What to Expect With a Newborn: A BC Guide to the First Weeks and How a Postpartum Doula Can Help

Bringing your newborn home is exciting, emotional and, sometimes, completely overwhelming. Even if you have spent months preparing for your baby, those first few weeks can leave you wondering:

Is this normal? Is my baby getting enough to eat? Why are they making that noise? Why aren't they sleeping? When should I call someone?

Newborns can look and behave very differently from what new parents expect. Their skin may peel, their head may look a little misshapen, they may make surprising noises and their sleep can feel completely unpredictable.

As a postpartum doula in the Lower Mainland, BC, we spend a lot of time helping families understand what is common in the early weeks, offering practical newborn care support and helping parents feel more confident.

This guide covers some of the things you can expect with a newborn and how a postpartum doula can help.

A note for new parents: This article is for general education and is not a substitute for medical advice. If you are concerned about your baby, contact your midwife, doctor, public health nurse or other healthcare provider.

Newborn, Infant, or Toddler: Understanding the Terms

What Is a Newborn?

A newborn is generally considered a baby in the first 28 days of life. You will also hear healthcare providers use terms such as infant to describe babies during their first year.

Every baby develops differently. Babies born prematurely may have different developmental expectations than babies born at term, so your healthcare provider can help you understand what is appropriate for your baby's age and circumstances.

What Does a Newborn Look Like?

Newborns do not always look like the smooth, round babies you see in advertisements.

Their appearance can change significantly during the first days and weeks.

Umbilical Cord Stump

After birth, your baby's umbilical cord is clamped and cut, leaving a small stump.

Keep the area clean and dry and allow the stump to fall off on its own. Your healthcare provider can give you specific instructions for cord care.

If you notice signs that concern you, such as increasing redness, swelling, pus or a foul smell, contact your healthcare provider.

Peeling Skin

It is very common for newborns to have dry or peeling skin, particularly during the first days after birth. It can look alarming, but it is usually temporary.

Lanugo

Some babies are born with fine, soft hair called lanugo, particularly on the shoulders, back, ears or forehead.

It is more noticeable in some babies than others and usually disappears on its own.

Head Shape and Swelling

A newborn's head can look elongated, swollen or uneven after birth.

This can happen as the baby's head moves through the birth canal, and the appearance usually changes as the swelling settles and the skull gradually returns to its usual shape.

If you are concerned about your baby's head shape or swelling, talk with your healthcare provider.

What Other Newborn Changes Are Normal?

There are many newborn characteristics that can surprise new parents.

You may notice:

• Tiny white bumps called milia

• Baby acne

• Temporary breast swelling

• Swelling of the genitals

• Vaginal discharge in baby girls

• Red patches or marks on the skin

• Sneezing

• Hiccups

• Irregular movements

• Grunting or other unusual newborn sounds

Many of these are normal parts of the newborn period, but you do not have to figure out what is normal on your own. If something concerns you reach out to your medical care provider. The Nurse Health Link 24 hours a day 8-1-1 to ask any medical questions.

How Much Do Newborns Sleep?

Newborn sleep can be unpredictable.

Your baby may sleep for a few hours and then wake to feed, or they may have much shorter stretches of sleep. Newborns do not yet have the same day-and-night rhythm as adults.

Canadian guidance notes that newborns often sleep in short periods and wake frequently. This can be one of the hardest parts of the early weeks for new parents.

Rather than expecting your newborn to follow a schedule, focus on responding to your baby's needs and learning their individual cues.

And remember: you need care and rest too.

Ask family and friends for help. Let someone else make dinner. Sleep when you can. And don't worry if the laundry is piling up.

What About Newborn Crying?

Crying is one of the main ways newborns communicate.

Your baby may cry because they are:

• Hungry

• Tired

• Cold or warm

• Uncomfortable

• Overstimulated

• Looking for physical contact

• In need of a diaper change

• Simply needing help regulating

It can take time to learn what your particular baby's cries and cues mean.

You are not expected to understand everything immediately.

Holding, talking to, singing to and responding to your baby are all ways of building connection and helping them feel safe.

Newborn Reflexes

Newborns are born with several reflexes that help them feed, move and respond to their environment.

You may notice:

Rooting: Your baby turns toward something touching their cheek.

Sucking: Your baby instinctively sucks when something touches their mouth.

Moro or startle reflex: Your baby's arms may suddenly extend and then come back toward their body.

Grasp reflex: Your baby's fingers close when something touches their palm.

These reflexes gradually change as your baby develops.

What Should I Know About Newborn Safe Sleep?

Safe sleep is one of the most important things for new parents to understand.

Canadian guidance recommends placing babies on their backs for every sleep, on a firm, flat sleep surface such as a crib, cradle or bassinet. The sleep space should be free of pillows, bumper pads, toys and loose or soft bedding.

Room-sharing, with your baby's crib, cradle or bassinet in your room, is recommended for the first six months. This is different from bed-sharing.

A postpartum doula can help you learn about newborn sleep and routines, but safe sleep recommendations should always follow current Canadian guidance.

Here is a link to a valuable updated resource with the current recommendations https://www.healthlinkbc.ca/living-well/parenting/parenting-babies-0-12-months/baby-safety/safer-sleep-my-baby

or this guide https://cms.psbchealthhub.ca/sites/default/files/2023-10/PSBC_Safer_Infant_Sleep_Practice_Resource.pdf

When Should I Contact My Healthcare Provider?

It is normal to have questions about your newborn.

You should contact your healthcare provider if something doesn't seem right or you are worried about your baby's:

• Feeding

• Breathing

• Colour

• Temperature

• Behaviour

• Umbilical cord

• Wet or dirty diapers

• Weight gain

• Skin or jaundice

• Level of alertness

If your baby is having difficulty breathing, has blue or grey colouring, is unusually difficult to wake or you believe there is an emergency, seek urgent medical care.

You do not need to wait until you are certain something is wrong before asking for help. The Nurse Health Link 24 hours a day 8-1-1 to ask any medical questions.

How Can a Postpartum Doula Help With a Newborn?

The first few weeks with a baby can feel like a huge adjustment.

A postpartum doula provides practical, emotional and informational support to the whole family.

Depending on their training and the services they offer, a postpartum doula may help with:

• Newborn care and handling

• Feeding support and information

• Soothing and settling techniques

• Understanding newborn cues and behaviour

• Basic newborn routines

• Postpartum recovery support for the parent

• Preparing simple meals

• Light household support

• Helping parents get some much-needed rest

• Reassurance during those “Is this normal?” moments

• Helping parents identify when they should contact their healthcare provider

A postpartum doula does not replace your doctor, midwife or other healthcare provider. Instead, they work alongside your healthcare team and provide the practical support that can make those early weeks feel more manageable.

You Don't Have to Know Everything

One of the biggest surprises for new parents is how much there is to learn in such a short period of time.

You are learning your baby's cues, feeding patterns, sleep patterns and personality while also recovering from birth and adjusting to being a parent.

You do not have to know everything on day one.

Ask questions.

Accept help.

Rest when you can.

And remember that learning your baby takes time.

How Birth by Bloom Can Help

At Birth by Bloom, our prenatal education includes practical information about newborn care, feeding and those first weeks at home.

We also offer postpartum doula support for families who want additional help once their baby arrives.

Whether you need help understanding newborn behaviour, someone to prepare a meal while you feed your baby, support with settling and routines or simply another experienced person in the room saying, “Yes, that is very normal,” postpartum support can make a big difference.

You don't have to navigate the newborn stage alone.