Your Baby Week Five

1
Graduation to Infancy

Infant Girl Drinking From a Cup
Digital Vision./Photodisc/Getty Images

Parents are often surprised that their newborn has graduated, or are just as likely to miss this first graduation altogether.

Graduating?

Yes, graduating.

After week four, or day 28 to be more precise, your newborn officially becomes an "infant."

With four weeks of parenting a new baby under their belts, new parents can view this as a sort of graduation too. They may feel like they are graduating from the days when they first came home from the hospital and may have been afraid they would "break" their baby every time they picked her up. In their baby's second month, many parents are much more comfortable and confident in their ability to take care of their baby.

And think about how much more confident you will be at your baby's next graduation - when she becomes a toddler...

General definitions for the ages and stages of a child include:

  • Newborn or Neonate - birth to 28 days
  • Infant - 1 to 12 months
  • Toddler - 1 to 3 years
  • Preschooler - 3 to 5 years
  • School Age - 5 to 11 years
  • Preteen or Tween - 11 to 12 years
  • Teen - 13 and older

2
Breastfeeding in the Second Month

Mother breastfeeding baby girl
A good support team can help make sure you breastfeed your baby as long as you want to. Photo © Torsten Schon

Is your pediatrician and office staff supportive of breastfeeding?

With all that is known about the benefits of breastfeeding for both the mother and baby, you must think "of course my doctor is going to be supportive of breastfeeding."

Unfortunately, that is not always the case. And it usually isn't necessarily that they have anything against breastfeeding, but instead, many pediatricians and other health professionals just haven't received enough education or training to be supportive of breastfeeding.

Although breastfeeding is likely getting easier as you enter your baby's second month, there may be times that you need some help and support to continue breastfeeding your baby as long you both would like.

So how do you know if you doctor is supportive of breastfeeding? A good way to tell is if at the first sign that you are having problems breastfeeding, your pediatrician doesn't only recommend supplementing with a bottle, changing to formula, or to "just keep trying."

In addition to having a pediatrician that is supportive of breastfeeding, you can maximize your chances of breastfeeding successfully by learning as much as you can about breastfeeding and potential breastfeeding problems that may come up. There are many excellent books about breastfeeding that you should consider reading, such as The Nursing Mother's Companion by Kathleen Huggins.

Having a breastfeeding support system in place is also helpful. In addition to a supportive pediatrician, this can include a lactation consultant or lactation specialist, whose phone number you might keep with your list of emergency numbers. Family members and friends who have breastfed are other good sources of support.

3
Formula Feeding

A baby drinking from a bottle.
A baby drinking from a bottle. Photo © Joey Nelson

By five weeks, parents have often settled on a specific brand of formula. The main thing that changes now is how much your baby eats at each feeding and each day.

Although parents, especially first-time parents, often like specific rules on how much to feed their baby, there really are no one-size-fits-all rules to feeding a baby. Unlike breastfeeding babies, who simply breastfeed more to stimulate an increased production of breastmilk, you are more directly responsible for how much formula your baby drinks.

So how can you tell how much to feed your baby and when to give him more? You really just need to see how satisfied your baby is and increase his feedings when you notice that he may need more, such as when:

  • He quickly finishes a bottle and seems to be looking for more
  • It seems like he is wanting to eat more often, like every two hours, when he had been eating every three hours
  • He begins to wake up more often at night to eat
  • He isn't gaining weight well

Formula Feeding Guidelines

The American Academy of Pediatrics, in the book Your Baby's First Year, states that "most babies are satisfied with 3 to 4 ounces per feeding during the first month, and increase that amount by 1 ounce per month until reaching 8 ounces."

Although not an absolute rule, as a general guideline, that would mean that a baby would be drinking about 4 to 5 ounces per feeding during his second month. And most babies are eating about every 3 to 4 hours, with perhaps one longer stretch of 4 to 6 hours during the night when they are sleeping.

Be sure to talk to your pediatrician if your baby is drinking very much more or less than that amount of formula - about 24 to 32 ounces a day.

4
Growth and Development Week Five

Parents often wonder if their baby is growing normally.

Recording regular measurements of your child's height, weight and head circumference at your visits to your pediatrician and plotting them on a growth chart are a good way to see if your child is growing normally.

Unfortunately, some parents become preoccupied with worries that their child is small or near the bottom of the growth chart. Remember that it is your child's rate of growth that is the most important factor to consider when evaluating if your child is growing and developing normally and not where he is on the growth chart. If your child is following his growth curve, then he is likely growing normally.

So how much can you expect your baby to be growing at this age?

General guidelines for your infant's growth rate include:

  • Gaining about 1 1/2 to 2 pounds a month
  • Growing about 10 inches (25 cm) between the time he is born and he is twelve months old
  • Having a head circumference that grows at about 2 centimeters a month

Remember that these are general guidelines though. Your child may grow a little more or a little less than this each year. If you have concerns about your child's growth, especially if you think that he has failure to thrive (poor weight gain) or short stature (poor growth in height), be sure to talk to your pediatrician.

Links:

5
Baby Car Seats

A cut swimming pool noodle under the car seat base to get it reclined at the right angle.
A cut swimming pool noodle under the car seat base is a good way to get the car seat reclined at the right angle. Photo © Vincent Iannelli, MD

The American Academy of Pediatrics states that the best baby car seat is "the one that fits your child's size, is correctly installed, and is used properly every time you drive."

With a five-week-old baby, that means that you should:

  • Read the car seat instructions carefully to make sure that you have installed and are using it correctly
  • Use either an infant-only car seat (which has a detachable carrier) or a rear-facing convertible car seat
  • Place your baby rear-facing in the back seat of your car and never place your baby in the front seat of a car with a passenger side air bag
  • Attach the LATCH straps or seat belt to the car seat tightly
  • Make sure that the car seat is reclined at the proper angle, which may require that you place some foam padding under the car seat's base
  • Make sure the harness straps are snug when you strap your baby into the car seat and that the plastic harness clip is at her armpit level and not too low

And remember that according to the latest car seat guidelines, infants and toddlers should ride in a rear-facing car seat (infant-only rear facing car seat or rear-facing convertible car seat) until they are two years old or until they have reached the weight and height limits of their car seat.

Sources

American Academy of Pediatrics. Car Safety Seats: A Guide for Families 2011.

6
Shaken Baby Syndrome

Never shake a baby!

That seems like one of those things that should be able to go without being said.

Unfortunately, not everyone knows about the dangers of shaking a baby. Statistics from the National Center on Shaken Baby Syndrome show that every year in the United States:

  • At least 1,200 to 1,400 children are shaken
  • 25 to 30% of shaken babies die
  • Survivors of shaken baby syndrome are very likely to have lifelong complications, including brain damage and blindness
  • Many more children may be unknown victims of shaken baby syndrome, but aren't discovered because no external trauma, such as a bruise, are noticed

Shaken Baby Syndrome

Shaken baby syndrome occurs when a baby is shaken violently, causing bleeding in the brain. Other associated injuries often include bleeding in the retina of the eye, spinal cord and neck injuries, and rib fractures.

Symptoms of shaken baby syndrome typically include extreme fussiness, poor feeding, vomiting, seizures, and a baby may be sleeping much more than usual or hard to wake up (lethargic).

You should seek immediate medical attention if you think that your baby may have been a victim of shaken baby syndrome.

Shaken Baby Syndrome Victims

To help prevent shaken baby syndrome, it is important to educate all of your baby's caregivers that they should never shake a baby.

Parents commonly think that only younger babies and infants can suffer from shaken baby syndrome. It is important to realize that even children up to age two to five years old can suffer from shaken baby syndrome if they are shaken.

That makes it important to remind yourself, your spouse, significant other, family members, friends, siblings, and any other caregivers that they shouldn't shake your baby.

Sources

The National Center on Shaken Baby Syndrome.

National Institutes of Health. Shaken Baby Syndrome Information Page.

7
Spoiling a Baby

Man carrying infant in a Maya Wrap
A Maya Wrap is a great way to carry your baby and still keep your hands free. Photo © Vincent Iannelli, MD

Can you spoil a baby?

Fortunately, most experts think that you can't spoil a baby.

That is good news for all of the parents who are finding that the only way to comfort their baby right now is to carry simply carry them around.

Picking your baby up every time they cry will likely get you some negative feedback from more than a few friends and family members, though. These people are following some "old-school" parenting styles that have thankfully fallen out of favor. They commonly believe that if you always pick up your crying baby, then you will spoil them.

The American Academy of Pediatrics, in their book Your Baby's First Year, offers some good advice on the subject:

The best way to handle crying is to respond promptly to your infant whenever he cries during his first few months. You cannot spoil a young baby by giving him attention; and if you answer his calls for help, he'll cry less overall.

Slings, Wraps, and Carriers

Even if it won't spoil your baby, it can be hard to get anything done if you are always holding your baby.

You can hold your baby close to you, keep her comforted and calm, and still keep your hands free by using a baby carrier or sling.

Popular brands include the:

  • Maya Wrap Sling
  • Baby Bjorn Carrier
  • Moby Wrap Baby Carrier
  • Evenflo Snugli Comfort Vent Soft Carrier

Should you use a wrap or a carrier? It is really a personal preference, both for you and your baby, but can be a good idea to get either one or the other.

8
Week Five To Do List

Wall thermostat
Setting the temperature of your hot water heater to 120 degrees is one important baby proofing step on your to do list. Photo © Vincent Iannelli, MD

Although you may be feeling more confident about taking caring of your five-week-old baby, there is still a lot to keep up with.

Feeding your baby, changing diapers, calming her when she is crying, etc., can all take a lot of time. Spending so much time caring for your baby can make it easy to overlook the things that can keep your baby safe and healthy, such as:

  • If you haven't done so yet, make an appointment with your pediatrician for your baby's two-month well child check appointment and review our infant well child checklist before your appointment.
  • Make sure your home is well baby proofed so that your baby is safe.
  • Call your pediatrician or seek medical attention if your baby has a fever, which is typically considered to be a temperature that is at or above 100.4 degrees Fahrenheit.
  • Continue to put your baby to sleep on her back to reduce her risk of SIDS.
  • Until your baby's immune system is stronger when she is a few months old and she has had some of her immunizations, try to avoid exposing her to a lot of people. This may help her avoid common viruses and keep from getting sick.
  • Continue to put your baby in a rear-facing car seat in the back seat of your car. Learn to avoid common car seat mistakes, such as putting the harness chest clip in the wrong position.
  • Watch for signs of postpartum depression, including mothers who feel sad, anxious, afraid, or confused, etc.

9
Baby Ear Piercing

Baby with a big bow headband
A head bow can be a fun and safer alternative to earrings in your baby girl's first few years until she is ready to get her ear's pierced. Photo © Karen Frazier Photography

Q. When can I pierce my baby's ears?

Although some parents like to get their baby's ears pierced as early as possible, the American Academy of Pediatrics does recommend that you "postpone the piercing until your child is mature enough to take care of the pierced site herself."

This can help avoid some of the risks of baby ear piercing, including:

  • infection - younger infants have immature immune systems, so they might not be able to fight off an infection at the site of the piercing very well.
  • choking hazard - if they get the earring off.
  • allergic reactions - to the metals in the earrings (especially nickle and gold) she wears, but which can be hard to notice since infants normally rub their ears a lot.
  • embedded earring - this occurs when one part of the earring goes into the earring hole and gets embedded inside. Although this can happen at any age, it can be harder to remove from infants.

How big are the risks? They are likely fairly small, but since baby ear piercing is usually just a cosmetic procedure that can be put off to a safer time, there is little reason to take that even small risk.

Baby Ear Piercing

If you do decide to have your baby's ears pierced, try to wait until she is at least two or three months old, which is when she should be old enough to handle mild infections and will have gotten at least one round of vaccines.

Also consider getting earrings with lock or screw-on backs made of surgical steel (to reduce allergic reactions), which may help decrease your baby's chances of pulling the earring off and swallowing or choking on. And choose a facility that uses sterile equipment and has experience piercing baby ears, such as your pediatrician's office.

Sources:

AAP. Caring for Your School-Age Child: Ages 5 to 12.

Complications of body piercing. Meltzer DI - Am Fam Physician - 15-NOV-2005; 72(10): 2029-34.

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