The Ultimate Guide to Your Newborn's First 28 Days of Care
Discover everything you need to know about your newborn’s first 28 days of care, from feeding and sleep patterns to health monitoring and self-care tips for parents.
Written by Dr. Md Yusuf Shareef
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 16th Sep, 2025
Introduction
Welcome to the incredible, whirlwind journey of parenthood! The first 28 days with your newborn—often called the "fourth trimester"—are a period of immense joy, adjustment, and learning. This comprehensive guide is designed to walk you through every step of your newborn's care in these initial days, providing evidence-based advice and practical tips to build your confidence. We'll cover everything from those first crucial feeds and sleepy cuddles to deciphering cries and monitoring health. Whether you're a first-time parent or need a refresher, consider this your trusted handbook for navigating the beautiful chaos of the first month, ensuring you provide the best possible care for your new baby while also taking care of yourself.
Preparing for Your Newborn's Arrival
Setting up your home before your baby arrives can significantly reduce stress during those first hectic days. Focus on creating a safe, functional space rather than a perfectly decorated nursery.
The Essential Nursery Checklist
The core of your nursery needs just a few key items: a firm, flat cot or Moses basket that meets current safety standards, a changing station with storage, a comfortable chair for feeding, and soft lighting. Avoid bulky blankets, pillows, and stuffed animals in the sleep space. A white noise machine can be a helpful tool for soothing your new baby and masking household sounds.
Stocking Up on Nappy and Feeding Supplies
You'll be amazed at how many nappies a newborn goes through! Plan for 8-12 per day. Stock up on newborn and size 1 nappies, sensitive wipes, a nappy cream with zinc oxide, and a dedicated nappy bin. For feeding, whether you plan on breastfeeding or formula feeding, have the basics ready: nursing pillows, bottles, a pump, and formula samples (just in case). Having these supplies on hand will make your first week at home much smoother.
The First Week: Survival and Bonding
The first week is about survival mode. Prioritise skin-to-skin contact, feeding on demand, and resting whenever you can. Let the laundry and dishes wait.
Navigating the First 24 Hours at Home
This time is all about settling in. Expect your baby to sleep a lot, but also to wake frequently to feed. Their stomach is tiny—about the size of a cherry—so they need small, frequent meals. Focus on cuddles and bonding. Don't worry about a schedule; follow your baby's lead for newborn sleep patterns and hunger cues.
Mastering Nappy Changes and Umbilical Cord Care
You'll become a nappy-changing pro in no time. Always have a clean nappy ready underneath before you remove the dirty one. For girls, wipe front to back. For boys, point the penis downward to prevent leaks. Keep the umbilical cord stump clean and dry. Fold the nappy down below the stump to let air reach it and avoid submerging it in water during sponge baths. It will typically dry up and fall off on its own within 1-3 weeks.
Establishing Feeding: Breastfeeding and Formula Basics
Feeding a newborn is their primary job. Whether breastfeeding or formula feeding, look for early hunger cues like lip-smacking, rooting, and sucking on hands. Crying is a late sign. Breastfed babies may feed 8-12 times in 24 hours. Formula-fed babies may eat every 3-4 hours. Ensure a proper latch if breastfeeding, and always hold a bottle-fed baby to prevent ear infections. Track wet and dirty nappies to ensure they're getting enough milk.
Consult a Paediatrician for Personalised Advice
Understanding Newborn Sleep Patterns
Newborns sleep a lot—up to 16-17 hours a day—but in short, 2-4 hour stretches around the clock because of their small stomachs.
How Much Sleep is Normal?
There's a wide range of normal, but most newborns sleep in cycles of eat, sleep, nappy change, repeat. They haven't yet developed a circadian rhythm, so they don't distinguish between day and night. By the end of the first month, you might start to see slightly longer stretches at night.
Safe Sleep Practices to Reduce SIDS Risk
This is non-negotiable. The American Academy of Pediatrics recommends the ABCs of safe sleep: Alone, on their Back, in a bare Cot. This means no co-sleeping in an adult bed, no soft bedding, no pillows, and always placing them on their back to sleep. These practices drastically reduce the risk of Sudden Infant Death Syndrome (SIDS).
The Art of Swaddling
Swaddling can be a magical soothing technique, mimicking the snugness of the womb and preventing the startle reflex from waking your baby. Use a thin, breathable muslin blanket or a swaddle sack. Ensure it's snug around the arms but loose around the hips to allow for healthy hip development. Always stop swaddling once your baby shows signs of rolling over.
Weeks 2-4: Growth, Development, and Establishing a Routine
As you move into the second week and beyond, you'll start to recognise patterns and feel more confident in your role.
Tracking Wet and Dirty Nappies for Health
This is the best indicator that your baby is well-fed. By day 5, expect 6-8 wet nappies and 3-5 yellowish, seedy bowel movements (for breastfed babies; formula-fed babies may have fewer) every 24 hours. If you notice a significant decrease in output, it could signal a problem, and you should consult your paediatrician.
Bathing Your Newborn: A Step-by-Step Guide
Until the umbilical cord falls off, stick to sponge baths. After that, 2-3 tub baths per week are sufficient to keep them clean without drying out their skin. Gather all supplies (tub, warm water, mild soap, soft towel, clean nappy, clothes) beforehand. Never leave your baby unattended. Support their head and neck at all times, and use one hand to pour water to keep them warm.
Tummy Time and Early Developmental Cues
Start tummy time from the first week! Place your awake and supervised baby on their stomach for 3-5 minutes, 2-3 times a day. This builds crucial neck, shoulder, and core strength. You can do it on your chest initially. Watch for early milestones: turning their head towards sounds, focusing on your face, and making jerky, arm and leg movements.
Decoding Newborn Behaviour and Cues
Your baby communicates through sounds and movements. Learning their language is key to responsive care.
Hunger Cues vs. Sleepy Cues
Early hunger cues include stirring, rooting, and hand-to-mouth movements. Mid-stage cues are squirming and increased physical movement. Crying is a late cue. Sleepy cues are often mistaken for fussiness: yawning, staring into space, jerky movements, and rubbing eyes. Responding to early cues makes soothing much easier.
Soothing a Fussy Baby: The 5 S's and Beyond
Dr Harvey Karp's "5 S's" for soothing a crying baby are legendary for a reason: Swaddling, Side/Stomach position (while holding, not for sleep), Shushing (white noise), Swinging (gentle motion), and Sucking (dummy or breast). Try these in combination. Sometimes, a change of scenery, a walk outside, or a warm bath can also do the trick.
Health Monitoring and When to Seek Help
It's normal to worry, but knowing what's typical and what's a red flag is empowering.
Normal Newborn Conditions (Jaundice, Baby Acne)
Many newborns develop mild jaundice (yellowing of the skin) due to their liver's immaturity. It often resolves with frequent feeding. Baby acne and milia (tiny white bumps) are also common due to maternal hormones and will clear on their own. Always point out any concerns to your paediatrician at your well-baby visits.
Red Flags: Fever, Lethargy, and Breathing Difficulties
A fever (100.4°F / 38°C or higher) in a baby under 3 months is a medical emergency. Other major red flags include extreme lethargy (difficulty waking for feeds), dehydration (fewer than 6 wet nappies, sunken soft spot), and breathing problems (grunting, flaring nostrils, retractions where the skin pulls in around the ribs). If you observe any of these symptoms, consult a doctor online with Apollo24|7 for immediate guidance or seek emergency care.
Caring for Yourself: The Parent's Role
You cannot pour from an empty cup. Your well-being is directly tied to your ability to care for your baby.
The Fourth Trimester and Postnatal Recovery
Your body needs time to heal. You are experiencing massive hormonal shifts, sleep deprivation, and physical recovery. This "fourth trimester" is real. Accept all help offered with meals, chores, and errands. Your only jobs are to feed yourself, feed the baby, and rest.
Asking for Help and Managing Expectations
Be kind to yourself. You are learning, and it's okay to not have all the answers. Postnatal mood disorders like baby blues and postnatal depression are common. If you feel overwhelming sadness, anxiety, or anger that persists beyond two weeks, talk to your partner, doctor, or a mental health professional. Apollo24|7 offers convenient online consultations with therapists and counsellors who can provide support during this transition.
Conclusion
The first 28 days of your new baby's life are a profound and transformative time. While it may feel overwhelming, remember that you are your baby's perfect parent. This guide provides a foundation, but your intuition and love are the most important tools you have. Embrace the snuggles, take millions of photos, and don't strive for perfection. Focus on responding to your baby's needs, prioritising safe sleep and feeding practices, and, most importantly, taking care of yourself. This fourth trimester is a short season that passes in a blur, so be present, ask for help when you need it, and trust that you are doing an amazing job. If any health concerns arise for you or your baby at any point, remember that professional support is readily available.
Consult a Paediatrician for Personalised Advice
Consult a Paediatrician for Personalised Advice
Dr. Rohit Vohra
Paediatric Pulmonologist
10 Years • MBBS, MD PEDIATRICS, FELLOWSHIP IN PEDIATRIC INTENSIVE CARE,FELLOWSHIP IN PULMONOLOGY
Delhi
Apollo Hospitals Indraprastha, Delhi
(75+ Patients)
Dr. Prashanth S Urs
Paediatrician
25 Years • MBBS, DCH, DNB (Paediatrics), Fellowship in Advanced Neonatology (Australia)
Bengaluru
Meera Childrens Clinic, Bengaluru
Dr.aswad Khan
neonatologist
5 Years • MBBS,DNB(paediatrics),FIAP (Neonatology),PGPN (Boston)
Hyderabad
Apollo Sugar Clinic alkapuri colony, Hyderabad
Dr Varakishan Kuramana
Paediatrician
8 Years • MBBS MD Pediatrics Fellowship in Neonatology
Visakhapatnam
Apollo Hospital, Healthcity, Visakhapatnam, Visakhapatnam
Dr Akkammal Sathyabama
neonatologist
9 Years • MBBS,MD,F(NNF)
Madurai
Apollo Women & Child care Hospital, Madurai, Madurai
Consult a Paediatrician for Personalised Advice
Dr. Rohit Vohra
Paediatric Pulmonologist
10 Years • MBBS, MD PEDIATRICS, FELLOWSHIP IN PEDIATRIC INTENSIVE CARE,FELLOWSHIP IN PULMONOLOGY
Delhi
Apollo Hospitals Indraprastha, Delhi
(75+ Patients)
Dr. Prashanth S Urs
Paediatrician
25 Years • MBBS, DCH, DNB (Paediatrics), Fellowship in Advanced Neonatology (Australia)
Bengaluru
Meera Childrens Clinic, Bengaluru
Dr.aswad Khan
neonatologist
5 Years • MBBS,DNB(paediatrics),FIAP (Neonatology),PGPN (Boston)
Hyderabad
Apollo Sugar Clinic alkapuri colony, Hyderabad
Dr Varakishan Kuramana
Paediatrician
8 Years • MBBS MD Pediatrics Fellowship in Neonatology
Visakhapatnam
Apollo Hospital, Healthcity, Visakhapatnam, Visakhapatnam
Dr Akkammal Sathyabama
neonatologist
9 Years • MBBS,MD,F(NNF)
Madurai
Apollo Women & Child care Hospital, Madurai, Madurai
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Frequently Asked Questions
1. How often should I bathe my newborn in the first month?
Until the umbilical cord stump falls off and heals, give sponge baths 2-3 times a week. After that, tub baths 2-3 times a week are sufficient. Over-bathing can dry out their sensitive skin.
2. Is it normal for my newborn to lose weight initially?
Yes. It is normal for breastfed babies to lose up to 7-10% of their birth weight in the first few days. They should regain their birth weight by around two weeks of age. Your paediatrician will monitor this closely.
3. What is cluster feeding and is it normal?
Cluster feeding is when a baby feeds very frequently—sometimes every hour—over a short period, often in the evening. It is completely normal, common in breastfed babies, and helps increase your milk supply while satisfying a growth spurt.
4. How can I tell if my baby is too cold or too hot?
Feel the back of their neck or their chest, not their hands or feet (which are often cooler). They should feel warm and dry, not sweaty or cold. Dress them in one more layer than you are comfortably wearing.
5. When should we have our first paediatrician visit?
Most paediatricians want to see a new baby within 2-5 days after hospital discharge, then again at 2 weeks and 1 month for well-baby check-ups to monitor weight gain and development.