NEWBORN CARE: Pediatrician Guide to Week 2

Hello, hello. This week, we are continuing our newborn series and talking all about your two-week-old as we have a two-week-old at home. Yeah, so if we look a little tired this week, it's because we are. But this week is all about age-specific things. You need to know about feeding, sleeping patterns, developmental milestones, and some big things to watch out for at this age as well. If this is your first time meeting us, I'm Sarah. I'm a board-certified OBGYN. I'm Kurt. I'm a board-certified pediatrician and now dad of three littles. And we are the Doctors Bjorkman. Welcome back. So this week, we are continuing our much-anticipated newborn series because there's just so much to know about these tiny little humans and it all changes so fast. Yes. Each week, we're covering the very things we were wondering about when we were parents for the first time. But now, sharing our insights both as medical professionals but also as parents of three with our own two-week-old at home this week. We're going to start this week by talking about the things you're likely working on most, feeding and sleep. By two weeks, babies are still eating a lot, usually 8 to 12 times a day, breastfeeding, and if they're bottle feeding, it's probably about 2 to 3 ounces per feed. Cluster feeding, also really common and normal. Some babies kind of go through a growth spurt around this time and may want to eat more frequently for a day or two. However, you might be starting to get into a routine or some feelings of when baby wants to eat. Yeah, you've survived that like crazy two weeks and it's just starting to maybe transition. So I like to keep, in the early days especially, keep track of when baby breastfeeds on an app. There's many different ones out there. I have used Huckleberry for all three just because it's very user-friendly and easy. I like to be able to see stuff. So at this two-week mark, I'm sort of starting to see some patterns of where baby maybe is liking to eat and then use that to kind of guide some flexible routines moving forward. It's not a rigid schedule, like nothing's set in stone. You're really just starting to understand where's your baby at now because you're going to make plans for where do you want to be 4 to 6 weeks from now down the road. When it comes to feeding, the question that always comes up is how do you know your baby's getting enough to eat? And really there's two good ways to think about this. The first is just that they're staying hydrated. Are they having lots of wet diapers? Around this two-week mark, they should be having probably around six to eight wet diapers a day, generally around three to four poops a day if they're breastfed. Formula-fed babies maybe poop a little less often. Sometimes it's just once a day or even less frequently than that. Get asked about pooping frequency often. As long as they are pooping without significant straining or pain, longer times, even sometimes days between poops can be totally normal. Yes. And kind of the other way to tell if they're eating enough and truthfully a very important part is are they gaining weight? By two weeks of age, your baby should be about back to their birth weight and continuing to gain. Yeah. And as a physician provider, this is one of my favorite parts of these early visits is really just to open up the growth chart and hopefully sharing just how well baby's growing following their weight gain and growth curves. Yes. At that standard two-week visit, this is also an important time for your pediatrician to intervene if there is an appropriate weight gain. Exactly. If baby isn't gaining weight appropriately, now's the time to figure out why. Is it a feeding frequency or volume with feeds issue or is there some other medical reason that needs to be looked at? And I know I've said this before, but if you are breastfeeding and having trouble get help, it's not too late. And many, many pediatrician offices have lactation services available or can get you in touch with a great breastfeeding consultant. Absolutely. Now let's talk about sleep. At this two-week mark, newborns are still sleeping a ton, but maybe not quite as much as they were in those first two weeks. I think more like 14 to 18 hours a day, but again, not in long stretches, usually just two to three hours at a time. And remember, what your grandma says, never wake a sleeping baby. This only applies at nighttime. During the day, you want to be sure you are waking up that baby after they've been napping for around that two-hour mark, if they've been giving you longer stretches. So the reason for that is one, you are learning, you're trying to help them learn day and night, so getting them up, exposed to some daytime light. And also, you are working to fill that little tank of milk to be eating, fill that tank up during the day, as opposed to needing to finish filling up that tank at nighttime. It's really important to be thinking about this as well, because in the coming weeks and months, you are going to be wanting to get yourselves on a little bit more of a humane sleep schedule. And so everything you're doing in these first couple weeks is good practice and setting good foundations for good sleep habits in the future. If your baby still has day-night confusion at this time, some tricks in working through that is really just exposing them to natural light during the day. If they are up all night, snoozing during the day, making sure in the morning you're waking them up, they see bright light at night, keep those feeds calm and quiet as much as possible. So night is boring, daytime is exciting. Daylight, fresh air really helps them adjust to learn that, what's going on. We also need to remind people about safe sleep. For infants, that means baby is laying on their back on a flat surface without blankets, stuffies, anything else around them. When it comes to development at this two-week mark, it may seem like they're not doing much, but it's actually really important developmental time, and they're working on some key skills. They can recognize your voice. They can track objects, actually, like some high-contrast black-white things. They're not in a huge distance still. Their vision is really just kind of in this one-to-two-foot mark, but they can even start lifting their heads during tummy time briefly. Yes, so tummy time is important. A little tummy time, just one to two minutes a few times a day, really helps them build their neck and back strength. So think about using just a few minutes between feeding and going back to sleep to have your baby spend a little time on their belly on a mat. Often, they're not a fan, and so some ways around that are to have baby be on your chest, or you can put them on your knees, or even baby-wearing counts as some tummy time because they're using their neck and back muscles. At this two-week mark, we also wanted to cover some of those, is this normal, questions that come up all the time. Yes, okay, so rapid fire. First up, peeling skin. Yeah, it's really normal to have some peeling, flaking skin. This is just kind of newborn skin shedding. How about all their little sneezing? Yeah, so super common for babies to make all sorts of little extra noises, sneezing, lots of yawning. They've got little tiny nasal passages, and they're using these sneezing and little grunting intermittent noises to clear them. If your baby seems really congested, you can use a couple of saline drops and a bulb syringe to help out. How about baby acne? Yeah, so this is all those little red dots you can see. Sometimes there's a ton of them, sometimes just a few. Again, totally normal. You don't need to put anything on it. Just wash with warm water, and it clears up in the first couple of weeks. Some breast milk, if you want, also maybe helps, maybe doesn't, but can't hurt. Here's another one that I asked Kurt, which I knew this, but I still was like, Kurt, he has these little lumps under his nipples, like these little breast buds almost. I was like, is this normal? Are we worried about this? Yeah, so this is also very normal. Babies are exposed to mom's hormones, either from the peripartum birth time or even in breast milk. It can be very normal for them, even boys, to have little breast buds. Again, the best thing here is just leave them alone. Yes, and the same thing, same phenomenon can kind of happen for little girls, and also that with that hormone shift, they may have a tiny little bit of vaginal bleeding from that hormone shift from mom. So if you see a little blood in the diaper, that also can be totally normal. Yeah. So those are the non-concerning things. Is there anything that new moms and dads should be watching out for? Yeah, so there are some things you should definitely call your pediatrician about. My brief quick list for this would be a fever, so temperature above 100.4 degrees Fahrenheit, 38 degrees Celsius. If your baby's having trouble feeding with extreme sleepiness, so they've missed two or more feeds back-to-back, call your pediatrician. If they seem like they might be dehydrated, so they've had fewer than that kind of five or six wet diapers a day in 24 hours, call your pediatrician. Another thing, signs of infection, swollen or red around their belly button after that umbilical cord has fallen off or just before it falls off. And then finally, any breathing issues. If they've got persistent grunting or flaring of their little nostrils, call your pediatrician. So these first few weeks can be exhausting. Everyone kind of feels a little bit like, I have no idea what we're doing. I can't believe they let me come home with a baby, but now you're in it. You've had this little bean for two weeks. So you're doing amazing. Even if it doesn't always feel like it, lean on the support around you. If you need it, talk to your OB, call your pediatrician. If you feel like you're needing extra help or struggling, but hang in there. And hopefully you found this video helpful. If so, give it a like, make sure you're subscribed. We've got lots of newborn videos coming in the upcoming weeks. Indeed, and if you have any tips, tricks, or are in the trenches at two weeks, feel free to leave a comment or questions below. We get to them as we can, and it definitely helps us shape what kind of content you want to see and what we should put up next. Yeah, so we'll see you guys next week. Enjoy those newborn snuggles. We're doctors. But not your doctors. Anything we've said in this video is for education or entertainment purposes only. It is not medical advice. Any specific medical questions you have should be directed to your provider. You've got to make him look a little cuter. He looks uncute. Oh, but there go the boobs. They heard, they heard the baby. There go the boobs. Yeah. Isn't that nice? There go the boobs. Thanks, dear. We're ready. Oh, thank you. My baby. I love you.