Your Newborn’s First Days

Meeting your baby for the first time is an unforgettable experience. During the first few days after birth, your baby will be adapting to life outside the womb, while you get to know one another. It’s completely normal to have questions about how your baby looks, the checks they will receive, and what to expect with feeding, nappies and bowel movements.

Most babies go through many normal changes in the first week of life, and your midwife, doctor and public health nurse are there to support you every step of the way.

What Your Newborn May Look Like

Every newborn is unique. Your baby may not look exactly as you expected immediately after birth, and many of the features that concern new parents are completely normal.

Your baby may have:

A cone-shaped head after a vaginal birth, which usually settles within a few days.
Puffy eyelids or a slightly swollen face.
White creamy coating on the skin (vernix), which helps protect their skin before birth.
Fine soft hair (lanugo) on the shoulders, back or ears.
Mottled or blotchy skin, particularly when they are cold.
Tiny white spots on the nose or face (milia), which disappear naturally.
Bluish hands and feet during the first day or two while circulation adjusts.
Mild swelling of the breasts or genitals due to maternal hormones.

Your baby’s skin colour will gradually become more even over the first few days.

Umbilical Cord

The umbilical cord stump will gradually dry out, become darker in colour and fall off naturally, usually within 7 to 14 days.

Keep the cord clean and dry. It does not need any creams, powders or antiseptics unless advised by your healthcare professional.

Routine Checks and Tests After Birth

Your baby will receive several important examinations and screening tests during the first days of life.

Newborn Clinical Examination

Within the first 72 hours after birth, your baby will have a full newborn examination carried out by a doctor or specialist midwife.

This examination checks your baby’s general health and looks for any conditions that may benefit from early treatment.

The examination includes checking:

Eyes
Heart and pulse
Oxygen levels
Hips
Testicles (for boys)
General physical wellbeing

The healthcare professional will also discuss feeding, safe sleep, and answer any questions you may have.

Hearing Screening

Most babies are offered a hearing screening test before leaving hospital.

The test is quick, painless and usually performed while your baby is asleep. A soft earpiece measures how the inner ear responds to sound.

Early detection of hearing problems allows treatment and support to begin as soon as possible if required.

Heel Prick (Bloodspot) Screening

When your baby is between 72 hours and 5 days old, you will be offered newborn bloodspot screening, commonly known as the heel prick test.

A few drops of blood are collected from your baby’s heel to screen for several rare but serious medical conditions. Detecting these conditions early means treatment can begin promptly if needed.

You will be asked for your consent before the test is carried out.

Vitamin K

All newborn babies are offered a vitamin K injection within six hours of birth.

Vitamin K helps your baby’s blood clot normally and protects against a rare but serious condition called vitamin K deficiency bleeding (VKDB).

Although the injection is recommended because it offers the best protection, parents will be asked for consent before it is given.

Changing Your Baby’s Nappy

Newborn babies usually need frequent nappy changes.

Change your baby’s nappy:

As soon as possible after they pass urine or stool.
Before or after feeds, depending on your baby’s needs.
Whenever the nappy feels wet or soiled.

How to Change a Nappy

Wash your hands.
Gather everything you need before starting.
Lay your baby on a safe, flat changing surface.
Remove the dirty nappy and gently clean the area using cotton wool and water or fragrance-free baby wipes if appropriate.
Always wipe girls from front to back to reduce the risk of infection.
Pat the skin dry before putting on a clean nappy.
Fasten the nappy so it is snug but not tight.

Never leave your baby unattended on a changing table, even for a moment.

Wet and Dirty Nappies

Monitoring wet and dirty nappies is one of the easiest ways to know your baby is feeding well.

Wet nappies

During the first few days, the number of wet nappies gradually increases.

By around day 6, most babies will have at least 6 wet nappies every 24 hours.

Urine should be pale yellow or almost clear.

Bowel Movements in the First Few Days

Your baby’s first bowel movements change quickly during the first week.

Meconium

The first stools are called meconium.

These are:

Black or very dark green
Thick
Sticky
Tar-like

This is completely normal.

Transitional Stools

Over the next few days the stools become:

Greenish
Less sticky
Softer
Milk Stools

By around day 5, breastfed babies usually have stools that are:

Mustard yellow
Loose
Seedy in appearance

Formula-fed babies generally have stools that are:

More formed
Brown, yellow or green
Stronger smelling than breastfed stools.
When to Seek Medical Advice

Contact your midwife, public health nurse, GP or maternity hospital if your baby:

Is difficult to wake for feeds.
Is feeding poorly or refusing feeds.
Has fewer wet nappies than expected.
Has not passed meconium within the first 24 hours after birth.
Develops increasing yellowing of the skin or eyes (jaundice).
Has a fever or feels unusually cold.
Has difficulty breathing or appears very sleepy and difficult to rouse.

If you are ever worried about your newborn, trust your instincts and seek medical advice promptly.

Remember

The first few days with your newborn are a time of learning for both of you. It’s normal to have questions and to need support. Your maternity hospital team, public health nurse and GP are there to help you as you settle into life with your new baby.