Many years ago, I read an article by a first time mother and father. The mom described bonding to her baby immediately. The dad, on the other hand, did not feel the same attachment as his wife. He didn’t tell anyone about this for months because he was embarrassed about not immediately “falling in love” with his baby. He did everything he was supposed to in terms of supporting mom and baby, but he felt a bit like an outsider at the beginning of his son’s life.
Ever since I read that article, I have made a point of telling new fathers that it’s “normal” for moms to bond to babies before they do. My rationale for this is as follows:
- The baby was biologically connected to the mom for the entire pregnancy.
- Men typically grow up playing with action figures and balls instead of dolls.
- Adult men are less likely than women to interact with other people’s babies before they become parents themselves.
I find that most new fathers are relieved to hear this information. I often joke that this observation does not get them out of chores. I also reassure them that they will become deeply attached to their babies in time.
Having people visit during the first week at home is a mixed blessing. Doctors routinely encourage new mothers to breastfeed their baby 8 to 10 times a day. Immediately after giving this advice, they tell you to get lots of rest. If you do the math, you will quickly see that it’s impossible to feed babies that much and get much rest.
While it helps to have friends or relatives assist you in taking care of the baby, what begins as a 5-minute visit can easily stretch to an hour or more. As a result, loved ones can unintentionally prevent you from taking a catnap or just closing your eyes to rest.
I advise new parents to restrict or discourage visitors during their first week or two that a baby is at home. It’s terrific for people to bring food or do some shopping for you, but they shouldn’t stay for more than 30 minutes. In addition, it’s a good idea for fathers to tell friends and family about limited visiting hours so moms can concentrate on nursing.
I recommend that parents don’t worry about tummy time until babies are 4 weeks old. The reason for this is because it’s hard enough in the first month to feed, bathe and get babies to sleep without worrying about head contr
Once parents start tummy time, lots of questions come up. How long should it last? How many times a day should we do it? What should we do if our baby cries during tummy time?
No one has studied this scientifically, but I recommend doing tummy time 3 or 4 times a day for about 5 to 10 minutes per session. If your baby cries during tummy time, there are a few things that might help.
- Pull the baby’s elbows in towards the body. This stabilizes the shoulder area and may make it easier for the baby to lift her head.
- Lie on the floor with the baby so when she looks up, she sees your face.
- Put the baby on her dad’s chest while he’s leaning back at a 30 to 45 degree angle. This will make it easier for the baby to lift her head. This can also work on a mom’s chest unless the baby smells the breast and looks down instead of up.
- Babies may be more willing to do tummy time at certain points during the day. A good time to try it is shortly before a feeding when she’s alert, but not too hungry.
Some people recommend that parents ignore the whitish material that accumulates between the labia majora (outside vaginal lips) and labia minora (inside vaginal lips). I prefer that parents clean the area because otherwise poop can get mixed in with the discharge and irritate the baby’s skin.
However, cleaning this area often makes parents nervous. I recommend two things to make this easier. First, you don’t need to remove all of the goo at one time. Second, clean the area by gently wiping with a cotton washcloth in a downward direction. (I prefer washcloths to cotton balls because they have better traction.) Third, if you clean the area with each diaper change, less goo will accumulate and the whole process becomes simpler.
The medical name for a baby’s soft spot is called the anterior fontanel. This is an opening between the bones of the skull that allows the cranium to grow. The fontanel is covered with a very tough membrane so you will not hurt it when you wash your baby’s hair. Although doctors would never recommend poking the fontanel, you can scrub it gently with a hairbrush like the rest of your baby’s scalp.
After a baby is born, hospital nurses take armpit temperatures. They do this for two reasons. First, they want to be sure a baby’s temperature doesn’t drop as she adjusts to being outside the uterus. Second, because the nurses take temperatures multiple times per day, they do it in a way that is quicker and less disruptive for the baby.
Once you take your baby home, you should take rectal temperatures if you’re concerned that the baby is sick or has a fever. The reason for this is because rectal temperatures are the most accurate way to check for fever, and a doctor’s diagnostic approach to fever is based on rectal temperatures. Pediatricians define fever in the first three months as a rectal temperature of 100.4 degrees or higher.
It’s much easier to take rectal temperatures on newborns than older infants. There are different ways to do this, but I prefer having a baby lying across my legs with her bottom facing up. I separate her buttocks with one hand and gently insert a lubricated digital thermometer with the other. I insert the tip about ½ inch and hold the thermometer in place with two fingers of the same hand I used to separate the baby’s buttocks. That way I don’t have to worry that the device will poke the baby if she wiggles or moves.
In the past, babies rarely got funny shaped heads because they slept on their tummies. When we started putting babies to sleep on their backs 20 years ago, unusual head shapes started to be noticed. The pictures above show three types of head shapes: symmetrical, plagiocephaly (flat on one side) and brachycephaly (flat along the back).
A baby’s head will take on an unusual shape if he spends more time sleeping with his head in one direction. This occurs because more pressure is applied to one area and the head “molds” the corresponding location. In most cases, this represents a temporary finding that will resolve over time.
When pediatricians examine babies with unusual head shapes, we look for two problems. This first is a common condition called congenital muscular torticollis. If a baby has torticollis, the neck muscles that bend and rotate the head are tighter on one side causing the baby to spend more time turned in one direction when asleep. It many cases, it will also be noticed when the baby is awake. Over time, this will deform the shape of the skull. Torticollis is treated with physical therapy or watchful waiting depending on its severity.
The second is a rare condition called craniosynostosis. In this situation, one of the skull bones is not growing properly because it is “stuck” to the opposing bone, causing a misshapen head. If there is a question whether your baby has this condition, he will be x-rayed or referred to a pediatric specialist (neurosurgeon or plastic surgeon) for a thorough evaluation.
For the past 10 years or so, companies have sprung up to “fix” plagiocephaly and other asymmetric head shapes. A handful of studies have been published showing that this is not necessary. If your baby’s head is flat on the side or back because of positional forces, the problem will usually resolve by 2 to 3 years of age. The head may not look perfect, but a corrective helmet won’t make it look any better.