The first few weeks with a newborn come with a lot of questions. This guide covers some of the most common things parents ask about after coming home from the hospital.
Call right away
Please call for medical advice or seek urgent evaluation if your newborn has:
- A rectal temperature of 100.4°F (38°C) or higher
- Difficulty breathing, including ribs pulling in, grunting, persistent nostril flaring, or blue or gray coloring
- Difficulty waking for feeds or a significant change in feeding
- Fewer than 4 wet diapers per day after the first week of life
- Increasing jaundice or yellowing of the skin or eyes
- Repeated vomiting or green or bloody vomit
- Redness spreading around the umbilical cord, swelling, pus, or a foul odor
- Persistent or unusual inconsolable crying
- Any other change that makes you concerned that your baby is seriously ill
For a medical emergency, call 911.
Feeding and diapers
Most newborns feed frequently, usually 8-12 times in 24 hours during the early weeks. Breast milk, formula, or a combination of the two can all provide appropriate nutrition for your baby.
During the first several days, the number of wet diapers should increase each day. By around day 5, most babies should have about 4-5 or more wet diapers per day.
Newborn stools change significantly during the first week. They typically progress from dark, sticky meconium to green or brown transitional stools and then to yellow stools in breastfed babies or tan/brown stools in formula-fed babies.
Your baby's weight will be checked closely during the first visits. Some weight loss after birth is expected, and we will follow your baby's weight and feeding until we are comfortable that growth is progressing appropriately.
Please call if feeding is painful, your baby is consistently difficult to wake for feeds, feeds have significantly decreased, or you are concerned that your baby is not getting enough to eat.
Safe sleep
For every sleep, including naps:
- Place your baby on their back
- Use a firm, flat sleep surface such as a crib or bassinet
- Keep the sleep space free of blankets, pillows, bumpers, positioners, and stuffed animals
- Have your baby sleep in their own sleep space rather than an adult bed, couch, or chair
Newborns can be noisy sleepers. Grunting, squeaking, brief irregular breathing, and movement during sleep are common. Persistent difficulty breathing, color changes, or prolonged pauses in breathing are not normal and require medical attention.
Jaundice
Mild jaundice is common during the first week of life. It causes a yellow appearance to the skin and sometimes the whites of the eyes.
Please call if jaundice is becoming more noticeable, is spreading farther down your baby's body, your baby is very sleepy or feeding poorly, or you are otherwise concerned.
Umbilical cord care
Keep the umbilical cord clean and dry while it heals. Fold the diaper below the cord so it remains exposed to air.
The cord usually falls off on its own during the first few weeks. A small amount of dried blood around the time it separates can be normal.
Please call if you notice redness spreading onto the skin around the cord, swelling, pus, persistent bleeding, or a foul odor.
Common newborn findings
Many things that look unusual in a newborn are completely normal, including:
- Frequent sneezing and hiccups
- Peeling or flaky skin
- Small white bumps on the nose or face
- Temporary breast or genital swelling from maternal hormones
- A small amount of vaginal bleeding in newborn girls
- Grunting, straining, or turning red before passing a soft stool
- Brief crossing of the eyes
- A visibly pulsing soft spot
If you are unsure whether something you are seeing is normal, take a picture when appropriate and ask us.
Crying
Crying normally increases during the first several weeks of life and often peaks around 6-8 weeks.
If you have fed, changed, and comforted your baby and the crying is becoming overwhelming, it is okay to place your baby safely on their back in the crib and take a short break.
Never shake a baby.
Please call if your baby's crying is significantly different from usual, your baby cannot be consoled, or crying is accompanied by other symptoms.
We also check in about how parents and caregivers are doing during newborn visits. Please tell us if you are struggling with your mood, anxiety, sleep, or adjusting after your baby's birth.
Your first visits
Your baby's first visit will usually take place within the first few days after leaving the hospital. We will review feeding, weight, jaundice, newborn screening, and any concerns you have.
Please bring your hospital discharge paperwork and any newborn screening information you received.
After the first visit, we'll decide whether your baby needs an additional weight check before the one-month well visit.