Newborn General Advice: The First Month

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 2, 2026     |     Medical review completed: August 2, 2026

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

2497 E. Herndon Avenue, Suite 101, Clovis, CA 93611     |     559-538-3070

Urgent Warning Signs — Check This First

Not sure whether something is an emergency? Use this guide before reading the rest of this page.

CALL 911 NOW

  • Not breathing, severe trouble breathing, turning blue, or limp and unresponsive

  • A seizure

  • A serious injury or bleeding that will not stop

GET MEDICAL CARE NOW

  • A rectal temperature of 100.4°F (38°C) or higher in a baby 3 months old or younger — contact your baby's current clinician immediately for prompt in-person evaluation; if you cannot reach that clinician promptly, go to an emergency department

  • Very hard to wake, unusually weak, or not acting right

  • Refusing to feed or taking very little for 8 or more hours

  • No urine for more than 8 hours, a marked drop in wet diapers, or a sunken soft spot

  • Repeated vomiting rather than ordinary spit-up; green vomit; blood in the stool; or pale, white, or clay-colored stool

  • Jaundice in the first 24 hours, rapidly increasing yellow color, or jaundice with poor feeding or unusual sleepiness

  • Redness spreading from the umbilical cord area, swelling, pus, a foul odor, or bleeding that will not stop

  • Breathing persistently faster than 60 breaths per minute while calm, grunting, flaring nostrils, or skin pulling in between the ribs

  • Crying for more than 2 hours that nothing seems to soothe

  • Any concern that a baby may have been shaken or injured

CONTACT YOUR CHILD'S HEALTHCARE PROFESSIONAL TODAY

  • A new crying pattern that is difficult to console but eventually settles

  • New or increasing mild jaundice without the urgent signs above

  • A rash, feeding difficulty, or fussiness that is not improving

  • Any time-sensitive concern not described above

Sources and medical review

Feeding and Wet Diapers

Wet diapers, feeding behavior, stools, and weight checks together are more useful than any one number.

What you can do

  • Feed when your baby shows hunger cues. Breastfed newborns commonly nurse 8 to 12 times in 24 hours; formula-fed newborns commonly feed about every 2 to 3 hours. Follow the individualized plan given at discharge.

  • Wet-diaper counts should increase during the first several days. By about day 5 to 7, many well-hydrated newborns have 6 or more pale-yellow wet diapers each day. Before then, compare the pattern with your discharge plan and call for a marked reduction.

  • Some early weight loss is expected, but there is no single reassuring percentage for every baby. Your baby's clinician should interpret weight change together with gestational age, feeding, urine and stool output, bilirubin, and examination. Most babies regain birth weight by about 2 weeks; some take up to 3 weeks.

  • A sleepy newborn may need to be awakened for feeds. Ask your baby's current clinician how often and for how long this is needed.

  • Ask early for feeding help if latch, milk transfer, formula preparation, intake, or supply is a concern.

When your baby needs medical attention

No urine for more than 8 hours, a marked drop in wet diapers, poor intake, or unusual difficulty waking for feeds: get medical care now. Less urgent feeding questions: contact your child's healthcare professional.

Sources and medical review

Safe Sleep

Use the same safe sleep routine for every nap and every night.

What you can do

  • Place your baby on their back for every sleep.

  • Use a firm, flat crib, bassinet, or play-yard surface that meets current safety standards. Keep pillows, blankets, bumpers, positioners, and soft toys out of the sleep space.

  • Room-share without bed-sharing, ideally for at least the first 6 months. Couches, sofas, and armchairs are especially dangerous places to sleep with a baby.

  • If your baby falls asleep in a swing, car seat, carrier, or stroller, move them to a firm, flat sleep surface as soon as possible.

  • If swaddling, place your baby on their back and stop at the first sign of trying to roll. Do not use weighted swaddles, blankets, or other weighted sleep products.

  • Consider offering a pacifier for sleep once breastfeeding is well established. Keep the sleep space smoke-free and avoid overheating.

When your baby needs medical attention

Questions about whether a product or sleep setup is safe: contact your child's healthcare professional. Breathing trouble, blue color, or difficulty waking: use the warning-sign section above.

Sources and medical review

Bathing and Umbilical Cord Care

Newborn skin and the healing cord usually need gentle care and little intervention.

What you can do

  • About 3 baths a week is often enough. Use warm, not hot, water and mild fragrance-free products.

  • Use sponge baths until the cord stump falls off, commonly within 1 to 2 weeks. Keep the stump clean and dry; routine rubbing alcohol is not recommended unless your baby's clinician gives a specific reason.

  • Keep one hand on your baby and stay within arm's reach during every bath. Never leave to answer a phone or get supplies—take your baby with you.

When your baby needs medical attention

Redness spreading from the cord, swelling, pus, foul odor, fever, or bleeding that will not stop: get medical care now.

Sources and medical review

Stools and Urate Crystals

Diaper contents change quickly during the first month, especially during the first week.

What you can do

  • Stools normally change from dark meconium to green-brown and then yellow or tan. Frequency varies with age and feeding; hard pellet-like stool is not the same as ordinary newborn grunting with a soft stool.

  • Pink, rusty, or brick-colored urate crystals may appear in the first few days. Use them as a reason to review feeding and wet-diaper counts rather than assuming they are harmless.

When your baby needs medical attention

Blood in stool; pale, white, or clay-colored stool; a swollen abdomen with vomiting; or poor feeding with reduced urine: get medical care now. Urate crystals that persist or recur after the first week: contact your child's healthcare professional today.

Sources and medical review

Jaundice

Jaundice is common, but the bilirubin level and the baby's age in hours—not skin color alone—determine follow-up and treatment.

What you can do

  • The AAP recommends that every newborn have bilirubin measured at least once before hospital discharge. Ask for the result and the planned follow-up time.

  • Looking in natural light may help you notice change, but visual assessment cannot measure bilirubin or rule out risk, especially across different skin tones.

  • Frequent, effective feeding supports bilirubin clearance. Ask for feeding help early if intake is uncertain.

  • Do not treat jaundice with water or direct sunlight. Phototherapy and any supplementation plan should be guided by your baby's clinician.

When your baby needs medical attention

Jaundice in the first 24 hours, rapidly increasing yellow color, poor feeding, or unusual sleepiness: get medical care now. New or increasing mild jaundice without these signs: contact your child's healthcare professional today.

Sources and medical review

Crying and Caregiver Safety

Crying usually increases during the first weeks and often peaks near 6 to 8 weeks. A safe coping plan matters.

What you can do

  • Check feeding, burping, diaper, temperature, clothing, and sleep needs. Try holding, gentle rocking, walking, a pacifier, quiet singing, or low-volume white noise.

  • If frustration is building, place your baby on their back in an empty safe crib, step away briefly, and call a trusted person for support.

  • Never shake, hit, or forcefully jostle a baby. Make sure every caregiver knows the same rule and has a plan for taking a break.

  • Discuss persistent fussiness before starting drops, supplements, or broad maternal diet restrictions.

When your baby needs medical attention

Crying for more than 2 hours that nothing soothes, illness signs, injury, or any concern that the baby may have been shaken: get medical care now. Call 911 for breathing trouble, unresponsiveness, blue color, or seizure.

Sources and medical review

Common Normal Behaviors

Many newborn reflexes look surprising but are part of early adjustment.

What parents may notice

  • Sneezing, hiccups, passing gas, and occasional small spit-ups are common.

  • A brief cough or sputter during a fast feeding that resolves may occur. Persistent coughing, repeated choking, color change, breathing difficulty, or reduced intake needs assessment.

  • Eyes may briefly appear misaligned. A constant eye turn at any age, or recurrent misalignment after about 3 to 4 months, should be assessed.

  • Brief irregular breathing can occur, but persistent fast or labored breathing is not normal.

When your baby needs medical attention

Persistent cough or choking during feeds, color change, breathing difficulty, or poor intake: get medical care now. Constant eye turning or recurrent misalignment after 3 to 4 months: contact your child's healthcare professional.

Sources and medical review