There might not be any time in our lives that is more fraught with worry than when we bring a new life into the world. After all, it’s our responsibility to see to it that this new life thrives. What if something goes wrong? Will we know? Will that infamous mother’s intuition that everyone talks about kick in immediately? What if we don’t have it?
Rest assured, intuition is where it all starts. That feeling in the gut we get when something isn’t right — that’s our brain, our third eye, our intuition. Whatever we call it, the connection between the gut and brain is undeniable. Still, it can be daunting to trust the life of our new baby to a feeling we have. For that reason, we rely on science and evidence-based care to back us up.
Over the years, newborns have been monitored a great deal. We have come to know what’s normal, and what isn’t. We know what the warning signs are of a bigger problem, and how soon we need to intervene to correct them. We know what can happen if we don’t, too.
It is this kind of advice that parents everywhere need to be take heed of. Just because we may never need some of it doesn’t mean we shouldn’t be prepared. Should something happen, it is the moments we take to read an article or reference a medical journal and prepare ourselves that we will end up being grateful for — or the moment we spent passing it by that we end up regretting.
14 Normal: Molting
Molting usually waits a few days to set in. Parents get home from the hospital or birthing center and are just getting used to being at home with this new, fragile being when suddenly it seems as though the baby’s skin is shedding. Yes, shedding. It might be flaking a bit around the ankles where his socks were rubbing or peeling down her neck.
Fret not, new parents. Welcome to the molting stage. It might sound a little gross, but it’s totally normal. Babies who are born earlier tend to have more vernix on their skin, which provides intense moisture. Thus, they generally peel less. Therefore, those who are born at term or beyond typically have less vernix and are more likely to peel.
There are some anecdotal theories that rubbing the vernix into the skin — which has benefits of its own — and delaying bathing of the baby — which also has additional benefits — may prevent molting. There’s no solid answer to this yet, but comparing the babies I’ve had that were cleaned and bathed promptly versus the baby that was not, our story supports it.
13 Not Normal: Jaundice
I know. Jaundice doesn’t seem too scary, right? After all, we all know someone whose baby has been jaundiced. So, it must not be a very big deal. Just put baby in the sun and be done. Some babies may need to spend some time under a special blue lamp in the hospital. Sure, if it’s mild. But jaundice is a sign that bilirubin levels are too high, which can affect the liver and the rest of the renal system.
Did you know jaundice can lead to seizing, brain abnormalities, cerebral palsy, hearing loss, mental retardation, intellectual disability, and even death. So, maybe it’s not so mild after all. While certain diseases may contribute, most of the time, jaundice occurs when a baby is born before their liver is mature enough to excrete all the excess bilirubin it has accumulated.
It's most common in babies born before 38 weeks. The vitamin K injection is also linked to causing jaundice.
If your baby has jaundice or their coloring worsens after being sent home with a mild case, don’t be afraid to call the doctor and bring it to their attention. Jaundice should get better with feedings and time, not worse.
12 Normal: Rashes
Within a few days to a week of birth, many babies start to develop a breakout of pimple-like pustules on their bodies. The most common site is the face, but the rash can spread across virtually every surface of the body. New parents might be alarmed initially, but this process is also completely normal.
Baby acne surfaces as excess hormones from Mom excrete from the baby’s body post-birth. Not to be confused with erythema toxicum — which typically starts on the face and spreads downward before resolving — baby acne is standalone pustules while erythema toxicum usually presents as red blotches on the skin along with white pustules. Still, both are normal.
Some babies will also develop small milky white blisters or bumps on their cheeks and nose called milia. These are also normal. In any case, parents should never try to rupture these fluid-filled pustules. Doing so could aggravate the symptoms and actually lead to infection.
11 Not Normal: Sunken Soft Spot
Babies are born with plates of bone that make up their skull, and these plates are not yet fully fused together. Instead, they are separate to allow flexibility when the head must pass through the birth canal. There are two of spots on the top of the head where these bones are not connected known as fontanels.
These soft spots are typically harmless. They will remain until the skull fuses together between the first and second year of life. Sometimes, you might notice this spot pulsating. That is normal. What isn’t normal is if it is sunken or depressed. That means the baby is likely dehydrated.
In some cases, it may be cause for concern about malnutrition or warrant a diagnosis of failure to thrive if other symptoms of such are present. If your baby’s soft spot is depressed, you don’t need to rush to the emergency room. Still, fluids should be given, and then the soft spot should be reassessed to determine if the issue is improving. If it’s not, it’s worth a call to the pediatrician or family doctor.
10 Normal: Cone head
Many parents dream about the first time they meet their son or daughter. Unless their cone head is quite obvious, they may not even notice the pointy shape until closer inspection or trying to put a hat on the baby. As previously mentioned, the bones in the skull are purposely not fused together, because the baby needs to make it through one very tight squeeze in the birth canal to end up Earth side.
So, the plates of skull bone in the head get compressed and form the skull into a somewhat pointed shape toward the crown or top of the head, depending on the position of the baby during birth. No worries, your baby will not grow up looking like Dan Aykroyd. The cone shape will subtly dissipate within the days and weeks following birth. Suddenly, one day, they won’t have that head anymore.
9 Not Normal: Pain When Latching
A lot of first time mothers are taken aback when they start nursing. They might ask friends who are experienced moms if it’s supposed to hurt to breastfeed. They might even ask a lactation consultant. It’s discouraging that many of both will say yes, it can.
No, no, no. It’s not supposed to be painful to breastfeed. Can it feel overly sensitive? Sure. Will your nipples feel a little chapped or worn out after the baby is cluster feeding? They might. But should you be cracked and bleeding and shudder every time you baby latches on? No! That is not part of the normal breastfeeding process. It’s a sign that something is wrong, and it shouldn’t be ignored.
What could be wrong? It might be: a poor latch, a tongue tie, a lip tie, a high palate, inverted nipples, or a myriad of other things. All of these issues can be assessed and rectified with the right support. Unfortunately, many mothers fail to get the support they need.
For instance, a lactation consultant can rarely help with ties; you need a pediatric dentist or ENT for that. A nipple shield can help moms with flat nipples and an LC can indeed help you improve your latch. Don’t give up! Most of the discomforts involved with breastfeeding can be overcome with education and diligence.
8 Normal: Swollen Genitals
We talk a whole lot before childbirth about what mom can expect of her own body postpartum. No one wants you to be alarmed by your suddenly-engorged breasts or how numb and raw your bottom half feels. Don’t forget the hemorrhoids and the importance of 'padsicles!'
We get so wrapped up in the importance of postpartum mommy care that we often forget to educate moms- and dads-to-be on what they can expect from their baby. Meanwhile, dads everywhere often get their hopes up when their little men are born looking rather well-endowed. Sorry dads, all that swelling is temporary.
Fortunately, the same goes for little girls who are born with very swollen genitalia. This happens because the baby retains a lot of fluid throughout the birthing process. In fact, they lose 10 percent or more of their weight post-birth just from fluids alone. No worries. This swelling goes down within the first few days of life and doesn’t return.
7 Not Normal: Strained Or Croupy Coughing
Initially, a baby that is born with a croupy or strained cough will be assessed by the attending pediatrician. This is to confirm that there isn’t any fluid in the lungs, which can happen if the baby aspirates any amniotic fluid before they are born.
That being said, don’t panic if your baby is coughing here and there and it doesn’t sound productive. No phlegm is a good sign. As long as baby’s lungs and airways are clear, it’s completely normal for them to cough and sneeze — even more than most people do — in the first days after birth. Often, they are clearing out excess product from the birth canal.
Otherwise, a croupy or congested cough could be a sign of illness in your little one that shouldn’t be overlooked. While a baby even as young as three months can likely fight off a common cold, newborns do not yet have the immune system required to tackle illness well.
Many of these babies end up needing to be hospitalized to make sure they’re getting adequate fluids and medications as required. If your newborn is struggling to breathe or coughing in excess, get to the doctor.
6 Normal: Irregular Bowel Movements
So, you checked it off the list when they passed their meconium. You counted their wet and dirty diapers in those first days after birth. Everything checked out and you felt relieved that this hurdle was behind you. The baby has been having those trademark mustardy diapers every day, five times a day, since birth.
Then, suddenly, they aren’t pooping. They were so regular that something had to come out every time something went in, and now nothing is coming out. Should you give them a laxative? No. What about the Q-tip trick? Nope. Should you call the doctor? Not necessary.
Since formula fed babies are known to constipate more easily because formula is harder for the baby’s body to digest, they may not have a bowel movement for several days and this can be normal. However, if the baby has been pooping regularly and suddenly isn’t, formula choice should be examined just in case intolerance is the issue.
Exclusively breastfed babies can actually go up to ten days without pooping at all and it’s completely normal if they aren’t in any pain. Some parents wonder how this can be. Logically, they think is breastmilk is easiest to digest then shouldn’t the baby be pooping more? Nope. Sometimes they literally consume every ounce of fluid and nutrients in momma’s milk. Fascinating stuff!
5 Not Normal: Pus Or Odour From The Umbilical Stump
The umbilical cord is severed after birth. Currently, most hospitals are segueing into supporting the evidence-based trend of delaying cord clamping. This is great and it doesn’t impact how the cord will heal at all. Some mothers also opt for cord threading afterward. Still, the stump will heal the same way.
That being said, a healing umbilical site should be clean and clear of pus or blood. If bumped or snagged, blood spotting may occur. This is normal, but the site should not ooze anything when unprovoked. Furthermore, redness and irritation are other warning signs that there may be an infection looming.
If the umbilical stump site is putting off an odour that you didn’t notice before, it is also worth getting checked out — yes, even if there is no oozing of fluid or other obvious signs of a problem.
4 Normal: Meconium
Hopefully, someone has warned you about those first few bowel movements after birth. No, not yours, momma — though they might be traumatic all on their own. The baby’s first few bowel movements will be thick and tar-like. They may range in color from a light green, to a hunter green to black! This is meconium.
When the baby is in utero, they digest amniotic fluid, epithelial cells, bile, mucus, and lanugo — fine hairs found on their own body at birth. All of this matter makes up meconium. When it is excreted, it’s quite thick and as such, it can be difficult to clean the baby off after each bowel movement.
Parents who are planning to use cloth diapers will want to use liners or prefolds that they don’t mind staining in the initial diapering period where meconium is a concern. Otherwise, there is nothing to worry about. The passing of meconium is actually a good thing. It means your baby’s bowels are working. Yay!
3 Not Normal: Cradle Cap
A lot of babies have cradle cap. Seriously, a lot. Sometimes, when something happens a lot, we confuse it being common with it being normal. Cradle cap is common, but it is not normal. Yes, cradle cap occurs as a result of oil build up underneath dead skin cells. This isn’t the problem.
The problem is why certain babies get it and what environment allows this to occur. Why? It all boils down to candida — otherwise known as yeast. Generally, babies who develop cradle cap have yeast — a fungus — in their sebum that is causing these clogs on the scalp.
Why is yeast an issue? If it’s on the baby’s scalp, it is likely also in the baby’s body where an overgrowth of yeast can cause a plethora of other issues, such as gut dysbiosis, bowel conditions like irritable bowel syndrome, eczema, yeast infections, neurodevelopment disorders like autism and ADHD, and much more.
So, cradle cap may seem like a mild issue that can be sloughed off with a little coconut oil and soft brushing, but it’s also a sign of potential underlying issues that should be blindly ignored.
2 Normal: Blood In Baby Girl’s Diaper
A lot of parents are warned about this step before they have a little girl. Often referred to as the newborn period, it’s normal for infant girls to excrete a small amount of blood from their vagina after birth. This usually happens in the first week of life.
This phenomenon occurs as a result of the uterus shedding some blood which is caused by the loss of hormones from her body since she is no longer inside her very hormonal mother. All that estrogen and progesterone are fading away for the next decade or better.
This bleeding experience normally only happens once or twice, and it shouldn’t be any more than a few specks of blood. As the baby’s own hormone levels adjust to a normal level for an infant, it will cease. It is not cause for alarm unless it fails to stop.
1 Not Normal: Heavy Bleeding After Circumcision
Bleeding isn’t exclusive to girls, but baby boys won’t bleed because of hormones. Instead, they often bleed after being circumcised. Some droplets of blood are normal as the wound heals. Keep in mind that the foreskin — which contains as many as 70,000 nerve endings — is forcibly removed from the infant during a circumcision.
In another procedure, it may be crushed over a period of a few days. Bleeding appears more likely with the latter.
Regardless of how it is performed, bleeding after a circumcision should be minimal. It’s particularly important to watch for because hemorrhaging and excessive bleeding post-op is one of the most common complications of this surgery, and the cause of many of the 117 deaths caused by circumcision each year.
Research on the incidence of bleeding from circumcision ranges from 0.1 to as high as 35 percent. Excessive bleeding may require a blood transfusion. So, if your baby is bleeding enough to saturate even part of his diaper, this warrants an immediate trip to the doctor.
Sources: BabyCentre, New York Times