This guide gives you information on the health and wellbeing of your new baby, particularly in the first year.
Caring for a newborn baby can be daunting and it can be difficult to know where to find accurate information.
This guide can be used alongside your baby’s 6 to 8 week check with your GP for clarity, and also lists other useful sources of information. It can’t cover everything, so if you’re worried or there’s a problem which is getting worse then don’t hesitate to contact your GP, health visitor or midwife.
For information on your own health and wellbeing after giving birth, see the FPA guide After A Baby: Your Health and Wellbeing.
Depending on the birth and how your baby is, you’ll often go home between 6 and 24 hours after delivery.
Before going home:
If you have a home birth, your midwives will be able to do these checks at home (unless there are any concerns for which you’d need to be referred to hospital).
Once home, you’ll be visited by a midwife. The first visit is often, but not always, within 24 hours of arriving home. The midwife will usually be your point of contact until 10 days after the birth. After this, if all is well, the health visitor will take over.
If you have any concerns, speak to your midwife or health visitor.
Before discharge, the staff will make sure you feel confident looking after your baby on your own at home, including feeding, changing, skin to skin contact and other aspects of their care.
For information and support if you’ve had a premature or sick baby see Bliss.org.uk.
They’re simple and quick tests to check your baby is healthy. They’re offered within the first 6 to 8 weeks.
This is done by a specialist midwife or paediatric doctor within 72 hours of the birth.
It’s a ‘top to toe’ examination of the mouth, eyes, heart, hips, back and, in boys, the testicles (testes). Your baby will also be weighed.
If any problems are found, such as a heart murmur, clicky hips, or a hernia, or there are any other concerns, your baby may need further investigations or be referred on to a paediatrician.
This is often done before you leave hospital or can be done at home within the first few weeks. It involves putting a soft earpiece in the baby’s ear and playing clicking noises.
You’ll usually be told the results straight away. Sometimes the test needs repeating if there’s not a clear reading. This is often due to background noise, the baby being unsettled, or fluid or a temporary blockage in the ear canal.
If there are any concerns, you’ll be referred to an audiologist (a healthcare professional who specialises in hearing).
This is done by a midwife when the baby is 5 days old. It’s a small prick on the baby’s foot and 4 drops of blood are put on a special card.
The test is looking for 9 rare but serious conditions, including sickle cell disease, an inherited thyroid disease, cystic fibrosis and some metabolic conditions (conditions that affect how the body converts food to energy).
You’ll get the results in 6 to 8 weeks. If any conditions are detected, your baby will likely need further testing and to be seen by a paediatrician.
Most newborns are healthy and the tests will come back normal. However, some babies do have a health problem.
Detecting a condition early can improve your baby’s health and may prevent disability or even death, so it’s recommended that your baby has these tests, although you can choose to decline them. For more information see ‘newborn screening’ at nhs.uk
The small clamp on the umbilical cord usually takes about a week to drop off. Until then, keep the area clean and dry. It doesn’t routinely need cleaning.
If it gets dirty, for example with poo, wash it with cotton wool and boiled, cooled water and gently pat dry.
If you notice any bleeding, redness of the skin or yellow discharge (a small amount of clear fluid oozing is normal), tell your health visitor, midwife or GP.
After the cord falls off, you may notice a small lump, called an umbilical hernia. As long as it’s not causing any problems this can be monitored. If it hasn’t disappeared by age 3 to 4, an operation may be advised. See umbilical hernia at nhs.uk for more.
Neonatal (newborn) jaundice is common and usually harmless.
It usually develops around day 2 to 3 and causes yellowing of the skin and white parts of the eye. It can sometimes cause urine (wee) to be lighter and poo to be darker.
It’s more common if you’ve had a forceps or ventouse delivery. It usually fades on its own by 2 weeks (can be longer in breastfed babies), but more severe jaundice may need treatment.
Your midwife will monitor for jaundice and refer you to the hospital if they feel treatment is needed.
If jaundice develops within 24 hours of birth, your baby needs to be checked by a health professional straight away.
Nappy rash should clear in a few days. If it’s not clearing, or it’s getting worse or oozing, contact your health visitor or GP as there could be an infection.
In the first few days it’s important to know what to expect in terms of wees and poos.
After the first week, your baby continues to wee and poo several times a day.
After around 6 weeks, some (not all) babies poo much less often. Breastfed babies may go many days without doing a poo. Every baby is slightly different, and you’ll learn what’s normal for your baby.
If they’re growing well and the poo is soft, don’t worry.
If you have any questions, ask your health visitor or GP.
Colic is common, but the exact cause is unknown. It usually starts when the baby is a few weeks old and stops around 4 to 6 months.
Symptoms in an otherwise healthy baby (who’s not losing weight) include:
What to do to help:
Sometimes nothing you do helps, and you may feel at the end of your tether. Remember, it will stop and doesn’t mean there’s an underlying problem.
Get help and support from family and friends or see your GP. Helpful sites include www.cry-sis.org.uk and www.iconcope.org.
This is a common condition where your baby brings up milk during, or just after, a feed. It’s because muscles at the base of your baby’s oesophagus (food pipe) haven’t fully developed, so milk can come back up easily. Your baby will grow out of it as they get older and the muscles develop.
Symptoms include:
On most occasions, symptoms settle with simple solutions. Get advice from your health visitor and try:
Sometimes reflux can lead to pain, leaving your baby very unsettled. Your GP can recommend different formula (if using) or medications to help with the symptoms.
Sometimes conditions such as cow’s milk protein allergy can cause the symptoms, and this will need to be investigated.
Most babies will grow out of reflux by the time they’re 1 year old.
It can be difficult to tell if your baby is very unwell.
Trust your instincts. You know your baby better than anybody else, so you’ll usually know if something isn’t right.
If you have any concerns, get medical advice by calling your health visitor, GP, or 111 (if it’s out of hours). In an emergency, go to A&E or call 999.
The signs listed below need medical attention straight away.
Temperature:
Breathing:
Other signs:
For more information:
Many common accidents are preventable. There are some useful resources on how to reduce the risk of accidents, ‘baby proof’ your home and minimise risk to your baby.
Initially, you produce colostrum (first milk), which is very concentrated, and your baby only needs a small amount (about a teaspoon full).
You’ll likely need to feed often, sometimes even hourly, but after a few days your baby will have fewer, longer feeds.
As a very rough guide, your baby should feed at least 8 to 12 times, or more, every 24 hours during the first few weeks.
The more you breastfeed, the more milk you’ll make, so it’s important to breastfeed both day and night.
You know when your baby is feeding as their sucking changes to deep rhythmic swallows.
See ‘breastfeeding: positioning and attachment’ at nhs.uk for a helpful video.
Breastfeeding can be difficult at first, so do get support if you’re struggling. Your GP, midwife or health visitor can recommend drop-in centres.
Other useful resources are:
There are many reasons why women decide to bottle feed. It may be that you’re unable to breastfeed or that you’ve chosen not to. If you feel under huge pressure to breastfeed but, for whatever reason, it’s not possible, this can sometimes cause you to feel a lot of stress.
Remember, a happy mother means a happy baby and you have to do what’s right for both you and your baby.
For a useful guide on bottle feeding, sterilising, what bottles to use and more, see ‘bottle feeding’ at nhs.uk.
It’s normal for babies to lose up to 10% of their weight in the first days after birth. Your midwife will check the weight on day 3 or 4 and, generally, your baby should be back to their birth weight by 3 weeks.
If your baby has lost more than 10%, the midwife will give tips to try and improve weight gain, such as techniques to improve breast feeding, expressing milk, and sometimes introducing a top up formula feed (if you’re breastfeeding this can be temporary, and you can go back to fully breastfeeding).
If your baby has lost more than 12% of their weight, they may need to be seen in hospital to check nothing else is causing the weight loss.
This is a condition which can make it harder for babies to breastfeed.
It’s caused by the frenulum (the strip of skin below the tongue) being shorter than normal. This makes it harder for your baby to latch on to the breast which can lead to sore or cracked nipples.
It can be difficult to diagnose but should be considered if you’re struggling to breastfeed your baby. It is checked for at the newborn check before leaving hospital.
Sometimes tongue tie causes no problems and doesn’t need to be treated. But if it’s causing problems, your baby may need a simple procedure called a frenulotomy, which involves cutting the small piece of skin. It’s done by a specially trained midwife, health visitor or doctor.
For more information and trained practitioners, see Tongue-Tie.org.uk
All children between 6 months and 5 years old are recommended to take vitamin A, C and D as they don’t always get enough in their diet.
All breastfed babies should have vitamin D from birth, even if you’re taking supplements yourself, as babies don’t get enough from breast milk.
If your baby has formula milk and is drinking more than 500ml a day, they don’t need supplements.
All pregnant women, babies under 12 months and some children under 5 years can get free vitamins from Healthy Start. See HealthyStart.nhs.uk.
This is most common in babies under the age of 1. Children are likely to grow out of it by age 5.
It typically starts when cow’s milk is first introduced, either in formula milk or when the baby starts weaning.
Less often, it can occur in breastfed children as cow’s milk can pass to the baby through breast milk.
Symptoms include:
If your baby has any of these symptoms, see your GP.
Rarely, it can cause severe symptoms of swelling in the mouth and difficulty breathing. If this happens, call 999 or go straight to A&E.
Treatment involves removing cow’s milk protein from the diet. Your baby should be monitored every 6 to 12 months to see if they’ve grown out of the allergy.
The lack of sleep that often goes hand in hand with a new baby can have an impact on the whole family.
Over time, sleep does improve in all babies, but when you’re in the midst of sleep deprivation it’s difficult to believe it will ever end. Every baby and family are different, so there’s no one-size-fits- all approach.
Below are some tips and reassurance from a sleep specialist. For more tips see helping your baby sleep’ at nhs.uk.
SIDS (sometimes known as ‘cot death’) is thankfully rare, but in the UK affects more than 200 babies a year.
The cause isn’t fully understood, but there are ways to reduce the risk.
For more information see:
It’s a physical examination of your baby, similar to when your baby was first born. Some GPs do it at 8 weeks to combine with first immunisations – also see What immunisations does my baby need?
The GP will ask how your baby is feeding and developing.
GPs must also offer the mother a 6 to 8 week postnatal check. This can often be done at the same time.
One of the best ways to stop your baby getting serious diseases and illnesses is to get them immunised.
When they’re born, babies get some immunity from infections from their mother, but this wears off.
In the UK, a vaccination schedule is recommended for all children, with vaccinations at 8, 12 and 16 weeks, 1 year, and 3 years 4 months. They’re done at your GP surgery (take your red book with you).
Some babies are offered a vaccination to protect against TB (tuberculosis), depending on where they live and the risk of getting TB. This is often done in hospital soon after birth.
For more information see your baby’s vaccinations’ at nhs.uk/start4life.
You’ll have appointments with a health visitor when your child is aged around 1 and 2 to check how you both are and check your baby’s development.
Children develop at different rates, but there are some skills known as ‘milestones’ which are monitored, and which children tend to reach at around the same age range.
These include how they play, learn, speak, act and move.
If a child hasn’t reached a milestone, it doesn’t necessarily mean there’s a problem, but they may sometimes need to be monitored by the health visitor or referred to check there isn’t a developmental delay.
Premature babies or babies who’ve been unwell may be delayed in meeting milestones.
If your baby was premature, their developmental age will be based on their original due date, not their actual birthday, until they’re 2 years old.
For more information see NHSGGC.org.uk/kids/child-development.
Being a parent can be hugely rewarding but very challenging. Almost all parents worry about whether they’re doing the right thing from the moment a baby is born, until they’re fully grown.
If you’re struggling, don’t suffer. There are lots of resources to help, as well as your health visitor and GP.
The first few days and weeks with your newborn baby is one of the most exciting but challenging times of your life. Hopefully, this leaflet can help and support you, as well as pointing you to useful resources.
Remember, communication is key. Talk to friends, talk to family, talk to your health visitor or GP. You’re not alone, but you may need to ask for help.
This guide is aimed at women who’ve given birth, but we recognise that not everyone who has given birth identifies as a woman.
The information is based on evidence-guided research from the National Institute for Health and Care Excellence (NICE), and the Royal College of Obstetricians and Gynaecologists (RCOG).
Author:
This guide was written on behalf of the FPA by Dr Eloise Elphinstone, GP with Specialist Interest in Women’s Health MRCGP, DRCOG, FRSH. @EloiseElphinst1.
It was clinically reviewed by:
Thank you to Helen Davies, a holistic sleep coach for her advice on the sleep section – EssentialParenting.co.uk
Thank you to all the women who reviewed this guide as part of our user testing group.
This guide was accurate at the time of writing. Guides are reviewed regularly.
Last complete review: March 2021, last clinical update: March 2021, next review scheduled: March 2024.
If you’d like information on the evidence used to produce this guide or would like to give feedback, email fpadirect@fpa.org.uk.
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