Newborns: What's Normal And What's Not?

is it normal for a newborn

The arrival of a newborn baby is an exciting time for new parents, but it can also be overwhelming as you get to know your baby and understand their different behaviours. Newborns are still adjusting to life in the outside world, and it is important to monitor them carefully for any signs of illness or infection, especially during the first week of life. Newborns have unique physical characteristics, such as a creamy, waxy white substance called vernix, fine hair called lanugo, and a variety of skin hues and colour patterns. They also have specific reflexes, such as the sucking reflex, grasp reflex, and Moro reflex, which help them interact with their new environment. During the first few weeks, newborns spend most of their time sleeping and eating, with feeding schedules depending on whether they are breastfed or formula-fed. Newborns communicate through crying, which can indicate hunger, tiredness, or the need for a diaper change, and it is important to respond to their cries promptly. In addition to crying, newborns use various cues to signal hunger, such as sucking motions and putting their hands or fingers in their mouths. They also have unique sleep patterns, with newborns sleeping up to 18 hours a day in short stretches of 2 to 4 hours at a time.

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Is it normal for a newborn to have skin issues?

A newborn's skin is much thinner and more fragile than an adult's, and it is prone to rashes and other skin issues. Most of these skin issues are harmless and will go away on their own, but some are birthmarks that may stay with the baby throughout their life.

  • Desquamation or skin peeling is common in babies in the first few days of life, especially if they are born after their due date. It can be treated with moisturiser, but it will also clear up on its own.
  • Cradle cap is a crusty, greasy scalp rash caused by a build-up of sebum that makes skin cells stick together. It can occur on its own or with a nappy/diaper rash on the neck or underarms. It usually clears up on its own within a few weeks or months, but mineral oil or petroleum jelly can be applied to loosen the crusts.
  • Milia are small white bumps on a baby's face that look like whiteheads but are actually small cysts filled with sebum and keratin. They are very common during the first few days of life and will go away without treatment.
  • Miliaria, or prickly heat/heat rash, is caused by blocked sweat ducts on the skin. It can look like tiny red bumps or blisters filled with fluid or pus, usually on the baby's chest, back, underarms or neck. It can be prevented by avoiding hot temperatures and overdressing the baby. It will disappear without treatment.
  • Neonatal cephalic pustulosis, or neonatal acne, is a common rash that occurs mostly on the face and scalp and looks like pimples. It is thought to be related to yeast that lives on the skin. It usually clears up on its own within several weeks or months, but a doctor can prescribe treatment cream if desired.
  • Erythema toxicum neonatorum is a rash of small red dots that sometimes have a central white dot. It occurs in the first three to five days after birth and usually appears on the chest, back, face and arms. It is a normal reaction and goes away within a day to a few weeks without treatment.
  • Transient pustular melanosis are tiny white raised bumps on a baby's neck, chest, back or buttocks that are more common in darker-skinned babies. The bumps last a few days before rupturing and leaving behind a ring of scale that fades on its own.
  • Salmon patches, or angel's kiss (between the eyes) or a stork bite (back of the neck), are simple nests of blood vessels that usually fade within a few weeks or months but can sometimes be permanent.
  • Jaundice is a yellow colouration of the skin and eyes caused by an excess of bilirubin, a breakdown product of red blood cells. It can sometimes pose a health hazard, and blue or white lights may be used to lower bilirubin levels.
  • Congenital melanocytosis, or Mongolian spots, are very common in dark-skinned babies but can occur in any baby. They are flat, grey-blue patches that can look like bruises and can appear anywhere on the body. They are harmless and usually fade by school-going age.
  • Eczema is red, itchy patches on the skin, often caused by dry, sensitive skin and sometimes allergies. Treatment includes using a gentle soap and detergent, skin moisturisers, and steroid cream if the eczema won't go away.
  • Fungal infections can show up as thrush on the tongue or an intense red rash in the diaper/nappy area. They are treated with antifungal oral gel or liquid medicine for oral thrush, or antifungal cream for the nappy area, or both.

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Is it normal for a newborn to sleep a lot?

Newborns generally sleep between 12 and 19 hours a day, so it is normal for them to sleep a lot. They have tiny stomachs, so they get full quickly and need to be fed every couple of hours. They also don't know the difference between day and night and don't produce melatonin, the hormone that promotes sleep.

According to the National Sleep Foundation, newborns should get 14-17 hours of sleep over a 24-hour period. Some newborns may sleep up to 18-19 hours a day, and this is still considered normal. Preemies can sleep up to 22 hours a day.

Newborns should be fed every 2-4 hours. Breastfed babies should feed about every 2-3 hours, while bottle-fed babies tend to feed every 3-4 hours. In the first 2-3 weeks, keep a close eye on the clock and wake your baby when it's time to feed. Once your baby has established a weight gain pattern, your paediatrician will likely give you the go-ahead to wait for overnight feedings until your baby wakes up.

If your newborn is sleeping so much that they aren't waking up to feed every 2-4 hours, talk to your paediatrician. If your newborn is regularly sleeping for more than 17 hours a day and it's interfering with their ability to eat at least eight times per day, you should consult a doctor.

If your older baby is sleeping too much, you may need to wake them to ensure they're staying hydrated and getting enough calories. Capping their daytime sleep to no more than four hours will help them settle at bedtime and prevent them from waking up too early in the morning.

It's normal for your baby to need more sleep when they're sick. However, wake them up if they nap for longer than 3-4 hours, as longer stretches could interrupt their nighttime sleep.

  • Take your baby out for walks during the day so they are exposed to natural light.
  • Develop a calming evening routine that includes a bath, massage, and nursing.
  • Remove some layers of clothing so they will be less warm and wake up when it's time to feed.
  • Expose them to light and play with them gently during the day, and provide a dim and quiet environment at night.
  • Keep a log of their sleep schedule for 1-2 days.

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Is it normal for a newborn to cry a lot?

All newborns cry and get fussy sometimes, and it's normal for a baby to cry for 2-3 hours a day for the first 6 weeks. Crying peaks at about 6-8 weeks and during the first 3 months of life, they cry more than at any other time. Crying is a baby's way of communicating their needs and feelings. They cry when they're hungry, tired, uncomfortable, sick or in pain. Sometimes they cry because they need a change of scenery or comfort, or because they need to know you're there.

Some babies cry a lot more than others, and there could be several reasons for this. If your baby is crying constantly and you cannot console or distract them, or the cry does not sound like their normal cry, it can be a sign that they're ill. Contact your health visitor, GP, or call NHS 111 if you are concerned.

Colic is the main cause of recurrent crying during the early months. All babies have some normal fussy crying every day, but when this occurs over 3 hours per day, it's called colic. Colic happens to a lot of newborns, and while it's hard to see your baby cry so much, it isn't caused by anything a parent did or didn't do. The good news is that babies outgrow colic.

If you feel like your baby cries a lot, for a long time, and you find it hard to soothe them, you're not alone. In fact, between two and five out of ten babies cry for long stretches, without an obvious reason, during the first three to four months. Long stretches of crying can start when your baby is around two weeks old and continue until they reach three to four months. Inconsolable crying that can last up to five hours a day is a perfectly normal stage of development called the period of PURPLE crying. PURPLE stands for Peak of crying, Unexpected, Resists soothing, Pain-like face, Long lasting, and Evening.

  • Make sure your baby doesn't have a fever. In a baby, a fever is a temperature of 100.4°F (38°C). Call the doctor right away if your baby has a fever.
  • Make sure your baby isn't hungry and has a clean diaper.
  • Rock or walk with the baby.
  • Sing or talk to your baby.
  • Offer the baby a pacifier.
  • Take the baby for a ride in a stroller or car. The vibration and movement of the car can be calming.
  • Hold your baby close against your body and take calm, slow breaths.
  • Give the baby a warm bath.
  • Pat or rub the baby's back.
  • Place your baby across your lap on their belly and rub their back.
  • Put your baby in a swing or vibrating seat. The motion may be soothing.
  • Play music—some babies respond to sound as well as movement.
  • Try swaddling your baby. This can help calm crying babies and prevent them from waking up with a startle reflex.
  • Limit how long your baby sleeps in a car seat to up to 30 minutes for newborns and up to 2 hours for older babies.
  • Try some gentle noise in the background to help distract your baby.
  • If you're breastfeeding, let your baby suckle at your breast.
  • If you're breastfeeding, limit your caffeine intake as it can cause increased crying and trouble falling asleep.

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Is it normal for a newborn to have a lot of diaper changes?

It is normal for newborns to require a lot of diaper changes. In fact, it is recommended that newborn babies have their diapers changed every two to three hours, or after every feeding. This is because newborn babies tend to feed more frequently, and their bladders are small and don't hold much urine, so they need to be changed often.

In the first 48 hours, a newborn will usually only need to be changed every four to six hours. After this, it is recommended to change their diaper every two to three hours. Newborns tend to defecate about 5-12 times a day, and the stool is usually liquidy, so they need to be changed quite often. This number decreases incrementally as the baby gets older, with babies over one month old defecating about 6-8 times a day, and babies over 12 months old beginning to resemble adult excretion patterns.

It is important to change a baby's diaper regularly to prevent diaper dermatitis and ensure the baby feels comfortable. It is also important to keep the diaper area clean and dry to avoid diaper rash. Some sources recommend changing a baby's diaper around six to ten times a day, or about 8-12 diapers per day in the first few weeks.

It is worth noting that the type of diaper used can also affect the frequency of changes. Cloth diapers, for example, are not as absorbent as disposable diapers and therefore need to be changed more often (about every 90 minutes).

Additionally, some babies with sensitive skin may not tolerate even slightly damp diapers and will need more frequent changes to prevent skin irritation.

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Is it normal for a newborn to have trouble feeding?

Yes, it is normal for newborns to have trouble feeding, and it is quite common. Feeding problems can manifest in newborns refusing food, eating small amounts, or having problems digesting food. Newborns who are still on breast milk or formula may spit up too much, or refuse the nipple or bottle.

Feeding problems can occur for a number of reasons, including illness and vomiting in the first months of life. In some cases, newborns may have an underlying physical problem, such as a cleft palate or tongue tie, which makes it difficult for them to suck, chew, or swallow.

It is important to monitor your newborn's feeding habits and weight gain, as poor feeding can lead to malnutrition and stunted growth. If your newborn is very uncomfortable while eating, or their spit-up is green or bloody, seek medical attention.

To improve feeding habits, it is recommended to introduce a relaxed feeding environment with regular meals, conversation, exploration of foods, and small portions.

Frequently asked questions

Yes, newborns can sleep up to 18 hours per day, typically in 2-4 hour periods.

Yes, newborns commonly experience pimples, dry skin, mild rashes, and lumps under their nipples.

Yes, babies cry to communicate hunger, soiled diapers, overstimulation, pain, frustration, and loneliness.

Yes, regurgitating after feedings is common in newborns.

Yes, a slight yellowish colour to the skin, known as jaundice, is common in infants due to a buildup of bilirubin in the body.

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