Weight gain in babies are directly correlated to health and wellness, and it is therefore no surprise that the initial weight loss a newborn experiences is of great concern to the new parents. In the vast unknown when caring for newborns, the weight metric is the one thing we can keep an eye on.

It is normal for almost all babies to loose up to 10% of their body weight in the first 3-5 days of life.  There is a really good reason for this. Newborn babies transition from an environment where they are submerged in hydrating amniotic fluid for many months. After birth they loose some of this excess fluid, and their lungs, skin and other organs start to dry out. They begin to live outside of the uterus, breathe, and their previously fluid filled lungs now fill with air.

This initial weight loss happens for both breast and formula fed infants, but it seems that breastfed babies can loose slightly more weight than formula fed babies. 

The reason for this is two-fold. Firstly, newborn babies are generally more sleepy for the first 48 hours, and mom’s milk supply can also be limited for the first day or two. As baby becomes more alert, 72 hours after birth, their sucking reflex becomes stronger. This stronger suck leads to more Oxytocin hormone production in the brain, which in turn stimulates more milk production and better flow. This whole cycle takes a few days to kick in fully.

Babies can loose weight up to day 7, but thereafter it stabilises and baby begins to gain weight daily, usually at a rate of about 25g per day. Your newborn should be back at birthweight no later than day 14 of life. In this time, it is normal for your baby to produce 6-7 wet nappies per day, and to have between 3 and 5 poopy nappies per day. These parameters are usually a good indication that the feeding routine has been well established, and that all is well.

It is not normal for any baby to loose more than 12% of his/hers birthweight, or to continue loosing weight after day 7. If your baby is very sleepy and lethargic, doesn’t produce enough wet nappies and remains continuously and deeply jaundiced, it may be a sign that there could be a feeding issue. 

If your baby is difficult to wake with a poor suck, please contact your dr’s offices immediately.  

To prevent these complications, feed your baby on demand, at regular intervals.  This is one time where I will advise you to wake your baby if they sleep  longer than 3-3.5 hours during the day and 4 hours at night. Getting in more feeds per day ensures that their nutrient intake is optimal, and also that they get rid of the pigment that causes jaundice ( Bilirubin) through urine and stools.

 It is important to keep to those early scheduled visits at your Paediatricians rooms. If there is a problem we would want to identify these, sooner, rather than later. Your baby’s first follow-up visit is usually scheduled between 10 and 14 days of life and one of the most important things that will be assessed at this visit is their weight and any feeding issues encountered, will be addressed.

Remember, that the more you know about your new baby, the less you have to be anxious about. I hope that you find these posts helpful. Please let me know if there are any specific questions regarding newborn cares which you would like me to address.

When I was a medical student one of the older midwives taught me to swaddle babies, which is basically wrapping your baby up to look like a papoose. The idea behind this age old practice is that it simulates the womb, make the babies feel safe and secure… and maybe even sleep better. Over the years I have swaddled my own daughter and taught many parents to also swaddle their babies. As a woman of science I know that practices, knowledge and beliefs change and decided to take a closer look at the pros and cons of swaddling.

Why swaddle?

• If one considers the growing trend of looking at the first 3 months of outside life as the fourth trimester, it makes sense to assume that your baby might enjoy feeling snug and secure when swaddled, as they did in the womb.
• Babies can potentially sleep better and longer as they are not woken up by their own startling (Moro) reflexes. Their arms and legs are contained within the swaddle and therefore they don’t startle at the faintest little noise or movement.
• Swaddling could possible calm fussy and colicky babies. Some anecdotal reports claim that babies settle easier and sleep better. There is unfortunately little to no research that supports this view.
• It can help ensures baby stays sleeping on their backs, as recommended to prevent SIDS (Sudden Infant Death Syndrome) or cot death.
• It may help calm and contain babies going through withdrawal syndromes following maternal drug use during pregnancy. 

Reasons not to swaddle.

• It is potentially unsafe if baby is not swaddled correctly. The head and neck should be free, only swaddle the body.
• There is a risk of overheating (another risk factor for SIDS), if the blanket used is too thick, or if they are wrapped in too many layers.
• If not swaddled correctly the blanket can come loose and this may be dangerous and a suffocation and strangulation risk.
• Un-swaddle while breastfeeding as they can get hot quickly and overheat whilst feeding. It’s also good for the hands to be open to explore and feel mom’s skin. It’s also easier to get a comfortable good latch if baby is not swaddled. Some research has found that swaddled babies feed less frequently and less effective.
• If the swaddle is too tight it might inhibit leg, and especially hip development and cause hip dysplasia ( a condition where the hip joint is shallow and can dislocate easier). This risk can be overcome by not swaddling too tightly and leaving room for the legs to straighten and bend with ease.  A newborn baby’s legs should have room to fall into the natural froggy style (rotated outwards).
• Never position a swaddled baby to sleep on their tummies or even sides. Back lying is the recommended position to prevent SIDS.
• It is advised to stop swaddling your baby as soon as they show any signs of wanting or attempting to roll. This happens between 3 and 4 months of age. Head lifting and turning is important in a tummy lying position to prevent suffocation and this reflex action is inhibited in the swaddled baby.

Is swaddling safe?

If the guidelines for safe sleeping and healthy hips are followed… then absolutely yes! 

Safe swaddling tips.

• Use thin, breathable fabrics. Stretchy cotton or soft cotton muslin swaddles are the best. Don’t put too many layers over that.
• Make sure whatever you use to swaddle cannot come undone.
• Do not let the swaddle extend above their shoulders. Head and neck should be open.
• You get arms up babies and arms down babies… the arms up babies usually love to lie with arms stretched out above their heads and they do much better in a star shaped sleep sack, than swaddled in the traditional way. Arms down babies are usually content to be swaddled in the conventional way.
• Wrap your baby firmly but gently (not tightly). Your baby should still be able to move his or her hips and legs must be able to move and kick. For a younger baby the legs should be able to fall into the natural froggy style legs.
• Check their temperature and dress appropriately for the weather. No thick fleecy jumpsuits in the middle of summer.
• Always put your swaddled baby on their backs to sleep. Tummy is only for play, never to sleep.

Remember that some babies hate to be swaddled. If your baby is one of them it’s also ok not to swaddle. If you have questions regarding swaddling or other newborn niggles please come and  Ask Dr Christa anytime.

If you have a baby boy you would have seen and first-hand experienced that they wee everywhere; on you, themselves pretty much all over as soon as those nappies come off…  You will also find  that they wee escape the sides of their nappies and  you will end end up changing clothes all day long. Here is a trick to prevent this.

When changing their nappies, position the penis so that it points downward. Use cotton round make-up remover pads and place two over the tip of the penis before securing their nappies in place with the velcro strips. 

By doing this you will never have a side escape of urine ever again. Try it and let me know how it works.