The neonatal period starts from the moment the baby is born and lasts until the end of the first month of age, which is the first four weeks after birth. This is a very sensitive time as the newborn is transitioning from life inside the womb to life outside.
During this time, parents need to focus on basic care areas like feeding, hygiene, sleep, bonding, and health care. The baby is also more prone to health issues like neonatal jaundice, normal weight loss after birth, and breathing problems.
Good care and support during this period play a big role in the healthy growth and development of the baby.
In this article, we will explore in detail what the neonatal period is, the baby's development during the first four weeks, and how to care for them through their growth journey.
Why is the neonatal period important?
Newborns are closely monitored during the first few hours of life, especially preterm babies born before 37 weeks of pregnancy, or if there were any complications during delivery.
The fetus grows a lot during pregnancy, including the last months and weeks. Premature babies born before 37 weeks can face problems like underdeveloped lungs, trouble regulating body temperature, poor nutrition, slow weight gain, and higher risk of death. In 2018, prematurity and low birth weight made up about 17% of infant deaths under one year old.
Right after birth, the medical team checks the baby's vital signs, alertness, and general health quickly. Extra oxygen and emergency care can be given if the baby has trouble breathing.
Also, you might hear that the baby had an Apgar score test, which includes these checks:-
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Color assessment.
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Heart rate.
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Response to stimuli.
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Muscle activity.
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Breathing.
The scores from these checks are added up and reassessed every five minutes in the first 20 minutes of the baby's life. The Apgar score helps doctors and nurses quickly decide on the care the baby needs right after birth.
Risks and complications in the neonatal period
The neonatal period is the most dangerous time after birth. Worldwide, about 2.4 million infants died in the first month in 2019. Death rates have dropped recently, but problems during pregnancy and birth are still high. 75% of infant deaths happen in the first week of life.
With proper prenatal care, some complications or conditions can be detected before birth. Some babies can be flagged as high-risk even before they are born. This gives medical teams enough warning to make sure the right tools are ready to care for the baby at birth.
Even babies not classified as high-risk before birth will be closely monitored by healthcare providers after birth. Ideally, any illness or complications will be noticed in the first two hours of life.
Potential complications or issues during birth and the neonatal period can include:-
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Birth defects.
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Birth injuries.
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Breathing problems.
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Infection.
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Jaundice.
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Low birth weight.
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Low blood sugar.
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Neurological problems, like seizures.
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Feeding difficulties.
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Difficulty controlling body temperature.
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Growth delay.
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Problems with vision.
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Problems with hearing.
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Anemia.
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Hormone issues, like thyroid problems.
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Troubles with vomiting and stool.
Babies needing intensive care from early birth or other newborn complications may need treatment in the newborn intensive care unit after birth.
If no problems happen, the birth team plans to move babies to postnatal care hours after birth. Hospitals usually keep mothers for at least 48 hours after natural birth and 96 hours after C-section.
What happens during the newborn period?
A lot happens during the newborn phase, especially right after birth. Every child moves at their own pace, but there are some general milestones to expect during this time.
The baby's development during the newborn phase includes the following:
1. In the hospital
The baby will have many exams and tests for common diseases, hearing issues, and more. The baby also gets the first dose of Hepatitis B vaccine, plus a vitamin K shot in the muscle to prevent bleeding problems. Eye ointment will be applied to stop certain infections that could pass during birth.
The healthcare provider might ask to pick a pediatrician before birth or help find one. Before leaving the hospital, the mom should have a care plan ready for the baby.
2. During the first week after birth
In the first week, the baby and parents get to know each other. Bonding and feeding are key tasks this week. Whether the mom breastfeeds or uses formula, the baby's pee and poop patterns will tell if they're getting enough food.
It's normal for babies to lose weight after birth and to sleep a lot in the first week. So don’t worry. Newborns usually sleep 14-17 hours a day in the first weeks, but they also wake every 2 to 4 hours to feed. Parents should expect the first follow-up visit with the pediatrician outside the hospital within 1 to 4 days after birth.
3. During the second week after birth
Both sleep and feeding are irregular at this stage. The baby might be going throughtheir first growth spurt, after returning to their birth weight. Most babies consume between 450-680 grams of breast milk or formula daily during this time.
Also, contact the healthcare provider right away if there's any feeding problem or you notice fewer wet or dirty diapers.
4. During the third week after birth
Feeding and sleep schedules are still irregular. But the baby will start improving control of their muscles now. Most babies begin lifting their heads. They should also get regular tummy time, which means placing the baby on their stomach while awake to help neck and trunk muscles grow and prevent skull deformities. Parents should supervise this.
Plus, your pediatrician will closely watch the baby's weight and growth in the first few weeks to spot any feeding issues early.
5. During the fourth week after birth
The baby officially finishes the newborn stage. For many parents, feeding and sleeping become more routine now. The baby may respond more as senses like hearing and sight develop.
The mom may also start recognizing the baby's sounds and cries patterns. Another visit to your pediatrician is expected now to check the baby's growth and discuss care for the next stages plus more vaccinations.
How to cope during the newborn phase
Dealing with newborn challenges can be tough, especially for first-time moms. They face hormonal and physical challenges from birth plus possible complications. Dads may also struggle with sleep, feeding schedules, and bonding with the new baby.
Also, talk to healthcare providers if the mom struggles caring for the baby. It's important to have good support before birth and don't hesitate to ask for help when needed.
Moms should watch for postpartum depression signs. Pediatricians or hospital healthcare providers should review newborn care basics with parents and help keep growth and development on track.
In the end, postpartum is an exciting time as the baby grows and the mom bonds, but it can be hard due to irregular sleep and feeding schedules. So don't be afraid to ask for help and support from family, friends, and professionals.
