Watching your baby grow

After keeping track of your baby's growth and development during pregnancy, you can now watch the wonderful changes in your newborn. In the first month of life, babies usually catch up and surpass their birthweight, then steadily continue to gain weight. A weight loss up to about 10 percent of birthweight is normal in the first two to three days after birth. However, your baby should have regained his or her birthweight by about day 10 or 11. While all babies may grow at a different rate, the following indicates the average for boys and girls up to one month of age:

• Weight: after the first two weeks, should gain about 1 ounce each day
• Average length at birth:
  • 20 inches for boys
  • 19 3/4 inches for girls
• Average length at one month:
  • 21 1/2 inches for boys
  • 21 inches for girls
• Head size: increases to about 1 inch more than birth measurement by the end of the first month

Newborn reflexes

Although a newborn spends about 16 hours a day sleeping, the time a baby is awake can be busy. Much of a newborn's movements and activity are reflexes or involuntary--a baby does not purposefully make these movements. As the nervous system begins to mature, these reflexes give way to purposeful behaviors.

• Root reflex. This reflex occurs when the corner of the baby's mouth is stroked or touched. The baby will turn his or her head and opens his or her mouth to follow and "root" in the direction of the stroking. The root reflex helps the baby find the breast or bottle.
• Suck reflex. When the roof of the baby's mouth is touched with the breast or bottle nipple, the baby will begin to suck. This reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because they are born prior to the development of this reflex. Babies also have a hand-to-mouth reflex that accompanies rooting and sucking and may suck on their fingers or hands.
• Moro reflex. The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, throws out his or her arms and legs, cries, then pulls his or her arms and legs back in. Sometimes, a baby's own cries can startle him or her, initiating this reflex. The Moro reflex lasts until the baby is about 5 to 6 months old.
• Tonic neck reflex. When a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the "fencing" position. The tonic neck reflex is present until the baby is about 6 to 7 months old.
• Grasp reflex. With the grasp reflex, stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts only a couple of months and is stronger in premature babies.
• Babinski reflex. With the Babinski reflex, when the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex until the child is about 2 years old.
• Step reflex. This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface.

Understanding your baby

At this early age, crying is a baby's only form of communication. At first, all of a baby's cries sound similar. But you will soon recognize the cries that your newborn will communicate to you. Cries may result from hunger, discomfort, frustration, fatigue, and even loneliness. Sometimes, a baby's cries can easily be answered with a feeding or a diaper change. Other times, the cause of crying can be a mystery and crying stops as quickly as it begins. Regardless of the cause, responding to your baby's cries with a comforting touch and words is essential in helping your baby learn to trust you and rely on you for love and security. You may also use cuddling and rocking movements to comfort your baby.

You may find that your baby responds in many ways, including the following:

• Startles at loud noises
• Looks at faces and pictures with contrasting black and white images
• Gives attention to voices, and may turn to a sound
• Hints of a smile, especially during sleep

Young babies need the security of a parent's arms, and they understand the reassurance and comfort of your voice, tone, and emotions.

Consider the following as ways to foster the emotional security of your newborn:

• Hold your baby face to face.
• Talk in a soothing tone and let your baby hear your affectionate and friendly voice.
• Sing to your baby.
• Walk with your baby in a sling, carrier, or a stroller.
• Swaddle your baby in a soft blanket to help him or her feel secure and prevent startling by the baby's own movements.
• Rock your baby in a rhythmic, gentle motion.
• Respond quickly to your baby's cries.

When a baby has difficulty after birth

Babies who may have difficulty at birth include those born prematurely, those born with a difficult birth, or those born with a birth defect(s). Fortunately, for these babies, special care is available. Newborn babies who need intensive medical attention are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU). The NICU combines advanced technology and trained health professionals to provide specialized care for the tiniest patients. NICUs may also have intermediate or continuing care areas for babies who are not as sick, but need specialized nursing care.

Having a sick baby can be distressing. Few parents expect complications of pregnancy, nor do they expect their baby to be sick or premature. It is quite natural for parents to have many different emotions as they try to cope with the difficulties of a sick baby. However, it is reassuring to know that today's advanced technology is helping sick babies get better, and go home sooner than ever before. And, it helps knowing that although separation from a baby is unsettling, it does not harm the relationship between mother and baby.