Caring for a newborn and when to see a doctor

Feeding and signs that the baby is feeding well

Exclusive breastfeeding is recommended for the first six months. A newborn needs to feed often, usually 8 to 12 times in 24 hours, including at night. Signs of adequate feeding are audible swallowing during feeds, a settled baby after feeding and wet diapers: from day 5, at least 5 or 6 wet diapers a day.

It is normal for a baby to lose up to about 10 percent of birth weight in the first days and to regain it within two weeks. Greater loss, very few wet diapers, stools that remain black after day five, or a baby who is hard to wake for feeds need prompt assessment. When formula is used, it is prepared exactly according to the instructions, without diluting or concentrating it. Water, tea or honey are not given to a baby at this age.

Safe sleep

Always put the baby to sleep on the back, in their own cot with a firm mattress and a fitted sheet, in the parents’ room. Do not put pillows, loose blankets, toys or bumpers in the cot. Do not let the baby sleep on a sofa or armchair, and avoid sharing a bed, especially when there is tobacco, alcohol or great tiredness in the parent.

Keep the room at a comfortable temperature and do not overdress the baby; the head is not covered. A smoke-free environment is one of the most important protective measures. Tummy time while the baby is awake and supervised helps development, but never during sleep.

Bathing, the cord and skin care

Keep the umbilical cord clean and dry and let it fall off by itself, usually within 1 to 3 weeks. Do not apply powder, alcohol or ointments without advice. Folding the diaper below the cord keeps the area aired. Redness spreading around the cord, foul-smelling discharge, persistent bleeding or fever call for prompt assessment.

Bathe with warm water and mild soap, only a few times a week. Small spots, dryness or tiny white dots on the skin are often harmless, but spreading redness or wounds need assessment. Frequent changes and a simple barrier cream reduce diaper rash.

Jaundice in newborns

Many babies turn yellow in the first week because the liver is still maturing its ability to process bilirubin. Mild jaundice that appears after two days and fades gradually is often physiological. Jaundice that appears within the first 24 hours, spreads to the legs, lasts longer than two weeks, or comes with poor feeding, sleepiness, dark urine or pale stools needs urgent medical assessment.

At home, look at the baby in natural light and press the skin lightly to judge the color. Do not rely on sunlight as treatment. Frequent feeding helps eliminate bilirubin.

Crying, soothing and parental rest

Crying is the baby’s main way of communicating. The most frequent causes are hunger, a wet diaper, tiredness, feeling cold or hot, and the need for contact. Once these have been checked, holding, gentle rocking, a calm voice and a quiet environment help. Some babies have longer crying periods in the evening during the first weeks; this usually peaks around the sixth week and fades gradually.

Persistent crying that cannot be settled, accompanied by fever, vomiting, refusal of feeds or a change in behavior, needs medical assessment. Parents also need rest: sleep when the baby sleeps, accept help from family and do not hesitate to talk to the doctor when you feel exhausted or low for a long time.

When to see a doctor

Seek prompt assessment if the baby refuses two feeds in a row, passes noticeably less urine, is limp or irritable and cannot be settled, breathes fast or with effort, vomits green or bloody material, has blood in the stool, a swollen abdomen or worsening jaundice. A fever under 3 months is always urgent; in babies these illnesses can progress quickly, so do not wait for the temperature to fall on its own.

Do not give a baby any medicine, including paracetamol, without the doctor’s guidance, because the dose depends on weight and age and because it can mask signs of illness. Never shake a baby; if you are exhausted by crying, lay the baby in a safe cot and take a break.

First check-ups and vaccination

The pediatrician assesses the baby in the first days after leaving the maternity unit and then according to their plan: weighing, measuring length and head circumference, assessing feeding, jaundice and development, and answering parents’ questions. Vaccines follow the national schedule in force; bring the vaccination booklet with you.

If you are unsure about a sign, it is better to ask. In these weeks, early assessment is often worth more than waiting.

Care at Tirana Polyclinic: we offer pediatric consultation for assessing the baby, feeding and growth, and interpretation of the results of tests performed outside the clinic. When the condition requires neonatal or hospital care, the baby is referred immediately to the appropriate service.