The first 28-day adventure of your baby from birth is called the newborn period. When the warm, dark, relatively quiet and safe environment in the mother’s womb is replaced by a dynamic, noisy and bright environment, our baby takes its first breath. The stress of this miraculous moment decreases the earlier the baby is brought into contact with the mother. Waiting 30-60 seconds before cutting the umbilical cord allows more stem cells to pass to the baby, which can protect the baby from anemia and infections. The first breastfeeding can also be done in the delivery room.
After necessary care is provided, vitamin K, which is a very important vitamin for bleeding control, is administered along with the first Hepatitis B vaccine.
Newborn Screenings
These are tests performed to detect certain diseases that are common in society, asymptomatic in the early stages, and cause permanent damage if left untreated. They are taken from the heel on days 2-5, after feeding and before discharge from the hospital. It is then repeated on the 7th day by the health center.
In our country, Phenylketonuria, Biotinidase deficiency, congenital hypothyroidism, and Cystic fibrosis are congenital diseases within the screening scope. Additionally, hearing and developmental hip dysplasia are also screened.
Umbilical Cord
In a healthy newborn, the umbilical cord falls off within 6-10 days. If it doesn’t fall off for more than four weeks, it could be due to some infections or immune system diseases. It’s sufficient to keep the cord dry and prevent contact with urine and feces. No special care is needed; the baby can be bathed even before the cord falls off, but should be dried thoroughly. Bleeding, redness, or bad odor from the navel are reasons to consult a doctor. Any herniation that may occur will decrease as the abdominal muscles strengthen. It can be monitored under doctor’s supervision up to 1 year of age.
Newborn Skin
Some self-resolving changes may be observed. In the first days, hands and feet may appear purple, which can improve as circulation normalizes. Other parts of the body are pink. Peeling may occur in some areas. At birth, there may be a white, creamy layer that is more intense in the first days and decreases later; this has a protective function for the skin. Various birthmarks may be seen on the skin. Most of them disappear over time and are harmless. For example, Mongolian spots, which are prominent blue-purple marks on the back and buttocks, usually disappear around 1 year of age or in later years. Hemangiomas are capillary dilations. They can be pink or purple and raised from the skin. They may grow in the first months but then shrink and disappear. Some may be very prominent and prone to bleeding; these can be treated with medication or surgically. Milia are white, pinhead-sized lesions on the face that resemble pimples, caused by blocked sweat and oil glands, and resolve on their own. Newborn acne is also a condition that may be related to hormones passed from the mother and usually doesn’t require treatment. Lanugo is fine hair prominent on the baby’s back, shoulders, and ears, which falls out naturally.
Breast Swelling
Breast swelling: This occurs due to hormones passed from the mother. Although it may sometimes persist, it usually resolves in the first months. The breasts should not be squeezed or massaged. If the swelling becomes very hard and red, or if there’s a risk of infection, a doctor should be consulted.
Fontanelles
Fontanelles: There are spaces on the upper, side, and back parts of the baby’s head where the skull bones haven’t fully joined, allowing the brain to grow comfortably. While the posterior fontanelles are expected to close in 3-4 months, the anterior fontanelle closes between 3-18 months. Sometimes it can take up to 2 years. Even after closure, vitamin D is given at the recommended dose and should never be discontinued. Pulse can be seen over the fontanelles, and swelling may occur when crying.
Eyes
Eyes: The eye color, which is typically gray or light blue at birth, takes on its permanent color in the first 6 months. Newborns tend to keep their eyes closed most of the time, but they can see, focus, and comfortably view objects 20-40 cm away. Temporary eye deviation or squinting may occur. This usually resolves by the 3rd month as eye muscles develop. The tear gland is also not fully developed, so there are often no tears when crying in the first 3 months. The most important eye examination for newborns is the red reflex test. Seeing the red color in the pupil with an ophthalmoscope allows early detection of pathologies such as congenital cataracts and retinoblastoma. It’s beneficial to continue this examination in the following months.
Hearing
Hearing: All newborns are screened with a hearing test. Screening programs aim to diagnose within the first 3 months and treat before 6 months. Hearing loss is a condition that requires rapid diagnosis as it affects mental development, speech, and language development.
Nutrition
NutritionBreastfeeding: Babies should be fed with breast milk for the first 6 months after birth. Breast milk is the most natural and beneficial food. Our aim should be to feed exclusively with breast milk for 6 months without even giving water, but of course, there may be situations where breast milk cannot be given or the baby cannot take it. In that case, age-appropriate formula milk should be given. Breastfeeding should be started as soon as possible after birth. The first colostrum is yellow, thick in consistency, and small in quantity, but it is both sufficient and miraculous food for the newborn. In the newborn period, especially in the first days, there may not be very regular feeding intervals. The baby should be breastfed whenever they want. The breastfeeding interval should not exceed 3 hours. In the first days, there is a physiological, natural weight loss which is normal up to 10%. Frequent breastfeeding and drinking plenty of water will increase milk production. Unless there is a medical need, pumping etc. is not necessary. The baby’s weight control, number of urine and stools show us whether they are feeding adequately.
Sleep
Sleep: Each baby’s sleep and wake times vary. In the first days, most of the day is spent sleeping. The baby should be woken up for breastfeeding. In the first months, there isn’t much of a sleep pattern, they don’t know the difference between night and day, and feeding continues at night. The baby should be in a separate bed next to the mother, not in the same bed as the mother. It is beneficial for the baby to sleep on a not too soft mattress, without a pillow, and with the head of the bed slightly elevated for babies who vomit a lot. Not putting them to sleep in very quiet and dark conditions during the day can be the first step in developing a sleep pattern. After the 4th month, sleep patterns can be expected to regularize. Starting sleep routines that include bathing and massage can be effective for this.
Gas Problem
Gas problem: Gas problems in newborns can become more noticeable after the first 2-3 weeks. Burping after each feeding and massage can be helpful. Herbal teas and gas medications are not recommended. The mother’s diet is reviewed, but a very restrictive diet for fear of causing gas is not correct. A balanced diet is necessary for the health of both. As for colic, it’s not always gas-related; it’s generally crying spells that occur at least 3 days a week, lasting at least 3 hours, and for more than 3 weeks. It ends in 90% of cases after 4 months. There is no proven treatment. However, before making this diagnosis, the baby should be thoroughly examined and tests may be necessary. Conditions such as urinary tract infection, reflux, allergy, hair tourniquet syndrome, constipation, hernias, diaper dermatitis, anal fissure, etc. should be ruled out. Although there is no proven treatment, explaining to the family that it will pass around 3-4 months, reviewing feeding techniques, calming techniques, possibly changing formula if the baby is on it, adding probiotics, and giving lactase can be tried.
Neonatal Jaundice
Neonatal jaundice: Yellowing can occur in the baby due to the accumulation of a substance called bilirubin in the mucosa and skin. This substance is formed by the breakdown of red blood cells and accumulates because the liver in babies has not yet fully developed. The yellow color starts in the eyes first and spreads to the lower parts of the body. It usually resolves on its own, but sometimes, especially if there are risk factors, it can reach high levels and require treatment. The baby’s first week check-up is very important, and if necessary, blood bilirubin levels are checked and monitored. Premature birth, insufficient weight gain, blood group or Rh incompatibility, and the presence of a sibling with high bilirubin are risk factors. Phototherapy and blood exchange may be necessary treatments. Frequent breastfeeding is the first treatment; the better the baby is fed, the quicker the jaundice improves. It usually resolves within 1-2 weeks, but sometimes prolonged jaundice can occur. In periods extending up to 1-2 months, some tests should be done again. Breastfed babies may have slightly longer jaundice; treatment should still be plenty of breastfeeding.
