The first forty-eight hours

The first two days involve a series of routine observations and checks, most of which nobody explains at the time because everybody assumes somebody else has.

Immediately after birth

Skin-to-skin contact is recommended for healthy babies and mothers, and the evidence supports it for temperature regulation, breastfeeding initiation and calming.

It can continue for an extended period and it does not need to be interrupted for weighing or dressing, which can wait.

Cord clamping is now generally delayed for at least a minute in most guidance, which improves the baby's iron stores.

The Apgar score is recorded at one and five minutes, assessing colour, heart rate, reflex response, muscle tone and breathing.

It is a snapshot for the clinical team rather than a grade, and a score of nine is entirely ordinary since the colour point is rarely full at one minute.

The newborn examination

A head-to-toe check performed within the first day or two, which covers a great deal.

The head, fontanelles and facial features.

The eyes, including a red reflex test that screens for cataract and other conditions.

The heart, listening for murmurs, and the femoral pulses.

The lungs.

The abdomen and the cord.

The hips, checked with specific manoeuvres for developmental dysplasia, which is treatable when detected early and difficult later.

The genitalia and, in boys, whether the testes have descended.

The spine and the base of it.

And the limbs, digits and reflexes.

The screening tests

Offered rather than compulsory, and worth understanding.

The newborn blood spot test, taken from a heel prick around day five in many countries, screening for a set of rare but serious conditions where early treatment changes the outcome entirely.

The conditions covered vary by country.

Newborn hearing screening, done before discharge or in the first weeks, which detects permanent hearing loss early enough for intervention to matter for language development.

Pulse oximetry screening in many places, detecting certain critical heart conditions before symptoms appear.

Vitamin K is offered — as an injection or oral doses — to prevent vitamin K deficiency bleeding, which is rare, unpredictable and can be devastating.

The injection is considerably more reliable than the oral course, which requires all doses to be given.

What is normal and looks alarming

A long list, and almost all of it resolves.

A cone-shaped or bruised head from delivery, which reshapes over days.

Swollen eyelids and puffy features.

Peeling, flaking skin, particularly in babies born after their due date.

Milia — tiny white spots on the face.

Erythema toxicum, a blotchy red rash with small pale centres, which appears in the first days and disappears.

Swollen breast tissue and, in girls, a small amount of vaginal discharge or bleeding, both caused by maternal hormones.

Irregular breathing with pauses of a few seconds, which is normal in newborns.

Sneezing, hiccups and noisy digestion.

Crossed or wandering eyes in the early weeks.

And startling, trembling chins and jerky movements, which are neurological immaturity rather than distress.

Feeding and output in the first days

Newborn stomachs are very small, and colostrum is produced in small volumes deliberately.

Frequent feeding is expected — eight to twelve times in twenty-four hours or more — and cluster feeding in the evenings is normal.

Weight loss of up to around a tenth of birth weight is usual, with birth weight generally regained by around two weeks.

Nappies are the practical measure: the first stool is meconium, dark and sticky, changing to green then yellow as feeding establishes.

Wet nappies increase day by day, with a rough guide of one on day one, two on day two and so on, settling to six or more heavy wet nappies daily once feeding is established.

What needs urgent attention

Worth knowing before you leave hospital.

Jaundice appearing in the first twenty-four hours, or deepening rapidly, or involving the palms and soles.

Difficulty breathing: grunting, flaring nostrils, drawing in beneath the ribs, or rapid breathing.

A temperature above or below the normal range.

Persistent vomiting, particularly if green.

Reluctance to feed, or a baby who cannot be roused to feed.

Floppiness or unusual irritability.

No urine in twenty-four hours, or no stool in forty-eight.

And any instinct that something is wrong, which is a legitimate reason to ask.

General information only, not medical advice. Guidance varies by country — consult your midwife, health visitor or paediatric service, and seek urgent care if you are worried about your baby.