Well-Baby Checkup: Newborn
Your baby’s first checkup will likely happen within a week of birth. At this newborn visit, the healthcare provider will examine your baby and ask questions about the first few days at home. This sheet describes some of what you can expect.
All babies develop some yellowing of the skin and the white part of the eyes (jaundice) in the first week of life. Your healthcare provider will advise you if you need to have your baby's bilirubin level checked. Your provider will advise you if your baby needs a follow-up check or needs treatment with phototherapy.
Development and milestones
The healthcare provider will ask questions about your newborn. He or she will watch your baby to get an idea of his or her development. By this visit, your newborn is likely doing some of the following:
Blinking at a bright light
Trying to lift his or her head
Wiggling and squirming. Each arm and leg should move about the same amount. If the baby favors one side, tell the healthcare provider.
Becoming startled when hearing a loud noise
It’s normal for a newborn to lose up to 10% of his or her birth weight during the first week. This is usually gained back by about 2 weeks of age. If you are concerned about your newborn’s weight, tell the healthcare provider. To help your baby eat well, follow these tips:
Breastmilk is recommended for your baby's first 6 months.
Your baby should not have water unless his or her healthcare provider recommends it.
During the day, feed at least every 2 to 3 hours. You may need to wake your baby for daytime feedings.
At night, feed every 3 to 4 hours. At first, wake your baby for feedings if needed. Once your newborn is back to his or her birth weight, you may choose to let your baby sleep until he or she is hungry. Discuss this with your baby’s healthcare provider.
Ask the healthcare provider if your baby should take vitamin D.
If you breastfeed
Once your milk comes in, your breasts should feel full before a feeding and soft and deflated afterward. This likely means that your baby is getting enough to eat.
Breastfeeding sessions usually take 15 to 20 minutes. If you feed the baby breastmilk from a bottle, give 1 to 3 ounces at each feeding.
Breastfed babies may want to eat more often than every 2 to 3 hours. It’s OK to feed your baby more often if he or she seems hungry. Talk with the healthcare provider if you are concerned about your baby’s breastfeeding habits or weight gain.
It can take some time to get the hang of breastfeeding. It may be uncomfortable at first. If you have questions or need help, a lactation consultant can give you tips.
If you use formula
Use a formula made just for infants. If you need help choosing, ask the healthcare provider for a recommendation. Regular cow's milk is not an appropriate food for a newborn baby.
Feed around 1 to 3 ounces of formula at each feeding.
Some newborns poop (stool) after every feeding. Others stool less often. Both are normal. Change the diaper whenever it’s wet or dirty.
It’s normal for a newborn’s stool to be yellow, watery, and look like it contains little seeds. The color may range from mustard yellow to pale yellow to green. If it’s another color, tell the healthcare provider.
A boy should have a strong stream when he urinates. If your son doesn’t, tell the healthcare provider.
Give your baby sponge baths until the umbilical cord falls off. If you have questions about caring for the umbilical cord, ask your baby’s healthcare provider.
Follow your healthcare provider's recommendations about how to care for the umbilical cord. This care might include:
Keeping the area clean and dry.
Folding down the top of the diaper to expose the umbilical cord to the air.
Cleaning the umbilical cord gently with a baby wipe or with a cotton swab dipped in rubbing alcohol.
Call your healthcare provider if the umbilical cord area has pus or redness.
After the cord falls off, bathe your newborn a few times per week. You may give baths more often if the baby seems to like it. But because you are cleaning the baby during diaper changes, a daily bath often isn’t needed.
It’s OK to use mild (hypoallergenic) creams or lotions on the baby’s skin. Avoid putting lotion on the baby’s hands.
Newborns usually sleep around 18 to 20 hours each day. To help your newborn sleep safely and soundly and prevent SIDS (sudden infant death syndrome):
Place the infant on his or her back for all sleeping until the child is 1-year-old. This can decrease the risk for SIDS, aspiration, and choking. Never place the baby on his or her side or stomach for sleep or naps. If the baby is awake, allow the child time on his or her tummy as long as there is supervision. This helps the child build strong tummy and neck muscles. This will also help minimize flattening of the head that can happen when babies spend so much time on their backs.
Offer the baby a pacifier for sleeping or naps. If the child is breastfeeding, do not give the baby a pacifier until breastfeeding has been fully established. Breastfeeding is associated with reduced risk of SIDS.
Use a firm mattress (covered by a tight fitted sheet) to prevent gaps between the mattress and the sides of a crib, play yard, or bassinet. This can decrease the risk of entrapment, suffocation, and SIDS.
Don’t put a pillow, heavy blankets, or stuffed animals in the crib. These could suffocate the baby.
Swaddling (wrapping the baby tightly in a blanket) may cause your baby to overheat. Don't let your child get too hot.
Avoid placing infants on a couch or armchair for sleep. Sleeping on a couch or armchair puts the infant at a much higher risk of death, including SIDS.
Avoid using infant seats, car seats, and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant's airway or suffocation.
Don't share a bed (co-sleep) with your baby. It's not safe.
The AAP recommends that infants sleep in the same room as their parents, close to their parents' bed, but in a separate bed or crib appropriate for infants. This sleeping arrangement is recommended ideally for the baby's first year, but should at least be maintained for the first 6 months.
Always place cribs, bassinets, and play yards in hazard-free areas—those with no dangling cords, wires, or window coverings—to help decrease strangulation.
Avoid using cardiorespiratory monitors and commercial devices—wedges, positioners, and special mattresses—to help decrease the risk for SIDS and sleep-related infant deaths. These devices have not been shown to prevent SIDS. In rare cases, they have resulted in the death of an infant.
Discuss these and other health and safety issues with your baby’s healthcare provider.
To avoid burns, don’t carry or drink hot liquids such as coffee near the baby. Turn the water heater down to a temperature of 120°F (49°C) or below.
Don’t smoke or allow others to smoke near the baby. If you or other family members smoke, do so outdoors and never around the baby.
It’s usually fine to take a newborn out of the house. But avoid confined, crowded places where germs can spread. You may invite visitors to your home to see your baby, as long as they are not sick.
When you do take the baby outside, avoid staying too long in direct sunlight. Keep the baby covered, or seek out the shade.
In the car, always put the baby in a rear-facing car seat. This should be secured in the back seat, according to the car seat’s directions. Never leave your baby alone in the car.
Do not leave your baby on a high surface, such as a table, bed, or couch. He or she could fall and get hurt.
Older siblings will likely want to hold, play with, and get to know the baby. This is fine as long as an adult supervises.
Call the doctor right away if your baby has a fever (see Fever and children, below)
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Based on recommendations from the American Association of Pediatrics, at this visit your baby may get the hepatitis B vaccine if he or she did not already get it in the hospital.
Parental fatigue: A tiring problem
Taking care of a newborn can be physically and emotionally draining. Right now it may seem like you have time for nothing else. But taking good care of yourself will help you care for your baby too. Here are some tips:
Take a break. When your baby is sleeping, take a little time for yourself. Lie down for a nap or put up your feet and rest. Know when to say “no” to visitors. Until you feel rested, ignore household clutter and put off nonessential tasks. Give yourself time to settle into your new role as a parent.
Eat healthy. Good nutrition gives you energy. And if you have just given birth, healthy eating helps your body recover. Try to eat a variety of fruits, vegetables, grains, and sources of protein. Avoid processed “junk” foods. And limit caffeine, especially if you’re breastfeeding. Stay hydrated by drinking plenty of water.
Accept help. Caring for a new baby can be overwhelming. Don’t be afraid to ask others for help. Allow family and friends to help with the housework, meals, and laundry, so you and your partner have time to bond with your new baby. If you need more help, talk to the healthcare provider about other options.
Next checkup at: _______________________________
February 14, 2018
SIDs and Other Sleep Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, American Academy of Pediatrics
Adler, Liora C, MD,Goode, Paula, RN, BSN, MSN,Image reviewed by StayWell art team.,Turley, Ray, BSN, MSN