The everyday stuff, honestly

How much crying is normal?

More than feels normal. The largest analysis of infant crying pooled 28 diary studies covering 8,690 infants. Fussing and crying averaged 117 to 133 minutes a day across the first six weeks, roughly two hours, and dropped to a mean of 68 minutes a day by 10 to 12 weeks (Wolke, Bilgin & Samara, 2017). The spread is wide: standard deviations of over an hour, so a baby who cries three hours a day at five weeks is still inside the ordinary range.

The American Academy of Pediatrics describes normal fussiness as peaking around six weeks and declining to one or two hours a day by three to four months, commonly in the evening. The meta-analysis found no statistically universal six-week peak across studies, only a plateau then a drop after eight to nine weeks. Either way, the direction is the same: it gets better, and it gets better soon.

Colic has an expiry date

Colic, defined by the modified Wessel criteria (roughly: crying more than three hours a day, more than three days a week), affected 17 to 25% of infants in the first six weeks, 11% at eight to nine weeks, and 0.6% at 10 to 12 weeks (Wolke et al., 2017). The AAP puts it at about one in five babies, usually starting between the second and fourth weeks and generally stopping by three to four months; less than 5% of colicky crying is caused by food sensitivity. Colicky infants cry inconsolably, often pulling up their legs and passing gas, and episodes worsen in the early evening.

Baby poop: colors, frequency, and when to call

For the first few days, stools are meconium: the thick, black or dark-green substance that filled the intestines before birth. Once passed, stools turn yellow-green, then settle into the pattern for the diet: yellow, liquid and seedy for breastfed babies; tan to yellow and no firmer than soft clay for formula-fed babies. Green stools "are not unusual, either, and they should not cause alarm" (AAP). Iron supplements can turn stools dark brown.

Frequency varies enormously. Many newborns pass a stool after every feeding (the gastrocolic reflex). By three to six weeks, some breastfed babies go a week between stools and are entirely normal, as long as the stools are soft, the baby is gaining weight steadily and nursing regularly. After a long gap, expect a large one.

Spit-up: how common, and when it stops

"All babies spit up," the AAP says plainly. In a survey of 948 healthy infants across 19 pediatric practices, half of 0 to 3 month olds regurgitated at least once a day. Reported spit-up peaked at 67% at 4 months, dropped sharply from 61% to 21% between six and seven months, and reached 5% by 10 to 12 months (Nelson et al., 1997). Most infants outgrow it by seven months and nearly all by a year.

Mild reflux, small amounts after most feedings in a baby who is not distressed, needs no treatment; burping, calm upright time after feeds and less bouncing help. Spit-up brings up small amounts and does not upset the baby; vomiting is different.

Under 3 months, 100.4 is a phone call

The one number every new parent should know: for a baby younger than 3 months (12 weeks), a temperature of 100.4°F (38.0°C) or higher means call the pediatrician right away (AAP). Not wait and see, and not a dose of anything first. At any age, call if the temperature rises above 104°F (40°C) repeatedly, or if your baby simply looks sick.

Your newborn is supposed to lose weight

A well-nourished newborn loses no more than 8 to 10% of birth weight in the first few days before starting to gain again (AAP). The reassurance is in the diaper, not the scale: by 5 to 7 days old a baby should have 6 or more wet diapers a day with nearly colorless or pale-yellow urine, and at least 3 to 4 yellow, loose stools a day. Breastfed babies nurse 8 to 12 times in 24 hours and seem satisfied for one to three hours between feeds. The first checkup should happen within 48 hours of leaving the hospital, and the weight check there is how adequate intake is confirmed.

Swaddling: the one rule, and the numbers behind safe sleep

The AAP's rule is simple: "Stop swaddling as soon as your baby shows any signs of trying to roll over." There is no fixed age; "some babies start working on rolling as early as 2 months." Swaddle with a thin blanket only, hips free to bend up and out, two or three fingers of room at the chest, baby on the back, and never a weighted swaddle or blanket. Swaddling itself "doesn't reduce the risk of SIDS."

The safe-sleep numbers worth knowing (AAP 2022 policy, HealthyChildren.org): around 3,500 US babies a year die suddenly during sleep; room-sharing without bed-sharing can cut the risk by as much as 50%, and the AAP advises it for at least the first six months; a pacifier at nap and bedtime lowers risk "even if the pacifier falls out"; bed-sharing with a baby under 4 months carries 5 to 10 times the risk, and sleeping with an infant on a couch or armchair up to 67 times. Back, firm and flat, nothing soft in the crib, one more layer than you would wear, no hat indoors.

Newborn reflexes, and when they fade

Many early movements are involuntary, and they are meant to disappear as the brain takes over (AAP): the stepping reflex and the Moro (startle) reflex fade by about 2 months (the startle "peaks during the first month"); rooting by 4 months; the palm grasp by 5 to 6 months; the tonic neck ("fencing") reflex by 5 to 7 months; the plantar (toe) grasp by 9 to 12 months. Not every baby is on exactly this schedule. The Moro and tonic neck reflexes should be symmetrical; tell your pediatrician if they are not.

First tooth: usually 6 months, and the fever myth

"Most babies will develop teeth between 6 and 12 months," usually the lower front teeth first, and "some babies may not have any teeth by their first birthday" (AAP). Teething can raise body temperature slightly, but a true fever, over 100.4°F (38°C), "is not associated with teething"; it is a sign of illness. Clean fingers, solid teething rings or a cold washcloth help; do not use benzocaine gels, teething tablets, homeopathic gels, or amber necklaces. Brush from the first tooth with a rice-grain smear of fluoride toothpaste, and book the first dental visit by the first birthday.

The cord stump

"The umbilical cord stump should dry and fall off by the time your baby is 3 weeks old"; if it is still there beyond that, see the doctor (AAP). Keep it clean and dry, fold the diaper below it, and skip the alcohol. A few drops of blood around the time it falls off are normal, but call if it actively bleeds, or for foul-smelling yellowish discharge, red skin around the base, or crying when it is touched.

Water and juice

The AAP recommends breast milk as the sole source of nutrition for about the first 6 months; formula-fed babies likewise need no extra water. "Around 6 months, you can start offering your baby a little bit of water (4–8 oz/day)" in an open, sippy or strawed cup, mostly to build cup skills. And "infants less than 1 year of age should not drink juice"; fruit is always preferred.

Seven things about your newborn that are true, and sourced

• They chose your voice on day one. In a classic experiment, newborns could make either their mother's voice or another woman's play by changing how they sucked on a pacifier; they learned to produce, and produced more often, their mother's (DeCasper & Fifer, Science, 1980).
• They find the breast by smell. With one breast washed right after delivery and the other not, 22 of 30 newborns placed between them chose the unwashed breast (Varendi, Porter & Winberg, Lancet, 1994).
• They can hear every language's sounds. Young infants discriminate speech sounds across phonetic boundaries regardless of experience, while adults often cannot hear contrasts their own language never used; the ear tunes to the native language(s) toward the end of the first year (Werker & Tees, 1984; Kuhl, 2004).
• Two soft spots, two timelines. The posterior fontanelle "usually closes by age 1 to 2 months" and the anterior "within 7 to 19 months"; they should feel flat and firm. Bulging can signal pressure in the brain, sunken can signal dehydration: call (NIH MedlinePlus).
• They breathe up to three times faster than you. Infants at rest: 30 to 60 breaths a minute; adults: 12 to 20 (NIH MedlinePlus). Rapid breathing with blue or gray lips, the chest pulling in, fever, or labored breathing is an emergency.
• They double by 4 to 6 months. After losing about 10 to 12% of birth weight in the first days, babies gain quickly from about 2 weeks and double their birth weight by 4 to 6 months (NIH MedlinePlus).
• A watery eye is usually a tear duct that hasn't opened. The tearing becomes noticeable in the first 2 to 3 weeks, and "most of the time, the tear duct will open on its own by the time the infant is 1 year old"; gentle massage 2 to 3 times a day can help. Pus, or lids stuck shut, means see the doctor (NIH MedlinePlus).

Seven things that look alarming and usually aren't

Each of these has a normal range and a line that means call. The range is the reassuring part; the line is the part worth memorising.

A flat spot on the head

Researchers examined 440 healthy full-term infants at 7 to 12 weeks of age and found positional plagiocephaly — a flat spot from lying in one position — in 46.6% of them (Mawji et al., Pediatrics, 2013). Nearly one in two. The AAP notes a flat spot "usually rounds out as they grow older and sit up."

The prevention is free and it is tummy time: start "the day your baby gets home from the hospital," 3 to 5 minutes, 2 to 3 times each day, building to 15 to 30 minutes a day by 7 weeks — awake and closely supervised only. Also alternate which end of the crib you lay them down at, vary their position when awake, and limit time in swings, bouncy chairs and car seats (AAP).

Yellow skin: the day it starts is the whole message

Most newborns get some jaundice. It is "usually noticeable when the baby is 2 to 4 days old" and "goes away within 2 weeks." In some healthy breastfed babies, breast milk jaundice appears after day 7 and peaks during weeks 2 and 3 (NIH MedlinePlus).

Call now for jaundice in the first 24 hours. Also call for bright yellow skin, yellow on the soles of the feet, jaundice that keeps increasing or lasts longer than 2 weeks, or a jaundiced baby who is feverish, listless or feeding poorly. Every newborn needs its own follow-up visit after discharge, and the timing depends on how early you went home.

Feeding again already: 10 to 12 times a day is the norm

Breastfed newborns "usually nurse every 2 hours from the start of the feeding to the next feeding so 10-12 sessions in 24 hours is the norm." Bottle-fed newborns eat every 2 to 3 hours, with 8 feeds per 24 hours "generally recommended as the minimum" (AAP). Most breastfed babies take about 1 oz per feeding in the first weeks; bottle-fed babies reach 3 to 4 oz per feeding by the end of the first month.

So a baby who wants to feed again an hour later is not evidence that your milk is failing. That is a newborn stomach doing what it is built to do.

Counting diapers instead of ounces

You cannot measure what a breastfed baby drank. You can count what came out. The AAP gives 2 to 3 wet diapers a day in the first few days, then at least 5 to 6 wet diapers a day after 4 to 5 days, and "by the fourth day your baby should be having at least 4 stools a day."

Fewer than that, or urine that looks dark yellow, is worth a call to your pediatrician today.

The eyes that look crossed (and the flash-photo test)

A wide nasal bridge and the folds of skin beside it cover the inner white of each eye, and that fakes a squint. Ophthalmologists call it pseudostrabismus: "one or both of a child's eyes look misaligned (crossed), but really they are not." It is "common in babies from birth to about 18 months old" and "does not need to be treated" (American Academy of Ophthalmology).

The check takes thirty seconds. Take a flash photo with your baby looking straight at the lens. If the small light reflection sits in the same place in both eyes — usually the centre of the pupil — the eyes are aligned. If the reflections sit in different places in each eye, book an eye doctor. A child "can outgrow pseudostrabismus but not strabismus," and true strabismus "should be evaluated promptly" (NIH MedlinePlus), because it affects how vision develops.

Peeling, bumps and baby acne: there is a calendar

Newborn skin runs to a schedule (NIH MedlinePlus, Skin findings in newborns): "by the baby's second or third day, the skin lightens somewhat and may become dry and flaky." A red blotchy rash, erythema toxicum, "tends to appear on the face, trunk, legs, and arms about 1 to 3 days after delivery" and "disappears by 1 week." Milia — "tiny, pearly-white, firm raised bumps on the face" — "disappear on their own." And "mild acne that most often clears in a few weeks" is "caused by some of the mother's hormones that stay in the baby's blood."

None of it needs lotion, scrubbing or popping. What is not on this calendar: blisters, pus, or a rash together with a fever. That gets a call.

A belly button that pops out

A belly button that bulges when your baby cries or strains is usually an umbilical hernia: a small gap in the abdominal muscle lets tissue push forward. They are "common in infants," and "most umbilical hernias get better without treatment by the time the child is 3 to 4 years old" (NIH MedlinePlus). Surgery is considered only if it has not closed by about 3 or 4 years.

Do not tape it and do not strap a coin over it. Go to hospital if the bulge turns hard, dark or painful or cannot be pushed back in, which can mean the tissue has lost its blood supply.

Seven decisions you make tonight, with the actual rule

Each of these is a yes-or-no you face at 3 a.m. Here is what the American Academy of Pediatrics or the NIH says, with the one number worth remembering.

Should I give my baby a pacifier?

At bedtime, yes. "Pacifiers help reduce the risk of SIDS, even if the pacifier falls out after your baby is asleep," and "if the pacifier falls out after your baby falls asleep, you don't have to put it back in." If you are breastfeeding, "wait until breastfeeding is established before offering a pacifier." If you are not, "you can start the pacifier whenever you like." Never hang it around the neck or attach it to clothing for sleep. "It's OK if your baby doesn't want a pacifier" (AAP).

Baby rolled onto their tummy in the crib. Do I flip them back?

"Rolling over usually happens around 3 to 4 months, but it can happen earlier." You should "always place your baby to sleep on their back." Once your baby is comfortable rolling in both directions, the AAP says you don't need to keep turning them back, as long as "there are no blankets, pillows, stuffed toys or bumper pads in your baby's bed." And "when your baby looks like they're trying to roll over, you should stop swaddling them" (AAP).

Baby fell asleep in the car seat. Can I leave them?

No. "If your baby falls asleep in a car seat, stroller, swing, infant carrier or sling," move them, face up, onto a firm flat sleep surface as soon as you can. "Any surface that inclines more than 10 degrees isn't safe for your baby to sleep on," and "don't use products for sleep that aren't specifically marketed for infant sleep" (AAP).

Is my baby too cold at night?

Probably not. "Your baby only needs one more layer than you would wear in the same environment to be comfortable." "Don't put a hat on your baby while indoors once you're home from the hospital." "Overheating can increase the risk of SIDS," so "check your baby for signs of overheating such as sweating, a hot chest or flushed skin" (AAP).

How often should I bathe my newborn?

"Newborns don't need a bath every day. Three baths per week during baby's first year may be enough. Bathing more frequently can dry out your baby's skin." Give sponge baths only "until the stump of the umbilical cord falls off, which usually happens by about one or two weeks of age." Then "fill the basin with 2 inches of water that feels warm, not hot, to the inside of your wrist or elbow," with the faucet set to no more than 120°F (AAP).

Cradle cap: do I pick it?

No. Cradle cap is "seborrheic dermatitis that affects the scalp of infants": thick, crusty, yellow or brown scales. "It is also not caused by poor hygiene," "not spread from person to person," and "not dangerous." It "often lasts a few months," and "in some children, the condition can last until age 2 or 3." Home care: "massage your baby's scalp gently with your fingers or a soft brush," give "daily, gentle shampoos with a mild shampoo as long as there are scales," and if scales do not loosen, "apply mineral oil to your baby's scalp" and wrap warm, wet cloths around the head for up to an hour before shampooing. Call if patches "drain fluid or pus, form crusts, or become very red or painful," or your baby develops a fever (NIH MedlinePlus).

Baby's hands and feet are blue. Normal?

Usually. Newborns arrive with "deep red or purple skin and bluish hands and feet," and for weeks "the lips, hands, and feet may turn bluish or spotted (mottled) when the baby is cold." Warm them up. The line is breathing: for a child with bluish skin, call your provider or 911 if they also have a "hard time breathing," are "breathing faster than 50 to 60 breaths per minute (when not crying)," are "making a grunting noise," or have "a limp or floppy body" (NIH MedlinePlus).