Your Baby Week One - A Guide

First Day's in the Nursery

Sleeping Baby with Hat and Pacifier
Alexandra Grablewski/Digital Vision/Getty Images

How you experience your baby's first days depend on a lot of factors. Chief among these is if you have a full-term baby without any medical problems who can room with you or stay in the well-baby nursery and whether you had a vaginal delivery or c-section. Keep in mind that babies who are born premature or with medical problems may have to go straight to the Neonatal Intensive Care Unit instead.

The other big thing that can influence your experiences with your new baby is whether or not this is your first baby.

With your first baby, everything that happens from her first cries to her first diaper change can be new, unexpected, exciting, and sometimes overwhelming.

Why are diaper changes overwhelming, for example? Because many new parents aren't ready for the large, black, tarry meconium stools that newborn babies have for their first few days.

What You Need To Know

  • Plan to breastfeed your baby within one hour of her birth and then 8 to 12 times a day.
  • Don't be surprised if your baby loses weight before she leaves the hospital. It is normal for babies to lose 5% to 8% of their birth weight during their first week.
  • Your baby will likely have a hearing test, newborn screening test, and will be screened for jaundice before she goes home.
  • Early discharge (less than 48 hours) is reserved for babies who are full-term, feeding well, and have no medical problems or risk factors (large baby, small baby, fever, etc.).
  • Remember that the Apgar score, with which your baby may be assigned when she is born, is not a good predictor of a baby's long-term health. According to the Nelson Textbook of Pediatrics, "The Apgar score was not designed to predict neurologic outcome. Indeed, the score is normal in most patients in whom cerebral palsy subsequently develops."

Feeding Your Newborn Baby

A breastfeeding newborn baby.
A breastfeeding newborn baby. Photo © Tari Faris

Breastfeeding Your Baby

Most parents know that breastfeeding has health benefits for both the breastfeeding baby and mother. So get help breastfeeding from a lactation consultant, nurse, or doctor, while you are in the hospital so that you can get off to a good start.

Other tips to help you breastfeed can include:

  • Planning to breastfeed your newborn baby 8 to 12 times a day during her first few weeks. Remember that the more you breastfeed your baby, the sooner your breastmilk will usually come in.
  • Setting breastfeeding goals for yourself. Having a goal for how long you want to breastfeed can help ensure that you won't stop early if you begin to have problems, as you get help and advice to keep going until you meet your goal.
  • Getting help if you begin to have problems, including a poor latch, engorgement, sore nipples, or to improve your breast milk supply. This help might come from other moms who have breastfed their children, a pediatrician who is supportive of breastfeeding, and/or a lactation consultant.
  • Avoiding formula supplements unless your pediatrician thinks that they are medically necessary.
  • Avoiding bottles or a pacifier until your baby is breastfeeding well.

Baby Formula

If not breastfeeding, your baby will likely be drinking a milk-based, iron-fortified baby formula. She will probably only be drinking about one to two ounces at a time, every two to three hours, during her first days. This amount will slowly increase to two to four ounces by the end of the first week.

On Demand or On a Schedule

Especially during the first few weeks, it is usually best to feed your baby on demand every 1 1/2 to 3 hours and not on a strict schedule.

Keep Reading:


CDC. Breastfeeding Report Card, United States - 2007: Outcome Indicators.

Baby Proofing and Safety

A newborn going home from the hospital safely in her car seat.
A newborn going home from the hospital safely in her car seat. Photo © Melissa Carroll

Ideally, your home will be well baby proofed before your baby is born. In fact, it is a policy in most hospitals that you show that you have a properly installed car seat before you are allowed to bring your baby home. In addition to a car seat (a rear-facing infant or convertible car seat in the backseat), you can baby proof your home and make it safer for your newborn baby by:

  • Making sure her crib is safe: Have no more than 2 3/8 inches between the bars. The mattress should be firm and fit snugly within the crib. Keep it away from windows and drafts. Avoid placing fluffy blankets, stuffed animals, or pillows in the crib as they can cause smothering. You should also remove pillow-like bumper pads. In fact, some experts recommend not using bumper pads at all, as they are mostly decorative and can possibly increase a baby's risk of SIDS.
  • Making sure that used or hand-me-down equipment, such as car seats, strollers and cribs, etc, haven't been recalled for safety reasons. Call the manufacturer or the Consumer Product Safety Commission for an up to date list of recalled products.
  • Setting the temperature of your hot water heater to 120 F to prevent scalding burns.
  • Installing smoke and carbon monoxide detectors and using flame-retardant bedtime clothing.
  • Making your home smoke-free so that your baby isn't exposed to secondhand smoke. Simply smoking outside is not enough to reduce your baby's risk of SIDS, ear infections, asthma, and other conditions.
  • Reviewing your home's risk for causing lead poisoning, especially if it was built before 1950 or before 1978 and you plan on having it remodeled.


U.S. Environmental Protection Agency. Health Effects of Exposure to Secondhand Smoke.

Where Should Your Baby Sleep?

Newborn babies should sleep on their back, near their mother's bed.
Newborn babies should sleep on their back, in a bassinet, cradle, or crib, near their mother's bed. Photo © Vincent Iannelli, MD

New parents are often told to put their newborn babies to sleep wherever they sleep best.

That isn't always good advise though, as some new parents go so far as to let their babies sleep in a swing or car seat.

While a newborn won't necessarily pick up any bad habits at this age, such as if she is sleeping in a car seat, it isn't the safest place for her to sleep.

One study on cases of SIDS found that a small percentage of infants who died were seated in car seats. That doesn't mean that you shouldn't put your baby in a car seat when you are driving in the car. However, you likely should find a more appropriate place for your baby to sleep.

According to the American Academy of Pediatrics, which advises against co-sleeping, your baby should sleep:

  • in a bassinet, cradle, or crib that is near her mother's bed, but not in her bed.
  • on her back, not on her side or stomach.
  • on a firm sleep surface, such as a firm crib mattress, which has been covered by a well-fitted sheet.
  • without any soft objects (pillows and toys) or loose bedding (blankets and sheets) in her bassinet, cradle, or crib.

Getting your Baby to Sleep

If you are having trouble getting your baby to sleep in a crib, consider using a bassinet or cradle instead. A full-size crib is sometimes too big for a newborn.

Swaddling often helps babies get to sleep, stay asleep, and get comforted quickly, especially when they are newborns.

Sleep-Deprived Parents

To help make sure everyone gets enough sleep, parents should try to take turns caring for their baby at night, take naps during the day when their baby is sleeping, and get help from family and friends when possible.

Dad can help a breastfeeding mom get more rest at night by changing the baby's diaper, bringing her to mom for the feeding, and putting her back to bed.

Week One Developmental Milestones

A smiling newborn baby, an important early developmental milestone.
A smiling newborn baby, an important early developmental milestone. Photo © Tari Faris

Developmental milestones in the first week of life? Most parents don't expect that their newborn baby is going to be able to do much besides eat, sleep, and cry. While it will be some time before you watch your baby's first steps and hear her first words, there are some important developmental milestones to look for, even at this age. In your baby's first week, you can usually expect her to:

  • Have a spontaneous or almost reflexive smile, which can occur as early as your baby's first few days of life and should be present by the time she is 10 weeks old. This is different than the social smile that occurs in response to something, like when you talk or sing to your baby. Babies develop the social smile a little later when they are one to two months old.
  • Have equal movements of her arms and legs on both sides of her body. For example, she shouldn't move one arm or one leg much more than the other, which could be a sign of injury or weakness.
  • Lift her head briefly when she is on her tummy, although remember that newborn babies have poor head control and need their head supported at all times.
  • Focus briefly on objects that are near her face and up to about 12 to 15 inches away, which is about the distance of a breastfeeding baby looking at her mother's face. She can also see simple, high contrast patterns and her vision will quickly mature over the next few months.

Your baby may also be able to respond to loud noises, and look at and follow objects toward the midline of her face.

Week One Care Tips

Baby's first bath at home, which should be a sponge bath until her umbilical cord comes off.
Baby's first bath at home, which should be a sponge bath until her umbilical cord comes off. Photo © Vincent Iannelli, MD

Umbilical Cord Care

While parents used to be told to frequently put alcohol on their baby's umbilical cord until it falls off, they are just as likely to be told to not put any alcohol on it at all anymore. It is usually best to just ask your pediatrician what he or she recommends concerning umbilical cord care.

Sponge Baths

To avoid getting her umbilical cord too wet, it is usually best to give your baby a sponge bath until her cord falls off.

Diaper Changes

By the time she is five to seven days old, your baby will be needing a lot of diaper changes and should be having six or more wet diapers and three to four loose yellow stools each day.

During this week, your baby's stools will change from the large, black, tarry meconium of the first few days, to green/yellow transitional stools, to the more regular yellow bowel movements of an older baby.

Nail Trimming

Trimming your baby's fingernails when they seem long is important so that your baby doesn't scratch her face, or more seriously, her eye. You can use a baby nail clipper or a nail file to trim your baby's nails. Get help or do it when she is sleeping or eating if she fights having them trimmed.


You should usually burp your baby after each feeding to prevent gas and fussiness. Some babies do better, especially if they spit up a lot, if you burp them after they drink every ounce or so instead of waiting until the end of the feeding.

If you are having trouble getting your baby to burp, consider varying the position you are holding your baby. For example, first try burping her while she is lying against your shoulder. Then, if you don't get a burp, sit her in a more upright position and burp her while she is sitting up.

Week One Q&A

A baby traveling on an airplane.
A baby traveling on an airplane. Jerry Driendl / Getty Images

Common new baby questions include:

Can we travel with our newborn baby? Is it safe to let her fly on a plane?
You will have to check with the specific airline that you are using. American Airlines, for example, says that they don't allow younger babies to fly, including "newborn babies (within seven days of delivery) unless parent or guardian has a medical certificate indicating travel is authorized."

Even if the airline said it was OK, that doesn't mean that it is a good idea, though. In addition to being stressful, traveling through an airport, on an airplane, and then visiting family would likely expose your child to viral illnesses, at a time when she doesn't have a strong immune system and hasn't had many shots. Unless travel was more essential, like if you just adopted a baby and need to get back home, it might be best to wait until your baby was older, with a more mature immune system and on a more predictable schedule, when he is two to three months old. { read more }

Can you use warm or hot water from the tap to make your baby's formula?
According to the U.S. Environmental Protection Agency, you should, "Never cook or mix infant formula using hot water from the tap." Many homes have plumbing with lead or lead solder and hot water can concentrate the lead. Running the water for 15 to 30 seconds and only using cold water can help reduce your baby's exposure to lead from tap water. { read more }

Do you have to boil the water when making baby formula?
While most brands of baby formula once recommended boiling as a part of their instructions, they now often recommend, "Asking your baby's doctor" or "local health department" instead. { read more }

Week One Medical Issues

Newborn babies often have
Newborn babies often have "dry" flaky skin. Photo © Vincent Iannelli, MD

Since so many of the things your baby will do are new to you, it can sometimes be hard to tell what is normal and what is a sign of an illness.

Normal Baby "Problems"

Fortunately, many of the "problems" that parents notice are usually normal. These include:

  • periodic breathing - short periods of slow and then fast breathing
  • baby rashes - including milia (small white pimples) and erythema toxicum (larger red bumps)
  • dry-looking, flaky skin - this is usually normal "baby skin"
  • hiccups and gas
  • acrocyanosis - the condition in which a baby has blue hands and feet, while the rest of her body is still pink. It is a sign of an immature circulatory system and not low oxygen.


Up to half of newborn babies develop jaundice, a yellowing of the skin, in their first few days. Fortunately, their jaundice usually goes away on its own without treatment. Jaundice typically reaches a peak level by four to five days, and may need treatment with phototherapy if it gets too high. That makes it important to see your pediatrician to monitor your baby's jaundice levels so they don't reach a high level this first week.


Infections are not common during your baby's first week, but it is important to recognize signs and symptoms of infections, including:

  • fever (temp at or above 100.4 F)
  • low temperature
  • trouble breathing
  • missing feedings
  • sleeping too much
  • irritability
  • vomiting

Losing Too Much Weight

Although the average baby loses 5% to 10% of their birth weight during his first week, losing more than 10% can be a sign that your baby isn't getting enough to eat.


Spitting up or reflux is common, affecting up to half of all babies. It usually isn't a problem unless your baby is having problems gaining weight, is choking, or is frequently fussy.

Week One Tools and Quizzes

You can use your baby's weight to track her growth on a growth chart.
You can use your baby's weight to track her growth on a growth chart. Photo © Vincent Iannelli, MD

Some new parents are too busy taking care of their newborn baby to have time to do anything else, like visit friends, keep up with regular hobbies, or even take a shower every day.

Others have plenty of extra time, either because they have a lot of help or they have an 'easy' baby.

Parents of a newborn baby may find the following quizzes and tools helpful (if they have the time to use them right now):

First Visit to the Pediatrician

A baby being checked for jaundice at her first visit to her pediatrician.
A baby being checked for jaundice at her first visit to her pediatrician. Photo © Vincent Iannelli, MD

This will likely surprise most parents, but the first visit to your pediatrician may be the most important.

Especially if your baby was discharged from the nursery early, the first visit to her pediatrician can help:

  • make sure your baby is feeding well, especially if she is breastfeeding
  • is not losing too much weight
  • monitor your baby for jaundice
  • diagnosis medical conditions, especially congenital heart disease (heart murmur, blue skin color, difficulty breathing, etc.)

Baby's First Visit

When should your baby first see her pediatrician?

Although it depends on whether or not your baby was already jaundiced when she went home, how well she was feeding, and if she had any medical problems, the American Academy of Pediatrics (AAP) advises that "it is important for your baby to be seen by a nurse or doctor when the baby is between 3 and 5 days old."

An early checkup for your baby is especially important if your baby had an early discharge from the nursery and went home before she was 48 hours old. According to the AAP, these babies should be examined by a health professional within 48 hours of going home.

And of course if your child is not feeding well, has a fever, is jaundiced, or shows other signs of illness, then you may need to see your pediatrician even sooner.


American Academy of Pediatrics. Question and Answers: Jaundice and Your Newborn

Hospital Stay for Healthy Term Newborns. PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1434-1436

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