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You've been waiting nine months for this moment - to bring your new baby home. You've read books, talked to friends and family, logged online, and gotten organized. You're prepared - well, almost. It seems this new person you brought home isn't following the schedule. Now what?

Taking care of your baby, or... do I know what I'm doing?
While your baby's needs are in most respects quite simple, the task of meeting them often seems daunting. Confidence that we have developed in other areas of our lives frequently does not seem to transfer into parenting, especially with the first child. The result? Overwhelmed parents who doubt their ability to meet their new child's basic needs.

In my practice, I see a lot of such parents. For me, success is measured not just by the outcome of resolving a newborn's jaundice, for example, but also by sensing that the new parents have begun to trust their instincts; that they realize they will make mistakes, but none will cause harm; and that the miracle that created this new being extends to the creation of a new family unit.

What goes in must come out
While we might overlook this guideline, there is a distinct relationship between what goes into your baby's mouth and what comes out in the diaper. A baby that is taking in adequate nutrition will need a minimum of six diapers in twenty-four hours, and might well need twelve to fourteen. The first difficulty for new parents is often figuring out if the diaper is, indeed, wet. While this might seem obvious to those used to dealing with cloth diapers, the new "high-tech" disposables can be tricky. Many a parent has stuck his or her finger into the diaper to check for wetness. While this is one possible technique, if little Emily has had a bowel movement, a less invasive technique might be preferable.

Since disposables are designed to draw wetness away from your baby's bottom, urine is drawn towards the outside lining instead of remaining near the center. Pick up a fresh diaper from the pack. It should have a rough, "crackly" sound when rubbed between your fingers. Now take a used (wet only) one. Add a bit of water if it is not distinctly wet. When you rub the outside, it will have a smoother, more gelatinous feel, and a softer sound.

Gauging nutrition by your baby's urine
Keeping track of the number of wet diapers and the color of the urine is the best, albeit perhaps backwards, way of determining if your baby is feeding enough. The concern over adequate intake is greater for breast-feeding parents, as there is no gauge to show how much has been taken in from the breast. As a new mom, it is a huge weight on your shoulders to feel that you are solely responsible for your baby's nutrition, and to be questioning whether the intake is sufficient. This uncertainty is a major factor in causing many moms to discontinue breast-feeding.

A well-hydrated infant should produce urine that is clear or pale yellow in color. Dark urine that stains the white diaper, and/or orange spots in the diaper-which indicate uric acid crystals-are signs of dehydration. What comes out in the diaper is waste, like the overflowing of a cup. If little TJ is well-hydrated, he will produce six to eight wet diapers of clear/pale yellow urine and a couple of stools (included in the six to eight diaper count) in a twenty-four-hour period.

How much to feed
If you are feeding by bottle, count on about one ounce per hour. The newborn stomach can hold about two and a half ounces at a time. While infants may be able to take in more if they feed quickly, they are likely to bring it back up. So, if your baby takes two ounces, feed again in two to two and a half hours. If your baby takes one ounce or less, feed again in about one hour. In these early days, plan on feeding about every two hours during the day, and no longer than three hours apart at night.

For the breast-feeding mom, use these guidelines:
If you are getting those six to eight wet diapers, whatever you are doing is working! Breast milk is more easily digested than formula, therefore babies may feed more often. Also, personality differences are more obvious with breast-feeding - there are those who want a full meal, others who are snackers, and still others who are cluster eaters and feed frequently, seemingly non-stop for an hour or two, and then take a break.

Pay attention to your breasts. After a few days of breast-feeding, you will feel the breasts fill up: they will feel heavy and/or firm. After a good feeding, the breast should feel soft. Not every feeding will be the same. Your goal is to have more good feedings than fair or poor feedings. Fair feedings leave your breast feeling only somewhat emptied. After a poor feeding your breast feels no different after than it did before.

One phrase I hear quite often from breast-feeding moms is, "My milk isn't in yet." This somehow implies that until the heavier milk, which is perceived as the "real" milk, comes in, the baby has been starving. The milk that comes in during the first few days is called colostrum. It is every bit as "real" to the baby as the heavier milk that will come in shortly and make the breasts feel heavy. Its composition is different, but it is designed for the special needs of the just newly born.

Breast or formula?
The research on the benefits of breast-feeding is voluminous. The more it is studied, the more we learn about the intricate perfection of breast milk for an infant. Breast-feeding, even for a short time, still brings benefit to the newborn. However, the decision to feed by breast or use formula is a personal one.

There are many reasons why women choose one method over another, and it is important to understand and support whichever decision they make. If breast-feeding is too stressful for a particular mom, especially if she has little support around her and is lacking in self-confidence about her ability to breast-feed, then formula may be a better choice for her. Indeed, it may allow her to be more relaxed and therefore bond better with her newborn.

Conclusion
All new family units need support: emotional as well as the physical, chore-type of help. If you are a new family, ask. If you know a new one, give support. Each new baby makes the world a little bit bigger. Helping each other makes the world a little bit smaller.