You’ve gotten through the first couple of weeks with your new baby and you think you’ve figured things out and then WHAM! Something changes. We often forget this, but our children are constantly growing, maturing, changing (and so are we), so this is only the first change we’ll face as new parents. And they happen weekly, if not daily! Unfortunately, if we aren’t used to babies and are getting used to parenting on our own, with only our partner…. (and many fewer people to turn to for guidance, especially as expatriates), well, the numerous changes that occur in the initial weeks are often tricky to comprehend. And, we’re recovering from pregnancy and childbirth too. So, to help the new parent, let’s talk about some of the changes that occur in the baby in the first two months.
There are several growth / developmental spurts that occur one after the other starting around 2-3 weeks and lasting until about 4 months (with another at about 6 months). Lots of things are going on during these spurts, not just growth in length and weight, but also in abilities and understanding, i.e. the brain and muscles are developing too (see publications like The Baby Book or Your Amazing Newborn to learn more). In other words, newborn babies are growing, learning and developing at a fast pace. When these spurts occur, babies need additional nourishment (water, food, immune support, suckling, affection), so want to be at the breast more often. And as a result a mother’s milk supply fluctuates up and down.
So long as you let baby stay at the breast as he/she seems to want and there are no issues with latch or tongue or lip ties, nor any physiologic issues in your ability to make milk (e.g. hormonal imbalance, thyroid issue, hypoplasia) your supply will keep up! This said, in addition to often feeling like you don’t have enough milk (because you are unused to newborn behaviour and/or you hear comments around you like “feeding AGAIN?” or “you are going to spoil her if you keep picking her up”), you might feel like you have too much! The latter is because milk supply fluctuation can often result in fast let-down (with babies sometimes pulling off or spitting up more, which is not fun for the mother, but it means they are naturally managing this stage of breastfeeding).
Sometimes the fluctuations also result in a higher amount of lactose in the milk (as the mother’s body has adjusted to make more milk, but with more milk there is also more lactose). Lactose is simply milk sugar so it’s always there, but when there is a lot of it, babies sometimes get unsettled tummies, can seem fussy, and as lactose is digested differently their stools can turn green and frothy/mucousy (or like algae).
The green stools can worry many a new parent, but in general, if green or changed texture stools are the only thing going on and the baby seems otherwise content (even if fussy), has enough wet and poopy diapers, has periods of alertness, etc., then a parent can just think of this as a normal stage of infant development. If, on the other hand the fussiness is making the days harder or making the baby not only fussy but apparently uncomfortable (or the mother is getting a lot less sleep as a result), then a mother can “manage” breastfeeding by doing things like:
- Feeding against gravity (so leaning back more, using laid-back positions)
- Letting the first flow (let-down) of milk go into a towel/diaper (or bottle to freeze for another purpose) and then re-latching baby to breast afterwards (or hand-expressing off a bit and then latching baby)
- Feeding with shorter intervals between feeds
- Increasing time at the breast (& using breast compression to stimulate additional let-downs) and using only one breast at a time
Often mothers will do these things automatically and won’t realise it until later. But these are NOT things that must be tried or that all new mothers try. They’re just things to think about “in case” of need. And they are short term fixes, think days & weeks. Anything longer than that and you can end up with the opposite problem: slow flow & lower supply!
Parents must also remember that stools can also be green (and also smelly) from allergies (to cow’s milk protein, gluten, etc.) and in these cases in addition to the stronger smell, there can be traces of blood. Whenever there is blood in a baby’s stools, a quick call to the baby’s paediatrician or other health care provider can provide guidance, but in general blood simply means that there is a broken blood vessel in the bum or that mother has a few cracks on her nipples (check baby’s tongue and latch and think about silverettes for healing) and baby has swallowed some blood himself. If the latter two are ruled out and it’s not a normal fluctuation of milk supply, then mothers look into eliminating common culprits from their diets (milk, gluten, eggs). Unfortunately it takes around 3 weeks for things like cow’s milk protein (casein) to totally leave the system, but a marked improvement should already be felt about a week after elimination. Allergies often show up around the same time as the first growth spurt, i.e. ~4 weeks. Other mothers ADD things to their diets, such as probiotics, to ensure their own physical well-being.
Now let’s go back to the changes in baby: her eyesight is improving, she’s starting to recognise patterns and people, her muscles are developing, including stronger head control, stronger abdomen, etc. (see The Baby Book for more ideas). This means that from around 2-3 weeks of age, baby is transitioning out of the “newborn” phase. Every day, every week, parents will notice things that baby wasn’t able to do before. And all these changes mean that every day a baby’s active alert time, sleep time, and overnight time will also change. There’s just too much going on developmentally in baby’s brain for patterns to last more than a few days/weeks. In fact, it’s VERY common for babies to wake 4-5 times overnight in these 6-7 weeks (not every day, but 2-4 nights in a row repeatedly is common and physiologically expected). This is because not only do they need to be at the breast more, which satisfies:
- Development & Immune-Defense
- Need to suckle
- Need for affection
But also she may wake more because she wants to communicate with her parents about her day, relay information, etc. A baby’s evening might be between 11-14 hours long, but overnight wakings are expected to continue during this time and for the first few YEARS of a baby’s life. With 1-3 wakings a common pattern (more during spurts), usually with a long overnight period of sleep of 5-6 hours (either at the beginning of the night or later, if at the beginning, you’ll want to go to bed early!). A baby’s sleep is quite easy to understand, once you know why it is the way it is. To learn more about baby’s sleep, read Nighttime Parenting or visit the Ask Dr. Sears web pages about sleep.