What to Expect the First Year (31 page)

Take your time.
A nursing baby can keep suckling on a breast long after it's been drained, just for comfort and sucking satisfaction. Your bottle-fed baby can't do the same with an empty bottle, but there are ways you can supply some of the same satisfactions. Extend the pleasure of the feeding session by chatting, singing, or cooing to your baby once the bottle is drained—assuming he or she hasn't dropped off into a milk-induced sleep. The sound of your voice is like music to your baby's ears and makes a feeding session even more special. If your baby doesn't seem satisfied with the amount of sucking each feeding is providing, try using nipples with smaller holes (or slower flow), which will ensure that your baby will get to suck longer for the same meal. Or finish off feedings by offering a pacifier. If your baby seems to be rooting around for more at meal's end, consider whether you're offering enough formula. Increase feeds by an ounce or two to see if it's really hunger that's making your baby fussy.

Bottle-feeding pumped milk or formula can give dad and other family members the chance to get close to baby for some quality cuddle time.

“My friends all seem to be having babies who weigh 8 and 9 pounds at birth. Mine weighed in at a little over 6½ pounds at full term. She's healthy, but she seems so small.”

Just like healthy grown-ups, healthy babies come in all kinds of packages—long and lanky, big and bulky, slight and slender. And more often than not, a baby can thank the grown-ups in her life for her birth stats—and her future stats. After all, the laws of genetics dictate that large parents generally have large babies who become large grown-ups, while small parents generally have small babies who become small grown-ups. When dad's large and mom's small (or the other way around), their little ones can be little, big, or somewhere in between.

Mom's own birthweight can also influence her offspring's (if she was born small, her baby's more likely to arrive that way, too). Still another factor is a baby's sex: Girls tend to weigh in lighter and measure up shorter than boys do. And though there is a laundry list of other factors that can affect a baby's size at birth—such as how much weight mom gained during pregnancy—the only factor that matters now is that your baby is completely healthy … and likely, every bit as healthy as any newborn chubster.

Keep in mind, too, that some babies who start out small quickly outpace their peers on the growth charts as they start catching up to their genetic potential. In the meantime, enjoy your sweet little bundle while she's still a relatively light load. It won't be long before just hearing the words “Carry me!” from your strapping preschooler will make your back start aching.

Was your baby born small for her gestational age? Check out
Chapter 21
for information on low-birthweight babies.

“I expected my baby to lose some weight in the hospital, but he dropped from 7½ pounds to just over 7 pounds. Isn't that a lot to lose?”

Not to worry. Nearly all newborns check out of the hospital weighing considerably less than when they checked in. In fact, thanks to normal postdelivery fluid loss, babies lose
an average of 5 to 10 percent of their birthweight within the first 5 days of life. That loss (essentially, “water weight”) is not immediately recouped, since brand new babies initially need and take in very little food. Breastfed babies, who consume only teaspoons of colostrum in those early days of feeding, may lose even more weight than formula-fed babies and may be slower to regain it (which, again, is nothing to worry about). Happily, your newborn is likely to stop losing weight by the time he's 5 days old, and to have regained or surpassed his birthweight by 10 to 14 days—at which point, you'll be able to start posting those weight gain bulletins.

“People ask me whether the baby looks like his mom or his dad. Not sure what to say, since neither one of us has a pointy head, puffy eyes, an ear that bends forward, and a pushed-in nose.”

If you've ever wondered why 2- and 3-month-olds are used to play newborns on TV, you've just discovered a key reason: Most babies aren't exactly born photogenic. Beautiful to their parents, of course, but not nearly ready for their close-ups. Instead, most newborns—especially those who arrived via the vagina (C-section babies definitely have an edge in appearance)—have a few wrinkles to work out first, not to mention some puffiness.

As you probably already guessed, the features you're describing weren't inherited from some distant pointy-headed, puffy-eyed, flap-eared relative. They were picked up during your baby's stay in the cramped quarters of your water-filled uterus and during the tight squeeze through your bony pelvis and birth canal during labor and delivery.

Let's break down the features, starting with your precious bundle's unexpectedly pointy head. Believe it or not, nature has your baby's back—if not his just-born looks—in the miraculous design of the fetal head. Since the bones of the skull aren't yet fully formed, a baby's head can be pushed and molded as he's making his descent to and through the exit—allowing for a vaginal birth in most cases, something that wouldn't be possible if his skull were unyielding. That's the upside. The very temporary downside? Being a cone head for a few days or so—after which his head will return to cherubic roundness. Good thing baby beanies are part of the nursery ensemble, right?

The swelling around your baby's eyes is also due, at least in part, to the rough road he took on his fantastic voyage into the world. Another contributing factor might be the antibiotic ointment placed in those precious peepers at birth. And here's one more thought: Some experts speculate that this swelling serves as natural protection for newborns, whose eyes are being exposed to light for the first time. No matter what the cause, puffiness, too, is temporary—lasting just a few days. In the meantime, don't worry that it might interfere with your baby's ability to see mommy and daddy. Though he can't yet distinguish one from another, a newborn can make out blurry faces at birth—even through swollen lids.

The bent ear probably also comes courtesy of the cozy but crowded conditions your baby experienced in his uterine home. As a fetus grows and becomes more snugly lodged in his mother's amniotic sac, an ear that happens to get pushed forward may stay that way even after birth. Again, it's only temporary—and it won't interfere with his being able to hear (or recognize) the sweet music of your voices.

The pushed-in nose that may make him look a bit like a baby boxer is also very likely the result of going a long round in your narrow birth canal. It, too, should return to its genetic blueprint. Just remember, baby noses are still a work in progress. Even once your little guy's nose is back to baby normal, the bridge may be broad, almost nonexistent, and the shape often nondescript, making it very different from the nose he'll sport as an adult … and meaning it may be a while before you'll know whose nose he has.

“Why does my newborn have ointment in his eyes, and how long will it blur his vision?”

There are a lot of factors standing between a newborn baby and a clear view of his surroundings. His eyes are puffy from delivery, still adjusting to the bright lights of the outside world after spending nine months in a dark womb, naturally nearsighted, and, as you've noticed, gooey with ointment. But the ointment serves an important purpose that makes a little increased blurriness well worthwhile—it's administered (as recommended by the AAP and mandated by most states) to prevent a gonococcal or chlamydial infection. Once a major cause of blindness, such infections have been virtually eliminated by this preventive treatment. The antibiotic ointment, usually erythromycin, is mild and not as potentially irritating to the eyes as the silver nitrate drops that were once the treatment of choice.

The slight swelling and oozy blurriness of your newborn's eyes will last only a day or two. Tearing, swelling, or infection that begins after that may be caused by a blocked tear duct (
click here
).

Portrait of a Newborn

They may be crowd pleasers—especially in a crowd of excited family and friends—but most freshly delivered babies aren't exactly the dimpled, round, button-nosed bundles of cuteness most parents expect to be handed.

Taking it from the top, babies arrive top-heavy—with their heads looking too large for their body (that head takes up about one quarter of baby's total length). If the trip through the birth canal was a particularly tight squeeze, that head may be somewhat molded—sometimes to the point of being pointy, even “cone” shaped. A bruise might also have been raised on the scalp during delivery.

Newborn hair may be limited to a sprinkling of fuzz, or so full it looks like it's due for a trim. It may lie flat or stand up straight in spikes. When hair is sparse, blood vessels may be seen as a blue road map across baby's scalp, and the pulse may be visible at the soft spot, or fontanel, on the top of the head.

Many newborns appear to have gone a few rounds in the ring after a vaginal delivery. Their eyes may appear squinty because of the folds at the inner corners, swelling from delivery and, possibly, because of the infection-protecting eye ointment gooping them up. Their eyes may also be bloodshot from the pressures of labor. The nose may be flattened and the chin unsymmetrical or pushed in from being squeezed through the pelvis, adding to the boxerlike appearance. Babies who arrive by cesarean, plucked neatly from the womb, often have a significant temporary edge in the looks department, especially if they didn't go through the compression of labor first.

Because a newborn's skin is thin, it usually has a pale pinkish cast (even in non-Caucasian babies) from the blood vessels just beneath it. Right after delivery, it's most often covered with the remains of the vernix caseosa, a cheesy coating that protects fetuses during the time spent soaking in the amniotic fluid (the earlier a baby arrives, the more vernix is left on the skin). Babies born late may have skin that's wrinkled or peeling (because they had little or no vernix left to protect it). Babies born late are also less likely than early babies to be covered with lanugo, a downy prenatal fur that can appear on shoulders, back, forehead, and cheeks and that disappears within the first few weeks of life.

A baby's legs and arms, which haven't yet plumped up, may seem more chicken-scrawny than squeezably chubby. And finally, because of an infusion of female hormones from the placenta just before birth, many babies—both boys and girls—have swollen breasts and/or genitals. There may even be a milky discharge from the breasts and, in girls, a vaginal discharge (sometimes bloody).

Be sure to capture those newborn features quickly for your baby book or app (as if you'll need to be told to take some pictures!), because they're all fleeting. Most are gone within the first few days, the rest within a few weeks, leaving nothing but darling dimpled cuteness in their place.