The first weeks at home with a newborn are full of wonder, and full of questions. Is she eating enough? Is that breathing sound normal? Why is he so sleepy, or so fussy? Almost every new parent feels unsure at times. This guide covers the basics of newborn care, the signs that mean you should call, and which parts of your baby's care need to happen in person. It is general information and not a substitute for advice from your baby's own provider.
Feeding
Newborns have small stomachs and eat often, usually every two to three hours around the clock, and sometimes more often during growth spurts. Breastfed babies often nurse 8 to 12 times in 24 hours. Watch for early hunger cues, such as rooting, sucking on hands or smacking lips, rather than waiting for crying, which is a late sign of hunger.
Diapers tell you a lot. In the first few days, the number of wet diapers usually goes up each day, and by about the end of the first week most babies have six or more wet diapers a day. Stools change from dark, sticky meconium to a lighter, yellowish color. If you are worried about the number of wet diapers, or your baby seems uninterested in feeding, call your baby's provider.
If feeding is hard, you are not failing. Feeding takes practice for both of you, and support from a lactation consultant or your baby's provider can make a real difference.
Why Weight Checks Happen in Person
Most babies lose some weight in the first few days after birth, and most are back to their birth weight by about two weeks of age. Following that pattern takes an accurate infant scale, so newborn weight checks are in-person visits. Your baby will also need in-person newborn checkups, often within a few days of going home, and vaccines on schedule.
Sagebrooke Family Medicine is starting as a telehealth practice, so we cannot weigh your baby by video. When your baby needs an in-person visit, we will help you arrange it. Telehealth can still be a good fit for many questions in between, such as feeding concerns, sleep, fussiness and how you are doing as a parent.
Safe Sleep
Safe sleep is one of the most important ways to protect your baby. National guidance recommends:
- Place your baby on their back for every sleep, including naps
- Use a firm, flat sleep surface, such as a crib or bassinet with a fitted sheet
- Keep pillows, blankets, bumpers and soft toys out of the sleep space
- Share a room with your baby, but not a bed, ideally for at least the first six months
- Keep your baby away from smoke, and avoid overheating
Umbilical Cord and Skin
Keep the cord stump clean and dry. It usually falls off within the first few weeks, and a little dried blood near the stump can be normal. Call if you notice redness spreading onto the belly, swelling, pus or a bad smell. Many newborns also have dry, peeling skin, tiny white bumps or blotchy rashes that fade on their own.
Jaundice
Many newborns develop a yellow tint to the skin or the whites of the eyes in the first days of life. This is called jaundice. It is common and often mild, but it should be checked. Call your baby's provider if the yellow color is spreading or getting deeper, if your baby is very sleepy or hard to wake for feedings, or if your baby is not feeding well.
Crying and Soothing
All babies cry, and crying often increases over the first several weeks. Swaddling, gentle rocking, white noise, a pacifier or skin-to-skin contact may help. If you feel overwhelmed, it is okay to place your baby safely on their back in the crib and step away for a few minutes to calm down. Never shake a baby.
When to Call Right Away
Trust your instincts. Contact your baby's provider right away for:
- A temperature of 100.4°F (38°C) or higher, taken rectally, in a baby under three months old
- Poor feeding, or far fewer wet diapers than usual
- Unusual sleepiness, or trouble waking your baby
- Repeated forceful vomiting, or vomit that is green
- Yellow skin or eyes that are spreading or getting worse
- Signs of a cord infection, or any breathing that seems fast or labored
Call 911 or go to the nearest emergency room if your baby has trouble breathing, has blue or gray lips or skin, is limp or unresponsive, or has a seizure. For a fever in a young baby, if you cannot reach your baby's provider quickly, do not wait. Go to the nearest emergency room.
Taking Care of You
Your health matters too. Mood swings, tearfulness and worry are common in the first two weeks after birth and are often called the baby blues. If those feelings last longer, feel intense, or make it hard to care for yourself or your baby, reach out to your provider. Postpartum depression and anxiety are common and treatable. If you have thoughts of harming yourself or your baby, call or text 988, or call 911. Accept help when it is offered, rest when you can, and try to eat and drink regularly.
You do not have to have every answer. Asking questions is part of caring for your baby well.
Getting Started
Before becoming a nurse practitioner, Brooke Tuttle, FNP-C, spent 11 years as a registered nurse in labor and delivery, postpartum and the well-baby nursery. Learn more about pediatric and adolescent care, read about childhood illnesses parents commonly ask about, or contact the practice with your questions.