Postpartum Notes: The First Three Months

The first three months after a baby’s birth can be overwhelming for some first-time parents. These months can also be full of joy and excitement as each new milestone is reached and the baby gradually turns into an individual, who might not yet be articulate and mobile but surely knows who her parents are and often rewards them with a wide, gummy smile.

Overview 

During the first six weeks, a typical baby would cry a lot, eat a little but frequently, and wet/soil her diaper almost as often. Since the baby will demand to be fed every two hours (or less), a parent’s schedule would no longer be divided into day and night. Sleep could be done in increments of one or two hours, and time in general will be meaningful only as a measure between the hours elapsed between feedings.

The mere absence of free time for the parent, however, would make the clock seem to tick extra fast. Before you know it, the first six weeks will be over, and the pace of parenthood will gradually slow. Your baby won’t be fussing so much and will begin showing interest in the world around her. By the end of the third month, she will be eating less frequently, sleeping in longer stretches, smiling, laughing, and even sighing in contented delight. The hardest period of raising a baby is at that point officially over.

Some Details

Though I do not precisely recall how my baby progressed from one month to the next, here are a few details that are worth sharing.

Crying

In the first month, a baby will often cry uncontrollably, and you might have a difficult time appeasing her. You should try all of the regular methods (feeding her, changing her diaper, swaddling her, making sure she is not cold or hot, turning the vacuum cleaner on, or making loud shushing noises). If you are lucky, you might find a method that works well for you and your baby most of the times.

When a newborn isn’t swaddled, it takes her longer to calm down, so I recommend swaddling as one of the first measures you take. However, some babies will resist swaddling even if they are not a month old yet. Mine passionately hated having his arms constrained and usually found a way to undo the swaddling very quickly. He was always very upset in the process, so I stopped trying to swaddle him after the first month.

I discovered that my baby always quieted when I offered him the breast, but I knew that this was not always the right solution, especially if I had fed him just half an hour before. So, whenever he started crying less than an hour or so after feeding, I first tried swaddling and rocking him in my arms, while shushing loudly in his ear. This routine helped only sometimes. Giving him the breast helped nearly every time.

(Note: At first I had assumed that my baby was not getting enough milk and that was why he was crying. He was, however, gaining weight steadily, so I knew that wasn’t the issue. He probably just wanted to suck for comfort.)

In the absence of other irritants, sucking will most likely quiet a baby. The downside is that frequent sucking can make a woman’s nipples so sore that she might start dreading breastfeeding. This in turn could reduce her milk supply, and her baby will not get enough nourishment. As a result, he will cry more, and the cycle will repeat.

Pacifiers are invented precisely so that a woman doesn’t have to offer her own nipple every time her baby needs to be comforted. However, current literature advises against introducing a pacifier until a baby is at least six weeks old or until she has learned how to properly latch onto the breast. Introducing a pacifier too early may cause confusion as it requires a different tongue motion from the baby, and your child may then take longer to master the proper latching technique.

Once a baby learns to use a pacifier, crying becomes less of an issue. Undoing the habit later in life, however, might present an equally difficult problem. Some parents opt to never even introduce this device. I felt the need to use it as a substitute to the nipple as I was weaning my baby off the breast. Now he has become quite depended on it, but he is far from being the only baby who uses one, so I am not too concerned about it just yet.

Feeding

If you are breastfeeding, you might want to spend extra time early on teaching your baby how to latch on properly so that she hurts you as little as possible. An inefficient eater (i.e., a baby who spends too much time on the breast because she cannot get enough milk with each suck) might eventually get tired and fall asleep during feeding (as my baby often did). Worse, however, is the pain that the mother might experience from cracked or sore nipples.

Ointments like Lanolin help nipples heal fast and are not harmful to the baby. I recommend using one during the first month of breastfeeding. After that, you should no longer need it. By that time your baby should have learned how to properly latch. If not, go to a lactation consultant for advice.

I knew everything there was to know about proper latching, but teaching my baby to do it was a different matter. He got so much comfort from sucking that he wanted to stay attached to my breast nearly all day long. For him, sucking for comfort vs. nourishment was not clearly delineated, so he typically made only feeble attempts to open his mouth big enough to latch properly.

It wasn’t until later, when I stopped giving him the breast for comfort, that he became an efficient eater all of a sudden. Finding himself limited in the amount of time he was being allowed to spend on my breast, he learned to take care of business as quickly as possible. Ironically, he became a proficient sucker just as I was trying to wean him off the breast at three months old.

(Note: If you can continue breastfeeding for longer, you should. I stopped because I wanted to start another in vitro cycle, and I needed to bring my levels of prolactin down.)

In terms of frequency of feeding, a breastfed baby should be fed on demand for at least the first couple of months. My son demanded to be fed frequently—sometimes two and a half hours after the previous session, other times only forty-five minutes later. There was no clear feeding pattern until I introduced the bottle and was able to measure and control the amount of milk he was getting.

A newborn needs very little milk since her stomach is so small. As her needs increase, your breasts will automatically begin to produce more milk. If you are worried that you have a low milk supply, be sure to use a breast pump. It helps stimulate the production of milk, and the more often you pump, the faster you’ll produce more milk. You can also try herbal supplements or tea. A week after my baby was born, I had purchased Fenugreek capsules and organic Mother’s Milk tea. Both helped increase my milk supply very quickly.

Supplementing with formula is also an option, though most breastfeeding women rarely need it. (Pumping typically solves the problem of low milk supply.) If you choose to do it, however, be warned that it takes time for a baby to get used to the bottle. You should also try not to introduce the bottle too early (before the baby is six weeks old) as, similarly to a pacifier, it can cause confusion and prevent the baby from mastering the proper technique of latching onto the breast (assuming she continues to be breastfed).

If you are planning to feed your baby with formula only, obviously you don’t need to worry about sore nipples or low milk supply. You only need to be concerned with the quality of the formula you buy and, possibly, with its cost. (It’s not cheap!)

Just as he turned three months old and fully transitioned to formula, my son wanted to be fed every three hours, and he needed at least 4 oz of formula to feel satisfied. A sort of a daily schedule began to form, though it didn’t get firmly established until a month later. By then, my baby had increased his formula intake to 6 oz per feeding but could go roughly four hours between feedings.

At his two-month check-up, when he was still breastfed, he was in the 25th percentile for weight, but as he transitioned to being bottle-fed at three months, he gained a lot of weight quickly, and at his four-month check-up he was already in the 50th-75th percentile for weight. Note that most babies experience a growth spurt at around three weeks, six weeks, and three months of age, but bottle-feeding can contribute to overfeeding even if the baby doesn’t need the extra calories. How come? Well, a baby does not need to work that hard to get milk from the nipple of a bottle, and the feeding sessions are much shorter. At two months of age, mine would take an average of forty-five minutes per breastfeeding session. A month later, as soon as we introduced the bottle, he could finish the same amount of milk in ten minutes or less.

If you are concerned that your baby is becoming overweight, your pediatrician would probably advise you not to worry about it too much at this age. In the first three months, as the brain and body of a baby continue to develop at a fast rate, you should be more concerned if you had the opposite problem, i.e., if your baby was malnourished.

If you still want to be on the cautious side and try to keep the baby’s appetite under control, consider the following: A baby needs to consume a daily average of about 2.3 oz of milk per pound of body weight. (For example, if a baby weighs 10 lbs, she should have about 23 oz of milk per day.) If your baby demands much more milk than what this rule-of-thumb suggests, and if she isn’t going through a growth spurt, chances are she might not be hungry but either bored or anxious.

So what can you do? Try to play with your child more to distract her and thus increase the time between feedings. Or try to make her feel secure by picking her up and comforting her as soon as she begins to cry. Also, if you are bottle-feeding, use a slow-dripping nipple and keep the bottle as close to horizontal as possible, while still ensuring that the nipple is filled with milk. This will slow down the feeding, and your baby’s brain will register sooner that her stomach is full.

Sleeping

In her first couple of days, a newborn will sleep a lot. She is still getting over the shock of being born and needs all the rest she can get. In the next three months, she will continue to sleep a lot, but there will be notable differences in the duration and schedule of sleep.

In the first two months, my son fell asleep either right after being fed or during feeding (since he was such an inefficient eater and took him so much time and effort to get the amount of milk he needed). He would then wake up an hour or two later, ready to be fed again. Sometimes he slept for only forty-five minutes at a time and engaged in cluster-feedings (feedings that happen close together in time). Rarely (only twice, to be precise), he slept three hours or more without interruption, and on those occasions I had to wake him up to feed him (per doctor’s advice).

When he turned three months old, my son began to stay awake for longer stretches of time during the day and started sleeping longer at night. During the day, he would typically take only 45-minute naps between feedings (and the feedings occurred at an interval of about three hours). At night, he would typically sleep three to five hours uninterruptedly in the beginning of the night and then wake up every three hours or so for the rest of the night but would fall back asleep promptly after being fed.

Playing

Don’t be surprised if your baby does not seem interested in toys. My son was largely oblivious to such distractions until he was about two months old. It was then that he finally noticed the mobile over his crib and started batting his hands against the toys hanging from his play yard arch. By three months old, he was grasping and holding these toys, but I don’t think he enjoyed the activity much. Instead of squealing with joy, he made upset noises while banging at the hanging toys. (He still hasn’t warmed up to his Fisher-Price Kick-and-Play Piano Gym.)

My son also didn’t enjoy tummy time in his first couple of months. His muscles were weak, and he tired easily. That made him cry in frustration after only a minute or so attempting to keep his head and upper chest elevated. By his third month, however, he was able to hold his upper torso up for longer periods of time and seemed to enjoy being on his tummy more than being on his back. I believe it’s because it allowed him a better view of his surroundings.

Still, my baby did not like to play much during his first three months. Though he curiously eyed and touched and bit many toys, he did not show deep enthusiasm for any. Musical toys (like Baby Einstein Take-Along Musical Toy and Fisher-Price Laugh-and-Learn Keys) kept his attention the longest. He could also be distracted by his Lamaze Freddie The Firefly, which combines various textures and colors. He loves watching TV, I have to admit, but since it isn’t equivalent to playing, as it is a passive activity, I try to restrict his TV time to a couple of minutes at a time—long enough to quiet him down if he has been fussing or crying.

Socializing

A baby will always crave attention from her parents/caregivers. They will be her preferred playmates, and she will find them more fascinating than any toy. She won’t need other social interactions at this age. Being around other kids won’t interest her, and visitors might confuse and frighten her.

On the flip side, a baby will often smile at the sight of a familiar face (e.g., that of a parent or caregiver). The ability to smile typically manifests itself for the first time at week six. (Anything approximating a smile before that is most likely a sign of gas.) Smiling will soon be followed by laughter, and the genuine delight a baby will display upon seeing a loved one can make any parent’s heart melt.