What the First Week With a Newborn Is Really Like

Your first week with a newborn can be blissful, anxiety-ridden, and sleepless. Many parents feel like emotional wrecks during this time and struggle to settle into a routine. Because of the sleep-deprived emotional landmine, it can be challenging to have a balanced perspective when common newborn health concerns pop up.

Feeling out of sorts is just part of the postbirth experience. "Those first days are a complex mix of physical, psychological, and social changes," says Leena Mittal, M.D., director of the Reproductive Psychiatry Consultation Service at Brigham and Women's Hospital in Boston.

Read on for what to expect in that first week with a newborn and some tips for gracefully clearing the hurdles ahead.

Your Body Will Be Sore

Often, first-time parents-to-be spend so much time thinking about childbirth that the thought of what postpartum recovery is really like isn't on their radar.

"I didn't realize it would be so traumatic," says Sarah Camacho, a mom of two in Denver, recalling a lot of "down there" discomfort from her vaginal delivery. "I had to use a squirt bottle every time I went to the bathroom to soothe the pain of my stitches, and I felt bruised. I couldn't sit down without a donut pillow. Even walking was exhausting."

What to expect

According to the American College of Obstetricians and Gynecologists (ACOG), common postpartum symptoms include:

• Vaginal bleeding
• Cramping
• Back, neck, and joint pain
• Perineum pain and swelling
• C-section incision pain
• Swollen breasts
• Pain when going to the bathroom
• Hemorrhoids

What to do

If you deliver vaginally, you will be extremely sore—a baby the size of a Virginia ham just came out of a very small spot. Ice the area for the first 24 hours and then take frequent warm baths to soften stitches and to keep them from feeling tight, says Laura Riley, M.D., author of You and Your Baby: Pregnancy.

The good news? "Because a lot of blood flows to your vagina, the area heals quickly—in a matter of days," she says.

In addition, ACOG recommends the following to soothe postpartum pain:

• A heating pad for cramping and joint pain
• Over-the-counter (OTC) pain relievers and taking pain medication as directed
• A nursing pillow for support
• Applying witch hazel to the perineum
• Sitting on a pillow
• Soaking your bottom in a sitz bath
• Rinsing with a squeeze bottle (also called a "peri bottle") when going to the bathroom
• Taking a stool softener if needed
• Breastfeeding lying on your side if it's more comfortable
• Breastfeeding frequently to reduce breast pain and pressure
• Appling cold packs to breasts if they are swollen
• Asking for a referral to a lactation consultant if you have nipple pain associated with a poor latch
• Drinking plenty of water
• Taking short walks
• Eating high-fiber foods

For cesarean births, over-the-counter or prescription pain medication can relieve the soreness and pulling sensation at your incision site.

"It's important that you take enough medication during the first week so you feel good enough to move around, which is what encourages recovery," explains Dr. Riley. Your C-section incision will take four to six weeks to heal fully, so keep an eye out for infection. If it leaks, smells, burns, or looks red, or if you develop a fever of more than 100.4 degrees F, call a health care provider.

Your Baby May Develop a Common Newborn Health Condition

Several common health conditions can pop up in your first week with a newborn. According to the American Academy of Pediatrics (AAP), health conditions that are common in newborns include:

• Abdominal distension
• Acrocyanosis
• Birth injuries
• Skin discoloration
  
• Unusual bowel movements
• Colic
• Jaundice
• Excessive sleepiness
• Umbilical stump problems
  

What to Expect

Babies' abdomens often protrude, but they should feel soft. If their belly is hard, they may have gas, constipation, or an intestinal problem.

If you had any complications during childbirth, your newborn may have birth injuries, like scrapes from forceps, a broken collarbone, or muscle weakness. Fortunately, these minor injuries often heal quickly.

In addition, parents often notice that their newborns have mildly blue or purple hands and feet. This is pretty common in a newborn's early days. It's usually due to them getting cold, and they should go back to a more typical color when they get warm.

When it comes to diaper changes, know that bowel movements in the first week with a newborn can be a wild ride! Their poop will start out thick and tarry in a one- or two-day-old baby (called meconium), then transition to yellow, green, or tan depending on whether they're fed breast milk or formula.

It may also surprise you to know that coughing is common in a newborn's first week. It's often caused by sputtering on milk. However, if your newborn is coughing a lot including when not feeding, they may have caught a cold or another infection.

While you may be familiar with colic, rest assured that it usually doesn't start in the first week with a newborn. However, lots of crying can still happen in that early week. For example, newborns might cry because they're hungry, tired, want a clean diaper, are cold or warm, or just want to be held.

Jaundice is another common newborn health condition. It occurs when bilirubin levels build up too excessively in a newborn's bloodstream. It often appears when your baby is 3 to 5 days old. The telltale yellow coloring usually starts at the head and works its way down, says Lisa M. Asta, M.D., associate professor of clinical pediatrics at the University of California in San Francisco.

One of the perks of newborns in the first week is that they tend to sleep a lot. This is usually perfectly normal, especially if your baby wakes every few hours to eat and they seem content.

Finally, parents commonly wonder if their newborn's umbilical stump is healing properly. Usually, the umbilical stump with fall off on its own during the first week or two. In the meantime, offer your baby sponge baths.

What to do

Always call a healthcare provider if you notice the following:

• Your baby's abdomen, arms, legs, or the whites of their eyes are yellow
• Your newborn is fussy, hard to wake, or not feeding well
• They are not having bowel movements
• They are vomiting
• Your baby is persistently blue coloring, especially on the trunk
• They have blood in the stool
• They have coughing that is not related to choking on milk
• Their crying is more of a shriek
• They are breathing too rapidly (more than 60 breaths in a minute)
• They have a foul-smelling discharge from the umbilical cord
• There is redness around the base of the cord
• They appear to experience discomfort when you touch the umbilical cord
• They have a fever (rectal temperature of 100.4 or higher)

About 60% of newborns will experience some degree of jaundice, according to the Centers for Disease Control and Prevention (CDC). Most cases resolve on their own, but because jaundice can cause brain damage if left untreated, pediatricians don't take it lightly.

"It's stressful for parents during baby's first days," says Dr. Asta, "but jaundice levels that fall outside of the accepted range are very curable." In addition, many pediatricians will have you schedule a newborn visit about two days after you get home from the hospital to check for jaundice.

Feeding May Be as Hard as It Will Ever Be

When parents of older kids dreamily tell you how much they loved nursing their infants, they are probably not talking about the first week with a newborn.

What to expect

Whether formula feeding or breastfeeding, the early days of newborn feeding can be overwhelming. Latching may be difficult or painful, and choosing a bottle or formula may seem impossible. To top it all off, you may feel confused about when and how often your baby should feed.

You may experience some tingling or irritation at latch-on for the first week or two. (In the first few days, it may induce some uterine cramping, which is normal.)

Keep in mind that milk can come in anywhere from 36 to 72 hours after birth, and for some, it could take four to five days.

Know that formulas come in three general forms: powders, which must be mixed with water; concentrates, which come in liquid form but must be diluted with water; and ready-to-use liquids, which can be poured directly into bottles.

What to do

If you’re breastfeeding or chestfeeding, take it one step at a time. Your goal right now is to get your baby to latch on correctly—lips flipped out, chin close to your breast, jaw and ear moving slightly in a rhythmic motion as they suck, says Laura Jana, M.D., a pediatrician and author of Heading Home With Your Newborn.

If your breast or nipple hurts or you’re concerned about your supply, talk to a health care provider and consider hiring a lactation consultant to show you different ways to latch and see whether your baby is eating enough. Check if the hospital’s specialist is available, or find one at the International Lactation Consultant Association website.

While you’re waiting, continue offering your breast to stimulate milk production. Lisa Marasco, IBCLC, a lactation consultant in Santa Maria, California, explains: “Your body expects your baby to be at the breast very soon to start suckling. If that doesn’t happen, you can mimic the baby with hand expression and pumping to get the milk going sooner.”

Formula-feeding? Choosing a brand can be overwhelming, so ask a health care provider for one they recommend. The type you choose may depend on both your baby’s preference and your budget.

Whether you nurse or bottle-feed, keeping a record of when feedings occur and how long they feed or how much they eat can help you stay on track.

You Might Cry a Lot

"I had a healthy baby, I knew I should be happy, but I couldn't stop sobbing about the trauma and disappointment of my unplanned C-section," recalls Megan Orringer, a mom in Ann Arbor, Michigan.

What to expect

With over a third of babies in the U.S. now delivered via cesarean, feeling sad about not having the birth experience they planned jolts many people. And regardless of how you delivered, your body is on a hormone roller coaster during these first weeks. The highs can help you bond with your baby, but you may hit lows you've never experienced before.

Adds Dr. Riley: "Your body doesn't feel like your own, your boobs hurt, your bottom is sore, you're not sleeping, and you may not have much help. The postpartum blues magnify all of that stress."

Baby blues commonly begin in the first week with a newborn. According to ACOG, signs include:

• Crying for no apparent reason
• Having trouble sleeping, eating, and making choices
• Questioning whether you are capable of caring for your baby

Baby blues usually improve on their own within a few days or weeks without treatment.

What to do

It's OK to feel somewhat disconnected from your newborn or anxious about not knowing how to take care of your baby at first. Give yourself time to be with your little one. Doing tasks like feeding and changing them will help your confidence grow, says Dr. Mittal. When your baby is alert, focus on them. Hold your baby, noting what positions they prefer. Sing, imitate their sounds, and make eye contact with them.

If you continue to feel indifferent or anxious, or your feelings of sadness worsen, especially if you begin to have thoughts of harming yourself or your baby, you may have postpartum depression (PPD) or postpartum anxiety (PPA). Contact a health care provider who can steer you to help right away.

You’ll Likely Experience Sleep Deprivation

At first, the adrenaline rush of having a baby carries you through. Then comes the crash—the rude awakening that this is no temporary matter.

What to expect

"I labored through the night and struggled to sleep in the maternity ward," recalls Emily Jo Hoover, a mom in Pacifica, California. "At home, my baby wanted to nurse all night. Then after a day that included a doctor's appointment and seeing a lactation consultant, I started shaking from exhaustion."

Tending to a newborn is exhausting. Newborns feed every few hours around the clock (yes, that includes overnight). That means your uninterrupted nights of sleep are gone—at least for now.

What to do

To try to prevent the physical and mental wear down that comes with sleep deprivation try the following:

• Consider taking cat naps whenever your baby sleeps.
• Match your own bedtime to your baby's.
• If you're formula-feeding, alternate late-night bottles with your partner.
• If breastfeeding, ask your partner to share other middle-of-the-night tasks, like diapering and burping.
• At night, keep the lights dim during diaper changes and feedings to avoid waking them up fully.

If you're nursing, it's trickier to share feedings in the middle of the night, but once you and your baby have mastered nursing and you're ready to pump and offer breast milk in a bottle, you and your partner can discuss sharing this task, too. The AAP recommends waiting on a pacifier until 3 to 4 weeks if exclusively breastfeeding.

Newborns sleep 16 to 18 hours a day. During the day, wake them for feeding if they slumber for more than four hours at a stretch so they maintain their weight gain. When your baby can't settle down, but you know they've been fed and had enough to eat, soothe them by rocking, offering a pacifier, or swaddling.

Finally, the AAP advises room-sharing but not bed-sharing with newborns due to the risk of suffocation and other sleep-related accidental deaths. So, avoid drifting off after feeding your baby in bed or on another surface like a couch.

Your Baby’s Skin Will Need Some TLC

We know: There's nothing like that first bath photo! But hold off on sudsing your newborn up. Research has found that not washing away the vernix—the white, waxy substance that covers your baby in the womb and that they'll likely be coated with at birth—has many benefits, including lower hypothermia rates, less crying, and skin protection and immunity. So, experts recommend waiting until your baby is 1 day old.

Vernix also contributes to the makeup of your newborn's skin's microbiome, a layer of microorganisms that help keep their skin healthy. Washing your baby with a cleanser can disrupt the microbiome's formation, which may make them more susceptible to skin issues like eczema down the line, says Sandy Skotnicki, M.D., a dermatologist in Toronto and author of Beyond Soap.

What to expect

In addition to vernix, you may notice the following common newborn skincare issues:

• Birthmarks
• Cradle cap (an accumulation of dead skin cells that causes flaking on the scalp)
• Rashes like heat rash, diaper rash, and contact dermatitis
• Baby acne (common on the face)
• Milia (tiny cysts on the face)

All of these issues are most often mild and not concerning. But you can discuss them at your baby's first pediatrician visit.

What to do

Of course, some cleaning is essential with all the diapers your baby will go through in a day (8 to 12, on average). Breastfed babies often poop with every feeding in their first weeks of life, and formula-fed babies can poop three to four times a day.

Washing with water alone won’t remove poop and pee completely, so if your baby has an extra-dirty diaper, washing them more thoroughly is OK. Use a soft cloth and a gentle pH-adjusted cleanser that protects and nourishes the microbiome on their messy skin. You should continue to use this product at bath time after the first week.

To prevent rashes, use super-absorbent diapers and fragrance-free wipes. If the area is irritated, apply a barrier like plain petroleum jelly or a zinc-oxide paste.

Cradle cap usually goes away on its own, but if it bothers you, you can lather up the scalp with mild baby shampoo and use a soft brush to help loosen the dead skin. Milia and baby acne require no treatment and go away with time. Never try to pinch or pop them; it can cause pain and lead to infection.

You’ll Adjust to a New Normal

You likely won’t have the energy to socialize like you did pre-baby, so talk with your partner about which visitors will make the cut. It’s OK to make some people wait. Eager pals can help in other ways: Accept their homemade soups, let them walk the dog, and welcome their grocery drop-offs. They can peek at your baby then.

What to expect

As far as chores go, you might find you can’t get much done. “Caring for a baby is time-consuming,” says Deborah Ledley, Ph.D., a psychologist and author of Becoming a Calm Mom. “Feeding alone takes eight hours. That’s a full day’s work!”

What to do

Be realistic. You might set one non-baby-related goal every day, like doing a load of laundry or writing two thank-you cards. If your baby doesn't want to be put down, use a swing or wear them in a carrier as you move around. No one keeps their house perfectly tidy during the newborn stage, so give yourself some slack.

"Managing household chores has been the most stressful part since our second child was born," says Drea Dalzell, of Sartell, Minnesota. "I remember to ask for help and rely on my in-laws for that extra bit of sanity. I may be less focused on cleaning, but I'd rather spend time with my girls."