Newborn Care
Essential practices for maintaining the health, safety, and wellbeing of infants from birth through 4 weeks of age.
| Age range | 0–4 weeks (birth to 28 days) |
| Key focus | Feeding, Sleep Safety, hygiene, monitoring |
| Medical visits | Days 1–2, Week 1, Week 2–4 |
Feeding
Frequency: Every 2–3 hours (8–12 times per 24 hours)
Breast milk intake:
- Day 1: 5–7 ml per feed
- Day 3: 22–27 ml per feed
- Week 1: 45–60 ml per feed
- Week 2–4: 60–90 ml per feed
Formula intake: 60–90 ml per feed by Week 2
Feeding cues: Rooting, hand-to-mouth movement, sucking motions, fussiness
Warning signs: Fewer than 8 feeds in 24 hours, consistently refusing feeds, no swallowing sounds
Weight and Growth
| Timeframe | Expected Pattern |
|---|---|
| Days 1–3 | Loss of 7–10% birth weight (normal) |
| Days 5–7 | Weight stabilises |
| Week 2 | Returns to birth weight |
| Weeks 2–4 | Gains 150–200g per week |
Consult doctor if:
- Weight loss exceeds 10% of birth weight
- No return to birth weight by Day 14
- Fewer than 6 wet Nappies per day after Day 5
Sleep Safety
Position: Back only (never stomach or side)
Environment:
- Firm, flat surface
- Fitted sheet only—no loose bedding, pillows, or toys
- Room temperature 16–20°C
- No overheating (check back of neck)
Duration: 14–17 hours per 24 hours (irregular patterns normal)
Location options:
- Separate cot/Moses basket in parents' room (recommended 0–6 months)
- Bedside cot attached to parent bed
- Bed-sharing only if: no alcohol/drugs/smoking, firm mattress, no gaps, no siblings present
Basic Care
- Frequency: 2–3 times per week
- Delay first bath 24 hours to preserve vernix (protective coating)
- Water temperature: 37–38°C
- Duration: 5–10 minutes
- Keep dry and exposed to air
- Falls off Days 5–15
- Clean with cooled boiled water if soiled
- Seek help if: red skin around base, discharge, bleeding beyond few drops
Nappies:
- Changes: 8–12 per day
- Expected output after Day 5: 6+ wet nappies, 3+ dirty nappies
Clothing:
- Layers: One more layer than adult comfort level
- Avoid: Mittens (risk of thread entanglement), loose hats indoors
Medical Monitoring
Routine procedures (first 48 hours):
- Vitamin K injection (prevents bleeding disorders)
- Newborn blood spot screening (Days 5–8)
- Newborn hearing test
- Physical examination
Jaundice monitoring:
- Onset: Day 2–3 (60% of newborns)
- Peak: Days 3–5
- Resolves: Week 2
- Check: Yellowing of skin/eyes, especially in natural light
- Treatment threshold: Bilirubin >250 μmol/L (phototherapy required)
Temperature:
- Normal range: 36.5–37.5°C (axillary)
- Check if baby feels unusually hot or cold
- Seek immediate help if: <36°C or >38°C
Warning Signs Requiring Medical Attention
Seek immediate help if baby:
- Has temperature <36°C or >38°C
- Shows difficulty breathing (grunting, flaring nostrils, chest retractions)
- Refuses feeds for >6 hours
- Has fewer than 6 wet nappies after Day 5
- Appears floppy or unresponsive
- Has persistent vomiting (not just posseting)
- Shows rapidly spreading jaundice
See also: [[Breastfeeding]], [[Safe Sleep]], Jaundice, [[Weight Loss in Newborns]], [[Umbilical Cord Care]], [[Nappy Changes]]