Academy · Prevention · Pediatrics
A calm guide to the first days—and the first trip home.
Understand what happens before discharge, what to watch at home, and what will be checked again at the 3–5-day visit.
Newborn visit overview
Newborn preventive care starts during the birth hospitalization and continues at the first check, usually at 3–5 days of life.
First pillar
Second pillar
What happens at the newborn visit
Care begins in the hospital and is revisited soon after discharge. The order may vary, but these are the core parts.
01
Pregnancy and delivery, family history, maternal test results, medications, exposures, and any birth complications.
02
Weight, length, head size, vital signs, and a full examination from reflexes and feeding to the heart, hips, skin, and cord.
03
Latch or bottle feeding, swallowing, alertness, consolability, movement, hearing response, wet diapers, and stools.
04
Bloodspot, hearing, heart, and bilirubin screening are routine for newborns.
05
Hepatitis B, vitamin K, and eye ointment are addressed; RSV protection depends on season and maternal vaccine history.
06
Safe sleep, car-seat use, jaundice, feeding, infection avoidance, urgent warning signs, and the 3–5-day follow-up.
Screening and protection at birth
These labels help separate routine care from decisions based on birth weight, maternal history, season, or the baby’s condition.
A small blood sample screens for serious conditions included in state newborn programs, usually at 24–48 hours.
Completed before discharge, or by 1 month at the latest.
Oxygen levels in the right hand and a foot screen for critical congenital heart disease at 24 hours or later—or before an earlier discharge.
A skin or blood measurement checks jaundice risk between 24 and 48 hours, or before an earlier discharge.
Medical protection at birth
For a medically stable baby weighing at least 2,000 g, the routine first dose is given within 24 hours. Lower birth weight or maternal hepatitis B results change the timing.
A one-time injection soon after birth helps prevent dangerous bleeding. The dose depends on birth weight.
Erythromycin ointment is applied within 24 hours to prevent gonococcal eye infection. U.S. guidance supports routine use; international guidance differs.
Whether a baby receives nirsevimab or clesrovimab depends on the season of birth and maternal RSV vaccination. A maternal dose at least 14 days before delivery generally means the baby does not need an antibody, except in rare high-risk circumstances.
Protection is needed when maternal vaccination was not given, is unknown, occurred in a prior pregnancy, or was given less than 14 days before delivery. A baby born October–March receives it within the first week when eligible; a baby born April–September receives it shortly before RSV season.
Blood-group testing, G6PD testing, or toxicology testing is not universal. Each is considered only when maternal history, ancestry, jaundice, suspected exposure, or the baby’s condition supports it.
Feeding and growth in the first days
The care team watches how the baby feeds, hydrates, and changes weight—and repeats that assessment at the first follow-up.
Growth check
Weight loss greater than 7% by days 3–5—or greater than 10% at any time—needs evaluation.
Feed at least 8–12 times in 24 hours. Skin-to-skin contact and an observed feeding assessment before discharge and at follow-up help identify latch, transfer, or supply concerns.
Use iron-fortified formula and review safe preparation and storage. Do not add water or other supplements unless medically indicated.
By day 4, the supplied guidance identifies at least six wet diapers a day, changing stools, and limited weight loss as reassuring signs.
Clinicians observe movement on both sides, newborn reflexes, brief visual fixation, response to sound, feeding cues, sleep-state changes, and consolability. There is no routine formal developmental screen now.
Safety in the first week
Safe sleep
Offer a pacifier for sleep after breastfeeding is established. Swaddling does not reduce sudden infant death risk; if used, keep the baby on the back and stop when rolling begins.
Seek care now
Also seek care for poor feeding, unusual sleepiness, breathing difficulty, persistent vomiting, fewer wet or dirty diapers than expected, or concerning jaundice.
Use a properly installed rear-facing seat for every ride. Do not use it as a sleep space outside travel.
Use careful hand hygiene and limit contact with people who are sick.
Keep the cord clean and dry. Review circumcision care when applicable and watch for jaundice.
Healthy daily life · Contrada second pillar
In the newborn period, feeding, sleep, touch, support, and exposure avoidance carry the most weight.
Nutrition
Breast milk is recommended as the exclusive nutrition source for about 6 months. When formula is used, use iron-fortified formula. Feeding cues, swallowing, diapers, weight change, and an observed feeding help show whether intake is adequate.
Begin short, supervised tummy-time periods after discharge and build gradually toward 15–30 total minutes a day by 7 weeks.
Use the same safe-sleep plan for every nap, every night, and every caregiver.
Skin-to-skin contact, calm responses to cues, and support for caregiver stress help bonding and adjustment.
Keep the home and car free of tobacco and nicotine. Avoid alcohol, marijuana, opioids, and illicit drugs while breastfeeding or caring for the baby.
Looking ahead
This first outpatient check is close by because feeding, weight, jaundice, and screening follow-up can change quickly in the first days.
Primary next step
Expect weight, bilirubin, and feeding to be reassessed. Bring questions and confirm how all newborn-screening results will be communicated.
After that
Formal caregiver postpartum-depression screening begins on the AAP schedule at 1 month, then repeats at 2, 4, and 6 months.
References & review
This family guide was last reviewed August 10, 2026. It is educational and does not replace individualized clinical care.
Evidence reviewed includes guidance from the American Academy of Pediatrics and Bright Futures, CDC/ACIP, USPSTF, HHS/ACHDNC, JCIH, ACOG, and FDA. Where recommendations differ, those differences are identified explicitly.
