In your baby’s first hours, the priorities are breathing, warmth, feeding and checking that they are adapting well after birth. If you and your baby are stable, much of this can happen while your baby stays close to you. If either of you needs treatment, the order of events may change.
Ask the midwife to explain what is happening as you go. You do not need to remember every test name or work out on your own whether something is normal.
The first checks
The birth team assesses your baby immediately and helps with breathing if needed. Some babies need support beside the bed or at a warming station; others need a neonatal unit. An assisted or caesarean birth does not automatically mean your baby will need resuscitation.
The Apgar score records features including breathing, heart rate, muscle tone, responsiveness and colour, usually at one and five minutes. It describes how your baby is doing at that time. It is not a prediction of intelligence or a verdict on their future development, and urgent care does not wait for a score.
When appropriate, your baby will be weighed and measured and have a newborn examination. Ask when the full examination will happen and whether any findings need another check.
Skin-to-skin contact, safely
Skin-to-skin means holding your baby directly against your bare chest. It can help with warmth, settling and early feeding. It may be possible after a caesarean too, with staff supporting you. If you are unwell, your partner or another support person may be able to help, depending on your baby’s needs.
Ask staff to help position your baby securely, with the head supported, face visible and nose and mouth unobstructed. You need to be awake and able to respond. If you become sleepy or are affected by pain relief, ask for help and have your baby placed in their own safe sleep space before you sleep.
A delayed first cuddle does not prevent you from bonding. Talking gently, touching and responding to your baby are things you can keep doing as they grow.
The cord and your baby’s appearance
For a well baby, the team will usually allow a short delay before clamping the umbilical cord. The timing may change if you or your baby need urgent care. Ask about your preferences before the birth when possible. After cutting, a small cord stump remains; your midwife can show you how to keep it clean and dry.
Vernix, the creamy white coating on the skin, is common. Some babies have a temporarily moulded head or bruising, particularly after an assisted birth, and the team will examine this. There is no need to hurry into a bath.
Do not dismiss blue or grey lips or tongue, difficult breathing, unusual floppiness or poor responsiveness as normal newborn colour changes. Call staff immediately. Outside hospital, call 000 if your baby is blue or grey around the lips or tongue, struggling to breathe or unresponsive.
The first feeds
If you plan to breastfeed and your baby is well, staff can support an early feed during skin-to-skin time. Colostrum is the first milk. Ask someone to watch a feed and help with positioning, attachment and checking that feeding is effective.
If your baby cannot feed at the breast straight away, ask about expressing and a feeding plan. Formula feeding and mixed feeding also need practical support: ask how to prepare feeds safely and how to recognise when your baby has had enough. Do not force a feed into a baby who is struggling to breathe or too sleepy to feed safely; call staff.
Babies may have alert and sleepy periods, but a baby who is hard to wake or repeatedly not feeding needs assessment. Ask your midwife when to offer feeds, when to wake your baby and what nappies to expect for their age. The first poo is usually dark and sticky meconium; tell staff when your baby first wees and poos.
Vitamin K and hepatitis B vaccination
Vitamin K helps blood clot. An injection soon after birth is recommended to prevent vitamin K deficiency bleeding, which can be serious. The injection is the most reliable approach. If you are considering oral vitamin K instead, discuss whether it is suitable and how all required doses will be arranged. The team should explain the options and ask for your consent.
Hepatitis B vaccination is recommended for newborns, preferably within 24 hours once medically stable. It protects against hepatitis B, not HPV. Later vaccine doses are still needed. If the birth parent has hepatitis B, the baby also needs hepatitis B immunoglobulin promptly after birth; your team should arrange this time-sensitive care.
Screening happens over the first days
Not every newborn test happens in the delivery room. Before going home, ask what has been done and what is still booked.
- Bloodspot screening: a small heel-prick blood sample screens for selected rare but serious conditions. It is usually collected around 48–72 hours after birth, with timing guided by your local program and your baby’s care. The test is offered with parental consent. A result needing follow-up is not itself a diagnosis.
- Hearing screening: a quick test is usually offered before discharge or at an early outpatient appointment. A repeat or referral result means more testing is needed; it does not by itself confirm hearing loss.
If you leave hospital before screening, or have a homebirth, confirm who will arrange it. Ask how results and any repeat tests will be followed up. Screening does not look for every possible condition and does not replace medical assessment if your baby seems unwell.
When your baby sleeps
For sleep, place your baby on their back in their own safe cot or bassinet, on a firm, flat mattress with their head and face uncovered. Keep pillows, toys and loose bedding out. Ask for help transferring your baby if you are exhausted; sleeping with a baby on your chest, particularly on a sofa or chair, is unsafe.
When to ask for urgent help
While in hospital, call the midwife immediately if your baby has breathing trouble, is very difficult to wake, feels unusually hot or cold, repeatedly refuses feeds, or vomits green fluid. Yellowing of the skin or eyes in the first 24 hours also needs prompt assessment.
After discharge, a newborn with a temperature of 38°C or higher, green vomit, poor feeding with unusual sleepiness or other signs of illness needs urgent medical assessment. Go to an emergency department. Call 000 for severe breathing difficulty, blue or grey lips or tongue, a seizure, collapse or unresponsiveness.
For your own immediate care, see what to expect after delivery. For ongoing recovery, see recovering from birth.
General information for Australian families. Premature or unwell babies may need a different care plan.
Sources and further reading
- Pregnancy, Birth and Baby: baby’s first 24 hours
- Pregnancy, Birth and Baby: Apgar scores
- Royal Hospital for Women: skin-to-skin at birth
- NHMRC: vitamin K for newborn babies
- Australian Immunisation Handbook: hepatitis B vaccination for infants
- Australian Government: newborn bloodspot screening
- Children’s Health Queensland: newborn hearing screening
- Red Nose: a safe sleep environment
- Healthdirect: your baby and the first few weeks