for physical or emotional help to get it. Practice explicitly asking your partner for what you need without blame. Openly acknowledge and praise him for what he is doing right, instead of what he is failing to do. Trust that he’s doing the best he can under these trying circumstances, and also try to remember that life will soon get easier. Don’t forget your parents and in-laws, too. More likely than not, they want to help as much as they can, they just need to be told how and when.

If you need someone to talk to who can understand what you’re going through, know that any mother or father who remembers the newborn phase will probably understand immediately and identify if you express that you’re feeling overwhelmed and isolated. If there’s no one in your circle, consider calling up a professional counselor, family therapist, a psychologist, or your pastor, priest, or rabbi.

Your dream baby versus your real baby

Sometimes parents-to-be say they want to have a baby to love or be loved. But right now, what you’re going through may not feel much like love or at least as you’re used to experiencing it! Your baby’s total dependency, her constant need for your care and attention, and your own physical recovery hampered by lack of sleep can translate into your feeling enormously stressed. Days and nights blur together, and time seems to slow down.

Remember how you imagined your dream baby looked when you were pregnant? No doubt she was adorable and had pudgy cheeks and big, shiny eyes. Did you envision yourself in sensuous lingerie staring dreamily out the window while you held your beloved baby in your arms?

Well, your REAL baby is something completely different from what you imagined, most likely, and you’re almost certainly not wearing lingerie right now, and you’ve never been further from romance. Whatever grungy T-shirt you’re wearing right now probably has nipple-level milk stains and a stream of spit-up dribbling down the back.

The seamy side of motherhood can take some getting used to.

Baby’s sleep (and yours)

Finding answers for your own sleep needs will be one of the biggest challenges you’ll face during this first year of life with your baby. As a new parent, your lack of sleep tends to color everything about your life. Piles of unwashed baby clothes and food-encrusted dishes turn into huge mountains. Dust bunnies and piles of junk mail can snowball at an alarming rate. Part of the problem is your waning energy. Things that would have been a snap now seem like a heavy burden.

Most newborns sleep a lot both day and night, waking up just to be fed every few hours. But it’s hard to know how long your baby will sleep and when the next wake-up alarm will sound. The unpredictability is part of the challenge.

Studies show that newborns are much more likely to be awake at night than during the day, with night sleeping times lengthening around month three or when your baby weighs 12 to 13 pounds. You may hear other parents bragging about how their little darling is “sleeping through the night,” but what they really mean is that she is sleeping continuously for 5 to 6 hours calculated from midnight till dawn.

 

“I didn’t like being in the hospital at all, but now that we’re home, I wish there was a button beside my bed to call the nurse.”

If your baby is full term, it won’t be necessary to wake her up for feedings, nor should you attempt to feed a baby this young on some kind of schedule. In fact, scheduling your baby’s feedings at this early stage in her life could lead to weight loss and a serious failure to thrive. Always follow your baby’s signals about when she’s hungry, and be concerned if she isn’t consistently waking up at least every 5 hours to feed during her first five to six weeks.

New baby fog

Recovering from giving birth and being woken up over and over every few hours by your baby’s demands may finally get to the point at which you feel like you’re on another planet. We call it “New Baby Fog.” When your head’s in the Fog you’ll forget what you planned to do next, even eating and drinking, and you’re apt to be irritable and hard to get along with.

The Fog will increase the friction between you and your partner. A few misunderstandings and arguments are bound to arise during this early stage of parenting, simply because of the stress the two of you are undergoing. Don’t be tempted to play the blame game with your partner because you’re finding this stage of parenting so challenging. Your baby’s dad is probably struggling with his own issues and exhaustion, too, and his personal needs may make it hard for him to clearly see or respond to yours.

Hopefully, not too long from now, all of you—mom, dad, and baby— will finally reach a new, and livable balance together. In the meantime, responding to your baby is like investing in a bank account: You make deposits, holding to the faith that all you’re giving will pay off someday with a secure, independent, and loving child.

 

“Later on in life when you face some of life’s most difficult challenges, you’ll say it’s almost as hard as taking care of a newborn.”

Recognize that even now, this stage in your baby’s life offers lots of exquisite and once-in-a-lifetime moments, too. There’s the softness of your baby’s skin; the sweet aroma of the tuft of hair on the top of her head; the amazing beauty and perfection of her body; and, later on, the first gorgeous, toothless smile she will flash just for you. So hang on, things really do get easier.

 

“Carry your baby outside and let her see trees, grass, and sky. Hold her up to God and call out her name and express gratitude for the gift of this child who has come here to be a powerful teacher for you. The lifelong lessons are hard. The lessons are wonderful!”

Fears and challenges

Do you find yourself checking in on your sleeping baby just to be sure she’s still breathing? Are you afraid that SIDS will strike when you’re not paying attention? That happens to even the most secure parents.

You may discover you have trouble falling off to sleep yourself— even when you have a golden moment to grab the chance. Your head’s filled with thoughts about your baby; about being a mother or a dad; and you’re worrying about little things, like if the bills have been paid, or how you’re going to afford all of those diapers.

In the early days, you may even experience a heart-pounding nightmare or two about being separated from your baby or your baby falling off a balcony, only to awaken with your heart pounding, and with immense relief that it was only a dream.

Your mind is struggling to comprehend this amazing, life-changing responsibility for the little dependent you’ve taken on.

Chore checklist

If you didn’t do so while you were pregnant, write out a detailed list of the things that need to be done, and then make a list of people who might be able to do them. The list might look something like this:

Separate the laundry by colors. Wash colored and bloodstained clothes in cold water, and towels and sheets in warm or hot water. Dry, fold, and put away.

Wash the dishes or run them in the dishwasher. Dry and put away.

Sweep the kitchen floor and vacuum the carpets and rugs.

Run errands and bring home a take-out dinner.

Do grocery shopping, and prepare a couple of meals that can be frozen for later.

Mind the baby while I: eat . . . sleep . . . read . . . take a shower . . . go for a long walk.

  Tip

Note to self: Don’t try to drive a car, slice anything hard or frozen with a sharp knife, pick a fight with your partner, or do anything complicated when I’m tired and my head is still in New Baby Fog.

Feeding your baby

As we mentioned before, your baby’s stomach is about the size of a walnut, which is why she wakes up hungry every couple of hours. And when we say hungry, we mean for one thing—your living tissue (also known as milk), which the baby extracts from you through the actions of her mouth, tongue, and bony little gums. She can’t talk or walk, but she’s born to suck.

If you’ve never breastfed before (and even if you have), you may be surprised at how strange, tiring, or even painful it can feel at first. The good news is that once you and your baby have mastered the art of it, it’s a lot easier (and much cheaper) than mixing formula.

If you’re having trouble breastfeeding, or if you feel the least bit discouraged, put in a call to a lactation consultant, a postpartum doula, a midwife, or an experienced breastfeeding mom. Ask if you can have a home visit to help you find the most comfortable and effective positions for nursing.

If your nipples hurt, ask your care provider to prescribe or recommend a painkiller to help take the edge off, and possibly a nipple salve to help with healing. Relaxation techniques you learned in childbirth class may help during those initial teeth-gritting moments when your baby first latches on. And don’t forget, when you’re finished feeding, to break the baby’s mouth suction on your nipple by putting your finger in the corner of her mouth. (For more about breastfeeding, see in 3. Your Baby Maintenance Guide.)

Your baby’s need to suck

Whether breastfed or bottle fed, babies have a strong sucking instinct that often persists even after they’re full.

This is known as nonnutritive sucking because it follows a different pattern from the bursts and pauses of normal nursing. By now, some babies have learned how to suck their fists or fingers and will do this to help relieve their sucking urge. Giving your baby a pacifier is another option. A recent study appears to show that pacifier sucking may be associated with a reduced risk of SIDS. A downside is that pacifier sucking is associated with an increased risk of inner-ear infections, and babies can find the pacifier habit hard to let go of.

 

“I wish somebody had warned me about how messy breastfeeding is! I constantly have to change my bras and T-shirts because my breasts are always leaking and spraying, and I have to be prepared to cover my chest whenever we go out.”

Most pediatricians recommend that pacifiers not be introduced until a baby is at least four weeks old, since sucking a pacifier too early on may encourage a baby to adopt abnormal mouth actions that could interfere with nursing. Having said this, sometimes babies are given pacifiers in the hospital. If your baby becomes attached to her pacifier, expect to spend a lot of time in the year ahead scrambling around car seats and between sofa pillows searching for her lost “Binky”® (or passy or lovey), and getting awakened in the night when the plug falls out. After baby’s teeth begin to come in, your pediatrician or child’s dentist will probably recommend banning the pacifier to make sure her mouth shape forms correctly.

Breast care for bottle-feeding moms

Unless your child is adopted, choosing not to breastfeed won’t cause you less breast discomfort. Turning off your body’s drive to make milk isn’t easy. The first week after giving birth, your breasts may become engorged and feel painful and rock-hard until they get the message that they won’t get to “express” themselves.

Don’t introduce formula until you’re sure you want to wean your baby to the bottle. Drinking out of a bottle with a nipple is much easier for a baby than the work of nursing from a breast, so she won’t develop the tongue and throat coordination breastfeeding requires. Plus, introducing formula will slow your milk production, so you’ll be weaning your baby whether you intended to or not. (For more on weaning, see in 3. Your Baby Maintenance Guide.)

If you decide to wean abruptly, here are some old-fashioned remedies for helping the process along:

• Bind. Wear a sports bra or have someone tightly bind your chest with an elastic bandage. Keep your breasts bound everywhere but in the shower.

• Don’t stimulate. When you do take a shower, make it a cool one and stand with your back to the spray.

• Try the “Cabbage Cure.” Tuck a few whole, cold, firm-fleshed cabbage leaves inside your bra. Moms swear that this helps to reduce swelling and pain. Change the leaves when they start to warm and wilt.

DadNotes: Pitching in After Birth

This is a challenging time for both of you, as individuals and as a couple. However, no matter how tired you may feel, we can guarantee that your baby’s mom feels more exhausted (and sore). Don’t just stand there, do something. (For more on the relationship challenges of parenting, see in 5. Managing Your First Year.)

Here are some suggestions for how you can make things easier on her (and therefore, yourself):

• Do chores. Dry dishes, empty the trash, sort the mail, run the vacuum, walk the dog, clean the cat’s litter box, run a load of laundry (read the instructions!)—do anything but sit around. If there’s any recreation to be had, figure out how to have it while washing dishes with the baby in a sling. Consider installing a small, portable TV over the sink during football season.

• Take calls. Be the first line of defense against mom, the baby, and the world. Answer the telephone, take messages, and manage all callers and visitors at arm’s length until your baby and her mom are ready to receive them.

• Come to terms with reality versus fantasy. You may have imagined coming home from work, putting your feet up, bouncing the baby on your knee, and quietly going to bed. While this behavior was the norm for dads in your father’s generation, today this will get dishes thrown at your head. Don’t expect to do anything when you get home from work but pitch in with either the baby or household chores.

   Body Symptoms You Shouldn’t Ignore

Sometimes women can experience serious physical aftereffects following birth that don’t show up until they get home. Here’s a list of the symptoms that you need to watch for over the next few weeks. If you experience any one of them, notify your doctor or midwife right away:

• Excessive bleeding. Soaking a sanitary pad every hour for several hours (except for the flood when you first get out of bed in the morning). Passing a large number of blood clots, or the return of bright red bleeding after your lochia—vaginal discharge after delivery that resembles a heavy period, and which lasts for about six weeks—has turned pink or brownish.

• Foul-smelling vaginal discharge.

• Fever. A fever over 100.4° F.

• Pain. Pain or burning during urination, severe pain in your lower abdomen, or pain and tenderness in your genital area that doesn’t get better over time.

• Nausea or vomiting.

• Breast pain. Pain, redness, or hot spots inside your breasts.

• Incision pain. Severe pain, redness, or discharge from an episiotomy or cesarean incision or a tear.

• Leg pain. Pain or heat in the calf of one leg.

• Tend the baby. When you’re on duty, be totally on duty. Change the baby’s diaper and soothe her to sleep on your chest if she’s fussy. Put her in a soft carrier and take her on a brief outing outside or for a stroller ride. Make sure that mom’s break includes being far away from baby noises, which are much more disturbing to her than to you.

• Hunt and gather. Prepare something for dinner (follow a recipe, if you need to) or order in.

• Buy groceries. Do a grocery run using the checklist below for starters.

Dad and baby bonding

First week’s grocery list

Several packages of newborn-sized baby diapers (if you don’t already have a stack of them), and an extra trash can with liners

Baby wipes

Maxi-pads

Facial tissues

Witch hazel wipes (like Tucks®)

Nipple salve

Petroleum jelly for umbilical cord and/or circumcision site

A tube of zinc-oxide-based diaper rash cream

Food and drinks high in iron: blackstrap molasses (mix with milk or use in place of sugar), black cherry juice, shellfish, or meat

Easy-to-eat fruit, such as berries, apples, or bananas

Prune juice or dried prunes to help with constipation

Whole-grain cereal and bread

A case of bottled water for your ever-thirsty baby feeder

Milk or soy milk (for you and mom)

Several bottles of healthy drinks, such as fortified orange juice or mineral water (read labels to find a brand with plenty of minerals like calcium, iron, and magnesium)

Frozen entrées or ingredients for anything you plan to prepare and eat for the next 72 hours or so. If following a recipe, remember to take the list of ingredients with you to the store.

Magazines or light reading for mom to read while breastfeeding

A package of newborn-sized silicone pacifier(s), if you plan to use them, and if your baby is drinking formula: formula, bottles, silicone nipples, and a bottle brush. (Note that bottle supplies need to be washed in warm, soapy water before being used the first time.)