Credit...Aart-jan Venema


Newborn Baby Care Basics: What to Know When You Leave the Hospital

What to pay attention to, the kinds of schedules to follow, and what you don’t need to worry about at all.

This guide was originally published on May 6, 2019 in NYT Parenting.

Life with a newborn can be magical — and also overwhelming, exhausting and terrifying. I still remember the day I brought my son home from the hospital and thought: How do I care for this tiny, needy creature? Where is his owner’s manual? But hard as being a new parent can be, you’re probably going to do fine. “Babies are a lot stronger than parents may give them credit for,” said Dr. Jennifer Shu, M.D., an Atlanta-based pediatrician and co-author of “Heading Home With Your Newborn: From Birth to Reality.” (I remember our week-old son rolling off a couch once and thinking we had broken him. He was fine.) Over time, too, parents learn to detect and understand their baby’s needs, desires and schedules. Caring for a newborn — a baby under 28 days old — is not easy, but it does become more manageable, especially with the right advice on hand. For this newborn guide, I spoke with three pediatricians and a certified pediatric sleep consultant, collecting tips on what parents should pay attention to, what kinds of schedules they should follow, what they should do and what they don’t need to worry about.

If a mom is breastfeeding — the American Academy of Pediatrics recommends doing so for at least six months — her body will usually start producing breast milk within three days of birth. Before that, her breasts will produce a thick, yellow nutrient-filled liquid called colostrum.

At first, a nursing mother might have to work to ensure that her baby correctly latches, or fastens onto her breast, in order to eat. If you’re having trouble establishing a good latch or getting your baby to eat, talk to a certified lactation consultant; most hospitals and birthing centers have at least one on staff. You can also find a private lactation consultant via the United States Lactation Consultant Association.

[How to breastfeed during the first two weeks of life]

No matter whether you’re breastfeeding or formula feeding, newborns should be fed every one to three hours, so that they eat eight to 12 times in 24 hours. (If you’re using formula, feed one to two ounces at a time. The C.D.C. has information on how to choose, prepare and store formula.) Frequent meals help newborns regain weight that they may have lost after birth. As your baby grows, she will gradually be able to eat more at each feeding and eat fewer times each day and night.

Don’t fret if your baby doesn’t burp after a feeding. “Babies will burp if and when they need to,” said Dr. Diane Cicatello, M.D., a developmental and behavioral pediatrician and vice chair of pediatrics at CareMount Medical in Poughkeepsie, N.Y.

Babies under the age of 1 should always be put to sleep on their backs — never on their sides or stomachs — because back sleep minimizes the risk of sudden infant death syndrome. After the American Academy of Pediatrics began recommending that babies be put to sleep on their backs, the incidence of SIDS dropped by more than half.

At first, newborns sleep a lot — about 16 to 17 hours a day — but that sleep is broken up every hour or two by periods of wakefulness. “In the early weeks, your baby will mostly wake just long enough to be fed and changed,” said Massachusetts-based certified pediatric sleep consultant Arielle Greenleaf. Since your baby will also be awake for short periods throughout the night, which will inevitably disrupt your sleep, “in order to stay well rested, you should absolutely sleep when your baby sleeps,” she said.

Some babies have their days and nights mixed up and may sleep more during the day than at night. If that’s the case, Greenleaf suggested waking your baby whenever daytime naps exceed two hours. You may also want to start a bedtime routine, which serves as a social cue that it is time for your baby to sleep for a longer stretch. A newborn bedtime routine might involve changing your baby into pajamas, swaddling him, feeding him, reading to him and singing him songs. “When parents are able to create a predictable routine for a baby — or as predictable as it can be in the early days — babies start to understand the flow of their day and what to expect next,” Greenleaf explained.

It’s also fine to let your baby fuss for a few minutes at night if she’s not hungry or soiled; you don’t have to rock or hold her constantly. “Let them see if they can naturally fall asleep on their own,” said Dr. Angela Mattke, M.D., a pediatrician at the Mayo Clinic Children’s Center in Rochester, Minn.

Spot clean your baby every day around his mouth, neck and groin — basically, anywhere that gets dirty. As for proper bathing, “one to two times a week is actually plenty,” Shu said, and bathing too frequently can lead to dry skin or eczema, a skin condition characterized by red, itchy skin and rashes.

[How often should you bathe your baby?]

To wash a baby before her umbilical cord stump falls off — which usually happens 5 to 15 days after birth — you’ll want to give sponge baths. To do that, the American Academy of Pediatrics recommends wrapping your baby in a towel and laying her down on a soft flat surface. First wipe her face with a clean, moist washcloth — you don’t want to use soap because it could get into her eyes or mouth — then apply a small amount of baby soap onto the washcloth and gently wipe the rest of her body. Then wipe your baby’s body again with a clean damp washcloth. After the bath, consider applying a baby moisturizer, such as petroleum jelly, Mattke said, to prevent dry skin.

Once your baby’s umbilical cord stump has fallen off, you can bathe him in a hard plastic baby bathtub or basin. Before starting the bath, make sure you have everything you need within reach — baby soap or shampoo, washcloths, a cup for rinsing and a dry towel. (If you need to get something after you’ve put your baby in the bath, bring your baby with you — never leave a baby unattended in a bath or he could drown.) Fill the bath with two inches of warm water around 100 degrees Fahrenheit. Place your baby on his back in the bath and wash him with a washcloth and a small amount of baby soap, rinsing with clean warm water afterwards. Consider applying moisturizer such as petroleum jelly to your baby’s damp skin afterward.

One of the best ways to bond with your baby when she’s awake is through skin-to-skin contact — resting your bare-chested baby on your bare chest, for example. Studies have shown that babies who experience skin-to-skin contact immediately after birth are more likely to be breastfed, are breastfed for longer and have healthier responses on heart and breathing tests. Shu also suggested talking to your baby regularly and, since babies are nearsighted, getting your face up close to her so she can see you better.

When your baby gets fussy, consider using some or all of the “five S’s” — swaddle, side or stomach position (only when awake!), shush, swing and suck — which were first suggested by pediatrician Harvey Karp, M.D., author of “The Happiest Baby on the Block.” If you want to introduce a pacifier to give your baby something to suck on, it’s best to wait until after he has learned how to nurse or drink well from a bottle, Shu said.

Don’t forget about tummy time, which is “really important for gross motor development, head control and neck strength,” Mattke said. To do tummy time, place your awake baby on her stomach on a stable soft surface two to three times a day for three to five minutes. Engage with your baby on the floor to keep her entertained. You can also do tummy time on your chest if your baby prefers that, Mattke added.

Becoming a parent is exciting, but it can also be exhausting and unsettling. If you are struggling with the transition, ask your partner, if you have one, for help or reach out to other family members or friends. “A tired, stressed out, poorly nourished and emotionally impoverished parent or caregiver cannot nurture their child,” Cicatello said. Ask friends or family members to hold your baby, change him, take him out for walks or bottle-feed him expressed breast milk or formula.

More than half of mothers experience “postpartum blues” — mood swings, loss of appetite or sleeping problems. (Partners can feel depressed, too.) Often, these symptoms resolve on their own within two weeks of birth. But if your mood swings are severe, you aren’t sleeping much or are sleeping too much, or you are feeling like you can’t do everyday tasks, you may be experiencing postpartum depression, which affects one in nine mothers. If you think you might be depressed, talk to your doctor right away to get the help you need.

If your baby has a temperature above 100.4 (always take a baby’s temperature with a rectal thermometer), call your doctor immediately, because a fever in a newborn can be a sign of a serious infection. It’s also a good idea to call your pediatrician if your baby isn’t eating well or if she is crying constantly. Talk to your doctor, too, if you see signs of worsening jaundice — a condition in which there is too much bilirubin, a yellow pigment made by red blood cells, in the blood. Signs of worsening jaundice include increased yellowing of your baby’s skin (especially on her face, stomach, arms or legs) or yellowing of the whites of her eyes.

Melinda Wenner Moyer is a science journalist, mom of two, and writer for Slate’s science-based parenting column.