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Quick reference

Dr Jubal's Key Tips for Newborn Parents

A short, personal one-page overview of the things newborn parents most need to know — during the hospital stay, after discharge, and through the unsettled peak.

Last reviewed

A newborn's hand grasping an adult's finger

During the hospital stay

Vitamin K

Shortly after birth, and with your consent, your baby receives a vitamin K injection to prevent vitamin K deficiency bleeding, a rare but serious condition. It’s essential for blood clotting. See the vitamin K guide for the full picture, including the oral-vs-IM choice and the evidence behind it.

Feeding

Breastfeeding has clear benefits for you and your baby, and the team at the hospital will help you with positioning, latch, and any early problems.

A pattern many parents aren’t warned about: in the first day many babies don’t latch well and look sleepy. Then from the second night onwards, most babies become ravenously hungry, “cluster feeding”, until the milk comes in. This is normal and helps with both latching and milk supply.

Some mothers need to express with a pump. If breastfeeding isn’t suitable, formula feeding is also safe and effective. No standard formula brand has evidence over another; specialist formulas are for specific medical needs (like allergy), after a medical consultation.

More on attachment, signs of effective feeding, and support lines: breastfeeding support guide. If you’re unsure whether the latch is comfortable, see also the latch anatomy diagram.

Weighing and measuring

At about 48 hours old, your baby will be weighed and measured. Some weight loss in the first days is normal; loss exceeding 10% is the threshold for active review. Once home, your MCH nurse will keep monitoring; most babies are back to their birthweight by two weeks of age.

Newborn bloodspot screening: 48–72 hours

At 48–72 hours, your midwife will collect blood from your baby’s heel onto a card. The card screens for a panel of rare medical conditions that benefit from early detection. No news is good news: if results are normal, you won’t be contacted. If there’s anything to follow up, the hospital will reach out, so please keep your phone reachable.

Full detail on what’s tested and why: newborn screening guide.

Jaundice

A yellow tinge of the skin in the first days is normal in most newborns and usually resolves within two weeks. If it looks more pronounced, a quick non-invasive TcB (transcutaneous bilirubin) test on the skin will tell the team whether a blood test is needed.

The typical course of newborn jaundiceA smooth curve of visible yellowing against days after birth. Jaundice appears after the first day, climbs to a peak around day 3 to 5, then fades steadily and is usually gone by day 10 to 14.Peak — day 3 to 5yellow is most obvious nowappears after day 1usually faded by day 10–14birthday 2day 4day 7day 10day 14Days after birthVisible yellowing

Red flags — a same-day review (GP, paediatrician or hospital) if:

  • Jaundice in the first 24 hours of life
  • Deep yellow reaching the chest, tummy or legs, or worsening quickly
  • Still jaundiced at 2 weeks (term) or 3 weeks (preterm)
  • Pale, chalky stools or dark urine — at any age

A jaundiced baby who also seems unwell — unusually sleepy, feeding poorly, or with fewer wet nappies — should go straight to the emergency department.

Most term babies look a little yellow in the first week — only about 1 in 20 needs phototherapy.

The typical course of physiological jaundice in a term baby. Course and red flags per RCH Kids Health Info and Safer Care Victoria jaundice guidance.

For the full clinical picture (when treatment is needed, what phototherapy actually does, the warning signs that mean see-the-team-now), see neonatal jaundice.

Vitamin D drops

All babies should receive a daily vitamin D supplement as drops, this is recommended by the Royal Women’s Hospital and is available at any pharmacy without a prescription — ask the pharmacist for an infant vitamin D3 preparation. Continue daily until one year of age.

Special Care Nursery (SCN)

Some babies need SCN admission for a stretch, common reasons include prematurity, low birth weight, low blood-sugar (hypoglycaemia), temperature regulation, or breathing difficulties. Special Care isn’t always alarming; for many babies it’s a brief observation period.

If your baby is in SCN, the late preterm journey guide and the 31-33 week journey guide explain what to expect day by day.

Transfer to the InterContinental

Well mothers and babies may be offered transfer to the InterContinental for the remainder of the stay, where a midwife visits daily to monitor weight and jaundice and notifies me of any concerns. Best suited to families who feel confident with feeding and everyday newborn care.

After discharge

A Maternal & Child Health (MCH) Nurse will visit your home, ideally in the first week, to check weight and wellbeing, and arrange regular assessments after that. The MCH service is universal in Victoria and free — your local council will contact you to arrange visits. For advice at any hour, the separate MCH Line on 13 22 29 runs 24/7.

The two-week rule of thumb

By two weeks of age: back to birth weight, and jaundice resolved. If either hasn’t happened, your baby should be reviewed. One exception that can’t wait two weeks: pale, white or chalky stools, or dark urine, need a same-day GP review (or an emergency department) whatever your baby’s age.

Hip, kidney, or spinal ultrasounds (if needed)

If your baby needs an ultrasound, the practice team will let you know and book the appointment for you. Reports come to Dr Jubal for review, and anything needing prompt action is acted on straight away. Results are discussed at a review — book a telehealth or clinic appointment after the investigation — and with your consent we endeavour to send some results through electronically. If you haven’t heard from us after the investigation, please contact the rooms.

Thyroid or other pathology tests (if needed)

If a blood test is needed after discharge, the practice team will email a pathology slip for you to take to a pathology collection centre that is set up to do heel-prick tests on babies. Results come to Dr Jubal for review, and anything needing prompt action is acted on straight away. Same rule: results are discussed at a review, with your consent some can be sent electronically, and if you haven’t heard from us, contact the rooms and book a review to discuss them.

Reviews after discharge: why they keep happening

A newborn is a body in transition: feeding, weight, jaundice and circulation change by the day, and some issues start subtly and only show themselves on repeated review. The MCH surveillance schedule (first home visit ideally in the first week) and the 6-week GP check are essential, and a paediatric review at 6 weeks is recommended. Where jaundice, weight, feeding or a hospital finding needs an earlier look, we’ll tell you before you go home — please book it in as soon as you’re home.

Whooping cough (pertussis) booster

To protect your baby, parents and frequent adult caregivers should have a whooping cough (dTpa) booster if their last dose was more than 10 years ago — ideally at least two weeks before spending time with the baby. Mum is usually already covered by the vaccine given during pregnancy, and if she also had the RSV vaccine in pregnancy, that protection carries into the first months too (it needs at least two weeks before birth to transfer well; babies without that window can be offered an RSV antibody injection instead). This is one of the most effective things the adults around the baby can do.

Your baby’s timeline, in your calendar

The baby timeline shows what to expect at each age through the first 18 months: milestones, typical weight ranges, and when the check-ups and immunisations fall. Enter a birth date and you can add the whole set to your own calendar as dated reminders. Everything is made on your device; nothing is sent to us.

The unsettled peak

Most babies are hungry and unsettled on nights 2–4, then reasonably settled for the first week or two once feeding is going well. From weeks 2–3 the fussiness builds, typically peaking at 6–8 weeks, then gradually abating by 3–4 months.

Curves of early infant crying and fussiness — birth to 5 monthsA shaded band showing hours of fussiness per day from birth to 5 months of age. Babies are briefly unsettled on nights 2 to 4 while cluster feeding, then mostly settled for the first two weeks. From weeks 2 to 3 fussiness builds, peaking at 6 to 8 weeks, then settling by 3 to 5 months. At the peak, high criers along the top of the band fuss up to 5 or 6 hours a day, the average baby about 2 to 2 and a half hours, and low criers along the bottom as little as 20 to 30 minutes.0 hr2 hr4 hr6 hrHours of fussiness per 24 hoursbirth2 wks1 mth2 mths3 mths4 mths5 mthsAge of babyPeak — 6 to 8 weeksthe average baby: about 2–2½ hrs a daysettlednights 2–4High criersup to 5–6 hrs a day at the peakLow criers— as little as 20–30 mins a dayaveragesettling by 3–5 months

Hungry and unsettled on nights 2–4, settled once feeding is going well, then a fussy period that builds from weeks 2–3, peaks at 6–8 weeks, and gradually eases from 3 months. Your baby can sit anywhere in this band and still be completely normal.

The "curves of early infant crying", redrawn from the crying-curve literature (Brazelton; Barr) summarised by the Period of PURPLE Crying program.

Parents often describe the baby as upset in the stomach, squirming, gassy, straining with stools. This pattern is normal and well-described.

Support is there for this stretch: the MCH nurse and your GP can help; the unsettled-baby-peak guide has the detail. Occasionally a medical cause (e.g. cow’s milk protein allergy) is part of the picture, if symptoms feel severe or persistent, please review with me or your GP. And if your baby seems unwell at any point — fever, poor feeding, vomiting, unusual drowsiness — don’t wait for an appointment: go to the emergency department. The when to seek help guide has the full traffic-light list.

The Royal Children’s Hospital page on crying and unsettled babies is a good external reference, and the Period of PURPLE Crying site explains the normal crying curve above in more depth.

Lastly: enjoy it

Congratulations again. The early weeks are hard work and often a blur, be kind to yourself, take help when it’s offered, and make time to enjoy your baby.

I’m here to support you and your child, please get in touch after discharge if you run into concerns.

Need to reach the practice?

Email admin@neopaeds.au or call (03) 9007 2099 (Mon–Fri 9am–5pm). For advice outside hours, MCH Line 13 22 29 (24/7) and Nurse-On-Call 1300 60 60 24; in an emergency, call 000 or go to an emergency department.

References