Common Newborn Health Concerns
Most of what worries new parents in the first weeks is completely normal — but knowing which things are normal, and which need attention, is genuinely useful. This guide covers the most common newborn health questions with honesty and warmth.
🌿 Open full lesson in WiseMama — free, with quizzes & flashcardsNewborn Jaundice
Jaundice — a yellowing of the skin and whites of the eyes — affects around 60% of newborns and 80% of premature babies. In the vast majority of cases it is physiological jaundice: a normal, transient response to the breakdown of fetal red blood cells as the newborn transitions to a different type of haemoglobin. It is not caused by anything you did, and it is not a sign of illness in most cases.
Physiological jaundice typically appears on day 2–3, peaks around days 4–5, and resolves on its own by week 2. Your midwife will assess your baby using a transcutaneous bilirubinometer (a handheld device held against the skin) or a blood test if levels appear elevated. Mild to moderate jaundice usually requires only monitoring and good feeding to support clearance.
When jaundice needs treatment
If bilirubin levels are high enough, phototherapy — exposure to a specific wavelength of blue light — is used to break down bilirubin in the skin. It is effective and well-tolerated. Your baby lies under or is wrapped in a bililight (a blanket of fibreoptic light), wearing small eye shields. Treatment typically lasts 24–48 hours. Feeding frequently during phototherapy is important — good hydration and milk intake helps flush bilirubin from the body.
Our baby had jaundice bad enough for phototherapy. We were handed a baby in a light box with sunglasses on and no instruction. What nobody said: treatment is usually 24–48 hours, it works, and the tiny sunglasses are genuinely adorable. Ask your ward nurse to explain every tube and light before they leave the room.
Newborn Breathing
Newborn breathing is startlingly different from adult breathing, and it alarms most new parents at some point. Understanding what is normal makes the 3am breathing check significantly less frightening.
Newborns are obligate nose breathers — they breathe primarily through their nose rather than their mouth. Their breathing rate is much faster than adults (30–60 breaths per minute), irregular in pattern, and interrupted by perfectly normal pauses of up to 10 seconds. They grunt, snuffle, squeak, and make a remarkable variety of sounds in their sleep. This is all completely normal.
I called 111 at 2am because my 6-day-old was breathing funny. It turned out to be normal newborn breathing — they're very noisy, irregular breathers. But I will never regret making that call. You cannot overcommunicate your concern about a newborn. 111 and midwives expect and welcome those calls.
Newborn Skin
Newborn skin goes through a remarkable amount of change in the first weeks, and most of it looks considerably more alarming than it is. Here is a guide to the most common things you might see.
Vernix
The white, cheese-like coating sometimes present at birth is vernix caseosa — a protective substance that develops in the third trimester. The WHO recommends leaving it in place rather than washing it off immediately, as it has antimicrobial and moisturising properties. It absorbs naturally within 24 hours.
Milia
Small white spots across the nose and cheeks, sometimes called "milk spots," affect around half of all newborns. They are caused by blocked sebaceous glands and require no treatment — they resolve on their own within a few weeks.
Baby acne
Red or white pimples on the face, chest, or back, typically appearing between 2 and 4 weeks and resolving by 3–4 months. Caused by maternal hormones still present in the baby's system. No treatment is needed — simply keep the skin clean and avoid creams or lotions.
Cradle cap (seborrhoeic dermatitis)
Thick, yellowish or brownish scaly patches on the scalp, commonly appearing in the first weeks and lasting several months. It looks more unpleasant than it is — it does not cause the baby any discomfort and is not caused by poor hygiene. Gently massaging baby oil into the scalp and brushing away the scales with a soft brush helps manage it. It almost always resolves on its own by 12 months.
Erythema toxicum
A rash of red blotches with small white or yellow centres, affecting up to half of all newborns in the first few days. Despite its alarming name, it is entirely benign and resolves within 2 weeks without treatment.
Colic, Reflux, and the Unsettled Baby
Few words in early parenthood are used more loosely than "colic." In medical terms, colic is defined as crying for more than three hours a day, more than three days a week, for more than three weeks, in an otherwise healthy, well-fed baby. By this definition, it affects around 20% of babies. It peaks around 6 weeks and almost always resolves by 3–4 months.
The honest answer about colic is that its cause is still not well understood, which is partly why it is so difficult to treat. Carrying, rocking, white noise, and skin-to-skin contact are the most reliably helpful strategies — not because they solve anything, but because they meet the baby's nervous system needs and reduce distress.
Reflux
Gastro-oesophageal reflux — stomach contents washing back up the oesophagus — is extremely common in young babies because the lower oesophageal sphincter is immature. Most babies reflux to some degree; in many it causes no distress beyond posseting (small bringing-up of milk). Silent reflux (reflux without visible vomiting) can cause significant discomfort and feeding reluctance. Signs include arching of the back during or after feeds, persistent crying, and feeding refusal despite apparent hunger.
If you think your baby has reflux causing significant distress, speak to your GP. Positioning strategies (keeping baby slightly upright after feeds), smaller and more frequent feeds, and if breastfeeding, maternal dietary adjustments, can all help. In more severe cases, medication is available. A diagnosis of silent reflux can be elusive — be persistent with your GP if symptoms continue.
Your Newborn's Checks and Screenings
The NHS provides a structured set of checks for all newborns in the first days and weeks. Understanding what each involves removes the anxiety of being in a clinical setting with a new baby and a head full of questions.
- APGAR score (1 and 5 minutes after birth) — a quick assessment of Appearance, Pulse, Grimace, Activity, and Respiration. Scored out of 10; 7 or above is reassuring. This is done while you hold your baby — it does not interrupt skin-to-skin unless the score is low.
- Newborn physical examination (within 72 hours) — a head-to-toe check by a paediatrician or trained midwife, covering the eyes, heart, hips, and testes in male babies. This is also done at 6–8 weeks by your GP.
- Heel prick test (day 5) — a small blood sample taken from the baby's heel to screen for nine conditions: PKU, congenital hypothyroidism, cystic fibrosis, sickle cell disease, MCADD, MSUD, IVA, GA1, and HCU. Most results are normal; you will only be contacted if further investigation is needed.
- Newborn hearing screening — a quick, painless test (OAE or AABR) offered before discharge or in the first few weeks. Most babies pass first time; a referral for further testing is not a confirmed hearing loss, just a need for more information.
- 6–8 week check — with your GP. Reviews your baby's growth, development, feeding, and your own postnatal wellbeing.
Sticky eyes are extremely common in newborns and are usually caused by a blocked tear duct rather than infection. The tear duct is often not fully open at birth and takes a few weeks to clear. The recommended treatment is gentle massage of the inner corner of the eye (along the nose) several times a day, and wiping away discharge with a clean cotton wool ball dampened with cooled boiled water. If the white of the eye becomes red or there is significant yellow-green discharge, see your GP as this may indicate conjunctivitis requiring antibiotic drops.
Yes, completely normal. Newborns hiccup frequently — sometimes for prolonged periods — because the diaphragm is immature and easily stimulated. Hiccups do not cause the baby any distress, despite looking uncomfortable to a watching parent. They tend to reduce in frequency naturally over the first few months. No intervention is needed.
After regaining their birth weight by around day 10–14, most babies gain approximately 150–200g per week in the first few months. Your health visitor will plot your baby's weight on a growth chart at each check. What matters most is that the trajectory is upward and consistent — crossing centile lines downward, or persistent weight loss after day 5, warrants a feeding review. Single weigh-ins are less useful than the pattern over time.
The umbilical cord stump — the remnant of the cord clamped at birth — dries, shrivels, and falls off on its own, usually within 1–2 weeks. Keep it clean and dry; fold nappies down below it to allow airflow. Do not try to pull it off. Signs of infection include redness, swelling, or discharge around the base, or a stump that smells unpleasant — if you notice these, contact your midwife or GP.