You have just brought your baby home. The hospital felt structured: nurses checking in, monitors beeping, someone always nearby. Now it is just you, your baby, and a growing list of questions.

This is the part nobody prepares you for. Not the sleepless nights (you expected those). The part where you are suddenly the one making every call, and you are not sure which things are normal and which things need a doctor.

So here is what I give every parent who walks out of my clinic with a newborn: a simple, week-by-week checklist. Not everything you could know. Just what you need to watch, when you need to watch it, and what should send you back to the clinic.

Print it. Screenshot it. Stick it on the fridge. Come back to it at 3am when you need it.

Your Newborn's First 30 Days: week-by-week checklist infographic by Dr Nisa Khalil

The First 24 Hours: What Should Have Happened Before Discharge

Before you leave the hospital, a few things should already be ticked off. If they were not, follow up with your paediatrician immediately.

Essential checks before going home:

Vitamin K injection. Given within the first hour of birth. This prevents a rare but serious bleeding disorder called Vitamin K Deficiency Bleeding (VKDB). It is a single injection and it is non-negotiable.
Hepatitis B vaccine (first dose). Part of the Malaysian National Immunisation Programme. Given within 24 hours of birth.
Newborn screening. A heel-prick blood test that screens for metabolic conditions like hypothyroidism and G6PD deficiency. G6PD is particularly important in Malaysia because it is more common in our population.
Hearing screening. A quick, painless test done before discharge. Early detection of hearing issues matters because it affects speech and language development down the line.

If you are unsure whether any of these were done, ask. Do not assume.

Week 1 (Days 1 to 7): The Jaundice Watch

This is the week most parents feel the sharpest anxiety. Your baby is tiny, your confidence is fragile, and everything feels like a potential emergency. Here is what actually matters.

Jaundice

Most newborns develop some degree of jaundice. The yellow tint in the skin and eyes comes from bilirubin, a substance the baby's immature liver is still learning to process. In most cases, it peaks around day 3 to 5 and resolves on its own.

What to watch for:

Yellowing that spreads below the chest to the abdomen and legs
A baby who is too sleepy to feed, difficult to wake, or feeding poorly
Dark urine (it should be clear or pale yellow) or pale, chalky stools (they should be yellow or greenish)

What to do:

Feed frequently. Breast milk or formula helps flush bilirubin through the gut. Aim for 8 to 12 feeds in 24 hours.
Keep your follow-up appointment. Your paediatrician will check bilirubin levels, either with a skin sensor or a blood test. This is the only reliable way to know if levels are safe. You cannot judge severity by looking at the skin colour alone.

What not to do:

Do not rely on sunlight exposure. I know this is common advice. But direct sunlight carries risks of overheating and UV damage without providing the controlled intensity needed to lower bilirubin. If phototherapy is required, it needs to be done properly with medical-grade equipment.

Feeding

Whether you are breastfeeding or formula feeding, the goal this week is establishing a rhythm.

Breastfed babies: Feed on demand, roughly every 2 to 3 hours. Your baby's stomach is tiny (about the size of a marble on day 1, a walnut by day 3). Colostrum is small in volume but packed with antibodies and nutrients. Your milk will come in around day 3 to 5, and yes, it can feel overwhelming when it does.
Formula-fed babies: Follow the preparation instructions exactly. Overconcentrating formula is dangerous. Start with about 30 to 60ml per feed and follow your baby's hunger cues.

Signs feeding is going well: Your baby has at least 6 wet nappies a day by day 5, and stools transition from dark meconium to yellow, seedy stools (for breastfed babies) or soft, formed stools (for formula-fed babies).

Umbilical Cord Care

Keep it clean and dry. That is the current evidence-based recommendation. No alcohol, no antiseptic, no traditional pastes or oils.

The stump usually falls off within 7 to 21 days. Until then, fold the nappy below it, sponge bathe instead of submerging in water, and leave it alone.

See your doctor if: you notice redness spreading around the base, swelling, pus, or a foul smell. These are signs of omphalitis (cord infection) and need prompt treatment.

Week 2 (Days 8 to 14): Weight and Feeding Check

The Weight Question

Most newborns lose up to 7 to 10 percent of their birth weight in the first few days. This is normal. By day 10 to 14, your baby should be back to birth weight or very close.

This is why the week 2 check-up matters. It is not optional. If your baby has not regained birth weight by two weeks, we need to look at feeding more closely.

After regaining birth weight, expect a gain of roughly 150 to 200 grams per week for the first few months.

Feeding Adjustment

By now, feeding should feel slightly less chaotic. Slightly.

Breastfed babies may start to cluster feed in the evenings. This is normal. It does not mean your supply is low. It means your baby is doing exactly what they are designed to do to build your supply.
If you are struggling with latch, pain, or supply concerns, this is the right time to get help. A lactation consultant or your paediatrician can assess and troubleshoot before small problems become big ones.

A note on supplemental water: You do not need to give your baby water, even in Malaysian heat. Breast milk and formula are roughly 80 to 90 percent water. They provide all the hydration your baby needs for the first 6 months. Giving water to a newborn can cause water intoxication or fill them up so they drink less milk, missing out on the calories they need to grow.

Week 3 (Days 15 to 21): Finding a Rhythm

By the third week, some patterns start to emerge. Your baby may have slightly more predictable sleep and wake windows. Or they may not. Both are normal at this stage.

Sleep

Newborns sleep 14 to 17 hours a day, but in short bursts of 2 to 4 hours. There is no schedule to impose yet. Your only job with sleep right now is keeping it safe.

Safe sleep, every time:

On their back. Every nap, every night. Not on the stomach, not on the side.
On a firm, flat mattress. No pillows, no bolsters, no soft toys, no loose blankets.
In your room, but not in your bed. Room-sharing for the first 6 months is recommended by the AAP because it reduces the risk of sudden infant death syndrome (SIDS). Bed-sharing increases the risk of accidental suffocation.
Do not overdress. If you are comfortable in a single layer, your baby needs one layer more. That is it.

Skin

Newborn skin does odd things in the first few weeks. Peeling, blotchy patches, tiny white bumps (milia), and even baby acne are common and usually resolve without treatment.

When to be concerned: A rash with fever, blisters, or spreading redness warrants a clinic visit. Otherwise, keep the skin clean, avoid fragranced products, and do not over-bathe (2 to 3 times a week is enough for most newborns).

Week 4 (Days 22 to 30): The One-Month Check

This is a milestone visit. It is also where we start looking forward rather than just putting out fires.

What Happens at the One-Month Check

Weight and growth. We plot your baby on a growth chart. What matters is not the percentile itself, but that your baby is following their own curve consistently.
Head circumference. This tracks brain growth. Measured at every visit.
Feeding review. How is it going? Any pain, any concerns about output or weight gain?
Hepatitis B vaccine (second dose). Due at one month as per the Malaysian immunisation schedule.
Early developmental observations. At this age, I am looking for things like: does your baby respond to sound? Do they briefly fix on your face? Do they have some limb movement against gravity? These are very early markers and most babies meet them comfortably, but it is worth checking.

Looking Ahead

After the one-month visit, the next key appointment is usually at two months, when the primary immunisation series begins (DTaP, IPV, Hib, Hepatitis B, Pneumococcal). Mark it in your calendar now.

Red Flags: When to See a Doctor Immediately

Some things cannot wait for the next scheduled appointment. If your newborn shows any of the following, contact your paediatrician or go to the emergency department straight away.

Fever of 38°C or above (rectal). In a baby under 30 days old, this is a medical emergency. Do not give paracetamol and wait. Go in.
Difficulty breathing. Fast breathing (more than 60 breaths per minute), grunting, nostril flaring, or chest indrawing (you can see the ribs pulling in with each breath).
Not feeding. Refusing multiple feeds or showing no interest in feeding.
Excessive sleepiness. A baby who is very difficult to wake or seems floppy and unresponsive.
Projectile vomiting. Occasional spit-up is normal. Forceful vomiting after every feed is not.
Colour changes. Blue or grey tint around the lips, pale or mottled skin that does not improve with warming.
Fewer than 6 wet nappies in 24 hours after day 5, which may indicate dehydration.

Trust your instincts here. If something feels wrong, it is always better to check and be reassured than to wait and worry.

The Myth Section: Three Things You Can Stop Worrying About

"You are spoiling your baby by holding them too much."
You cannot spoil a newborn. Responsive care, picking them up when they cry, holding them close, providing comfort, is exactly what builds secure attachment. The research on this is clear. Responding to your baby's needs in the early months supports healthy brain development and emotional regulation later on.

"Your baby needs extra water in hot weather."
Covered above, but worth repeating because I hear it weekly. No water before 6 months. Breast milk and formula have it covered.

"Jaundice will go away if you put the baby in sunlight."
Mild jaundice often resolves with frequent feeding. If bilirubin levels are high enough to need treatment, your baby needs proper phototherapy under medical supervision, not a spot by the window.

Your Checklist at a Glance

Before discharge:

Vitamin K injection
Hepatitis B (dose 1)
Newborn screening (heel-prick)
Hearing screening

Week 1:

Jaundice check (paediatrician visit by day 3 to 5)
Establish feeding (8 to 12 feeds per 24 hours)
Umbilical cord: clean and dry, no topical applications

Week 2:

Weight check (should be back to birth weight by day 10 to 14)
Feeding assessment if any concerns
Continue safe sleep practices

Week 3:

Monitor sleep safety
Watch for skin changes (normal peeling vs concerning rash)
Continue demand feeding

Week 4:

One-month check-up
Hepatitis B (dose 2)
Growth chart plotting
Early developmental observation
Schedule 2-month vaccination appointment

One Last Thing

The first 30 days are intense. There is no way around that. But you do not need to know everything. You just need to know what to watch for, and who to call when you are not sure.

That is what I am here for. If anything on this checklist raises a question, or if your gut tells you something is off, book an appointment. Earlier is always better, and no question is too small.

You are doing a good job. Keep going. 💜

‹ Baby Jaundice Consultation KL: When to Seek Help

Baby Colic Specialist KL: Finding Relief for Your Infant ›