What to Expect in the First Week With Your Newborn

The first few days and weeks with your newborn are likely to feel pretty wild, especially if he or she is your first child. Your body will have a significant amount of healing to do, no matter how you ended up giving birth, both you and your partner will be figuring out your new role as parents, and your little one will be adjusting to life outside the womb. I thought that I’d cover just a few of the things that you can expect in the first week of your newborn’s life, including some great resources that helped me.

Just a quick note before we get started:

There are so many changes that happen in your body during the first week after giving birth, from bleeding and for some sweating a lot, to having your milk ‘come in’ and experiencing the biggest hormonal drop you’ll ever have happen to you. Covering all the physical and emotional changes that you will go through as a new mother in the first week after giving birth deserves it’s own post, so in this post I’ve decided to only cover the things that your newborn will be going through and save the rest for a post that I’ll share next week.

Feeding your newborn

As I’ve mentioned before, breastfeeding may be considered the most ‘natural’ way of feeding a baby BUT that doesn’t make it easy or intuitive by any means. It’s a learned skill for both a new mama and baby, so it’s important to know that there is nothing wrong with you if it doesn’t come naturally to you without a bit of guidance. I exclusively breastfed my daughter and will be writing from my own experience here, but if your story turns out differently please don’t be scared or ashamed to ask for help from your healthcare provider, local infant feeding support group, and the many resources that are out there. If exclusive breastfeeding doesn’t work for you, that’s ok too! There are some amazing resources out there if you end up pumping, combination feeding, or moving on to feeding your little one formula. If you do, however, choose to breastfeed your newborn, there are some key things to remember in the first few days with them:

  • Your milk will transition from very small amounts of thick, yellowish colostrum to thinner, whiter mature milk over the course of the week

  • Keep your baby close and spend time having skin-to-skin contact

  • Nursing every 2 hours is normal!

  • Your baby’s hunger signs will include rooting, putting their fist to their mouth, and lip-smacking

  • Generally 3 to 5 poop-filled nappies and 5 to 6 wet nappies per day are considered normal

  • Nipple sensitivity is very normal in the first week or so, but your latch shouldn't be painful or last throughout an entire feed - get help if you need it

1. The transition from colostrum to mature milk

Colostrum is the thick, sticky, golden yellow liquid that your body will first produce to feed your newborn. Your body will only produce a very small amount of it, but this is all that a newborn baby needs at first (their stomach will be the size of a macadamia nut when they are born). Colostrum is easy for a newborn to digest, acts as a gentle laxative to help get your baby’s tummy moving, is rich in antibodies and immunoglobulins that help your newborn’s developing immune system, and can even help prevent jaundice in the first few days of their life. Around 2-7 days after giving milk, you will begin to produce more milk as your breast milk changes composition from colostrum to a thinner, creamier, whiter milk. You will usually know that this is happening as your breasts will probably feed fuller, firmer, and even a bit more sore than normal. I remember going to sleep on day 2 post-baby being born with very tender breasts, and woke up the next morning with HUGE, engorged boobs. You can read more about the physiology of breastfeeding and this transition over in this blogpost. Engorgement can be really uncomfortable, and can make latching your little one quite difficult, but there are a few things that you can do to try relieve any pressure or pain and hopefully make the process of your milk coming in a bit easier for you and your baby:

  • Get as much support as you can to master a good latch as soon after birth, before your milk comes in and your breasts become firmer (if you are having latch problems, seek the help of a lactation consultant or other breastfeeding specialist as soon as possible)

  • Feed your newborn on demand (i.e. whenever they are hungry), and even when your breasts are feeling uncomfortable and they are willing to feed

  • Use a warm compress or take a warm shower for a few minutes (< 5 mins) before breastfeeding to help your milk to flow

  • Use a cold compress for 10 minutes after feedings to reduce any swelling

  • If you are able to, gently massage and compress your breast when your baby pauses between sucks to help drain your breast better

  • Hand express or pump just until your breasts feel a bit more comfortable (i.e. don’t empty them) if you are feeling really engorged and your baby doesn’t want to feed

  • Expressing a bit before a feed can also make it easier for your newborn to latch on

It’s important to mention that these changes will take place after birthing a baby even if you choose not to breastfeed, so make sure to chat to your healthcare provider about steps that you can take to prevent pain and discomfort if this is a decision that you wish to make.

2. Skin-to-Skin contact

Skin-to-skin contact is technique where a newborn baby is dried and laid directly on its mother’s bare chest after birth, both of them are covered in a warm blanket, and they left for at least an hour or until after their first feed. It can also take place whenever a baby needs comforting or calming and to help boost a mother’s milk supply. There is some evidence to suggest that early skin-to-skin contact may benefit both mother and baby in a number of ways. For full-term infants it:

  • May promote attachment and bonding between a newborn and parents

  • Is linked to lower parental (both mother and father) anxiety levels

  • Can lead to greater confidence in parenting skills

  • Helps to calm and relaxe both mother and baby

  • Regulates a baby’s heart rate, temperature, and breathing

  • Stimulates the release of hormones involved in breastfeeding and mothering

  • Stimulates an infant’s interest in feeding

  • Enables colonisation of the baby’s skin with the mother’s friendly bacteria, which may provide protection against infection

(and for pre-term infants there are a number of additional benefits of skin-to-skin too!). Although it might be a bit tricky to get the hang of at first, breastfeeding using the laid-back (or biological) nursing position can be a great way to experience skin-to-skin whilst feeding your newborn. For anyone whose birth didn’t or doesn’t end up going to plan, remember that there is so much value in starting skin-to-skin when you are able to, even if it doesn’t end up being straight after giving birth. For example, some medications might affect you and your baby’s normal abilities and behaviours, you may be feeling exhausted after a long labour or unexpected surgery, or your baby may need to be attended to for an important reason. Just do what you can, when you are able to.

 

My experience with skin-to-skin:

When I gave birth to my daughter, I experienced severe tearing that needed to be examined (ouch) straight after giving birth. I was in quite a bit of pain whilst I was examined, so I was encouraged to use gas-and-air for some pain relief. Although my midwife encouraged and helped us with skin-to-skin contact, the gas-and-air made me feel a bit out of it so my husband and midwife had to hold my daughter on my chest and help her latch. To be honest I don’t really remember it much at all! About an hour and a bit after Rylee was born, I was wheeled off to have surgery and only returned quite a few hours later, so my husband was encouraged to have skin-to-skin time with her. At the time I was very worried that this would be detrimental to breastfeeding (thankfully in our case it wasn’t) and was a bit sad that I had missed out on the first few hours of skin-to-skin with my little girl, but in the end I did what I could when circumstances allowed for it and that really is the best that you can do.

 

3. frequent Feeding

The first days and weeks of breastfeeding a newborn can be pretty relentless (i.e. unceasingly intense). In the first few days and weeks after being born, your baby may want to feed very often, possibly even every hour or two. This is very normal, and is not an indication of how much or how little milk you are producing! Remember that a newborn’s tummy is very small, and breastmilk is very easily digested so they will get hungry a lot quicker than you do after eating a meal. It’s important to feed your baby as often as they want and for long as they want to in the early days to help establish a good milk supply. Over the course of the first few days and weeks they will start to have fewer, longer feeds. Your baby should feed roughly 8 times or more every 24 hours during the first few weeks.

4. baby’s hunger cues and cries

In the first few days after the birth of your newborn every single cry, snuffle, and noise that they make will be completely foreign to you. It takes time to figure out what they all mean. Knowing some common early hunger cues to look out for can help you better identify when they are beginning to feel hungry so that you can start to feed them before they become inconsolable (a hysterical baby is hard to feed). When your newborn is hungry they may:

  • Be restless

  • Suck on their hands

  • Make mmmmm sounds

  • ‘Root’ (i.e. turn their head and open their mouth)

I remember really struggling to figure out what Rylee’s little cries were trying to tell me in the first weeks of her life - ‘Waaaah!!!’ … ‘Is she hungry? Tired? Needs a nappy change??’. But that makes sense, in the first week with your newborn you’re only just getting to know one another and it takes some time to learn how to understand what your baby is telling you. Some sources claim that babies have different sounding cries for different needs, and maybe over time this becomes a bit more obvious, but I must be honest they all sounded the same to me in the first weeks of my newborn’s life. I found it useful to go through a checklist in my head when Rylee cried to try and troubleshoot things:

  • Is she fed?

  • Has she been changed?

  • Does she need a nap?

  • And if not, maybe she just wants a cuddle?

5. Your Baby’s nappies

Dirty and wet nappies give a good indication that they are getting enough milk. This is why your midwife / nurses / doctor will ask you how many your baby is producing. To be honest with you I found that remembering this was incredibly difficult to do (particularly when sleep deprived), so I ended up using an app to keep track of this whenever we changed a nappy. In the first week or so of life, a baby will typically have one dirty nappy for each day of life (i.e. 1 on day 1, 2 on day 2, 3 on day 3 etc.). In the 1-2 days, your baby’s poo will be dark green/brown/black and sticky and is known as meconium. This will gradually change in colour and consistency over the first week of life until it becomes more yellow in colour (this post has a pretty good visual guide of what you can expect). After about day 4, your baby should have at least 3-4 dirty nappies each day. Each baby is different though, and some babies may even do a poop every time they nurse (or even more often!). A breastfed baby will have loose (soft to runny) poop that may be seedy or curdy. A formula fed baby will have stool that is typically firmer than a breastfed baby and almost peanut butter-like.

6. Nipple sensitivity, pain, and discomfort

Breastfeeding can be uncomfortable or painful at first. I know that I’ve read a few sources that claim that ‘breast-feeding shouldn’t hurt’, but feel like this takes away from what a new mothers’ breasts go through in the first week of nursing a newborn - of course there will be some degree of discomfort as your nipples adjust to being sucked on really hard right? Sore, tender nipples are very common when you start breastfeeding, and the fact that your newborn will probably feed every few hours means that your nipples won’t get a lot of time to rest and recover. Typical nipple pain that does not indicate a problem:

  • Shouldn’t last long - it shouldn’t last much longer than 30 seconds into a feeding, continue throughout an entire feeding, or continue to be a problem between feedings

  • Is worst in the first week or so after commencing breastfeeding, but should get less and less painful within a couple of weeks

  • Shouldn’t be due to skin damage

Although this sensitivity/tenderness is normal, if the pain is excruciating, lasts throughout a feeding, or is experienced 24/7, your baby may not be latching correctly. If this is the case it is a good idea to see a lactation consultant or breastfeeding specialist who can make sure that your baby’s mouth is positioned correctly and that there aren’t any issues like tongue-tie that are making it hard for your baby to achieve a deep latch. To soothe tender nipples, you can try to:

  • Gently wipe damaged nipples with moistened cotton wool after feeding to remove anything that could lead to infection

  • Air-dry your nipples or gently dab them dry using a clean, soft muslin

  • Soothe your nipples using a good-quality nipple cream or apply a few drops of your own breastmilk

  • Consult a healthcare professional, lactation consultant or breastfeeding specialist if the pain while breastfeeding doesn’t go away after a few days

you and your baby’s Sleep

I have never felt as tired before in my life as I did in the first few weeks after Rylee’s arrival. Each baby has their own pattern of waking and sleeping, and the reality is that some will sleep more than others, others will sleep in short bursts; some will sleep through the night, and others will not. I’ve noticed that sleep is a popular topic of conversation between new parents from even as early on as the newborn stage, but it sucks to talk about sleep when your baby is the one that isn’t sleeping ‘well’. Infant sleep isn’t really my field of expertise, but I read and used insights from a few good resources that will hopefully help you better understand what you can expect and what you can do to facilitate good sleep habits with your newborn:

and last, but not least, Some advice from other mothers:

  • Your husband may not bond with your baby as much or as quickly as you do at first, and you may end up getting frustrated with them because of this. Give it time!

  • You may not want other people to hold your newborn baby, and that’s ok.

  • You also may not want to see any visitors for a few days or weeks, and that’s also ok - you are allowed to say ‘no’ or ‘not now’ to visitors.

  • Breastfeeding can be hard! How your baby latches has a big role to play, so getting it right from the beginning is important. Have a lactation consultant help you with breastfeeding concerns from day 1 if you are struggling.

  • Nipple pain! Although sensitive nipples and discomfort is normal as your nipples adjust to breastfeeding, a lot of pain and hectic bleeding may be a sign of a bad latch that needs to be looked at and sorted out.

  • It is normal for your newborn to wake every 2 hours to feed. Although it will probably leave you feeling really tired, newborns have really tiny tummies and need to feed frequently.

  • Cluster feeding is a thing - ‘I wish I knew what it was or that it existed! I thought I was doing something wrong in those first weeks where she would feed for hours on end with no break’.

  • Everything passes much quicker than you’d expect, so try to enjoy snuggling with your newborn baby, get some rest, and don’t try rush back to ‘normal’ too quickly.


References

  1. Moore ER, Bergman N, Anderson GC, Medly N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev [Internet]. 2016 Nov;2016(11):CD003519. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464366/

  2. Ludington-Hoe S, Lewis T, Morgan K, Cong X, Anderson L, Reese S. Breast and infant temperatures with twins during shared kangaroo care. J Obstet Gynecol Neonatal Nurs. 2006:2;223-231.

  3. Sweeney S, Rothstein R, Visintainer P, Rothstein R, Singh R. Impact of kangaroo care on parental anxiety level and parenting skills for preterm infants in the neonatal intensive care unit. J Neonatal Nurs. 2017;23(3):151–158.

  4. https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/implementing-standards-resources/skin-to-skin-contact/

  5. https://www.mother.ly/child/milk-mama-expert-tips-for-the-first-week-of-breastfeeding

  6. https://www.llli.org/breastfeeding-info/frequency-feeding-frequently-asked-questions-faqs/

  7. https://kellymom.com/hot-topics/newborn-nursing/

  8. https://www.medelabreastfeedingus.com/tips-and-solutions/47/relieving-and-treating-engorged-breasts

  9. https://www.medela.co.uk/breastfeeding/mums-journey/problems-newborn