Newborn and Infant Care

When should the first checkup be?

The first checkup is recommended within the first 3–5 days after leaving the hospital. At this visit, the level of jaundice, whether weight loss is within the expected range, how breastfeeding is going and a general examination are assessed. In healthy babies born at term (after 37 weeks), losing some of the birth weight in the first days is normal; the baby is expected to return to birth weight within about 10–14 days.

Newborn jaundice

Jaundice (yellowing of the skin) appears in most newborns and usually goes away on its own. Still, its level and timing need to be assessed; follow-up matters because if the yellow pigment in the blood (bilirubin) rises very high, it can, though rarely, harm the brain.

Trying to clear jaundice by "putting the baby in the sun" is not recommended; it does not work and it puts the baby at risk of sunburn and losing body heat.

Safe sleep

The American Academy of Pediatrics recommends the following to protect against sudden infant death syndrome (SIDS):

• Put the baby to sleep on their back for every sleep
• Use a firm, flat mattress; no pillows, blankets, toys or bumper pads in the bed
• For the first 6 months, the baby should sleep in the same room but in their own bed
• There should be no cigarette smoke around the baby
• Avoid overdressing the baby and overheating the room

Feeding and supplements

Breast milk only is recommended for the first 6 months. Under the Turkish Ministry of Health programme, all babies, whether breastfed or not, receive 400 IU of vitamin D a day from birth until age 1 and iron supplements from 4 months. For breastfeeding problems, you can see the breastfeeding support page.

Gas, fussiness and crying

In healthy babies, crying peaks in the first 6–8 weeks and usually eases by 3–4 months. Excessive crying, called "colic", is a phase that settles on its own once an underlying illness has been ruled out. The two most important things in this phase are confirming that feeding and weight gain are on track and supporting the family. Routinely changing formula, switching to lactose-free formula or trying drops and syrups is not needed for most babies, and an assessment is recommended first.

Umbilical cord care

The umbilical cord stump is kept clean and dry; it usually falls off on its own within 1–2 weeks. Putting powder, oil or herbal mixtures on it is not recommended. If there is redness, swelling, foul-smelling discharge around the belly button or fever, it should be assessed promptly.

Signs that need urgent assessment

• A fever of 38 °C or higher in a baby younger than 3 months — at this age, fever always needs urgent assessment
• Refusing to feed, cannot be woken, extreme drowsiness or weakness
• Fast or labored breathing, skin pulling in between the ribs, turning blue
• Forceful (projectile) and repeated vomiting, bilious (green) vomiting
• Clearly fewer wet diapers, dry mouth, crying without tears
• Having a seizure (fit)