The shape of your baby's head will be changing now. If you had a vaginal delivery, your baby's skull will have needed to mould itself to fit through your pelvic opening. By 4 weeks, your baby's head will take on a more rounded and symmetrical shape.
Your baby may still keep some lanugo (soft, downy hair) on their skin, particularly over the shoulders and back. Lanugo will be more obvious if your baby was born prematurely or if their hair is darkly pigmented, but this will go away soon.
Don't worry if your baby has small spills of milk after they have fed. The valve at the top of a newborn's stomach is often very relaxed and milk can easily regurgitate back up the oesophagus. A small amount of milk can spread a long way, so get into the habit of keeping a hand towel close to mop up any spills. You only need to be concerned if your baby is failing to gain weight, is projectile vomiting or failing to thrive – otherwise these spills are perfectly normal.
Your baby may be happy to be awake for a little longer after feeds this week. Their personality and temperament will already be evident, even at this early stage. Some babies are naturally more placid and easier to “read” than others.
Some demand more attention and need more cuddles to calm down. At this age, your baby cannot regulate emotions and will need your help to do so.
They will need to be calm and relaxed before they drop off to sleep. Rocking, soothing, patting and letting them know that you are close by will help them feel secure enough to relax and go to sleep.
Behaviour and Development
This is the week during which you are likely to hear your baby start cooing and making little noises. These early, pre-verbal attempts at speaking will be their way of building skills in communication. Engage with them by getting up close to their face and delighting in their chatter.
It is still a little early for any true smiles just yet, but you may find your baby grimaces and scrunches up their little face. Whether they have feel pain, hunger, tiredness, or bored, their range of facial expressions will amaze you.
Your baby may be able to lift their head for a short period when lying on their tummy. It is important to provide them with some supervised tummy time every day. This will help them to build strong muscles in their neck and chest.
By now, you will be in a finely-tuned pattern of nappy changing. Your baby's output (the rate at which they fill nappies) will give you an indication of just how well they are feeding. One of the signs of sufficient milk intake for a breast-fed baby is if they are having 6 or more pale, wet nappies every 24 hours. Their poo should be soft and mustard yellow.
If you are formula feeding, don't be concerned if your baby does not have a poo nappy every day. As long as the consistency is still soft, your baby is not constipated.
Some babies have moist or sticky eyes at around 4 weeks. Occasionally, there is a discharge from one or both eyes. Cleaning the eyes from the inside corner to the outside with warm water is helpful. Occasionally, a blocked tear duct or a bacterial infection is the cause. Check with your doctor if your baby's sticky eyes have not cleared up by now.
If your baby is a boy, there is no need to pay any particular attention to his foreskin. It will gradually separate from the glands of his penis by the time he is around 4-5 years of age.
If you have older children, it may be more practical for you to bath the baby with the sibling. They are likely to want to help, so stress the importance of being gentle and keeping water away from the baby's face. Alternatively, you may prefer to bath your newborn separately.
You may be feeling very tired by week 4. The reality of getting up through the night and the constant demands of baby care can be very draining. Try to remember that this stage does not last for long, although it may seem like it at the moment.
It is important to look after yourself, so do not skip meals, rest when you can and aim for a simple life. This is not a time to compare yourself or your baby with others. Everyone's experience of early parenting is unique.
At 4 weeks after birth, there are likely to be times when you feel overwhelmed with love for your baby; and others where you may even feel torn in two. Every new mother experiences fluctuating emotions that can be almost frightening in their intensity.
Your hormones will still be stabilising after the pregnancy and it may take a few more weeks before you feel normal again. Speak with your partner, your healthcare professional or your GP about how you're feeling.
Your Physical Recovery
By now, you are likely to be feeling physically stronger. If you had a vaginal delivery, your womb and internal organs will almost be back to their original pelvic position. If you had a caesarean section delivery, your recovery will be a little slower. Your abdominal scar will be healing at this stage, but it will remain a little tender for a few more weeks. As long as it is clean and dry, you don't need to be concerned.
What About Dad?
Your baby will respond equally to both of you if you both share in its care. Try not to always be seen as the expert as babies benefit from seeing their dads in a nurturing, caring capacity. Encourage them to get to know each other, especially if dad is a bit reluctant at first.