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Knowing when an infant is ill can be a challenge for new parents. Sometimes a parent's concerns can be treated as a casual inquiry by medical workers who are accustomed to soothing new-mother nervousness. Rather than trust her own instincts, a mother can begin to doubt herself.

It will come as a relief to know that there IS a way to objectively measure a baby's health.

From the start, newborns will need to nurse for no less than 15 minutes, 8 times per day during the first week of life. A mama can hear her baby swallow milk during feeding. Baby's first bowel movement will be a black paste called muconium. The texture and color will change from a blackish green to a brownie batter consistency. The color will appear yellow by the 4th or 5th day. Within 48 hours after birth, the baby will have wet diapers. The number of wet diapers will increase to two or three each day be the end of the week.

An ill baby will show definite physical signs of his condition. Nursing for less than fifteen minutes fewer than 8 times per day, showing no desire to eat and having a sucking reflex that is week are all signs for a parent to be concerned. Signs that something is wrong can include a clicking sound when the baby nurses, cheeks that pucker inward and dimple when the baby sucks, or the inability to stay awake for a full 15 minute feeding. It is outside of a healthy range if the baby's stools haven't changed and there is no urination two days after the birth. Such symptoms persisting for two days mean your child should be seen by a health care provider.

Signs of a healthy baby will be similar for the first month. Each day a healthy baby will nurse for eight sessions and produce 2-4 yellow bowel movements. Track your baby's wet diapers. You should see between six and eight of them each day with clear urine, not yellow. Along with observing some milk and hearing your baby swallow during nursing, you should see a strengthening of the suck reflex. Your baby will grow both in weight and alertness.

Continue to monitor anything out of the ordinary in weeks 2 to 4 -- infrequent or bright yellow urination, stools that are small or too seldom, fewer than 8 feedings per day. Your baby should gain weight and grow longer. A baby that has a weak suck, doesn't make swallowing noises during nursing, becomes sluggish and lacks quick responses and doesn't sleep between feedings, is a reason for concern. If you observe these behaviors for more than two days in a row, contact a health provider for assistance.

A baby may change from 8 to 7 feedings per day during this time. This is due to your growing baby's ability to hold more food. Bowel movements will continue to change and will settle into a pattern of either several small stools in a day or a large bowel movement every 2 days. This isn't unusual in breastfed babies as they assimilate much of the milk. Check the wet diapers to make sure the urine isn't bright yellow; there should be six to eight wet diapers daily. You should notice that your baby is increasing in his awareness, has a stronger suck, audible swallowing and a little milk dripping at feeding time.

There may be reason for concern if a baby fails to produce the right amount of wet diapers without bright yellow color, or if the baby doesn't nurse at least seven times daily. Length and weight should increase for baby. Babies that can't be heard swallowing and have a weak suck are not likely to be getting enough nourishment. Seek medical assistance if your baby becomes lethargic, slow to respond or unable to sleep between nursing sessions. A couple of days in a row of these indicators mean that something is not well with your baby.

A well-rested person would be hard-pressed to know when and how often an infant ate. It can be overwhelming to expect a new mother to know this with reduced sleep. Have note paper and a pencil near the baby's bed. Write down the time of each feeding and changing along with your notes. One example of an entry might be: "10:00 a.m. -- BIG BM, brownish green, nursed 30 minutes." Start with a clean sheet each day. Write the date at the top of the page.

Your detailed list will be of great value to you and your doctor should your little one become ill. Your notes can also help you bond more effectively with your little one. By looking over her list, even a weary mama can tell at a glance if the crying is due to hunger (too long between feedings) or constipation (hasn't moved his bowels). This tool helps a mama learn to identify the different cries of her newborn. This list will then encourage a mother to trust her instincts as she learns to identify her baby's different cries and meet those needs.

Yet, BEST advice is often the most common advice, and it comes from the not-so-new mothers. Don't take for granted any of those first weeks. Other things can wait while you take the time to get to know your baby. They aren't little for long.


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