The first stools are sticky, greenish-black and are called meconium.
As the baby takes milk feeds, the stools become a mustard colour and sometimes have a seedy appearance.
Breastfed babies will have soft, yellow stools that do not smell, while a bottle fed baby will have stools that are more formed, darker and smellier.
All babies should pass at least two soft stools per day for the first six weeks regardless of feeding method.
If you have any concerns, ask your midwife/health visitor or GP for advice.
Newborn Blood Spot & Hearing Tests
(Day 5 screening tests)
On Day 5 your baby will be offered the newborn bloodspot screening, also known as the heel prick test and the newborn hearing screen. This will be done either in a clinic, the home, or the postnatal ward by specialist screeners.
If your baby is in the neonatal unit for more than 48 hours the hearing screen will be completed in the unit, and if your baby remains in the neonatal unit on day 5 the bloodspot screen will be completed by a neonatal nurse.
If you would like to discuss your baby's screening tests further please call the Newborn Screening Team on:
Newborn and Infant Physical Examinations (NIPE)
Your midwife will complete an initial examination of your baby immediately after the birth.
A more detailed examination will take place within 72 hours of giving birth, all parents are offered a thorough physical examination for their baby. This includes babies who are born at home.
If you gave birth in the hospital the examination will be done before you leave or you may be offered an appointment to return back to the hospital for the check.
The examination includes eyes, heart, hips and in baby boys checking if their testes are in the right place.
The aim of the NIPE is to spot any problems early so treatment can be started as soon as possible. Usually, nothing of concern is found.
If the health professional carrying out the examination does find a possible problem, they may refer your baby for more tests or ask for a second opinion. You may also be referred to the appropriate specialist baby doctor, such as a paediatrician or neonatologist. It is really important you attend any appointments made as they may affect the health of your baby.
You will be offered another physical examination for your baby at six to eight weeks, as some of the conditions it screens for can take a while to develop. This second examination is usually done at your GP's surgery.
Please see further information on pages 36-39 of Screening tests for you and your baby
Neonatal jaundice is one of the most commonest conditions requiring medical attention in newborn babies. It is very common in the first two weeks of a baby's life. It is usually harmless but may be due to a serious cause which needs treatment in hospital.
Neonatal jaundice is more likely to have a serious cause if it is seen in the first 24 hours of life or doesn't disappear by 2 weeks of age.
Jaundice is caused by a raised level of bilirubin in the blood. Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life.
Breast fed babies are more likely to develop jaundice in the first week of life. Before birth babies require a higher level of red blood cells in order to carry oxygen around their body. Once they are born they no longer require this so any additional blood cells are broken down. This produces a dark yellow waste substance known as bilirubin, which is passed out in the urine.
Sometimes this process in newborn babies can be slower so they get a build-up of bilirubin in the blood. For most babies, jaundice is not an indication of any underlying condition and this type of jaundice is generally harmless.
At each postnatal assessment, the midwife or maternity care assistant will check your baby's health and well-being. The following observations help to build up a complete picture of your baby and the findings will be discussed with you.
Depending on your baby's needs, closer monitoring maybe carried out during the first 12-24 hours after birth. This may include observing your baby's breathing rate, temperature, colour, blood glucose levels and how your baby responds. Staff caring for you will explain the reason why this is being done.
Please discuss any concerns you may have about your baby with your health care team.
Safe Sleeping: how to reduce the risk of cot death
Meeting and getting to know your baby is an extremely exciting and rewarding time. It's also the beginning of a new relationship.
Babies need a lot of sleep during the first few months of their lives so it's important to ensure that they are sleeping as safely as possible.
Sudden Infant Death Syndrome (SIDS) is the sudden and unexplained death of a baby where no cause is found. While SIDS is rare, it can still happen and there are steps parents can take to help reduce the chance of this tragedy occurring.
Urine and nappy rash
Your baby should have at least two wet nappies per day in the first two days, increasing to six or more per day by seven days.
Urates are tiny orange/ pink crystals that look like brick dust that may appear in the nappy, but with regular feeding will disappear.
The skin on a baby's bottom is sensitive and prolonged contact with urine or stools can cause burning or reddening of the skin. Nappies should be changed frequently, either before or after feeds to prevent this. If the skin does become sore it is better to use warm water and cotton wool rather than wipes or lotions.
Vitamin D for newborns
The Department of Health and Social Care recommends:
- Babies from birth to 1 year of age who are being breastfed should be given a daily supplement containing 8.5 to 10 micrograms of vitamin D to make sure they get enough. This is whether or not you're taking a supplement containing vitamin D yourself.
- Babies fed infant formula should not be given a vitamin D supplement if they're having more than 500ml (about a pint) of infant formula a day, because infant formula is fortified with vitamin D and other nutrients.
- Children aged 1 to 4 years old should be given a daily supplement containing 10 micrograms of vitamin D.
Available Healthy Start vitamins
There are 2 Healthy Start branded products available:
- Healthy Start children’s vitamins drops
- Healthy Start vitamins for women
Soon after the birth of your baby, you'll be asked if you want your baby to have vitamin K injection or oral drops.
Newborn babies do not start to make vitamin K on their own until they have bacteria in their gut. Vitamin K is one of many factors in the blood that helps it to clot.
Although rare, if the baby were to bleed without vitamin K, its life could be at risk.
If your baby needs a BCG vaccine
The BCG vaccination is given to children under 5 who have a higher chance of catching human tuberculosis (TB). The BCG vaccination helps your child’s immune system fight the germs that cause TB and helps stop them from getting serious TB disease.
You child has a higher chance of catching TB and is eligible for the vaccine if:
- Baby has been born in a country with a TB incidence of 40 in every 100,000.
- Baby has been in contact with a TB case or has a family history of TB in the past 5 years.
- Baby's parent or grandparent was born in a country where the annual incidence of TB is 40 in every 100,000 or higher.
- Baby is likely to travel to a high incidence country for more than 3 months in the next 5 years.
Your midwife will ask about BCG and will request it, if needed, after your baby is born. You will be contacted directly with an appointment for when baby is over 28 days of age.