Tuesday, February 22, 2011

Baby Science: The First 72 Hours

Recently, Jen B described the first 72 hours she and her husband shared with her new baby, Charlotte, Afterward, we shared the "mommy science" behind the experiences she described.  This time, we review the "baby science" related to those early days. Using Jen B's posts as a guide, we'll ask and answer some of the questions that many parents have about newborns. As usual, we have to remind you that not all babies will follow the timelines we describe but many will follow a similar pattern.

Why are newborns so sleepy on the first day?
I'm sure it is obvious that both babies and mothers are exhausted after their birth experience. After the first hour or so when adrenaline and excitement may keep babies relatively alert, they typically sleep for 2 to 4 hours before starting to wake more frequently. A few hours of deeper sleep on the first day helps mom recover and helps baby conserve calories while feeding is still being established. Most babies struggle staying awake on the first day, falling asleep off and on, even while they are feeding. That's why it is important to practice feeding during the first couple of hours and each time the baby becomes alert.

Why are newborns so fussy on the second day?
Many parents are surprised by the sudden behavior shift in their quiet sleeping newborns that comes along on the second day. Babies' alert periods are still very short but they are also likely to be fussy, even a bit frantic, when they are awake. While we know how hard it is to listen to your baby's crying, it is one of his most important baby-skills. Crying is an extremely effective mechanism to alert parents when they are needed. Without this skill, newborns would not be able to wake their caregivers when they need to be fed, diapered, warmed, or calmed. Babies cry out whenever they become uncomfortable or distressed and a quick response will minimize but not eliminate crying, especially during the first few weeks.

Brand new baby-tummies are so small that newborns typically consume only about a teaspoon of milk during a feeding. An average milk volume for the first 24 hours is about 50 ml (or a little over 3 tablespoons). During the second day, babies become more alert and they work hard to give cues (including hunger cues) to their parents. Being more alert means they are more likely to feed frequently enough to grow and stimulate mom's milk supply, But being alert also means they will be sensitive to all the discomforts of the new world they have entered. Some babies are better than others with dealing with stimulation and calming down when their parents try to soothe them. So, some babies will cry more than others independently of how they are cared for but all newborns do better when their parents are careful not to let them get overstimulated. Limiting visitors and using repetition to calm the baby can help new parents get through that tough second day.

Why don't babies breastfeed perfectly the first time?
In her sleep-deprived state, Jen B was frustrated that Charlotte seemed so "stubborn" about breastfeeding. She would cry out for feeds, not latch very well and then, when she did latch, fall asleep almost immediately. It is easy for parents to imagine their babies thinking like older children (like being stubborn) but Charlotte was only using instincts and reflexes that just weren't quite ready for her new world. Her body was overreacting to the world around her and her sucking reflex was sending her to sleep. She needed a few days to get better control over her responses to stimulation and to use all of her reflexes for feeding at the right time and in the right order. With practice, babies get better at feeding very quickly and by the time mom's milk supply is increasing rapidly (typically when babies are between 2 and 4 days old), they are ready to take in a much larger volume.

Next time: Jen B will share more of her early experiences


  1. I do wonder about babies not "breastfeeding perfectly" as there is quite a body of evidence to support babies in an unmedicated labour doing so quite "perfectly" but we just need to be in sync. The work of Kittie Franz, Dr. Nils Bergstrom, Lennart Righart are good examples of self- attached babies.

  2. Oh yes! Of course many babies are able to breastfeed immediately. Jennifer had a c-section so Charlotte was far from unmedicated. However, in our work (collecting data for the WHO growth charts), we found that a little under half of the babies had a tough time latching well in the first 24 hours, even with a low medication rate. Some babies' reflexes just took a little longer to kick in. They did kick in, and quickly. We just want to make sure moms know that and don't give up. Thanks!

  3. I know a woman who had a totally unmedicated (no induction, no pain medications) birth which went quite quickly and without trauma (she didn't even tear) and her baby still had a bad latch. It happens.

  4. I had a perfect unmedicated birth and immediate skin to skin but my little sweet pea took a day to latch and months to do it correctly. I love my birth experience but it did not make breastfeeding any easier unfortunately.

  5. I had a medicated (epidural) birth and my baby (born 20 years after my first) was happily nursing within 20 minutes of birth.

    My first baby, an unmedicated birth, took several days to get the hang of breast feeding and I was beyond exhausted from the pain. Unmedicated births are highly overrated.