With the newborn’s arrival, the entire home starts buzzing with excitement. Friends and family visit to catch a glimpse and many times it is impossible for the new parents to get any form of rest. Especially for the mother. Her body has just undergone many changes with pregnancy and childbirth and to add to all this comes breastfeeding, lack of sleep and caring for the newborn. If you have an older child, his or her needs are meant to be met as well.

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I have made this chapter in the form of questions and answers so that it becomes an easy read for you like a quick reference guide. All these queries have been answered from a paediatrician’s point of few based on the latest research and evidence.

Q1. How often do I feed my baby?

Feeds should be on demand. Roughly babies need a total of 8-10 feeds per day which means feeding every 2-3 hours. Breastfed babies tend to digest milk quickly and may need to be fed very frequently. Try to look for signs of hunger like baby stirring, twisting or moving lips rather than wait for the baby to become frustrated and give out a loud cry when things can get out of control.

Also putting the baby to the breast is the biggest stimulator for milk production.

Q2. Should I give my baby water?

No. 88 % of breast milk is water. This water content is enough not only to quench its thirst but also to meet its fluid requirement even in hot climates. There is a practice in many cultures to give additional teas, sugar water or herbal supplements. These have no benefits and can, in fact, harm the baby. Exclusive breastfeeding is recommended by the World Health Organisation for 6 months.

Q3. How many times should the baby open bowels?

Baby’s poop color starts changing from its dark green color to yellow by 2nd or 3rd day.

It is normal for babies to open bowels 10-15 times a day. The digestive tract of the baby is still immature and many times you would notice that the baby instantly poops after feeds.

On the other side, it is not uncommon for babies to poop once in 5-10 days as well! As long as the baby is passing soft poos and not in pain, it does not matter.

The breastfeed poop is typically bright golden yellow color and curd-like while the formula poop may be firmer.

Q4. Help! My baby sleeps all day and is awake all night. When will this change?

Unfortunately, newborns do not have any fixed sleep pattern. In the first few days, the baby might sleep most of the day and night waking up briefly just for feeds. The sleeping hours could be as long as 16-18! It is important to wake the baby up by gently stimulating the feet or gently rocking the baby so that it feeds atlas once in 3-4 hours.

Many times the babies start sleeping overnight by 3 months but it varies from one baby to another.

So mums and dads, good luck as how your baby will sleep solely depends on your luck! The good news is that it gets easier and better with time. Try to get rest yourself when your little one sleeps.

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Q5. My baby looks yellow. What is it? Is it harmful?

The yellowish coloration of your babes’ skin is also called jaundice. The white part of the baby’s eyes may appear yellow as well.

Jaundice is common and almost 60-80 % of babies get it. In the majority of babies, it happens after the first 24 hours and resolves by 7-10 days. Jaundice is caused by a breakdown of your baby’s circulating red blood cells which releases a pigment called bilirubin which imparts a yellow color to the skin and eyes. The lifespan of baby’s red cells is short leading to this breakdown.

It is important that you get jaundice checked out by your doctor as he/she can examine your baby and able to tell you whether jaundice that your baby has is the common one or something that needs further investigation and treatment.

The danger signs to look out for in a jaundiced baby are as follows

• If jaundice appears within the first 24 hours of life – may indicate infection or reaction between mothers and baby’s blood group

• If the baby is very drowsy or lethargic or feeding poorly

• If anytime you notice the baby be passing whitish color stools and very dark urine. This may indicate an obstruction in the liver system as bilirubin is produced in the liver.

• If mother’s blood group was negative and mother did not receive the anti-D injection during pregnancy ( Rh incompatibility is a condition where there is a mismatch between baby’s and mother’s blood group leading to a severe form of jaundice )

The doctor will check your baby out and may request to perform a blood test to check the level of jaundice. Very high levels of jaundice can lead to brain damage but it is a rare phenomenon. Sometimes the baby might need light therapy for treating it. It is a very safe and effective way of treating the common form of jaundice.

So please take jaundice seriously and get it checked out by a doctor.

Exposing the baby to sunlight may help to reduce jaundice but please use your common sense! Do not attempt this if the outside temperature in the sun is 40 degree Celsius!

Also, breastfed babies tend to be jaundiced for a longer period. This is harmless. Regardless all babies with visible jaundice need to be checked out by a paediatrician.

Q6. Oh ! What are these spots on my baby? Are they harmful and need treatment?

Erythema Toxicum: These red spots are an extremely common occurrence in newborns. It consists of small red spots and occasionally is fluid filled and look like a blister. These blisters are surrounded by a reddish halo. They may be found in any area of the body and typically appear on the third or fourth day of life. It does not need any treatment and it resolves in 5-7 days.

 Milia: They commonly present as tiny white bumps on a newborn’s face. They contain keratin ( skin protein ) and is harmless. They spontaneously disappear in a few days.

Baby acne: This rash develops in the first two to four weeks of newborn life. It is characterized by small red, white and red bumps on the face, cheeks, and nose. They may look exactly like acne in teenagers. In general, these are harmless and disappear in a months time. If these persist beyond one month, please seek paediatrician’s advice.

Seborrheic dermatitis: Again an extremely common rash in Newborn characterized by greasy scales. Many parents know this as ‘ the cradle cap ‘ as it very commonly occurs on the scalp.

There is scaling and redness. It can spread to the diaper area as well.

This condition tends to be self-limiting resolving between several weeks to months. If you find the scales concerning, try applying vegetable oil or petroleum jelly ( Vaseline ) overnight and brush the scales off with a soft brush next morning. Another effective treatment is with nizoral shampoo ( contains 2% ketoconazole , an antifungal agent). Apply twice weekly for 4-6 weeks.

The above lists the most common rashes which are harmless and self-resolving. However, if the baby has fever, irritability and poor feeds please consult your paediatrician urgently. None of the above rashes are associated with these symptoms. This could be a sign of a bacterial infection.

Q7. What should I do for diaper rashes?

Diaper rashes are very common and almost all babies get it at least once in the first two years of life. Diaper rash can occur due to irritation ( contact with urine/stools), allergy or fungal infection. The area appears red and swollen and may be painful for the baby.

Simple rashes resolve by keeping the diaper area as dry as possible by frequently changing nappies, pat drying the area with a soft cotton towel rather than scrubbing it and application of barrier creams containing zinc oxide (commonly available over the counter. )

Exposing the diaper area to air for 10-15 mins may expedite the healing process.

If the rash does not clear up in 3-4 days, please seek medical help. There might be fungal or bacterial infection needing medications and further evaluation.

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