Normal Growth And Development Of Newborns

GENERAL INFORMATION:

Who are newborns? The first month of life is often called the newborn period. Your newborn baby needs your love, attention, and care as he adjusts to the world around him. Babies have their own special personalities so no two newborns are alike. There is no one "right way" to raise your baby. You can help your baby grow up happy, healthy, confident, and help him have positive self-esteem (think good about himself). Learning what your baby likes and dislikes and caring for him shows your baby that you love him.

• Physical Growth & Development: Your newborn baby may look wrinkled and chubby when he is born.
  
  
  • Your baby will lose about 10% of his birth weight in water loss during the first 3 to 5 days. But, he will regain this weight by the time he is 7 to 10 days old. Your baby will gain about 1 1/2 to 2 pounds and grow about 1 to 1 1/2 inches during his first month. And, your baby will go through a growth spurt when he is about 3 to 6 weeks old.
    
    
  • It is normal for your baby's head to look large compared to the rest of his body. The average head size of a newborn is about 13 1/2 inches at birth. And, your baby's head should increase by 1/2 an inch a month for the first 6 months.
    
    
    • Your baby's skull may have become misshaped, bruised, or swollen if he was born through your vagina. But, it will return to a normal rounded shape within a couple of weeks. And, any bruises or swelling also goes away in a few weeks.
      
      
    • Your baby has 2 soft spots on top of his head. The soft spot in the back of the head closes at about 2 months old. The front one closes by the end of your baby's first year.
    
    
  • Your newborn baby is born with some automatic (aw-tuh-mah-tik) reflexes (actions). These reflexes go away as your newborn grows and develops. Following are some of the automatic reflexes your newborn is born with.
    
    
    • Rooting and sucking reflexes make your baby turn his head toward your hand if you stroke his cheeks or mouth. These reflexes help your baby find the nipple at feeding times. The rooting reflex starts to disappear by 4 months old. By this time, your baby knows how to move his head and mouth to eat.
      
      
    • The Moro reflex causes your baby to flail his arms out and cry. This happens when your baby is startled by suddenly changing his position or by a loud noise. This reflex disappears when your baby is about 2 months old.
      
      
    • The grasp reflex is when the palms of your baby's hand closes when you stroke them. The hand grasp turns into purposeful grasping when your baby is about 5 to 6 months old.
      
      
    • The eye blinking reflex happens if your baby sees bright lights or an object moves toward him very fast.
      
      
    • The crawling reflex happens when your baby is put on his stomach.
  
  
• Movement - Gross Motor (Body Control and Skills): It is normal for your baby to curl up in a "fetal" position during his first couple of days of life. Your baby's posture straightens as your baby grows and develops. Your newborn's movements may be jerky because his nervous system and muscle control is developing. Make sure you support your baby's head when changing your baby's position. This is especially important when you put your newborn in a sitting position. Your newborn may be able to turn his head from side to side when lying on his back. Your newborn may be able to lift his head for a brief second but he is unable to hold his head up by himself.
  
  
• Movement - Fine Motor (Hand and Finger Skills): Fine motor movements are when your baby can control his fingers purposefully. Your newborn can bring his hands toward his mouth and suck on his fingers. But, newborns cannot do other fine motor things until the grasp reflex goes away.
  
  
• Daily Living Activities: Your newborn sleeps about 16 to 20 hours a day in 20 minute to 6 hours blocks. Your newborn will awaken about every 4 hours to eat. Your newborn baby needs to eat every 3 hours if your are breastfeeding. You can tell if your newborn is getting enough breast milk or formula by how many wet diapers he has. Your newborn is probably getting enough to fluid if he is having 6 to 8 wet diapers a day.
  
  
  • Set up a routine or daily pattern of sleeping and eating. A regular routine is very important to make sure you and your baby get enough rest and sleep. A routine also makes your baby feel safe and learn to trust you.
    
    
  • Babies have 6 states of alertness. Two are sleep states and four are awake states. It is important to know what state your baby is in. This helps you know how he well he is able to interact with you.
    
    
    • The 2 sleep states are deep and active sleep. Your baby is quiet and sleeping without moving much during deep sleep. Trying to wake your baby don't work very well when your baby is in deep sleep. Active sleep is lighter than deep sleep. Noise and activity will probably wake your baby up when he is in active sleep.
      
      
    • The 4 awake states include drowsiness, quiet alert, active alert, and crying. Your baby may move between being asleep or alert when he drowsy. During quiet alert, your baby's eyes are wide open, his body is quiet, and his face is bright and attentive. The best time to play and talk with your baby is when he is active alert. Show your baby things that he can see, hear, smell, and touch. Your baby is not able to interact or listen to you when he is crying. Trying to distract your baby with things like toys or music will not stop his crying. The best way to quiet your crying baby is to pick up and hold.
  
  
• Language and Intellectual Development: Your newborn communicates (lets you know what he needs and feels) by his face expressions and body movements. He cries to let you know that he is stressed, uncomfortable, or just wants your attention. You will soon be able to hear the difference in your baby's crying. You will be able to tell whether he is hungry, in pain, afraid, uncomfortable, bored, or upset. It is important to react quickly and consistently (the same way each time) to your baby's different cries. This tells your baby that you care and understand him.
  
  
  • Your newborn is very sensitive to light, so make sure it isn't too bright or too dark. He is able to look at something held about 8 to 12 inches away from him. Your newborn would rather look at black and white pictures or high contrast patterns, like stripes or simple faces. But, mostly your baby likes to look at a human face rather than pictures or toys.
    
    
  • Your newborn is also very sensitive to sound. Your baby most like the sound of high pitched human voice. And, your baby likes your voice most because it is the one he's heard before he was born. Your baby will be able to identify you by your voice by the time he is one month old. Your baby prefers to be spoken to in a soft, comforting way. Loud noise may startle your baby or make him cry.
  
  
• Family and Social Relationships: Your newborn baby does not understand that he is a person by himself and that you are a separate person. The most important people in your newborn's life are you, his parents. He depends on you for love, to take care of all his needs, for safety, and for play. Your newborn will learn to trust and feel like he "belongs" when you love and care for him. Make sure your older children are allowed to be a part of your newborn's activities and care.
  
  
• Personality and Emotional Development:
  
  
  • Your baby's personality and emotions start to show as you care for and play with your baby. You are telling your baby that his thoughts and feelings are important when you react to your child's signs. This help develops your baby's self-esteem (how he thinks about himself). Do not worry about spoiling your baby by giving him too much attention. You give your baby a feeling of safety and trust when you quickly and consistently comfort your baby when "demanded."
    
    
  • Colic is when your baby cries and cannot be calmed down at the same time each day usually around dinnertime. He stretches his legs and then pulls his legs toward his stomach. Colic usually starts between the 2nd and 4th week of life and stops around the end of the 3rd month. One out of 5 babies has colic. Attempts at trying to comfort your baby do not usually work. Following are some ways to deal with colic.
    
    
    • Try carrying your baby in a snuggling wrap or offering him a pacifier.
      
      
    • Rock your baby or walk and move in a rhythmic slow motion.
      
      
    • Gently rub your baby's back while putting your baby's abdomen (tummy) down across your knees or arms.
      
      
    • Breast feeding mothers have tried changing their diet. Try to stop eating and drinking caffeine, onions, cabbage, and other irritating foods.
      
      
    • It is important to remember that your baby is not trying to make you angry or upset. Set your baby down in a safe place and step away if you are frustrated or upset. Or, have someone else look after your baby for awhile. Never take out your anger on your baby. Shaking your baby can cause brain damage or death. Ask caregivers for the CareNotes™ handout about shaken baby syndrome.

How can you keep your child safe during the newborn period? Your newborn completely depends on you to keep him safe. Following are ways to keep your baby safe and to prevent accidents.

• Your baby should have a physical exam by a caregiver before he leaves the hospital. Take your baby to see a caregiver again after about 1 week. Be sure to make and keep appointments to your baby's caregivers for routine medical checkups and vaccinations.
  
  
• Call your caregiver if you are tired or upset.
  
  
• Make sure your house is childproofed if you haven't already done so. Use childproof locks, safety gates, and window guards to prevent accidents and falls. Smoke and carbon monoxide detectors are also important.
  
  
• Put your baby on his back for sleeping.
  
  
• Handle your baby with gentle, slow movements. Speak in a soft, quiet, soothing way.
  
  
• To prevent choking, do not attach pacifiers or other objects to the crib or body with a string or cord. Keep small objects away from your baby. This includes toys or stuff animals that have small breakaway parts. Baby's can suffocate if they play with plastic bags. Never leave plastic bags or wrappings where your baby can reach them.
  
  
• Always keep your baby in a smoke-free area. Do not allow people to smoke around your baby.
  
  
• To prevent burns, do not hold your baby when smoking, drink hot liquids or when cooking. Do not heat formula or breast milk in the microwave. Your baby skin is also very sensitive to the sun. Keep your baby out of direct sunlight to prevent sunburn.
  
  
• Your baby is not able to control his own temperature so he can get very cold or very hot easily. Make sure he is dressed correctly in both cold and warm weather.
  
  
• Check the water temperature before putting your child in the tub. Have your water heater set to less than 120° F to lessen the chance of an accidental burning. Never leave your baby alone in the water. Do not leave your baby to answer the phone or doorbell. Either let it ring or wrap your baby in a towel and take your baby with you.
  
  
• Never leave your baby alone up high like on a changing table, the couch, a chair, or the bed. Always keep a hand on your baby and never walk away when your baby is on a high place.
  
  
• Do not use walkers. They are dangerous and have caused serious injuries and even death when they fall down stairs.
  
  
• Never leave your baby alone in the home or yard. Never leave your baby alone in the car. The temperature inside the car can change a lot.
  
  
• Always use approved car seats correctly. Put the car seat in the back seat of the car in a rear facing position (your baby will be facing the back of the car). Never put your baby in a front seat with a safety airbag. Ask your caregiver for the CareNotes™ handout on using car seats. Or, call:

• National Highway Traffic Safety Administration
  400 Seventh Street SW
  Washington, DC 20590
  Phone: 1-888-327-4236
  Web Address: http://www.nhtsa.dot.gov
  

• Keep anyone with a cough, cold, or infectious disease (spreadable illness) away from your newborn.
  
  
• Call caregivers if your baby seems ill. Fever, refusing to eat, vomiting (throwing up), or diarrhea (runny, watery BMs) are good reasons to call. Also call if your baby is more fussy or quieter than usual or looks jaundiced (yellow skin and eyes).
  
  
• And, call your baby's caregiver if you are worried or have questions about your baby's growth or development.

How do newborns react to being sick or in the hospital? Newborns are extremely attached to you, their parents. This means that your baby needs you near in order to feel safe. Following is list of signs that can tell you your baby is stressed (not OK).

• Breathing and heartbeat are very fast.
  
  
• Eating poorly or regurgitation (food keeps coming up and vomiting).
  
  
• Eyes don't look at you or your baby keeps looking away and doesn't want to be touched.
  
  
• Fussier than normal or listlessness (not moving much at all).
  
  
• Hiccoughs, sneezing, and yawning a lot.
  
  
• Shaking.
  
  
• Skin changes from his normal color to red, pale, gray or blue.

How can you help your newborn when he is sick or in the hospital? Following are ways to help lessen your baby's fear at being in the hospital.

• Be involved in caring for baby each day, like helping with feedings, baths, dressing, and diapering. Try to keep your baby's schedule as much like it is at home as possible.
  
  
• Ask for the same caregiver to lessen the number of people caring for your baby. Soon your baby will recognize his caregivers and won't be so afraid.
  
  
• Always try to be present when your baby is getting medical care. Hold your baby in your lap during procedures if at all possible. This helps calm your baby and make him feel safe. Comfort your baby and provide support by stroking (touch) your baby and talking in a soothing way.
  
  
• Make sure your baby has things that remind him of you and make him feel safe, like his blanket. Leave a picture of you or a recording of your voice to be played if you can't be with him.

CARE AGREEMENT:

You have the right to help plan your baby's care. To help with this plan, you must learn about your newborn baby's growth and development. You can then discuss treatment options with your child's caregivers. Work with them to decide what care will be used to treat your baby.

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