Things to Watch for in Baby’s First Weeks

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Some physical conditions are especially common during the first couple of weeks after birth. If you notice any of the following in your baby, contact your pediatrician where recommended.

Abdominal Distention – A baby’s belly might stick out after a large feeding, but between feedings, the belly should feel quite soft. If your child’s abdomen feels swollen and hard, and if he has not had a bowel movement for more than one or two days, or if he is vomiting, call your pediatrician. Though the distention might be caused by gas, it could also signal a more serious problem.

Birth Injuries – A broken collar bone or muscle weakness might occur during a particularly long or difficult labor. Your pediatrician will advise you how to help keep your baby’s side relatively motionless to allow the bone to heal. In the case of muscle weaknesses, usually appearing on one side of the face or one shoulder or arm, your pediatrician will advise you how to feed or hold baby to promote healing until the area returns to normal, usually in a few weeks.

Blue Baby – Blue hands and feet are not usually something to worry about in a newborn. His face, tongue and lips may turn a little blue occasionally when he’s crying hard. But once he becomes calm, his color in these areas should quickly return to normal. If his hands and feet turn blue from cold, they should return to pink when they are warm. Persistent blue skin coloring is a sign that heart or lungs are not operating properly and the baby is not getting enough oxygen in his blood. Immediate medical attention is necessary.

Coughing – If your baby eats very fast or is trying to drink water for the first time, he may choke, cough and sputter a bit. But the coughing should stop once he returns to his familiar feeding routine. If he coughs persistently or routinely during feedings, consult the pediatrician. These symptoms could mean an underlying problem in the lungs or digestive tract.

Excessive Crying – All newborns cry, sometimes for no apparent reason. If you’ve made sure baby is fed, burped, warm and dressed in a clean diaper, the best tactic is probably to hold him and talk or sing to him until he stops. If this doesn’t work, try one of the tactics on page 15. You will become accustomed to your baby’s normal pattern of crying. But if it ever sounds peculiar – such as shrieks of pain – or if it persists for an unusual length of time, it could mean a medical problem. Call the pediatrician for advice.

Jaundice – Infants sometimes develop a yellowish tinge to their skin in the first few days of life. The condition, called jaundice, is a sign that the blood contains an excess of bilirubin. Everybody’s blood contains small amounts of bilirubin, but newborns tend to have higher levels because they have extra red blood cells at birth and their immature livers may have trouble processing the additional bilirubin. Most infants have mild jaundice that is harmless, but in very rare cases, the bilirubin level can get very high and cause brain damage. Your pediatrician will check your baby for jaundice and recommend treatment in the case of significant jaundice.

Respiratory Distress – It may take your baby a few hours after birth to form a normal pattern of breathing, but then he should have no further difficulties. If he has any of the following signs, notify your pediatrician immediately:

• Fast breathing (more than 60 breaths in a minute)
• Retractions (sucking in the muscles between the ribs with each breath, making his ribs stick out)
• Flaring of his nostrils
• Grunting while breathing
• Persistent blue skin coloring

Swollen Breasts – Your new baby’s breasts may feel large or swollen and secrete a thin, white substance. This is a result of your high hormone levels during pregnancy. The baby’s breasts will soon be normal.

Thrush – This common yeast infection appears as white patches in the baby’s mouth and is treated with an oral anti-fungal medication prescribed by your pediatrician.

Umbilical Hernia – If your baby’s umbilical cord seems to push outward when he cries, he may have an umbilical hernia. This is a small hole in the muscular part of the abdominal wall that allows tissue to bulge out when there’s pressure inside the abdomen (such as when baby cries). This is not a serious condition, and it usually heals by itself in the first few years of life. In the unlikely event that it doesn’t heal, the hole may need to be surgically closed.