2 Weeks to 2 Months

Feeding/Nutrition

Baby's Weight

  • If baby has regained birth weight, the new rule is “never wake a sleeping baby.”
    • This is the rule for both day and night sleep.

Feeding Baby "On Demand"

  • Once baby has regained birthweight (around 2 weeks of life), we stop feeding baby on a schedule.
    • Instead, wait until your baby "demands" to be fed.
      • In other words, wait until your baby starts to fuss.
      • Many babies will suck their hands or move their mouths, even when they aren't hungry yet.

How to Know Your Baby is Hungry

  • In the first 2 months of life crying = hungry
    • This is true no matter how recently, or how much, you fed your baby.
      • Remember: "You can't overfeed a baby."
      • There's no such thing as too much.
    • Try not to let yourself be distracted by other “reasons” your baby is fussy or crying:
      • Needs to burp, needs to pass gas
      • Too hot/cold
      • Only wants to be held, hates the bassinet, hates being on his back
  • If your baby is crying and won’t eat from the breast, offer food from the bottle (pumped milk or formula).
    • Early bottle introduction does not interrupt or derail breastfeeding in families who are motivated to make it work!
  • Important: If your baby won't stop crying and won’t eat from the breast or the bottle, you should contact us right away.

How to Know Your Baby is Full: The Hunger Test

  • When you think your baby is done eating, perform The Hunger Test, by placing him down in the bassinet or crib (not your lap, a pillow, or any other comfortable/cozy location).
    • If he doesn't cry, you can assume he is full and the feed is complete.
    • If he cries, he is still hungry.
      • If this happens, and baby has already fed on both breasts, offer pumped milk or formula from the bottle.
        • Offer as much as it takes for baby to pass The Hunger Test.
  • Please remember: “You can’t overfeed a baby”
    • There is no such thing as "too much."
    • If your baby is full, she will stop eating, and you can verify she is actually full by performing The Hunger Test.
  • In the first 2 months of life, babies often fall asleep at the breast or stop crying when you pick them up.
    • This does not (necessarily) mean the baby is full.
    • We often tell caregivers that it's impossible to know if a baby is still hungry when they are being held.
      • Right from the start, caregivers are very good at soothing their newborn.

Burping Baby

  • If you want, burp baby for 1-2 minutes after the feed is over (not during), then put her down to see if she is actually full.
    • If baby cries when you put her down, she needs more food.
  • Please don't spend a lot of time trying to get your baby to burp.
    • Babies know how to burp when they need to, so your time is better spent getting sleep yourself!

Milk Supply

  • Continue to feed baby on both breasts with every feed. Around 10-20 minutes on both sides.
  • Around 1 month of life breast feeding may become more efficient, and baby may empty each breast in less than 10 minutes. This is a good thing!
  • After feeding on both breasts, check to see if your baby is still hungry by placing them in the bassinet.
    • If you do this and your baby doesn't cry, you can assume she got everything she needed from your body.
      • In this situation, you don't need to pump.
    • If you do this and your baby starts crying, she is still hungry.
      • In this situation, have another caregiver provide pumped milk from the bottle.
        • Mom should pump for 5 minutes to let her body know the baby needed more than she had that time.
  • Only pump the breasts immediately after a feed, not in between feeds.
  • If your breasts are painfully engorged with milk, but your baby is not ready to eat, you can manually express breast milk to relieve the pressure. If you pump your breasts until they are empty, it will increase your production and worsen this problem.

Nipple Symptoms (Cracks, Bleeding, Blisters)

  • If nipple symptoms occur, the baby is not latching properly.
  • You should consult a certified lactation consultant (LC) to figure out why.
    • Please reach out to us if you have questions or would like LC recommendations!

Vitamins for Mom

  • Moms should continue to take the prenatal vitamin every day as long as baby is breast feeding.

Vitamins for Baby

  • Baby needs 400 IU of vitamin D every day as long as he is breast feeding. The easiest option is one where the dose is 1 drop per day. This can be given while baby is sleeping.
  • Here a some good options:
  • Avoid options where the dose is 1 mL per day, because you'll need to wake baby up for this amount, and the taste is not well tolerated.
  • Formula does contain vitamin D, but if baby is taking less than 32 ounces of formula per day, she still needs the vitamin D supplement.
  • 400 IU of vitamin D (via infant drops or 32 ounces of formula) is required every day for the entire first year of life.

Development

  • If baby is awake and quiet, you can take the opportunity to help their development.
  • Babies only need two things for development at this age.
    • Tummy time
    • Hearing words from the people they care about
    • Do these at the same time!

Tummy Time

  • Do this when your baby is awake and happy.
    • Only do this during the day.
      • If baby is awake and happy during the night, try to get some sleep yourself!
  • Push up position on a firm, flat surface.
  • Keep baby’s head in midline. This forces your baby to work harder.
    • When they try to move the head to the side, simply reposition in the midline.
  • Do tummy time until baby cries. Feel the burn!
    • Most babies don't like tummy time at first, and this is completely normal.
    • Around 2 months of life, they begin to enjoy the tummy time. Keep practicing!

Preventing Head Flattening

  • Some babies get flat heads, which may require a helmet to mold the head back to normal.
  • Tummy time whenever baby is awake and quiet.
  • Avoid excessive time in equipment such as bouncers, swings, floor chairs, etc.
    • Spending too much time here can contribute to head flattening.
  • Alternate which arm you hold baby with.

Sleep

  • Please don't expect any sleep pattern at this age.
    • Just when you get used to a pattern, your baby will go through a growth spurt, with associated cluster feeding.
    • There are 2-3 growth spurts during this period of time (2 weeks to 2 months).
  • Never wake a sleeping baby.
  • If your baby is crying, assume he is hungry until proven otherwise.
  • Please see our guide to infant sleep in the first year for more information.

Just When You Think You Know Someone...

It is natural for new parents to pay close attention to their baby's daily patterns, and to get used to those patterns. Unfortunately, constant change is the rule, and just when you start getting used to your baby's habits and patterns, everything will change. Understandably, this surprises and worries parents if they aren't expecting it. It's important you know these changes are normal, there's nothing you did to cause them to happen, and there's nothing you can or should do to try to change them. 

Spitting Up

  • In the first 6 months of life, your baby's spit up patterns will change all the time.
    • Just when you get comfortable with these patterns, everything will change.
  • In the first 6 months of life, most babies spit up 20-30 times per day.
    • Most of the time they swallow it back down without you seeing it at all.
    • This occurs because the sphincter (think of a rubber band) that keeps food from leaving the stomach back to the mouth is loose in babies and gets tighter and stronger as they approach 6 months.
  • Normal Spit Up Includes:
    • A lot or a little
    • After every feed or just some of the feeds
    • 2 minutes or several hours after a feed
    • Clear, yellow, or the color of whatever they have been eating
    • Curdled or uncurdled
  • Spit Up is Not Caused By:
    • Eating too much (if you follow the hunger cues, you can’t overfeed a baby!)
    • Eating too fast
    • Not burping enough, or the baby being a “bad burper”
    • Mom’s diet
    • Putting them down too fast after a feed
    • Indigestion
    • Gas
  • What You Can Do
    • If your baby isn’t in pain while eating, this reflux is completely normal and should be ignored.
    • If you try to fix it, you won’t get the results you want, and you may create a new problem, such as feeding your baby less than she needs.
    • If it ain’t broke, don’t fix it!
  • Important
    • Your baby will not suffocate on their own spit up.
      • They will swallow it back down, or it will make a mess, but they will not choke to death if they spit up while lying on their back.
    • "Projectile" vomiting is a buzzword reserved pyloric stenosis, and it literally brings The Exorcist movie to mind.
      • This problem happens in 0.3% of children, usually happens around a month of life, and requires surgery to correct.
  • When To Worry
    • Your baby:
      • Is inconsolable 
      • Refuses to eat from the breast or the bottle
      • Becomes dehydrated
    • All babies have reflux, but a very small percentage of babies have painful reflux.
      • Babies with painful reflux have pain when they eat.
      • They show signs of hunger, and feed for a few sucks when offered food, but then scream in pain while eating, and refuse to eat anymore.
      • Sometimes these babies will lose weight due to painful eating, and may need medicine to reduce the acid in their stomachs so eating isn’t painful.

Poop

  • In the first year, your baby's pooping patterns will change all the time.
    • Just when you get comfortable with these patterns, everything will change.
  • From a medical standpoint, the poop is almost never important.
  • Poop Frequency
    • Your baby will go from pooping once a day, to pooping after every feed, and back again without warning.
    • Around a month of life, a baby’s digestive system becomes more efficient, and they may go 10+ days without pooping. 
  • Consistency
    • From little smears, to giant soupy blowouts, all consistencies are normal except:
      • Hard, little pellets/pebbles (think rabbit poop).
      • This is the way we define constipation in children.
  • Color
    • All the colors of the rainbow are normal, except for bright red blood.
    • White or "acholic" (without color) poop indicates a dangerous problem in children under 2 months old.
      • If older than 2 months of age, this is not concerning.
  • Odor
    • The odor of your baby's poop may change often, and is never a cause for concern.
  • Taste
    • Don't taste your baby's poop!
  • When to Worry
    • Bright red blood in the poop
    • Hard, little pellets/pebbles
    • Your baby:
      • is inconsolable
      • refuses to eat from the breast or the bottle
      • becomes dehydrated

Skin Rashes

  • In the 4 months of life, your baby may suddenly develop skin rashes.
    • Just when you get used to the appearance of their skin, everything will change.
  • These normal newborn rashes will spread and get smaller no matter what you do.
  • When to worry
    • Your baby:
      • is obviously itching at the rash throughout the day (even newborns will scratch at itchy skin).
      • has a fever in the first 90 days of life
      • is inconsolable
      • refuses to eat from the breast or the bottle
      • becomes dehydrated
      • develops respiratory distress

Nasal Congestion of the Newborn

  • Occurs between birth and 6 months of life
  • Unlike the runny nose caused by a cold virus, this congestion is something you hear in your baby, and is often accompanied with dried boogers in the nose you can see.
  • It’s important for you to know your baby does not have a cold when this occurs.
  • This is actually caused by silent reflux, which all babies and is completely normal.
  • The “boogers” you see and hear in the nose are actually dried breast milk or formula.
  • This is also the reason babies sneeze so much during the newborn period.
  • This congestion will not bother your baby, and almost never causes difficulty with feeding.

Eye Goop/Crusting

  • A blocked tear duct is a very common, non-infectious, cause of eye goop and crusting in the first ten months of life.
  • The tear duct normally drains tears when the eye makes them.
  • These ducts are small and easily blocked by debris during the first ten months of life.
  • When this happens, the tears don’t drain properly and accumulate into eye goop and crust.
  • The whites of the eye are not red, which lets you know there is no infection.
    • Wiping away the goop should be done sparingly (for example, if they can’t open the eye because of the crusting).
    • Wiping should only be done with sterile products to avoid introducing bacteria from tap water or a “clean” washcloth on your shelf.
    • Saline water and gauze are good options for wiping the goop if you need to. 
  • The blocked tear ducts usually come and go, often including both eyes, throughout the first ten months of life.