What kinds of development occur in your baby's first month?
Babies are called newborns during their first month of
life. Although your newborn sleeps a lot, powerful changes are occurring in the
five major areas of development.
Watching your baby grow in size is part of the fun of being a new parent. Don't
be alarmed if your newborn loses some weight shortly after birth. This weight
usually is regained within 10 to 12 days. Most newborns gain about
4 oz (113 g) to
8 oz (227 g) a week and grow
about 1 in. (2.5 cm) to
1.5 in. (3.5 cm) in the first
Cognitive development. Cognition is
the ability to think, learn, and remember. Your newborn's brain is developing
rapidly. You promote healthy brain growth every time you interact in a positive
way with your baby.
Emotional and social development. Newborns quickly learn to communicate. They seek
interaction with you and express how they feel with sounds and facial
expressions. At first, instinctual behaviors, such as crying when
uncomfortable, are your baby's ways to signal his or her needs. Soon your
newborn starts to subtly communicate and interact with you. For example, your
baby's eyes will track your movements. And his or her face will brighten when
you cuddle and talk soothingly. Even at a few days old, your baby may try to
mimic you sticking out your tongue.
Language development. Your newborn is listening to and absorbing the basic and
distinct sounds of language. This process forms the foundation for
Sensory and motor skills development. Newborns have all five senses. Your newborn quickly learns
to recognize your face, the sound of your voice, and how you smell. Your
newborn's sense of touch is especially developed, particularly around the
mouth. Your baby also has a strong sense of smell. After a few days, your
newborn hears fairly well and responds most noticeably to high-pitched and loud
sounds. Your baby recognizes and prefers sweet tastes to those that are sour,
bitter, or salty. Vision is developing quickly but is believed to be the
weakest of the senses.
Motor skills develop as your baby's muscles and nerves
work together. Movements are mostly controlled by
reflexes, such as the rooting reflex, which is when a
newborn's head turns and his or her mouth "reaches" toward a touch. Hands are
tightly fisted when the baby is alert.
How can you help your newborn grow and develop?
The most important way to help your baby grow and develop is to
communicate with him or her. Use a high-pitched voice, gentle touch, hugs, and
kisses. An environment that is rich in stimulation, comfort, and loving
attention enhances many areas of a baby's development. Research shows that
babies who are talked to throughout their first few years usually learn
language skills more easily than those who are not. Newborns are more
interested in their caregivers than they are in toys or other objects.
How do you know if you are caring for your newborn correctly?
You may feel overwhelmed during your baby's first
month and wonder "Am I doing this right?" No previous life experiences prepare
first-time parents for this new role. It is completely normal to be confused
and frustrated by your newborn.
You will become familiar with
your newborn's needs by paying attention to his or her behavior. For example, a
fussy cry and turning away usually means "Change what we are doing." And an
alert, bright-eyed look means "I am interested in what's going on." Trusting
your instincts—to cuddle and rock a crying baby or to talk to your baby in a
high-pitched "baby talk" voice—is usually the "right" thing to do. You will
begin to develop a rhythm with your baby, where you will be able to read each
other's needs and moods.
What kinds of checkups should your newborn have?
Your baby's doctor will likely recommend a specific schedule of routine
newborn visits. These visits are important to check for problems and to make sure that your child is growing and developing as expected.
Do not be
afraid to call your baby's doctor any time you have concerns about your
newborn's health or general care. It is normal and expected for parents of
newborns to have questions and to make frequent visits and calls to the
Physical development. Your newborn
gains about 0.7 oz (20 g) a
day, or about 4 oz (113 g) to
8 oz (227 g) a week in the
first month. He or she grows about
1 in. (2.5 cm) to
1.5 in. (3.5 cm) in length by
age 1 month.
You may wonder whether your baby's daily patterns are
typical. During your baby's first few weeks, most of your time will be spent
simply making sure your baby is fed every few hours, comforted, and held, and
has his or her diaper changed. Pay attention to cues. You will begin to
discover your baby's individual needs and preferences.
following information can give you an idea about what to expect about your
Reflexes. Babies are born with a number of automatic
physical responses that help them handle their world.
Sleeping and eating patterns. A newborn's main routines center around these two
activities, although by about 3 weeks of age, he or she begins to socialize
Diaper habits. You can expect to change your newborn's
diaper frequently. The specific number of times a day varies and in part
depends on whether you feed your baby breast milk or formula.
Crying. Newborns cry when they are hungry, tired,
overstimulated, or otherwise uncomfortable. They may also cry for no apparent
reason and be difficult to console.
Although you may feel prepared for
your baby, the reality of the constant care a newborn needs can shock many
parents. A newborn affects your life in ways that simply can't be anticipated.
It is only through experience that you can fully understand the impact of
these new responsibilities and how your expected roles change. It is normal to
shift frequently between feeling confident and ecstatic one minute, and
drained, scared, and unsure the next.
When you realize that your
baby is physically completely dependent on you, you may worry whether you are
giving your baby the best care. Common concerns in this first month
Umbilical cord care. Basic care of your
baby's umbilical cord is keeping it clean and dry. Gently clean the umbilical
cord stump and the surrounding skin at least one time a day and as needed
during diaper changes or baths. Gently pat the area dry with a soft cloth. The
stump usually falls off within a couple of weeks.
Your newborn's sleepiness. Especially in the first few
days after birth, your baby may seem to be in a distant world, only pausing
long enough in this one to wake you up for a little snack or a diaper change.
Your baby will become gradually more alert throughout the month. By the end of
the first month, your baby will likely begin developing sleeping and eating
patterns. In general, your baby will likely have periods where he or she is
awake for 2 or 3 hours straight. Around 3 months of age, the patterns will
become more predictable.
Your exhaustion and sleep deprivation.
Although newborns sleep a lot, they also wake up a lot for brief periods and
need feeding, diapering, and attention. Nights of long, restorative sleep can
seem a foggy memory to parents. This may be especially true for mothers, who
start with a deficit after the physical exertion of and recovery from giving
birth. Be sure to ask for help when you need it. Don't hesitate to ask a family
member, friend, or neighbor to help you with daily tasks, such as laundry,
cleaning, or making meals. This can help you to nap while your baby sleeps
instead of doing chores.
Worry over whether your baby is getting
enough to eat. This is especially a common concern among
breast-feeding mothers. As long as your baby feeds
regularly (every 1 to 3 hours in the first few weeks, then 2 to 4 hours over
the next few weeks), he or she should be fine. Sometimes you may need to
wake a sleepy baby to eat. It's good to check your baby's diaper for
signs that your baby is getting enough breast milk. For example, your baby may have about 3 wet diapers a day for the first few days. After that, expect 6 or more wet diapers a day throughout the first month of life. During
well-child checkups, the doctor will monitor your
baby's weight gain and growth.
Urine color. The urine should be yellow. Don't be alarmed, though, if you notice a pink color to the urine during your newborn's first 3 days of life. It is common for newborns to pass crystals in the urine (highly concentrated urine) which makes the urine look pink. If the pink color lasts, or if at any time your baby seems to be in pain while urinating, call your doctor.
Newborn jaundice. Many babies get
jaundice (also called hyperbilirubinemia) in their first few days of life.
Jaundice is a condition in which the skin and the whites of a baby's eyes
appear yellow because of a buildup of
bilirubin in the blood. Bilirubin is a yellow-brown
substance produced by the breakdown of red blood cells. Although jaundice
should be monitored, it most often does not require medical treatment. Usually,
increasing the number of feedings helps reduce jaundice.
Phototherapy, in which a baby is placed under special
lights or fiber-optic blankets, may be used if bilirubin levels are too high.
Keep your baby's well-child appointments with your doctor, or call anytime if
you are concerned about jaundice or your baby's skin. For more information, see
Jaundice in Newborns.
Skin care. In general, use mild shampoo or soap when you bathe your baby. Avoid lotions and other skin care products unless your doctor tells you otherwise. Newborns have sensitive skin, and healthy newborn skin doesn't need skin care products applied. For more information, see
Newborn Rashes and Skin Conditions.
misshapen head. Right after birth, especially after lengthy vaginal
deliveries, your baby's head may look misshapen. This is normal, and your
baby's head will most likely take on a more normal shape within a few days to
weeks after delivery. In rare instances, a misshapen head can be a sign of
an abnormal condition, such as
craniosynostosis. After your baby is born and during
your baby's well-child checkups, your doctor will monitor your baby's head
shape and skull growth. If you are concerned that your newborn's head has not
returned to a normal shape within several weeks of delivery, talk with your
It is normal to question your feelings for your baby.
A bond doesn't necessarily happen the moment you set eyes on your child. But
you will develop stronger feelings and love for your baby every day. For some
parents, it takes time to develop this bond, especially when the baby's
physical demands take a great deal of time and energy. Talk to your doctor if
you do not feel that you are bonding with your baby in the first week or
Also keep in mind:
Your baby will soon be able to engage with you.
But this first month, your baby may seem to be in a semi-conscious state.
Sleeping and eating are a newborn's main activities. He or she will gradually
emerge from this groggy state, and you can rest assured that your loving care
will be rewarded with interaction very soon.
Gradually within the
first month, your newborn will begin to look more "baby-like." Although many
parents don't like to admit it, even to themselves, it is common to feel
disappointed that their baby isn't as cute as they had hoped. If you feel this
way, don't despair. Labor and delivery takes its toll on your baby's
appearance. He or she may have an odd-shaped head, swollen or squinty eyes,
blotchy skin, and a flattened nose in the first few weeks. Soon, these
irregularities will fade away and your baby will start to develop more
Your baby may have a
birthmark that is noticed at birth or within this
first month. Most birthmarks need no treatment. They often fade as a child
grows older. But sometimes a birthmark needs treatment or close monitoring.
Talk to your doctor if you have concerns. For more information, see the topic
Although you will go through some major adjustments to this
new little person in your life, your baby's first month is also a period of
amazing growth and change. Treasure these first weeks as you gradually
introduce your baby to the world.
Promoting Healthy Growth and Development
growth and development, newborns need physical and emotional care. You enhance
development and give your newborn a sense of security and being loved by:
Although your baby's needs are basic, it is important to
respond promptly to his or her cues and to recognize safety issues.
Reduce the risk of
sudden infant death syndrome (SIDS) by always placing
your baby to sleep on his or her back (not on the stomach). Make sure that the
crib mattress is firm and covered by a sheet and that there are no pillows or
blankets that could block the baby's mouth or nose. For more information, see
Sudden Infant Death Syndrome (SIDS).
Support your newborn's head. In the first few months, your baby's
neck muscles are weak, and the head needs to be supported at all
car seat that is appropriate for a newborn, and use it properly. And always
use a car seat when traveling with your baby on an airplane.
leave your baby alone with a
Never leave your newborn alone or in
the care of an older child while the baby is:
On a changing table or other
place where he or she could fall or get injured.
Post emergency numbers in several places throughout your house. Or store them in your cell phone. Include
numbers for your doctor, friends, and neighbors. Keep your
local Poison Control Center number handy, too.
Never shake your
baby. A baby's skull is not developed enough to protect it against injury.
Shaking your baby in anger or frustration can lead to
shaken baby syndrome.
Get help right away if you feel that you or another
caregiver might hurt your baby. Call 911
if it is an emergency. Call your doctor, a friend, a relative, or a parent
hotline if you are feeling overwhelmed to the point that you feel you are not
able to care for your baby.
your doctor if you think you or your partner has
postpartum depression. It can make a mom feel very
sad, hopeless, and worthless. And she may have trouble caring for and bonding
with the baby. For more information, see the topic
When to Call a Doctor
Call your doctor right away if you notice anything that concerns you. You are the
expert on your baby. Although usually everything is fine, do not be afraid to
contact your doctor for any reason.
Physical problems to watch
for in your newborn include:
An umbilical cord stump that looks infected, as
indicated by pus or reddened skin at the base of the cord.
Signs of dehydration, such as having no wet diapers for 6 hours.
Not having regular bowel movements.
Jaundice that has
not improved by 4 days after birth.
Be sure to call your doctor if your newborn:
Cries in a peculiar manner or for an
unusual length of time.
circumcision problems. Signs may include
greater-than-expected bleeding at the circumcision site, a bloodstained area
larger than the size of a grape on his diaper or wound dressing, or signs of
infection (such as swelling and redness).
rectal temperature that is less than
97.8 °F (36.6 °C) or that is 100.4 °F (38 °C) or higher.
rarely awake and does not wake up for feedings, or seems too tired or
uninterested to eat.
Talk to your doctor if you are concerned about the
Your baby seems to be acting odd, even though
you can't identify exactly what concerns you.
You feel that you are
unable to nurture your newborn.
You feel that you are unable to
emotionally connect with your newborn. Although it is normal to feel some
distance at first, you should develop increasing feelings for your baby during
the first week or two.
Your baby's first checkup
begins in the hospital right after birth when a nurse assesses the baby's
Apgar scores. This test checks certain physical traits
to help determine whether your newborn needs any interventions or special
monitoring right away. Temperature and vital signs are always closely watched
during the baby's first 6 hours. Your baby may also have the following soon
A thorough physical exam. Within 24 hours of
birth, a doctor will examine your baby, check his or her breathing and
heartbeat, and assess the baby's ability to pass urine and
Measurements of length, head circumference, and
Antibiotic eyedrops. Because
newborns can get eye infections from bacteria in the birth canal, some states
require that antibiotic eyedrops or ointment be given.
Injections, such as vitamin K, and possibly some
immunizations, such as for
In the first weeks after birth,
your baby begins a series of health exams, sometimes called
well-child visits. Doctors have individual approaches
to the timing of these appointments. During one or more of these visits, your baby will have:
Length, weight, and head circumference
measurements taken. These measurements are plotted on a growth chart and are
compared to previous and later markings to make sure the baby is growing as
A physical exam. The doctor examines your baby
thoroughly for any problems. The doctor also assesses the baby's
reflexes and general development and observes how you
and your baby interact. You are asked questions about how the baby and the rest
of the family are doing, how the baby is eating and sleeping, and whether you
have noticed any changes in behavior.
Immunizations. Your doctor can provide you with a schedule so that you
know how many vaccines to expect at each visit. For more information, see the
Screening test follow-up, if needed.
Routine checkups are a good time for parents to ask about
what to expect in the weeks to come. You may find it helpful to go to your
baby's checkups with a prepared
list of concerns(What is a PDF document?).
Other Places To Get Help
141 Northwest Point Boulevard
Elk Grove Village, IL 60007
This American Academy of Pediatrics website has information for parents about childhood issues, from before the child is born to young adulthood. You'll find information on child growth and development, immunizations, safety, health issues, behavior, and much more.
P.O. Box 571272
Washington, DC 20057-1272
The Bright Futures Web site offers current information
about health promotion and health care needs of infants, children, teens,
families, and communities. Bright Futures is sponsored by the National Center
for Education in Maternal and Child Health at Georgetown University.
KidsHealth for Parents, Children, and
Nemours Home Office
10140 Centurion Parkway
Jacksonville, FL 32256
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
Buescher JJ, Bland H (2011). Care of the newborn. In RE Rakel, DP Rakel, eds., Textbook of Family Medicine, 8th ed., pp. 402–420. Philadelphia: Saunders.
Hagan JF, et al., eds. (2008). Health supervision:
Newborn visit. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 271–288.
Elk Grove Village, IL: American Academy of Pediatrics.
Olsson J (2011). The newborn. In RM Kleigman et al., eds., Nelson Textbook of Pediatrics, 19th ed., online chap. 7. Philadelphia: Saunders. Available online: http://www.expertconsult.com.
Thilo EH, Rosenburg AA (2012). The newborn infant. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 9–72. New York: McGraw-Hill.
How this information was developed to help you make better health decisions.