The first weeks with a newborn are equal parts wonder and second-guessing. Most of what worries new parents turns out to be normal — but a few things genuinely are not, and knowing which is which makes those weeks a great deal easier.
Your baby’s first visit: 3 to 5 days old
We see newborns within a few days of leaving hospital. At that visit we check weight, feeding, jaundice and the umbilical cord, review anything from the birth, and answer whatever has come up since you got home.
Bring the hospital discharge paperwork, your baby’s immunisation record (the hepatitis B vaccine is usually given at birth), your insurance card, and a written list of questions. Sleep deprivation and a short appointment are a poor combination for remembering what you meant to ask.
Feeding and wet nappies
Newborns feed often, typically every two to three hours including overnight, whether breastfed or formula-fed. In the early days the most reassuring sign is not the amount you can measure but the output: steadily increasing wet nappies, and stools changing from dark meconium to softer, lighter ones over the first week.
Some weight loss in the first days is expected, and babies normally regain it over the following couple of weeks. We track this at each early visit. If feeding is painful, if your baby is consistently difficult to rouse for feeds, or if wet nappies drop off, call us — early feeding problems are common and very fixable, and far easier to sort out early than late.
Safe sleep
This is the one section worth reading twice. Current American Academy of Pediatrics guidance:
- On their back, every sleep — naps included, by every carer
- On a firm, flat surface — a crib, bassinet or play yard with a fitted sheet
- Nothing else in the sleep space — no bumpers, pillows, loose blankets, wedges or soft toys
- Share a room, not a bed. A separate sleep surface in your room for at least the first six months is associated with a substantially lower risk of SIDS; bed-sharing is not recommended
- Avoid overheating — a sleep sack instead of blankets, and one more layer than you are comfortable in, not three
- Car seats, swings and slings are for travel, not for sleep. If your baby falls asleep in one, move them to a flat surface when you can
Jaundice
Mild yellowing of the skin and eyes is very common in the first week and usually settles on its own. What matters is the degree and the trend, which is part of why the early visit happens when it does. Call us if the yellow colour is deepening, spreading down the body or reaching the legs, or if your baby is feeding poorly or unusually sleepy with it. Jaundice getting worse rather than better always warrants a call.
Umbilical cord and first bath
Keep the stump clean and dry and let it fall off on its own, usually within one to three weeks. Fold the nappy down below it. Sponge baths until it separates; after that, a bath two or three times a week is plenty — newborn skin does not need daily washing. Call us if there is redness spreading onto the belly, pus, a foul smell, or bleeding beyond a spot or two.
Normal newborn things that worry parents
- Sneezing, hiccups and noisy, snuffly breathing
- Irregular breathing with brief pauses while asleep, then catching up
- The startle reflex — arms flinging out at a noise or a change of position
- Crossed or wandering eyes in the early weeks
- Baby acne, milia and peeling skin
- Crying that peaks somewhere around six weeks and then eases
None of these need treatment. Ask us at a visit if you would rather hear it in person.
When to call us straight away
- Any fever — a rectal temperature of 100.4°F (38°C) or higher. In a baby under three months this needs same-day medical attention, even if your baby seems well, and do not give fever medicine before they are seen
- Difficulty breathing, grunting with each breath, flaring nostrils, or any blue or grey colour around the lips
- Very hard to wake, floppy, or not responding as usual
- Refusing to feed, or markedly fewer wet nappies
- Persistent vomiting, especially if it is green, or blood in the stool
- Deepening jaundice, or signs of infection at the cord
For anything in that list outside our hours, go to the emergency room. See also our guide to when to call versus when to go to the ER.
Newborn care in MetroWest, Orlando
Dr. Revati Narahari is a board-certified pediatrician and a Fellow of the American Academy of Pediatrics. We welcome new babies at 1507 S Hiawassee Rd, Suite 105, Orlando, FL 32835, Monday to Friday, 9:00 AM – 5:00 PM. Call (407) 445-9224 to register your baby — expecting parents are welcome to call before the birth and arrange the first visit in advance. See also well-child visits.
