Newborn Care: The Complete Guide to the First Six Weeks at Home

The first six weeks with a newborn are a crash course nobody fully prepares you for. This guide walks you through what is normal, what helps, and the signs that mean your baby needs to be seen today.

Imagine it is 3am on your fourth night home. Your baby has fed, been changed and rocked, and is still crying. Their skin looks a little yellow, they have hiccups, and you are not sure whether the sound of their breathing is normal. You search online and find a hundred answers. What you need is one calm guide that tells you what is normal and what is not.

Before you leave hospital or the birth centre

Most babies have a full newborn physical examination within 72 hours of birth, checking the eyes, heart, hips and, in boys, the testes. Many countries also offer a hearing screen and a heel-prick blood spot test in the first week to look for rare but serious conditions such as sickle cell disease, cystic fibrosis and an underactive thyroid.,Before going home, make sure you know how to contact your midwife or community nurse, when your first home or clinic visit will be, and who to call at night. Ask for a quick demonstration of how to position your baby for feeding and how to put them down to sleep safely.

What a newborn looks like

Newborns rarely look like the babies in advertisements. Their heads may be slightly elongated after a vaginal birth, their eyes may be puffy, and their hands and feet may look bluish for the first day or two because circulation is still adjusting. Fine hair called lanugo, peeling skin, swollen breasts or genitals, and small white spots on the nose called milia are all common and usually fade in the first weeks.,Birthmarks are common too. Salmon patches on the eyelids or the back of the neck, and blue-grey patches on the lower back (often seen in babies with darker skin) are harmless. Any new mark that grows rapidly should be checked.

Feeding in the first weeks

Whether you breastfeed, formula feed or do both, newborns need to feed often, usually 8 to 12 times in 24 hours. Their stomachs are tiny, and frequent feeding is normal, not a sign that something is wrong. Feed responsively, watching for early hunger cues such as rooting, sucking on hands and stirring, rather than waiting for crying, which is a late cue.,If you are formula feeding, make up each feed fresh following the instructions on the tin, use the scoop provided, and never add extra powder. Hold your baby close and semi-upright, and try paced feeding so they can pause and control the flow.

Is my baby getting enough?

• By day five, at least six heavy wet nappies every 24 hours
• Pale, straw-coloured urine
• Stools that change from black meconium to green and then yellow by day four or five
• Baby seems content after most feeds
• Steady weight gain after the first week
• Back to birth weight by about two weeks

Weight loss after birth

Most babies lose some weight in the first few days, typically up to 7 to 10 percent of their birth weight, then regain it by around two weeks. Your midwife or nurse will weigh your baby and may suggest a feeding review if the loss is greater than expected. Early help with feeding usually solves the problem quickly.

Nappies and stools

The first stools, called meconium, are black and sticky. Over the next few days they become greenish and then, for breastfed babies, mustard yellow, seedy and loose. Formula-fed babies tend to have firmer, paler stools. Breastfed babies may pass a stool after every feed in the early weeks, or occasionally go several days without one later on.,Pale, chalky or white stools can be a sign of a liver problem and need to be checked the same day. Blood in the stool, very hard pellets, or green vomit also need prompt assessment.

Umbilical cord care

The cord stump usually dries and falls off within one to three weeks. Keep it clean and dry, fold the nappy below it, and let it fall off on its own. A little blood when it separates is normal. Redness spreading onto the skin around the base, a bad smell, pus or fever can mean infection and need same-day review.

Bathing and skin care

Newborns do not need a daily bath. Two or three times a week is plenty, with plain warm water for the first month. Test the water with your elbow or a thermometer (around 37°C), never leave your baby alone in the bath even for a moment, and keep everything you need within reach.,Avoid perfumed products and baby wipes with fragrance in the early weeks. Dry skin creases well, especially behind the ears and in the neck folds. If your baby’s skin is dry or cracked, a plain unperfumed emollient can help.

Safe sleep

Sudden infant death syndrome (SIDS) is rare, but simple steps reduce the risk significantly. Always place your baby on their back to sleep, for every sleep, day and night. Use a firm, flat mattress in a cot, crib or Moses basket with no pillows, bumpers, soft toys or loose bedding. Keep your baby in the same room as you for at least the first six months.,Keep the room at a comfortable temperature, usually 16 to 20°C, and avoid overheating: no hats indoors and no heavy blankets. A baby sleeping bag that fits well is a good option. Never sleep with your baby on a sofa or armchair, and avoid bed-sharing if you or your partner smoke, have drunk alcohol, taken drugs or medicines that make you drowsy, or if your baby was premature or small at birth.

How much do newborns sleep?

Newborns sleep for 14 to 17 hours a day, but in short stretches of two to four hours because they need to feed often. They have no sense of day and night at first. Keeping daytime feeds bright and sociable and night feeds dim and quiet helps their body clock develop over the first few months. A fixed schedule is not realistic in the first weeks, and responding to your baby is not “spoiling” them.

Crying and how to soothe your baby

All babies cry, and crying often increases from around two weeks, peaking at six to eight weeks before settling. Common reasons include hunger, wind, a wet nappy, being too hot or cold, tiredness or simply wanting to be held.,Things that often help include skin-to-skin contact, gentle rocking or walking, white noise, swaddling with the hips free to move (stop once your baby shows signs of rolling), a warm bath, or a walk in the pram. Sometimes nothing works, and that is not your fault.

When crying becomes too much

If you feel overwhelmed, put your baby down safely on their back in their cot, close the door and take a few minutes to calm yourself. Call someone you trust. Never shake a baby: shaking can cause serious brain injury or death. Ask your midwife or nurse about local support for parents of crying babies; many areas have helplines.

Colic

Colic is usually described as crying for more than three hours a day, at least three days a week, in an otherwise healthy, well-fed baby. It often starts in the first few weeks and resolves by three to four months. There is little evidence for most colic drops. Holding, rocking and responding to your baby, and getting support for yourself, remain the mainstay. If crying is high-pitched, constant, or accompanied by fever, poor feeding or vomiting, your baby needs to be seen.

Jaundice

Jaundice, a yellow tinge to the skin and whites of the eyes, is common in the first week because a newborn’s liver is still maturing. It is often easier to see on the gums, palms or soles in babies with darker skin. Most jaundice is mild and fades within two weeks, sooner in formula-fed babies and a little later in breastfed babies.,Get your baby checked the same day if jaundice appears in the first 24 hours, is spreading or getting deeper, if your baby is very sleepy and not feeding well, or if stools are pale and urine is dark yellow. Jaundice lasting beyond two weeks (three weeks in premature babies) also needs a check.

Temperature and fever

Use a digital thermometer under the armpit for young babies. A normal temperature is around 36.5 to 37.5°C. In a baby under three months, a temperature of 38°C or higher is a medical emergency, even if they otherwise seem well, because serious infections can progress quickly at this age. Seek urgent care straight away. A temperature below 36°C with a baby who is floppy or not feeding is also a concern.

Vomiting and possetting

Bringing up small amounts of milk after feeds, called possetting or reflux, is very common and usually harmless if your baby is gaining weight and content. Keeping them upright for a while after feeds may help. Projectile vomiting after every feed, green or bloody vomit, or vomiting with a swollen tummy, fever or fewer wet nappies needs urgent assessment.

Breathing: what is normal

Newborn breathing is often irregular. Babies may breathe quickly for a few seconds, then pause briefly for up to 10 seconds, then start again. This is called periodic breathing and is normal. Snuffly noises are common too, because newborn nasal passages are narrow.,Call emergency services if your baby stops breathing for more than 20 seconds, turns blue or grey around the lips, or is struggling to breathe, with grunting, the skin pulling in between or under the ribs, or nostrils flaring. Seek same-day help for persistent fast breathing (more than 60 breaths a minute when calm).

Eyes, mouth and skin problems

• Sticky eyes are common because tear ducts are not fully open; clean from the inner corner outwards with cooled boiled water and a fresh cotton pad for each eye
• Red, swollen eyelids or thick pus need same-day review
• White patches inside the cheeks that do not wipe away may be oral thrush, which is treatable
• Cradle cap (yellow scaly patches on the scalp) is harmless and usually clears with gentle washing and an emollient
• Nappy rash usually responds to frequent changes, nappy-free time and a barrier cream
• A rash that does not fade when a glass is pressed against it is an emergency

Immunisations

Vaccinations protect babies from serious diseases such as whooping cough, measles, meningitis and hepatitis B. Schedules differ between countries, but many start at birth (for example BCG or hepatitis B in some regions) and again at around six to eight weeks. Keep your baby’s health record book safe and bring it to every appointment. If you were vaccinated against whooping cough or RSV during pregnancy, your baby has some early protection, but they still need their own vaccines.

The six-to-eight-week check

Around six to eight weeks, your baby will usually have a second full examination of their eyes, heart, hips and growth, and you will be asked about feeding, sleep and how you are feeling. It is a good moment to raise any worries, however small. Many services also offer a postnatal check for the birthing parent at the same time.

Looking after yourself

Recovering from birth takes time, whether you had a vaginal birth or a caesarean. Rest when you can, eat regularly, drink plenty of water and accept help with meals, laundry and older children. Bleeding after birth (lochia) gradually lightens over four to six weeks.,Contact your midwife or another healthcare provider urgently for heavy bleeding that soaks a pad in an hour, large clots, fever, severe tummy pain, a painful swollen calf, chest pain or breathlessness, or a severe headache with vision changes.

Baby blues and postnatal depression

Up to eight in ten new parents feel tearful, anxious or irritable in the first few days. These “baby blues” usually pass within two weeks. If low mood, hopelessness, anxiety or difficulty bonding last longer, or start later, it may be postnatal depression, which affects around one in ten mothers and also some fathers and partners.,Postnatal depression is common and treatable. Talk to your midwife, health visitor or another healthcare provider. Seek help urgently if you have thoughts of harming yourself or your baby, feel confused, or are seeing or hearing things others do not; this can be a sign of postpartum psychosis, which needs emergency care.

Bonding with your baby

Bonding is a process, not an instant feeling. Skin-to-skin contact, talking and singing, eye contact during feeds and responding to your baby’s cues all help. Some parents feel a rush of love straight away; for others it grows over weeks. Both are normal. If you feel detached for a long time, mention it at your next check.

Partners and family

• Do skin-to-skin, nappy changes and bath time from day one
• Take night shifts if your baby is formula or bottle-fed
• Protect the birthing parent’s rest and recovery
• Handle visitors, meals and shopping
• Notice signs of low mood in both parents and encourage help early

Siblings and pets

Older children may feel jealous or unsettled. Involving them in small tasks, spending one-to-one time with them, and keeping routines as normal as possible helps. Never leave a baby alone with a pet, however gentle, and keep pets out of the room where your baby sleeps.

Car seats and travel

Use a rear-facing car seat suitable for your baby’s weight from the very first journey home, fitted according to the manufacturer’s instructions. Avoid bulky snowsuits under the harness, and limit time in the car seat on long journeys, taking breaks at least every two hours. Never place a rear-facing seat in front of an active airbag.

Tummy time

Babies sleep on their backs, so short periods of supervised tummy time while awake help build neck and shoulder strength and prevent flat spots on the head. Start with a minute or two on your chest or a firm mat a few times a day, and build up gradually. Stop if your baby becomes tired or distressed.

Premature and small babies

Babies born early or small may need extra support with feeding, warmth and monitoring after discharge. Follow the plan from the neonatal team, keep follow-up appointments, and know your direct contact number. Premature babies are more vulnerable to infections, so handwashing and avoiding contact with people who are unwell are especially important. Use your baby’s corrected age when thinking about development.

Warning signs: get urgent help

• Temperature of 38°C or higher in a baby under three months
• Breathing difficulty, pauses over 20 seconds, or blue or grey lips
• Floppy, unusually drowsy or hard to wake
• Not feeding, or far fewer wet nappies
• Green or bloody vomit, or a swollen tummy
• A rash that does not fade under a glass
• A seizure (fit)
• Bulging soft spot on the head
• Jaundice in the first 24 hours or that is spreading

Dressing your baby

A simple rule is to dress your baby in one more layer than you would wear to feel comfortable. Feel the back of their neck or their tummy rather than their hands and feet, which are often cool. If they are sweaty or hot, remove a layer. Avoid hats indoors and when sleeping, because babies lose heat through their heads and need that to regulate their temperature.

Nails, hair and nose care

Newborn nails are soft but sharp. Filing them with a baby emery board is safer than cutting in the first weeks. Many parents do it while the baby sleeps. Gently wash the scalp with water a few times a week. For a blocked nose, saline drops and a few minutes upright usually help; avoid cotton buds inside the nose or ears.

Keeping your baby safe from infection

• Wash your hands before feeding and after nappy changes
• Ask visitors to wash their hands and to stay away if they are unwell
• Do not let anyone with a cold sore kiss your baby, as the herpes virus can be dangerous for newborns
• Keep your home smoke-free and your baby away from second-hand smoke
• Clean and sterilise bottles and pump parts carefully

Developmental milestones in the first six weeks

By around six weeks, many babies start to focus on faces, follow a moving object briefly with their eyes, react to loud sounds and may give their first social smile. They begin to lift their head briefly during tummy time. Every baby develops at their own pace. Mention any concerns, such as not responding to sounds or not looking at faces, at your next check.

Frequently asked questions

How often should my newborn feed?

Usually 8 to 12 times in 24 hours, sometimes more during growth spurts. Feed responsively rather than by the clock.

Should I wake my baby for feeds?

In the first weeks, many experts suggest waking your baby if they sleep longer than three to four hours, especially if they are jaundiced or not yet back to birth weight. Ask your midwife or nurse what is right for your baby.

Can I take my newborn outside?

Yes. Fresh air is fine. Dress them in one more layer than you, protect them from direct sun, and avoid crowded indoor spaces in the first weeks if you can.

When should hiccups or sneezing worry me?

Rarely. Hiccups and sneezes are normal in newborns and usually stop on their own.

Is it normal for my baby to have a flat spot on their head?

Mild flattening is common. Tummy time and changing which way your baby faces in the cot help. Mention it at your next check if it is getting worse.

How do I take my baby’s temperature?

Use a digital thermometer under the armpit for babies under five years old, holding their arm gently against their side. Do not use forehead strips, which are unreliable.

But how do I know if I am doing it right?

If your baby is feeding, has plenty of wet nappies, is gaining weight and you know the warning signs, you are doing it right. Nobody gets everything perfect. Trust your instincts: if something feels wrong, ask a nurse or midwife. You will never be wasting their time.

Related: Newborn jaundice · Colic and soothing · Baby fever · Breastfeeding guide

Sources: World Health Organization, UNICEF, National Institute for Health and Care Excellence (postnatal care guideline NG194), American Academy of Pediatrics, The Lullaby Trust.