What Should I Be Doing with My Baby the First 6 Weeks? A Pediatric Chiropractor and IBCLC's Perspective

Congratulations on your new bundle of joy! The first six weeks with your newborn can be both exhilarating and overwhelming. As a pediatric chiropractor, lactation consultant (IBCLC) and mom, I’m here to share some friendly advice on how to make the most of this precious time. Frequent questions I get asked include “When should I start tummy time?” “What are the first milestones we are working on?” “What do I need to watch out for?”. Let's dive into simple activities you can do with your baby that support their development and well-being.

Tummy Time

Tummy time is crucial for developing your baby’s neck and shoulder muscles. It’s what sets them up to learn to roll and then crawl. In the first four weeks, your little one will have limited head control and can only see about 8-9 inches away, so don't worry if they seem a bit wobbly. You don’t need to lay them flat on the floor! Elevate their upper body using a Boppy pillow, a wedge pillow, or some couch cushions to create a gentle incline.

By weeks 4 to 8, you should notice your baby can lift their head to about 45 degrees and look in different directions without dragging their nose. Aim for 1-5 minute sessions of tummy time at a time. By the end of month three, we want to work up to a total of 60 minutes per day.

And guess what? Time spent with baby laying on your chest counts too! You can make these moments active by stacking their little elbows under their shoulders to help them lift their head. Breastfeeding in a reclined position encourages your baby to work on keeping their head up—bonus tummy time!

Playtime

Don’t forget to incorporate side-lying time and back-lying time! You can gently prop a pillow behind your baby's back to encourage side lying. Your floor play gym is a great tool, even from week one. While they might not be able to see or interact with those fun dangly toys just yet, it’s vital for their development to have opportunities for free movement.

As your baby grows, they’ll start to bring their hands to the midline, a key milestone around three months. Help them along by showing them how to clap their hands and gently guiding their little hands together.

Visual Tracking

Engaging your baby’s vision is another important aspect of these early weeks. Use contrast cards to encourage visual tracking by moving the cards in all directions. Visual tracking and head and neck control go hand in hand. Visual tracking is not only important for exploring the world, but also a necessary skill for rolling, crawling and interacting with you!

Feeding!!!

For the first 6 weeks, feeding should arguably be our biggest focus. Breastfeeding is often considered baby’s first milestone. There are so many amazing benefits of breastfeeding including the nutrition and immune system support it provides, reduction of certain cancer risks in both mom and baby, reduced risk of postpartum depression, quicker recovery from childbirth, and developing oral motor skills which set the foundation to eating solids and speech. Breastfeeding is a natural thing, but does not always come naturally. Feeds every 2-3 hours are a big job. The first 6 weeks is the time to learn your baby’s hunger cues, experiment with different nursing pillows and feeding positions. Consider introducing paced bottle feeding with a slow flow nipple after a couple of weeks if you would like your baby to have the skill to take a bottle. If you would like to try a pacifier, I’d recommend waiting until breastfeeding is well established, and using a pacifier designed for breastfed babies.

Keep an eye out for signs of feeding issues, such as clicking or smacking sounds, excessive gassiness, nipple pain or concerns around milk supply. If you notice these, don’t hesitate to reach out for help.

Healing, Bonding and Community Support

The first six weeks are also a time for healing your body, and bonding with your new baby. The time for long stroller walks and mommy-and-me workouts will come, but not quite yet! Take advantage of the support from your community—let friends and family bring you a warm meal or watch the baby while you take a much-needed nap. Baby’s gonna be a sleepy little potato for their first month or so on earth, and that’s completely normal and to be expected. Soon enough you’ll be chasing them around. Enjoy all those melt-in-your-arms skin to skin contact naps! Rather than sticking baby in a swing or bouncer every time (try to limit container use to 15 minutes at a time, 1 hour max per day), try out baby wearing when you’d like to throw some laundry in or get dinner going. Babies have a strong need and instinct to be close to their caregiver to form a secure attachment. Bonding with your baby is one of the best things you can do for their long term development.

Keep It Fun!

One piece of advice: don’t stress! These activities should be fun and enjoyable, not just another chore on your to-do list. Don’t let yourself be consumed by the tracking apps. Celebrate every little milestone, whether it’s those big sparkly eyes opening wide or the joy of seeing them lift their head during tummy time. Some days you’ll do more, and some days less. Now that you know what developmental activities you are generally aiming for—balance is key!

A fantastic way to incorporate these activities is through habit stacking. For instance, after a diaper change, flip your baby onto their tummy for a quick session of tummy time. Babies often enjoy their diaper change mat! Another idea is to read a book while lying on the floor side by side. This is a wonderful way to get that floor time in while bonding and encouraging their early love for stories.

Common Flags to Watch Out For

As you enjoy these early days, keep an eye out for a few common issues:
- Head Turn Preferences: It’s common due to uterine positioning and birth. If not addressed, it can lead to head flattening or delays in milestones.
- C-Shaped Body Positioning: When on their back, does your baby lay straight or curve to one side?
- Feeding Troubles: Do they show a preference for one breast or experience pain while feeding? Is breastfeeding painful or inefficient?
- Discomfort: If your baby seems to hate the car seat, tummy time, or specific positions, they may be experiencing discomfort due to joint restrictions, tension and feeding issues.

Early intervention is key! Addressing these issues now will set the stage for a smoother first year full of smiles and achieving all their milestones. I think every mom and baby should have a skilled lactation consultant and bodyworker on their team from day 0. We would love to be a part of your team.

Remember, it’s all about balance, connection, and having fun. Cherish these moments, and don’t hesitate to reach out if you need support—you're not alone in this sweet and messy adventure!

Happy parenting!

Belly Birth Scar Care And Core Activations

Let’s talk about scar tissue

Scar tissue needs to be addressed to prevent loss of mobility and to ensure normal strength and range of motion. Sources say scar tissue can continue to grow and change for 12-18 months after it’s formation. It is not a permanent fixture in the body, and can be remodeled and reduced to allow it to tolerate the stresses and forces the body encounters. Taking care of your scar is not only important for aesthetics, but also for the function of your core!

Scarring can commonly cause:

• Pain, itchiness and sensitivity around the scar

• Low back, pelvic and sacral pain

• Discomfort with bending and lifting

• Bladder urgency and frequency

• Trigger points with referral to the urethra and clitoris

• Pain with sex

• “Shelfing” look or lack of tone in the lower belly

Before working directly on your scar, make sure:

• You are 6 weeks post-surgical

• No severe incision pain

• No bleeding

• No stitches or staples

• No infection, redness, pus or fever

Prior to 6 weeks

1. Scar Care

Goals:

• Bring nervous system connection to the belly 

• Bring blood flow to the belly

• Activate deep core & pelvic floor

What to do

• Light massage with circular pressure around the scar along the abdomen/belly, changing from clockwise to counterclockwise

• Gradually increase the amount of pressure every day. Do not cause pain.

• Spend 2-5 minutes massaging in the morning and evening daily to establish good mind body connection, bring blood flow and encourage healing.

2. Deep core activations

Transverse Abdominal Activation Cues

1. Imagine a wire between your front pelvic bones (ASISs) and generate a force to pull the bones together.

2. Imagine the front of the pelvis is like an open book with each cover on a pelvic bone (ASIS). Now close the book covers.

3. Pull lower belly away from the pelvic bone.

Multifidus Activation Cues

1. Imagine a wire between your SI joints and generate a force to pull the SI joints together.

2. Imagine the back of the pelvis is like an open book with each cover on a SI joint. Now close the book covers.

Perform 3 sets of 10 reps (or as many to 10 as possible), and 3 sets of 30 second holds (or as close to 30 seconds as possible)

3. Pelvic floor activations

These cues help to activate all the layers if the pelvic floor muscles, which is the goal when doing pelvic floor muscle training.

1. Imagine you are drinking a milkshake through a straw up through your vagina. The goal is to hold this for 30 seconds. How long can you hold it?

2. Imagine you are picking up a blueberry with your vagina. The goal is to pick up 10. How many can you pick up?

3. Activate your anus as if holding in a toot. Now, pull the anus up, and towards your pubic bone. Can you do this 10 times?

4. Imagine the vagina as an elevator and you are slowly pulling up to the top floor. The goal is to take 5 seconds from top to bottom, and perform 10 times.

When performing these pelvic floor exercises, put your hands on your belly, medial to your iliums.

4. Diaphragmatic breathing

Place both hands on the side of your rib cage. Take a deep breath, driving the breath into your hands. You should feel your rib cage go up with the inhale, and down with the exhale. Next, place one hand on the front of your chest, and the other on your midback. You will feel the belly “go along for the ride” meaning it will come up and down slightly. It is important not to drive the breath into the belly, and into your ribcage and diaphragm instead. Finally, place one hand on your upper shoulder, and the other hand on the side of your neck, right above your collarbone. Take a deep breath. Do you feel this area contract or your shoulders go up and down? We don’t want this! These muscles are considered the secondary muscles of breathing, and we want the primary muscle, your diaphragm to be doing the majority of the work.

Take 2-5 minutes and practice diaphragmatic breathing

Now, do it ACTIVE:

Inhale through the nose into your ribcage (front, back, and into sides). As you do this, your diaphragm will come down, your lungs will fill, and your belly will expand slightly. Exhale though your mouth and allow the air to exit while engaging your pelvic floor and transverse abdominis.

Scar Care Post 6 Weeks

Why Massage?

Massaging helps to mobilize the scar, and to allow the fibres within the scar tissue to align properly allowing proper mobility and reducing pain. Massaging prevents the scar tissue from pulling on the surrounding tissues such as the skin, muscle and organs affecting functions of the bladder, sex, pelvis, etc.

How to massage

1. Continue with the circular massage around the scar with light pressure. This light pressure allows us to address the more superficial layer, the skin. Bring this massage over the scar as well, changing from clockwise to counterclockwise. Make sure to mobilize and pull the tissue in every direction.

2. Repeat the circular massage along the abdomen and scar with medium pressure. This allows us to address the deeper muscular layer.

3. Repeat the circular massage a third time along the abdomen and scar with firm pressure. Make sure to avoid any pain. This deeper pressure allows us to address the deep visceral layer.

4. Finish up with “skin-tugging” and “skin pulling” along the scar. With firm pressure pull the skin, stretching it in all directions. Think of creating *asterisks* in 5 spots along the scar. You may feel like the skin is stretching, and stuck in some areas more than others. Give these areas extra attention.

5. Perform this for 5 minutes, twice daily.

At 2 weeks, we recommend a postpartum evaluation with your chiropractor. At this point, we can evaluate the scar, assess the function of the core, pelvic floor and diaphragm!

A specific postpartum rehab and return to fitness plan will be made to advance you from the basic core and pelvic floor exercises and diaphragmatic breathing, to something more fun, dynamic and functional.