It’s not easy for a new parent to be certain when an infant is ill. Medical professionals field so many questions from mothers of newborns that they often treat concerns as nothing more than just new-mama nerves. Rather than trust her own instincts, a mother can begin to doubt herself.

The good news is that there are tangible and objective measures of a baby’s health.

THE FIRST SEVEN DAYS
During the first week of life a baby should nurse at least 8 times a day for more than 15 minutes at each feeding. Listen and you should hear the baby swallowing milk. Baby’s first bowel movement will be a black paste called muconium. The texture and color will change from a blackish green to a brownie batter consistency. By the fourth or fifth day, this will appear yellow. Within 48 hours after birth, the baby will have wet diapers. The number of wet diapers will increase to two or three each day be the end of the week.

That first week will also give you clues if a baby isn’t doing well. There is reason to be concerned if a baby has a weak sucking reflex, little or no desire to nurse and cannot sustain a feeding for at least 15 minutes, 8 times per day. Signs that something is wrong can include a clicking sound when the baby nurses, cheeks that pucker inward and dimple when the baby sucks, or the inability to stay awake for a full 15 minute feeding. If the pattern of stools don’t progress and transition and there aren’t wet diapers within two days of birth, this is not normal. If these symptoms are observed for two days in a row, seek medical assistance.

THE INITIAL 30 DAYS
A healthy baby will continue to have healthy signs for the next month. Each day a healthy baby will nurse for eight sessions and produce 2-4 yellow bowel movements. Wet diapers will likely occur between six to eight times per day with clear, not yellow, urine. Along with observing some milk and hearing your baby swallow during nursing, you should see a strengthening of the suck reflex. Your baby will grow both in weight and alertness.

Take special note of anything out of the ordinary: infrequent feedings, small stools or missed stools, decreased urination or bright yellow urine. You should be able to measure an increase in your baby’s weight and length. A baby that has a weak suck, doesn’t make swallowing noises during nursing, becomes sluggish and lacks quick responses and doesn’t sleep between feedings, is a reason for concern. Should you observe these behaviors for a couple of days in a row, seek out a health care provider.

WEEKS FIVE THROUGH TEN
During this stage, the baby’s feedings may go down to seven per day. This is because he is growing and can take in more milk. Bowel movements will continue to change and will settle into a pattern of either several small stools in a day or a large bowel movement every 2 days. This isn’t unusual in breastfed babies as they assimilate much of the milk. The wet diapers (6-8 per day) will continue in frequency, but check to be sure the urine isn’t a yellow concentrate. You should notice that your baby is increasing in his awareness, has a stronger suck, audible swallowing and a little milk dripping at feeding time.

There may be reason for concern if a baby fails to produce the right amount of wet diapers without bright yellow color, or if the baby doesn’t nurse at least seven times daily. Make a note if your child stops gaining weight or doesn’t grow in length. A baby that isn’t getting enough nourishment may have a weak sucking reflex and may nurse without an audible swallow. Should the baby become sluggish, slow to respond and be unable to sleep between feedings, seek medical assistance in rectifying this problem. A couple of days in a row of these indicators mean that something is not well with your baby.

MONITORING YOUR BABY
Remembering how often and when a baby ate can be a challenge when you are well-rested. It can be overwhelming to expect a new mother to know this with reduced sleep. One simple way to remedy this is to leave a notebook and pencil near the baby’s sleeping area. Whenever mama feeds or changes the baby, note the time and what was done along with your observations. One example of an entry might be: “10:00 a.m. – BIG BM, brownish green, nursed 30 minutes.” It may help you to start a new page each day with the date written at the top.

Should you need to confer with your doctor, you’ll be able to reference your notes for detailed information. This is also a good way for a new mama to bond with her baby. By looking over her list, even a weary mama can tell at a glance if the crying is due to hunger (too long between feedings) or constipation (hasn’t moved his bowels). This helps mama learn the different sounds of her baby’s cries. In turn, the new mother gains confidence in her ability to identify and meet her child’s needs.

Yet, BEST advice is often the most common advice, and it comes from the not-so-new mothers. Enjoy these first few weeks to their fullest. There’s nothing more important than getting acquainted with your new baby. Too soon, they are no longer little.

If you’re a new parent, you might like more tips on child training. No Greater Joy has written a best a bestseller called To Train Up A Child that has helped thousands as well as publishing many articles on their website dedicated to helping parents bring up children they enjoy.

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