Newborn Baby Guide: The First 4 Weeks, Feeding, Sleep & NHS Checks

What to expect in the newborn period

A newborn may feed around the clock, sleep without a day-night pattern, startle often, and settle most easily in contact. Cold hands and feet can be common, but persistent changes in the lips, tongue, breathing, alertness, or overall colour should not be dismissed as “just newborn behaviour”.

Babies born before 37 completed weeks need an individual discharge and follow-up plan. Their feeding stamina, temperature control, weight checks, and later development are considered in the context of prematurity and, where appropriate, corrected age.

The UK newborn timeline: NIPE, hearing and heel-prick screening

The newborn and infant physical examination (NIPE) is offered within 72 hours of birth and checks the eyes, heart, hips and, in boys, testes. Hearing screening is usually offered before discharge or in the first weeks. The newborn blood spot—or heel-prick test—is normally offered on day 5. In England it screens for nine rare conditions; arrangements and any additions can differ across the four nations.

A midwife usually remains involved after discharge and weighs the baby and reviews feeding, jaundice and recovery. The exact number and timing of visits depend on need and local service, with care handed to the health visitor around day 10–14. A screening recall is not a diagnosis; it means another sample or further tests are needed.

Feeding and nappies in the first weeks

Breastfed newborns often feed at least 8–12 times in 24 hours, including clustered periods. Offer feeds at rooting, hands-to-mouth movements, and other early cues rather than waiting for crying. If you use formula, prepare it exactly as directed and agree amounts with your midwife, health visitor, or GP around your baby’s weight and health.

By day 5, at least six wet nappies in 24 hours is a useful NHS sign that feeding is progressing, alongside swallowing, alertness and weight. In the first 48 hours, two or three wet nappies may be normal. Contact your midwife, GP or NHS 111 the same day for painful latch, no clear swallowing, a baby too sleepy to feed, repeated vomiting, or a sharp fall from their established nappy pattern.

Weight and jaundice: trends matter

Some weight loss after birth is expected. NICE recommends a clinical and feeding assessment when loss exceeds 10% of birth weight; the number is a trigger to look more closely, not a diagnosis by itself. Most babies return towards birth weight within the first two to three weeks. If yours has not regained it by three weeks, the feeding and growth picture should be reviewed.

Jaundice in the first 24 hours needs urgent assessment. Seek prompt help if yellowing intensifies, your baby is hard to wake or feeds poorly, urine is dark, stools are pale or chalky, or nappies become much drier. Putting a baby in sunlight is not a safe replacement for bilirubin testing or phototherapy.

Newborn sleep: fragmented, personal, and worth tracking

Sleep is scattered through day and night in the first weeks, and there is no official minute-perfect wake-window timetable for a 0–27-day-old baby. Personal records are still powerful: they reveal how feeds and sleep connect, which stretch is beginning to lengthen, and how your baby’s own awake periods change. Nerumi builds those observations into increasingly useful personal sleep estimates as the history grows.

For every sleep, place your baby on their back in a clear cot or Moses basket with a firm, flat mattress. Keep pillows, duvets, pods, nests, bumpers, toys, and loose bedding out. The safest place for the first six months is in the same room as you in a separate sleep space. Never sleep with a baby on a sofa or armchair.

Cord care, vitamins and birth vaccinations

Keep the cord stump clean and dry, fold the nappy below it, and avoid powders or home remedies. Contact your midwife, GP or NHS 111 the same day if redness spreads onto the skin, there is pus or a bad smell, bleeding will not stop, or your baby is unwell. It does not need to fall off on a particular day.

Vitamin K is offered after birth. Vitamin D advice depends on feeding and the Healthy Start guidance; follow the dose given by your midwife or health visitor. There is no universal routine birth vaccination for every UK baby. Hepatitis B and BCG are offered promptly to babies with defined risks, so the actual maternity plan and Red Book matter more than a generic online list.

When to seek urgent help

Call 999 for severe breathing difficulty, blue or grey lips or skin, a seizure, or a baby who will not wake. Seek urgent medical help for a temperature of 38°C or above, an unusually low temperature, grunting or chest recession, inability to feed, green vomit, repeated projectile vomiting, jaundice in the first 24 hours, rapidly worsening jaundice, pale stools, or a marked fall in wet nappies.

Contact your midwife, NHS 111, GP, or maternity unit the same day if the cord redness is spreading, feeding is painful or ineffective, or your baby looks distinctly different from normal. Your sense that something is wrong is a valid reason to call.

Vaccinations

United Kingdom

This schedule is for reference. Which vaccine your child needs and when is your doctor's call.

Schedule: UK Health Security Agency · GB-UKHSA-2026-01 · reviewed 2026-08-09