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Characteristics of a Newborn Baby

The first sight and sound of your newborn may be very surprising, especially if you had a preconceived idea that your baby would look like you, your mate, or the older babies prominently displayed in magazine ads and television commercials. Being prepared for what the newborn will look like can remove unnecessary anxieties during the early postpartum period.

In their first days, babies recover from the experience of birth and learn to deal with living in our world. All their systems must change from intrauterine dependence to extrauterine independence. They must now breathe, eat, digest, eliminate, and stabilize their circulatory system, body temperature, and hormone levels on their own.

Crying And Breathing

Some babies cry immediately upon exposure to the air - even if only their heads are outside the mother's body; other babies take several seconds longer. Some make very loud announcements upon their arrival; others cry softly. Still others emit a few cries - loud or soft - broken up by long stretches of silence. Some cry a lot within the first few seconds of birth and then suddenly there is no sound of crying for hours. You may notice extreme quivering of the baby's lower lip when he or she cries. If the baby cries hard, you may notice the veins beneath the skin of the head swell. However, no matter how much the newborn cries, you may not notice tears for several weeks.

The baby's first breaths of air take much more effort than what is necessary for normal breathing. This extra effort is required to expand the alveoli, thousands of uninflated sacs in the lungs. Crying soon after birth serves as an effective means of clearing mucus and fluids from the passages. Gradually, by the third day of life, the baby's breathing becomes easier, although inconsistent breathing patterns continue for several weeks.

Each baby has a distinct personality. Some are criers, loud and gusty, eat heartily and noisily, and are very active. Others cry softly and rarely and are generally very quiet and relaxed. When in need, they may whimper and frown, not cry a lot.

A newborn's heart beats about 120 times a minute - twice as fast as an adult's. He or she takes about 33 breaths a minute, also twice as fast as an adult. Breathing and heartbeat can vary widely, depending on the baby's degree of activity and excitement.

Sleepy Babies

The type and dosage of pain-relief medication given to the mother, when and how it was administered during labor and delivery and for how long, all have a bearing on whether or not the medication will influence the baby's condition at birth. Therefore, babies whose mothers were excessively sedated may have more difficulty in establishing good respiration. In some extreme cases, emergency resuscitation efforts must be made.

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In addition to respiration, the baby's other reflexes (e.g., sucking) may be affected by certain pain-relief medications administered to the mother during labor and delivery. Whether or not their mothers received such medication, many newborns fall into a much needed sleep within fifteen minutes of being born. Others are wide awake for as long as two hours after birth. In the beginning the newborn sleeps about fourteen to eighteen hours each day - hours not necessarily coinciding with your sleeping and waking hours.

Weight

The average newborn weighs approximately seven to eight pounds and measures eighteen to twenty-two inches in length. Boys tend to be larger than girls. Because the newborn excretes more than he or she takes in (probably as a result of hospital feeding schedules) during the first three or four days of life, some newborns lose weight. By the tenth day, however, if the baby is eating properly, the birth weight is usually regained.

The head of the newborn is disproportionately larger than the rest of the body, comprising about one-fourth of its entire length. It may appear lopsided, pointy, or flattened. This is caused by “molding” of the baby's skull to conform to the confines of the birth canal. The four large bone plates of the skull are not attached to each other; they therefore can be pushed together by the pressure of the birth canal, enabling the baby to fit through this narrow passageway. During birth the bones may even overlap each other, which may explain why some babies appear to have ridges on their heads.

You may notice or feel two soft spots on the baby's head - one above the brow, the other near the crown - where the bones of the skull have not yet fused together. It can take as long as two weeks for the head to assume a normal shape and about eighteen months for the skull bones to fuse together.

If your baby tends to lie in the same position most of the time, one side of the head may become flatter than the other. If the baby is bald, you may notice that the skin of the scalp may be surprisingly loose and the brow may be wrinkled.

Hair

Some babies are born with a thick crop of hair, while others are born completely bald. The fact that your baby has dark thick hair at birth does not mean that it will remain that way. Permanent hair growth at about four or five months may even be blond - and thinner.

Cheeks, Nose, Chin, Forehead, Mouth

“Sucking pads” inside the baby's cheeks may make it appear that the face is somewhat swollen. The newborn has a broad, flat nose and receding chin and jaw - all of which facilitate breastfeeding. The chin and lips often tremble soon after birth.

There may be small raised white spots on the cheeks, chin, or forehead. Called milia, these are accumulations of natural oils in the gland ducts. As the glands mature and function more completely, these will disappear.

Eyes

The eyelids may be reddish and swollen due to the pressure of the birth process. The swelling usually disappears in two or three days. In addition, there may be patches of red or purple on the eyelids. These too will disappear in time.

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The color of a newborn's eyes is usually grey-blue, although some babies of Negro, Mediterranean, or Asian descent may have brown eyes at birth. Permanent eye color usually sets in within the first six months, although it may take longer. Your baby's eyes may appear bloodshot or have a small red spot in the white area of the eye, caused by the breaking of tiny blood vessels during the birth process. This usually disappears in a few days. If the baby's eyes were treated with silver nitrate, as opposed to an antibiotic ointment, you may notice a clear or whitish drainage coming from the eyes. This should be brought to the nurse's or doctor's attention. Simple rinsing with clear, warm water generally clears this up.

One or both eyes may turn and appear crossed or wall-eyed. This condition is normal and usually disappears as eye muscle strength and coordination mature. Newborns do see. New babies can focus on a bright red or soft yellow object about eight to twelve inches away. When their eye muscles are more developed and do not easily cross or go outward, babies will stare at and show interest in any object for a while. If the object is moved slowly in front of them, they will try unsuccessfully to follow it with their eyes, moving their heads from side to side or up and down. Newborns can tell the difference between shapes and patterns. They usually prefer looking at pattern rather than solid colors, whether they are bright or dull. And the patterns they dwell on longer are stripes and angles rather than circular shapes. Their focusing on patterns helps them discern between various human faces - each of which has a different facial pattern, but basically the same shape head!

Newborns' eyes are sensitive to light. They squint if the light becomes brighter and shut their eyes tightly and keep them shut if they are suddenly faced with extremely bright light.

Neck

The newborn's neck is short and the muscles are not yet well developed. The head must be carefully supported when the baby is lifted or carried. The nape of the neck may have patches of red or purple which go away in time.

Trunk

The circumference of the newborn's chest is smaller than that of the head. Due to the weakness of abdominal muscles, the stomach may appear surprisingly large and rounded compared to the very small hip and buttock area.

The umbilical cord is shimmery-moist and bluish-white at birth. After it has been clamped and cut, the remaining stump dries and becomes almost black within twenty-four hours. It shrivels and blackens completely by the time it drops off – painlessly - about seven days after birth, at which time you may notice some bloody discharge at the site. If, instead of alcohol, an antiseptic purple dye was used on the stump to prevent infection and promote drying, the surrounding skin may take on a purplish stain.

If the baby is a boy, you may notice an erect penis and immediate urination soon after birth. Both are good signs. The scrotum may seem especially large in relation to the rest of the baby and some boys are born with one or both testes as yet undescended.

A brownish-red or white cheesy discharge may come out of a baby girl's vagina and her clitoris may be swollen. Swollen breasts and genitals on girl and boy babies are common and caused by the mother's hormones, still in the infant's bloodstream. In addition, the hormone estrogen, which is present in the mother's bloodstream at the time of delivery, may cause a milky substance to appear from the nipples of a girl or boy. Called witch's milk, this usually lasts for a few days, although it can continue for as long as six weeks.

Because of the restricted space occupied by your baby in the uterus, the legs are somewhat bowed at birth and may remain so for many months. Both legs and arms are short in relation to the entire body length. Many babies remain in their curled-up fetal position for several days with their arms and legs kept close to their bodies and fists clenched. In their own time they straighten out.

The baby's fingernails may be very long and sharp. In fact, some babies are born with scratches on their faces , caused by their own nails while inside the uterus. Sometimes a newborn's thumb is red and wrinkled, indicating that he or she sucked the thumb while still in the uterus!

The newborn's movements are usually jerky and twitching, especially so if he or she was born prematurely. The more mature the baby is at birth, the more smooth the movements.

The newborn responds more often to a high- rather than a low-pitched voice. It has been noted that many new mothers instinctively coo to the baby in a high-pitched tone, to which the infant responds with body movements in matching rhythmic patterns.

Skin

The skin of many newborns appears almost transparent, with veins quite visible beneath the surface. Sometimes there is blood on the skin, especially on the head or buttocks, whichever part was born first, usually picked up from the mother's episiotomy site as the baby passed through the vaginal opening. Some babies have more blood on them than others.

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Sometimes the baby's skin is covered with vernix caseosa, a sticky white substance made of dead skin cells mixed with secretions from the oil glands. This lubricates and protects the baby's skin from the constant exposure to the amniotic fluid while in the uterus, and some believe its greasy character helps the baby slide more easily through the birth canal. Vernix is thicker on some babies than on others and may not be apparent on many. Usually, smaller infants have less or none, while “older” babies who have spent more time in the uterus, perhaps past their due dates, tend to have more vernix. Depending on the routine of your hospital, the vernix may or may not be removed entirely; only the excess and whatever blood and meconium (the blackish first stool) might be present is wiped off or washed off later in the nursery. Whatever vernix is left becomes absorbed by the baby's skin within the first twenty-four hours. During the next few days, you may notice the skin peeling as the result of dryness.

The baby's body may be coated with fine downy hair, called lanugo, which may not even be seen on some babies, while on other babies may be quite thick and very noticeable, particularly if it is dark. Lanugo is usually more evident on the baby's shoulders, back, forehead, or cheeks, and sheds during the first few weeks. The presence of lanugo or its thickness does not mean your baby will be “hairy” later on in life.

Pigmentation

Before the baby’s first breath, he or she may appear lifeless, almost like a child's rubber doll, without movement or normal pigmentation in the skin. As soon as breathing begins, however, the skin tone begins to change from a greyish-blue or a mottled red to pinkish or a ruddiness starting in the face and traveling to the rest of the body, although not always to the hands or feet which may remain bluish for several days. Sometimes a baby's skin tone at birth is purplish or bluish; some have a soft pink tone at the moment of birth.

The natural pigmentation of Negro, Mediterranean, or Asian babies does not usually appear for several hours or days. Many of these babies, born with relatively light skin, have areas of dark bluish-black pigmentation, called Mongolian spots, on their backs and/or buttocks which may last for months or even years, sometimes until the child reaches school age, when they blend into the rest of the skin tone or disappear. Sometimes these spots are present on Caucasian babies but will disappear in time. Mongolian spots have no relation to Mongolism a form of mental retardation.

Jaundice

Newborn babies often develop what is known as physiological jaundice on the third or fourth day of life. All newborn babies are born with high red blood cell counts which were necessary during their prenatal existence. As infants use their lungs and increase their oxygen supply, these become unnecessary and are broken down by the body, giving off a by-product known as bilirubin which must be excreted. If the liver is not mature enough to filter this waste product from the blood, the skin takes on the characteristic yellow appearance of jaundice. Within a few days, as the infant's liver matures normal skin pigmentation returns without special treatment. Physiological jaundice is more common m premature than in full-term infants.

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In contrast, a more severe form of jaundice occurring before the third or fourth day of life can be caused by an incompatibility between the blood types of the mother and baby. This must be watched more closely and treated to prevent brain damage or death. Treatment usually consists of placing the infant under a bright fluorescent lamp - called a bilirubin lamp - for several hours, or even days, with the body completely exposed and the eyes protected by gauze bandages or an eye mask. This lamp helps destroy the bilirubin which the liver cannot yet handle. In the most extreme cases of hyperbilirubinemia an exchange blood transfusion may be necessary.

Bowels

The baby's first bowel movement (which might occur in the delivery room) will be a blackish tar-like substance called meconium. Its presence indicates that the baby's intestinal tract is in good working order. If you do not have rooming-in and therefore do not change your baby's diaper during the first three days, you may not ever see meconium, which is usually completely excreted by the second or third day. If the newborn does not eliminate meconium and/or urinate within twenty-four to forty-eight hours, something may be wrong.

As feeding becomes established, the color of the stool changes from black to green-black to green-brown to brown-yellow to soft yellow (if bottle fed) or golden yellow (if breastfed). Bowel movements are loose in newborns. In a few days, the stools of bottle fed babies takes on a more characteristic shape and odor, while the stools of breastfed babies remain the consistency of thick soup and have a more acceptable scent.

The baby may have several bowel movements each day. Bowel schedules of individual babies vary widely - some babies have a movement with each feeding; others have one or two a week!

Reflexes

All infants are born with several reflexes which help them to survive and adapt to life outside the womb.

ROOTING. When the baby's mouth or cheek is touched, the head turns toward the side that is stimulated and the mouth opens. This is an instinctive way to seek food. If, however, someone touches or grasps both cheeks at the same time, perhaps trying to turn the newborn's face in a particular direction, the infant may become frustrated and confused. The baby may draw his or her hand up toward the mouth and suck on the fist or finger for several minutes at a time, sometimes even as long as fifteen minutes. This may not be new to him or her; hand-to-mouth activity and finger sucking while in the womb have been observed via ultrasound techniques.

STARTLE, OR MORO, REFLEX. The newborn reacts to a loud noise or quick movement by throwing both arms and legs outward, with fingers and toes spread apart, and then bringing them together toward the body. The baby also may begin to cry. If crying is the result of being startled, the baby can be calmed by being turned on the stomach.

STEPPING. If held upright with feet touching a flat surface, the newborn will appear to be trying to walk, making stepping motions. This reflex may remain for about six weeks whereupon it disappears. The baby's legs are not yet nearly strong enough to support his or her weight and should not be encouraged to do so.

GAGGING. The newborn will gag reflexively if too much liquid is taken in. The infant will also spit up mucus to clear breathing passages.

SNEEZING. An irritation in the nose may cause the newborn to sneeze.

DOLL'S EYE. If babies are turned to one side quickly, their eyes will turn in the opposite direction and will then slowly move in the direction in which they have been turned.

GRASP. The baby's hands are usually clenched tight. If an object or a finger is placed in the infant's hand, he or she will reflexively grip it. The strength of the grip may surprise you. If the sole of the foot is touched, the toes will curl downward.

Other Sense Reactions

By the third or fourth day of life your baby will let you know that his or her taste buds are operating - that he or she likes sweet stuff and doesn't care at all for bitter flavors. As early as the fifth day of life a baby will react to strong offensive odors by turning the head away and crying. A newborn's hearing is very acute, and he or she can even turn in the direction of a sound as early as ten minutes after birth.

If the baby's foot is uncovered and exposed to cool air and the rest of the body becomes cool as a result, the baby pulls in the legs to warm them; if cold enough, he or she cries and begins to shiver, which increases the blood circulation, helps raise the body temperature, and lets you know that he or she is in need of some help. If a blanket or other object covers the face and is causing difficulty in breathing, the baby twists the head from side to side in attempts to remove it.

Health | Reproduction | Pregnancy


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