It would be wonderful if newborns came with instruction manuals. Problem is, they don’t. Your newborn nursery likely does a very good job of giving information at discharge on not-so-good things to look for and reasons to call or visit your baby’s provider. “But,” you may wonder, “what about when she (fill in the blank)? No one said anything about her doing THAT”!
While your newborn’s provider is a great source of information and you should absolutely bring up any questions, the following is a primer on some newborn behaviors that parents frequently witness.
If you felt your baby hiccupping when he was inside you, your obstetrician may have reassured you that this was a very normal finding. The same can be said of hiccups in young infants. They occur due to contraction of the diaphragm, a muscle which separates the chest cavity from the abdomen (which houses the stomach and intestines). The diaphragm becomes irritated—it’s not always apparent why, but at times, it seems to be related to feeding—and this causes the contractions.
Very, very rarely, hiccups can signify a medical problem; if they seem continuous or otherwise excessive, discuss them with your newborn’s provider. If there is any association that is seen with any frequency, it’s gastroesophageal reflux. But even babies with this issue likely have other signs.
More likely, this issue is a normal variant in your baby. While watchful waiting may be best in the majority of cases, sometimes a slow feeding, particularly on the breast, seems to help.
Sneezing (and Other Goings-On in the Respiratory System)
While many parents experience distress upon witnessing a sneezing newborn, babies seem to do just fine with it. For babies, sneezing is actually a gift from nature—an adaptive response that helps their nasal passages stay clear. And they need to stay clear, since young babies must breathe through their nose!
When a young infant breathes, it’s important to realize that the air must move through relatively small nasal passages. And those little channels can become clogged by virtually anything. It’s worth remembering that a newborn has just come from a nine-month residency in amniotic fluid; those first few sneezes may be helping to get rid of dried bits of fluid. After that, challenges to the nose come from the outside world: dust, smoke, and pollen can be culprits. Also, like the rest of us, they can normally develop mucus that needs to be cleared. Additionally, since the nose and mouth are connected, some breast milk or formula can get into the nasal passages. Since it isn’t doing any good there, sneezing is a way to eliminate it.
Could it be a cold? After a few days of life, the answer is yes. However, it the baby is comfortable and there aren’t other concerning symptoms, she’s likely doing most of what she needs to take care of it.
Small nasal passages also count for a large portion of noisy baby breathing. As concerning as those sounds can be, if a baby is feeding well, looks comfortable, and doesn’t show other signs of illness, they’re probably less worrisome. Here’s a little more on when to be concerned and when to worry less.
Dealing with a spitty infant is another difficult matter. Even for healthcare providers, it’s sometimes daunting to determine where spitting ends and a more concerning problem, such as gastroesophageal reflux disease, begins.
One thing that helps providers tell whether spitting is a benign problem or something signifying medical illness is the baby’s weight. If he’s gaining, that’s a good sign that an adequate amount of feeding is staying down. Providers will also make sure that the baby otherwise looks well, and that feeding isn’t associated with other concerning symptoms, such as green (“bilious”) vomiting or extreme fussiness during feeds.
There are some signs that worry pediatricians a little less, though they may concern parents. For example, milk coming through the nose doesn’t mean there is a bad disease. The baby’s mouth and nose are normally connected, so if there’s spitting up, some feeding may come through the nose. Also, although it’s worrisome if the baby is truly vomiting “the entire feed,” what looks like a lot is sometimes a relatively small amount. In order to get an idea of this, pediatricians will often tell a parent to spill a tablespoon of milk on a kitchen counter.
So if the spitting isn’t really a problem for the baby, is there any relief? One thing that may help is best described as “up, up and up.” In other words, feeding the baby in the upright position, keeping her up for 20 to 30 minutes, and elevating the head of the bed may decrease the symptoms.
Again, parents should feel free to consult their pediatric provider on any concerning behavior. By and large, providers have seen enough to have conditions that need more attention on their radar. But the good news is the majority of babies exhibit a variety of acceptable behaviors that will disappear over time.