Guide to First 28 Days of Newborn Care
Get essential tips for first-time parents. Our comprehensive guide covers bathing, feeding, sleeping, and health care for your newborn's first 28 days.
Introduction
Those first 28 days—often called the neonatal period—are a whirlwind of love, learning, and lots of questions. What’s normal on day 2 may look very different by day 10, and it’s easy to second-guess what your new baby needs. This guide brings together trusted, evidence-based advice to help you feel confident about day-to-day new baby care in the first month. You’ll find clear expectations for sleep and feeding, simple steps for cord and skin care, what’s normal (and not) with poop and pee, and when to call the doctor. We’ve included practical checklists, real-world tips, and quick decision points to save you late-night searches. You’ll also see how skin-to-skin and responsive routines support bonding and brain development, plus guidance on common concerns like jaundice, rashes, and fevers. Whether you’re breastfeeding, formula feeding, or doing both, this first-28-days new baby care guide is here to help you and your baby thrive—one day at a time.
The First 28 Days at a Glance: What’s Normal, What’s Not
Day 0–2: Transition to life outside the womb
• Many newborns are sleepy, feed in short bursts, and may lose up to 7–10% of birth weight; this is typically normal and usually regained by 10–14 days. Stools transition from sticky black meconium to greenish-brown.
• Expect 1 wet diaper on day 1, 2 on day 2, then increasing daily; stool count rises as feeding increases.
• Skin-to-skin (also known as kangaroo mother care, KMC) stabilizes body temperature, heart rate, and blood sugar, and supports breastfeeding from the start.
Day 3–7: Jaundice watch, feeding rhythm, weight changes
• Physiologic jaundice often peaks between days 3–5; mild yellowing of the face/sclera can be normal, but worsening yellowing, lethargy, poor feeding, or spreading below the chest warrant a call to your doctor.
• Breastfeeding frequency averages 8–12 times in 24 hours. Formula-fed newborns often take 30–60 mL (1–2 oz) every 2–4 hours, guided by cues.
• Diaper output target by day 5: at least 6 wet diapers and 3–4 yellow, seedy stools daily (breastfed), though formula-fed stool frequency may vary.
Week 2–4: Growth spurts, more alert time
• Expect 20–30 minutes of alert, quiet wakefulness several times a day. Growth spurts can temporarily increase feeding frequency around weeks 2–3.
• New babies sleep 14–17 hours across 24 hours, often in short stretches; nights gradually lengthen, but variability is normal.
• If they haven’t regained birth weight by 2 weeks, check in with your pediatrician or a lactation specialist. If your baby is hard to wake to feed, or feeds are consistently shorter than 5 minutes or very sleepy, seek guidance promptly.
When to call a doctor urgently?
• Rectal temperature ≥ 100.4°F (38°C), breathing difficulty, blue/gray lips or face, poor feeding (fewer than 6 wets by day 5), projectile vomiting, or less responsive than usual should prompt immediate care. If symptoms persist beyond two days or worry you, consult a doctor online with Apollo 24|7 for further evaluation, or book an urgent visit if recommended.
Consult a Top General Physician
Feeding Your New Baby: Breastfeeding, Formula, and Cues
How often and how much in the first 28 days?
• Responsive feeding—watching your baby’s cues rather than the clock—works best. Look for early hunger cues, such as stirring, hand-to-mouth movements, rooting, and lip smacking. Crying is a late cue.
• Breastfed infants: 8–12 feeds per 24 hours. Early volumes are small: colostrum days 0–2, then transitional milk. Cluster feeding is common during growth spurts and evenings.
• Formula-fed infants: typically 60–90 mL (2–3 oz) every 3–4 hours by the end of the first month. Avoid overfeeding; paced bottle feeding helps babies regulate intake like at the breast.
Latch tips, expressing, and mixed feeding
• Deep latch: baby’s mouth wide, more areola below than above, lips flanged, chin touching breast, rhythmic suck-swallow. Pain beyond initial seconds suggests a shallow latch; seek help early (lactation consults are invaluable).
• If separated from the baby or managing supply, hand expression and pumping in the first hours–days protect supply. Short, frequent sessions (8+ per 24 hours) mimic a baby's pattern.
• Mixed feeding can be done thoughtfully: offer breast first to stimulate supply, then top-up only as needed. Reassess volumes weekly as breastfeeding efficiency improves. Related terms to weave in: breastfeeding tips 0–4 weeks; formula and mixed feeding first month.
Diaper output by day as a reality check
• Day 1: 1 wet, meconium stools; Day 2: 2 wets; Day 3: 3 wets, transitioning stools; Day 4: 4+ wets; Day 5+: 6–8 wets with pale urine, 3–4 yellow, seedy stools (breastfed). Fewer wets by day 5 warrants a call.
• Brick-red “urate crystals” can appear in the first days; if they persist beyond day 3–4, it may indicate low intake—seek guidance.
Vitamin D for breastfed babies
• The AAP recommends 400 IU of vitamin D daily for exclusively or mostly breastfed infants starting in the first days of life [4,5]. Formula-fed babies typically meet needs if consuming about 1 liter/day, which usually isn’t reached in the first 28 days—ask your clinician.
Unique insight: Build a “feed map.” For three days, jot time, side/volume, and baby’s state before/after each feed. Patterns emerge (e.g., evening cluster feeds), helping you adjust naps and support your own meals and rest.
Sleep and Safe Sleep in the First 28 Days
How newborn sleep works (and why nights feel long)?
• Newborns cycle rapidly between light and active sleep; short sleep cycles (about 45–60 minutes) and small stomachs mean frequent waking. Day–night confusion is normal early on.
Safe sleep setup that reduces SIDS risk
• Back to sleep for every sleep; firm, flat sleep surface; fitted sheet only; no pillows, blankets, bumpers, or toys in the crib; room-share but don’t bed-share; avoid overheating; smoke-free environment.
• Pacifiers at sleep times (if breastfeeding is established) may reduce SIDS risk. Offer once the latch is solid.
• Use an approved bassinet or crib; car seats are for transport, not routine sleep. Related terms: safe sleep guidelines newborn first 4 weeks.
Soothing routines and day–night cues
• Try the “5 S’s”: swaddle (hip-friendly), side/stomach hold for calming only (not for sleep), shush (white noise), swing (gentle), and suck.
• Day cues: light, gentle play after feeds; Night cues: dim light, quiet, diaper only if needed.
• If you’re ever unsure whether a sleep product or position is safe, err on the side of caution. If your baby is extremely hard to settle or shows breathing noise/pauses, consult a doctor online with Apollo 24|7.
Unique insight: Think in “sleep cycles,” not hours. Aim for one calm, drowsy-to-sleep transition daily without full rocking—this builds self-soothing gradually without expecting independent sleep in the first month.
Hygiene, Cord Care, and Bathing Basics
Cord stump care (dry care vs chlorhexidine)
• In most high-resource settings, dry cord care (keep clean and dry, fold diaper below the stump, no alcohol) is recommended; the stump usually falls off by 1–2 weeks.
• In settings with higher neonatal infection risk, the WHO recommends 7.1% chlorhexidine digluconate for cord care to reduce sepsis and mortality. Related term: umbilical cord care chlorhexidine vs dry.
• Seek care for redness spreading onto the skin, foul odor with pus, fever, or the baby seeming unwell.
First bath: timing, how-to, and products
• Delayed bathing (24 hours or later) supports temperature stability and breastfeeding. Until the cord falls off, consider sponge baths.
• Water alone is enough for most baths; if using cleanser, choose fragrance-free, pH-balanced baby products. Keep baths brief (5–10 minutes), warm room, and test water temperature on your wrist.
• Moisturize dry areas with simple, hypoallergenic emollients.
Diapering, rashes, and skin care
• Change promptly, clean front to back, and let skin air-dry. Use a barrier ointment (zinc oxide or petrolatum) preventively if stools are frequent.
• Newborn rashes are common and usually harmless: erythema toxicum (flea-bite-like), milia, and baby acne. Call if the rash is blistering, widespread with fever, or if you suspect a yeast rash not improving with barrier care.
Circumcision and umbilical hernia notes
• Circumcision care: keep clean, apply petroleum jelly gauze as advised; mild redness is normal for a few days—call for increasing redness, swelling, or discharge.
• Umbilical hernias are common and usually resolve by age 1–2 years; no taping or binders needed—ask your pediatrician to monitor.
Unique insight: Keep a “bath caddy” pre-packed with everything (towel, washcloth, diaper, moisturizer) so you can finish the bath calmly without searching for supplies mid-bath.
Health Checks, Jaundice, and When to Seek Help?
Weight, temperature, breathing, and color checks
• Weight: up to 7–10% loss in the first days, regained by 10–14 days; average gain thereafter 20–30 g/day . If not tracking upward by week 2, seek help.
• Temperature: Check rectally for accuracy in newborns. A rectal temp ≥ 100.4°F (38°C) is an emergency; seek care immediately
• Breathing: Occasional brief pauses can be normal. Persistent fast breathing (> 60 breaths/min), grunting, flaring nostrils, or chest retractions require urgent evaluation.
• Color: Persistent blue around lips/face, gray tone, or pronounced jaundice below the chest is concerning..
Jaundice: normal vs concerning
• Physiologic jaundice peaks days 3–5; breastfeeding jaundice and breast milk jaundice are distinct patterns. Excessive sleepiness, poor feeding, or spreading yellowing may need bilirubin testing and, sometimes, phototherapy.
• If your baby looks more yellow or is harder to wake, don’t wait. If access is an issue, consult a doctor online with Apollo 24|7; they can triage if tests or in-person care are needed quickly.
Vaccines and newborn screening in the first month
• Birth dose Hepatitis B vaccine is recommended within 24 hours in many countries. Some regions also give BCG and OPV at birth—follow your local schedule.
• Newborn metabolic and hearing screens are usually done before hospital discharge; if you missed these, book them promptly with your pediatric provider.
Telehealth and urgent care decision points
Call or seek urgent care for fever, breathing difficulty, poor feeding, fewer than 6 wets by day 5, vomiting green bile, or decreased responsiveness. If your condition does not improve after trying these methods, book a physical visit to a doctor with Apollo 24|7 for hands-on evaluation.
Unique insight: Create a “Go/Call/Wait” magnet card. List your pediatrician’s number, local urgent care, poison control, and your telehealth portal (e.g., Apollo 24|7). Pre-deciding speed action when you’re worried.
Bonding, Soothing, and Parental Well-Being
kin-to-skin and kangaroo mother care
• Skin-to-skin helps stabilize temperature, heart rate, and breathing, supports breastfeeding, and reduces crying. Preterm and low-birth-weight babies benefit significantly (KMC reduces mortality).
• Aim for frequent skin-to-skin sessions daily, especially before feeds, during fussy periods, and after baths. Related term: Kangaroo mother care benefits the first month.
Tummy time and developmental play
• Tummy time helps head control and motor development. Start with 1–2 minutes, 2–3 times a day, and build up as tolerated. Use a chest-to-chest or a rolled towel under the chest if the floor is challenging.
Postpartum recovery and mental health
• Expect physical recovery and shifting emotions. The “baby blues” often resolve within two weeks; persistent low mood, anxiety, or intrusive thoughts could be postpartum depression/anxiety—reaching out early. AAP and NHS encourage timely support .
• If you’re overwhelmed or anxious most days, or sleep is impossible even when the baby sleeps, consult a clinician. If symptoms persist beyond two weeks, consult a doctor online with Apollo 24|7 for further evaluation and support.
Visitors, travel, and infection prevention
• Limit close contact with anyone sick, practice hand hygiene, and keep the baby’s environment smoke-free. Delay crowded indoor spaces in the early weeks when possible.
• Travel: Short, necessary trips only; follow safe car seat use and plan feeds around stops.
Unique insight: Make a “visit kit” by the door—hand sanitizer, spare masks, and a gentle script for visitors. It normalizes your boundaries and reduces awkwardness when you need to cut a visit short for feeds or naps.
Conclusion
The first 28 days move fast: one moment you’re counting wets and the next you’re marveling at new alert stretches and little grins. You don’t need to memorize everything—just anchor to a few essentials. Feed responsively and watch output as your reality check. Create a safe sleep space every time. Keep cord care simple and clean. Use skin-to-skin and short, calming routines to settle your baby and to recharge yourself. And don’t hesitate to call for help if something feels off; you know your baby best. Trusted newborn care isn’t about perfection but about noticing patterns, responding with warmth, and getting timely support when needed. Save this guide for quick reference and share it with anyone caring for your baby. If your baby develops a fever, has trouble breathing or feeding, or jaundice worsens, seek urgent evaluation—and if you want quick guidance at home, consult a doctor online with Apollo 24|7 to decide next steps. With a little planning and a lot of love, your first 28 days can be steady and sweet, even with the inevitable surprises. You’ve got this.
Consult a Top General Physician
Consult a Top General Physician
Dr. Harshendra Jaiswal
General Physician/ Internal Medicine Specialist
12 Years • MBBS , MD (General medicine)
Kolkata
108 DHANA DHANVANTARI Clinic, Kolkata
(25+ Patients)
Dr. Swagata Sircar
General Physician/ Internal Medicine Specialist
8 Years • MBBS, MD General Medicine
Kolkata
HealthYou Speciality Clinic & Diagnostics., Kolkata
Dr Bhargav Vuppumalla
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD GENERAL MEDICINE
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Dhanraj K
General Physician/ Internal Medicine Specialist
25 Years • MBBS, MD Internal Medicine - Osmania Medical College, Hyderabad
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
(400+ Patients)
Dr. Gunashree V L
General Physician/ Internal Medicine Specialist
3 Years • MBBS
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Consult a Top General Physician
Dr. Harshendra Jaiswal
General Physician/ Internal Medicine Specialist
12 Years • MBBS , MD (General medicine)
Kolkata
108 DHANA DHANVANTARI Clinic, Kolkata
(25+ Patients)
Dr. Swagata Sircar
General Physician/ Internal Medicine Specialist
8 Years • MBBS, MD General Medicine
Kolkata
HealthYou Speciality Clinic & Diagnostics., Kolkata
Dr Bhargav Vuppumalla
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD GENERAL MEDICINE
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Dhanraj K
General Physician/ Internal Medicine Specialist
25 Years • MBBS, MD Internal Medicine - Osmania Medical College, Hyderabad
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
(400+ Patients)
Dr. Gunashree V L
General Physician/ Internal Medicine Specialist
3 Years • MBBS
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
More articles from General Medical Consultation
Frequently Asked Questions
1) How many wet diapers should my newborn have by day 5?
Aim for at least 6 wet diapers and 3–4 yellow, seedy stools daily by day 5; fewer wets can signal low intake—call your pediatrician. Related term: how many wet diapers day 3 newborn.
2) Is it normal for my newborn to lose weight in the first week?
Yes—up to 7–10% loss can be normal, usually regained by 10–14 days. If your baby hasn’t regained birth weight by two weeks, ask for a feeding assessment. Related term: newborn weight loss first week normal.
3) When should I worry about newborn jaundice?
Mild yellowing peaking days 3–5 is common; call if yellowing deepens/spreads, your baby is too sleepy to feed, or there are fewer wets/stools. Related term: newborn jaundice when to worry.
4) How can I reduce SIDS risk in the first month?
Back to sleep, firm flat mattress, no soft bedding, room-sharing (no bed-sharing), smoke-free environment, and consider a pacifier once breastfeeding is established. Related term: safe sleep guidelines newborn first 4 weeks.
5) Does my breastfed baby need vitamin D?
Yes—AAP recommends 400 IU daily for exclusively or mostly breastfed infants starting in the first days. Ask your clinician for dosing guidance. Related term: breastfeeding tips 0–4 weeks.