What You Need to Know About Your 2-Week-Old

Common Newborn Issues For a 2-Week Old Baby

Mother with baby, 2 weeks
What do you need to know about your 2-week old baby?. Michaela Begsteiger/Getty Images

When your baby hits the age of 2 weeks, you may feel you have left some of your worries behind. Labor and delivery may seem like ancient history, and you've overcome some of the initial worries about whether she will eat, sleep, or poop. At the same time, you're probably feeling more protective of your baby than you ever could have imagined prior to her birth.

What do you need to know about your 2-week old baby, and what issues might you face with regard to her eating, growth, and safety?

Newborn Nutrition

Your baby will get all of his nutrition from breast milk or an iron-fortified infant formula until he is four to six months old. There is no need to supplement with water, juice, or cereal at this time. She will probably be eating every two to six hours and, if feeding on-demand and following your baby's cues, remember that not all cries are "hunger-cries" and you may have to set some limits (for example, not allowing her to feed every hour). If you don't, you'll find that, unlike with adults who overeat, the excess may return and land on your lap. Plus the little sleep you are getting will decrease further.

Most breastfeeding babies will eat for 10-15 minutes on each breast (although you shouldn't time your feedings) every 1 1/2 to 3 hours, and bottle feeding babies will take 2-3 ounces every 2-4 hours. By 4-8 weeks, your baby will likely be on a more predictable schedule.

Your newborn will spend most of his time either sleeping or eating. At first, wake your baby for a feeding if she is sleeping for more than four to five hours. Later, if she is gaining weight well, you can let her sleep as long as she likes. Remember that a newborn should usually breastfeed about 8 to 12 times a day.

She will probably not begin to sleep through the night until she is three to four months old.

Feeding practices to avoid are giving a breastfed baby a bottle before she is 4 to 6 weeks old, putting the bottle in bed or propping the bottle while feeding, putting cereal in the bottle, feeding honey, introducing solids before 4 to 6 months, or heating bottles in the microwave.

Also, avoid the use of low-iron formulas, which are nutritionally inadequate to meet the needs of a growing infant. Low iron formulas do not contain enough iron and will put your child at risk for developing iron deficiency anemia (which has been strongly associated with poor growth and development and with learning disabilities). Iron-fortified formulas do not cause colic, constipation or acid reflux and you should not switch to a low iron formula if your baby has one of these problems. 

Other than breast milk or formula, one essential supplement for many babies is vitamin D. We've learned in recent years that vitamin D deficiency can result in a multitude of problems, and rickets (a condition due to deficiency of vitamin D) is actually increasing. Many babies are simply not getting enough vitamin D. It's recommended that all breastfed babies be given a supplement of vitamin D 400 IU's daily, beginning just a few days after birth.

Babies who are being fed with a vitamin D-fortified formula but aren't consuming at least 32 ounces daily should also receive a supplement of vitamin D 400 IUs daily.

Some of the common nutrition issues you may face at this time include knowing how to best pump and store breast milk, and what can be done to sooth a fussy baby who requires frequent feedings.

Newborn Growth and Development

Your 2-week old baby will probably have regained most or all of the weight that she lost in her first week. At this age, you can expect your baby to look at your face, startle with loud noises, lift her head, and begin to smile spontaneously.

She may even begin to recognize familiar objects and sounds. These responses are referred to as "developmental milestones," and your pediatrician will probably ask you when your baby first smiled and when she first laughs (usually between 6 and 12 weeks.)

If using a pacifier, try and restrict its use to when your baby seems to need the self-comforting behavior of sucking. Avoid using it every time your baby cries (it is usually better to pick up and hold your baby to comfort her when she is crying) and to be safe, use a one-piece commercial pacifier and do not hang it around your baby's neck.

Remember that all babies are unique and have different temperaments. Some are quiet and calm, while others are very active and some are very sensitive and get fussy easily (and may need less stimulating environments to stay calm). Try and keep your babies temperament in mind as you react to her needs. 

Newborn Safety

Accidents are the leading cause of death for children. Most of these deaths could easily be prevented and it is therefore very important to keep your child's safety mind at all times. Here are some tips to keep your two-week-old baby safe:

  • According to the latest car seat guidelines, you should use a rear-facing infant or convertible care seat, and place it in the back seat until your baby is two years old or outgrows the rear-facing weight or height limits. Never place your baby in the front seat of a car with a passenger side airbag.
  • Make sure your baby's crib is safe: have no more than 2 3/8 inches between the bars; the mattress should be firm and fit snugly in the crib; place it away from windows and drafts; and avoid placing fluffy blankets, stuffed animals, or pillows in the crib as they can cause smothering.
  • Make sure that used or hand-me-down equipment, such as used car seats, strollers, and cribs haven't been recalled for safety reasons. Call the manufacturer or the Consumer Product Safety Commission for an up to date list of recalled products.
  • Set the temperature of your hot water heater to 120 degrees F to prevent scalding burns.
  • To prevent choking, never leave small objects or plastic bags in your baby's reach.
  • Back To Sleep: put your baby to sleep on his back to reduce his risk of sudden infant death syndrome (SIDS) and never put him down alone on a waterbed, beanbag, or soft blanket that can cover his face and cause choking.
  • Prevent falls by not leaving your baby alone on a bed or changing table.
  • Install smoke and carbon monoxide detectors and use flame retardant sleepwear.
  • Follow our step by step guide to childproofing your home, being alert to hidden dangers.
  • Until your baby is older and his immune system is stronger, it is probably a good idea to keep him from large groups of people or other sick children to minimize his exposure to infections.
  • Know signs and symptoms of childhood illness: fever (call your pediatrician right away if your baby has a temp at or above 100.4 before he is 2-3 months old), decreased appetite, vomiting, irritability, and lethargy, or even your gut feeling as a parent that something is wrong.
  • Know the number and when to call poison control before calling your pediatrician.

Taking Your Baby to the Doctor

It used to be that most babies were discharged from the nursery and then didn't see their pediatrician until they were two weeks old, but that advice has changed over the years.

Although it depends on whether or not your baby was already jaundiced when she went home, how well she was feeding, and if she had any medical problems, the American Academy of Pediatrics advises that babies should be seen by a nurse or doctor between the age of 3 days and 5 days. Your baby will also likely have a checkup when he is two weeks old.

At the two week checkup, you can expect your doctor to check your baby's weight, height and head circumference and review her growth and development. A newborn screen test is usually repeated and she may have her first Hepatitis B vaccine (unless it was already given in the nursery). You may heard some of the controversy about immunizations and it's helpful to learn about the myths that keep some people from vaccinating their kids.

The next check up with your pediatrician will be when your infant is two months old (although some doctors also recommend a visit at four weeks of age) or earlier if you have any concerns.

Common Newborn Problems

There are a number of concerns that are common in newborn babies. Some of these include:

  • Jaundice: Jaundice is a yellowing of the skin which occurs in almost half of all babies. It is usually treated by frequent feedings and the use of bilirubin lights in severe cases. Your doctor will be able to tell if treatment is necessary by examining your baby and/or doing a blood test. If your baby is yellow on his face and upper part of his chest, then you may be asked to place him in front of a window for ten to fifteen minutes 3 to 4 times each day, although many experts say that this is unnecessary. If you are asked to do this, make sure that your baby doesn't get too hot or too cold. The sunlight (and ultraviolet light if it is cloudy) helps to convert the bilirubin that makes his skin yellow into another substance that can pass in the urine. In some cases of blood type incompatibility, your baby may become severely jaundiced and require more aggressive treatment.
  • Constipation: Constipation in infants is defined as the passage of hard, pellet-like stools that cause pain or bleeding (groaning or straining is normal) and not so much by how often your baby has a bowel movement (some breastfed babies only have one bowel movement each week after they are 1 to 2 months old). Initial treatment is by giving 2 to 4 ounces of water or diluted prune juice once or twice a day or by changing to a soy based formula. It is unusual for newborns to be constipated, though, so call your pediatrician if your baby isn't having regular bowel movements.
  • Stuffy Nose/Sneezing: A stuffy nose or sneezing is very common in newborns and usually caused by irritation from dry air, smoke, or dust. Try to eliminate common irritants from your home. You can try using a humidifier or salt water nose drops if your baby appears uncomfortable.
  • Thrush: Thrush is diagnosed by the presence of white patches that coat the inside of your baby's cheeks and tongue that cannot be easily wiped off. It is caused by a very mild yeast infection and is easily cleared up with a prescription medicine called Nystatin or Fluconazole.
  • Skin rashes: Drooling rashes, baby acne, and flaky skin that will usually clear up on their own without treatment.
  • Dry skin:  Dry skin is usually normal in babies, but you can use a mild soap and a moisturizer once or twice a day if you wish.
  • Spitting Up: Many babies spit up (reflux) after eating due to overfeeding or because the valve that closes the upper part of the stomach is immature. It is usually not a concern as long as your baby is gaining weight and it is not causing him to cough or choke. Some steps to take to improve this problem are feeding smaller amounts, more frequent burping during feeds, avoiding pressure on his belly, or limiting vigorous activity after eating. Reflux improves with age, usually without treatment.
  • Watery Eyes: Watery eyes in babies is usually caused by a blocked tear duct and is not a concern unless the eyes become infected (let your pediatrician know so that they can prescribe antibiotic eye drops.) It usually clears up on its own before your baby is 12 months old.
  • Diaper rashes: Diaper rashes are very common and usually clear up in 3 to 4 days with a diaper rash cream. If it is not clearing up or is bright red and surrounded by red dots, your baby may have a yeast infection and will need an antifungal cream to help clear it up. Diaper rashes can be prevented by frequent diaper changes, increasing air exposure by keeping the diaper off as much as possible, and using a mild soap only after bowel movements (rinse with just warm water at other times).
  • Upper Respiratory Infections: Upper respiratory infections are very common and include symptoms of a clear or a green runny nose and cough. They are usually caused by cold viruses and rarely are antibiotics needed (only for babies who develop a secondary bacterial infection.) The best treatment is to use saltwater nasal drops and a bulb suctioner to keep their nose clear. Call your pediatrician if your child has high fever, difficulty breathing or is not improving in 7 to 10 days

Bottom Line on What You Should Know About Your 2-Week Old Baby

Your 2-week-old baby has probably already become the center and joy of your life. Taking some time to familiarize yourself with newborn nutrition, normal growth and development, childhood safety, and common childhood ailments is important in ensuring the health of your child and reducing some of the anxiety that comes with having a new life totally dependent on you in every way. What we left out above is the message to enjoy these moments. At this point you're likely somewhat (understatement?) sleep deprived and wondering what you ever did with your time before baby was born. Remember to take a moment to be quiet and simply enjoy the presence of this precious new life.

Sources:

Kliegman, Robert M., Bonita Stanton, St Geme III Joseph W., Nina Felice. Schor, Richard E. Behrman, and Waldo E. Nelson. Nelson Textbook of Pediatrics. 20th Edition. Philadelphia, PA: Elsevier, 2015. Print.

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