PARENTS

Your Baby's First Month

02/07/2015 14:22 | Updated 02 July 2015
Newborn baby and motherGetty

Congratulations! After nine months of hope and anxiety, spiced up with a liberal dose of hormones, your baby has finally arrived. Taking your newborn home for the first time is daunting for all of us and the first weeks will be a mix of elation and exhaustion and becoming the expert on your baby as you learn to recognise and respond to your baby's needs.

YOUR NEWBORN BABY'S APPEARANCE

If you're used to seeing images of newborns in films and on TV dramas being handed to their mums all plump, peachy, clean and wrapped in a blanket, you might be in for a bit of a surprise when you first see your baby.

In reality, babies used on film are rarely truly 'newborn', and your baby may well look blotchy, wrinkly and covered in a creamy-coloured, waxy substance as well as your blood.

Skin

Some babies are born wrinkly - usually those born earlier than their due date. Others have blotchy skin or, in some cases, tiny white spots known as milk spots or 'milia' across their faces. You might see quite pronounced red marks, known as 'stork marks' in places, too.

Most of these minor skin blemishes resolve during the first few weeks or months after birth, and wrinkly babies fill out as you establish feeding and they gain weight.

You may see quite a lot of a creamy-coloured waxy substance called 'vernix' on your baby's skin: it's a water-resistance coating that's been protecting your baby's skin in the amniotic sac.

Again, the earlier your baby was born, the more of a coating they'll have: full-term babies may have only traces in their skin folds. In any case, it's best left on your baby's skin to be absorbed as a natural moisturiser.

Your baby may have a yellowish tinge to their skin and the whites of their eyes, which indicates a degree of jaundice. This is usually a minor condition that clears on its own within the first fortnight and your midwives will keep an eye on it.

Eyes

Most Caucasian babies are born with dark blue-grey eyes, whereas dark-skinned babies are usually born with dark brown eyes. The final colour of Caucasian babies' eyes can take up to a year to develop depending on how long the pigment continues to increase in the irises.

Don't be concerned if your baby appears to have a squint. As the eye muscles develop over the coming weeks this will probably correct itself. Some babies are born with sticky, crusty eyes, which usually respond to gentle bathing. In some cases, antibiotic drops might be prescribed.

Hair

Some newborns are born with a shock of hair, whilst others are almost bald. In either case, newborn hair doesn't always bear any relation to later hair colour: in some cases hair falls out after birth, and is replaced by a completely different colour. Babies born with a crop of dark hair might grow up to be true blondes or redheads.

Head

If you had an assisted delivery with forceps or ventouse, or if your baby had a traumatic or prolonged unassisted birth, you may notice they have a misshapen or pointy head. This is because the main bones in the skull are not fused at birth – a deliberate quirk of nature to allow for movement during the birth, enabling the head to fit through the birth canal more easily. Don't worry about any misshapenness: this will resolve in the early weeks and months after birth.

Genitals

Don't be surprised if your baby's genitals and nipples look overly large or swollen at birth. Both boys and girls are born with some of your hormones in their system, and things will normalise as those hormones leave their body. Baby girls sometimes bleed a little from the vagina, and this is also nothing to worry about at all at this stage.

CARING FOR YOUR NEWBORN BABY

Your baby's first month: newborn baby's hand and mother's handPA

If you gave birth in hospital, you'll hopefully have had a little guidance on how to look after your baby - or you may have gathered useful information at your antenatal classes.

Hospital stays are usually only a matter of a day or two unless you've had complications, and once you arrive home with your newborn you could be forgiven for wondering how on earth you're going to remember what to do when, and how to keep your baby safe and well cared for.

We've got a checklist to help you get into the swing of caring for your baby.

Topping and tailing

There's no need at all to start bathing your baby in the early days after birth if you don't feel confident. Start off by topping and tailing.

You'll need a small plastic bowl of lukewarm (not hot) water and some cotton wool balls, plus a clean towel.

Using a new piece of cotton wool after each wipe, gently cleanse and dry your baby in the following order:

  • Start with her eyes, wiping from the inner corner outwards.

  • Wipe her face and forehead.

  • Gently clean her ears and the folds under her chin.

  • Cleanse the skin folds of her neck.

  • Wipe the length of each arm.

  • Cleanse her armpits.

  • Clean her hands.

  • Gently clean around her cord stump without actually touching the stump itself.

  • Remove her nappy and wipe away any excess poo or wee with a baby wipe.

  • Go over the area thoroughly with dampened cotton wool, wiping front to back - and remembering to use a new piece of cotton wool after every wipe.

  • Cleanse the skin folds of her groin,thighs and legs.

  • Gently wipe her feet.

This is all that's required for the first few days or week or so, and you don't need to wash her hair (if she has any) at all. A wipe over with a damp flannel will keep her fresh for now.

First baths

When you do come to bath your baby for the first time, it may be more relaxing if you have a helper standing by just in case you find handling your baby as well as bathing her tricky. Gather all your equipment together.

You will need:

  • A clean, fresh towel laid over a baby changing mat.

  • A clean nappy.

  • A clean vest.

  • A fresh stretchsuit or other baby outfit.

You don't need any products in your baby's bath at all. First run a shallow, lukewarm bath.

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The temperature is very important, as your baby's skin is five times more sensitive than yours, so check it by dipping your elbow in first.

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Cradling your baby along your left arm (or right, if you're left-handed), and grasping her left thigh with your hand, while supporting her head with your right hand, gently lower her into the water. (She may or may not enjoy this, so be prepared for her to jump or cry at first.)

Sloosh water all over your baby's body using your right hand, not forgetting to gently wash her head, keeping the water out of her eyes. Keep moving your baby gently back and forth in the water (unless you're using a baby bath seat) so that she keeps warm.

As soon as you're happy your baby has had enough (and a few minutes will be more than enough or she'll start to chill), gently lift her out, keeping a firm grasp as her skin will be very slippery.

Lie your baby down on to the towel and wrap her quickly, including her head.

Dry her nappy area first, paying attention to the skin folds in her legs, then put on a fresh nappy.

Pat her gently dry all over, then dress her quickly. Done!

Caring for her cord stump

Your baby's umbilical cord stump is an odd-looking thing, and is best left alone to dry out, shrivel and drop off on its own. It's important to keep the area around the stump clean and dry, so follow the instructions for topping and tailing, trying not to disturb the stump itself.

Until it drops off - usually within the first fortnight - make sure to fold the front of your baby's nappy down to prevent wee or poo contaminating the stump, and never pull on it, even if it's hanging on by a thread.

If the skin around the stump starts to look red and angry, it's possible it's become infected, so ask your midwife, health visitor or GP for advice.

Once it's fallen off, it'll take about 10 days to heal. You may see a little spot of blood or two on your baby's clothes after the stump falls off - this is quite normal.

DEVELOPMENT: WHAT CAN YOUR NEWBORN SEE, HEAR & DO?

Sight

New parents are often entranced by their baby's beautiful eyes. A newborn's eyes are in fact nearly 70 per cent of their full adult size which is why they appear so big.

They may seem to focus from birth, or - more usually - they may seem to drift inwards and outwards sometimes without clear focus, crossing and uncrossing again. In fact, at birth your baby's eyesight is pretty limited and what he can see most clearly are objects that are about 20-25cm away.

It's either a happy coincidence or part of nature's grand plan that this happens to be the approximate distance between your two faces during a feed, so your baby will be mainly focusing on you during those early days.

Studies have proven that newborns prefer faces (even rough drawings of faces) to any other objects, so he'll be as content gazing at you as you will be at him.

Your baby won't be able to distinguish between colours until he's about three months old, and until this time he'll show a marked preference for strongly contrasting patterns, especially in black-and-white.

Research has shown that young babies prefer patterns with curvy lines rather than straight, too. He'll be three to five months old before he gets a good perspective of depth, which requires both eyes to be focusing strongly together.

If your baby's eyes remain crossed more than just briefly, if they seem cloudy, excessively teary or if they move in circles as he tries to focus, get him checked out by your health visitor or doctor. The sooner problems are detected, the quicker they can be rectified.

Hearing

Your baby's hearing is pretty good from birth and he'll probably recognise and be soothed by your voice, from life inside the womb.

His hearing will be almost fully developed by the end of his first month.

If you have any concerns about your baby's hearing talk to your health visitor or GP. You can also perform a simple test at home: try clapping suddenly behind your baby; he should jump a little and turn towards the sound.

Activity

At this stage, your newborn will be happy observing and interacting with you.

He may make little cooing noises when you hold 'conversations' with him: talk to him, then wait, watch and see if he makes some noises back.

Try pulling faces at him: even as a new baby he may react by copying you. At this stage it's a reflex rather than a real achievement, but soon he'll be able to do things deliberately.

Your baby will follow some objects with his eyes, especially those that are patterned in bold, contrasting colours, so do play with him often.

There's so much growth and development to look forward to in the coming months. Why not start recording your baby developmental milestones, then look back as the months pass to see just how far he's come.

Games to play with your newborn

There are responses your newborn can make and things you can do to hold her interest, even in the early weeks after birth. Finding time to play with your baby will help to build the bond between you as well as giving you a benchmark of how much she can do and how she's developing.

Your baby's fascinated most of all by faces, and she focuses best on objects between 20-25cms away, so use your own face to change expressions and to gaze at your beautiful newborn. She'll seem to study you in concentration, and will look away when she loses concentration or becomes bored.

Hold photos of different faces up for your baby to look at, and see if she seems to prefer some over others.

Hold a mirror up to your baby: she won't realise she's looking at her own reflection for a long time yet, but she might enjoy studying her face nonetheless.

Dangle objects in front of your baby and see if she follows their movement. You don't need to invest in special toys: try a bunch of keys, a playing card or anything you have that has a bright, contrasting pattern.

Let your baby grasp your fingers, then move her arms about for her, singing 'up, down, left, right' as you do so.

Sing the same songs to your baby until they become familiar. You may find these same songs soothe her later on when she's tired and struggling to sleep.

FEEDING YOUR NEWBORN BABY

Breastfeeding your babyGetty

Breastfeeding

Breastfeeding is widely recognised - even by formula manufacturers - as being the very best start you can give your baby, and with the right support most new mums can get a feeding routine established.

There are lots of benefits for you and your baby, including the following:

Breast milk boosts your baby's immune system.

It encourages a hormonal release that helps to relax and calm you.

Breast milk is easier for a baby to digest.

Breast milk is on tap 24 hours a day.

It's quicker to soothe a crying baby with a breastfeed than having to wait to prepare a bottle

Breastfeeding helps to establish a close bond between mum and baby.

Breast milk is free!

Breast feeding helps new mums to lose their baby weight more quickly.

Breastfed babies' poo is less smelly.

Studies show that breastfeeding decreases the risk of Sudden Infant Death Syndrome (SIDS).

Getting started

Massage your breasts a little to soften them. If they are very engorged, try to release a little milk by placing your thumb above your areola and your first two fingers underneath, then rolling thumb and fingers together, squeezing your breast tissue at the same time.

Repeat the motion and continue expressing until your breast softens a little.

  • Settle yourself comfortably with a pillow or breastfeeding cushion across your lap.
  • Support your back and shoulders with extra pillows or cushions.
  • Bring your baby towards you until their nose is level with your nipple.
  • Stroke your baby gently under the chin to encourage him to open his mouth.
  • Wait until your baby's mouth is very wide open, then drop your breast into it.
  • Make sure your baby gets a good mouthful of breast tissue, rather than clamping on to your nipple, which will only cause soreness. (It's the tissue surrounding your nipple that contains the milk, and your baby needs to work that tissue with his jaws: your nipple is just an outlet.)

A good sign that your baby is feeding efficiently is if you can see his jaws moving and his temples contracting rhythmically.

Finding breastfeeding support

If you are struggling with breastfeeding, see if you can get access to a breastfeeding counsellor through your local National Childbirth Trust (NCT).

National Breastfeeding Helpline: 0300 100 0212

Giving a bottle

Bottle feeding your babyPA

You may decide to bottle feed your baby or to combine breast and bottle feeding. However you choose to feed your baby, it's important to prepare a bottle exactly according to the formula manufacturer's instructions.

Prepare feeds as and when you need them rather than getting them ready in advance. You'll need to ensure that the bottles are completely sterile and that you add the correct proportion of milk powder to cool, boiled water. At first, your baby will probably not take full six-ounce feeds, and you might want to use smaller bottles so there's less space for air to collect. Otherwise, make up four-ounce feeds in full-size bottles.

Offer your baby the bottle only once you have tipped it up so that there is no space between teat and milk. This will help prevent wind by cutting down on the amount of air your baby can swallow.

Try to keep the teat full of milk during the feed, and wind your baby regularly by sitting him on your lap, facing away from you, supporting his chin with one hand whilst firmly massaging and patting him between the shoulder blades. You'll know you've succeeded when he rewards you with a burp or two: then you can resume the feed.

Always throw away any undrunk milk. Don't be tempted to put it back in the fridge or reheat it again later. It should be discarded an hour after it was made up or bacteria could grow which

could upset your baby's stomach.

YOUR BABY'S CRYING

Newborn baby cryingRex Features

Responding on demand

You may find yourself weighing up conflicting advice on how to respond to your baby from birth: some people might tell you to pacify your baby as soon as you hear a whimper; others will tell you that you'd be making a rod for your own back, and that you'd risk 'spoiling' your newborn.

Read our advice to help you comfort your newborn - but don't forget that crying is your baby's only method of communicating with you, and it doesn't necessarily mean he's very unhappy.

Follow your instincts

Probably the best advice is to follow your own instincts and respond to your baby 'on demand': this doesn't mean every time he stirs, sighs or gurgles, but it does mean each time you feel that he seems in need of comfort, whether through a feed, nappy change or cuddle.

Newborn babies can't be 'spoilt' as they don't have the sophistication to be able to demand attention for the sake of it. Crying is his only way of communicating with you, and at this stage he needs the feeling of reassurance that you'll come and attend to him when he needs you.

Basic checks

In the early days you may not recognise your baby's individual cries for what they're telling you, but over time you'll realise by the tone and pitch whether your baby is hungry, tired, over-stimulated or wanting some reassurance.

Recognising your baby's cries

There are a number of reasons why your baby may be crying, and it won't be too long before you can take an educated guess at which problem each type of cry represents.

In general, whingey, sobbing crying usually happens when your baby is tired, bored or wanting a cuddle, so first of all see if he'll engage in a bit of baby play with you.

If the crying escalates, he's probably ready for a sleep, so put him down in a daylit room (to help him discern between day- and night-time sleep) and leave him to settle himself if he can.

Otherwise, talk to him gently, pat him a little, then gradually retreat from the room. If your baby doesn't drop of within five minutes or so, he may just be in need of a bit of comfort, so gather him up and give him a lovely reassuring cuddle.

Persistent 'waa-waa' crying could mean one of several different things: your baby could need a nappy change; be too hot or cold; be hungry or thirsty or just over-stimulated.

Start by checking his nappy: this is the quickest thing to put right. If his nappy is clean or he's still crying after a change, check he's neither too hot nor chilly: the most reliable way is to place the flat of your hand on his upper chest, which should feel just warm, as your skin does when you're at a comfortable temperature. Don't rely on feeling his extremities, which are often cool to touch.

If he still doesn't calm down, offer him a little water if he's usually bottlefed, or your breast if you're feeding him yourself. If a bottlefed baby is still fractious, make him up a feed even if he's recently had one: you could always make a half-size amount or use a ready-mixed carton.

If nothing seems to pacify your baby, try letting him alone for a little while: put him down in his Moses basket or pram and let him have some down time. He might play with his own fingers and toes, gurgle and coo to himself or just enjoy a peaceful time looking around.

There's no need for him to be entertained and cuddled all day long: too much will make him as crabby as too little attention.

If your baby is screwing up his face, going bright red and really letting rip, he may be in pain.

A colicky baby will alternately draw his legs to his chest, then shoot them out rigid and may clench and unclench his fists, too.

Try lying him face down securely across your lap and patting or rubbing his back whilst swaying your knees rhythmically from side to side. Or try rhythmic rocking .Your baby may have knocked himself on something or be lying on something that's making him really uncomfortable. Check him over; give him a cuddle; let him have a soother if he uses them; try giving him a warm, relaxing bath (or having one together).

Here's a checklist of things to run through if you can't pacify your baby:

Is he in pain?

Are his cries more like screams? Is he going red in the face? Is he drawing his knees up to his chest or clenching his fists?

These signs may be easier to spot in an older baby, but you could phone your midwife or health visitor for advice if his cries seem desperate or seem to increase in intensity.

Check his temperature; note whether he's listless; has his skin colour changed?; does he resist you touching him anywhere?

If not and you think he might have wind, try winding him, rocking him rythmically in your arms or taking him out for a drive to soothe him.

Is he hungry?

Offer a feed, even if he's been fed fairly recently: this is important during the first few weeks at least, as your baby's gut is still maturing and he might not yet be in a rhythm of regular feeds.

With a bottlefed baby, try offering a little cooled, boiled water first, as formula-fed infants can sometimes get thirsty and it would be a waste to make up a feed before checking this first.

Is his nappy wet or soiled?

Some babies can tolerate a dirty nappy for a while before you notice it; others want changing straightaway.

In the interest of hygiene and your baby's skincare, you should change a wet or soiled nappy as soon as possible after your baby's had a poo or wee.

Does he want a cuddle?

It may be he's seeking the comfort, smell and warmth of your body, and a lovely close cuddle may be all that's needed to settle your baby.

Is he over-stimulated or tired?

Sometimes your baby will just have had enough of being played with, cooed over and handed around.

Even if he doesn't seem to need to sleep, he might just need a little 'down time' to chill out, look around him and relax. Put him down in his Moses basket or cot, switch on the baby monitor and leave him to it.

Is he bored?

If he's had a prolonged sleep or period of time resting, try playing gently with your baby or singing, talking or catching his eye with patterned objects.

Responding to your baby on demand during your early weeks together will build a bond of trust that will help him to settle and feel secure. This will help build a strong foundation for getting into a routine from about six weeks onwards.

Warning signs

If your baby's crying seems to increase in pitch and intensity, or if his cry is shrill and unlike any you've heard before, contact your health visitor, GP or NHS Direct for advice.

It could be that he has an underlying problem that needs urgent medical attention, so don't delay. And don't feel silly for raising the alarm - just follow your instinct. Good healthcare professionals would always rather answer a false alarm than miss something potentially serious.

Baby cryingRex Features

Sometimes it seems that young babies do little but feed and cry - and a baby who cries excessively and is seemingly unable to be pacified is a trial to any new mum.

There are things you can try, though, that might soothe your baby - and, if nothing else, they'll pass the time while you try them! If all else fails, we have tips on getting a much-needed break from the crying too.

Skin-to-skin cuddling

Cuddling your baby skin-to-skin, also known as 'kangaroo cuddling' has been proven to reduce baby stress levels. It's thought the skin contact and rhythm of your heartbeat can have a calming effect.

Rhythmic rocking

Some babies find it soothing to be rocked fairly robustly (but not in a 'shaking' sense!) to a repetitive rhythm, so try shifting your weight from one foot to the other and rocking your baby at the same time.

Or you could try dancing gently while you rock her, so that you know you're in a rhythm. If your baby seems to be colicky, try rocking her whilst holding her face-down along a supporting arm and gently patting her back with your free hand.

Swaddling

Try wrapping your baby firmly in a blanket with her arms and legs tucked in. It's known as swaddling, and the sense of being restricted can make some babies feel secure enough to stop them crying, particularly if they've previously been flailing around.

Vacuuming

The sound of a vacuum cleaner has been likened to the kind of 'white noise' that babies hear in the womb, and some are soothed by the constant drone of a vac. Either strap your baby to you in a sling while you vacuum (you could try doing this rhythmically and kill two birds with one stone!). Otherwise, switch the vacuum cleaner on and leave it in the same room as your baby. A hairdryer can have a similar effect, so if your baby seems inconsolable, you could do worse that using the time to wash and dry your hair!

Driving

The continuous motion of a car being driven, coupled with the constant background noise of the engine, is enough to stop some babies crying - but it only really works if you have a good clear run, and not if you get stuck just outside the Heathrow junction on the M25!

Try to work out a route in your head that takes you a bit out of the main town (first making sure your phone battery is fully charged and you have sufficient petrol in your tank!)

GETTING A BREAK FROM A CRYING BABY

Crying baby comforted by motherRex Features

Continuous crying can break a new mum, and you need to look after yourself as well as your baby, so do try to get some respite from it if you can.

Hand your baby to a neighbour, friend, partner or other visitor you trust with her - or put her down safely in her cot by herself - then take a few minutes to yourself, preferably away from the noise of her crying.

It's OK to shut the door on her or go down the garden for a breather as long as you're sure she's safe from harm.

Your sanity is crucial in caring for your baby, and there can come times when you get so tense or wound up you fear you might harm her.

If a short cooling-off period doesn't work for you, ask your health visitor or GP for help. You can also find a listening ear at the Cry-Sis Helpline on 08451 228 669 (7 days a week, 9am - 10pm)

Building a support network

One of the commonest feelings experienced by new mums is loneliness, especially if they've had a partner at home for the first week or so after the birth then find themselves left to cope without support.

Yes, you'll have your health visitor popping in from time to time and you can take your baby to your GP's baby clinic if there is one, but you really need to get a proper support network around you and there are several ways you can go about it.

Join or form a postnatal group

If your antenatal class feeds on to a postnatal group, so much the better. If not, ask at your GP practice whether there's a group of new mums that meets regularly.

If you can't find a group, why not start one up yourself? You could get chatting at the baby clinic if you attend one; join an online parenting network with chat boards and post a notice to local mums; ask if you can display a notice on the noticeboard of your local library or noticeboard.

Don't give details of your name, home number and address - just give an email address and/or mobile number, or set up a social networking group and post the details of that.

Seek out other new mums

If it's proving hard to get a group together, think about the sorts of places new mums might go, and go and find them! Is there a mum-and-baby group that meets locally at a leisure centre, for instance? An aquatots class where you take your baby into the pool with you? Baby music-making sessions? Coffee shops where you've previously seen mums congregating - in the park or shopping mall, perhaps? Go and hang out with your baby, then casually start making conversation.

Arrange baby-minding swaps

If you made friends with another new mum or two during pregnancy, get in touch and see if they'd be interested in starting up a baby-minding swap. It doesn't have to be in the evenings if you're all too sleep deprived to want to get involved with that yet, but just an hour off to go round the supermarket without a fractious baby, or the opportunity to go and get your hair cut are great incentives to start organising 'baby swaps'.

Try to make it a regular, rolling arrangement where you take it in turns to mind each others' babies: that way you can plan ahead to go out and do other things baby-free!

THINGS TO DO FOR YOURSELF

It can be so overwhelming when you first bring your newborn home, that it can be hard to find time just for yourself. As well as adapting to new motherhood, you'll have plenty to do as your newborn will need regular feeds - and these can be lengthy if you're breastfeeeding - regular nappy changes and plenty of cuddles. And your newborn will have no sense of time, so you'll be on call 24 hours a day, which is utterly exhausting.

You'll also have all your normal chores to attend to, but if you can let some of these go for now, so much the better, as you need time to recharge your batteries.

Grab whatever time you can to sleep: perhaps you could get back into bed whilst your baby has some day time sleep in her cot beside you. Set your alarm if you feel you'll sleep for too long: about half an hour can be extremely restorative.

Take up any offers of help from friends and family, and don't be afraid to be specific about the help you'd appreciate most: it might be help with cooking an evening meal; half an hour off from your baby; bringing in some shopping; doing a bit of ironing or changing the beds. Most people who offer to help do so genuinely and will love to feel useful.

Get your partner as involved as possible with your baby's care from the outset. It's no good moaning that he doesn't change nappies if you don't let him have a look-in. Treat these early days as a learning curve for both of you.

Take the opportunity to have a long bath or go for a massage or haircut when your partner is confident about looking after your baby alone for a while.

Whilst it's important to keep your baby safe from infection, it's not necessary to have a completely pristine house, so try to relax a bit about dusting and hoovering. You can always catch up at the weekends.

Keep meals quick and simple: a chilli could be made to last for two days; jacket potatoes are nutritious and easy to prepare; a one-pot stew can be left to cook without much attention. Stock up on fresh fruit for snacking on, and make a point of eating healthy snacks and drinking plenty of water throughout the day.

Don't worry if you can't keep up your usual appearances when it comes to your own grooming, but do try to wash and dress as soon as you feel able to each day as you'll feel more in control, and the days won't seem to merge together quite so much as if you spend all your time in your pyjamas. You may not have time for full make-up, but just washing your hair and applying a little lip gloss might make you feel more human.

NEWBORN TESTS

Apgar score

Immediately after birth your baby will have some checks to make sure all is well. The first is called the Apgar test, during which your baby's heart rate, breathing, colour, activity and response to stimulation are each given a score of 1-10.

If your baby scores 7-10, your baby is doing fine; if the score is below 7, there is still usually nothing to worry about but your baby might need a little extra help.

The test is performed twice: once immediately after delivery, then again five minutes later.

Physical examination

Some time before you go home with your baby, a full examination will be made by a midwife, doctor or paediatrician, who will check and record:

  • your baby's head circumference and head-to-toe length
  • the fontanelles (soft spots on the scalp)
  • mouth and palate
  • heart and pulse
  • lung
  • abdominal organs
  • testicles in boys (to check they have descended into the scrotum)
  • feet, spine and hips
  • ears and eyes
  • hearing.
Vitamin K

You'll be asked for your consent for your baby to receive an injection of vitamin K, which is vitally important for blood clotting. If you don't want your baby to have an injection, the vitamin can be given as drops by mouth straight after birth and again about a week later. If you're breastfeeding, you'll be offered another dose for your baby at the end of four weeks. The decision as to whether or not your baby has vitamin K is yours.

In the late 1990s an association was made between the vitamin K injection and childhood leukaemia, but subsequent studies haven't found any support for a link.

Newborn blood spot screening (or 'heel prick' test)

When your baby's about a week old, your midwife will ask to take a sample of blood from your baby's heel to test for rare but potentially serious illnesses. All babies are tested for phenylketonuria (a metabolic disorder also known as PKU) and congenital hypothyroidism (low thyroid hormone), both of which are treatable when diagnosed. They're also tested for other conditions, including sickle cell disorders and cystic fibrosis.

Hepatitis B and C

Any babies born to mothers with hepatitis B should be vaccinated to prevent them from getting it and becoming a carrier. This is because infected babies are at high risk of becoming a carrier and developing liver disease later in life. If you have hepatatis C when your baby is born, there's a risk you might pass on the infection so your baby will be tested when appropriate.

YOUR MIDWIFE AND HEALTH VISITOR

Once home with your newborn baby, you should receive some support from your local health professionals. A community midwife will usually visit you at home on the day after you leave hospital, and will discuss your needs with you before arranging further visits, some of which might be made by a Maternity Care Assistant. Depending on your local health authority, you may be invited to attend a postnatal clinic as an alternative to home visits.

Midwifery home visits tend to happen on and off during the first 10 days after the birth; then if all is going well you and your baby will be placed under the care of a health visitor.

It's helpful if you can get some idea of when your visits are likely to happen, but sometimes demand for maternity services is so great that you might get fitted in as and when there's a gap. Usually you'll be told the day of a visit and, if you're lucky, whether it will be morning or afternoon.

Try to be flexible if you can, as the visits can give you a really usefull opportunity to ask any questions about your baby or yourself without having to make appointments with your GP practice.

Your midwife will be checking on your health and wellbeing following the birth - monitoring any wounds or stitches, renewing dressings where appropriate - and will also be recording your baby's growth and development.

She should be able to help you with breastfeeding queries and give you advice on any practical or emotional worries you may have.

Your midwife and health visitor should be alert for signs in you of postnatal depression (also referred to as perinatal depression), which affects at least one in 10 women.

There's a special questionnaire you may be asked to complete which gives a good indication of your frame of mind. However, local cutbacks might mean you have to be more proactive, and you can complete the questionnaire yourself online if you or people close to you feel you're not yourself.

If your summary suggests you are at risk of depression, make sure you contact your health visitor or GP as soon as possible, as all types of depression respond best when treated early.

When your health visitor takes over she'll provide you with a Personal Child Health Record book, which you keep in the home and take to any medical appointments your child may have, including all the routine immunisations. There are pages for you to fill in yourself about your child's development, sections to be completed by healthcare professionals which show when immunisations have taken place, and include growth charts, and other pages that offer advice on your baby's health, development and general care.

Remember that you can always ring your maternity unit or health visitor between visits or speak to a trained advisor anytime by calling NHS Direct.

DRESSING YOUR BABY FOR THE WEATHER

We hear so many warnings about not allowing babies to overheat for fear of sudden infant death syndrome (SIDS) that it can be a worry knowing just how to dress your baby for the weather.

A good rule of thumb is to use yourself as a gauge when you're trying to judge how to dress your baby. In any event, layering up is the best way to dress a baby so you can easily adjust things if he starts to get too warm or cold.

Baby, it's cold outside

If it's cold and you feel the need to wear three layers yourself, do the same for your baby: dress him in a vest, stretchsuit and cardigan, for instance. If he's in trousers, don't be afraid to dress him in baby girls' tights underneath if you feel he needs another layer on his legs. Make sure you have a hat, coat and gloves for him, too, and take an extra blanket for tucking him up warmly in his pram or pushhchair.

In very cold weather an all-in-one snowsuit is both showerproof and cosy. The only possible drawback is that it can be hard to keep your baby at a consistent temperature if you're in and out of doors - when shopping, for example.

It can be a bit of a struggle wrestling a baby in and out of a snowsuit, and it's not always enough to unzip the front when you're in a well-heated shop. All-in-ones are probably best for when you are going on a long walk and won't be nipping in and out from warm to cold.

Your baby won't need pram shoes, which can be costly, even if attractive. A pair or two of sox should keep his feet toasty.

When the temperature rises

If it's warm outside and you're comfy in just a T-shirt and lightweight trousers, your baby will be fine in the same number of layers - although he should wear long-sleeved, long-legged garments to protect his skin from the sun.

Take a lightweight cardigan and blanket if you're going out and staying out beyond mid-afternoon, though, as he may chill more quickly than you do as the sun starts to go down, especially if he gets sleepy, when his body temperature will drop in any case.

Try to choose natural fabrics wherever possible to allow your baby's skin to breathe. This will help prevent sweat and heat rashes, which will irritate his skin.

Always put a sunhat on your baby, as his head and neck are vulnerable to sunburn and his eyes should be shaded.

You'll need a parasol if you're taking him out in his pram or buggy, to protect his skin from the sun. Even if your baby doesn't need socks during the hottest part of the day, pop a pair into your bag in case you find yourself in a cool, shady spot or the temperature drops.

YOUR BABY CHECKLIST

Towards the end of your baby's first month, take a moment to gather your thoughts and run through our handy checklist to make sure you're all set up and have done all you need to do so far.

Register your baby's birth

In England and Wales, by law you have up to 42 days to do this, and you can easily lose sight of it if you don't do it soon after the birth. It can take a while to come up with a name you and your partner agree on, but once you have, don't delay.

It's a simple matter of filling forms at your local registry office and no big deal. If your baby was born in England or Wales, the birth must be registered in these countries, but you can go to a register office outside of the area where you gave birth if it's more convenient. If you do register in the district where you delivered your baby you'll get the birth certificate straightaway; otherwise it'll take a few days to be sent on to you.

Buy any outstanding equipment

You'll probably have been managing with the bare basics up till now, but if you haven't got any of the following yet, it might be time to have a re-think:

A baby sling (very useful for carrying on doing hands-on chores whilst comforting your baby).

Read our best buy guide here.

A bouncing cradle chair (for safe movement your baby can generate himself).

A lightweight pushchair or buggy (look for the type that's suitable from newborn).

Read our best buy guide here.

A baby bath seat (for hands-free bathing).

Some next-stage stretchsuits, vests and other clothing.

Start keeping memories

If you have a few spare moments (or can make some for yourself somehow):

Fill in the early details in your baby book or a simple notebook before you forget, like the first moments after birth, your first day at home with your baby, and so on.

Note down any 'firsts' (eg smile, even if windy!).

Print off your favourite photos and start a first album.

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