Your baby's first checkup will likely happen within 1 week of birth. At this newborn visit, the doctor will examine your baby. They will ask questions about the first few days at home. This sheet describes some of what you can expect.

Most babies have some yellowing of the skin and the white part of the eyes (jaundice) in the first week of life. Your baby's doctor will tell you if you need to have your baby's bilirubin level checked. They will also let you know if your baby needs a follow-up check or if treatment with phototherapy is needed.

The doctor will ask questions about your newborn. They will watch your baby to get an idea of their development. By this visit, your newborn is likely doing some of the following actions. Your baby may:

• Blink at a bright light.
• Try to lift their head.
• Wiggle and squirm. Each arm and leg should move about the same amount. But if the baby favors one side, tell the doctor.
• Become startled when hearing a loud noise.

It's normal for a newborn to lose up to 10% of their birth weight during the first week. This is often gained back by about age 2 weeks. If you're concerned about your newborn's weight, tell the doctor. To help your baby eat well, follow these tips:

• Feed your baby only breast milk or iron-fortified formula for about the first 6 months.
• Don't give the baby water unless their doctor recommends it.
• Feed your newborn when they seem hungry. They might show this by waking up, moving their head, or sucking on their hands, lips, or tongue.
• Feed at least every 2 to 3 hours during the day. You may need to wake your baby for these feedings.
• Feed every 3 to 4 hours at night. At first, wake your baby for feedings if needed. When your newborn is back to their birth weight, you may choose to let them sleep until they are hungry. Discuss this with your baby's doctor.
• Ask the doctor if your baby should take vitamin D.
• Burp your baby after each feeding.

• After your milk comes in, your breasts should feel full before a feeding and soft and deflated afterward. This likely means that your baby is getting enough to eat.
• Breastfeeding sessions often take 15 to 20 minutes. If you feed the baby breast milk from a bottle, give about 1 to 3 ounces at each feeding.
• Breastfed babies may want to eat more often than every 2 to 3 hours. It's okay to feed your baby more often if they seem hungry. Talk with the doctor if you are concerned about your baby's breastfeeding habits or weight gain.
• It can take some time to get the hang of breastfeeding. It may be uncomfortable at first. If you have questions or need help, a lactation consultant can give you tips.

• Use a formula made just for infants. If you need help choosing, ask the doctor to recommend one. Regular cow's milk is not a good food for a newborn baby.
• Feed around 1 to 3 ounces of formula at each feeding.

• Some newborns have a bowel movement after every feeding. Others do so less often. Both are normal. Change the diaper whenever it's wet or dirty.
• It's normal for a newborn's stool to be yellow, watery, and look like it contains little seeds. The color may range from mustard yellow, to pale yellow, to green. If it's another color, tell the doctor.
• A boy should have a strong stream when he pees. If your baby doesn't, tell the doctor.
• Give your baby sponge baths until the umbilical cord falls off. If you have questions about caring for the umbilical cord, ask your baby's doctor.
• Follow your doctor's advice about how to care for the umbilical cord. This care might include:
  • Keeping the area clean and dry.
  • Folding down the top of the diaper to expose the umbilical cord to the air.
• Contact your doctor if the umbilical cord area has pus or redness.
• After the cord falls off, bathe your newborn a few times a week. You may give baths more often if the baby seems to like it. But because you are cleaning the baby during diaper changes, a daily bath often isn't needed.
• It's okay to use mild (hypoallergenic) creams or lotions on the baby's skin. Don't put lotion on the baby's hands.

Newborns usually sleep around 18 to 20 hours each day. To help your newborn sleep safely and soundly and prevent SIDS (sudden infant death syndrome):

• Place the infant on their back for all sleeping until they are 1 year old. This can decrease the risk for SIDS, aspiration, and choking. Never place the baby on their side or stomach for sleep or naps. If the baby is awake, give them time on their tummy, as long as there is supervision. This helps the child build strong tummy and neck muscles. This will also help minimize flattening of the head. That can happen when babies spend so much time on their backs.
• Offer the baby a pacifier for sleeping or naps. If the child is breastfeeding, do not give the baby a pacifier until breastfeeding has been well established. Breastfeeding is linked to reduced risk of SIDS.
• Your baby should sleep on a firm, flat mattress or sleep surface with no slant. Cover the mattress with a fitted sheet to prevent gaps between the mattress and the sides of a crib, play yard, or bassinet. This can decrease the risk of entrapment, suffocation, and SIDS.
• Don't put a pillow, heavy blankets, or stuffed animals in the crib. These could suffocate the baby.
• Swaddling (wrapping the baby tightly in a blanket) may cause your baby to overheat. Don't let your child get too hot. Stop swaddling when your baby starts to show signs of rolling over.
• Don't place infants on a couch or armchair for sleep. Sleeping on a couch or armchair puts the infant at a much higher risk of death, including SIDS.
• Don't use infant seats, car seats, and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant's airway or suffocation.
• Don't share a bed (co-sleep) with your baby. It's not safe.
• The American Academy of Pediatrics (AAP) recommends that infants sleep in the same room as their parents, close to their parents' bed, but in a separate crib that's right for infants. This sleeping arrangement is recommended ideally for the baby's first year, but at least for the first 6 months.
• Always place cribs, bassinets, and play yards in hazard-free areas—those with no dangling cords, wires, or window coverings. This helps lower the risk of strangulation.
• Don't use cardiorespiratory monitors and commercial devices (wedges, positioners, or special mattresses) to help lower the risk for SIDS and sleep-related infant deaths. They have not been shown to prevent SIDS. In rare cases, they have resulted in the death of an infant.
• Discuss these and other health and safety issues with your baby's doctor.

• To prevent burns, don't carry or drink hot liquids, such as coffee, near the baby. Turn the water heater down to a temperature of 120°F (49°C) or below.
• Don't smoke or allow others to smoke near the baby. If you or other family members smoke, do it outdoors and never around the baby.
• It's usually fine to take a newborn out of the house. But stay away from confined, crowded places where germs can spread. You may invite visitors to your home to see your baby, as long as they aren't sick.
• When you do take the baby outside, don't stay too long in direct sunlight. Keep the baby covered or seek out the shade.
• In the car, always put the baby in a rear-facing car seat. This should be secured in the back seat, according to the car seat's directions. Never leave your baby alone in the car.
• Do not leave your baby on a high surface, such as a table, bed, or couch. They could fall and get hurt.
• Older siblings will likely want to hold, play with, and get to know the baby. This is fine as long as an adult supervises.
• Check your home for mold and radon.
• Never shake, hit, or throw your baby. This can cause serious damage to your baby's brain. There may be times when your baby is crying and you are tired, frustrated, or even angry. The best thing to do is to put your baby in the crib and take a break for yourself or ask for help from family or friends.
• Seek help if you have been hurt by your partner. The National Domestic Violence Hotline (800-799-7233 or text START to 88788) and other agencies can provide confidential help. Check out programs such as WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) and SNAP (Supplemental Nutrition Assistance Program) if you are worried about expenses for living or food. They can provide help and information.
• Contact the doctor right away if your baby has a fever (see Fever and children, below).

Use a digital thermometer to check your child's temperature. Don't use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
• Forehead (temporal). This works for children ages 3 months and older. If a child younger than 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
• Mouth (oral). Don't use a thermometer in your child's mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker's directions for correct use. Insert it gently. Label it, and make sure it's not used in the mouth. It may pass on germs from the stool. If you don't feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any health care provider about your child's fever, tell them which type you used.

Below is when to contact the doctor if your child has a fever. Your child's doctor may give you different numbers. Follow their instructions.

When to contact a doctor about your child's fever

For a baby under 3 months old:

First, ask your child's doctor how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher.
• Armpit: 99°F (37.2°C) or higher.
• A fever of ___________as advised by the doctor.

Your baby may get the hepatitis B vaccine if they did not already get it in the hospital. Your baby may get the infant immunization with the respiratory syncytial virus (RSV) monoclonal antibody. Ask your baby's doctor which vaccines are advised at this visit.

Taking care of a newborn can be physically and emotionally draining. Right now, it may seem like you have time for nothing else. But taking good care of yourself will help you care for your baby too. Here are some tips:

• Take a break. When your baby is sleeping, take a little time for yourself. Lie down for a nap, or put up your feet and rest. Know when to say no to visitors. Until you feel rested, ignore household clutter. Put off tasks that don't need to be done right away. Give yourself time to settle into your new role as a parent.
• Eat healthily. Good nutrition gives you energy. And if you have just given birth, healthy eating helps your body recover. Try to eat a variety of fruits, vegetables, grains, and sources of protein. Stay away from processed “junk” foods. And limit caffeine, especially if you're breastfeeding. Stay hydrated by drinking plenty of water.
• Accept help. Caring for a new baby can be overwhelming. Don't be afraid to ask others for help. Allow family and friends to help with the housework, meals, and laundry, so you and your partner have time to bond with your new baby. If you need more help, talk to your doctor about other options.

Next checkup at: _______________________________

PARENT NOTES: