Week 1

Feeding and Digestive Issues: Reflux

Since your newborn’s digestive system is still maturing, a small amount of spit-up or even vomit after a feeding is normal and eventually outgrown. A more serious condition, however, is Gastroesophageal Reflux Disease (GERD). Similar to what we adults would call heartburn, GERD is when the acidic stomach contents return up the esophagus and cause painful irritation, abdominal discomfort, spit-up and sometimes vomiting. The reason it’s so common in babies under a year (especially preemies) is because sometimes the barrier-like muscles at the bottom of the esophagus are too underdeveloped to keep food from backing up during the digestion process. GERD usually develops around now (two weeks) and can last the rest of the first year or even longer, but the symptoms will be the worst during the first few months.

What to look for:

  • Inconsolable crying that sounds like he or she is in pain
  • Unusually large amounts of spit-up and drool
  • Projectile vomiting
  • Little weight gain
  • Trouble sleeping
  • Choking or gagging while eating
  • Signs of abdominal pain, like back arching or curling up
  • Constant burping or hiccupping
  • Chronic coughing, often causing a sore throat and/or respiratory problems
  • Frequent ear infections

If the vomiting is exceptionally violent and projectile, this could be pyloric stenosis, a serious condition where the pylorus muscle, located in the lower part of the stomach, thickens and blocks food from entering the small intestine. This needs to be addressed immediately, as babies suffering from pyloric stenosis aren’t getting any nutrients and will need surgery.

While there isn’t much treatment for GERD (the doctor might prescribe a medication to reduce or neutralize stomach acid in more severe cases), fortunately almost all babies outgrow it – it’s just a matter of making him or her as comfortable as possible until then. There are some measures you can take to reduce the pain:

  • First of all, if you’re breastfeeding, try and continue doing so for as long as possible. We know this isn’t always an option, but breast milk -a natural antacid – is more quickly digested than formula, making it less painful.
  • Feed your baby more frequently but in smaller portions. (If the problem continues until the solid-food stage, avoid large amounts of acidic or fatty foods.)
  • Burp your baby more often than normal
  • Sucking can sometimes reduce reflux, so try giving a pacifier after a feeding.
  • Make sure your baby stays upright for at least an hour after a feeding. Since babies tend to drift off while noshing, there are wedge-like pillows babies can be strapped into for reflux purposes.
  • Ask your doctor about adding rice cereal to the baby’s formula.

When to call the doctor:

Although most cases of GERD can be successfully managed at home, call the doctor if symptoms persist after trying the aforementioned suggestions – especially if the baby isn’t gaining weight or sleeping. In rare cases GERD can cause choking, pneumonia or even apnea.

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12 thoughts on “Caring for Your Newborn: A complete guide to the first week with your new baby

  1. says:

    If you plan on breast feeding, having formula in the house is an invitation to failure. Pleas consider NOT having “back up” formula. Instead have good breast feeding books (like The Womanly Art of Breastfeeding) & the number of a good lactation consultant.

  2. says:

    I agree entirely on not keeping formula in your house. Breastfeeding can take awhile to get a hang of, and that’s okay for the baby. That first week is such a vulnerable time, it’s easy to give in. If you need formula, your doctor will tell you at your one week appointment, or you can see a lactation consultant, and pick it up on the way home. It’s not that hard to stop by a drug store or get someone to stop for you if it’s needed.

  3. says:

    If you’ve decided to cloth diaper, I’d still use disposables for the first month or so. For one thing, it’s not particularly cost effective over disposables to buy that tiny size in addition to the bigger sizes or one size diapers. Also, figuring out a laundry routine for cloth diapers can take some experimentation and troubleshooting, which I think is better left for a little later on.

  4. says:

    This is a really well thought-out and written piece. Week one is so overwhelming, I’m glad it’s acknowledged and supported.

  5. says:

    I completely agree with the cloth diaper comment – and I’m glad this article pointed that out as well. While I’m a big fan of cloth diapers LATER, trying to use them in the beginning is a set-up for failure and a HUGE waste of what should have been an investment. I’d try them in a few months.

  6. says:

    Give yourself complete permission to do nothing that isn’t crucial to your infant’s (and your) survival in those early weeks. This probably means feeding the baby and yourself, changing the baby, and getting as much rest as possible. I am one of those people who can’t easily fall asleep, no matter how exhausted I am, so napping while my newborn took 30-minute “naps” just was not possible (and the people who cheerfully told me “just sleep when the baby sleeps!” became very irritating). Between that and breastfeeding every 90-120 minutes, exhaustion got me quickly and probably set me up for a few very rough months. So rest if you can, even if you can’t sleep, and ignore the guilt that might come along with seeing the laundry stack up.

  7. says:

    I breastfed my infant for over a year, but those early weeks were tougher than I ever expected. As much as I agree with not “caving in” by giving the baby formula early on, recognize that for some people, this *may* be a much-needed bridge to full-blown breastfeeding. In my case my milk didn’t come in for 6 full days and my lactation consultant from La Leche League didn’t get back to me for almost 36 hours, which is a lifetime when your baby is hungry and crying constantly and no one is sleeping. At day 5 we decided to use some formula and this covered us until my milk arrived. I beat myself up over this repeatedly (as did so-called “friends” who viewed using formula as practically the equivalent of giving the baby red Kool-Aid). Formula isn’t poison; try not to add guilt to everything else you’re probably feeling in those weeks.

  8. says:

    Excellent article Babble – bravo! I am mixed with the formula in the house debate. I only have one can and one bottle that someone gave me – low and behold a month later and I’m being rushed to the ER with a serious intra-uterine infection. My neighbors took our daughter and gave her her first bottle. They kept asking him how much she took and we were like “we have no idea!” we went right back to BFing when I got home from the hospital. but if we hadn’t had that one little can and lone bottle we would have really been up a creek and inconvienced our neighbors.

    I totally agree with the comment of don’t do anything that you don’t HAVE to. I am about as earthy as the come….but the first two weeks solid..we used paper plates and cups. It’s just a “pass” I gave myself. I threw all the laundry into the machine together and went to bed at 7 when the baby went “down for the night”

    DON”T FEEL GUILTY and DON”T LET ANYONE ELSE MAKE YOU FEEL GUILTY for doing whatever you need (within reason obviously!!!) to get by! This is even more true with subsequent babies

  9. says:

    I was so relieved at how easy it was to switch back and forth between breastfeeding and formula. I had been told that my baby, given a bottle, would never go back to the breast and that was absolutely not the case. It saved my health and sanity for my husband to be able to feed the baby overnight — and gave him (and my parental visitors) a chance to bond with her as well. If you must use breastmilk only, you can always pump, but I highly recommend getting used to not being the sole feeder early on. You will be grateful for the rest and your partner will be grateful to share such an important role.

  10. says:

    I agree with most of the advice in this article, however breastfeeding mothers should NOT keep formula in the house “just in case”. Breastfeeding can be hard in the beginning and having an easy out right under your nose is counter-productive. If the baby isn’t gaining well and you need to supplement, it can be easy enough to pick some up on the way home from the pediatrician’s office, as someone already pointed out. Also, pumping a little milk from engorged breasts will not make your body produce even more milk. It’s *emptying* the breast that signals the brain to produce more milk. Pumping or hand expressing a little to soften the breasts and allow the baby to latch easier, relieve the mother’s discomfort and prevent a plugged duct is absolutely fine.

  11. Jane says:

    I disagree with many of these comments. You should absolutely have a good formula on hand (organic!) even if you plan on exclusively breastfeeding. I had to go to the ER for postpartum hemmorhage when my son was just 10 days old, and I was there for 18 hours (had to have a D&C). I didn’t have time to pump before I went (obviously) and if I hadn’t had formula on hand at home, it would have been a lot more difficult for my sister to deal with at 3am in the middle of the night. And I’d rather have the best formula on hand than have someone run out and buy the crappy stuff, not to mention having a screaming hungry newborn who has to wait for them to go to the store and back and then make a bottle. Anyway, I believe in having formula on hand for other emergency situations (storms, earthquakes, etc). Be prepared! If you really want to breastfeed, you can do it and a bottle of formula in your pantry won’t deter you.

  12. Hi,

    Thanks for your valuable tips about Parenting. I am also a mother of 2 year old daughter and I know how naughty she is. Your tips is really helpful to calm in irritating situations as well

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