First 12 Weeks: Week 2–Transcript and Resources Developmental Milestones in Month 1
Week 2 Transcript:
Hello and Welcome! I’m Laura Ellis and this is Week 2 in my First 12 Weeks Series. In this episode, in addition to going over fact based information about infant feeding, sleep, and growth, I will also give more in-depth information about newborn reflexes and milestones for month one.
At this point, your newborn’s stomach should be about the size of an apricot, which is about 45-60 mL or 1.5 to 2 ounces. It’s still growing and expanding, and by one month, baby’s stomach will hold about 80-150 mL or 2.5 to 5 ounces, which is about the size of a large egg. Some of you might be starting to feel like you’re getting the hang of feeding baby with whatever method you’re using, be it chest or breastfeeding, bottle feeding, cup or finger feeding. Other families might really be struggling still, which is completely normal too. We will go more in depth into this topic next week, but in general, if your baby is gaining weight, eating every 2-3 hours, having at least 6-8 wet diapers per day, and baby seems satisfied after eating, then you’re probably on the right track. If you’re concerned, however, I would encourage you to check in with your medical provider.
Now for sleep, unless your medical provider has given the go ahead to let baby sleep longer stretches, this week you will still be waking them up every three hours to eat. Most babies will be waking more frequently on their own to eat anyway, but during the first two weeks, feeding in my opinion is a higher priority than sleep for baby’s growth and development. That’s not to say that sleep isn’t important. Generally, during the first two months of life, babies only have two sleep cycles: REM sleep, which is noisy and active, and Non REM sleep, which is still and quiet. Usually around three months babies transition into their adult sleep pattern, which includes two Non REM light sleep stages, a Non REM deep sleep stage, and REM sleep. Because of the Moro or startle reflex, which I will discuss more in a bit, combined with newborn’s having mostly light sleep stages, swaddling your baby will help them stay asleep better as they transition between sleep cycles. This week, your baby will likely still have 30-45 minutes wake windows around the clock and they will sleep between 30 minutes and three hours in a stretch. They will be sleeping between 16-18 hours per day.
This week many babies will get back to their birthweight. For some babies it will be next week, and that's fine too. I've had some parents ask me, "what is the ideal percentile we should be aiming for?" I think that's a great question, and I would love to dig a little deeper here. My first recommendation here would be to not compare your baby to other babies. It is more important to be comparing your baby to your own baby. You might hear your provider say that your baby is “following the curve,“ and that sounds good, but what does that mean? I will give you an example: years ago I took care of a baby who was born in the 20th percentile as they grew they were always between the 20th percentile and the 25th percentile. The parents were concerned because the baby was so small, but their provider didn’t seem as concerned to the parents. But why? Because their provider was comparing their baby to their own baby. As their baby grew, their growth was consistent with other babies between the 20th and 25th percentile. For their baby’s size, their growth pattern was normal. From 1 percent to 100 percent, your baby’s percentile is within the normal growth range. Their baby was in the 20th percentile of the normal range. Now from my experience, if your baby is below the 10th percentile or above the 90th percentile, or jumps from a low percentile to a high percentile or especially if they jump from a high percentile to a low percentile, this may be a cause for concern and addressed by your provider. Generally speaking though, as long as your baby is following their own growth curve, you’re on the right track.
That leads us to development, which is our big topic this week. For clarification the information I’m giving in each episode—but especially when it comes to infant development—is based on full-term and post-term babies. If your baby was premature or preterm, you will want to check with your medical provider for their developmental milestones based around their adjusted age and additional needs.
I would like to start by going over the six reflexes that newborns have from birth. The first reflex is the rooting reflex. This is most noticeable when something brushes against the corner of baby’s mouth. When that happens, baby will turn their head toward that object and will open their mouth, which leads to the second reflex, which is sucking. The sucking reflex begins to develop around 32 weeks gestation but usually isn’t fully developed until closer to 36 weeks. This reflex is vital to baby’s growth since this reflex is what instinctively allows them to nurse or suck a bottle. The third reflex is the Palmer grasp reflex. If you brush an object against babies palm or the bottom of their foot, you will notice that their fingers and toes will curl to grasp the object. This reflex usually lessens by 5 to 7 months old for their hands and 9 to 12 months old for their feet. The fourth reflex is the tonic neck or fencing reflex. With this reflex you’ll notice that baby will be looking towards their extended or reaching arm while the other arm is bent up towards their face. This reflex usually phases out around 5 to 7 months old. The fifth reflex is the stepping reflex. With this reflex if baby’s feet are placed on a firm surface, you’ll notice them moving their feet alternately as if they are walking or dancing. This reflex usually lasts until baby is about two months old. Our sixth and last reflex is everyone’s favorite: the Moro reflex or startle reflex. With this reflex when baby is startled, their head arches back and their arms and legs extend out. This usually has the effect of startling baby even more which causes them to cry. If this happens when a baby is sleeping, from personal experience, it can be even harder to soothe and calm them. I’ve also noticed that using a firm swaddle on baby’s arms really helps with the Moro reflex while sleeping. Babies typically outgrow the Moro reflex around two months old.
By the end of the first month, while your baby’s vision will still be blurry they will be able to see a bit farther and they will be able to focus on objects close to them. They will be interested in faces, circles, and high contrast patterns—especially black and white patterns. They were also recognize changes and movements in light intensity. They will also recognize different temperatures and textures. They will turn their heads to avoid bad odors. They will begin to recognize different human voices and will begin to look for the speaker. While they are growing and getting stronger, they will still be weak at the end of the first month with only limited muscle strength. Their primary communication will still be crying, and they will definitely be more loud and vocal with their communication as they grow. Lastly, at the end of the first month, feeding and sleep will still be disorganized, and you will be feeding on-demand around the clock, but hopefully around the end of the first month, they will begin to sleep slightly longer stretches and have slightly longer waking periods, which are usually 40 to 60 minutes of awake time followed by 30 minutes to 4 hours of sleeping. They will still be sleeping the majority of the time, or about 14 to 17 hours in a 24 hour period.
So, that’s it! That wraps week two. For a transcript of this episode and a list of resources, please visit my blog, which is 40winksncs.blogspot.com. If you have any questions or comments, please reach out through my blog or on Facebook @40winksncs or Instagram @40winksnewborncare. I would love to connect!
In my next episode, week three, we will discuss infant nutrition, introducing a bottle and pacifier, and paced feeding.
As always I hope you have a wonderful week and remember to give yourself some grace because we’re all here learning together.
Resources Week 2:
Fan & SIDS risk reduction
Wake to Feed?
Infant Sleep Cycles
Infant Growth—Following the curve