When you’re new parents, it can be hard to know what’s normal for your newborn baby and what’s not. What should my baby be doing at this age? Should I bring him to the doctor if he does this or that?
Bringing home a new baby can be exciting and overwhelming at first. You are still in the process of getting to know your baby and understanding the different types of behaviour they exhibit.
This information will help you develop realistic expectations and feel confident about caring for your new baby.
What Should We Expect?
In most cases, infants seem to be in a state of quiet alertness during the first hour or so after delivery.
It’s an excellent time for you and you’re newborn to get acquainted and begin the bonding process.
And it’s OK if circumstances prevent you from meeting your infant right away — you’ll have plenty of quality time together soon.
During the first several weeks, you’ll notice that much of the time, your baby will tend to keep his or her fists clenched, elbows bent, hips and knees flexed, and arms and legs held close to the front her body.
This position is similar to the fetal position during the last months of pregnancy.
Infants born prematurely may display several differences in their posture, appearance, activity, and behaviour compared with full-term newborns.
Because an infant’s head is usually the first part through the birth canal, it can be affected by the delivery process.
A newborn’s skull is made of several separate bones (which will eventually fuse) to allow the large head to be squeezed through the narrow birth canal without injury to the mother or baby.
The heads of infants born by vaginal delivery often show some degree of moulding, which is when the skull bones shift and overlap, making the top of the head look elongated, stretched out, or even pointed at birth.
This sometimes bizarre appearance will go away over the next several days as the skull bones move into a more rounded configuration.
The heads of babies born by cesarean section or breech (buttocks or feet first) delivery usually don’t show moulding.
Because of the separation of your newborn’s skull bones, you’ll be able to feel (go ahead, you won’t harm anything) two fontanels, or soft spots, on the top of the head.
The larger one, located toward the front of the head, is diamond-shaped and usually about 1 to 3 inches wide.
A smaller, triangle-shaped fontanel is found farther back on the head, where a beanie might be worn.
Don’t be alarmed if you see the fontanels bulge out when your infant cries or strains or if they seem to move up and down in time with the baby’s heartbeat.
This is perfectly normal. The fontanels will eventually disappear as the skull bones close together — usually in about 12 to 18 months for the front fontanel and in about six months for the one in the back.
In addition to looking elongated, a newborn’s head may have a lump or two due to the trauma of delivery.
Caput succedaneum is a circular swelling and bruising of the scalp usually seen on top of the head toward the back, which is the part of the scalp most often leading the way through the birth canal. This will fade over a few days.
A cephalohematoma is a collection of blood that has seeped under the outer covering membrane of one of the skull bones.
This is usually caused during birth by the pressure of the head against the mother’s pelvic bones.
The lump is confined to one side of the top of the baby’s head and, in contrast to caput succedaneum, may take a week or two to disappear.
The breakdown of the blood collected in a cephalohematoma may cause these infants to become somewhat more jaundiced than others during the first week of life.
It’s important to remember that both caput succedaneum and cephalohematoma occur due to trauma outside of the skull — neither indicates that there has been any injury to the infant’s brain.
A newborn’s face may look quite puffy due to fluid accumulation and the rough trip through the birth canal.
The infant’s facial appearance often changes significantly during the first few days as the baby gets rid of the extra fluid and the trauma of delivery eases.
That’s why the photos you take of your baby later on at home usually look a lot different than those “new arrival” nursery shots.
In some cases, a newborn’s facial features can be entirely distorted due to positioning in the uterus and the squeeze through the birth canal.
Not to worry — that folded ear, flattened nose, or crooked jaw usually comes back into place over time.
A few minutes after birth, most infants open their eyes and start to look around at their environment.
Newborns can see, but they probably don’t focus well at first, which is why their eyes may seem out of line or crossed at times during the first 2 to 3 months.
Because of the puffiness of their eyelids, some infants may not be able to open their eyes wide right away.
When holding your newborn, you can encourage eye opening by taking advantage of your baby’s “doll’s eye” reflex, which tends to open the eyes more when held in an upright position.
Parents are sometimes startled to see that the white part of one or both of their newborn’s eyes appears blood-red.
Called subconjunctival hemorrhage occurs when blood leaks under the covering of the eyeball due to the trauma of delivery.
It’s a harmless condition similar to a skin bruise that goes away after several days, and it generally doesn’t indicate that there has been any damage to the infant’s eyes.
Parents are often curious to know what colour eyes their infant will have. If a baby’s eyes are brown at birth, they will remain so.
This is the case for most black and Asian infants.
Most white infants are born with bluish-grey eyes. Still, the pigmentation of the iris (the coloured part of the eye) may progressively darken, usually not reaching its permanent colour until about 3 to 6 months of age.
A newborn’s ears and other features may be distorted by the position they were in a while inside the uterus.
Because the baby hasn’t yet developed the thick cartilage that gives a firm shape to an older child’s ears, it isn’t unusual for newborns to come out with temporarily folded or otherwise misshapen ears.
Small tags of skin or pits (shallow holes) in the skin on the side of the face just in front of the ear are also common. Usually, these skin tags can be easily removed (talk to your doctor).
Because newborns tend to breathe through their noses and their nasal passages are narrow, small amounts of nasal fluid or mucus can cause them to sniff or sound congested even when they don’t have a cold or other problem.
Talk with your doctor about using saltwater nose drops and a bulb syringe to help clear the nasal passages if necessary.
Sneezing is also common in newborns. This is a normal reflex and isn’t due to an infection, allergies, or other problems.
When your newborn opens his or her mouth to yawn or cry, you may notice some minor white spots on the roof of the mouth, usually near the centre.
These small collections of cells are called Epstein’s pearls and, along with fluid-filled cysts sometimes present on the gums, will disappear during the first few weeks.
Yes, it’s there. Usually, the neck looks short in newborns because it tends to get lost in the chubby cheeks and folds of skin.
Because an infant’s chest wall is thin, you may quickly feel or observe your baby’s upper chest move with each heartbeat. This is normal and isn’t a cause for concern.
Also, both male and female newborns can have breast enlargement. This is due to the female hormone estrogen passed to the fetus from the mother during pregnancy.
You may feel firm, disc-shaped lumps of tissue beneath the nipples, and, occasionally, a small amount of milky fluid (called “witch’s milk” in folklore) may be released from the nipples.
Breast enlargement almost always disappears during the first few weeks.
Despite what some parents believe, you shouldn’t squeeze the breast tissue — it will not make the breasts shrink any faster than they will on their own.
Arms and Legs
Following birth, full-term newborns tend to assume a posture similar to what their position in the cramped uterus had been: arms and legs flexed and held close to their bodies.
The hands are usually tightly closed, and it may be difficult for you to open them up because touching or placing an object in the palms triggers a strong grasp reflex.
Infants’ fingernails can be long enough at birth to scratch their skin as they bring their hands to their faces.
If this is the case, you can carefully trim your baby’s nails with a pair of small scissors.
Sometimes parents are concerned about the curved appearance of their newborn’s feet and legs.
But if you recall the usual position of the fetus in the womb during the final months of pregnancy — hips flexed, and knees bent with the legs and feet crossed tightly up against the abdomen — it’s no surprise that a newborn’s legs and feet tend to curve inward.
You can usually move your newborn’s legs and feet into a “walking” position, and this will happen naturally as a baby begins to bear weight, walk, and grow through the first 2 to 3 years of life.
It’s normal for a baby’s abdomen (belly) to appear somewhat full and rounded.
When your baby cries or strains, you may also note that the skin over the central area of the abdomen may protrude between the strips of muscle tissue making up the abdominal wall on either side.
This almost always disappears during the next several months as a baby grows.
Many parents are concerned about the appearance and care of their infant’s umbilical cord.
The cord contains three blood vessels (two arteries and a vein) encased in a jelly-like substance.
Following delivery, the cord is clamped or tied off before it’s cut to separate the infant from the placenta.
The umbilical stump is then simply allowed to wither and drop off, usually in about ten days to 3 weeks.
You may be instructed to swab the area with alcohol periodically or wash it with soap and water if the stump becomes dirty or sticky to help prevent infection until the cord falls off and the stump dries up.
The baby’s navel area shouldn’t be submerged in water during bathing until this occurs. The withering cord will go through colour changes, from yellow to brown or black — this is normal.
You should consult your baby’s doctor if the navel area becomes red or if a foul odour or discharge develops.
Umbilical (navel) hernias are common in newborns, particularly in infants of African heritage.
A hole in the abdomen wall at the site of the umbilical cord/future navel allows the baby’s intestine to protrude through when he or she cries or strains, causing the overlying skin to bulge outward.
These hernias are generally harmless and aren’t painful to the infant. Most close on their own during the first few years, but a simple surgical procedure can fix the hernia if it doesn’t close by itself.
Home remedies for umbilical hernias that have been tried through the years, such as strapping and taping coins over the area, should not be attempted.
These techniques are ineffective and may result in skin infections or other injuries.
The genitalia (sexual organs) of male and female infants may appear relatively large and swollen at birth.
Why? It’s due to several factors, including exposure to hormones produced by both the mother and the fetus, bruising and swelling of the genital tissues related to birth trauma, and the natural course of development of the genitalia.
In girls, the outer lips of the vagina (labia majora) may appear puffy at birth. The skin of the labia may be either smooth or somewhat wrinkled.
Sometimes, a small piece of pink tissue may protrude between the labia — this is a hymenal tag, and it’s of no significance; it will eventually recede into the labia as the genitals grow.
Due to the effects of maternal hormones, most newborn girls will have a vaginal discharge of mucus and perhaps some blood that lasts for a few days.
This “mini-period” is normal menstrual-type bleeding from the infant’s uterus that occurs as the estrogen passed to the infant by the mother begins to disappear.
Although it’s much more common in boys, swelling in the groin of an infant girl can indicate the presence of an inguinal (groin) hernia.
There’s little doubt about the origin of the expression “still wet behind the ears,” used to describe someone new or inexperienced.
Newborns are covered with various fluids at delivery, including amniotic fluid and often some blood (the mother’s, not the baby’s).
Nurses or other personnel attending the birth will promptly begin drying the infant to avoid a drop in the baby’s body temperature that will occur if moisture on the skin evaporates rapidly.
Newborns are also coated with a thick, pasty, white material called vernix caseosa (made up of the fetus’ shed skin cells and skin gland secretions), most of which will be washed off during the baby’s first bath.
The hue and colour patterns of a newborn’s skin may be startling to some parents.
Mottling the skin, a lacy pattern of small reddish and pale areas is expected because of the typical instability of the blood circulation at the skin’s surface.
For similar reasons, acrocyanosis, or blueness of the skin of the hands and feet and the area surrounding the lips, is often present, especially if the infant is in a relaxed environment.
When bearing down to cry or having a bowel movement, an infant’s skin temporarily may appear beet-red or bluish-purple.
Red marks, scratches, bruises, and petechiae (specks of blood that have leaked from small blood vessels in the skin) are all standard on the face and other body parts.
They’re caused by the trauma of squeezing through the birth canal. These will heal and disappear during the first week or two of life.
Fine, soft hair, called lanugo, maybe on a newborn’s face, shoulders, and back.
Most of this hair is usually shed in the uterus before the baby is delivered; for this reason, lanugo is more often seen in babies born prematurely. In any case, this hair will disappear in a few weeks.
The top layer of a newborn’s skin will flake off during the first week or two. This is normal and doesn’t require any exceptional skincare. Peeling skin may be present at birth in some infants, particularly those born past their due date.
What Behaviors Can I Expect from My Baby?
Many new parents might not know what is considered “normal” newborn behaviour. Babies develop at different rates, but they still display many of the same behaviours.
Don’t be alarmed if your baby seems a little behind. It is essential to know what kind of behaviours to expect from your newborn so that you can tell if there is a problem.
If your baby was born prematurely, don’t compare his or her development to that of full-term newborns.
Premature babies are often developmentally behind full-term babies. If your baby was born two months early, then he or she might be two months behind a full-term baby.
Your doctor will follow the developmental progress of your premature baby. Contact your doctor if you think your baby is developing at an unusually delayed rate.
Newborn babies usually sleep 20 minutes to 4 hours, up to 20 hours a day.
Their stomachs are too small to keep them full for long, so they need to be fed every few hours. We have the best range of baby nursery blankets to keep your baby just right day and night.
Babies have different sleeping habits, but most babies sleep 6 to 8 hours a night at three months.
Newborns might cry for several hours a day. It is their way of telling you they need something or that something is wrong. Newborns cry when they:
- Are hungry
- Are tired
- Are too cold or too hot
- Need their diaper changed
- Need to be comforted
- Have gas
- Are over-stimulated
- Are sick
It is also common for newborns to hiccup, sneeze, yawn, spit-up, burp, and gurgle. Sometimes newborns cry for no reason at all.
If this happens, try comforting your baby by rocking, singing, whispering, or wrapping him or her in a blanket.
Soon you will be able to tell what your baby needs by how he or she cries.
You might not always be able to comfort your newborn. This is not your fault. Try to be patient and remain calm when your newborn does not stop crying.
If necessary, have someone else stay with your baby while you take a break. Never shake your baby under any circumstance.
Shaking your baby can cause severe brain damage, known as Shaken Baby Syndrome, resulting in lifelong disabilities.
Contact your doctor if your newborn cries more than usual, cries at a different time of day than usual, or if the crying sounds other than average. These might be signs that your newborn is sick.
Infants are born with instinctual responses to stimuli, such as light or touch, known as primitive reflexes, which gradually disappear as the baby matures.
During their first few weeks, newborns maintain their position in the womb (fetal position):
- Clenched fists
- Bent elbows, hips, and knees
- Arms and legs close to the front of the body
This will change when your baby develops more control over his or her movements.
Newborns have several natural reflexes. Understanding these reflexes will help you know the cause of some of your newborn’s behaviours.
Newborn reflexes include the following:
- The rooting reflex: The newborn turns in the direction of food and is ready to suck. Stroking a newborn’s cheek will cause this response.
- The sucking reflex: If you place an object in a baby’s mouth, the baby naturally begins to suck.
- The startle response: The baby throws out his or her arms and legs and then curls them in when startled. This response often includes crying.
- The tonic neck reflex: The baby turns his or her head to one side and holds out the arm on the same side.
- The grasp reflex: The baby’s fingers close tightly around an object placed in his or her palm.
- The stepping reflex: The baby’s feet imitate a stepping action when he or she is held upright with the feet touching a hard surface. A baby’s arms, legs, and chin might tremble, especially when crying. This occurs because newborns’ nervous systems are not fully developed.
It is not uncommon for newborns to experience irregular breathing. This is when newborns stop breathing for 5 to 10 seconds and immediately begin living again independently.
This is normal. However, you should call your doctor or take your baby to the emergency room if he or she stops breathing for longer than 10 seconds or begins to turn blue.
Newborns can see, but their eyes might be crossed because it is hard for them to focus first.
Newborns can see movement and the contrast between black and white objects. It is easier for them to look at things from an angle for the first couple of months.
By 2 to 3 months, babies have more control of their eye muscles and can focus their eyes on one thing. They can also follow objects with their eyes.
Newborns can distinguish between different sounds. They recognize familiar voices, so you should talk to your baby often.
You might soon find that your baby turns toward the sound of your voice. To newborns, the language sounds like music with different tones and rhythms.
Should You Worry?
Many new parents are filled with worry when a baby enters their life. After all, infants look fragile and are helpless.
And aside from those shrieking cries, newborns can’t communicate their specific needs in apparent ways.
So it’s natural to have concerns when caring for them. Here are the questions parents commonly ask — with reassuring advice from physicians.
My Newborn’s Eyes Sometimes Cross, and They Have Red Spots. Should I Be Worried?
It’s normal for babies to cross their eyes, even at six months, intermittently. But if your baby’s eyes are always crossed, tell your pediatrician.
Red spots are also prevalent. They’re apparent at birth due to the increased pressure the baby experiences as he passes through the birth canal.
They’ll go away within a few weeks, but if your baby is born without these spots and they develop later, alert your pediatrician. They could indicate an infection.
Is it Normal for Baby’s Breasts and Genitals to Appear Swollen?
Both girls and boys can have swollen breasts that might express some milk — possibly due to exposure to hormones.
For this reason, a baby girl’s labia may also swell, and she might have a little bloody discharge. This is normal as long as it’s just a tiny spot and doesn’t persist.
On the other hand, swelling around a boy’s genital area may be due to a hydrocele. This is a fluid-filled sac around the testes, so it makes the scrotum look enlarged.
Hydroceles are more likely in premature babies and can be inherited, but any baby boy can be born with one.
A hydrocele will usually resolve on its own within a year, but surgery is sometimes necessary. Contact your pediatrician if you notice a swelling, particularly a difference in the size of the two sides of the scrotum.
How Should I Diaper My Baby? Are There Special Considerations for Girls Versus Boys?
When changing girls, wipe front to back. And don’t worry if you see clear or whitish discharge in the genital area.
Again, this is from the baby’s exposure to Mom’s hormones while in the womb. If your son is circumcised, you’ll replace the gauze bandage at every diaper change, and your pediatrician will probably tell you also to apply some antibiotic ointment (e.g. Bacitracin) or petroleum jelly.
In addition, if you notice that your son has only one testicle, it’s probably because the other one didn’t yet move into place in the scrotum. Point it out to your doctor, though it should descend within the first year. If it doesn’t, an operation may be necessary.
Are a Baby’s Bowel Movements Similar to What an Adult Experiences?
Not at all. Your baby’s first poop will be meconium, a tar-like, blackish-green substance that you’ll see for a couple of days.
After the meconium runs its course, greenish-brown transitional stools follow; by the fourth or fifth day, breastfed babies pass yellowish, seedy poop, while formula-fed infants’ stool is denser and ranges in colour from yellow to brown-green.
Expect variation in how often your infant has bowel movements. A formula-fed infant may poop three or four times a day, while a breastfed infant may go after every feeding or as infrequently as once a week.
Getting to Know Your Little One
The first days and weeks of a newborn’s life are a time of great wonder and delight for most new parents.
However, being responsible for this tiny creature can be scary, particularly if you’re not familiar with how a newborn looks and behaves. Check out our range of baby nursery products and furniture for all your baby needs.
If you feel anxious or uncertain about any part of caring for your baby, don’t hesitate to call your doctor, other health care professionals, or family or friends who have had experience caring for a newborn.