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