IN THIS CHAPTER
Examining your newborn’s appearance
Viewing the hospital’s role in the first days of life
Knowing what the pediatrician looks for
Being at home with your new family
For almost 40 weeks, you and your baby have been in one body, and if you’re like most women, you’ve focused on staying healthy to help your baby grow — and on preparing to deliver your baby safely. Now suddenly, your baby is out in the world, and you finally get to take your first real look at her. You may find that in some ways, your baby’s appearance surprises you. Newborns typically look a little funny. Remember that many superficial aspects of your baby’s appearance — the cone-shaped head, the blotches, and especially the white, pasty goo — will soon disappear.
This chapter gives you an idea of what to expect when you first meet your little darling and explains the role of the hospital and the pediatrician who visits your baby in the first hours or days.
Looking at Your Bundle of Joy
Immediately after delivery, your practitioner puts your baby on your belly or hands her over to a nurse for some judicious cleansing and toweling off before putting the baby in your arms.
In the first moments after your baby is born, you may be overwhelmed by feelings of love. The shock and relief of it all may daze you. Most likely, you also think that your baby is the most beautiful thing you’ve ever seen. Then again, maybe you don’t. Contrary to the fairy tales you see on TV soap operas, I Love Lucy reruns, and cartoons, babies don’t always come out clean and smelling like a spring shower. Your baby is far more likely to be covered with some of your blood, amniotic fluid, and white goo known as vernix. Her skin may be blotchy, and she may even have a few bruises from delivery. So you may need to keep an open mind when assessing her appearance right off the bat.
Feeling a little hesitant at first or overwhelmed at the sight of your new baby actually isn’t uncommon. Often it takes a few days before you establish a true connection or bond with your baby. If you’re feeling a little detached, don’t worry. As reality sets in and you get to know your baby, you’ll feel much better.
Soon, you notice other features about your new baby’s appearance, from her little stump of an umbilical cord to the amazingly long fingernails and toenails. And you observe her first behaviors, from the initial cry to the way she startles at loud noises. This section goes over many of your newborn’s characteristics.
Varnished in vernix
A thick, white, waxy substance typically covers a newborn baby from head to toe. The formal name for this substance is vernix caseosa, a phrase with Latin roots meaning “cheesy varnish.” Vernix is a mixture of cells that have sloughed off the baby’s skin and debris from the amniotic fluid.
Experts have several theories about this substance. Some doctors believe that vernix acts as an emollient to protect the tender fetal skin from the dryness that may result from living within a bag of amniotic fluid. Others believe that the vernix acts as a lubricant to help the baby slide through the birth canal. Some babies have more vernix than others; some have none at all. The amount isn’t significant. If your baby passed meconium while inside the uterus (see Book 2, Chapter 3), the vernix may look a little greenish.
Regardless of what it looks like, most of the vernix usually comes off when the nurses dry off your baby. There’s no reason to leave the vernix on the baby’s skin. Any vernix that doesn’t come off in the drying process is usually absorbed within the first 24 hours.
The shape of the head
Caput succedaneum — more commonly called caput — refers to a circular area of swelling on the baby’s head, located at the spot that pushed against the cervix’s opening during delivery. The exact location of the swelling varies, depending on the position that the baby’s head was in. The swollen area can range in size from only a few millimeters in diameter to several centimeters (a few inches). Caput generally goes kaput within 24 to 48 hours after birth.
Babies who are born headfirst (vertex) often go through a process known as molding. This molding occurs because throughout labor, as the baby descends gradually through the birth canal, she “fits” her way along (see Figure 6-1). In fact, your practitioner may tell you that he can feel the baby’s head molding to the canal even before the baby is born. Molding doesn’t cause any harm. The bones and soft tissues in the baby’s head are designed to allow this molding to happen. The result is often a baby with a cone-shaped head (see Figure 6-2). By 24 hours after delivery, the molding usually disappears, and the baby’s head appears round and smooth.
Illustration by Kathryn Born, MA
FIGURE 6-1: A baby’s head is often molded as it descends through the birth canal.
Illustration by Kathryn Born, MA
FIGURE 6-2: The cone shape usually goes away after about 24 hours.
Some women, particularly those who have had children before or who had rapid labor, have babies with no molding. Also, babies born in the breech presentation or by cesarean may not have molding.
Sometimes, during the passage through the birth canal, a baby’s ears can also fold down into strange positions. The same thing can happen with the baby’s nose, so that at first, it may appear asymmetric, or pushed to one side, but these features are no reason to rush your baby to a plastic surgeon. These minor oddities are temporary and disappear during the first few days.
Black and blue marks
Quite often, babies are born with black and blue marks on their heads from the labor and delivery process. These marks usually happen because the forces of labor put so much pressure on the baby’s scalp. They can also be the result of a forceps or vacuum delivery. A bruise doesn’t indicate that anything harmful has occurred; it’s merely a reflection of how vigorous the labor process can be. Most black and blue marks go away within the first few days of life.
Blotches, patches, and more
Most people think of newborn skin as blemish-free — the very definition of perfection — but newborns have all kinds of spots and markings. Most disappear within a matter of days or weeks. Some of the most common newborn skin conditions include the following:
· Dry skin: Some babies, particularly those who are born late, have an outer layer of skin that looks shriveled like a raisin and peels off easily shortly after birth. You can use lotion or baby oil, if needed, as a moisturizer.
· Hemangiomas: A type of reddish spot, known as a hemangioma, may not appear until a week or so after delivery. It can be almost any size, large or small, and can occur anywhere on the infant’s body. Although the majority of these spots go away in early childhood, some persist. You can treat the spots that become bothersome (because of their appearance). Discuss treatment options, if needed, with your pediatrician.
· Mongolian spots: Bluish-gray patches of skin on the lower back, buttocks, and thighs are especially common in Asian, Southern European, and African-American infants. These patches are sometimes called Mongolian spots. They often disappear in early childhood.
· Neonatal acne: Some babies are born with tiny white or red pimples around the nose, lips, and cheeks, and some babies develop them weeks or months later. These bumps are completely normal and are sometimes called neonatal acne or milia. No need to rush to the dermatologist, though. The little bumps disappear in time.
· Red spots: Reddish discoloration on the skin, whether very deep and dark or light and hardly noticeable, is very common in newborns. Most of these discolorations go away or fade, but some may persist as birthmarks. One type of discoloration in particular, erythema taxicum, can be extensive. It looks like bad hives, and it comes and goes over the baby’s first few days of life.
· Stork bites: You may notice small ruptured blood vessels around your baby’s nose and eyes or on the back of the neck. These marks are commonly known as stork bites or angel kisses. They’re common in newborns, and they also disappear after a while, although it sometimes takes weeks or months.
Baby hair
Some babies enter the world totally bald, whereas others come out looking like they need a haircut. The amount of hair present at birth doesn’t necessarily predict what the baby’s hair will look like later on. Most often, newborn hair thins out and is replaced by new hair. Different babies grow hair at different rates; some have relatively little hair even at a year of age, whereas others already need a trip to the beauty salon.
Often, a soft, fine layer of dark hair, which can be especially prominent on the forehead, shoulders, and back, covers babies’ bodies. This hair is called lanugo and is quite normal. Lanugo is most common in preterm babies and in infants of mothers who have diabetes. It falls out within several weeks of life.
Extremities
Newborn babies often assume a position similar to the one that they became familiar with inside the uterus, the so-called fetal position. You may notice that your baby likes to be curled up a bit, with her arms and legs bent and fingers balled into a fist.
Watch out for those nails, though! Newborn fingernails and toenails may be surprisingly long and sharp. Many hospitals dress newborn babies in little shirts with mitten-like attachments to cover the hands so that the babies can’t scratch themselves. To minimize this risk, keep the nails relatively short. Pick up a pair of baby nail scissors or clippers from your local drugstore.
A good time to trim fingernails and toenails is when your baby is fast asleep and oblivious to what you’re doing.
Eyes and ears
At birth, a baby’s vision is quite limited. Newborns can see an object only if it’s close; they see things best at a distance of about 7 to 8 inches away. They also respond to light and appear to be interested in bright objects.
All newborn babies have dark blue or brown eyes, regardless of what color of eyes the parents have. By the age of 4 months, baby eye color changes to the permanent hue. Right after birth, the whites of your baby’s eyes may have a bluish tint. This tint is normal and disappears in time.
Often, a newborn’s eyes appear a little swollen or puffy. The whole delivery process causes this puffiness; it’s perfectly normal, and it quickly subsides. Some puffiness may also be due to an antibiotic ointment put in the eyes after birth (see the later section “Caring for your baby’s eyes”).
Babies are fully able to hear from the moment they’re born, which is why you may notice that your baby reacts with a startled motion to loud or sudden noises. Newborns also can distinguish various tastes and smells.
Genitalia and breasts
Babies are often born with a swollen or puffy scrotum or labia. The breasts also may appear slightly enlarged. Maternal hormones that cross the placenta cause this swelling. Sometimes, high maternal hormone levels even cause female babies to secrete a whitish or pinkish discharge from the breasts (known as witch’s milk) or from the vagina (like a period). Like so many newborn characteristics, these secretions are both normal and transient; they go away within a few weeks after birth.
The umbilical cord
The stump of your baby’s umbilical cord probably has a little piece of plastic attached to it. After delivery, your practitioner closes the cord with a small plastic clamp and then cuts it. Usually, your practitioner removes this clamp before you take the baby home. Then the umbilical cord stump quickly dries up and shrivels so that it looks like a hard, dark cord. Within one to three weeks, the stump usually falls off. Don’t try to pull it off.
To keep the stump clean, you can dip a cotton swab in water, alcohol, or peroxide and clean around the base. However, some pediatricians think this cleaning is unnecessary — unless a lot of goopy stuff is around the base.
Newborn size
In general, newborn babies weigh about 6 to 8 pounds (about 2,700 to 3,600 grams) and measure 18 to 22 inches (46 to 56 centimeters) long. The exact size depends on the baby’s gestational age (the number of weeks the pregnancy lasted), genetics, and many other factors, such as whether the mother had diabetes, whether she smoked, and how healthy her diet was during pregnancy.
You may notice that your baby’s head seems disproportionately large compared to her body. This feature is true of all newborns. Your baby can’t hold up her head and needs time to develop muscles strong enough to hold it up without assistance. You also may notice soft spots on the back and top of your baby’s head. These are fontanelles, areas where the baby’s skull bones meet. Fontanelles allow for the rapid growth of the baby’s brain. The back spot (posterior fontanelle) usually closes within a few months, but the anterior or top fontanelle (the one most typically called the soft spot) usually remains until the baby is 10 months to 1 year old.
Seeing how your baby breathes
Often, the baby starts to cry spontaneously shortly after delivery, but not every baby cries right away. A full-throated cry is music to the ears of the hospital staff because they know that the cry triggers the baby’s first breathing efforts. Healthy breathing can begin without a loud cry, however, and some babies give only a little whimper. Some babies have normal respiration even if they don’t wail at high decibels.
If your baby is slow to start breathing spontaneously, you may notice the doctor, nurse, or midwife stimulating your baby by rubbing her back, drying her off, or tapping her feet. Contrary to the stereotype portrayed in old movies, your practitioner is unlikely to turn your baby upside down and give her a little spank on the behind to elicit that first cry.
During pregnancy, a fetus receives oxygen through the placenta. After delivery, the baby takes over respiratory function by using her own lungs. While the baby is in the womb, a special fluid bathes your baby’s lungs, and this fluid is often pushed out during delivery. Sometimes, however, a baby needs extra time and help — in the form of suctioning or stimuli — to expel all the fluid in the lungs.
You may notice that your baby breathes differently than you do. Most babies breathe 30 to 40 times a minute. A newborn’s respiratory rate also can increase with physical activity. Newborns breathe through their noses rather than their mouths. This great natural adaptation enables them to breathe while nursing or bottle-feeding.
You may also think that your baby’s belly looks unusually large and protuberant, but it’s just a normal new baby’s belly. The fact that the belly rises up and down quite noticeably during breathing and gets somewhat distended as the baby starts to swallow some air only enhances the effect. This movement is also normal because babies use their diaphragms to breathe, not their chest muscles, as older children and adults usually do.
Knowing What to Expect in the Hospital
After your nurse and practitioner are assured that your baby is fine (usually determined by an Apgar test — see Book 2, Chapter 5 for details), the hospital staff starts cleaning the baby and helping her make a comfortable transition to life outside the womb. Like butterflies emerging from their cocoons, newborns must adjust to a new state of being in various ways. Suddenly, and for the first time, they can breathe on their own and see the wide world around them. This section points out what happens next in the hospital to ensure that your baby is warm, safe, and healthy.
BRACELETS ARE FOR SECURITY, NOT A FASHION STATEMENT
At the hospital, your baby wears an identification bracelet to identify her as yours. All hospitals also require that the mother wear a bracelet with the baby’s ID number on it. (Many hospitals now also require every new partner to wear an ID band.) Each time the staff brings the baby to the mother, the staff member reads off the numbers to ensure that the right baby is given to the right mother. Most hospitals also take additional security measures to prevent any mix-ups and to prevent unauthorized individuals from gaining access to the nursery. Many nurseries are locked, and all are closely supervised.
Preparing baby for life outside the womb
A lot happens in the few hours immediately after your baby is born. She has made a pretty significant change and has a lot to adjust to. The medical staff takes immediate action to give her the best start in life.
Keeping your baby warm and dry
Because body temperature drops rapidly after birth, keeping your new baby warm and dry is important. If newborns become cold, their oxygen requirements increase. For this reason, a nurse dries the baby off, places her in a warmer or warmed bassinet, and then watches her temperature closely. Often the nurse wraps or swaddles her in a blanket and puts a little hat on her to reduce the loss of heat from the head. When the baby gets to the nursery, a nurse usually dresses her in a little shirt and then wraps her again in a blanket.
Caring for your baby’s eyes
Most hospital staffs routinely place an antibiotic ointment into a newborn’s eyes to lower the chance that she’ll develop an infection from passage through the vagina of a mother who has chlamydia or gonorrhea. The ointment doesn’t appear to be bothersome to babies and is completely absorbed within a few hours.
Some parents worry that the ointment may blur the baby’s vision and thus hinder parent-child bonding. You don’t have any reason to be concerned about possible blurring, however. Babies don’t see clearly in any case (see the “Eyes and ears” section earlier in this chapter).
Boosting vitamin K
Most hospitals give newborns an injection of vitamin K to decrease the risk of serious bleeding. Vitamin K is important in the body’s production of substances that help the blood clot. This nutrient doesn’t pass through the placenta to a baby very easily, however, and newborn livers, because they’re immature, produce very little of it. So babies are typically low in this nutrient. Giving the baby vitamin K is an important preventive measure.
Making tracks: Baby’s footprints
Most likely, a nurse takes your baby’s footprints shortly after she is born to make a permanent record of identity. (The unique ridges that form on a baby’s feet are actually present several months before birth.) Some hospitals give you a copy of your baby’s footprints for your scrapbook. Although most hospitals still use this technique of identification, not all do.
Vaccinating for hepatitis B
Many hospitals now routinely start the vaccination process against hepatitis B for newborn babies, whereas others prefer that a pediatrician administer the first of the three shots after the baby is discharged from the hospital. (The last two are given over the course of the next six months.) Wherever your baby receives the vaccine, this shot is an important tool to reduce her chances of contracting hepatitis B later in life.
Understanding baby’s developing digestive system
Most babies wet their diapers six to ten times a day by the time they’re one week old. The frequency of bowel movements depends on whether you bottle- or breastfeed. Typically, a breast-fed baby has two or more bowel movements per day, whereas a formula-fed baby has only one or two per day.
Don’t be surprised if your baby’s first stool looks like thick, sticky, black tar — that’s normal. It’s called meconium. Ninety percent of newborns pass their first stool within the first 24 hours, and almost all the rest do so by 36 hours. Later on, the color of the stools lightens, and the texture becomes more normal. A formula-fed baby typically has semi-formed, yellow-green stools, whereas a breast-fed baby has looser, more granular, yellowish stools.
Most newborns urinate within the first few hours after birth, but some don’t urinate until the second day. The passage of meconium and urine is an important sign that your baby’s gastrointestinal and urinary tracts are functioning well.
Considering circumcision
Circumcision is the surgical removal of the foreskin of a male infant’s penis. Parents of boy babies must decide whether they want their son to have this procedure performed. The decision to have a circumcision may involve cultural and religious considerations as well as personal preferences. More than half of newborn boys in the United States are circumcised, but in many other countries, circumcision is rarely performed. The frequency of circumcision in the United States is on the decline, as new information is emerging that challenges the medical arguments for performing the procedure.
Doctors once thought that circumcision helped reduce the incidence of penile cancer, that it prevented infections, and that it reduced the incidence of changes in the appearance of a penis related to a tight foreskin. However, these advantages haven’t proved to be true. In fact, the American Academy of Pediatrics has issued a formal statement that existing evidence is not sufficient to recommend routine circumcision. That said, there is some data that shows that circumcision may decrease the risk of a male infant contracting a urinary tract infection or the risk of a male contracting HIV from an infected female partner. Some possible complications associated with circumcision include bleeding, infection, and scarring. Circumcision based on cultural or religious views is still relatively common. The decision, of course, is one that both parents should be comfortable with.
Some people feel that circumcision is beneficial for hygienic reasons. For example, some uncircumcised males build up a thick white discharge called smegma under the foreskin, which may lead to a bad odor or infection. However, a boy can be taught to wash his penis and prevent this from happening.
If you decide to circumcise your son, your obstetrician or pediatrician performs the procedure within a day or two after your son is born — as long as he is healthy, full-term (or nearly full-term), and without any congenital abnormalities that would cause your doctor not to do the procedure. For some Jewish and Muslim families, male circumcision is part of their religious practice. Jewish families often have a ceremonial circumcision after the baby is discharged from the hospital, performed by a mohel.
Many hospitals offer injectable anesthetics or an anesthetic cream that doctors apply to the baby’s penis prior to the procedure. The emphasis on pain medication is a humane and important medical advance, prompted by studies that show that newborns do indeed react to the pain and stress associated with circumcision. Just doing comforting things like swaddling the baby, giving him sugary fluid by mouth, and administering Tylenol are not enough to decrease the pain associated with circumcision, although they can help reduce the stress level. Good options for real pain management, or analgesia, include a topical anesthetic cream (EMLA cream); a nerve block called a dorsal nerve block, which reduces pain sensation to the area; or a subcutaneous ring block, again acting as a block to pain sensation.
After circumcision, the doctor wraps the baby’s penis in petroleum jelly–soaked gauze. When this gauze falls off after about four hours, the top of the penis may look reddish and slightly swollen.
If the gauze doesn’t fall off, don’t pull at it. Squeeze warm water over the gauze to help it loosen. In the first few days, clean the area with warm water and keep it dry. After each diaper change, apply an antibacterial ointment or petroleum jelly until the penis heals.
The penis is usually completely healed within one week. During this time, you may notice a crusty substance at the tip; this substance is normal and goes away with time. But if the penis looks unusually swollen and discolored or if your baby has a fever, call your pediatrician.
Spending time in the neonatal intensive care unit
During the hospital stay after delivery, most newborns room with their mothers or stay at least part of the time in the regular hospital nursery — sometimes called the well-baby nursery. But sometimes newborns need the kind of extra attention they can get only in a neonatal intensive care unit — sometimes called a special care nursery. Within such a nursery, you may find a special area for critical care, where one-on-one nursing, sophisticated monitors, breathing machines, and so on are available. You may also find the so-called step-down area, for babies who aren’t yet ready to go to the well-baby nursery but don’t need critical, one-on-one care.
If your pediatrician thinks that your baby needs care in the neonatal intensive care unit, it doesn’t automatically mean that something is wrong. Often, doctors place babies in special care nurseries for a short while just for observation — for any number of reasons. Here are some of the most common reasons (this list is far from inclusive):
· The baby was born prematurely.
· The baby doesn’t weigh quite enough to make the birth weight cutoff established by your particular hospital.
· The baby may need antibiotics — for example, because the mother had a fever during labor or because she had a prolonged rupture of membranes prior to delivery.
· The baby’s breathing seems somewhat labored. This reason is a relatively common one for putting a baby under observation for a short period of time.
· The baby has a fever or had a seizure.
· The baby is anemic.
· The baby was born with certain congenital abnormalities.
· The baby requires surgery.
Checking In: Baby’s First Doctor Visit
Before or after delivery, someone from the hospital asks for your pediatrician’s name. Your pediatrician should be someone who is authorized to work at the hospital where you delivered but may or may not be the same pediatrician you plan to use after you leave the hospital. If you live some distance from the hospital and have selected a pediatrician close to your home who doesn’t have privileges at the hospital where you deliver, you still need another pediatrician to care for your baby during the hospital stay. Depending on the time you deliver, the pediatrician may see the baby on the same day, or he may see the baby the next day.
When the pediatrician examines your baby, he checks the baby’s general appearance, listens for heart murmurs, feels the fontanelles (the openings in the baby’s skull where the various bones come together), looks at the extremities, checks the hips, and generally makes sure that the baby is in good condition. The pediatrician orders a variety of standard blood tests and newborn screening tests. The specific screens that are required vary from state to state but often include tests for thyroid disease, PKU (a condition in which a person has trouble metabolizing some amino acids), and other inherited metabolic disorders. The results of these screening tests usually don’t come back until after you take your baby home. The pediatrician gives you the results at your baby’s first office visit. If any of the tests come back positive, the state also notifies you by mail. Upon discharge, be sure to ask the pediatrician when your baby should be seen again.
Considering heart rate and circulatory changes
Remember how your practitioner checked the fetal heart rate during prenatal visits? You may have noticed then how fast the beat was. In utero, the baby’s heart rate is, on average, 120 to 160 beats per minute, and this heart rate pattern continues during the newborn period. Your baby’s heart rate also can increase with physical activity and slow down when she sleeps.
After your baby is born, important changes in circulation occur. In utero, because a fetus doesn’t use the lungs to breathe, a structure called the ductus arteriosus shunts away much of the blood from the lungs. Normally, this shunt closes on the first day of life. Sometimes, a murmur is heard in the first days after the baby is born, which indicates changes in blood flow. This murmur, which is called a PDA (for patent ductus arteriosus), is usually normal and nothing to worry about. However, some heart murmurs may require further investigation — specifically, by having a special sonogram, or echocardiogram, of the baby’s heart. Even when a cardiologist finds murmurs due to small structural problems (like a small hole in the heart’s septum), many murmurs go away on their own. If your baby is diagnosed with a murmur, discuss it thoroughly with the baby’s pediatrician or a pediatric cardiologist who specializes in these conditions.
Looking at weight changes
Most newborns lose weight during their first few days of life — usually about 10 percent of their body weight — which, of course, if she weighs only 7 or 8 pounds (3,200 or 3,600 grams), amounts to less than a pound (454 grams). This phenomenon is completely normal and is usually caused by fluid loss from urine, feces, and sweat. During the first few days of life, the typical infant takes in very little food or water to replace this weight loss. Preterm babies lose more weight than full-term babies, and it may take them longer to regain their weight. In contrast, babies who are small for their gestational age may gain weight more rapidly. Generally, most newborns regain their birth weight by the tenth day of life. By the age of 5 months, they’re likely to double their birth weight. By the end of the first year, they triple it.
For Partners: Home at Last — with the New Family
In the hospital, the primary focus is on the patients — in the case of childbirth, the mother and her baby. But the hospital stay is usually short, and as soon as Mom and baby come home, the partner is expected to join them on center stage. In fact, you’re likely to find yourself in a starring role.
If pregnancy, labor, and delivery weren’t enough to jolt you into the realization that your life is changing forever, getting home from the hospital with your new family certainly does. You and your partner now have a new set of responsibilities.
Long gone are the days when it was normal for men to assume that the mother would take on those responsibilities all by herself. Men can help change diapers (they even have changing tables in men’s restrooms these days), feed the baby, shop, and do household chores. Even if your partner is breastfeeding, you can sometimes feed the baby breast milk she has pumped and put into a bottle. In fact, parents may want to prepare bottles this way regularly because feeding the baby is an important and highly satisfying way to bond.
Your partner is going to need at least six weeks to get back to her pre-pregnancy shape — probably longer. During the first couple of months, she may be exhausted. She’s recovering from labor and delivery, after all. And chances are good that both you and she are somewhat sleep-deprived. Conditions like these make it easy for anyone to lose patience from time to time or to lose his or her temper more often than usual. Simply being aware of the fact that you’re operating under special circumstances for a while is helpful. See that your partner has time for rest — and try to take naps yourself.
In a stressful (even if very joyful) situation such as having a new baby, sex may not be a huge priority. Give yourself and your partner the time you both need to adjust your sex drives. Even after your partner’s practitioner gives her the go-ahead to resume sex (usually about six weeks after delivery) and you’re both ready, take things slow and easy at first. The tissue around your partner’s vagina and perineum (the area between her vagina and rectum) may still be a little sore. And the fact that it has been some number of weeks or months since the two of you have had intercourse may add to the discomfort. Many couples find it useful to use a water-based lubricant for the first few times; some new mothers need to wait longer than six weeks after delivery before they’re comfortable enough for sex.
Finally, don’t be surprised if you feel unprepared for parenthood, lacking not only skills but also an understanding of what it takes to do a good job. Unlike cats, dogs, or jungle animals, humans aren’t born with surefire instincts about how to be perfect parents. Both you and your partner need time to develop the skills it takes to handle babies — and children, and teenagers. Along the way, you often work by trial and error. Just realize and accept this situation. Talk about it with each other — often. And fasten your seat belts. You’re in for an incredible adventure.