In this episode of The Care Circle by Motherhood Hospitals, host Sahiba is joined by Dr. Prathap Chandra, Senior Paediatrician and Neonatologist at Motherhood Hospitals, Indiranagar, to simplify newborn care for new parents.

The conversation begins by addressing the emotional reality of childbirth, where along with the baby, a new set of questions and uncertainties are born for parents. He explains that newborn care often feels overwhelming not because it is complicated, but because everything is unfamiliar and carries a sense of urgency.

The episode walks through what happens immediately after birth, including essential medical checks, vaccinations, and the importance of early breastfeeding and bonding. It then explores newborn screenings such as hearing tests, pulse oximetry, jaundice monitoring, and blood tests, highlighting how these help detect potential concerns early while reassuring parents.
As families transition home, the discussion focuses on the importance of follow up visits, where doctors monitor weight, feeding, and overall development, while also addressing the many questions parents may have. Dr. Prathap emphasises that initial weight loss is normal, but tracking it is key to identifying any underlying issues.

A significant portion of the episode is dedicated to decoding common newborn behaviours such as sneezing, hiccups, spit ups, crying, rashes, and bowel movements. These are often misunderstood and can cause unnecessary worry, but are largely normal in the early days.
Breastfeeding is explored in depth, covering latching, milk supply, feeding cues, and common challenges. The episode highlights that while breastfeeding is natural, it requires patience, support, and time for both mother and baby to adapt.

The conversation also addresses sleep patterns, explaining that newborns sleep extensively but without a fixed rhythm initially, and offers guidance on creating a safe sleep environment.
Practical care topics such as umbilical cord care, hygiene, safe travel, feeding practices, and common myths are also discussed. He debunks misconceptions around sunlight for jaundice, water intake, and reasons for crying, helping parents differentiate between normal behaviour and signs that need medical attention.

Ultimately, the episode reassures parents that newborn care is not about doing everything perfectly, but about understanding what matters, letting go of unnecessary worry, and building confidence one day at a time.

Key Takeaways. Here are the key points you shouldn’t miss from this episode:

• Newborn care feels difficult not because it is complex, but because everything is new and suddenly feels important.
• The first few days after birth can feel overwhelming, but simplifying what truly matters helps reduce anxiety.
• Immediate newborn care includes essential steps like examination, early feeding, vaccinations, and bonding with the mother.
• Early screenings such as hearing tests, pulse oximetry, jaundice checks, and newborn blood tests help detect issues early and provide reassurance.
• Follow up visits are crucial to monitor weight, feeding, and address parental concerns in a calm, guided environment.
• It is normal for newborns to lose weight initially, but excessive weight loss may indicate feeding or health issues.
• Common newborn behaviours like sneezing, hiccups, spit ups, and irregular bowel movements are usually normal and often misunderstood.
• Crying is the baby’s primary way of communication and can indicate multiple needs beyond hunger.
• Breastfeeding is natural but can come with challenges; proper latching, patience, and support are key in the early days.
• Feeding should be guided by the baby’s cues rather than a strict schedule to ensure comfort and adequate nutrition.
• Signs of adequate feeding include good sleep, regular urination, weight gain, and calm behaviour after feeds.
• Newborn sleep patterns are irregular, with babies sleeping up to 20 hours initially and gradually developing a rhythm over time.
• A safe sleep environment includes a firm mattress, minimal noise and light, and avoiding co-sleeping to reduce risks.
• Umbilical cord care requires keeping the area clean, dry, and untouched until it naturally falls off.
• Hygiene is critical as newborns have developing immunity and are more vulnerable to infections.
• Breast milk alone is sufficient for hydration, even in hot weather; additional water is not required.
• Many common beliefs such as sunlight curing jaundice or crying always meaning hunger are myths and should be approached with medical guidance.
• Parenting in the newborn phase is about understanding, not perfection, and building confidence over time.

Dr. Prathap Chandra, Consultant – Paediatrician and Neonatologist, Motherhood Hospitals, Indiranagar, Bangalore

0:16 – Opening: The emotional reality of newborn care and why it feels overwhelming
0:58 – Introduction: Welcome to The Care Circle and start of Season 2
1:27 – Guest introduction: Dr. Prathap Chandra and his expertise
2:24 – First moments after birth: What happens immediately and what parents should know
4:07 – Newborn screenings: Essential tests and why they matter
6:10 – Transition home: Importance of follow up visits and parental guidance
8:06 – Weight loss: What is normal and when to be concerned
9:17 – Common behaviours: Sneezing, hiccups, and spit ups explained
11:37 – Crying: Understanding communication and different causes
14:44 – Skin concerns: Rashes and newborn skin changes
16:22 – Bowel movements: What is normal in the first few weeks
18:02 – Breastfeeding basics: Latching, milk supply, and early challenges
20:42 – Latching issues: Solutions and support systems
23:01 – Adequate feeding: Signs the baby is getting enough milk
24:20 – Feeding twins: Managing breastfeeding with multiple babies
25:45 – Feeding frequency: Following baby cues vs schedules
27:52 – Poor feeding: When to be concerned
29:22 – Sleep during feeds: Is it normal and what to do
33:01 – Sleep patterns: How newborn sleep evolves
34:23 – Safe sleep setup: Environment and co-sleeping risks
35:53 – Umbilical cord care: Dos and don’ts
37:46 – Hygiene: Importance in newborn care
43:23 – Myths: Mattress, water intake, crying, jaundice, and breathing
46:18 – FAQs: Temperature, outings, massage, toys, and travel
51:13 – Closing: Final thoughts and reassurance for parents

(0:05) Sahiba: The moment a baby is born, something else is born with it. Questions: Is it normal? Am I doing this right? Why didn’t anyone tell me this before? Because the truth is, newborn care isn’t difficult; it’s complicated. It’s difficult because everything is new and everything suddenly feels important. From feeding and sleep to the smallest behaviours that can feel unfamiliar or even worrying, those first few days can quickly become overwhelming. So today, instead of adding more information, we are simplifying it. What actually matters in newborn care? What is completely normal but often misunderstood? And what do parents tend to overthink? Welcome to the Care Circle, a podcast series by Motherhood Hospitals, your trusted space for expert-led, real conversations on everyday health. 

With 20 episodes behind us, Season 1 has been a journey of shared questions, honest conversations and everyday clarity. And as we continue that journey, we begin Season 2 by returning to one of the very first and most defining phases of care.

 I am your host, Sahiba, and in this first episode, we are decoding newborn care. From the delivery room to your daily routine at home. Joining us is someone who works closely with newborns and parents during these exact moments.

 Dr. Pratap Chandra, Senior Paediatrician and Neutrologist at Motherhood Hospitals, Indranagar. With over 20 years of experience in newborn and child care, he has extensive expertise in managing newborn health, neonatal intensive care and guiding parents through those critical early days with confidence. 

Sahiba: So, doctor, let’s begin with those first few minutes after a baby is born. Parents often don’t fully know what’s happening in that moment. So, what are those key things they should be aware of, doctor?

(2:00) Dr. Prathap Chandra: Yeah, rightly said, it’s about the unknown factors. We always say this: whenever a newborn baby is born, there is a new mother, and there’s a new father also born. So, there’s a lot to learn, and then there’s a lot of myths associated with the baby care. Firstly, to say a baby who’s going to be born either by caesarean section or by a normal vaginal delivery, that obviously the call will be taken by parents along with the discussion with the gynaecologist. So, rest assured, during the time of delivery, the neonatologist and the team of nurses will be there to receive the baby. We ensure that the baby is dried and then put the new clothes on. Then we make sure that the baby is examined from the head to toe, making sure that all the organs are in good shape and performing really well. Ensure that we give some vaccination, which is absolutely essential at the time of birth. And then another important vitamin that we give to all the babies is the vitamin K that will also be administered. So, once we do all this, we always make it an important aspect that a baby is reunited with the mother so that, you know, the first feeding can be initiated as early as possible. And then on, I think, you know, we will allow the baby and the mother to settle in and then have a little bonding time. Then the rest of things unfold after that.

(3:31) Sahiba: I think that’s quite reassuring for the new mother and the new fathers to know, doctor. So, doctor, soon after birth, parents start hearing about multiple checks and procedures. So, could you walk us through the essential screenings and tests that are done for the newborns and why they matter so much?

(3:47) Dr. Prathap Chandra: Absolutely. It’s a great question because anything that is revolving around screening, whether it’s an investigation or whether it’s the test that we do on the babies, comes with a lot of anxiety amongst the parents. So, some of the important screening that we do are, firstly, as I mentioned earlier, the head-to-toe examination just to make sure everything is okay with the baby. We check the baby’s heart condition by a method called pulse oximetry, where we check the saturations of the babies in their right hand and also in the foot to make sure that the heart is functioning well. Then the other screening tool that we use is the hearing test. We want to ensure that the baby’s hearing is, you know, up to speed because this is one area where it is very difficult for us to understand whether the baby has got good hearing or not unless we do this test. The blood test, when people mention it, is mostly about the newborn screening because a lot of babies can be born with underacting thyroid, and it’s nowhere that you can pick up unless you do the blood test. Similarly, there are some other common investigations with regards to the blood, for example, to understand what is the blood group of the baby. And almost all babies who are born end up having jaundice. So, we also ensure that the jaundice levels are not too high and if it is so, then we ensure the treatment happens at the same time. So, likewise, there are screening tools which is devised so that any issues that we think are commonly associated in the newborn period can be picked up as soon as possible. And if there are issues, then we are there to treat that issues from the beginning itself. So, as much as it creates anxiety, it also reassures us when the tests are normal.

(5:38) Sahiba: Understood, doctor. So, doctor, once families go home, the journey continues in a very different way. Follow-up visits are usually advised by the doctors. So, doctor, I wanted to understand that why are these visits so important and what you typically monitor in these visits?

(5:55) Dr. Prathap Chandra: Yeah. So, when the babies go home, I think a lot of parents tell me this that they feel like fish out of water. There are a lot of things that are surrounding the baby’s care, the skin care of the baby, the hygiene of the babies. So, there is a lot of people around giving a huge amount of information to this newborn baby’s parents. And it is given in good faith, but a lot of them can be confusing and, you know, there could be misinformation. So, parents feel a little bit lost just after going home. So, I always advise them to write down the things that they’re worried about and then they are having doubts about so that when they come after two or three days in the clinic, it is a very calm atmosphere so that they can actually discuss these issues that is bothering them. Also important that babies lose weight after the birth and we check that weight once they come back to the clinic, ensuring that the weight loss is not too much. And a very important aspect is the breastfeeding. So, although they would be knowing about how to do the breastfeeding and all that, but when they’re out of the hospital circumstances and they’re at home, there will be a lot of doubts and sometimes mothers might not be getting enough milk, sometimes they’re getting a lot of milk, sometimes there’s an issue with the latching. All these things can be discussed when they come for the outpatient visits.

(7:23) Sahiba: I think, Doctor. I love the advice of jotting down all the queries so that they remember what they have to ask when they meet you.

(7:27) Dr. Prathap Chandra: Absolutely, because there’s a lot of things going around, you know, surrounding the baby’s birth and, you know, a lot of anxiety. It is important that they don’t forget things.

(7:36) Sahiba: Dr. you also mentioned about the baby losing weight in the initial days. So, how normal is the weight loss in the kids and when the parents should be worried about it?

(7:46) Dr. Prathap Chandra: Right. So, almost all babies lose weight after the birth and it takes up to 10 to 12 days for them to reach, come back to the birth weight. What we are trying to check here is to understand that the weight loss is not too much. 8 to 10 percent of weight loss is allowed. Beyond that, usually babies end up having some issues like dehydration or if they’re having jaundice and the jaundice levels might go up just because of the dehydration and the weight loss. It also gives us an opportunity to understand whether it’s the milk issue, whether mother is not secreting enough milk or if the baby is actually not latching well and not taking the feeds well or it’s a combination of both. So, that’s why weight becomes a very important tool for us to understand and that parameter helps us to reassure parents or in some cases if we have found a problem, we will have to address at that point in time.

(8:44) Sahiba: Moving on, once the baby is home, parents start noticing a lot of small things that can feel unusual. So, let’s go through some common newborn behaviours that tend to worry parents.

 For instance, newborns tend to sneeze quite often. Should this be seen as a concern or it is usually harmless?

(9:02) Dr. Prathap Chandra: Sneezing is quite harmless and it is one of the defence mechanisms for the babies. If they encounter any dirt or something irritating their nose, it’s the natural defence for the babies to sneeze. So, you should not think that there is any allergy or anything like that. So, sneezing is absolutely normal in the newborn period.

(9:19) Sahiba: The other point is, doctor, hiccups are something which parents notice frequently. So, what about them? Is it normal for newborns?

(9:30) Dr. Prathap Chandra: Yes, absolutely normal and there’s a quite interesting story around this. When I ask the grandparents especially, why do you think the baby is having hiccups? They say that the stomach is getting bigger and it’s growing. So, in a way, it is also true that when a baby is being fed, the tummy gets distended and usually the stomach and the diaphragm muscle are very close to each other during the newborn period and it can actually quite irritate that diaphragm and that can cause the hiccups. So, grandmother saying that the stomach is getting bigger, there is a truth in that.

(10:04) Sahiba: That’s really interesting to know. 

So, babies also tend to spit up milk. How can parents tell the difference between normal spit up and something that needs attention?

(10:17) Dr. Prathap Chandra: Again here, spit up is quite normal and they can do a small amount of spit ups. We also call that as posits and vomiting is something where they throw up a large amount of milk and then they keep throwing that every time. So, with the spit ups, usually they don’t have associated weight loss. However, in terms of vomiting, they usually tend to lose weight because almost all the milk keeps coming out and spit ups are physiological. Sometimes when you’re burping the baby, they bring the up and during this stage, they tend to bring a small amount of milk up a little bit. So, it’s absolutely normal. What we have to identify here is whether this is actually the spit ups of the posits or it’s the vomiting because on contrary to the spit ups, vomiting can be associated with other conditions where we need to find out and make a diagnosis.

(11:09) Sahiba: Understood. Next question is doctor, very major concern which all the mothers and the fathers have is crying. So, they are always concerned that the baby keeps crying a lot or not crying or is it enough crying. So, how much crying is actually considered normal?

(11:20) Dr. Prathap Chandra: Okay. So, here again, we should understand newborn babies don’t talk. One of the ways that they communicate or the only way that they can communicate is by crying. So, crying is absolutely normal in the newborn babies and some of the reasons why they cry obviously is for milk. Okay. So, there’s a myth that every time a baby cries, it’s only for the milk and then they keep feeding the baby, you know, even half an hourly and then that can again cause discomfort for the baby and not to mention here, you know, mother is involved and imagine the condition of the mother, you know, feeding half an hour hourly that can be quite distressing for the entire family and obviously, nobody would like to hear a distressing cry from a, you know, baby. It just unsettles the entire family. Some of the common reasons why they tend to do especially in seasons like summer and all that because it’s too hot. They don’t like it and the tendency especially in Indian circumstances is to keep the entire room and the entire house really, really warm. We should move away from that and then try and see, maintain a temperature of about 25 degrees at home and make sure that there’s a cross ventilation that is going on and that temperature baby is usually comfortable. The other reasons why they cry is if it’s too cold, if you put the AC on and if it’s not comfortable for the baby, for example, then sometimes the wind is stuck and they tend to arch their back and then give a shrill cry. So, this is a little bit of a painful cry. So, you should be able to, you know, as we go along, you should be able to differentiate these sort of different cries because mothers definitely have got natural instincts in that. Then if it’s just a wet nappy, dirty nappy, that itself is, you know, uncomfortable for the babies and then they cry. Sometimes if we have not washed or cleaned the nappy area quickly, that would have resulted in some rash. Okay, nappy rash can be very painful. So, again, it’s important for us to understand there are various other reasons that the babies cry and they are normal as well and that is their way of communicating to the parents of something that they want and seek their attention. However, there’s something else called the incessant cry where the cry doesn’t stop at all for, you know, a long periods of time, like even hours together. So, that needs to be looked at because sometimes there is a reason that the baby might be in distress, whether there’s an infection. Infection can go from top to bottom basically, even the ear infection, even the tummy disturbance, all of this can result in incessant cry. So, it is always worth getting the babies checked if there is an incessant cry. Otherwise, majority of the things what I discussed, we should be able to start out if we have a knowledge about those things.

(14:10) Sahiba: Definitely, doctor. 

Next point is, doctor, parents often notice small rashes, especially on the cheeks. Are these common in newborns?

(14:21) Dr. Prathap Chandra: Yes, absolutely common. A lot of them could be just heat rashes and again, the reason could be the room is really, really hot and we, you know, snuggle the baby quite wet and then, you know, we wrap them around, swaddle sometimes. So, all this causes the heat doesn’t escape from the skin and then the glands can get blocked and this can actually cause the rashes. Some other reasons are basically where mother is breastfeeding the baby and then the mother’s skin is in contact with the baby’s skin and then they develop moisture and once the moisture is, you know, settling down, that again causes the rash. So, it’s very common for them to have it. Just make sure that you clean the area, dab the area. You can use a baby cream or a moisturiser in between. As the babies age, you know, few months, three, four months of age, their skin matures and these problems will stop. There are some other conditions where the rash may need attention. You can get a neonatal acne. You can have what is called a seborrheic dermatitis or the cradle cap where, you know, that needs a little bit of treatment and looked after. So, whenever the babies come for the visits, it’s important for you to discuss these things with your paediatrician so that, you know, we reassure you if there is no treatment is required.

(15:39) Sahiba: So, we should not avoid any kind of small rash also because it can turn on to something serious ? 

(15:45) Dr. Prathap Chandra: I wouldn’t put it that way. Majority of the rashes are quite benign. There are some rashes where it needs attention.

(15:52) Sahiba: Understood. Moving on to the bowel movements that can vary a lot. So, what does a normal poop pattern really looks like in the first few weeks?

(15:58) Dr. Prathap Chandra: Yeah, this is very disturbing for the parents because they would not have expected a baby to be pooping after every feed and a lot of times they think whatever the baby is feeding, it’s coming out. It’s actually not right. So, babies can, you know, pass motion about eight to ten, twelve times per day or some babies can pass motion once in eight to ten days. So, there’s a huge variation because we are seven to eight billion population. So, I think not everybody will be the same and same with the babies. Not every baby is the same. More and more if mother is giving breastfeeding to the baby, their poop is going to be usually, you know, a little bit watery, small amounts, little white spots in there. People do mistake this as loose motions and this is one of the reasons why they come also for concentration thinking that it’s loose motion. So, it is not. So, this is how the breast milk stools are. However, if for some reason mom’s milk is less and they are using more of formula feed, they tend to have a bit more, you know, harder or formed stools compared to the breast milk stools. So, there is quite a lot of variations that is there and all of these are within the normal limits. If, however, the motion is very, very watery and, you know, the babies are really struggling with it and crying with it and if there is any blood that is seen in the stools, that is more concerning and that needs immediate attention.

(17:25) Sahiba: Understood, doctor. So, initially, doctor, you mentioned about breastfeeding and how it is like a major concern for the new mothers and it’s like a blank slate, like they don’t know anything about it. It’s a completely new topic for them. So, let’s dig deep into it, doctor, now. So, to start with the basics, how can mothers ensure that the baby is latching properly during the feeds?

(17:47) Dr. Prathap Chandra: Right. So, as much as we say it is a concern about the breastfeeding, it’s a natural thing. So, majority of the mothers will take it as if a fish to the water. So, there’s no issue in a lot of mothers and so much so that there is not an issue in the animal field also. Right. So, it is a natural process. However, I think there’s a lot of anxiety that comes with it. A mother would have had a caesarean section, she’s got a lot of pain, you know, the milk takes a little bit of time to come. So, during these times, the anxiety will be there. So, how do you know that her milk is coming enough? Usually, by about four day onwards, four to about eight, nine days, the milk starts secreting in a good large amount. Before that is a very important component of the milk called the colostrum is secreted from the first day itself. Colostrum is very rich in energy, its quantity is small, but qualitatively it is very superior. It’s got all the immunoglobulins, it’s got lactoferrins. So, these are the ones which will protect the newborn from getting the infection. And the first time when they take the breastfeed, the babies will colonise with the mother’s natural, you know, flora, which is friendly bacteria. Therefore, that again prevents the baby from acquiring any bad infections to start with. As we go along, she will start feeling heaviness in the breast. This is one of the ways to suggest that okay, she started getting more milk. This will be followed by leaking of milk as well. So, that is very reassuring. And I would say if a mother is experiencing these two, then I would say I think she’s got enough milk. There’s another way where if she’s secreting too much of milk, and the baby is not feeding that much, she can also end up having engorgement, and then pain, and then she can have some fever with it. So, it is paramount for us to examine her breast, make sure that she’s, you know, absolutely fine in that sense. And that, you know, the baby is actually trying to latch properly, and then the feeding is all going in in quite a tandem. So, there should be like a friendship that should be established between the baby and the mother as soon as possible. And I would suggest usually, they take around a week to 10 days to become best friends in the world.

(20:07) Sahiba: Loved how you put that, doctor. So, doctor, my next question is, if latching doesn’t go as expected in the beginning, what can parents do to improve it?

(20:20) Dr. Prathap Chandra: Yeah, I think some of the reasons why that happened would be if a mother has got a large nipple, or if she’s got a flat nipple, or if it’s inverted nipple. I think these are the things that we would have identified when we do the lactation counselling on day two of after the baby is born. Because the first day, usually mothers are, you know, really in pain, and come out of the anaesthesia, and all that stuff. So, their understanding is slightly less. So, on the second day, we do all these things. Whenever they have these issues, we should be able to address them. For example, if there’s a flat or an inverted nipple, we can always give them a nipple shield. A nipple shield will act like an artificial nipple, and then the babies are able to latch onto that much better. And we suggest them how to improve that condition. We have nipple pullers, where they can use that, which is like a vacuum created, and then they pull the nipple and hold it for a few seconds, few times just before every feed. And by doing this over a period of time, within a couple of weeks, if they’ve done it well, then the nipple would correct in majority of the cases. And then they can start direct breastfeeding without using the nipple shield. In the meantime, she’s got a lot of milk, and then baby is not able to latch. We also have the breast pumps. You know, the mothers can buy the breast pump, and then, you know, with the help of the breast pump, express the milk, and give the same milk by ways of palata, or the cup feeding. We discourage them to use bottle feed, because the babies develop what is called as nipple confusion, and they tend to prefer more of bottle than the breastfeeding. So, these are some of the things that we will explain to the parents or the mothers when they come out for the, you know, the follow-up clinics. And this is one way of easing them out, you know, into the feeding. And we have breastfeeding, or the lactation consultants, and the lactation specialist nurses, who can actually supervise them while they’re feeding, and then correct their techniques in some cases, if it is required.

(22:21) Sahiba: Another biggest concern parents have is whether the baby is getting enough milk or not. So, what signs they should look for, doctor?

(22:26) Dr. Prathap Chandra: Right. Firstly, from the mother’s perspective, the breast will be feeling heavier, and then, you know, she’s got some leaking of milk as well. So, that is reassuring to say that, you know, mothers have got good amount of milk. If the baby is feeding well or not, how do you know baby latches on really well, and make sure that, you know, empties the breast on one side, and then goes on to the next side of the breast, and then calmly finishes whatever the baby wants, and then he or she will let go of the feeding. They should sleep really well after the feeding is done, and they should not be waking up every half an hour for feed, you know. So, once they are full, they usually go without feed for about two to three, or even three and a half to four hours also. So, what is called as the demand feeding. Another sure way of knowing is whether the baby is passing motion, whether the baby is having regular urination, and finally, when they come for the visits to the doctors and the outpatients, we keep checking the weight. So, you know, gaining weight is one of the surest way to, and objective way of saying that the baby is getting enough milk.

(23:33) Sahiba: Another question that is popping up because of this question is, doctor, one of my best friends recently delivered twins.

(23:37) Dr. Prathap Chandra: Wow, congratulations.

(23:40) Sahiba: Thank you so much. So, how does the twin part play a role over here in breastfeeding?

(23:42) Dr. Prathap Chandra: Yeah, I think looking after one baby is hard. Imagine looking after twins. It is twice as hard. And here, the whole family has to play a part because, you know, it is quite overwhelming for the mother. Imagine if a baby is going to be breastfeeding two hourly or three hourly, but it’s two babies, then you’re looking at almost, you know, 24 feeds in a day. So, it is quite overwhelming. So, what we should reassure mother is, generally, if the breastfeeding is going on well, and she is healthy, she’s taking good amount of, you know, balanced diet, and her hydration is kept well, there are a lot of mothers with twins or even triplets been able to, you know, successfully breastfeed both the babies. There’s famous octuplets who were born in the US a few years ago, and we saw in the newspapers that she was able to breastfeed all eight babies. So, I know there is, you know, people take it for granted. It’s not easy. There is a lot of discomfort that comes with it. And I think in here, I would, you know, openly say, mother needs quite a lot of looking after and a lot of help so that she can actually, you know, nurture the newborn babies.

(24:56) Sahiba: Love how you put it up, doctor. So, my next question is, when it comes to feeding frequency, should parents follow a schedule or go as per the baby’s cues?

(25:09) Dr. Prathap Chandra: Yeah, I think following the baby’s cues is very important because in that way, you’re basically making sure that you’re allowing the baby to ask for the milk. Okay, there are good amount of feeding cues that the babies give, like looking for the milk, you know, lip smacking that they do, and then they keep taking their hands to the mouth, and then they have this cycling moments of both hands and the legs. These are called the feeding cues. This is when we need to understand that the baby is hungry, and then if you start feeding, everything will be happy and hunky-dory. However, if you miss the feeding cues, even for about a minute or two, and the baby is frustrated, and they start crying heavily and vigorously, that is when they struggle to even latch. So, that causes a lot of anxiety. So, understanding the cues and making sure that you’re ready for that. I always suggest mothers to just be relaxed during that time, and then have water and juices of things that she wants, you know, everything handy, and there should be some help whenever she shouts for any help, you know, to be around. By doing this, I think it can be very peaceful. And if the mother starts getting used to the baby, and the baby starts getting used to mom, usually it falls into a small pattern of, you know, the timing, you know, roughly around two to three hours. And as they grow a little bit older, it can become three to four hours also. This is also to do with the sizes of their stomach. The stomach size is very, very small to start with, you know, as a marble size. Therefore, the quantity required is not that much. And that’s why the useful here, where the quantity is less, but the quality is unbelievably good. Right? So, as they go to first week, the stomach size increases, second, third and fourth week, they will reach the size of an egg. So, by two to three weeks, they should be consuming anywhere around 60 to 100 ml. And beyond that, anywhere between 80 to 150 ml

(27:10) Sahiba: On the other hand, doctor, if the baby seems to be refusing feeds or feeding very poorly, when should parents start getting concerned?

(27:15) Dr. Prathap Chandra: Yeah, this is a very important question, because the dictum of nature is that every baby should be just feeding and feeding on demand. We should understand why is this baby not feeding. Sometimes it’s the poor understanding of the parents, you know, that the baby might not be hungry. So, we would have told them that the babies might need two hourly feed, but your baby would have taken good amount of feed and sleeping till three, three and a half, four hours. That is still not normal. So, to understand that we need to have the other parameters where is the baby passing urine okay, is the baby gaining weight, and baby is looking well, pink, and all that stuff. So, if on the contrary, the baby is very dull, very lethargic, and unable to latch, you know, has got other things like, you know, breathing issues. There are some babies who are born with, unfortunately, syndromes, like for example, Down syndrome, Patow syndrome, things like that, where feeding is difficult. Sometimes these babies are born with low birth weight, and in these conditions, along with babies who are born little early, like prematurity. So, in these conditions, again, we have to say, okay, the babies need a little bit more time for them to do this. So, we have to reassure them, we have to teach them the alternative ways of feeding, especially expressing the milk and giving the pallet of eggs. Beyond this, everything else, if the baby is not doing, then it should be checked by the paediatrician.

(28:36) Sahiba: Understood, doctor. Many newborns tend to sleep through feeds. Should parent wake them up or let them sleep?

(28:41) Dr. Prathap Chandra: Very interesting question. A lot of mothers ask this. Natural way of feeding for a newborn baby is latch on, and then feed five, six sucks at one go, and then after that, they just want to relish that milk, right? They want to, you know, have the taste, and therefore, they stop, and then they, you know, swallow the milk, and then they will take another few seconds, and then they start doing it in the same cycle repeats. So, it is very natural for them to do that. And breast, as we say, is the most comfortable place for anything, right? And therefore, because of the comfort that the baby is getting, and the warmth, and then the bonding, and then the love, that is what also makes them a bit more sleepy. So, generally, that’s why we say they don’t feed just in five minutes. They take up to 30 to 40 minutes to feed. And even for us, if you are eating, you cannot just be eating constantly. We also, you know, eat and then relish a little bit, watch a little bit of TV, talk to friends, and then eat again. You know, this is quite common, and it’s quite natural. So, what the babies are doing is not abnormal.

(29:47) Sahiba: Right, definitely. And from the mother’s perspective as well, doctor, how can she tell if a milk supply is adequate?

(30:00) Dr. Prathap Chandra: I think we discussed this a little bit earlier. Her breast will be feeling heavy. This generally tends to happen by four day onwards, and then leaking of milk. What we call as once the baby starts latching and starts sucking, she will feel the flow of milk. And this is called let down reflex. So, all these things, she can see that, and then she will be reassured that the milk is there. Also, when the baby is feeding, little bit of milk keeps, you know, coming out of the baby’s mouth, that she needs to, you know, look at, observe. All these things you have to do in the first few days of life. Once they are confident, it is like driving the car after that. You don’t be looking at the gears and the, you know, the clutches and all that.

(30:35) Sahiba: Right. And are there any specific dietary habits that can support better milk production?

(30:40) Dr. Prathap Chandra: Yes. First and foremost, I would say hydration. Mother’s hydration should be really adequate. Secondly, balanced diet. A lot of people and a lot of customs and, you know, traditions are surrounding the childbirth is quite heavy in India. So, we need to ensure that a balanced diet is given to the mother and not a restricted diet. Third one is there are a lot of food material which are called galactagogues, which will help in secreting more and more milk. A few examples are fenugreek or the methi seeds and the methi leaves. Then you have dill, green leafy vegetable. Then you have almonds. Then you have garlic, not too much of garlic, one or two slices of garlic per day. Barley water. All these things will help. Sometimes we say taking a little bit extra protein in terms of they’re eating non-veg chicken. All in moderation. Eggs. These are all in moderation. If you take too much of that, that might actually cause tummy upset to the baby and then they will not have a good sleep after that. So, these are the ways to improve the mother’s milk. But the best way to be is feeding. If she keeps feeding, her brain will understand that there is a demand. So, how much ever there is a demand, the supply will come in. Because of two very important hormones called prolactin and oxytocin. That will help in increasing the milk production.

(32:05) Sahiba: Mothers can make a diet plan for their adequate milk supply.

(32:10) Dr. Prathap Chandra: Absolutely.

(32:10) Sahiba: Now, doctor, we have heard that sleep patterns are another big area of confusion for parents. So, what does a typical sleep pattern look like for a new born in the first few weeks?

(32:21) Dr. Prathap Chandra: Right. Usually, the babies after their birth, they tend to sleep quite a lot. I even jokingly say that they’re very boring to start with. All they do is just feed and then they sleep. They can sleep up to about 20 hours after the birth for the first, you know, one or two weeks of life. And this, they start developing more awareness. The sleep duration starts reducing to about 16 hours and then to about 12 to 14 hours by one month of age. And they will settle down thereafter to about 12 hours, but never as a complete constant sleep. So, they might sleep for about six to eight hours at one go. Then they’ll sleep in the afternoon time, they’ll sleep in the evening time. So, they don’t have this circadian rhythm that is established. It takes around two and a half to three months for them to develop the circadian rhythm to understand what is day and what is night. So, it’s very important, therefore, mothers sleep when the baby is sleeping and take rest. And when the baby is awake, then she is also fresh.

(33:24) Sahiba: I wish I was a baby. I can sleep for 20 hours .

(33:28) Sahiba: And doctor, what kind of sleep environment or setup is considered safest for the babies?

(33:36) Dr. Prathap Chandra: Right. For any one of us to sleep, it should be quiet. Same with the babies, not too much of noise, not too much of lighting. You can have a small zero candle bulb, for example, so that, you know, in the night, if you have to walk around and things, you don’t sleep on things. Always I suggest baby not to be sleeping or co-sleeping with the mothers. This can be quite harmful because mothers in the first couple of weeks, at least, they’re very drowsy. They’re very tired and their hormones, hormonal imbalances will be there. And while sleeping and then the feeding also at the same point in time, the oxytocin hormone that releases will relax them. And because it’s also called as a love hormone, for example. So, during these times, there is a small chance that they lay over on the baby and that can be really detrimental for the babies. A lot of cot deaths have been reported because of that. So, co-sleeping is what we kind of discourage. They can have a cradle appropriate for your baby next to the bed, take the baby, feed the baby and burp and all that and put the baby back in the cradle. This is a great practise so that I think it gives a lot of relief for the mothers also. And they’re not in anxiety all through the sleep, whether they’re going to harm the baby or not.

(34:48) Sahiba: Never thought it that way, doctor. We always thought the other way around that co-sleeping with parents is helpful.

 Moving on doctor, there are also a few specific care practises parents worry about, specifically like cot care. So, what are the basics of taking care of an umbilical cord at home?

(35:02) Dr. Prathap Chandra: Right. A lot of consultation to me happens because of the anxiety around the cord. So, the umbilical cord is the bridge between the mother and the baby. That’s how through which she would have given all the nutrition to the baby when the baby is in her tummy. So, once the umbilical cord is cut, it’s natural that the umbilical cord will dry on its own and it takes a few days, usually between one and the second week that they become completely dry and fall. Important thing is not to put powder or oil on that, not to meddle with it. Just let it be. Keep the umbilical cord outside the nappy area so that it doesn’t keep getting contaminated with the urine or the motion. When the cord falls off, a lot of people get scared because there’s a small amount of blood will be seen there, but it’s not the baby who’s bleeding it. Remember the cord has got the blood, you know, which is going from the mother to the baby. So, there will be clotted blood in the cord and that is what will stain the nappies and people get worried that it is actually bleeding. The other thing is keep the cord area clean and dry, okay. There is a myth that we should not be bathing the baby when the cord is still on, but I would put it in a different way. By the time the cord falls off, usually it’s around that time where mother and baby would have established the bonding and feeding would have happened really well. And why this is important because if you bathe the baby, give a lot of massages, they will sleep forever, you know, they can sleep for so many hours and that can impair establishing the breastfeeding. So, that is the tie between the myth saying that you should not bathe the baby, you know, as opposed to saying, you know, it is quite safe to do that, but you have to have that idea in mind that the babies might sleep a lot after the bath, then you need to wake the baby and feed the baby every three to four hours.

(36:52) Sahiba: Finally, coming to everyday care and handling, how careful do parents need to be when it comes to hygiene around a newborn?

(36:58) Dr. Prathap Chandra: This is paramount, okay. Hygiene is very important because the newborn babies are still learning how to fight the infections. So, if they develop infection, then they usually become very unwell because they’re still, you know, the some of the organ systems are established but still immature and they’re not exposed to the germs. For example, if a mother has a cold or a cough, it’s very important for her to continue breastfeeding, but she can have a good hand hygiene, you know, use the alcohol and then make sure that your hand is clean, then she can actually put up a mask, so that, you know, the majority of the virus is spread by the droplet or by talking or by, you know, the breathing and stuff. So, that will be prevented. So, there is no contraindication for feeding even if the mother has infection, okay. On the other hand, I think giving bath to the baby, making sure that, you know, if the baby has vomited and you keep the area clean again, you know, it’s important if the baby has passed motion and, you know, you clean at the right time. Otherwise, that will attract a lot of rashes on the baby’s skin. So, needless to say, hygiene is very, very important.

(38:12) Sahiba: And is it okay for the visitors and family members to be around the baby and hold the baby in the early days?

(38:18) Dr. Prathap Chandra: I would put it this way. It’s not like a contraindication. It’s just that people are trying to offer a lot of love and affection to the newborn baby. Everybody is curious to see the newborn baby. However, think this from the mother’s perspective. She’s in a lot of pain. She’s had a caesarean. You know, she had to entertain the guests that come home. She had to give coffee, tea and, you know, all the rest of it. And it’s her privacy as well. You know, she will be breastfeeding and she won’t be in the nicest attire that she possibly can be in. And, you know, disturbing the baby and the feeding time, you know, is also not nice. So, I would always suggest, I think, you know, all the love and affection, let it be there, okay? Give space for the baby and the mother for at least about four to six weeks. Beyond that, I think people would have settled down, babies would have settled down and mother and father, usually they know what they are doing with their babies. So, I think give a little bit of privacy, maintain a small distance, always useful.

(39:20) Sahiba: Understood, doctor. And when should parents ideally start bathing their newborn and how often should bathing be done in the first few weeks?

(39:31) Dr. Prathap Chandra: Right. There’s a lot of myths surrounding the bathing. So, we generally tend to say, give sponge bath to the babies in the first few days so that they don’t sleep off too much and it doesn’t hamper the breastfeeding. Bathing can be done every day or some people do once in two days or alternate days. Both are okay. Why there is an issue is if you bathe every single day and quite vigorously, you will be washing out the oil from the baby’s skin and that can actually attract some of the rashes on the baby’s skin and skin can get dry and dry skin is always not so nice. So, in these circumstances, I would say, make it alternate days, give good massage to the baby using good oils like coconut oil or olive oil or any other oil that they like because it’s not going inside the mouth, it’s on the skin. And then after that, give a good bath, then apply moisturiser all over the body so that the baby’s skin is quite moist and supple.

(40:28) Sahiba: And something very practical, doctor, what is the safest way to trim a newborn’s nails ? ?

(40:33) Dr. Prathap Chandra: Yeah, a lot of people ask this question. I think there’s no right or wrong way of doing it. I generally suggest take a small clippers that’s available in the market. Sometimes you have the filers also that is also available in Amazon and other, you know, baby-friendly shops. After bathing the baby, usually the nails are quite soft and baby’s nails are very, very soft anyway. So, I would suggest do a small clip at one end and then peel the skin off, okay. Important thing is to make sure that you’re in good lighting, you’re seeing what you’re doing all the time, don’t do it blindly. There have been small accidents that I’ve seen where they inadvertently, you know, cut the skin also. So, you would not have done intentionally. So, don’t go in for a guilt trip for that, okay. So, if the cut is a little deeper, important for you to come and show it to the paediatrician so that we can suggest some things to be done.

(41:26) Sahiba: Let’s switch gears a bit and do a quick rapid fire round now, doctor. Are you ready?

(41:31) Dr. Prathap Chandra: I can never be ready for these things, but fire away.

(41:36) Sahiba: So, doctor, should feeding be on schedule or on demand?

(41:40) Dr. Prathap Chandra: On demand.

(41:42) Sahiba: Do babies always need to be woken up for feeds?

(41:44) Dr. Prathap Chandra: If they’re sleeping, then they’re satisfied. So, don’t wake them up.

(41:48) Sahiba: Great. Are pillows recommended for newborns?

(41:54) Dr. Prathap Chandra: Generally not, because the back part of the head is generally more prominent. So, if you’re using a mustard pillow or a horseshoe-shaped pillow, that is okay, but always ensure that there is a good gap between the chin and the chest of the baby.

(42:05) Sahiba: Understood. And what kind of mattress is safer?

(42:09) Dr. Prathap Chandra: Firm mattress.

(42:11) Sahiba: And what about screen exposure at this stage?

(42:13) Dr. Prathap Chandra: Absolutely zero. However, music is great. Music is definitely great.

(42:19) Sahiba: So, there are also many myths that can confuse new parents. Let’s clear a few of them, doctor, for our parents listening to us. 

So, the first statement is, does soft bedding actually help babies sleep better? Is it a myth or a fact?

(42:34) Dr. Prathap Chandra: It’s a myth. We always advise to go for a firm mattress.

(42:38) Sahiba: Do babies need water, especially in hot weather?

(42:40) Dr. Prathap Chandra: Generally no, because mother’s milk is designed in such a way that the first part of the foremilk is full of water to quench the baby’s thirst. Then the milk that comes after that is called hind milk, which has a lot of nutrition. So, if the mother is feeding very well, frequent feeding.

(42:54) Sahiba: Does keeping a baby awake during the day improve sleep at night?

(42:58) Dr. Prathap Chandra: I don’t think we can dictate terms to the babies. Babies usually do what they want. And in the initial phase, anyway, they sleep quite a lot. And I think we should allow the baby to sleep really well if the babies are sleeping, because that helps in their growth and the brain development as well.

(43:12) Sahiba: Next statement, doctor, does crying always mean the baby is hungry?

(43:16) Dr. Prathap Chandra: No. I think I’ve discussed this in detail earlier. You have to look for other causes, because crying is the only way that they can communicate to the parents, whether there is a wet nappy or a, you know, dirty nappy, nappy rash or whether there’s wind that is stuck or whether your house is too hot or too cold. So, you need to look at all these common things.

(43:37) Sahiba: Next one, can sunlight alone treat jaundice?

(43:42) Dr. Prathap Chandra: No, it’s a big myth. One part of the wavelength of the light is what we use to treat the jaundice, which is the blue light. However, when exposed to the sun, especially in the summer, you’re exposed to all the UV rays. That may not be the right way of doing it. However, if you want to expose the baby to the sun, take a stroll and things like that are allowed. To just cure the jaundice, sunlight exposure is a myth.

(44:02) Sahiba: The last one, does noisy breathing always indicate any kind of infection?

(44:11) Dr. Prathap Chandra: Not always. A lot of babies who are born, they’ll have their nostrils slightly smaller, and then the airway can be a little bit narrower. And a small amount of secretion itself can actually cause this sort of a rattling noise. And that is what we call the noisy breathing. Some babies generally also have the windpipe lined with the muzzles, and the muzzles can be slightly weaker. And we call it laryngomalacia or tracheomalacia, where it determines the weakness of the muzzles. And in those conditions also, you can hear what we call the stridor. So, it is important for you to get an understanding by checking with your paediatrician, to make sure that it’s not harming the baby. However, the noisy breathing, if it is associated with breathing difficulty for the baby and baby unable to latch on and feed, these are the alarming bells. This is when you need to seek expert advice.

(45:07) Sahiba: Thanks, doctor. That actually breaks off any myths that the parents hold. So, before we close, we talked to a few of our friends who are new mothers and fathers, and we collected some questions which are like FAQs, which they have in mind all the time. So, I would like to ask those questions to you, doctor.

(45:21) Dr. Prathap Chandra: Fire away.

(45:23) Sahiba: What is considered a comfortable room or AC temperature for a newborn?

(45:26) Dr. Prathap Chandra: I think a comfortable room is where you all feel comfortable. So, that applies to the babies as well. Whether you’re using an AC or a fan, depending on your house circumstances, I would always suggest you buy a thermometer, a digital one, and put it on the wall. The temperature should be around 25 degrees. Usually that is considered quite comfortable. If it’s too hot, it’s bad for both the babies and the mothers, because mothers also tend to get dehydrated, she gets a headache, and then milk production can be reduced and all that. If it’s too cold, obviously we are all uncomfortable.

(45:59) Sahiba: Next one is, doctor, when is it safe to start taking the baby outdoors for a stroll?

(46:05) Dr. Prathap Chandra: Once the baby starts establishing the feed, usually that is the time. And also, we have to allow mother to recover also. She should be actually walking around with the baby. And also, you have to see your house circumstance, whether you’ve got stairs, whether you’ve got the lifts, you know, whether mom can climb up the stairs or not. So, it depends on all these circumstances. If you ask me, you can take the baby on a stroll even on the second or the third day itself.

(46:32) Sahiba: Oh wow. Okay. And is daily oil massage something you recommend?

(46:38) Dr. Prathap Chandra: Oil massages are good. It helps in bonding, okay. It is a myth that the babies have got a lot of pain and they have to stretch and they will make their noses big and then they will actually make the babies grow really tall by doing these massages and stretches. Those are myths. Massages I always suggest to be done by the parents or even the grandparents. Have a very nice atmosphere, play some nice music, and then make sure that you’re in a comfortable position. And the massage should be using your not just, you know, heavy massages. And this will help in releasing oxytocin, which is the love hormone I mentioned earlier. So, that is what helps in bonding between the mother and the baby. And therefore, that helps in the milk production also.

(47:22) Sahiba: Understood. What kind of toys, if any, are suitable in the first few months?

(47:28) Dr. Prathap Chandra: In the first few months, generally, babies will start developing an accommodation reflex. That means they can fixate on certain toys by about three to four weeks onwards. Something which is colourful and then, you know, a little bit dangling around the babies. Nothing should be very small so that they can just get inside the mouth or sometimes, you know, it can act as a foreign body and it can get inhaled into the lungs, especially if the parts are a bit loose and all that stuff. So, blocks are always better for the babies, you know. And as they start growing up, then there are different things that they can do. Because their hands get mobile, they tend to look around and their accommodation reflex is much better. So, accordingly, suitable toys are available. And a lot of times, we suggest soft toys also to start with.

(48:19) Sahiba: The last one is, doctor, when is it generally safe to travel with a newborn?

(48:28) Dr. Prathap Chandra: Yeah, a lot of people ask this because they would have, they would be working in a place and they have to go back to their hometown after the, you know, the delivery because their parents live there and it’s usually comfortable for them. So, I always suggest six weeks plus, because mummy is also recovering from either caesarean section or even the normal delivery, if she’s had stitches down there. So, she’s also recovering. And they’re also going through this phase of, you know, establishing the feeding, a lot of other things that they’re learning and unlearning. Six weeks is where we give one of the primary vaccines. I would suggest after that, you know, vaccination, give a couple of days for the babies to be okay, and then travel, whether it is air travel or travel by road. I always suggest that if it’s travelling by air, while it’s taking off and landing, try to feed the baby or give that action to the mouth so that the air pressure, you know, around the ears are maintained. Otherwise, you know, if the eardrum can retract and it can cause quite a lot of pain and the babies will keep, you know, crying all the time. If that happens anyways, you need to go and see the paediatrician after you reach your hometown, okay. If you’re travelling by car, I would always suggest not carry the baby on your lap. It’s always important that you put the baby in the car seat. So, car seats are designed to keep your baby safe. In, you know, inadvertently there is an accident or sudden breakage, your baby’s weight will feel as if it’s 30 times more because of the momentum and the inertia, and there’s a chance of you throwing the baby in the car is very high. So, it’s also not comfortable for you to keep the baby on your lap all the time. So, make the baby sit in the car seat, and the car seat is usually facing the back of the car. That’s how it is designed to give safety to the baby.

(50:16) Sahiba: Quite interesting, doctor. Thank you so much, doctor, for such an interesting and amazing session we had today. Got so many new inputs, which like, you know, the parents must not be aware of. Thank you so much.

(50:26) Dr. Prathap Chandra: No pleasure is mine. Happy to help anytime. Thank you.

(50:31) Sahiba: Thank you. Newborn care isn’t about doing everything perfectly. It’s about understanding what truly matters and letting go of what doesn’t. To every parent listening, especially if you are in those first days or weeks, uncertainty is part of the experience. If this episode helped answer even one question you have been holding on to, share it with a new or expecting parent in your life, because sometimes the right guidance at the right time can ease an entire phase. Until next time, take it one day at a time and keep your care circle close.