Newborn care in the first 40 days

Feeding

Feed on demand, not by the clock — roughly 8 to 12 times in 24 hours, night included. Exclusive breastfeeding is recommended for the first six months, with nothing else, not even water, unless your doctor has advised otherwise.

Signs feeding is going well:

• Six or more wet nappies a day after the first week
• Regular stools, changing from dark meconium to yellow in the first days
• Weight regained to birth weight by about two weeks, then steady gain
• The baby settles after most feeds and is alert when awake

Breastfeeding is frequently painful or difficult at the start, and that is common rather than a failure. It is also usually fixable — often with a change of position or latch. Ask early. Struggling silently for three weeks helps nobody.

Weight

Almost all newborns lose weight in the first days. Birth weight is normally back by around two weeks. Weight that keeps falling past the first week, or has not recovered by two weeks, needs a pediatric review — it is usually a feeding problem, and feeding problems are solvable when caught early.

The cord stump

Keep it clean, keep it dry, and otherwise leave it alone. Fold the nappy below it. It generally separates within one to two weeks.

Do not apply anything to it — no oil, powder, ash, turmeric or traditional preparation. These remain a well-documented cause of newborn infection, and the belief that they help is one of the most persistent and most harmful in newborn care.

See a doctor the same day for redness spreading onto the belly, swelling, discharge, a bad smell, or fever.

Jaundice

Yellowing of the skin and eyes is common in the first week and often harmless. It needs medical assessment when it appears in the first 24 hours, deepens rapidly, reaches the palms and soles, lasts beyond two weeks, or comes with poor feeding or unusual sleepiness. Judging severity by eye is unreliable, particularly in good sunlight — if you are unsure, have the baby checked rather than guessing.

Warmth

Newborns lose heat quickly, especially small or preterm babies. Keep the head covered in cool weather, dress in layers, and keep the room comfortable rather than hot. Skin-to-skin contact is an excellent way to keep a baby warm and settled, and it helps feeding. A baby who feels cold to touch on the chest, or unusually hot, needs attention.

Sleep and safety

• Newborns sleep in short stretches around the clock. This is normal, however exhausting.
• Place the baby on their back to sleep.
• Keep the sleeping surface firm and clear of pillows, loose bedding and soft toys.
• Nobody who has been drinking, or who smokes, should share a sleeping surface with the baby.
• Keep the home smoke-free.

Immunisation

The first vaccines are given at birth — BCG, the birth dose of oral polio, and hepatitis B. The next set follows at around six weeks. Keep the immunisation card safe and bring it to every visit. If a dose has been missed, catching up is almost always possible; ask rather than assuming the schedule is ruined.

Danger signs — see a doctor now

Any one of these needs urgent attention, at any hour:

• Refusing to feed, or feeding much less than usual
• Unusually sleepy, floppy, or difficult to wake
• Fever, or unusually low body temperature
• Fast or laboured breathing, grunting, or the chest pulling in with each breath
• Convulsions or fits
• Persistent vomiting
• Yellowing that reaches the palms and soles
• Redness, swelling, discharge or smell at the cord stump

Naari Hospital runs inpatient and emergency care 24×7, with a neonatal intensive care unit on site. Call 93273 61084.

The mother matters too

These weeks are relentless, and low mood, anxiety or persistent tearfulness after birth are common and treatable. They are not a character failing and not something to endure quietly. Mention it at the postnatal visit, or bring it up whenever you next come in. Also report heavy bleeding, fever, severe headache or pain — the mother's own warning signs deserve the same seriousness as the baby's.

What we do at Naari

Our pediatric practice sits in the same building as the maternity unit, with the neonatal intensive care unit steps from the delivery room. The same team that receives your baby runs the well-baby checkups afterwards.

Read about pediatrics & NICU →   About Dr. Upasana Kubavat →