Preg Med

Pregnancy Articles

1 Month Old Baby: Developmental Milestones

Your newborn will go through a lot of vital physical, mental and motor development in the first month of his life. During this time, a lot of care and effort is required from the parents and caregivers to pave the path for a healthy development.

Vision development

Right after birth the baby’s eyesight is fuzzy, only being able to see things at a distance of eight to ten inches from him. Though he prefers human faces the most, he also likes to look at contrast colors, mainly black, and white. It is quite normal for his eyes to look crossed as his eye control skill is yet to advance [1, 2].

Hearing skills

Though the newborn’s hearing ability has not developed completely after birth, he can recognize his mother’s voice. High-pitched sounds attract him more as he finds it similar to the ones he heard in the mother’s womb[2]. The  ears of  newborns may be a little folded or out of shape after birth due to the position they were in before birth [27].

Weight

Babies born under the normal time span of 38 to 40 weeks have an average weight of 2.75 kg to 4 kg at birth. However, within the fifth and seventh day of birth they will lose a certain amount of their birth weight [3].

Newborns fed on formula milk are said to lose about 5% of their birth weight whereas breastfed babies experience 7% to 10% weight loss [2, 3]. By the second week, they should be able to return to their birth weight. In fact, during the first month they may gain about 0.15 kg to 0.30 kg every week [5].

Facial features

After birth, the baby’s face might have a puffy appearance because of the accumulation of fluids and the tedious process of delivery. This changes by the first week as the excess fluid gets away from his body [27]. Most of them even develop rashes that go away within few days as their skin takes the time to adapt to the environment.

Umbilical cord

The baby’s umbilical cord is clamped and closely cut to his body after birth in a painless manner, leaving a stump [33], that dries and falls off when the baby is between 5 and 21 days old resulting in a wound that might take some time to heal [33,34]. The stump should be cleaned using water and gauze, and the baby is to be given a sponge bath till the time it dries. Consult your doctor if the stump has not fallen by the fourth week as there may be a problem in the baby’s immune system or anatomy [34].

Reflex development

Immediately after birth the newborn goes on to develop most of the infantile reflexes like the Moro or startle reflex, the rooting reflex, where he can latch onto the mother’s breast for a feed as well as the Palmar grasp reflex [28].

Feeding

In the first few days breastfeeding babies will take about eight to fifteen feeds at an interval of two or three hours, reducing to six or eight feeds by the second week[2, 5,6]. They will let you know they are hungry by crying, being fussy, moving their head to search for your breast or turning their mouth when their cheeks are touched [2].

Properly fed babies will be less fussy and cranky, getting off to sleep the moment their stomach is full. Children depending on  mother’s milk are to be fed more compared to those taking formula milk [6]. As your milk flow increases, the number of soiled diapers gradually increases to around 6-9 [5] from 1-2 in the initial days.

Changing stool color

They have their first bowel movements on the first or second day, passing out meconium, a greenish-black, sticky substance [16] which may continue till the fourth day. There is a gradual change in stool color after four or five days, depending on their milk intake [30].

Those who only feed on mother’s milk will pass soft, mustard color stools many times a day [16]. On the other hand, babies having formula milk tend to pass stool of a bulky texture as it cannot be completely digested like breastmilk [18].Their stool color will be yellowish-brown, being smellier compared to breastfed infants [16, 18].

Sleep patterns

A newborn spends most of his time sleeping if not crying or feeding. Throughout the first month, the baby will sleep for about fifteen to eighteen hours a day divided into about eight naps [6,7]. He is unable to distinguish between day and night, resulting in reverse sleeping patterns [29]. On of the main reasons for this may be your increased activity in the daytime that rocks and lulls your baby to sleep [31,32] whereas lessened movements at night might keep him awake.

He spends most of his time in REM sleep, accompanied by excessive dreaming. This is why you may frequently spot a smile on a one-month-old baby’s face [2, 7].

Communication

The prime mode of communication for a one-month-old baby, especially in the initial weeks is crying. He will express his hunger, pain or any other needs in this way. However, if your baby keeps on crying for long, it may be because of colic, for which you should consult a doctor [8]. By the end of one month, he will begin responding to noises by getting startled or blinking his eyes.

Common health concerns

Physiological jaundice

Newborn jaundice or physiological jaundice is seen in most babies when they are two to four days of age. Their bilirubin level does not increase beyond 200µmol/L, and it is mostly harmless. This type of jaundice goes away by the tenth or fourteenth day [9, 10]. However, it is a matter of concern if it prevails even after two weeks in full-term babies and three weeks in preterm babies [10].

Fever

Fever in newborns may be a symptom more than an illness in itself or even a reaction to any vaccination [12]. If your baby’s temperature goes higher than 97°F to 100.4°F [11], consult your doctor at the earliest. It is also recommended to use a digital thermometer while checking his temperature as a mercury thermometer has the risk of breaking and poisoning [12].

Stuffy nose

Kids below two years of age are not adept in blowing or sniffing their nose. Neither can they inhale through their mouth when their nasal passages are congested, thus resulting in a stuffy nose. It may even occur because of an allergic reaction, infection or cold that they tend to catch in their initial weeks because of their weak immune system. A blocked nose will make the little ones fussy, preventing them from sleeping well. It is advisable to seek assistance from a doctor to relieve them from this discomfort [13, 14].

 Constipation

It is believed that infants feeding on powdered milk are more prone to constipation because of the protein content in it. Dehydration is also another cause of hard stool [17].

Certain inborn diseases like hypothyroidism, botulism, metabolic disorder and Hirschsprung€™s disease [17] can be a cause of constipation. Give your baby more water or try a different brand of formula milk after consulting with your health care provider. You can also use a glycerin suppository after seeking the doctor€™s advice [19].

Diarrhea

A baby between the first and fourth week of his life may have diarrhea because of an intestinal infection, food allergies or reaction to certain medicines. Consult your doctor whenever you see the first signs of loose motion in your month-old baby. There have been a lot of controversies over the mother’s diet affecting her child while nursing. However, she should still maintain a healthy diet, reducing intake of coffee, herbal teas, and fatty or junk foodsto keep her baby healthy [20,21].

Vaccinations

Hepatitis B: The first dose of hepatitis B vaccine should be given before being discharged from the hospital. Moreover, if the mother has HBsAg (Hepatitis B surface antigen) then along with the hepatitis B vaccine, the child must also be given hepatitis B immune globulin within a span of twelve hours after birth [22, 23].

Polio: The pediatrician will give a dose of polio orally at the hospital or in the first week’s visit [24].

BCG (Bacillus Calmette Guerin): This should be given at the first week before the baby is discharged, to prevent tuberculosis [24, 25].