Welcome to parenthood! Bringing a newborn home is an exciting and life-changing experience, and it's normal to have a lot of questions and concerns as you adjust to your new role. One thing you may be wondering about is what to expect from your newborn in the first few days. Newborns are still learning how to navigate the world outside the womb, so it's important to be patient and understanding as they adjust to their new environment. In the first few days, you can expect your newborn to sleep a lot, feed frequently, and have their own unique set of needs and preferences. In this blog post, we'll provide some helpful information to let you know what you can expect in the first few days with your newborn.

Newborn Behavior

Hiccups and sneezing are common and normal.

A newborn needs to be supported when held, but newborn babies should not feel completely limp in your arms. A newborn should display strong, well-flexed movements of his or her arms and legs.

Your baby will spend his or her early days and weeks in different states: deep sleep, light sleep, drowsy, quiet alert, active alert, crying.

While newborns sleep about 16 hours out of every day, their sleep patterns are unpredictable; they may sleep for a few minutes or a few hours at a time.

Because your baby’s stomach is so tiny at this age, he or she needs to wake to feed often. In the first days and weeks, your baby should sleep for stretches no longer than four to six hours without waking to feed. If your baby is sleeping for a period longer than that, wake your baby up and try to nurse.

Body/Breastfeeding

In the first 24 hours after birth, most babies will want to feed several times.

Colostrum is the name of the early milk that is present in the breast at the time of birth and it is the only thing that your baby needs to eat. Colostrum is yellowish and sticky, rather than thin and white like mature breast milk.

Their stomachs are very small, and therefore they need to eat frequently.

Putting your baby to the breast often gives your baby valuable, nutrient-rich colostrum, helps establish your milk supply, and helps both you and your baby learn how breastfeeding works. A newborn feeds nearly constantly, it can seem. As your baby grows a bit, he or she will need to eat at least every two to four hours (usually much more often). Nursing sessions will typically last at least 20 minutes at a time. A satisfied baby will detach from the breast after finishing a feed.

Your baby may cluster feed (feed many times in a row) and then have a longer stretch without feeding.

It can sometimes take time for you and your baby to learn how to breastfeed. Spending time together skin-to-skin will help encourage your baby to latch and feed.

Your body will typically begin to produce milk between two and five days after your birth.

Your baby may spit up after eating. Frequently small amounts of milk come out and dribble down his or her chin.

There is no need to keep track of feeding on a log, but if this reassures you, go ahead! After the first day, babies need to eat between 8 and 12 times in a 24 hour period. Mark down the time each feeding begins and how long it lasts. Also mark when you change a wet or dirty diaper.

It is normal for babies to lose some weight in the first few days and typically return to birth weight around 2 weeks of age.

Baby's Skin

It is very common for new babies to have a blue tinge to both hands and feet and for the extremities to feel slightly cool to the touch. The rest of your baby’s skin should be pink. A pink chest and face shows that your baby is getting enough oxygen. Your baby’s hands and feet may be blue, purple or grey and cool to the touch for the first few days – this is normal.

Babies may be blotchy and red when cold or crying.

It is normal to see mild jaundice (yellow face) after 24 hours, not on the first day of life. Jaundice is often at its peak around day 3 or 4. Sunlight and nursing/pooping are all most babies need to eliminate their jaundice.

It is fairly common for babies to have what is called “flea bite rash”. It isn’t actually flea bites, but it does resemble them. More common on the trunk, neck, and arms and exacerbated by warmth, the rash usually occurs between days 2-10 and will look like red spots, perhaps with a small raised white bump in the center. The rash can move around on the body a bit. Usually this is a reaction of the baby’s skin to life outside the womb - getting used to sweat, temperature changes, fabric, and so on.

Diapers

In the first 24 hours of life, expect your baby to have one wet diaper and at least one bowel movement - meconium, a black-ish sticky substance. Because meconium is difficult to clean off a baby’s skin, you can rub an oil (coconut , olive, almond etc) all over their bum to make cleaning them easier.

Your baby’s stool will appear black-greenish (meconium) for the first couple of days, until your colostrum (the thick, sticky and yellowish first milk) transitions to mature milk.

Number of diapers to expect:

Day 1 = 1 wet diaper

Day 2 = 2 wet diapers

Day 3-4 = 3 wet diapers per day

Days 5+ = 6-8 wet diapers per day

A disposable diaper feels heavier if it’s wet. Many diaper brands have a urine indicator that turns blue in the presence of a certain amount of urine. Not all diapers do, and some pees in the first few days may be too small to make this happen. If you have trouble telling when the diaper is wet, put a tissue in the bottom of a clean diaper.

You may see a red or orange color on a diaper after your baby urinates. This is normal in the first few days of life. They are uric crystals, sometimes called “brick dust”. For baby girls, you may even see a little bit of blood as they may have a discharge similar to a period in the first few days; this is also normal.

As your milk comes in, you can expect your baby’s bowel movements to change color over the first week of life: from black to a green color; and finally, to a yellowish, greenish or brownish color.

Stools that look ‘seedy’ are normal.

Temperature

The best way to take your baby’s temperature is under the armpit (also known as axillary temperature). Normal armpit temperature is 97.7°F to 99.5°F. Ear thermometers are not accurate for newborns and are not recommended.

A newborn should be dressed in one layer more than you are comfortable wearing. Placing your baby skin-to-skin (holding your bare baby against your bare chest or stomach), covered by a light blanket, will help them to regulate their temperature.

If you want to know if your baby is too hot or too cold, feeling their chest or the back of their neck will give you a more accurate idea of their temperature than their hands or feet. It is normal for a baby’s hands and feet to be cool for the first few days.

If your baby’s temperature is over 100.4°, take your baby to the ER or a doctor right away.

If your baby’s temperature is over 99.5°F, remove a layer of clothing and take his or her temperature again after 30 minutes have passed.

If your baby seems cold or his or her temperature is less than 97.7°F, place your baby skin-to-skin and cover you and your baby with a blanket. Take his or her temperature again after 30 minutes have passed.

Breathing

You can expect your baby to breathe 40 to 60 times in one minute.

Newborns often have irregular breathing patterns. Their breathing does not look or sound like an adult’s. At times, newborn babies will breathe progressively faster and deeper, and at other times their breathing is more slow and shallow. It is normal for babies to occasionally pause their breathing for 10 seconds and then start up with a deep breath. It is not normal for a baby to gasp for breaths or pant (quickly breathe) for 10 minutes or more.

It is normal for newborns to sound like a cat coughing up a hairball as they try to bring up mucus; they may also have bubbles at their mouths. If this happens, you can gently wipe out their mouth with a finger or a soft cloth, or lie them on their side and gently tap their back with your hand.

Your baby should see a doctor if you notice any of these signs that your baby is having difficulty breathing:

Your baby’s nostrils widen as he or she breathes (nasal flaring) for longer than a few minutes
Your baby makes grunting sounds with each breath for longer than a few minutes
The skin around your baby’s ribs or at the base of the throat pulls in sharply with each breath
Your baby’s breathing stops for more than 10 seconds

Umbilical Cord Care

The umbilical stump typically takes 3-14 days to fall off. For babies whose cords remained intact until the placenta was birthed, it’s often at the shorter end of this range.

As your baby’s cord begins to fall off it may begin to look “goopy” and a small amount of blood or discharge may come off on your baby’s diaper or clothing.

There is no need to treat the stump with any herbs or other products. Keeping it clean and dry is all that is necessary. If some goop develops, and you’d like to clean it, use a clean cotton swab or soft washcloth dipped into water and dab lightly.

Your baby’s cord may also have a strong smell; this usually means the stump will fall off within a day or two and is normal. It is not normal for the skin around the base of the umbilical cord (on your baby’s stomach) to become red and infected-looking. If it does, please call your provider!

Bathing

Newborn infants cannot control their body temperature as well as adults and become cold very quickly. The smell of amniotic fluid on the baby will help him/her with early breastfeeding, and the smell of your unwashed baby will stimulate your body to produce more oxytocin, an important hormone in bonding and a uterine contractor.

The white cheesy substance you may see on your baby, especially in his or her creases, is called vernix. It is actually healthy for your baby skin, and is often easier to wipe off the excess, then rub in what remains like a lotion, than it is to wash it off. Look in the baby’s armpits and groin for clumps of vernix.

As you near the end of your pregnancy or prepare to bring your newborn home from the hospital, it's natural to feel a mix of excitement and anxiety. The first few days with a newborn can sometimes be overwhelming as you adjust to your new role and figure out your baby's needs and preferences. But with a little preparation and patience, you'll be able to navigate this exciting time and start building a strong bond with your little one. I hope this blog made you feel a bit more prepared to navigate this time! Every baby is different and is their own unique person, so try not to compare yourself to others and trust your instincts as a parent. Before you know it, your newborn will be growing and changing before your eyes, so cherish these early moments and the special bond you are forming with your little one.