...on the upcoming birth of your new baby. 

The first days with your newborn can be wondrous and exciting. Parents often describe it as the most joyful, memorable, and sometimes even the most terrifying time of their life. For nine months you’ve been waiting for your little one to arrive. So now that you’ve got him or her here, what do you do?

Ensuring your baby has the best possible start in life is our top priority.  Leading Steps Paediatricians will check over your baby, answer your questions and are on call day and night so consultant level care is available when you need it.

Our "newborn toolkit"  can help you find out more about what to expect in the first days and weeks after birth and learn about:

• Newborn screening tests
• Normal development
• Bonding and attachment
• What to do when something isn't right

Biological Basics

Newborns have four basic behaviours. First of all, you’ll notice that they sleep. In the first month or two of life, your baby will need roughly three naps a day- around seven and a half hours sleep during the day and eight and a half hours at night. Often they are usually awake for stretches no longer than an hour or two.

Getting to know your baby. 

Babies also need to feed. You and your baby gain many benefits from breastfeeding. Breast milk is easy to digest and has antibodies that can protect your baby from bacterial and viral infections. The midwives at the hospital will give you plenty of help and support. They’ll show you how to attach the  baby correctly and ensure the feeding gets off to a good start. Particularly early on, breastfeeding should be ‘on demand’, whenever your baby is hungry. Expect this to be every three and to four hours. Ensure that your baby doesn’t go for more than four hours without feeding in the first month of life, even at night.

So where does all this milk go? This third behaviour is of course one of the most infamous yet integral aspects of parenthood - nappy changing. In the first few days after birth, the baby may have four or five dark, tarry stools (called meconium) as you are still developing mature milk. Following this, the first four weeks should see your newborn passing several bowel movements per day, plus you’ll change at least four wet nappies. Some breast fed babies pass very infrequent bowel motions subsequently, perhaps once per week, but they stay soft and aren’t constipated. Bottle fed babies need to pass bowel motions every day or two or they will become pebbly.

Finally, your baby will communicate, mainly by crying but also by watching your face.  Crying could indicate hunger, a wet nappy or wanting to be picked up and cuddled.  Otherwise it will mean the baby needs to be put down to sleep. You will gradually learn to recognise your own newborn’s cries and how to respond to them.

Bonding Basics

As important as it is to care for your newborn’s physical needs, it’s equally important to begin to get to know your baby and provide for their psychological and emotional needs. Babies need attention and affection; they need to feel safe and loved. It is important that you spend time in bonding activities such as holding your baby skin to skin, looking into their eyes, talking and singing to them, and cuddling them. This allows your baby to learn to love, trust and feel secure around you; emotional milestones that are the foundations for development into a psychologically healthy human.

Taking Care of Yourself

In this exhausting, overwhelming, yet thrilling time of your life, it is easy to forget that you yourself need looking after as well. Caring for yourself will help you recover from childbirth and care for your baby. Organise to have someone to help you out around the house, to cook and clean and offer support. Eat sustaining and nourishing foods, drink plenty of water, sleep when you can, get outside when you can. If you’re feeling stressed or sad, practise relaxation exercises or talk to a friend or your family doctor about it. Taking care of yourself ensures you can take care of your newborn. Remember, looking after your family includes looking after you.

Why screening tests are important

Although the majority of newborns are perfectly healthy, a small minority have disorders or illnesses that aren’t always recognisable at birth. There are three primary screening tests that are recommended in order to assist your doctor in identifying signs of these. If the disorders or diseases are picked up early with screening tests, most of these infants can be treated and will do well.

3% of children have an abnormality at birth, often minor, which won’t have been picked up on the antenatal ultrasound screening.

Heel prick (Neo-Natal Screening Test)

The heel prick test is done between 48 and 72 hours after delivery. A few drops of blood will be collected via a small prick of the baby’s heel. If you’re concerned about your baby experiencing pain during the test, it might be a good idea to contrast the short time minor discomfort with the potential long-term benefits of picking up on an illness immediately. The primary aim of this blood test is to detect more than 30 rare genetic disorders.

Hearing test

One in 500 children are born with a clinically significant hearing loss, making it the most common disorder that we screen for. These tests are extremely reliable at detecting moderate to profound hearing loss. Without the test, these same deficits would only be picked up at two to three years old, by which time the child has already lost the ability to properly develop language. During the examination, specific sounds are played to the baby and the baby’s neurological responses are recorded via small sensor pads on the head.

Heart Disease Test

A probe is put on the newborn’s fingers to check that oxygen levels are normal. This is typically done on day two. This test is performed at Pindara Hospital as a special initiative and is not generally available at other hospitals.

Developmental dysplasia of the hip (DDH)

DDH can affect roughly 1 in every 700 babies, with higher risk in some circumstances such as a family history. Your doctor will check for DDH within the first day or two after birth by feeling around each hip for signs of dislocation. Sometimes a baby may have DDH but it doesn’t present at birth- hence the doctor will examine for it again at your six week check.

Six Week Check

The six-week check is a good time for your Paediatrician to examine your baby’s vision and developmental progress. This is highly recommended in order to ensure that the newborn is growing normally and developing a reasonable routine. It is also the time when many cardiac defects become apparent.

Infant development begins at birth. It helps to know normal infant development milestones from birth to 3 months so if  something's not right it can be picked up early.

A lot happens during your baby's first three months. Most babies reach certain milestones at similar ages, but infant development isn't an exact science. Expect your baby to grow and develop at his or her own pace. As you get to know your baby, consider these general infant development milestones.

What to expect

At first, caring for your baby may feel like an endless cycle of feeding, nappies and soothing. But soon, signs of your baby's growth and development will emerge.

Motor skills

Your newborn's head will be wobbly at first. But within the first few months, most babies can face straight ahead while lying on their backs and lift their heads while lying on their tummies. Although newborns aren't likely to roll over, your baby may soon turn from side to back. Your baby's stretching and kicking are likely to get more vigorous. If you offer a toy, your baby may grasp it and hold on tight for a few moments.

Hearing

Within a few weeks, your baby may respond to loud noises by blinking, startling, frowning or waking from light sleep. Even everyday household sounds — footsteps on the floor, water running — may elicit subtle responses, such as increased limb movement or slowed sucking rhythm. Expect your baby to respond to the sound of your voice and turn their head towards sounds.

Vision

Your baby will probably focus on your face while feeding. Soon your baby may begin to examine more complex designs, along with various colours, sizes and shapes. You may notice your baby studying his or her hands and feet. By age 3 months, your baby may be easily distracted by an interesting sight or sound.

Communication

Newborns are sensitive to the way you hold, rock and feed them. By age 2 months, your baby may smile on purpose, blow bubbles and coo when you talk or gently play together. Your baby may even mimic your facial expressions. Soon your baby may reach for you when he or she needs attention, security or comfort. 

Social and emotional

By six weeks after the due date your baby should begin to smile at people. You'll notice he will try to look at you and is starting to be able to calm himself, for instance he may suck on his hands. 

Cognitive and learning

Even the youngest baby likes to pay attention to faces, and this increases over the the months. In these first few months your baby will begin to follow things with his eyes and recognise people at a distance. He may let you know if he is bored and ready for a new activity by crying or fussing.

Your relationship with your child is the foundation of his or her healthy development. Trust your ability to meet your baby's needs. You can:

Hold your baby

Gentle caresses and tender kisses can help your newborn feel safe, secure and loved. Hold and rock your baby. Allow him or her to study your face. Let your baby grasp your little finger and touch your face.

Talk to your baby

Simple conversation lays the groundwork for language development, even before your baby can understand a word. Ask questions and respond to your baby's coos and gurgles. Answer when your baby makes sounds by repeating the sounds and adding words. Describe what you see, hear and smell around the house, outdoors, and when you're out and about. Use simple words that apply to your baby's everyday life. Remember that your tone of voice communicates ideas and emotions as well. 

Change positions

Hold your baby facing outward. With close supervision, place your baby on his or her tummy to play. Hold a colourful toy or make an interesting noise to encourage your baby to pick up his or her head. Many newborns get fussy or frustrated on their tummies, so keep these sessions brief at first — just a few minutes at a time. If drowsiness sets in, place your baby on his or her back to sleep.

Respond to crying

 For most newborns, crying spells peak about six weeks after birth and then gradually decline. Whether your baby needs a nappy change, feeding  or just simply warm contact, respond promptly. Your attention will help build a strong bond with your baby — and the confidence he or she will  settle down without your help one day.

When a baby becomes part of your family it is time  to to ensure your home is a safe environment. As your baby grows and becomes more mobile supervision is the most important safety precaution.

Safe Sleeping

SIDS is the sudden unexpected death of an infant younger than one year that cannot be explained. Keep your baby safe by following the following guidelines.

How to Sleep your Baby Safely:

1. Sleep your baby on the back from birth, not on the tummy or side

2. Sleep your baby with head and face uncovered

3. Keep your baby smoke free before birth and after

4. Provide a safe sleeping environment night and day

5. Sleep your baby in their own safe sleeping place in the same room as an adult caregiver for the first six to twelve months

6. Breastfeed your baby

Visit Sidsandkids.org.au as some recommendations change from time to time.

Traveling

Car accidents are one of the leading causes of death among children in Australia.  Most accidents occur close to home, and most kids are hurt in the back seat.

Fitting and using an approved child restraint  is the most important thing you can do to keep your child safe in a moving car. Never move off in the car until everyone is properly restrained.

• A baby restraint, or 'capsule' is a rear facing seat should be used until your child is at least 6 months old.
• A child restraint  with it's own belt system should be used until your child is at least 4 years old.
• A booster seat is for children aged 4 - 7 years old.  If you have a booster seat that does not have it's own inbuilt seat belt system, ensure that you use the adult seat belt system correctly.  A lap-sash belt is the recommended system.  If you have a lap-only belt that can't be replaced with a lap-sash belt, consider using a child-harness.    More information on baby restraints

Blind and Curtain Cords

Looped curtain and blind cords pose a significant strangulation hazard for children as they can place the loop over their head and/or get tangled in the loose cords.

• Check every  room in the house for any blinds or curtains with long cords that are either loose or looped. This includes any cords that are within children’s reach at floor level or near furniture they can climb on.
• Secure any lose or looped cords with cleats or tension devices – these can be purchased from your local curtain and blind retailer or hardware store.
• Do not put furniture such as cots, beds, highchairs, playpens, couches, chairs, tables or bookshelves near a window where children can reach the blind or curtain cord. 
• When installing new blinds and curtains, make sure you or the installer secures any loose or looped cords immediately.  For more information on blind and curtain cord safety visit Kidsafe Victoria

Using a Sling

SAFETY TIPS

• Always keep the babies face uncovered (especially the nose and mouth)
• Avoid the baby being curled - chin against chest - in the 'C' position
• Seek medical advice before using a sling for premature or low birth weight babies, or those with a cold
• Reposition the baby after breastfeeding to ensure their nose and mouth are clear
• Regularly check the baby

Kids In Hot Cars : The Facts

When something's not right

Your baby may reach some developmental milestones ahead of schedule and lag behind a bit on others. This is perfectly normal. There's typically no cause for concern. It's a good idea to be aware of the warning signs, however. Consult your baby's doctor if you're concerned about your baby's development or you notice any of the following red flags by age 3 months:

• No improvement in head control
• Doesn't smile at people
• Doesn't bring hands to mouth
• No attempts to lift the head when lying facedown
• Extreme floppiness.
• Lack of response to sounds or visual cues, such as loud noises or bright lights
• Inability to focus on a caregiver's eyes
• Poor weight gain
• Remember that every baby is unique — but your instincts are important, too. The earlier a problem is detected, the earlier it can be treated.