The Apgar score is the first check for your baby. It is done at one and five minutes after they are born. 

The Apgar score checks five key areas of a newborn's health, including:

• skin colour
• heart rate
• reflexes and responsiveness
• muscle tone
• breathing rate.

Each area is scored from 0 - low to 2 - high. Your baby's total Apgar score is out of 10. 

A score of 7-10 at five minutes means they are adapting well to being in the outside world. 

A score of 0-6 can mean that they need some extra help, including:

• support with breathing
• monitoring for a longer period
• interventions like surgery or medication.

It is important to remember that the Apgar score is just one piece of information used by health professionals to check the health of a newborn baby. Many different things can cause a low Apgar score, and it is not always a sign of serious illness.

Your doctor, nurse or midwife will be there to answer any questions you might have about your baby after birth.

Newborn bloodspot screening is offered to every newborn baby in Australia. It is also called the heel prick test.

This test screens newborn babies for rare but serious medical conditions that might not appear until they are older. 

The test is done between 48 and 72 hours after birth and involves pricking the heel of the foot with a tiny needle. A small card is pressed onto the heel to absorb the tiny spot of blood, which is then sent off to be tested. 

Newborn bloodspot screening tests for conditions including:

• Phenylketonuria (PKU): a condition where the body can’t break down a chemical in food proteins, causing brain damage and intellectual disability
• Primary congenital hypothyroidism: a condition where the thyroid glands don’t make enough hormones, causing intellectual disability and growth issues
• Cystic fibrosis: a condition where the lungs and pancreas make mucus that clogs the organs and stops them from working properly
• Congenital adrenal hyperplasia (CAH): a condition where the adrenal glands do not produce hormones properly, causing issues with metabolism, reproductive organs, and salt regulation
• Medium chain acyl CoA dehydrogenase (MCAD) deficiency: a life-threatening condition that affects the body’s ability to process protein and fat.

Early detection and treatment of these conditions can make sure newborn babies avoid serious illness and access treatment as soon as possible.

Vitamin K

Newborn babies can receive a vitamin K injection shortly after birth. This helps their blood to clot and prevents bleeding. Newborn babies do not get enough vitamin K during pregnancy or from breast milk, so the injection is very important to bring their levels up. 

Low vitamin K levels can cause a life-threatening condition called Vitamin K Deficiency Bleeding (VKDB). Babies with VKDB can have bleeding in the body, which does not clot or stop. This bleeding can cause brain damage, organ failure and death.

The vitamin K injection is safe for newborn babies. Speak to your doctor or midwife if you have concerns or want more information.

Hepatitis B vaccination

Hepatitis B is a virus that can cause long-term liver disease and cancer. Hepatitis B is infectious and can be easily passed through:

• birth
• contact with infected blood
• cuts or scratches in the skin from unclean items like razors, nail clippers and needles.

Newborn babies are offered a hepatitis B vaccine before leaving the hospital and will receive additional doses at six weeks, four months, and six months of age.

The Statewide Infant Screening Hearing (SWISH) program is a routine hearing check for all newborn babies in NSW. This test is done a few days after birth and measures brain responses to soft clicking sounds to check for hearing loss. 

Early detection of hearing issues helps newborn babies access hearing services and support, lowering the risk of learning and development issues in the future.

Before going home from the hospital, the paediatrician will do a physical check to ensure newborn babies are physically healthy and are developing normally. 

This assessment will check a newborn's:

• general appearance
• skin
• head and neck movement
• facial features
• mouth, including lip and tongue ties
• lung and heart sounds
• abdomen shape and feel
• genitals
• anus
• limb movement
• reflexes like sucking, grasping, and stepping.

This assessment can help find any health concerns or differences in how a baby has grown that may not have been noticed during pregnancy or at birth. 

Assessments are important to ensure newborn babies are linked to the right specialists and support services as early as possible.

The first three months are a period of rapid growth for a newborn baby. By the end of this period, many parents and carers wonder where their tiny newborn went. 

During this time, a baby should:

• gain weight and grow bigger
• start to have more control over their head, arms, and legs
• make more deliberate movements.

Towards the end of the third month, a baby should start to: 

• lift their head and show interest in their environment
• see things more clearly
• develop a personality, including likes and dislikes
• smile and interact with you.

Whether breastfeeding or bottle-feeding, it's important to follow your baby's cues for hunger and offer feeds on demand in the first few months. Skin-to-skin contact while feeding can help with milk production, settling and bonding.

Babies will go through periods of cluster feeding, which can look like rapid bursts of constant feeds, almost like snacking. Cluster feeding is normal and is not usually a sign of low milk production in breastfeeding.

Breastfeeding can be an easy process for some and very difficult for others. It's important to remember that both breastfeeding parents and babies are learning a new skill, and practice makes perfect. 

Good support and information are essential for any breastfeeding journey. Contact an internationally board-certified lactation consultant (IBCLC), your hospital or your local child and family health nurse for help with things like:

• adjusting to breastfeeding
• trying different positions or equipment
• pumping or expressing milk
• identifying issues with latching or milk production
• issues with breasts like pain, infection or engorgement.

Newborn babies need help to release air that is swallowed while they are feeding. Burping helps reduce discomfort and gas buildup in babies. 

Burping can be done in a few different ways, including:

• holding your baby upright against your chest while gently patting and rubbing their back
• laying your baby face down across your lap while gently patting and rubbing their back
• sitting your baby on your lap with their back straight, supporting their chin and chest with your hand while using your other hand to gently pat their back.

Some other tips for reducing and relieving wind and reflux include:

• using slow-flow teats when bottle-feeding
• holding your baby upright as much as possible while feeding
• pace feeding– a technique where you slowly move the bottle at a horizontal angle to slow the flow of liquid while taking breaks and letting your baby decide when they are finished
• letting your baby rest for a few minutes after feeding, and do not go straight into a nappy change or tummy time
• lying your baby on their back and gently moving their legs in a circular motion, as if they were riding a bike.

Speak to your family doctor or child and family health nurse if your baby has ongoing reflux, unusual bloating, excessive crying, or you are concerned for any reason.

The Period of PURPLE crying is a model used to explain the first 6-8 weeks after birth when a baby's crying can reach its peak. While this is developmentally normal, it can be extremely difficult for parents and carers.

Crying is how babies communicate. While this can be stressful, it does not always mean they are sick or in pain. Comfort your baby, try different soothing techniques, and reach out for support if you are struggling.

It is important for parents and carers to have a safe plan for periods when the baby's crying is causing distress. 

If you are feeling overwhelmed or you are not coping, you can:

• put baby down in a safe space, like their bassinet
• eave the room for a few minutes
• sit down and try some slow breathing
• have a drink of water or a cup of tea
• call someone for help or support. 

This will help keep you and your baby safe.

See Parent and carer wellbeing- crying babies for support, tips, and advice for parents and carers.

Newborns sleep a lot, usually in short bursts around the clock.  

Babies do not “sleep through the night” as adults would. It is developmentally normal for babies to wake up multiple times during the night, as they need to feed.

Parents and carers may need to try adjusting their environment, settling and feeding strategies to find a sleep routine that works for their family.

See Newborn sleep for information and strategies around settling, swaddling and sleeping.

It is normal for babies to lose a small amount of weight after they are born. Up to 10% of their birth weight is generally considered acceptable. By day 10-14 of life, babies should have gained weight and be back to their birth weight.

Each time your baby is weighed, the measurement should be recorded in their ‘Blue Book’. There can be wide variations in the rate of infant growth. The accurate measurement and recording of your baby’s weight, length and head circumference will help health professionals track your baby’s growth patterns.