Newborn Baby Care: A Practical Guide to the First Week at Home

Bringing a newborn home is joyful, and overwhelming. Relatives will offer plenty of advice, some helpful, some outdated. This guide covers what the evidence says about the essentials of the first week.

Feeding

• Start breastfeeding within the first hour after birth. The first thick, yellowish milk, colostrum, is rich in antibodies: don't discard it.
• Feed on demand, usually 8 to 12 times in 24 hours. Early hunger signs include rooting, lip smacking and bringing hands to the mouth; crying is a late sign.
• Exclusive breastfeeding for 6 months means no water, honey, ghutti, gripe water or other liquids: breast milk provides all the fluid your baby needs, even in hot weather.
• Signs your baby is getting enough: 6 or more wet nappies a day after day 5, regular yellow stools, and steady weight gain after the first week.

It's normal for babies to lose up to about 10% of their birth weight in the first few days and regain it by around 2 weeks.

Umbilical cord care

• Keep the stump clean and dry. Fold the nappy below it so it gets air.
• Don't apply oil, powder, ghee, turmeric, ash or any other substance.
• It usually falls off in 1 to 2 weeks.
• See a doctor if the skin around it becomes red, swollen or smelly, or if it oozes pus.

Bathing and skin care

• A sponge bath is enough until the cord falls off; after that, a short tub bath 2 to 3 times a week is fine.
• Use lukewarm water (test with your elbow) and a mild, fragrance free baby cleanser.
• Keep the baby warm: bathe quickly in a warm room and dry immediately, especially for small or premature babies.
• Gentle oil massage is a traditional practice many families enjoy; use a light oil, avoid the face, and never put oil in the nose or ears.

Nappies

• Change nappies as soon as they're wet or soiled.
• Clean front to back with water and a soft cloth or unscented wipes.
• Let the skin air dry and use a barrier cream to prevent diaper rash.

Sleep and safety

• Newborns sleep 14 to 17 hours a day in short stretches.
• Always place your baby on their back to sleep, on a firm, flat surface.
• Keep pillows, quilts, bumpers and soft toys out of the sleep space.
• Room sharing (baby sleeping in the parents' room, on their own surface) is recommended.
• Don't smoke near the baby.

Vaccines at birth

Under India's Universal Immunisation Programme, babies receive BCG, OPV (zero dose) and hepatitis B (birth dose) soon after birth. Keep the vaccination card safe and follow the schedule your paediatrician gives you.

Danger signs: get medical help immediately

• not feeding well or too sleepy to feed
• fever (38°C or above) or feeling cold (below 35.5°C)
• fast breathing (60 or more breaths a minute) or chest in drawing
• convulsions (fits) or unusual stiffness
• yellow skin in the first 24 hours, or yellow palms and soles at any time
• very few wet nappies
• bleeding, or a red, pus filled cord stump
• lethargy or unresponsiveness

ASHA workers visit new mothers at home under the Home Based Newborn Care programme: don't hesitate to ask them for help.

Take care of yourself too

Rest when the baby sleeps, eat well, drink plenty of fluids and accept help. If you feel persistently low, anxious or unable to cope, talk to your doctor: postnatal depression is common and treatable.