Your baby's first day is mostly about warmth, feeding and a few quick checks. Straight after birth, your baby is usually dried and placed skin-to-skin on your chest, which keeps them warm and helps the first feed. Your midwife will check them at 1 and 5 minutes (the Apgar score), weigh and measure them, and offer vitamin K and, in Australia and the US, the hepatitis B vaccine.
Over the next 24 hours, expect small, frequent feeds of colostrum, at least one wet nappy and a sticky black meconium poo. Your baby sleeps on their back in their own cot or bassinet from the very first sleep. A few signs need help straight away, and they're listed at the end of this guide.
What happens in the first hour after birth?
The UK's NICE guideline on intrapartum care encourages skin-to-skin contact as soon as possible after birth, with your baby dried and covered with a warm blanket while they lie on your chest. It says routine weighing, measuring and bathing shouldn't separate you in the first hour unless you ask or your baby needs care. If you aren't well enough, your birth partner can hold your baby skin-to-skin instead.
Australia's Pregnancy, Birth and Baby guide to your baby's first 24 hours says skin-to-skin can help bonding and breastfeeding, keep your baby warm, and steady their heartbeat and breathing. It says that after a caesarean, you should still be able to have skin-to-skin.
Your baby may have blood and vernix, a white, sticky coating, on their skin. After a forceps or vacuum birth there may be some swelling or bruising on the head, which Pregnancy, Birth and Baby says soon fades.
NICE asks staff to keep your baby's head supported during skin-to-skin, so their airway stays clear, and to show you and your birth partner how. Tell a midwife straight away if your baby's colour or breathing changes, or if you feel very drowsy.
When is the first feed, and how often after that?
NICE encourages starting breastfeeding as soon as possible after birth, ideally within 1 hour, and many babies first feed during skin-to-skin. Pregnancy, Birth and Baby says a midwife can help with positioning and attachment, and if skin-to-skin is delayed, they can show you how to express breast milk until your baby is ready.
Your first milk is colostrum. The NHS guide to the first few days of breastfeeding says it's thick and golden, and so concentrated that about a teaspoon a feed is enough. Small amounts are exactly what a newborn needs.
How often:
- Pregnancy, Birth and Baby says your baby may feed 8 to 12 times or more in the first 24 hours, sometimes as often as every hour.
- The NHS says feeds may come every 1 to 3 hours in the first few days.
- Feed when you see hunger cues: restlessness, sucking hands, murmuring sounds, or turning the head with an open mouth.
If your baby is sleepy or the next few feeds take several tries, ask your midwife to help. If your baby is formula-fed, see feeding a newborn for first-day amounts. For the days ahead, see breastfeeding in the first week.
What checks and treatments does my baby have?
The Apgar score
The Apgar score is a quick check of how your baby is adjusting to life outside the womb. Pregnancy, Birth and Baby's Apgar page says it's done at 1 minute and 5 minutes after birth, and sometimes at 10 minutes. Each sign scores 0 to 2:
| Sign | What the midwife looks at |
|---|---|
| Colour | Pink all over, blue hands and feet, or pale or blue |
| Heart rate | Over 100 beats a minute, under 100, or absent |
| Reflexes | A cry or pulling away, a grimace, or no response |
| Muscle tone | Active movement, some bending, or limp |
| Breathing | Good effort and crying, weak or irregular, or absent |
The total is out of 10. Pregnancy, Birth and Baby says a score of 7 or above usually means your baby is doing well, and many healthy babies score 9 because blue hands and feet are normal in the first hours. A lower score means your baby needs some extra help at birth. The score doesn't predict later health, intelligence or development.
Other checks and treatments
Weighing and measuring. Pregnancy, Birth and Baby says the midwife weighs your baby and measures their length and head. NICE says routine weighing can wait until after the first hour of skin-to-skin.
Newborn physical examination. Your midwife or doctor checks your baby soon after birth. In the UK, the NHS newborn physical examination page says this head-to-toe check is done within 72 hours of birth and again at 6 to 8 weeks. It looks particularly at the eyes, heart and hips, and the testicles in boys. It isn't painful, and you'll get the results straight away.
Vitamin K. Babies are born with very little vitamin K, which helps blood clot. Pregnancy, Birth and Baby's vitamin K page says Australian guidelines recommend one injection soon after birth, and it's only given with your permission. Oral drops are an option for some babies but need 3 doses. The CDC says the shot can wait up to 6 hours so you can bond first, and that babies who don't have it are 81 times more likely to develop late vitamin K deficiency bleeding.
Hepatitis B vaccine. NSW Health's schedule gives it to all babies in Australia within 7 days, ideally within 24 hours. The NHS gives a birth dose within 24 hours only to babies whose mothers have hepatitis B. In the US, the AAP recommends a dose for all babies within 24 hours, while the CDC's December 2025 fact sheet leaves it to an individual decision when the mother tests negative. See vaccinations.
Your plan for these may already be in your birth plan. If you're Rh negative, Pregnancy, Birth and Baby says some cord blood is tested for your baby's blood group, and you're offered an anti-D injection if your baby is Rh positive.
When should my baby first wee and poo?
The first poo is meconium: black or dark green and very sticky. Frimley NHS maternity services say it's usually passed in the first 24 hours, and to tell your midwife if your baby hasn't passed meconium within 48 hours. Over the next few days, poo turns greenish-brown and then yellow; baby poo colours explains the changes.
The first wee. Pregnancy, Birth and Baby says your baby should have at least one wet nappy within 24 hours of birth. A neonatal guideline from Western Australia's Child and Adolescent Health Service says a newborn who hasn't passed urine in the first 24 hours needs a full medical check. A first wee is easy to miss in a disposable nappy, so check at every change.
Frimley NHS maternity services say some babies have pink or orange staining in the nappy in the first days, from concentrated urine. An NHS West Yorkshire guide calls these urates harmless.
What to tell your midwife:
- The time of the first wee and the first poo.
- How many wet and dirty nappies there have been since.
- Any pink or orange staining, or a nappy you're unsure about (keep it to show them).
- How feeds are going, and whether your baby is hard to wake for feeds.
On the first day, tell your midwife if there's been no wee after 12 hours, or call a health advice line (Pregnancy, Birth and Baby on 1800 882 436 in Australia, NHS 111 in the UK, your pediatrician's after-hours line in the US) if you're at home, so someone can check how feeding is going. If there's still no wee by 24 hours after birth, your baby needs a medical check straight away: tell your midwife in hospital, or call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) if you're at home. Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) at any point if your baby is also floppy, hard to wake or not feeding.
Once wees have started, our rule for any baby applies: no wet nappy or wee for 12 hours needs urgent help, which the NHS lists as a reason to call an ambulance.
Keeping a tally. A simple tally for the first 24 hours helps you and your midwife: the time of each feed, each wet nappy and each dirty nappy, and anything unusual. The first wee and first meconium poo are the two to write down with a time. Never wait to finish notes before getting help for a warning sign.
How do I keep my newborn warm and safe for sleep?
Keeping warm
Skin-to-skin under a warm blanket, as NICE describes, is the simplest way to keep your baby warm in the first hour. After that, the NHS West Yorkshire guide says:
- check by feeling your baby's tummy or back with the back of your hand
- avoid over-wrapping with too many layers, to prevent overheating
- cold hands and feet are common, and hands and feet may look blue for about 24 to 48 hours after birth.
The NHS SIDS page suggests feeling the chest or the back of the neck. Blue, grey or very pale lips, tongue or face is not the same as blue hands and feet, and needs your local emergency number (000 in Australia, 999 in the UK, 911 in the US) now. A temperature of 38°C (100.4°F) or higher, or below 36°C, is also an emergency at this age. See dressing your baby for sleep.
The first sleep
Safe sleep starts with the very first sleep, in hospital or at home. Red Nose's six safe sleep recommendations in Australia and the NHS SIDS page agree:
- on their back for every sleep
- head and face uncovered
- a firm, flat mattress in their own cot or bassinet, with nothing soft or loose in it
- in the same room as you for every sleep, for at least the first 6 months
- smoke-free, before and after birth.
The NHS says never to sleep on a sofa or in an armchair with your baby. In the first day, after a long labour, it can be easy to doze off while holding your baby. If you feel sleepy, put your baby down on their back in their bassinet, or hand them to your partner or press the call bell for a midwife. See safe sleep.
Is jaundice in the first 24 hours serious?
Yes. Jaundice that shows up when a baby is less than 24 hours old is an emergency: the NHS jaundice page says to call an ambulance or go to the emergency department. In hospital, tell your midwife straight away. The NHS suggests looking at the whites of the eyes, the skin, and under the tongue or inside the cheeks, as yellow can be harder to see on black or brown skin.
For most babies with jaundice, the NHS says the yellow is most noticeable at around 3 days old. See newborn jaundice for how to check and which later signs need help today.
What newborn screening tests happen, and when?
Timing differs by country, and you'll be asked for consent:
| Test | Australia | UK | US |
|---|---|---|---|
| Heel prick (blood spot) | Within the first 72 hours | Usually at 5 days old | Usually at 1 to 2 days old |
| Hearing screen | Usually within 2 days, in hospital | Usually before 4 weeks | Usually before going home |
| Heart (oxygen) check | Ask your hospital | Part of the physical exam | After 24 hours of age |
- Australia. Pregnancy, Birth and Baby's bloodspot page says the free heel prick test is done within the first 72 hours, and you're only contacted if there's a concern. Its hearing screening page says the hearing test is usually done in hospital within 2 days, from as early as 6 hours, and is recommended within 1 month for healthy babies.
- UK. The NHS blood spot test page says it's normally done at 5 days old, often at home, with results by 6 weeks. The NHS hearing test page says it's usually offered before 4 weeks.
- US. The AAP's newborn screening page says the blood, hearing and heart tests are usually done at 1 to 2 days old, and some states repeat the blood test at 1 to 2 weeks. The CDC says the painless pulse oximetry heart check is done once your baby is at least 24 hours old, or as late as possible before an earlier discharge.
Pregnancy, Birth and Baby says holding or breastfeeding your baby during the heel prick can help comfort them.
How will I feel in the first 24 hours?
Pregnancy, Birth and Baby says bleeding after birth is often bright red, like a heavy period, in the first few days. Expect to feel very tired, and ask your midwife about anything that worries you. Postpartum recovery covers afterpains, stitches and what's normal over the coming weeks.
Heavy bleeding is most common in the first 24 hours. Pregnancy, Birth and Baby's postpartum haemorrhage page says to call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) if you're soaking through a pad every hour or two and gave birth within the last 24 hours, or you're bleeding heavily and feel unwell, dizzy or clammy. In hospital, press the call bell.
If you have thoughts of harming yourself or your baby, call a crisis line (Lifeline on 13 11 14 in Australia, Samaritans on 116 123 in the UK, 988 in the US) or your local emergency number (000 in Australia, 999 in the UK, 911 in the US) now.
When to get help
These signs come from the NHS urgent help guide, the NHS jaundice page and the Sydney Children's Hospitals Network in Australia, which says green or yellow vomit can mean a blocked or twisted bowel. Also call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) if your baby's breathing stops for more than 20 seconds, or a pause comes with a pale, blue or grey colour or floppiness, as the AAP's guide to breathing pauses advises.
Get medical help today, or tell your midwife straight away, if your baby:
- had a pause in breathing of more than 10 seconds and is now breathing normally; the AAP's newborn symptom checker says to seek care now
- is refusing feeds or feeding much less than you'd expect, while alert
- hasn't passed meconium by 48 hours.
The AAP says short pauses of less than 10 seconds, with normal colour and a comfortable baby, are normal newborn breathing. Jitters or trembling of the arms and legs while crying are also normal.
Ask your midwife about anything else: a mark or shape that worries you, how feeding feels, or how to change a nappy around the cord stump (see umbilical cord care).
