Helping Families Be Healthy from the Beginning

Caring for Your Baby 0-1 Month

Materials and information presented is used with approval from and in accordance with the First 1,000 Days program, with the aim to improve the health of families from the beginning.

Caring for Your Baby 0-1 Month

Hold, look at and talk to your baby. When your baby makes sounds, repeat them back.

Learn your baby’s signs of hunger and fullness. Only feed when you see signs of hunger, and stop feeding when your baby shows signs of being full.

Learn ways to soothe your baby without feeding:

• Swaddle • Gently rock or bounce • Give pacifier or finger to suck on.

Newborns need about 16-17 hours of sleep a day. Sleep is important for brain development and healthy growth.

Try to give your baby only breast milk the first 6 months.

If formula feeding, follow the directions and only use the amount it says on the can.

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Your Baby’s Sleep

Sleep is really important! Sleep is a time for brain development and healthy growth.

How much sleep do newborn babies need? • Newborns need about 16-17 hours of sleep a day.

About 8 or 9 hours are during the day and the rest are at night.

• Most newborns wake up often throughout the night. They are still learning to sleep for longer periods of time.

• Once babies are growing well, they need to feed less often overnight. At one month, if your baby is gaining weight well, do not wake her to feed in the middle of the night. Ask your doctor if your baby can go for longer times at night without feeding.

• Newborns are just starting to develop sleep patterns, so their schedules can be different every day. Sleeping is a skill that takes time to learn!

• By 1 month, babies sleep about 14 hours a day, with a little more sleep at night and a little less during the day. Many babies still take 4 or more naps during the day.

Is it ok to swaddle? Yes. Just make sure your baby can bend her knees and that the swaddle is not too tight over her chest.

To be safe: • Always put your baby on her back to sleep. • Use a firm mattress for baby. • Never put your baby to sleep on a couch. • Do not put anything soft in the crib (no bumper pads, blankets,

pillows, or soft toys). Large soft things can block baby’s breathing.

If you have concerns about your baby’s sleep, talk to your baby’s doctor about it.

Soothing Your Baby

All babies cry.

It can be hard to listen to, but when your baby is crying, he is trying to tell you something.

Crying does not always mean your baby is hungry. If there are no signs of hunger, try to first comfort your baby without feeding. This can help you avoid feeding your baby more than she needs. It can also keep your baby from expecting to eat every time she cries.

Other reasons babies cry and fuss:

• Is he sleepy? Your baby may be sleepy if he is:

Yawning, fussing, rubbing eyes, looking away.

• Does he need a clean diaper?

• Is he uncomfortable? Cold or hot?

• Does he want to be played with?

• Does he want to suck on a finger or pacifier?

For more information go to www.AllBabiesCry.com (use code ABCMGH)

Some babies cry more and some cry less, but newborns cry about one hour over the course of a day. By 6 weeks they cry about 2 hours, and they cry less starting at about 8 weeks. Babies who are held for many hours a day tend to cry less.

Common Crying Patterns for Newborns

Never shake your baby.

If you are stressed and want to cry or scream, put your baby down

in a safe place and take a break. Ask someone to watch the baby for

a short time. Call the Parents Helping Parents line at 800-632-8188.

Help Your Baby’s Development

Other things to try when your baby is fussing:

• Swing, gently bounce or rock, swaddle, and sing to your baby.

• Repeat a word or sound, like shh, shh, shh. • Use noise like a vacuum, fan, or hair dryer.

If your baby cannot be soothed in the moment, it is not because you are a bad parent.

Your baby needs a lot of cuddle time. It is never wrong to hold your baby. Newborn babies are not spoiled by being held or comforted.

• Talk to your baby when you are together.

• When your baby makes a sounds, smile and repeat it back.

• Practice tummy time! When your baby is awake, put your baby on her tummy. Talk and make eye contact with her to help her learn to lift her head.

Try to give your baby only breast milk for the first 6 months. Why is breastfeeding best for babies?

• Breast milk is the perfect food for babies. It has all the nutrients babies need for healthy growth, except Vitamin D.

• It helps protect babies from getting sick.

• Breastfeeding can help your baby grow best in the first few years.

• Breast milk gives babies a taste of many flavors. This can help them like more foods as they grow, so be sure to eat lots of fruits and vegetables!

• It can even help your baby’s brain development!

Why is breastfeeding best for moms?

• It’s free!

• Breastfeeding can help you lose pregnancy weight faster.

How often should I breastfeed?

• Newborns breastfeed as often as every 1-2 hours. Keep your baby awake and sucking for at least 10-15 minutes at each feed. This will help with your milk supply and ensure your newborn is feeding enough.

• One month old babies feed about every 2-3 hours.

Should I breastfeed if I have a cold?

• Yes! Breastfeeding helps protect your baby from getting sick. If you take medicine, check with your doctor to make sure it is safe for breastfeeding.

The more you

breastfeed,

the more milk

you will make!

How long should I breastfeed?

• Try to give your baby only breast milk for the first 6 months, and to give some breast milk until at least 12 months.

• One month of age is a good time to start giving your baby some pumped breast milk in a bottle. Try to give it at least one time a day.

Is breast milk enough for my baby? Should I give formula too?

• Healthy breastfed babies do not need formula.

• Signs that your baby is getting enough breast milk:

6 or more wet diapers in a day 3 or more dirty diapers in a day

• If you are worried that your baby is not getting enough milk, ask your doctor. Your doctor weighs your baby at every visit and will let you know if there is concern that she is not getting enough milk. If your doctor has said that your baby is gaining weight well, your breast milk is enough.

If you continue to worry that you are not making enough milk:

• Switch which breast you give baby first at each feed.

• Fully nurse on one breast before switching to the other. There is more fat in the milk later in the feeding.

• Hold baby in different positions at each feed to use all milk ducts.

• Make sure your baby is latching well. Ask for help if not sure.

• Keep giving only breast milk. If you give formula, your baby will need less breast milk and your body will then make less of it.

If breastfeeding hurts...

Sore Nipples

If you continue to have nipple pain, something is not right.

• Try holding your baby in different positions at each feed. Then your baby’s mouth won’t always press in the same place.

• Do not use soap or lotion on your nipples. It can dry them out. Put 100% Lanolin cream or a little breast milk on sore nipples after feeding.

Plugged Duct

If you do not fully empty your breasts, a milk duct can get blocked.

• Hold your baby in different positions at each feed to use all milk ducts.

• A heating pad, warm compress, hot shower, rest, and massaging the breast can help get milk to flow again.

Breast Infection (Mastitis)

If you have a fever, pain in your breast, or your breast is hot, red, or swollen, you may have an infection and should call your doctor.

Yeast Infection (Thrush)

Thrush is a yeast infection that can spread between your nipples and your baby’s mouth.

• You nipples may hurt and be red, flaky, or itchy. There may be shooting pains in the breast during or after nursing.

• Your baby may have white patches on the tongue and inside the cheeks. Your baby may also have a diaper rash.

Call your doctor if you have a fever, pain in your breast or your breast is red, hot, or swollen.

If you are formula feeding...

Your baby needs your help to eat well and be healthy.

• If you are not breastfeeding, iron-fortified formula is the next best choice for your baby for the first 6 months of life.

• Always follow directions when mixing formula. If other people mix

formula for your baby, be sure they know it is very important to use only the amount it says on the can.

• Use 2-4 ounce bottles. Babies who drink from bigger bottles are more likely to take in more than their body needs.

• Mix formula with tap water. It is better than bottled water for your baby’s gums and future teeth.

• Do not overfeed your baby! Newborns take in about 1-3 ounces (30-90 ml) of formula at each feeding. At birth, their stomachs are about the size of a marble.

If your baby is getting less than 32 ounces of formula a day, or is breastfeeding, give

Vitamin D liquid (400 IU) once a day.

How much should my baby eat?

• Most newborns need to feed 8 to 12 times a day, or about every 2-3 hours. As they get older, they will take in more milk at each feeding and in less time.

• Your baby may eat more some days and less on other days. Feed when you see signs of hunger, not by the time on the clock.

• Babies who are growing well not do need to finish the breast milk or formula in the bottle. Letting them stop eating helps them learn to eat when hungry and stop eating when full.

• Hold your baby during feedings. Never prop a bottle up.

Babies can choke or get ear infections from propped bottles.

• Your baby should never sleep with a bottle. It is not good for growing teeth, or for teaching baby to eat only when hungry.

Feeding Tips for All Babies

More about Feeding

• Only breast milk and formula should go in bottles. Never put cereal or sweetened drinks in a bottle.

• No juice or other sugary drinks or honey for babies before 12 months. Best to wait even longer.

• Make feeding times quiet and pleasant. Keep TV and all other screens off.

• During a growth spurt, your baby may want to feed more. Many babies have growth spurts at 2-3 weeks old and at 6 weeks old.

• It is normal to spit up. If your baby seems well and is gaining weight, do not worry about spitting up.

At room temperature

In the refrigerator

In the freezer

Fresh breast milk

Can be at room temperature 6-10 hours

Can be in refrigerator 5-7 days

Can be in freezer 3-4 months

Thawed breast milk (milk that had been frozen)

Can be at room temperature 1 hour

Can be in refrigerator 24 hours

Do not re-freeze milk that was frozen before

Mixed formula

Can be at room temperature 1 hour

Can be in refrigerator 24 hours

Do not freeze formula

Storing Breast Milk and Formula

Hunger and Fullness

Even newborn babies know when they are

hungry or full. With practice, you can learn

when your baby is hungry and full by how

your baby acts. Only feed your baby when

you see signs of hunger.

• Feeding babies when they are not hungry can make them more likely to eat too much as they get older.

• Look for ways to calm or soothe without feeding when you do not see signs of hunger.

Ask your doctor about the difference

between nursing to feed and sucking

for comfort.

Signs of a Hungry Baby...

• Makes sucking or lip smacking noises

• Sucks hands or puts hands near mouth • Breathes quickly

• Moves head to look for nipple (rooting)

Signs of a Full Baby...

• Slows or stops sucking

• Pushes away from the breast or bottle • Stretches or relaxes fingers, arms, legs

• Closes lips • Turns away

Pooping —What is normal?

• Most babies have 0-10 poops a day.

• Green, yellow and brown are normal colors for newborn poop.

• Babies may cry or strain before pooping. If the poop comes

out soft, this is ok. It is not constipation.

Every baby develops differently, but at this age, your baby may...

Respond to your face and voice

Respond to sounds by blinking, crying, or changing breathing

See objects 6-12 inches away and focus on faces

Lift his head for a moment when on his tummy

The Boston Basics are 5 fun, simple, and powerful ways that every family can give every child a great start in life.

Newborns learn language! Point as you talk to give your baby clues to what you are saying.

Babies need to feel loved and safe. Manage your stress to help your baby feel secure.

Even babies start to learn math and thinking skills. Your baby will learn by watching you.

Babies learn by touching and exploring. Let your baby touch, bang and crawl to learn the way around.

Reading is a great way to bond. Your baby will learn how books work and start to develop language.

Take care of your mind and your body. As a new mom, you are thinking a lot about how to take care of your baby. Be sure to take care of yourself as well.

Many new moms feel sad, cry, or are moody in the days and weeks after giving birth. This is normal and can happen to any woman.

Some new moms also feel:

• Hopeless or overwhelmed • No energy or motivation to

do things they used to enjoy • Anxiety • Trouble concentrating • A lack of interest in the baby • Like they are eating or sleeping

too little or too much • Afraid of hurting themselves or their baby.

If you have any of these feelings, there are things you can do to feel better. Your midwife and doctor are there to help and want you to feel better. They have worked with many new moms who have also had these feelings and they are there to help you.

Caring for Yourself

Know who you can ask for help.

Ask your doctor, nurse, partner, friends, or family for help when you need it.

If you need to talk to someone right away, call the MA help line for new moms at 877-382-1609.

New Dads

Being a dad is an important job! Dad and baby bonding is very important. Studies show it can help baby’s brain and body develop and help them do better as they get older too. Ways to start bonding:

• Give your baby a bath

• Change your baby’s diapers

• Cuddle with your baby

• Do the Boston Basics!

Learn about them online at: BostonBasics.Org

Help your baby get a healthy start by supporting baby’s mother in trying to breastfeed. Breast milk helps protect babies from illnesses. But breastfeeding can be hard, so be patient with both mom and baby!

Stay healthy for your baby, your partner, and yourself. Your health and habits matter. Smoking, using drugs, depression, and not caring for your own health can impact your baby’s development. As you make healthy lifestyle changes, you can also encourage and support your child’s mother to stay healthy.

What kind of parent do you want to be?

We learn from our parents, no matter how much time they spent with us growing up. Think about how you want to be as a parent, and what ways you want to be like your own parents and what ways you want to be different.

Keeping Your Baby Safe

Always have

baby’s car seat

in the back seat,

facing the back

window.

Do not let

anyone smoke

near your baby

or in your house

or car.

Do not leave

your baby alone

on the couch, bed

or changing table.

Copyright © 2017, Massachusetts General Hospital; All rights reserved.

If you feel very

sad, or have more

bad days than

good days, call

your doctor.

Always put baby

on her back to

sleep. Do not use

blankets when

your baby is

sleeping.

Do not have

hot drinks when

you are holding

your baby.

Important Phone Numbers

• MGH Domestic Violence Help Line: (617) 724-0054

• Poison Control of Massachusetts: (800) 682-9211

• Smoking Quit Line (free): (800) TRY-TO-STOP