Congratulations on your new baby!

Bringing a newborn home can be exciting—and intimidating. Babies don't arrive with instruction manuals, and suddenly parents find themselves wondering things they never imagined they would need to know.

How often should my baby eat? Is that poop normal? How tight should the diaper be? Why does my newborn sneeze so much? Do I need diaper cream every time? How many layers should my baby wear? Can my baby sleep with a blanket?

Consider this your newborn starting guide.

And remember: There are no silly questions when it comes to your baby.

FEEDING YOUR NEWBORN

Newborn stomachs are small, so babies need to eat frequently.

Rather than focusing only on the clock, parents should also learn their baby's hunger and fullness cues.

Early hunger cues can include:

• Bringing hands toward the mouth
• Turning the head and searching for the breast or bottle (“rooting”)
• Opening and closing the mouth
• Lip smacking
• Becoming increasingly alert or active

Crying is often a late hunger cue.

Breastfeeding

During the first weeks, breastfed newborns commonly nurse approximately 8–12 times during a 24-hour period, and some babies may want to feed as often as every 1–3 hours.

Cluster feeding—wanting several feedings close together—can also occur.

Rather than judging milk intake only by the amount of time spent nursing, parents and pediatric clinicians monitor feeding effectiveness, swallowing, weight, and wet and dirty diapers.

Breastfeeding can take practice for both parent and baby. Painful feeding, difficulty latching, concerns about milk supply, poor weight gain, or a baby who consistently struggles to stay awake for feeds deserve additional evaluation.

CDC — How Much and How Often to Breastfeed

Formula Feeding

Formula feeding is another way to safely provide the nutrition a growing infant needs.

During the first days of life, many formula-fed newborns take approximately 1–2 ounces every 2–3 hours, although babies vary.

Follow your baby's hunger and fullness cues and your pediatric clinician's recommendations.

Never force a baby to finish a bottle simply because formula remains.

Preparing Formula Safely

Always:

• Wash your hands before preparing bottles.
• Use clean feeding equipment.
• Follow the formula manufacturer's preparation instructions exactly.
• Measure water and formula exactly as directed.
• Never dilute formula to make it last longer.
• Never add extra formula powder to make a bottle “more filling.”
• Never microwave a bottle. Microwaves can create dangerously hot areas even when the bottle feels comfortable from the outside.

CDC — Infant Formula Preparation and Storage

How Do I Know My Baby Is Getting Enough?

Your baby's pediatric clinician will monitor weight and growth.

Wet diapers are another useful indicator. During the first several days, urine output gradually increases. By approximately day 5, many adequately hydrated newborns have around six or more wet diapers per day.

Call your pediatric office if your baby is feeding poorly, consistently refuses feeds, has fewer wet diapers than expected, is unusually difficult to wake for feeding, or you are concerned about hydration.

DIAPER 101

You will change a lot of diapers—so learning a few tricks early helps.

Choosing the Right Size

Diaper sizes are generally based on weight ranges, but fit matters too.

Signs that a diaper may be becoming too small include:

• Frequent leaks or blowouts
• Deep red marks around the waist or thighs
• Difficulty fastening the tabs comfortably
• The diaper sitting unusually low
• Baby's weight exceeding the manufacturer's recommended range

A properly fitting diaper should be snug without digging into your baby's skin.

The Little Diaper Trick

After fastening the diaper, gently run your finger around each leg opening and make sure the ruffled elastic edges are pulled outward rather than tucked inside.

Those little ruffles help the diaper form its intended seal around the legs and can help reduce leaks.

Preventing Diaper Rash

Newborn skin is delicate. Urine, stool, moisture, friction, and prolonged contact with a wet or dirty diaper can irritate the skin.

Helpful habits include:

• Change wet and soiled diapers frequently.
• Gently clean the area.
• Allow the skin to dry when possible.
• Avoid aggressive rubbing.
• Consider a fragrance-free barrier ointment.

Barrier preparations containing petrolatum or zinc oxide can help protect irritated skin from moisture and friction.

Aquaphor and similar petrolatum-based products are examples of commonly used barriers, but parents do not necessarily need to apply a thick layer at every single diaper change if the baby's skin is healthy. Follow your pediatric clinician's recommendations.

Call the office for a severe rash, open sores, blisters, spreading redness, fever, or a rash that is not improving with routine care.

UMBILICAL CORD CARE

That little stump can look intimidating, but most umbilical cords need very little intervention.

Keep the stump clean and dry and allow it to fall off naturally.

Do not pull it off—even when it looks like it is hanging by a thread.

Fold the top of the diaper down when necessary so it doesn't continually rub against or cover the stump.

A small amount of blood around the time the cord separates can occur.

Contact your pediatric clinician if you notice:

• Spreading redness around the belly button
• Swelling
• Foul odor
• Pus or concerning drainage
• Persistent or significant bleeding
• Fever
• Baby appearing ill

AAP HealthyChildren — Umbilical Cord Care

CIRCUMCISION CARE

If your baby was circumcised, follow the specific instructions provided by the hospital and your baby's healthcare professional because aftercare can differ depending on the technique used.

For some circumcisions, petroleum jelly may be recommended to prevent the healing area from sticking to the diaper.

Some redness and a yellowish healing film can be part of normal healing and should not automatically be mistaken for infection.

Contact your pediatric clinician for significant bleeding, increasing redness or swelling, concerning drainage, fever, difficulty urinating, or other concerns.

BATHING YOUR NEWBORN

Newborns do not need a full bath every day.

A few baths per week are generally enough while keeping the face, neck folds, hands, and diaper area clean as needed.

Until the umbilical cord has fallen off and the area has healed, sponge bathing is commonly recommended.

When bathing:

• Gather everything before you begin.
• Check water temperature carefully.
• Support baby's head and neck.
• Keep one hand on the baby.
• Never leave a baby unattended in or near water—not even for a few seconds.

NEWBORN SKIN

Newborn skin can do some surprisingly strange-looking things.

Peeling, dryness, small bumps, and temporary newborn rashes can occur.

Avoid overloading newborn skin with fragranced products. Gentle, fragrance-free products are generally preferable.

If a rash is blistering, rapidly spreading, associated with fever, appears infected, or simply concerns you, contact your pediatric office.

HOW SHOULD I DRESS MY NEWBORN?

New parents understandably worry about babies becoming cold, but overheating is also a safety concern.

A useful general rule is to dress your baby in approximately one more layer than an adult would comfortably wear in the same environment.

A baby does not automatically need heavy layers, a hat, and socks simply because they are a newborn.

For sleep, avoid overheating and loose blankets.

If you're unsure, feel your baby's chest or back rather than relying solely on hands and feet, which may naturally feel cooler.

SAFE SLEEP — EVERY NAP, EVERY NIGHT

Safe sleep is one of the most important newborn safety practices.

The American Academy of Pediatrics recommends:

BACK: Place baby on their back for every sleep.

SURFACE: Use a firm, flat, noninclined sleep surface designed for infant sleep.

SPACE: Baby's sleep area should contain a fitted sheet and nothing else.

Keep out:

• Pillows
• Loose blankets
• Comforters
• Crib bumpers
• Stuffed animals
• Positioners
• Other soft objects

Room-sharing is recommended, but without bed-sharing. Keeping baby's bassinet or crib near the caregiver's bed allows the baby to remain close while maintaining a separate safe sleep surface.

Avoid overheating and smoke exposure.

These recommendations are supported by the AAP's evidence review addressing prevention of sleep-related infant deaths (Moon et al., 2022).

AAP Safe Sleep Resources

SWADDLING

Some newborns find swaddling soothing.

If you swaddle:

• Always place baby on their back.
• Make sure the swaddle cannot become loose bedding.
• Allow room for healthy hip movement.
• Avoid overheating.
• Stop swaddling as soon as baby shows signs of attempting to roll.

Weighted swaddles and weighted sleep products are not recommended.

TUMMY TIME

Babies should sleep on their backs—but when they're awake and supervised, tummy time helps develop the muscles used for head control and later movement.

Start with short, supervised sessions and gradually increase them as your baby tolerates more.

Tummy time is for awake babies only.

THE CAR SEAT

Your newborn should travel in an appropriately installed rear-facing car seat.

Some infant seats use a base, while other approved seats may allow installation without one. Always follow the instructions for your specific car seat and vehicle.

Important basics:

• Baby should remain rear-facing according to the seat manufacturer's height and weight limits.
• Harness straps should fit snugly.
• The harness chest clip should generally sit at armpit level.
• Avoid placing bulky coats or thick clothing underneath the harness.
• Never place aftermarket inserts, cushions, or accessories in the seat unless approved by the car-seat manufacturer.

A properly installed car seat is important enough that parents who are uncertain should seek hands-on assistance from a certified Child Passenger Safety Technician.

NHTSA — Find a Car Seat Inspection Station

WHAT SHOULD I PACK IN THE DIAPER BAG?

You don't need to pack your entire nursery every time you leave the house.

A practical starter bag might include:

• Several diapers
• Wipes
• Portable changing pad
• Diaper barrier cream/ointment
• Two changes of baby clothes
• Burp cloths
• Bib
• Feeding supplies appropriate for your baby
• Pacifier and a spare if used
• Lightweight extra clothing layer
• Wet/dry bag or plastic bag for dirty clothing
• Tissues
• Hand sanitizer for the caregiver
• Any medications or medical supplies specifically needed by your baby

Parent tip: Keep an emergency change of clothes and extra diapers in the car too. Blowouts have incredible timing.

WHY DOES MY NEWBORN KEEP SNEEZING?

Newborns sneeze—and they can sneeze a lot.

Sneezing can help clear tiny nasal passages and does not automatically mean your baby is sick.

Hiccups are also common.

Newborns can be noisy sleepers too: grunting, squeaking, stretching, brief movements, and making expressions while sleeping can surprise first-time parents.

However, persistent grunting with every breath, ribs pulling inward, nostrils flaring, blue/gray coloring, pauses in breathing, or obvious difficulty breathing are not simply normal newborn noises and require prompt medical attention.

CRYING & SOOTHING

Crying is communication.

Your baby may be hungry, tired, wet, overstimulated, uncomfortable, or simply want to be held.

Try:

• Feeding if hungry
• Checking the diaper
• Holding baby skin-to-skin when appropriate
• Gentle rocking
• Swaddling safely
• A pacifier if used
• Lowering lights and stimulation
• Quietly talking or singing

Sometimes babies cry even after every obvious need has been addressed.

If you become overwhelmed, place your baby on their back in a safe crib or bassinet and give yourself a few minutes to regroup.

Never shake a baby.

Ask someone you trust for help when you need a break.

PACIFIERS

Pacifiers can be helpful for soothing. Pacifier use during sleep is also associated with a reduced risk of SIDS.

If breastfeeding, discuss timing with your pediatric clinician or lactation professional if feeding is not yet well established.

Never attach a pacifier to the baby's neck or sleeping area with a cord, ribbon, or string.

VISITORS & GERMS

Everyone is excited to meet a new baby, but it is okay for parents to establish boundaries.

Ask visitors to:

• Wash their hands before holding baby.
• Avoid visiting when sick.
• Avoid kissing the baby's face and hands.
• Respect your family's feeding, sleeping, and visiting preferences.

Young infants are particularly vulnerable to certain infections, so protecting your baby's health is more important than worrying about disappointing visitors.

IS THIS NORMAL?

Many things that surprise first-time parents can be normal during the newborn period, including:

• Sneezing
• Hiccups
• Startle reflex
• Peeling skin
• Temporary newborn rashes
• Newborn acne
• Spitting up small amounts
• Noisy sleep
• Irregular sleep patterns
• Stool changing color and consistency during the first days
• Temporary breast swelling related to maternal hormones
• A small amount of vaginal discharge in newborn girls

If you're uncertain, however, call your pediatric office. Nobody expects a first-time parent to automatically know what's normal.

WHEN SHOULD I CALL THE PEDIATRICIAN?

Contact your pediatric clinician promptly if your newborn:

• Is feeding significantly less than usual
• Is unusually sleepy or difficult to wake
• Has substantially fewer wet diapers
• Has repeated or forceful vomiting
• Develops worsening jaundice
• Has redness, swelling, drainage, or another possible sign of infection around the umbilical cord
• Has concerning bleeding or problems following circumcision
• Develops a concerning or rapidly spreading rash
• Seems unusually irritable or inconsolable
• Is behaving significantly differently from usual
• Has any symptom that concerns you

Fever in a Young Infant

A rectal temperature of 100.4°F (38°C) or higher in a baby younger than 3 months requires prompt medical evaluation. Contact your pediatric clinician immediately for instructions.

Do not give fever medication to a newborn unless specifically instructed to do so by a healthcare professional.

CALL 911 FOR AN EMERGENCY

Seek emergency assistance for symptoms including:

• Significant difficulty breathing
• Blue, gray, or very pale coloring
• Baby becoming unresponsive
• A seizure
• Severe choking or inability to breathe
• Another immediately life-threatening condition

AND FINALLY: TRUST YOUR INSTINCTS

Nobody knows everything when they bring their first baby home.

You will learn your baby's different cries. You'll eventually pack a diaper bag without thinking. You'll discover exactly how many wipes a single diaper change can somehow require.

Until then, ask questions.

If something about your baby's feeding, breathing, behavior, temperature, skin, sleep, diapers, or overall appearance doesn't seem right, contact your pediatric healthcare team.

We would rather have you ask than sit at home worrying.

Helpful Parent Resources

American Academy of Pediatrics — HealthyChildren.org
Evidence-based pediatric information written for parents.
HealthyChildren.org

CDC Infant & Toddler Nutrition
Breastfeeding, formula feeding, vitamin D, and infant nutrition information.
CDC Infant & Toddler Nutrition

CDC Breastfeeding Support
CDC Breastfeeding Guidance

CDC Formula Preparation & Storage
CDC Formula Preparation Guidance

National Highway Traffic Safety Administration — Car Seats
Includes car-seat guidance and resources for finding installation assistance.
NHTSA Car Seat Resources

Massachusetts WIC
Nutrition, breastfeeding assistance, education, and other resources for eligible Massachusetts families.
Massachusetts WIC Program

Evidence & References

Moon, R. Y., Carlin, R. F., & Hand, I. (2022). Sleep-related infant deaths: Updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics, 150(1), e2022057990.
AAP Pediatrics — Safe Sleep Recommendations

Moon, R. Y., Carlin, R. F., & Hand, I. (2022). Evidence base for 2022 updated recommendations for a safe infant sleeping environment to reduce the risk of sleep-related infant deaths. Pediatrics, 150(1), e2022057991.
AAP Pediatrics — Safe Sleep Evidence Base

American Academy of Pediatrics. Umbilical cord care in newborns. HealthyChildren.org.
AAP — Umbilical Cord Care

Centers for Disease Control and Prevention. How much and how often to breastfeed.
CDC Breastfeeding Recommendations

Centers for Disease Control and Prevention. Infant formula preparation and storage.
CDC Formula Safety Recommendations

This guide provides general newborn education and does not replace individualized medical advice. Recommendations may differ for premature infants or babies with specific medical conditions. Follow the instructions provided by your baby's healthcare team.