A Parent’s Guide to the Newborn

What Baby Looks Like

Abdomen and Umbilical Cord

The abdomen will rise and fall with breathing.
The cord shrivels and starts to turn black by day 2.
It falls off in 7-14 days after birth.

Breasts

Both boys and girls may have swollen breast tissue. This is due to hormones from the mother. It usually disappears in three weeks.
Baby’s breasts may secrete fluid, called witches’ milk. This will go away.

Chest, Breathing and Lungs

The chest rises and falls with breathing.
The health-care provider will listen to the lungs to ensure they expanded correctly.
Baby’s breathing is variable at about 40 to 60 times per minute. It can be slow and deep, then fast and shallow. This is normal.
Baby’s breathing is most stable if he or she is held upright against your chest.
Babies make all sorts of sounds as they breathe. Sometimes the sounds come from small amounts of mucous in baby’s nose and throat.
Babies will also have periods of very quiet breathing, especially when they sleep.
When babies cry hard, they become redder in the face and take deep, gasping breaths.
Call your health-care provider if you notice any of the following abnormal breathing patterns:
- Grunting:
  Difficulty breathing with a grunting sound each time the baby breathes in.
- Retractions:
  When baby breathes in, the chest pulls in at the ribs, below the breastbone and/or just below the neck.
- Rapid Breathing:
  This is more than 60 breaths per minute. If the rapid rate lasts more than 15 minutes, it is abnormal.

Crying

How much baby cries and how loud varies a great deal. See the “Crying” Section for more information.

Ears

Babies will blink or startle when they hear a sound like clapping.
The ears contain soft cartilage and may be bent from pressure in the uterus. They will soon go back to normal.

Eyes

Baby can see clearly at about 30 to 40 cm (12 to 14 inches).
Baby may stare very intently.
Baby’s eyes are a deep violet or dark blue colour but may change colour within the next few months.
Baby’s eyes may not be aligned, or they may look crossed. This usually goes away by about 4 months as muscles become stronger and more coordinated.
Eyelids may be puffy from pressure of the birth canal. This will disappear.
There may be broken blood vessels because of pressure. These disappear within the first week of life.
Sometimes, a clogged tear duct can cause discharge in the eye. If you see yellow or green pus-like discharge, talk to your health-care provider.

Fingernails

Short fingernails are cleaner and may stop baby from scratching his or her face.
You can cut, clip or file baby’s nails short. Some parents bite the nails as the mouth is more sensitive than scissors and clippers which can easily injure baby.
You can do this more easily while baby is asleep.

Fontanelles

Fontanelles, or soft spots, are areas where the skull bones have not finished hardening.
There are 2 soft spots: 1 in the front and the 1 in the back.
The back fontanelle closes between birth and 2 months of age.
The front fontanelle closes at 12 – 18 months of age.
The skull is formed when the fontanelles completely close.
These areas can be carefully touched and washed without concern.
These areas should not bulge or dip in. If they do, seek medical help.

Genitals

Baby girls may have a blood-tinged mucous discharge. This is due to the mother’s hormones. It will stop shortly after birth.
The external genitals may look slightly swollen in both male and female infants.
Your health-care provider will check to make sure your baby boy’s testicles are normal.
The uncircumcised penis is easy to keep clean. There is no need to pull back the foreskin to clean the head of the penis.

Head and Neck

Baby’s head will look large compared to the rest of baby’s body (this is normal).
Baby’s neck is short and flexible.
Baby should be able to move his or her head from side to side and lift it up if he or she is lying on his or her stomach.
It is important to support baby’s head, especially for the first month.
Babies may have lots of hair or very little. The colour may change with time.
The bones of the skull may overlap. This is called moulding. These bones go back in place in a few days.
Sometimes there is a swelling of the scalp because of pressure. This also disappears soon after birth.

Heart

At birth, there are many changes in the heart and the blood vessels.
Your health-care provider will listen to baby’s heart to make sure it is working well.

Nose and Mouth

Baby’s nose is very flat.
Babies breathe only through their noses for about the first month.
They will sneeze to clear mucous out of their airway.
Baby’s lips should be moist.
Baby may get a “sucking” blister in the centre of the top lip. This is normal and will disappear over time.

Skin and Colour

Baby’s skin will be pinkish. His or her hands and feet may be pale.
At 2 to 3 days, baby’s skin will start to peel.
If parents are black, Latino, Asian, Native American or Middle Eastern, the baby may have blue, black or grey marks on his or her back. These are Mongolian spots.
Baby may have white spots on his or her nose. These are called milia. They are unopened oil glands. They disappear in a few weeks.

What Baby Does

Hiccups

These are very common and normal.
Pat your baby gently on the back or give him or her a bit more to drink.

Activity

Baby has some usual patterns of being awake. Typically, these are:
- Active, alert.
- Quiet, alert.
Most babies’ early movements are somewhat jerky.
Babies move both arms and legs at the same time.
Support baby’s head, neck and body at all times.
Baby should have some supervised tummy time every day. This allows baby to strengthen his or her neck, shoulders, arms and back muscles
Call your health-care provider if you see baby twitching, or if baby cannot move a part of his or her body.

Bowel Movements

The first bowel movements are sticky, green-black bowel movements called meconium.
Babies will pass meconium for about 24 to 48 hours.
Next, baby starts to pass transitional stool, which is between meconium and the milk bowel movement.
This will range in colour from brown to green and be quite soft.
These stools may last 3-4 days.
The breastmilk stool is mustard in colour and pasty in texture.
Breastfed babies tend to have many bowel movements (2 or more per day) in the first 2-4 weeks of life.

Meconium – green-black and sticky.

Transitional stool – brown-green and soft.

Breastfed stool is mustard colour and pasty.

Reflexes

Baby makes these movements automatically. They help to tell if the brain and nervous system are working normally.

Rooting Reflex:
Stroke the baby’s cheek. His or her head will turn, and he or she will try to find something to grasp with his or her open mouth. This is the way the baby finds and takes the nipple into his or her mouth to start nursing.
Suck Reflex:
When something touches the roof of baby’s mouth, baby will close his or her mouth and start to suck. Babies born before 36 weeks of pregnancy may have a weak suck reflex.
Startle or Moro Reflex:
This occurs when something has startled baby, like a loud noise or sudden movement. He or she throws his or her head back, flings out arms and then pulls them back. This reflex lasts until 5-6 months. Baby’s own cry can startle him or her!
Grasp Reflex:
Stroking the baby’s palm will cause him or her to close his or her fingers in a grasp. This lasts for 1-2 months.
Stepping:
Baby will make walking movements when he or she is held upright and his or her feet touch a surface. This disappears soon after birth. It reappears approximately one year later.

Sleeping Positions

The Canadian Paediatric Society recommends that normal, healthy infants sleep on their backs. Side lying is not safe. Refer to the “Babies and Sleep” section for more information.

Urine

Urine should be pale yellow, clear (not cloudy) and odourless.
If baby’s urine is dark yellow, has a fishy smell or has orange crystals, baby may be becoming dehydrated. If you notice this, please contact your health-care provider.

Reference:

Ontario Prenatal Education Key Messages (online) 2016