Baby's first month: development, medical and sleep
Your first few moments with your newborn
Congratulations you have a brand new addition to your family! Whether it is your first or fifth plenty of Mums can't remember exactly what's it's like to have newborn (blame the comb of sleep deprivation and pregnancy brain!), so find out about baby's first month on Essential Baby.
Many skills babies learn in the first year can be learnt only if there is an opportunity to practice when lying on their tummy. So allowing your baby to lie on her stomach during playtime is very important for this. But because babies breathe only centimetres from the ground make sure your baby is on a clean, safe surface, such as a blanket placed on carpet. She will start to uncurl from the foetal position and lift her head when in this position as she learns balance.
You may also hear them breathing rapidly, shallowly and irregularly, which is normal as you baby is still developing breathing control.
Newborn babies are born with a number of inherent, fundamental reflexes that are vital for survival. These include the sucking reflex, the swallowing reflex and the gagging reflex that prevents him from taking too much liquid and the labyrinthine reflex, where a baby that lies on his stomach will automatically turn his head, instead of just lying with his head down.
At this age babies can also move their head from side to side, bring their hands to their face, respond to familiar voices, blink at lights, extend their arms to grab hold of you and grip tightly with their fingers.
But your baby will still learn several important things in the first month. Your newborn's eyesight is still developing and as he learns to focus on objects in front of him, he may cross their eyes but this is typical. A one month old baby is short sighted, and focuses best on objects that are between 20 and 35 centimetres away to the left or the right rather than straight ahead, and will switch between attentiveness and vacant staring. Objects that are closer or farther away than this will appear blurry, although shiny, contrasting colours or moving objects will catch her eye. One month old babies are also fascinated by faces that are placed within their focus, even their own reflection in a mirror, and sometimes can tell the difference between a face and an object. Mirrors, mobiles and activity boards are all suitable for this reason. Taste and touch are two senses that develop quickly after birth, with babies being sensitive to both these things, while their sense of smell is less developed.
Babies often strain to listen carefully to sounds, without moving their heads. They may become irritated when they can’t switch off from a sound, and this is known as sensory overload or sensory fatigue. By comforting your baby immediately when she begins to cry in the first month, you will not be spoiling her or creating bad habits for the future – you are responding to her needs and giving her a sense of security. Babies harness their understanding of how you respond to their different cries in later months but are still crying instinctually at this point rather than deliberately trying to communicate.
If your baby isn’t thriving on your breast milk alone (gaining approximately three to five kilograms amount of weight within a month and growing to 50-60cm within the first month) formula is usually suggested.
A baby who is feeding properly should produce at least 8-12 wet nappies each day. Posseting is not a sign of failure to thrive unless it is attached to low weight gain, contains blood or is projectile. In that instance see your doctor.
Shortly after birth babies may have discoloured or scaly skin with red or pink blotchy patches and their skull may appear misshapen and their eyes puffy but this will subside over the next few weeks.
Bathing is important in order to keep the stump near the belly button, clean and free of infection.
Possetting is also common from the first month, which is when babies regurgitate milk in small quantities either because they have been overfed or when the baby gulps in air while feeding and releases partially digested milk when their stomach contract. Most babies outgrow this between six and twelve months but you can avoid this by keeping your baby still during and after a feed and by remembering to burp him during a feed as well as afterwards. Continual possetting may be related to reflux which isn’t serious but does require medical intervention.
Soft bowel movements are another good indication of your baby’s health. Five or more movements every day are normal initially and progressively lessen as time goes on. Diarrhoea can be distinguished by smell and in conjunction with other symptoms such as fever. Constipation can be distinguished by hard, infrequent stools. Babies often pull faces when passing stools so don’t be concerned about this but if you are in any doubt about your baby’s health talk to your doctor.
Newborn babies are not able to fall into a perfect slumber. Infant behaviour can be categorised into six states of consciousness: quiet alert, active alert, crying, drowsiness, quiet sleep and active sleep. The long periods of sleep are assisting with development and as they grow, babies will be able to stay awake for longer periods. But at this time, most babies are only alert for 2-3 hours per day. But you should use this time to catch up on your own sleep!
A newborn’s sleep is quite restless, and he will probably make facial expressions and move a lot. Newborns wake up often during sleep because much of their sleep is REM sleep, which is active sleep and if they sleep in the same room with you, you will hear them stir, twitch and grunt. You may also hear them breathing rapidly, shallowly and irregularly, which is normal as you baby is still developing breathing control.
Babies sleep for an average of 16 and a half hours each day in the first month, but this can vary between 14 and 22 hours, usually for one to three hours intervals, regardless of the time of day because they cannot distinguish between day and night.
They will pass through two states of sleep –quiet sleep and alert sleep– every half hour. Quiet sleep is the most restful period where your baby will remain still and her breathing will be smooth and she will rarely startle. Alert sleep is REM sleep where your baby’s eyes will move beneath her eyelids and she will breathe irregularly which is normal and this will lessen as your baby’s brain matures. Place your baby on her back to sleep, as this is the safest position to protect against SIDS, and keep blankets, pillows and toys out of the cot for further safety. Your baby’s head will stay turned to one side when lying on her back, with one arm out straight and the other bent at the elbow. Most of the time a baby’s head droops forward when tired.
They are usually able to sleep in a noisy environment and this can be a good thing as it enables them to sleep in a variety of places such as in the car and in the stroller.
Most babies reach milestones in their own time but if you have any concerns it’s best to check with your doctor. Be aware that premature babies may also reach milestones later than other babies, usually achieving them closer to their adjusted age. It is only when a baby is not achieving what a child of their age should be able to do on a regular basis that there is a need to be concerned. By providing a stimulating environment, adequate diet and health care, medical attention and affection you are helping your baby to develop to the best of their ability.