First pillar
Medical prevention
Before discharge: examine the baby, measure growth, complete newborn screening, provide preventive treatment, and identify feeding, jaundice, breathing, or birth concerns early.
Academy · Prevention · Pediatrics
Newborn
Preventive visit
Know what happens before discharge—and what your baby needs in the first days home.
Use this guide to understand newborn screening and protection, recognize whether feeding is going well, prepare the home, and know which signs should not wait.
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Start here · Five useful questions
The first days feel less scattered when the plan is visible.
Second pillar
Lifestyle prevention
From the first day: support feeding, protect every sleep, build connection, care for caregivers, and create a smoke-free, substance-safe, infection-conscious home.
Before going home
The hospital stay follows one clear arc: review, check, screen, protect, plan.
The order may vary, but these are the major parts of routine newborn preventive care.
01
Review
Pregnancy, delivery, maternal test results, family history, medicines, exposures, and birth complications.
02
Check
Weight, length, head size, vital signs, feeding, reflexes, movement, and a complete examination.
03
Screen
Bloodspot, hearing, heart, and bilirubin screening.
04
Protect
Hepatitis B, vitamin K, eye ointment, and RSV protection when indicated.
05
Plan
Feeding, sleep, car safety, jaundice, warning signs, results, and the first follow-up.
The first examination
A complete check from head to toe.
The clinician checks the baby’s skin, head, eyes, mouth, heart, lungs, abdomen, hips, spine, genitals, cord, reflexes, tone, and movement. Feeding, alertness, consolability, hearing response, wet diapers, and stools are part of the assessment too.
Ready to leave
A discharge list you can actually use.
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Screening and protection
Some care looks for hidden problems. Some prevents them.
Routine newborn care is shown first. Decisions based on birth weight, maternal history, season, or the baby’s condition remain separate.
Routine newborn screening
Bloodspot
A small blood sample screens for serious conditions included in the state newborn program.
Usually 24–48 hours
Hearing
Checks whether hearing needs further assessment.
Before discharge or by 1 month
Heart
Oxygen levels in the right hand and one foot screen for critical congenital heart disease.
At 24 hours or later, or before earlier discharge
Bilirubin
A skin or blood measurement helps assess the risk from jaundice.
24–48 hours, or before earlier discharge
Why results matter
Screening is only complete when results are followed.
Before leaving, know which screens are complete, which results are still pending, and how the care team will contact you. An abnormal result needs prompt follow-up and confirmatory testing through the appropriate state pathway.
Medical protection at birth
Three routine protections, plus a seasonal decision.
Hepatitis B
The first vaccine dose is given within 24 hours to a medically stable baby weighing at least 2,000 grams. Lower weight or maternal hepatitis B status changes the timing.
Vitamin K
A one-time injection soon after birth prevents dangerous bleeding. The dose depends on birth weight. Oral vitamin K is not considered an equivalent alternative in the United States.
Eye ointment
Erythromycin ointment is applied within 24 hours to prevent gonococcal eye infection. It does not prevent chlamydial conjunctivitis.
May be recommended for your baby
RSV protection
Whether the baby receives nirsevimab or clesrovimab depends on the season and RSV vaccination during pregnancy. Vaccination at least 14 days before delivery generally means infant antibody is not needed, except in rare higher-risk circumstances.
When infant protection may be needed
When vaccination during pregnancy was not given, is unknown, occurred in a prior pregnancy, or occurred less than 14 days before delivery. Timing then depends on the baby’s birth season.
Only when needed
Testing based on history
Blood-group testing, G6PD testing, and toxicology testing are not routine for every newborn. Maternal blood type, ancestry together with severe or unexplained jaundice, suspected exposure, or clinical findings may change the plan.
A family decision
Circumcision is optional
Circumcision is a family choice, not routine care for every newborn. The procedure requires informed consent, pain control, and a baby who is medically stable.
Location matters
Eye-ointment practices vary
Routine eye ointment is recommended in the United States and is legally required in many states. Practices differ in other countries.
Feeding and growth
Watch the baby, the diapers, and the weight—not only the clock.
Feeding is both a daily-life practice and one of the most important medical assessments in the first days.
Signs to follow
Feeding, hydration, stools, and weight move together.
By day 4, at least six wet diapers each day, changing stools, and limited weight loss are reassuring signs.
Weight loss greater than 7% by days 3–5—or greater than 10% at any time—needs evaluation.
Breastfeeding
Feed at least 8–12 times in 24 hours. Skin-to-skin contact and an observed feeding before discharge and at follow-up help identify latch, milk transfer, or supply concerns.
Formula feeding
Use iron-fortified formula and prepare it exactly as directed. Do not dilute it or add other supplements unless medically directed.
What the team watches
Latch or bottle feeding, swallowing, alertness, feeding cues, urine, stools, weight change, and caregiver concerns.
Where support belongs
Feeding questions deserve help before discharge and again at the 3–5-day visit. Lactation consultation is part of the available plan when needed.
First days at home · Contrada second pillar
The everyday environment is part of newborn care.
In the first week, feeding, sleep, touch, caregiver support, and exposure avoidance carry the most weight.
First-days practice 01
Protect every sleep
Place the baby on the back on a firm, flat, non-inclined crib or bassinet surface with only a fitted sheet. Share the room without sharing the bed. Keep soft items out and avoid overheating.
First-days practice 02
Feed and connect
Feed often, use skin-to-skin contact, and respond calmly to feeding and crying cues. Ask for help when feeding or exhaustion feels difficult to manage.
First-days practice 03
Support the caregivers
Name the primary caregivers and support network. Pay attention to stress, sleep deprivation, coping, sibling adjustment, and whether the family has enough practical support.
First-days practice 04
Reduce exposures
Keep the home and car free of tobacco and nicotine. Avoid alcohol, marijuana, opioids, and illicit drugs while breastfeeding or caring for the baby.
First-days practice 05
Move while awake
Begin short periods of supervised, awake tummy time after discharge and build gradually toward 15–30 minutes total each day by 7 weeks.
First-days practice 06
Prepare the surroundings
Use a rear-facing car seat for every ride, not as a sleep space outside travel. Use careful hand hygiene, limit sick contacts, and keep the cord clean and dry.
Pacifiers, swaddling, and monitors
Offer a pacifier at sleep after breastfeeding is established. Swaddling does not reduce sudden infant death risk; if used, keep the baby on the back and stop when signs of rolling begin. Home cardiorespiratory monitors do not replace safe-sleep practices.
When to get help
In a newborn, a few signs should change the plan immediately.
This is a focused guide, not a complete emergency manual. If the baby appears seriously unwell, seek medical care.
Medical emergency
Any rectal fever
A rectal temperature of 100.4°F (38°C) or higher before 2 months is a medical emergency.
Seek care now
Breathing difficulty, unusual sleepiness or poor responsiveness, persistent vomiting, or a baby who appears seriously unwell.
Feeding and jaundice
Poor feeding, fewer wet or dirty diapers than expected, concerning yellow skin or eyes, excessive sleepiness, or a high-pitched cry.
Developmental or behavior concerns to raise
Discuss very low or high muscle tone, movement that is not equal on both sides, absent response to sound, inability to fix briefly on a face, weak suck, poor feeding, unusual lethargy, or inconsolability.
Cord and circumcision concerns
Keep the cord clean and dry and follow the care plan provided. Review circumcision care when applicable and contact the care team about concerns.
First follow-up
Next routine visit: 3–5 days of life.
This check is close by because feeding, weight, hydration, jaundice, and screening follow-up can change quickly.
The immediate next step
Recheck feeding, weight, and jaundice.
The visit also reviews hydration, the home feeding plan, pending or abnormal screening results, and new family concerns. Bring discharge paperwork and questions.
After that
The 1-month visit
Formal caregiver postpartum-depression screening begins at the 1-month visit, 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 national pediatric preventive-care recommendations and evidence reviews. Where recommendations differ, those differences are identified explicitly.