Everything you need to know on the fourth day 
with your newborn baby.

Priceless information for your first week as a new parent

Practical information about your baby

Breastfeeding and burping:
The milk will start to flow more abundant by now and you will notice it in the way your baby is drinking. She will drink with big gulps and you will hear her swallow.
In general a breastfed baby does not feel much need to burb, although some of them do. You might notice that your baby stops drinking about halfway the feeding time. When you let your baby burp, she continues drinking without delay again.

Bottle feeding and burping:
Bottle fed babies in general need to burp more frequently, because there is more chance of swallowing a bit of air. When you buy a bottle, you can look for bottles with an anti-air mechanism.
Since the amounts of fluid get more by now, you might notice that your baby stops drinking at about ¾ of the bottle. Just hold her up and let her burp and she continues drinking without delay again.
Whether your baby needs to burp after the feeding also depends on your baby. Some really need to burp because otherwise they either are unhappy (start to cry and when the burp is out stop crying) or they start to spit back some milk, or even a lot of milk. You can avoid that by holding her up and pat her softly on her back.
Some babies really need a lot of time to digest the milk before you can put them back to bed. If the period of holding up is not long enough she might start to spit when you put her down.

How the mother latches on in the Madonna position

What to do to activate your baby while drinking

Formula feeding
Newborn babies want to be fed every two to three hours. The usual frequency is 6 to 8 feedings per 24 hours. It is not necessary to do this at fixed intervals. You increase the amount of feeding with 10 ml per day per feeding.

So on day 4 most babies drink 40 ml per feeding.

When your baby is small and/or less hungry she might drink 30 ml per feeding and when your baby is large and/or more hungry she might drink 50 ml per feeding. That is all okay.
If your baby stops drinking at the end of the quantity offered, then she shows you she is finished for now.

Note: Alternate between your right and left arm when feeding your baby or put her on your legs, straight in front of you to avoid her to develop a preference for one side of her head to sleep on. Babies always like to make contact, so if you alternate right and left she will have to change the position of her face to be able to look at you! 

Swaddling your baby
If your baby has difficulties to fall asleep it will help if she can’t move her arms all over the place. Therefore, swaddling is a very handy thing to do if your baby will stay on her back while sleeping and does not turn yet.
She now does not suffer from uncontrolled movements of her arms and hands while falling asleep, which creates the risk that she only naps and becomes overtired. Swaddling restricts your baby and does not over-stimulate her.
You can buy expensive swaddlers, but you can also make a swaddle with an old t-shirt.

Note: Swaddling can become dangerous when the baby is wrapped tightly from shoulders to toes in a large, non-stretchable cloth that prevents her from moving. 

How to make a swaddle from a t-shirt

How to use a swaddle

The baby's position in the cradle or cot
The recommended position for the baby is on her back in a cradle or cot halfway, with her head turned on one cheek. The baby should not sleep on her stomach. It is better not to let your baby sleep in the playpen if the floor of the playpen is too hard, which most of the time is the case, although nowadays it is also possible to buy thick matrasses with the exact size of the playpen. Having your baby sleep on the couch or on the dressing table is dangerous because there is the danger of rolling off.

Skin to skin contact
In general a good time to have skin to skin contact is in the morning hours after you have been taking care of the first morning feeding and of yourself! You are probably tired again of taking a shower, having breakfast etc. and it is to early to go to sleep again. But resting and have this quality time with your baby is wonderful. Just leave the outside world outside and enjoy and recover at the same time!

Your fourth night as parents

The fourth night after de delivery might be a better night then the second or third night. Your baby will latch on a lot during the day and evening, the amount of milk has become more per feeding and therfore she probably sleeps a bit longer during the night. If she wants to drink many times in the night that is perfectly okay. It is heavy on you as parents, but the baby knows exactly what she wants and when and she will help you through the engorgement period by drinking all the available milk from the breast!

When you give your baby formula the advice is to increase the amount already during the last feeding of the day (usually between 22.00-23.00 hours). So around the mentioned time of the evening you offer your baby 50 ml and you will keep on doing that during the whole night and next day.

Information about the mother's recovery

If the engorgement started at day 3 you will notice that on day 4 your breasts are not as hard anymore, and you are able to press in the breast and it will be easier for your baby to latch on again. If latching on is still a bit difficult for your baby you can apply warmth on the breast before you latch your baby on in order for the let down reflex to be activated.
For some mothers the engorgement starts at day 4 or even at day 5. If you are one of these mothers you can read the information on day 3 on how to take precautions before you start to feed your baby.
There are also a bunch of video's to support you shown on day 1.

Engorgement while giving formula
Your breasts may still feel hard and be bigger then you are used to. This will take one or two days to dwindle again.
Keep on wearing a tight bra or sport bra day and night. Even while taking a shower still leave your bra on. Don’t put the water jet directly on the breasts, because that way you get more stimulation. Quickly change your wet bra for a dry one after you have dried your body.
While changing the bra give your breasts a quick look to check for any red spots that might indicate a breast infection. The chance of a breast infection is not great, but if you see a red spot on one of your breasts which feels warm and painful if you touch it, contact your midwife or home doctor (GP).

Note: do not do heavy abdominal exercises before 6 weeks after the delivery as your straight abdominal muscles still have to return to the center of your abdomen to create your abdominal corset.

Perineum and stitches 
If you have stitches it is important to give your bottom rest by lying down a lot during the first days. If you sit up it is important to sit up straight on a hard surface (so not in your bed!). The counter-pressure may help to reduce the swelling.
To remove the waste products from the traumatized tissue more quickly, you can take Arnica D-6 drops 3 times a day, 10 drops with some water.
It is important to keep the traumatized and stitched tissue clean by flushing with water after you have urinated. Most practical is to use a sports-bottle with a pull cap to squeese the luke warm water in the right direction. Cleaning this area using the shower head twice a day is also recommended. Further it helps the recovery of this area to lie down without your underwear on a cellulose pad once or twice daily for about 1 to 2 hours to allow the stitches to heal in the air.
Stool urge will generally start up again a couple of days after delivery. Your stool may be a bit harder. It helps if you drink a lot and eat fibre-rich food.

Eat and drink well
Just to remind you again: in the post-natal period, you should look after yourself well. You will need to get used to a new rhythm, with your baby asking a lot of your time and attention, with night-time feedings requiring more energy, and with visitors coming to admire the new baby. Because so many new things are coming your way you intend to forget to eat and drink! So please ask your partner to remind you to drink and ask him or her to provide you with food several times a day.

Try to get sufficient rest. This is really one of the most important things!
Try to sleep when your baby sleeps. Switch off your doorbell when you sleep, turn off your phone and ignore the social media. Do not underestimate the amount of rest you will need for some time!
My advice is to sleep every afternoon as long as you give night-feedings.
You cannot force sleep, but you can rest; at least 1 1/2 hour low-stimulus time to recover and to be able to emotional proces everything you experience.
Another tip is to (also) go to bed early and already have 1 or 2 hours sleep before the last feeding of the day which usually takes place between 22.00-23.00 hours.