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Babies only require very small volumes of milk (colostrum) in the first days of life. They are born with some liquor in their digestive systems and it keeps them hydrated and provides nutrients. Frequent sucking at the breast affords stimulation and consequently assists with the production of milk.
The baby’s gastric wall is non-compliant and non-relaxing at birth and the duodenum is not very motile so this results in early satiety and frequent regurgitation in the first few days. Large feeds given too soon will just increase the amount of regurgitation.
The baby’s stomach capacity on day one is about 7ml. This increases to about 57ml by day five. You can see from this that the capacity increases quite quickly. While governed by the weight of the baby to some extent the average twenty-four hour intakes are approximately:
Day one: 37ml – from a few drops to 5mls per feed
Day two: 84 ml – from 5 to 15mls per feed
Day three: 408 ml – from 15 to 30mls per feed
Day five: 705 ml – from 45 to 60mls per feed
The first feed should occur immediately after birth and should be completely uninterrupted for at least an hour and preferably longer. In addition to commencing the bonding process and the introduction of breastfeeding, this period of closeness allows baby’s body to make the transition from intrauterine life and reduces stress levels in both mother and baby. Procedures that delay this contact can have an impact on the success of the baby to breast feed. This first feed is often followed by a long period of sleep – up to eight hours is acceptable unless there is a medical complication.
The following is a guide as to what to expect.
Day one: One or more wet nappies and one or more meconium stools.
Day two: Two or more wet nappies and one or more meconium/transitional stools
Day three: Three or more wet nappies and one or more transitional (green-yellow) stools
Day four and after: 6 to 8 thoroughly wet nappies with clear urine and soft, yellow, curdy stools (at least one daily, but often many, until about 6 weeks).
Always seek help if:
Sometimes a pinkish rusty stain will be seen on nappies. This is caused by the presence of urates in the urine and is very normal in the first 72 hours. The baby’s blood levels of uric acid at birth reflect the maternal level, thus they may be somewhat elevated. The secretion of urates occurs as a result of these elevated serum uric acid levels and is nothing to worry about.
Vaginal bleeding of the newborn:
Babies are exposed to maternal hormones in utero. Oestrogen withdrawal, which occurs upon birth, is the most common cause of vaginal bleeding of the newborn female. It may be preceded by a clear or whitish mucous discharge; usually occurs in the second or third week of life; lasts for a few days; and should be scant. Prolonged or excessive bleeding should be investigated.