Helpful Hints

Normal Newborn Behaviour

Baby should be alert and responsive when awake with bright eyes and good skin turgor.

Feeding Needs

A full term healthy baby should be fed to need.  Needs will vary according to the individual baby. 

After the first 24 hours a minimum of six feeds would be considered normal. Mothers should begin to be aware of baby’s early feeding cues eg. awake, alert, searching, sucking on fingers and starting to cry, and respond to them.  Baby’s attachment to the breast and sucking ability should be observed, along with mother’s comfort during the feed.  Baby should be offered both breasts in the first few days to maximise volume of milk available and stimulation to the breasts. 

Once the milk“comes in” mother should finish the first breast prior to offering the second breast i.e. if the first breast remains full and lumpy after the feed, baby should be encouraged to reattach to the same breast before changing breasts.  The breasts should become softer and more comfortable over the next few days.

Baby’s behaviour

Baby should appear satisfied after the feed but will not always sleep immediately.  Mum should cuddle the baby for a little while before putting him/her into the cot and to respond to her promptly when he cries.  Just prior to the milk “coming in” the baby usually seems very hungry and wants to feed  more  frequently.  This  is  often  called  the  “feeding  frenzy”.  He  may  also  have  a  low-grade temperature.  Mother should be encouraged to respond to the baby and see this as normal.

After the first week there will usually be one period during the day when baby does not settle in his cot but is often happy being held. 

Urine output

Urinary output is spasmodic in the first 48 hours.  As long as the baby is voiding one or more times per  day  during  this  time  there  is  usually  no  cause  for  concern  and  the  presence  of  urates  is  not clinically  significant.    As  milk  volume increases  around  day  4-5,  baby’s  urinary  output  should  also increase to a minimum of six wet nappies in 24 hours.

Bowel actions

For the first 24-48 hours the baby passes meconium that is greenish-black in colour.  This changes to greenish  brown  transitional  stools  by  day  3  and  by  day  4  the  stools  should  be  loose  and mustard/yellow in colour.  A baby who is still passing meconium at this stage may be signalling a problem with attachment to the breast or ability to suck correctly and this should be observed. 

Weight

It  is  normal  for  babies  to  lose  up  to  10%  of  their  birth  weight,  however  a  baby  who  is  not breastfeeding well will show other signs of being dehydrated from about the third day and weighing should not be seen as the main indicator.  Weighing should occur between days 3-5, as this would give a chance for the milk to “come in” and  provide a better overall picture.  It is expected that a breastfed baby will regain birth weight by day 10-14.

Use of Dummies

The use of dummies in full term breastfed babies is discouraged for the following reasons:

•  Sucking at the breast differs from sucking on a bottle or dummy

•  May reduce baby’s sucking capacity

•  Reduces breast stimulation

•  May lead to problems such as: - engorgement, breast refusal, cracked nipples, dehydration

1.  Food for Health Incorporating the Infant Feeding Guidelines for Health Workers, 2003. National Health & Medical Research Council

2.  Renfrew et al, 2000. Enabling Women to Breastfeed. A Review of Practices which Promote or Inhibit Breastfeeding with Evidence-based Guidelines

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