Your new baby

You’ll probably spend a large part of the first few days after birth looking at your baby. If you notice anything that worries you, however small, speak to your Midwife or Health Visitor.

Within the first 24 hours, a health professional will offer to give your baby an injection of vitamin K. This is to prevent a rare but serious blood disorder. Your baby will also have a thorough newborn physical examination in their first 72 hours. Among other things, their eyes, heart, hips and testicles (in boys) will be checked for possible problems.

In their first few weeks, you baby will also have the:

Register your baby with your GP

Register your baby with your GP as early as possible in case you need their help. You can use the pink card you’ll be given when you register your baby’s birth. Sign the card and take or post it to your GP.

You can contact your GP at any time, whether it’s for you or your child. Some GPs will see small babies at the beginning of surgery hours or without an appointment, but be prepared to wait. If you want the GP to see your baby before you’ve registered the birth, you can go to the surgery and fill in a registration form there. If you move, register with a new doctor close to you as soon as possible.

Caring for your baby

When you have a baby, there are a lot of things to think about. Here we look at three practical parts of caring for a baby. We hope it gives you some basic information but, perhaps more importantly, we would like to give you a few minutes to think about how you can make the most of these simple activities to develop a loving and sensitive relationship with your baby.

The interaction between you and your baby in these everyday tasks is really important for your baby’s development. This is an opportunity to talk to your baby, explain what you are doing and perhaps have a bit of a play at the same time. To us it may be just a task but to a baby it’s precious time with you.

Holding your baby

Parents have often heard or read advice about how you should hold a baby. These are some of the most common things that parents hear:

  • You have to hold a baby’s head.
  • You can hold a baby over your shoulder when winding.
  • Babies like to be held tight.
  • You can pat their back while holding them.
  • Babies like to be held close to you.
  • They can be hard to hold when you are bathing them.

Caring for a baby is not just physical. It is full of experiences that can stir up many different feelings. These are some feelings parents have expressed about holding a baby:

  • Worried about not supporting their head.
  • Frightened of dropping them
  • Worried about how firm to hold them.
  • Looking forward to cuddling their baby.
  • Worried about spoiling their baby by holding them too much.
  • Worried about dropping them when they are wet.
  • Excited.

When you hold your baby after they are first born, you may experience a mixture of feelings such as fear or excitement and you may even feel these at the same time. Your baby will be getting used to the world outside the womb, changing and developing rapidly, and your confidence and skills as a parent will increase as your baby grows. Getting to know your baby is the best way to speed up your learning as a parent.

As a parent, your senses will give you a lot of information to help you make decisions about how to hold your baby:

  • How floppy or steady does your baby’s head look and feel?
  • Does your baby respond in a certain way when you hold them in a particular way?
  • In what positions does your baby become more settled or wriggle or cry when you hold them?
  • In what positions does your baby appear most content?

Does my baby’s head need supporting?
When babies are born, it is true that their head will need supporting as their muscle control is still under development. Each baby is individual and, just as with other parts of their development, babies will gain control of their neck and body muscles at different rates. As the weeks progress, you will notice that the amount of support the baby needs will decrease. At first, it may feel like you have to think about this a lot but before you know it, you will adjust the
way you support your baby’s neck and body without even thinking about it.

In what positions can you hold a baby?
Parents hold babies in a range of positions, such as cradling or holding a baby upright against their chest with the baby’s head resting on their shoulder or positioning their baby facing downwards along their forearm.
Parents have said that holding a baby in certain positions can be helpful for different activities.

There are a range of positions and advice on this topic, such as sitting a baby upright on your lap while supporting your baby’s chin and upper body with your hand. You can also rub your baby’s back. This can be soothing for both you and your baby. Being relaxed may help with winding, but the action of rubbing the back does not actively bring up the wind. Holding your baby upright against your chest with their head resting on your shoulder may also help.
The best position is the one that works for your baby.

When your baby is unsettled or has colic, you may use a combination of all positions. This will depend on how your baby responds to different positions.

Settling to sleep
Again this will depend on what positions your baby prefers. You may have heard of or seen a reflex that babies have called the ‘moro reflex’ or ‘startle reflex’. The startle reflex is a survival instinct, where a baby stretches out their arms if they are startled or feel as though they are falling. If you have seen this, you may have noticed it occurs when a baby is put in a cot or bath. In both of these instances, babies are being lowered. Holding your baby close to you, but not too close, and watching your baby’s response may help to stop this reflex. You will be able to adjust how quickly you lower your baby into a bath or cot if you watch your baby’s response.

Washing and bathing your baby

General information about washing and bathing a baby can be obtained from the NHS Choices website.

How often do I need to bath my baby?
It is not necessary to bath your baby every day. Two or three times a week is fine. However, you may choose to bath your baby everyday if your baby enjoys a bath or a bath is part of your baby’s bedtime routine. On the days you do not bath your baby, you should wash their face, under their chin and neck, hands, bottom and genitals.

How often do I need to wash my baby?
You can wash your baby’s face, under their chin and neck, hands, bottom and genitals on the days you do not bath them. This is known as ‘top and tailing’.

What temperature should the water be?
The water should feel warm. You should check the temperature of the water with your wrist or elbow, as using your hand may not give you the best gauge. There are bath thermometers available if you choose to use one. The ideal temperature is between 37 and 38 degrees centigrade. Bath thermometers are not really necessary as you can use your judgement about what feels warm. It is still important to always test the water for yourself in case the thermometer is faulty.

If you watch how your baby reacts when you wash or bath them, you will learn what sort of temperature they prefer. Each baby will react differently to being washed or bathed. Some will remain calm while others will find the change in their skin temperature unsettling and may even cry at first.

If your baby is unsettled by being washed you can help your baby by talking to them in a soothing voice. You could gradually introduce them to the water by using your hand to let a small amount of water flow over their body before putting them into the water. When you are lowering your baby into the bath this is also a time when the startle reflex is most likely to be triggered and your baby may need to be soothed before you begin to wash them.

Do I need to soap?
It is best to just use water, especially in the first month. There are lots of bath solutions available and if you choose to use one, you will need to see what suits your baby’s skin.

How do I wash my baby?
You can use a small bowl, baby bath or even put your baby in the bath with you. Some parents use a sink. In this case, it is important to make sure your baby cannot touch the hot tap, to avoid the risk of a burn injury. When you start to wash your baby, you can wash your baby’s face and hair before you put them in the water. It is important that you feel comfortable when washing your baby.

Parents can feel a little worried at first about dropping their baby when their baby is wet, so you may find it helpful to collect everything together before you start and be sitting down.

When is the best time to wash / bath my baby?
The best time to bath your baby is when they are not too full, too tired or too unsettled and when you have time so that you can both enjoy the experience. Bath time is often a fun and special time for you and your baby. It can also be a way of calming a baby before bed and can be an important part of a bedtime routine.

How can I make bath time a pleasant experience for my baby and me?

  • Choose a time when you feel you have time to take your time. Relax and enjoy the experience.
  • Your baby will be tuning into your voice, so talking to them and telling them what you are doing will help you and your baby communicate with each other. They may not understand the words but they will begin to recognise the rhythm of your words and try to ‘talk’ back to you with their arms, legs and face.
  • Young babies focus a lot on human faces, so seeing a happy face and hearing a soothing voice while they are being washed will help to make bath time enjoyable for both of you.
  • Toys can add to the enjoyment of bath time. However, in the early weeks and months of life your baby will want to focus mainly on their relationship with you. Start off by talking, singing and having a chat with your baby. Then, as your baby develops, you can add toys at a later date.

Although it may seem obvious, it is important never to leave a baby alone when bathing a baby, even if there are only a few inches of water in the bowl or bath.

How do I change my baby’s nappy?

More information about changing a baby’s nappy can be found on the NHS Choices website.

How often do I need to change my baby’s nappy?
This may vary from baby to baby, but you need to change your baby’s nappy when they are wet or have passed a stool (also known as poo or faeces) to avoid their skin becoming sore. Each baby is individual and babies may give out a range of different signs that they are uncomfortable, such as wriggling, crying or appearing unsettled.

Your baby’s first poo will be greenish / black and is called meconium. Then it will change to a yellowish colour in the next few days. A baby will pass poos very frequently in the first few weeks. After this they will happen less often.
Some babies will need changing before a feed and others after a feed, or even both in the early weeks. As you get to know your baby you will begin to recognise the signs your baby gives that it is time to change their nappy.

What nappies can I use?
There is a range of nappies available, both cotton and disposable. The choice is yours and you can find more information on the NHS Choices website.

What do I use to clean my baby?
You can use cotton wool with water, baby lotion or baby wipes. Each baby’s skin is different so you will need to choose the one that suits your baby.

Do I need to use nappy cream?
You do not need to use nappy creams on a regular basis. Nappy creams can be helpful if your baby has nappy rash, as they can act as a barrier and soothe the skin. If you are still worried about your baby’s skin, you can talk to your Health Visitor or GP for advice.

Is there a difference in the way boys’ and girls’ nappy area is cleaned?
Yes. Because girls and boys are physically different in the nappy area, it can be helpful to clean them in the following ways:
Girls: To avoid getting germs and poo in the vagina, you should clean girls from the front to the back.

Boys: You can clean around the testicles (balls), as well as lifting them to clean underneath. You may have heard that you need pull back the foreskin to clean it but this is not necessary. You do not have to pull back the foreskin to clean it.

If you choose to position a changing mat on a raised area, it is common sense not to leave your baby alone even when they are very young. Although young babies may not move a lot, they can wriggle and could fall. As they become older and more mobile, you may find it easier to change their nappy on the floor.

Other things to think about when changing your baby’s nappy

  • Using nappy changing time to build your relationship and communicate with your baby.
  • When you are changing your baby’s nappy, it can be a great time to communicate with your baby. Your baby will respond to the sound of your voice and the expression on your face. You can tell your baby what you are doing or sing a nursery rhyme to help keep them calm. It is also a time when you can have a ‘chat’ with your baby.
  • When your baby begins to make sounds, you can acknowledge them and respond by replying to them. This is one of many opportunities in the day when you can start to have a two way conversation, taking turns with your baby. It will help your baby’s language development. If you start early, you will be building a smooth rhythm into how you and your baby interact when you change their nappy.

As your baby grows and begins to move around, you may find that having a conversation can help to calm them and focus on you rather then moving around too much. Later you may also find it helps to give your baby a toy to play with when they are having their nappy changed.

Getting to know your new baby

How do we look after our baby’s umbilical cord? How much can our baby see? Why are their genitals swollen? Newborn babies don’t come with an instruction manual and you’re bound to have lots of questions about their behaviour and appearance to begin with.

You’ll find some of the answers you need in Getting to know your newborn and UNICEF’s guide to Building a happy baby.

Infant Feeding

Find out more about

  • Breastfeeding
  • Formula Feeding
  • Benefits of skin to skin
  • Expressing milk
  • Responsive feeding
  • Weaning and moving on

Skin to skin

Did you know? Oxytocin that is released during breastfeeding, works to enable mothers to fall in love with their babies creating a deep life-long bond.
Skin-to-skin is a great way to calm a distressed infant at any time not just after birth.

Benefits of skin-to-skin contact

Did you know? Skin-to-skin…

  • … regulates baby’s breathing.
  • … regulates baby’s heart rate.
  • … maintains baby’s core temperature.
  • … increases oxygen uptake in the baby.
  • … calms mother & baby.
  • … increases prolactin production.

Newborn Jaundice

Jaundice describes a yellow tinge to the skin and to the whites of the eyes.

It can be difficult to detect in some babies’ skin colours, but might be obvious if you look at their gums, the palms of their hands or the soles of their feet. Jaundice is not liver disease!

Babies are born with extra red blood cells, and in the process of getting rid of these, their bodies make a substance called bilirubin, which is then broken down by the liver. In the first few days of life, a baby’s liver isn’t yet working very efficiently, so the amount of bilirubin in the blood can build up, causing the skin to look a bit yellow.

As a baby grows, their liver starts working more effectively, so the jaundice fades away gradually. Frequency of feeding (2-3 hourly) can help speed up this process, but sometimes bilirubin makes babies sleepy, so you may need to wake your baby for feeds.

For some reason, breastfed babies are more likely to have jaundice for longer than formula-fed babies, but don’t let that put you off breastfeeding!

Your midwife or public health nurse (health visitor) might feel your baby needs help breaking down the bilirubin, and may arrange for your baby to go to hospital for phototherapy – a treatment which involves shining light on the baby’s skin. Don’t try and recreate this by exposing your baby to direct sunlight. It won’t work in the same way, and could lead to sunburn or overheating.

When babies are born they have a lot of red blood cells going around their body. As these naturally break down they produce bilirubin which is yellow. This has to be cleared from the body by the liver. In the early weeks the liver is not fully developed so some of the bilirubin carries on travelling around the body causing the yellow of jaundice.

About 80% of babies will have some jaundice – mostly it will be gone in two weeks. It could take three weeks if your baby was premature, or 4 weeks if fully breastfed. Most babies will have no further problems because of their jaundice.

What do I need to look out for?

If your baby is less than 24 hours old and you suspect they have jaundice, seek immediate medical attention.

Check the colour of your baby’s wee and poo. Normal urine (wee) is colourless and not persistently darker than you would expect, and a couple of days after birth, your baby’s poo should be a yellow colour. If you think there may be a problem, talk to your midwife or public health nurse (health visitor) straightaway. This applies at any age, and whether there is jaundice present or not.

If your baby still has jaundice at two weeks old (or three weeks old if they were born before 37 weeks), your midwife or public health nurse (health visitor) will arrange for your baby to have a blood and urine (wee) test so more serious medical problems can be ruled out.

If at any time you think that the jaundice is getting more obvious, rather than fading away, then do not wait for your next midwife or public health nurse appointment, seek medical attention.

A baby’s cry can be upsetting and frustrating. It is designed to get your attention and you may be worried that something is wrong with your baby.

Your baby may start to cry more frequently at about 2 weeks of age. The crying may get more frequent and last longer during the next few weeks, hitting a peak at about 6 to 8 weeks.

Every baby is different, but after about 8 weeks, babies start to cry less and less each week.

Babies cry for many reasons – most commonly because they are uncomfortable or are unwell. This may be due to colic, reflux, constipation or infection amongst other things.

Soothing a crying baby

All babies cry, and some cry a lot. Crying is your baby’s way of telling you they need comfort and care. Sometimes it’s easy to work out what they want, and sometimes it isn’t. The most common reasons for crying are:

  • Hunger
  • A dirty or wet nappy
  • Tiredness
  • Wanting a cuddle
  • Wind
  • Being too hot or too cold
  • Boredom
  • Overstimulation

There may be times of the day when your baby tends to cry a lot and can’t be comforted. Early evening is the most common time for this to happen. This can be hard for you, as it’s often the time when you’re most tired and least able to cope.

The amount babies cry tends to peak at about seven weeks, then gradually tail off.

How to calm a crying baby

Try some of the following ways to comfort your baby. Some may work better than others:

  • Offer your baby another feed. To learn more about responsive feeding and cues see the information on breastfeeding and/or bottle feeding.
  • Some older babies like to use a bit of cloth or a blanket as a comforter.
  • Hold your baby or put them in a sling so they’re close to you (see Baby Sling Safety – the T.I.C.K.S. rule for safe babywearing). Move about gently, sway and dance, talk to them and sing.
  • Rock your baby backwards and forwards in the pram, or go out for a walk or a drive. Lots of babies like to sleep in cars. Even if they wake up again when you stop, at least you’ll have had a break.
  • Find something for them to listen to or look at. This could be music on the radio, a CD, a rattle, or a mobile above the cot.
  • Try stroking your baby’s back firmly and rhythmically, holding them against you or lying face downwards on your lap.
  • Undress your baby and massage them gently and firmly. Avoid using any oils or lotions until your baby is at least a month old. Talk soothingly as you do it and keep the room warm enough. Some health centres and clinics run baby massage courses. For information, ask your midwife or health visitor.
  • Try a warm bath. This calms some babies instantly, but makes others cry even more.
  • Sometimes too much rocking and singing can keep your baby awake. You might find lying them down after a feed will help.
  • Ask your health visitor for advice.

Crying during feeds

Some babies cry and seem unsettled around the time of a feed. If you’re breastfeeding, you may find that improving your baby’s positioning and attachment helps them settle. You can go to an infant feeding support group and ask for help, or talk to your health visitor.

It may be that something you’re eating or drinking is affecting your baby. If you think this is happening, try keeping a diary of what you eat and when the crying happens. If you see any patterns, talk to your health visitor.

Crying during feeds can sometimes be a symptom of reflux, a common condition where babies bring back milk after feeds. Speak to your health visitor or GP for more information and advice.

If your baby cries constantly

There are several reasons that can cause a baby to cry excessively. It can be exhausting if you’ve tried everything and nothing seems to comfort your baby.

Excessive crying could be a sign that your baby has colic. Everyone agrees that colic exists, but nobody knows what causes it.
Some doctors think it’s a kind of stomach cramp. The crying sounds miserable and distressed, and stops for a moment or two, then starts up again, which suggests it could be caused by waves of stomach pain.

The crying can go on for some hours. There may be little you can do except try to comfort your baby and wait for the crying to pass. See some tips for coping with colic.

Crying and illness
If your baby is crying constantly and you can’t console or distract them, or the cry doesn’t sound like their normal cry, it can be a sign they are ill.

Or they may be ill if they are crying and have other symptoms, such as a high temperature. If this is the case, contact your health visitor or GP.

Get medical attention as soon as you can if your baby:

  • Has much drier nappies than usual
  • Has a high temperature, but their hands and feet feel cold
  • Has a fit (seizure or convulsion)
  • Has blue, mottled, ashen (grey) or very pale skin
  • Breathes rapidly or makes a throaty noise while breathing, or seems to be working hard to breathe, perhaps sucking in their stomach under their ribcage
  • Has a spotty purple-red rash anywhere on the body – this could be a sign of meningitis

See more signs of serious illness.

If you think there’s something wrong, always follow your instincts.

During the day, Monday to Friday, contact your GP surgery. At evenings and weekends you can call NHS 111 or your GP’s out-of-hours number.

Getting help with your crying baby

You can talk to a friend, your health visitor or GP, or contact the Cry-sis helpline on 08451 228 669, open 9am to 10pm, 7 days a week. You will be charged for your call.

Cry-sis can put you in touch with other parents who have been in the same situation.

You can also visit the Cry-sis website for information on coping with crying babies.

If you decide to talk to your health visitor or GP, it can help to keep a record of how often and when your baby cries.

For example, this might be after every feed or during the evening. This can help your health visitor or GP to work out if there is a particular cause for the crying.

Keeping a record can also help you identify the times when you need extra support. You could think about possible changes to your routine.

There may be times when you’re so tired and angry you feel like you can’t take any more. This happens to a lot of parents, so don’t be ashamed to ask for help.

If you don’t have anyone who can take care of your baby for a short time and the crying is making you stressed, put your baby in their cot or pram, make sure they’re safe, close the door, go into another room and try to calm yourself down.

Set a time limit – for example, 10 minutes – then go back.

Never shake your baby
No matter how frustrated you feel, you must never shake your baby. Shaking moves their head violently and can cause brain damage.

Be careful to always handle your baby gently, never shake them. Some parents and carers have shaken their babies whilst feeling very stressed and babies have sadly been badly injured or died. It is very important to take a break when you need to.