Newborn Cues

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Newborns:  Reading Their Cues and Following Their Lead  

I think it’s harder than ever to feel confident about parenting a newborn.  There are so many books and models out there, each one telling you to do something different.    And most of us are having kids later, years after having success both at top academic institutions as well as established careers.  We were able to create a balance between work, family and maybe even a social life!   And we felt smart, confident, and perhaps even in control of our daily lives.  We managed our balance of sleep, exercise and healthy eating... and then comes the newborn!   

I think the hardest thing about the newborn is that they have no schedule in the beginning.  For nine months they were getting a continuous infusion of nutrients from mom, and they really never felt hunger.  They didn’t have to digest any milk – mom took care of all of that!  The changes that occur in the baby’s body during delivery and the days and weeks after are immense and intense!  They are literally taking their first breaths, and moments later drinking their first milk – asking their intestines to digest and break down milk into amino acids and fat and carbohydrates.  There really was no day or night for them, nor any true schedule, and now comes all this stimulation, and noises and kisses!  It is a lot for these newborns, and a lot for any new parent.

How then can we make sense of the newborn period and figure this thing out?  How can we crack the code, or get these kids on a schedule – both a feeding schedule and then a sleeping schedule.  Well – I will tell you the answer.  After 30 years of working with kids, and after seeing 10,000 of these little ones – I will tell you the secret: you don’t!

The newborn period will usually last 2-3 months for a full term healthy baby.  It is not that they need to get to a certain weight, but rather they need to develop.  They need to blossom and emerge.  We need to be able to truly understand them – to read their cues – and only then do we have a shot at figuring them out, and establishing a true pattern or schedule of sleeping and eating. 

You will hear about feeding on demand, and whether you are nursing or giving formula or both – that is honestly the right approach.  We don’t want to miss their cues, and not feed a baby who is truly hungry.  We want to meet all their needs, and immediately if possible.  Now that may not be my advice on older kids, and some would say you could spoil even a 9 month old!  But the newborn can not be spoiled – there can’t be any bad habit that you are starting with a brand new baby.    So the best approach is the watch their every cue, learn and love them, and feed them often.  When in doubt it is ok to offer milk.  And as much as they want.  A premature baby in the NICU will have to be monitored more carefully.  But a full term healthy baby will tell us when they are full.  They will pull off the bottle or breast, suck with less vigor, or give us the easiest cue to read, and simply fall asleep for a few hours.  This sleep proves they weren’t hungry, as hungry healthy babies will cry.  

In the hospital you do hear advice about waking a baby, and feeding them every 2.5 – 3 hours.  This isn’t necessarily wrong advice, but once they prove that they are healthy, and regain their birth weight and have seen the pediatrician, I usually say, “don’t wake a sleeping baby, ever”.   Healthy babies who have proven they can gain the appropriate amount of weight will not allow themselves to just get dehydrated or malnourished.  

There are of course a lot of issues that may come up with nursing and achieving an efficient latch, and I take great care in that first visit to look for any tongue-tie or yeast infection or supply issue that can interfere with nursing.  But once we get to that smooth sailing period, where nursing is natural and painless, and the baby is gaining their weight, then we really should follow their lead and feed on demand.

The growth spurts and cluster feeds don’t come at the same time for each child, so don’t read the books as much as you read your child and their cues.   When they do go through those growth spurts they will seem voracious, and most likely your supply will keep up without a problem.  The growth percentiles are not the laws nor should they be a measure of overall health, and every baby is different indeed.  A bigger child is not necessarily the healthier child, and it is just fine to have a petite child.   But there is nothing more reassuring than seeing a good growth velocity in the first few weeks and months – a good rate of rise – so I utilize the growth percentiles, but pay careful attention to the “bigger picture” as well in these newborns.  

Most babies get fussy or colicky in the first month, so expect a fuss, and hope it doesn’t turn into full on colic.  We often need to check the weight to reassure us that the fussy baby isn’t the hungry baby, but following their pees and poops can also be a guide.   Colic can be an intense phase, but most babies will power through it by 3 months old.

By looking for the proper scheduling we assume we can always read their cues, and that is just so hard in the newborn period.  If we were sure they weren’t hungry, then it would be easier.  You can feed an older baby for comfort, but I would advise against that.  The hard part is really knowing if they are hungry or just fussy in that first couple of months, as there are so many factors and variables all going on at the same time!

Once they get older, and blossom and develop, things do get easier.  They will talk with us in their own language, and you’ll be able to read them better.  You’ll see when they are truly hungry, or when they just want to be held.  You’ll read the growth spurt versus the pre-teething oral sensations versus the sassy attitude that starts way too young! 

Once they get old enough, where we are sure the weight is coming up nicely, and we can read all of their cues correctly, we absolutely can hope, beg or cajole a baby to give us a longer stretch of sleep. Although I feel strongly that there is no role for sleep training any baby who is a newborn until 2-3 months old, I would encourage you to read though my thoughts about sleep under “health topics” so you can start to plan your approach. Once the weight comes up, we should celebrate any stretch sleep that we get, but as a newborn I would not encourage any type of “cry it out”. On the other hand, I certainly feels it’s safe, or even recommended, but my no means necessary to “go for it” as your baby gets towards 3-4 months old. I spent over 3 hours writing about sleep and sleep learning, or sleep training - so check it out when you have free time. But for the first few months, just hang in there!

This newborn period is beautiful, precious, scary and draining! Perhaps the best attitude might be just too buckle up and ride the waves.  Look out for badness (fever, fast breathing or lethargy),and notice general patterns or flows, but try not to micromanage or over analyze each day when they are so young.  We all do it – and my wife and I went through it as well!  But I feel like the harder we try to find the schedule in the newborn, the higher the stress level.  The sooner we let it go, and allow them to take the lead, albeit on a very rocky road – the easier it will be for the entire family.  So love your baby to death, pace yourself, and hang in there!


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