Normal newborn behaviour and when to seek medical attention

Knowing what’s normal and what’s not with a newborn can be a tricky thing. Mater Mothers’ Hospitals have a few helpful tips to use as a guide when bringing your baby home for the first time.

There is a wide range of normal behaviour for babies in the first few months of life.

• They are born knowing how to suck and in the first few days learn how to coordinate their sucking and breathing
• They have irregular sleeping and feeding times in the first three months
• Sneezing is a way babies have of clearing their nose and most babies sneeze several times a day
• Hiccuping is normal behaviour, it will not harm your baby and no treatment is required
• Newborn babies can use all their senses:

– They will look at people and things, particularly at people’s faces if they are close

– They will enjoy gentle touch and the sound of a soothing voice

– They will react to bright light and noise

– They will grasp your finger with hands or feet and they will make stepping movements if they are held upright on a firm surface

• All these automatic responses, except sucking, are lost within a few months and your baby will make controlled movements instead.

Crying

• Babies cry to gain our attention and at times there may be no obvious reason. They may cry because they are hungry, have wind or pain, feel hot, cold or uncomfortable, feel tired and unable to sleep or feel lonely and want company. When you respond to your baby they learn to trust your ability to comfort them

• When babies cry it can be mild fussing or intense crying and screaming. Crying can stop as quickly as it started or last for hours at a time

• It is normal for babies to have at least one unsettled period each day (usually in the early evening) so it is important that you have some strategies to cope with these periods of crying e.g. holding your baby close, talking to them in a soft, soothing voice, singing, swaying, rocking, wrapping, using a sling or a pouch, use of music or noise, a warm bath or a walk in the pram

• Babies usually cry for hunger or comfort so always try feeding or holding your baby skin to skin first

• If your baby’s cry sounds different or unusual it may be the first sign of illness, particularly if your baby is not feeding well, won’t be comforted or has a temperature above 37.5 °C. If you think your baby is ill take them to your doctor immediately or to the nearest emergency department

• Never shake or toss your baby as this can cause bleeding and damage to the brain. If you become upset or distressed some helpful hints include: putting your baby down safely in a cot or pram; walking away and take deep calming breaths; making yourself a cup of tea; ringing a friend or asking someone to help you. Speak to your midwife, GP or child health nurse if you are having problems.

Sleeping and settling

• A newborn baby’s sleep cycles lasts about 20 to 40 minutes with broken sleep anywhere from two to six hours

• During light sleep, babies will sometimes move and make noises. Their breathing pattern is irregular and they can be woken easily at this time

• During deep sleep they are very still and will not move when touched

• Many parents stop wrapping their baby after the first few weeks. If you are having difficulty getting your baby off to sleep or keeping them asleep, it may be worth another try. If you choose to wrap your baby, make sure baby’s head is not covered and wrap baby firmly but not too tightly, allowing room for their legs to move. Wraps should be of lightweight cotton or muslin material and ensure your baby is not overdressed under the wrap. For instructions on safe wrapping, please see SIDS and Kids brochure: sidsandkids.org

Hearing test

The healthy hearing program aims to identify babies born with permanent hearing loss. It is free, available to all babies born at Mater Mothers’ Hospital and performed as soon as possible after birth. If this test is not done before you and your baby leave hospital, your baby can have the hearing test as an outpatient. The nurse or person trained in the conducting this test will explain the procedure to you and answer any questions you may have.

When to seek medical attention for your baby

The following are urgent problems. You need to take your baby to the nearest emergency department or dial 000 for an ambulance if your baby:

• Makes jerky movements
• Turns blue or very pale
• Has quick, difficult or grunting breathing
• Is very difficult to wake, unusually drowsy or does not know you
• Has any skin rashes, especially red spots which do not fade and lose colour when they are pressed.

Other problems that could be serious and require your baby to be seen by a GP, or an emergency department if out of hours, include:

• Your baby has a hoarse cough with noisy breathing, wheezing or cannot breathe through their nose
• Your baby feels unusually hot (fever), cold or floppy
• Your baby cries in an unusual way or for an unusually long time or seems to be in pain
• You notice any bleeding from the nose or any bruising
• Your baby keeps refusing feeds or continues to vomit up feeds
• You observe any sticky eyes or conjunctivitis
• Your baby has very liquid bowel motions which are green brown in colour—this could be diarrhoea
• Temperature above 37.5°C
• Your baby becomes more jaundiced

Find out more about Mater Mothers' Hospital here