“Overwhelmed” is a word that is often used by new parents when they first bring home their little ones from the hospital. The main reason for this is because parents would often get their information online, from friends, their parents or the antenatal classes that they attended. They have plenty of information and it’s typically a lot to process.
ParkCity Medical Centre consultant paediatrician Dr Lai Eng Meng shares that on top of all the information available, there are four main areas of concern. “What I often tell new parents when they first bring home their little one is that they have to go back and pay attention to the basics – the sleeping, the peeing, the pooping and the feeding, ” he says.
It is natural to be anxious about handling a newborn. However, in a few short weeks, first-time parents would have developed a routine to be confident at it. Feel free to ask a paediatrician or nurses for help on any questions or concerns as well.
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Good sleep is essential to a baby’s overall health, cognitive ability and mood. However, parents would also need to pay special attention to their newborn when he sleeps.
Dr Lai recommends, “Take note of the baby’s sleep cycle and his sleeping positions. A newborn baby’s sleep cycle should follow the feeding cycles, meaning that every two to three hours, he should be woken up, fed, burped and put back to sleep again for another two to three hours even throughout the night.”
Besides that, parents must pay close attention to the sleeping position they place their baby in. Always put a baby on his back for every sleep, whether day or night. The reason behind this is to avoid sudden infant death syndrome in which a baby suffocates. The best way to make sure that a baby sleeps on his back is to do it from the start for the first few months. Only once the baby has learnt to roll over (around four to five months) should sleeping on the tummy be fine.
“It is important not to share a bed with a newborn, and instead get a cot for the baby to sleep in. This is because there have been instances where babies suffocate when placed in between their parents. Parents must also not let their babies sleep in a swing bed at all because there have been scenarios where babies develop shaken baby syndrome and they have bleeding inside the brain, ” notes Dr Lai.
On comforting techniques for a newborn, Dr Lai says, “Try swaddling the child. Think of it this way, the baby has been inside his mother’s womb all this while and he isn’t used to open space. So, a blanket wrapped around him simulates the mother’s womb and psychologically helps to calm him down.
"Another way to comfort a baby is to try singing to him so that he can listen to the voices of his mother and father. Also, dim the lights in the baby’s room – but let some daylight stream through open curtains so that he gets used to the sunlight and night time, developing a circadian rhythm."
Dr Lai says parents should also be focusing on their baby’s urine. “It sounds like a minor topic, but there is a lot of insight to get when paying attention to a baby’s excretion. Things to pay attention to include the smell, quantity and, if it’s a boy, the urine stream, ” he elaborates.
If a newborn baby drinks plenty of milk and is well hydrated, then he should be fully soaking four to six diapers a day. If he pees less than this, it is recommended for parents to increase the frequency and quantity of the baby’s feed. Four to six fully soaked diapers are an indication that a baby is well hydrated.
The next thing to pay attention to regarding a baby’s urine is the colour. If a baby is drinking enough, his urine would be clear or a little yellow. However, if a baby’s urine is noticeably getting more concentrated with darker yellow and tea-like colours, he may be dehydrated and parents should thus feed him more.
Another thing to look out for is any pinkish stains on the diaper. If it isn’t blood, then the stain could be due to a condition called urate crystals – which is another signal that the baby hasn’t been drinking enough.
Moreover, the smell of a baby’s urine could be an indicator of something amiss. According to Dr Lai, parents usually get used to the normal scent of their baby. If they notice an odd smell when changing diapers, it could be a possible infection and they should consult their paediatrician.
Where baby boys are concerned, the urine stream is very important. When possible, Dr Lai suggests for parents to observe the stream. A good stream is a sign of healthy urine flow. However, if there is a weak stream (dribbling from the urethra), this could be an indication of phimosis which is when the baby’s foreskin is unable to retract yet. If parents have this concern, they should discuss the matter with their paediatrician.
A baby’s bowel movements can also be indicators of his health – hence, paying attention to the frequency, consistency, smell, texture and colour is important. Parents would want to ensure that their baby passes his bowel movement every day. For the first few days, a baby’s faeces would be black and sticky, which is known as meconium stool.
After three to four days, the faeces would start to change colour from black to dark green; and later around five to seven days, they’ll change to a golden yellow colour. “Parents must pay attention to this because if there is blood in the stool, or if it is any colour other than these three mentioned, they should alert their doctor, ” cautions Dr Lai.
Regarding the consistency of a baby’s stool, Dr Lai says parents know their child best and would be able to determine what the normal consistency is. However, if the stool is too hard or too soft, it means that something isn’t right. Additionally, having bowel movements two to six times a day is normal, but it is not normal if a baby passes motion more than 10 times a day.
Doctors always encourage parents to breastfeed and to always burb their baby. Before going home with the baby, the doctors will teach parents how to breastfeed, the position in which they should breastfeed, as well as the frequency (every two to three hours) and quantity.
Keep in mind that breastfeeding mothers should drink plenty of liquid to have good milk production. If they are struggling with producing milk, they shouldn’t stress out about it as they can always speak to their doctor to help figure out the best solution.
As an indicator, mothers who wish to express their breast milk should take note on the quantity when feeding their baby:
- Newborn full-term baby – Around two ounces/60ml every feeding
- One month old – Around three ounces/90ml every feeding
- Two months old – Around four ounces/120ml every feeding
Always remember to give extra feedings on the baby’s demand. Moreover, frozen and refrigerated breast milk usually have an expiration date. When reheating frozen milk to feed a baby, Dr Lai advises parents to heat the milk to body temperature (around 37°C).
“It’s important for fathers to participate in the feeding process as well – whether it’s with burping the baby, or topping up the baby’s feed with expressed breast milk – because this can help reduce the tension and stress that may be felt by mothers, ” encourages Dr Lai.
Room temperature (25 – 37°C)
Air-conditioned room (15 - 25°C)
Cooler box with ice packs (<15°C)
Refrigerator (2 - 4°C)
Freezer compartment inside a single-door fridge
Freezer part of a double-door fridge
Separate deep freezer
Frozen breast milk that is thawed in a refrigerator
24 hours (don’t refreeze)
Breast milk should not be stored above 37°C
If unsure of the temperature of the refrigerator, it is best to use the breast milk within three days.
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