Feeding

Newborn babies need to feed eight to 12 times a day up to 16 times a day when breast-fed.

By 3 months a more regular feeding pattern of 3 – 4 hourly with perhaps one longer stretch during the night can be expected.

Expect regular growth spurts, requiring increased frequency of feeding to increase supply can be expected. Baby may feed 1 – 2 hourly.

Some newborn babies can be a little sleepy and will need to be woken to feed 3 to 4 hourly during the day but they can be left longer at night.

A very sleepy newborn that is extremely difficult to waken may be jaundiced which is checked by a blood test. Slight jaundice is common and no cause for concern.

But if the SBR (serum bilirubin) rises to high levels referral to a Paediatrician and treatment in hospital under phototherapy lights is essential.

Your Birthright Obstetrician or Midwife will discuss this with you and refer when necessary.

Insufficient weight gain can indicate feeding or latching problems, and your Birthright Midwife, Plunket, GP, La Leche League, Lactation Consultant can help.

If baby is feeding well, but still not gaining weight, referral to a Paediatrician to exclude any medical conditions may provide reassurance.

Crying

When your baby cries they are asking for your attention. Babies cry about something happening at that moment.

Crying can be due to hunger – the cry builds in intensity and may be accompanied by rooting movements.

Other reasons babies cry include being hot or cold, having wind, being tired or over-stimulated, bored, lonely or expressing feelings.

Babies often have an unsettled period – usually in the early evening, but can be any other time including the middle of the night.

Colic – will start usually between 2-12 weeks. Prolonged intense crying often in the evening.

Abdomen hard, legs drawn up.

Talk to your Birthright Midwife, Plunket, GP, Alternative Health Practitioner (Homeopath, Osteopath), or obtain a referral to Paediatrician.

Pain – body tense, loud and insistent cry with agitated body movements. Contact your Birthright Midwife or GP.

Unwell – whinge and fuss, frequent but not necessarily continuous bouts of crying: contact Birthright Midwife or GP.

Sleeping

A newborn baby cannot distinguish between night and day and does not have a cyclical body rhythm until 2 weeks.

They will wake when hungry and fall asleep when full, at any time of the day and night.

Babies will remain asleep for periods lasting 20 minutes to five hours and between sleeps are either awake or feeding. A newborn sleeps for approximately 60% of the time – some more, some less.

By 6-8 weeks they will start to sleep more at night than during the day and may have one longer stretch during the night.

By three months they are likely to have one longer wakeful patch in the day – usually in the afternoon or evening.

Babies continue to wake several times at night and very few will sleep longer that 4-5 hours at four months. Babies will wake more frequently during a growth spurt.

A baby that is over stimulated or overwrought may be difficult to settle. If sleeping/settling issues occur consistently over several weeks, you need to eliminate any medical issues with your GP or Paediatrician.

Plunket Family Centre can provide practical assistance and education. You may self refer or be referred by Your Birthright Midwife, Plunket Nurse or GP.

Bowel motions

For the first few days after birth a baby passes meconium, dark green and sticky, which changes to transition stools and then to sweet smelling, runny mustard-coloured stools of a breastfed infant.

There is a wide variation of normal. From having a bowel movement every feed up to 12 bowel motions daily to once every few days. As long as the bowel movement is it’s usual colour and consistency then there is no cause for concern.

The form and frequency of bowel movements has usually developed into a pattern within six weeks.

Babies receiving formula milk may have less frequent bowel movements that are firmer, darker and have a different smell.

Baby’s bowel movements often sound very “explosive”.
Stools that are green in colour but normal consistency can be a sign of wind or overfeeding.

Diarrhoea – very watery, greenish stools more often than usual.
Accompanied by a fever or blood, must see a GP immediately or go to Starship Hospital. If diarrhoea symptoms have been experienced for more than six hours with any other symptoms or on their own for more than 24 hours, then see your GP.

Constipation – stools that are difficult to pass, may cause pain and are hard and dry. Not usually seen in breastfed infants – ensure that formula milk is being prepared in accordance to manufacturer’s instructions. For further assistance contact manufacturers help number.

If baby becomes pale, limp, or floppy, difficult to rouse and disinterested in feeding take immediately to Starship Hospital.

Spilling

A lot of babies spill a little milk during or after a feed – this is usually wind or they have taken too much milk. Sometimes they may vomit with great force what appears to be their whole feed. An occasional vomit should not cause concern.

Vomiting rather than spilling after each feed accompanied by slow weight gain and unsettled baby. Initial contact with a GP and possibly referral to a Paediatrician.

Frequent vomiting of a whole feed for more than two feeds, see your GP.

Dehydration is a very immediate concern – particularly with young babies.

Do not wait until morning before seeking medical help.

Frequent vomiting of formula milk perhaps accompanied by diarrhoea may indicate gastroenteritis.

Ensure correct sterilisation of equipment and see your GP.