First 12 Weeks: Week 4–The One Month Wellness Check and Soothing Techniques
Hello and welcome. I am Laura Ellis and this is Week 4 in my first 12 weeks series. In this episode in addition to briefly going over fact based information about infant feeding, sleep, growth, and development, I will talk about what to expect at the four week wellness check up and share some soothing techniques.
This week baby will likely still be stretching their feedings to every 2 to 4 hours around the clock or about 7 to 12 times a day. You may notice that they eat more per setting this week—perhaps up to 4 or 5 ounces each feeding, and you will likely see an increase in cluster feeding especially in the evenings around bedtime. This leads us to some good news, with baby eating more during the day and cluster feeding before bedtime, they will be more likely to start sleeping longer stretches overnight. But what does that mean? In week four during the day baby will still likely sleep for 45 minutes to 3 hours in a stretch, but at night they may begin sleeping closer to four hour stretches. They will still likely be sleeping between 14 and 17 hours in a 24 hour period this week. During their wake periods this week you may notice that they are reacting to loud noises, they’re more interested in different textures and patterns, especially black and white patterns, and they’re beginning to be a little more alert and social in their interactions.
So let’s talk about the four week check up. You might be asking yourself what exactly is the doctor going to check. To start with the doctor will do a physical exam, which will require the baby to be undressed with you present. They will check babies heart and pulses, their abdomen, hips, and they will do an eye exam. They will also check baby babies umbilical site and if baby with circumcised they will make sure that the circumcision is healing correctly. They will weigh baby measure babies length and head circumference. They will test babies newborn reflexes—including the Moro reflex, rooting reflex, grasping reflex, sucking reflex, stepping reflex, and the tonic neck reflex also known as the fencers pose. They will also check to see if baby is focusing on and tracking objects, and check to see how baby reacts to sounds, which could include turning their head, quieting down, startling, or crying. They may also check to see if baby’s head lifts during tummy time. They will also talk with you about your concerns around baby’s feeding, elimination and diapering, sleeping, and development. At this time if there were any concerns with any of the screenings when baby was born, the doctor made repeat those screenings at this wellness check. Beyond baby, the doctor may also screen the parents for postpartum mood and anxiety disorders.Lastly the doctor will give baby their one-month vaccinations. Some of you may be considering a delayed vaccination schedule or not vaccinating your baby. If you would like to learn more about the pros and cons of vaccination, I highly recommend the Facebook group “vaccine talk: an evidence-based discussion forum.“ They do a wonderful job of checking the credentials of people giving information about vaccinations, the risks, and the benefits. They allow both pro and anti-vaxx arguments, but they require citations for information given. I also recommend discussing your concerns with your doctor.
As your doctors visit concludes, you’re likely to have a very overstimulated, overtired, and grumpy baby, and you’re likely to be feeling overtired and grumpy yourself after the visit. My biggest recommendation to parents after this visit is to lean heavily into soothing techniques. Let’s start with discussing the five asses. Which are suck, sway, side position, shush, and swaddle. For sucking you might offer a pacifier a bottle, or may want to nurse baby. If you can hold baby and a side position and stand up and rock or sway baby or bounce them, that may really help sooth baby in that moment initially after the vaccinations. It might be a good idea to bring a shusher or white noise machine or play white noise on your phone immediately after your visit and on the drive home. Once you’re home either swaddle them and try to get them to sleep, or put them in a carrier and try to walk them to calm down or take a nap against you. A bath may also help baby calm down and relax and may also help if they are feeling achy or in pain. The biggest tip I can give any parent before this wellness check is to keep yourself calm. Babies take their cues from their parents and if their parents react strongly to the vaccinations or any part of the examination, baby may react more strongly because of the cues they’re getting from their parents. Whereas if parents are calm, baby will be more likely to remain calm as well. If you’re reassuring them that they are OK, then they’re more likely to calm down and return to their normal selves faster.
So that concludes our topic for this week. For a transcript of this episode and a list of resources, please visit my blog, which is 40WinksNCS.blogspot.com or you can find the link through my website 40winksnewborncare.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 five, we will discuss developmental milestones for month two and baby wearing. As always, I hope you have a wonderful week and remember to give yourself some grace because we are all here learning together.