Babies (0-12 months)

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 and sleeping.

See the ‘Baby’s first days’ section above for information on the checks and immunisations babies will have when they’re born.

Between 1 and 4 weeks of age, families are contacted by the local child and family health centre to make the first couple of appointments and send information about joining a parent’s group. 

If preferred, families can also make these appointments through their local doctor or paediatrician. It is important to note that local doctors and paediatricians may have a private fee for these appointments.

The first proper appointment will be at around four weeks old. Babies are weighed during this first appointment, and their length and head are measured. 

The doctor or nurse will discuss:

• how you are settling in at home
• how feeding is going
• where and how your baby is sleeping
• immunisations
• general safety
• how you are coping with your physical and mental health.

At the 6–8-week appointment, babies are weighed and measured, and their growth will be tracked on the percentile chart.

The doctor or nurse will discuss:

• any changes or progress since the last visit
• parent’s group
• feeding support
• sleep
• the first few milestones your baby should be reaching.

The first scheduled immunisation will happen at six weeks and will include protection against:

• Diphtheria
• Tetanus (lockjaw)
• Whooping cough (pertussis)
• Haemophilus influenzae type b
• Hepatitis B
• Poliomyelitis (polio).

Aboriginal or Torres Strait Islander children will also receive the Meningococcal B vaccine for free.

The appointment at 4 months is mainly for giving the next dose of childhood immunisations. 

It’s still a good opportunity to check in with the doctor or nurse about any concerns or questions.

The 4-month vaccines are a repeat of the vaccines given at 6 weeks. 

They include protection against:

• Diphtheria
• Tetanus (lockjaw)
• Whooping cough (pertussis)
• Haemophilus influenzae type b
• Hepatitis B
• Poliomyelitis (polio)

Aboriginal or Torres Strait Islander children will also receive the Meningococcal B vaccine for free.

At the six-month appointment, babies will be measured, and their developmental milestones, like movement, will be tracked. 

They’ll have a physical check, and the doctor or nurse will discuss things like: 

• changes in sleep
• changes in feeding
• introducing solid foods and water. 
• managing teething
• looking after new baby teeth.

The 6-month vaccines include protection against:

• Diphtheria
• Tetanus (lockjaw)
• Whooping cough (pertussis)
• Haemophilus influenzae type b
• Hepatitis B
• Poliomyelitis (polio).

Influenza vaccine

From 6 months, it's recommended that children have the annual influenza vaccine. Getting the flu vaccine each year protects your child from the most common type of influenza virus around each season.

Children aged 6 months to <5 years are eligible for a free influenza vaccine every year. Some providers may charge an administration or consultation fee. It is best to ask your provider if this applies to you.

At the 12-month appointment, babies will be measured, and their developmental milestones, like movement, will be tracked. 

The doctor or nurse will discuss:

• development of movement and speech
• transitioning to solid food as the primary source of nutrition
• teething
• transitioning from a bottle to a sippy, straw or open cup
• transitioning from infant formula to cow’s milk
• support for continuing breastfeeding
• any other questions or concerns.                           

The 12-month vaccines include protection against:

• Meningococcal ACWY
• Pneumococcal    
• Measles
• Mumps
• Rubella.

Discovering movement

In the first few months, babies will start to:

• gently move their head from side to side while on their tummy
• lift their head and chest when placed on their tummy, with great effort
• use their arms to support their upper body on their back or tummy
• kick and stretch their legs out with excitement
• become very interested in their hands, bringing them to their face and grasping at objects.

Try activities such as:

• laying your baby on their tummy and shaking a rattle in front of them
• singing songs and playing music
• slowly moving bright-coloured objects from side to side in front of their face.

Check-in with your doctor or nurse if your baby:

• can’t lift their head even slightly during tummy time.

Early grasping

In the first few months, babies will start to:

• clench their fists with their fingers wrapped around their thumb
• show an involuntary reflex called the palmar grasp, where stroking their palm causes their fingers to close tightly
• relax and open their hands, holding objects and bringing them to their mouth.

Try activities such as:

• dangling colourful toys above to reach and swat at
• offering items such as balls and rattles with a variety of colours and textures
• placing objects in your baby's palm to trigger the palmar grasp.

Check-in with your doctor or nurse if your baby:

• doesn’t follow things with their eyes
• keeps their hands clenched.

Communication foundations

During pregnancy, your baby could hear the familiar sounds of your voice. 

In the first few months outside, babies will start to:

• recognise voices more clearly, even if you're not in the same room
• smile and gurgle to engage with you
• make very early sounds like coo-ing, ooh-ooh-ooh and ah-ah-ah.

Try activities such as:

• narrating your everyday activities with baby, describing what you see and what you're doing
• singing and reading out loud to your baby
• having "conversations" with your baby by giving eye contact and enthusiastically answering their sounds.

Check-in with your doctor or nurse if your baby does not seem to hear you or respond to sound.

Building trust and connection

Babies will bond with their parents and carers as they grow and have their needs met.

In the first few months, babies will start to:

• calm down when spoken to or picked up by a parent or carer
• recognise your face and respond with intentional smiles
• cry as a form of communication for hunger, discomfort, or wanting to be held
• prefer contact naps as a way of connecting with you.

Try activities such as:

• responding quickly and calmly to your baby's cries to build trust and security.
• maintaining eye contact, smiling, and talking or singing gently to grow emotional connections
• using a mirror to help your baby explore facial expressions which will build the foundations for self-awareness.

Check-in with your doctor or nurse if your baby doesn't smile or start to interact with others.

Rolling and sitting

Babies will make some big leaps with movement during this period.

They will start to:

• hold their head up with confidence
• roll from front to back and back to front, getting faster and faster
• start to sit up with support from their hands
• explore their immediate surroundings by grabbing and grasping
• learn how to sit without support.

Try activities such as:

• moving toys slightly out of reach
• handing your baby toys or items to hold
• placing toys in their diagonal line of vision when on the floor to encourage rolling.

Check-in with your doctor or nurse if your baby:

• can’t hold up their head and shoulders when on the ground
• can’t hold up their head when sitting with support.

Exploring with hands

During this period, babies will start to take a liking to objects and realise they have hands. 

They will start to:

• grip, grasp, and manipulate toys and other objects by putting them in their mouth and transferring them between hands
• use clawing and raking motions with their hands to bring items closer, pick them up and examine them closely.

Try activities such as:

• threading ribbons through a baking rack for your baby to grasp and pull 
• giving your baby large slices of safe foods like avocado or teething rusks to hold and explore
• balling up or wrapping paper around the holiday season for your baby to crinkle and crush with their hands.

Check-in with your doctor or nurse if your baby:

• isn’t reaching things or holding objects
• keeps their hands clenched
• doesn’t track things with their eyes and head
• doesn’t bring things to their mouth
• can’t bring their hands together in the middle of their body.

Babbling babies

Between 4 to 7 months, your baby will know who you are and what you sound like. 

They will also start to:

• babble or baby talk, making sounds like muh-muh or bah-bah
• test just how loud their voice is by screeching 
• become more aware of voice cues, like recognising sing-song words you might say before a bath or going out for the day.

Continue activities like:

• having baby conversations and experimenting with volume, emphasis, and emotions like surprise
• narrating your day-to-day activities, trying new environments, like the zoo or aquarium
• continuing to read and sing, trying board books that involve interaction, like lifting flaps.

Check-in with your doctor or nurse if your baby doesn’t start to babble or vocalise.

Exploring emotions and social play

Babies will start to engage and connect with you more during this period. 

They will also start to:

• smile on their own or in response to you for positive attention
• start to laugh in response to play or noise
• look at you more intentionally and try to keep you engaged with vocalisation and movement.

Try activities such as:

• encouraging smiles and laughter through music and play
• playing peek-a-boo games to explore reactions like surprise and different emotions
• using a mirror to make funny faces.

Check-in with your doctor or nurse if your baby:

• doesn’t smile or interact with others
• doesn’t seem to make eye contact
• doesn’t make facial expressions.

Crawling, standing, and potential first steps

Babies approaching their first birthday may be on the move.

They will start to:

• get into a seated position by themselves and stay there without help
• crawl on their tummy, sometimes pulling and pushing with arms and legs
• get up on their hands and knees, rocking back and forth to practice their balance and coordination
• crawl slowly at first, then fast
• pull themselves up into a standing position and hold their body weight through their legs
• cruise along couches and furniture, practising side steps and balancing with more stability
• take a small number of steps on their own.

Try activities such as:

• making music with shakers, pots, and pans
• placing toys a short distance away to encourage crawling and, eventually, walking
• providing surfaces like furniture or a small handrail for your baby to practice pulling to stand and cruising.

Check-in with your doctor or nurse if your baby:

• isn’t moving at all, including commando crawl and shuffling
• is not pulling to stand independently and holding on to things for support.

Precision and coordination

Babies will use their developing fine motor skills to grab your attention and your keys. 

They will start to:

• develop a pincer grasp with their thumb and forefinger, pulling wipes out of a packet or stealing bits of your food
• learn about cause and effect, for example, tossing a spoon to the ground and watching you pick it back up
• get more coordinated in their exploration, figuring out latches, door hinges and opening drawers.

Try activities such as:

• games that require hand-eye coordination, like rolling a ball back and forth
• hiding things inside containers with lids to open and close
• letting them freely explore indoors and outside, with close supervision.

Check-in with your doctor or nurse if your baby:

• doesn’t hold objects independently
• doesn’t hand objects to other people on request
• cannot move an object from one hand to the other
• seems to prefer using one side of their body over the other.

Getting closer to first words

Babies will slowly become more confident in telling you what they want, even if they can't be understood yet.

They start to:

• change babbles into more defined syllables, like ba, da, and ma.
• link syllables to meaning based on your reaction, like recognising your excitement with ma-ma or da-da and associating the sound with you
• understand some commonly used words and phrases, like milk, sleep or nappy.

Try activities such as:

• encouraging your baby to copy the sound you make, and copying the sounds your baby makes in return
• getting more adventurous with items and environments you describe, like using kitchen equipment or reading out food items at the shops
• speaking in 'parentese' - using a sing-song voice, higher pitch and stretched-out vowels when speaking to your baby to help them focus on words.

Check-in with your doctor or nurse if your baby doesn't:

• babble using syllables, like dadadada or lalalala
• respond or "chat" when spoken to
• gesture using waves or pointing
• have any familiar words that get a response, like "bottle" or "bath".

Expressing independence and identity

Babies will develop their own personalities, likes, dislikes and individual traits that make them unique. 

They will start to:

• show shyness and fear around strangers or even people they have met before
• show different facial expressions for happiness, sadness, anger, and surprise
• respond to their name and react when you leave their line of sight.

Try activities such as:

• labelling emotions when they happen and providing reassurance - "I can see you are scared; it's ok to be scared. We will go home now, where you can calm down and play with your toys."
• using puppets to interact and demonstrate different situations
• using sensory play, like sand or water, to process physical emotions safely.

Check-in with your doctor or nurse if your baby doesn't:

• show signs of enjoyment like laughter or smiles
• notice or respond to new people
• start to take turns in play, like peekaboo.

Equipment

It's tempting to buy baby equipment to encourage movement in your baby. 

These might include things like:

• positioners
• supported seats
• seated walkers
• jumpers
• neck floaties. 

This equipment is not necessary for babies to develop properly and can be dangerous and even life-threatening. Equipment that forces or holds your baby in a position they cannot get into on their own can cause issues with muscle and bone development and can cause suffocation. 

If families choose to use these products, they should do so sparingly and under strict supervision for very short periods.

If you're unsure about baby items and play equipment, speak to your local doctor, child and family health nurse or paediatric physiotherapist for information and advice.

Babyproofing

Safety becomes more and more important as babies develop their gross and fine motor skills. 

Families can often feel like their baby has picked up new skills overnight, climbing, crawling and putting small objects in their mouth without warning.

See 'Home safety' for information on baby-proofing, managing pets, and first aid for choking and poisons.

Learning just one language is difficult and takes time. Babies who grow up in a household with multiple languages may take a bit more time to develop their skills, but it does not mean they are delayed.

Learning multiple languages has great advantages for babies, including: 

• a bigger vocabulary and better reading skills
• more advanced problem-solving skills
• better memory.

Babies learning multiple languages will follow similar milestones, with some key differences. 

These can include:

• language mixing: using two or more languages in the same sentence 
• code-switching: switching back and forth between languages from one sentence to another
• language choice: using one language, dependent on the situation or who they are speaking to.

Multilingual families can support their baby's development by: 

• regularly speaking in other languages at home
• playing radio, music, or television in other languages in the background
• using books written in other languages
• using toys that speak in other languages.

If you are concerned about language delay or are looking for opportunities for your child to be immersed in another language, speak to your doctor or child and family health nurse about bilingual speech pathologists.

Baby sign language is when a baby uses their hands to express their needs and reduce their frustration. This tool is used before babies develop language through speaking. 

Baby sign language differs from Auslan, as It is more universal and based on body language and actions.

There is no specific age to start with baby sign language, but babies may have an easier time learning when their fine motor skills improve around 9 months old.

Four common and useful baby signs include:

1. milk: opening and closing the hand from a fist to splayed fingers
2. more: bunching your hands so that your fingers touch your thumb and then meeting them together in front of you
3. all done: holding up hands with palms opened outwards and flicking the wrist so they rotate inwards 
4. up: raising one index finger to the sky or raising both hands above the head.

Babies will eventually stop signing once they can express themselves through speech. It is not an essential skill but can be a fun family bonding activity.

Around 4 weeks after birth, the local health district will reach out to book some appointments and set you up with a parents group.

Parent groups usually meet at the local community health centre but can also be held online in some situations. The group will be made up of other first-time parents in your area who have had a baby around the same time. 

Parent groups are optional but can be an excellent opportunity to:

• socialise and connect with other families going through the exact development at the same time
• learn valuable tips and strategies about feeding, settling, and soothing your baby
• access support services offered by community health
• set your child up with a group of babies to socialise with as they grow.

After the sessions finish, the group is encouraged to meet up regularly for as long as they want to. 

Local community health centres can also help with other types of support groups, including:

• dads, carers and non-birthing parents
• second or third-time parents
• playgroups for older children
• birth trauma
• breastfeeding
• LGBTIQ families.

Support for children with developmental delays is called early intervention. 

Early intervention helps children "catch up" and includes therapy, support and education from health professionals.

Support can come from health professionals, including: 

• occupational therapists 
• audiologists 
• physiotherapists 
• psychologists 
• speech pathologists 
• social workers. 

Early intervention helps children to develop the skills they need to thrive.

As they grow, a baby's sleep patterns change significantly in the first three months of life.

In these first three months, babies will:

• sleep for around 14-17 hours per day in short bursts
• sleep for 2-3 hour periods and then wake up for feeds
• need help settling to sleep.

Babies, parents and caregivers will all learn to communicate with each other and understand signals for basic needs during this period. It's important to be flexible and follow your baby's lead.

By the time a baby is three months old, their sleeping patterns should start to mature and become slightly more predictable.

During this time, a baby will: 

• start to produce melatonin, which will help their internal body clock with more regular bedtimes
• sleep for 2-3 hour periods and wake for feeds
• have around three naps during the day
• still need help settling to sleep.

Babies may also begin to roll over in their sleep, so it's important to transition from swaddling to a sleep sack that allows their arms to be free.

Doing this helps babies to roll back over and lower the risk of SIDs.

During the day, babies usually follow a pattern of waking up, playing, feeding, and then returning to sleep.

Consistent bedtime routines can create a positive association with sleep, making it easier to transition into longer evening sleep. 

This routine might include a bath, song, story, or any other calming signal that lets the baby know it's time to wind down. 

Sleep patterns should become more predictable at six to nine months, and sleep signals may be easier to recognise.

At this stage, a baby may drop from three to two naps, which can take a while to get used to.

Babies will also learn the difference between day and night and may slowly lower their need for night feeds. This leads to sleeping for longer stretches of up to six hours or more at night.

On average, babies between six and nine months need 12-16 hours of sleep within a 24-hour cycle. They will need help settling to sleep and may still wake up regularly throughout the night while they develop the ability to self-soothe.

Developmental milestones, such as crawling or teething, can affect a baby's sleep and lead to periods of "sleep regression."

Regression might include:

• waking up more during the night
• shorted naps than usual
• resisting sleep
• more crying than usual.

Babies who have started rolling will need to transition to having their arms free during sleep time to lower the risk of SIDs.

As babies grow, they will have longer periods of being awake and will want to explore their surroundings.

Sleep developments between six to nine months can include:

• needing around 10-14 hours of sleep in a 24-hour period
• fighting naps during the day
• dropping from two naps to just one
• dropping overnight feeds and stretching out evening sleep.

Babies will also start to use self-soothing methods like: 

• sucking on their hands
• making quiet humming noises
• rubbing their hair and ears
• using fine motor skills to put a dummy back in their mouth if it has fallen out.

Developmental milestones and growth changes will still impact sleep, and caregivers are still needed to provide comfort and help with settling.

Teething is a natural process that can cause some side effects in babies that look like illness.

Along with a strong urge to chew on hard objects like keys, babies may:

• drool more than usual
• develop a drool rash on the cheeks and around the mouth
• become irritable or upset
• eat less
• have disrupted sleep and feeding schedules
• develop a slightly increased temperature.

Some babies will not be bothered by teething; others may become very unsettled.

While teething can occasionally cause a slight increase in body temperature, it should not lead to a high fever or diarrhea. 

See your local doctor if your baby develops a high fever or becomes seriously ill while teething.

Here are some tips to help make teething more comfortable for babies:

• prevent and manage drool rash by gently wiping the face, applying a facial barrier cream, and using a cloth bib
• provide safe items for babies to chew on, like chilled wet washcloths or teething toys that are one solid piece
• avoid teething toys that are filled with liquid or come apart in pieces 
• introduce hard rusks and thick, frozen fruit slices like orange wedges when your baby is over six months old
• use over-the-counter pain relief like baby paracetamol and ibuprofen to manage fever and pain.

A baby's delicate skin should only be washed with plain water during the first few months. As they get older, parents and carers can try different baby bath products to make bath time more engaging. 

Choose products that are made for babies, are gentle on the skin, and do not contain any fragrances or harsh soaps.

Avoid using products like bubble baths for as long as possible, as they can increase the risk of urinary tract infections in some children.

Baby nails usually don't need frequent trimming early on, but getting into the habit is important. Taking care of a baby's finger and toenails can help prevent accidental scratches and avoid infections from dirt buildup.

Try:

• using clippers, scissors, or a gentle file designed for baby fingers. 
• trimming nails while baby is distracted, feeding, or sleeping. 
• using baby mittens or socks on the hands to prevent scratchingin the first couple of weeks after birth.

Babies use their hands and mouth to self-soothe and explore, so it's important not to cover their hands for long periods.

Changing a baby's nappy can be done on different surfaces, such as the bed, the floor, a changing table, or even the boot of a car. Make sure these surfaces are secure so babies are safe from falls during a nappy change.

Parents and carers should also bend safely while changing to avoid discomfort or back pain.

Changing a baby's nappy for the first time can be overwhelming, so the steps are broken down below:

1. gather supplies such as:
   • a clean nappy
   • wipes
   • a damp washcloth
   • barrier cream
   • spare clothes
   • a plastic bag or bin for dirty nappies
      
2. lay the baby down on a changing pad or mat and keep them entertained by singing a song or giving them an object to hold
    
3. remove clothing from the baby's bottom half, where possible, pulling downwards to avoid getting poo on their head
    
4. open the clean nappy and place it under the baby's bottom
    
5. open the tabs on either side of the dirty nappy and drag the front half down across the penis or vulva to wipe off any poo
    
6. lift baby's bottom gently and fold the front of the dirty nappy back over the other half
    
7. wipe baby's bottom from front to back to remove poo from the skin, using a fresh wipe each time
    
8. wipe any remaining poo away from the penis or vulva, taking care not to move any poo inside
    
9. remove the folded, dirty nappy from underneath, place the used wipes inside and use the sticky tabs to close it up
    
10. make sure the new nappy is still clean and in the right position, using a new nappy if there is any poo or urine
     
11. apply a layer of barrier cream around the anus and vulva or penis, covering any redness on the skin
     
12. secure the nappy using the sticky tabs and check that the elastic around the legs is fluffed out and secure.

"Poo explosions" and nappy leaks are common in the first year. Try and clean all poo and urine off a baby's skin, giving them a bath where appropriate.

Changing nappies is one of the biggest parts of hygiene for babies, so picking the right nappy for your family is important.

Both disposable and reusable nappies have advantages and disadvantages to consider, like:

• amount of waste generated
• impact on the environment
• cost for buying and washing
• how easy they are to use.

It's also important to have a space in the home that is safe and comfortable for nappy changing, whether it's on the bed, on a change table or the floor. 

Never leave your baby unattended on a changing table, even if they are secured with a strap.

As babies start to roll and crawl, changing them on their backs can become challenging, unhygienic, and sometimes dangerous. When a baby becomes too active to change on their back, try standing them up and using nappy pants.

Good nappy hygiene is important for avoiding the spread of germs, preventing infections, and protecting against nappy rash. 

Nappy hygiene tips include:

• washing hands thoroughly with soap and water before and after every nappy change
• immediately moving any dirty wipes or nappies away from the baby during a change 
• sealing used, disposable nappies and wipes in a tied plastic bag or nappy bin, keeping them out of reach of curious pets and other children 
• removing any solid poo from reusable nappies before washing by scraping it away with a tissue or toilet paper and flushing it down the toilet
• making sure to apply nappy cream around the anus and penis or vulva before securing the new nappy in place 
• following the wash routine instructions for reusable nappies, using hot water at least 60°C and making sure they are completely dry before using them again.

Minimise the impact on the environment for both disposable and reusable nappies by removing any solid pieces of poo and flushing them before disposing or washing them. 
 

Nappy rash can be common in babies and happens when urine and poo are in contact with the skin for too long. 
It can be prevented and managed by: 

• changing nappies regularly - at least every 2-3 hours and immediately after seeing or smelling poo and urine 
• avoiding plastic nappy covers
• using barrier creams that contain zinc oxide
• not using talcum powder, soap or fragranced products
• giving babies lots of nappy-free time to air out their skin
• checking any rashes and seeing a doctor if concerned.

See the Nappy rash factsheet for more information.

Sudden changes in a baby's poo can be concerning.

See your local doctor as soon as possible if you notice warning signs like: 

• newborn babies - black sticky poo that does not change to green or yellow in the first few days after birth
• constipation - small, hard or pebbly poo that causes babies to strain or appears difficult to push out
• diarrhea - loose, watery or runny poo
• blood in the poo
• pale yellow, white or grey poo
• green, frothy and explosive poo
• mucus in the poo.

It can be helpful to take a photo of the poo to show the doctor.

See the Constipation factsheet for more information.

At around six months of age, babies will need more energy and nutrients to support their healthy growth and development.

For example, babies are born with enough iron stores for the first six months before they need more iron in their diet.

These nutrient needs are higher than what they can get from breastmilk or formula alone and include:

• iron
• zinc
• B vitamins
• Vitamin D.

Breastfeeding and infant formula needs to continue until at least 12 months, alongside eating solid foods. This is called complementary feeding 

Starting a baby on solids too early or too late can impact their health and development.

Developmental changes will start around six months of age that help a baby learn to eat solid foods. 

Around six months, a baby's:

• digestive system will produce enzymes that let them digest solid food properly
• head and neck control gets better, letting them sit up safely and swallow foods easily
• kidneys develop to handle the extra work of processing solid food
• immune system becomes better at protecting them from germs and bacteria found in food
• tongue-thrust reflex stops or slows, stopping food from being pushed back out of the mouth
• tongue starts to move around more, letting food move safely to the back of the mouth to swallow.

Every baby develops differently and at their own pace.  

Look out for signs that your baby is ready to start solids around six months, including:

• loss of their tongue-thrust reflex
• sitting upright with or without support, with good control of the head
• putting things in their mouth
• showing interest in other people's food
• opening their mouth when food is offered 
• having more frequent feeds.

Choking 

Babies are at a greater risk of choking due to:

• their smaller windpipe, about the width of a drinking straw
• their lack of back teeth that are responsible for grinding and chewing food into smaller pieces.

Babies can accidentally choke on large pieces of food as they adjust to eating solids. Avoid giving them anything small, round or hard that could get stuck in their airway to lower the risk. Make sure always to supervise them while they're eating solid foods.

See Infant and baby nutrition for information on reducing the risk of choking.

Honey and raw or partially cooked eggs

Do not give honey, food items containing honey or raw/partially cooked eggs to infants under 12 months of age, as it can cause infant botulism. Infant botulism is a serious illness that causes paralysis. Children will develop their natural gut defences as they get older, protecting them from botulism.

Squeeze pouches

Squeeze pouches can be a handy way to feed babies at home or on the go. While convenient, there are some downsides to relying too much on squeeze pouches for feeding.

These can include:

• limiting opportunities to develop oral-motor skills, such as chewing
• affecting speech development
• restricting sensory development and exploration from touching and smelling new foods
• high levels of sugar and salt
• an increased risk of tooth decay.

If families do choose to use squeeze pouches, they can reduce these risks by:

• emptying the pouch contents into a bowl and letting baby explore with a safe spoon or fork
• using a screw-on spoon attachment to help with feeding
• limiting pouches to things like yoghurt for quick snacks on-the-go, rather than regular meals.

Most babies will have moved from purees to soft lumps and chewy food by seven months. This texture helps to develop oral-motor skills like chewing.

Avoid sugar and salt

Babies who eat a lot of sugar or salt can develop a taste for unhealthy foods, which can affect their eating habits and dental health in the future. Additionally, babies' kidneys are still developing and can only handle a small amount of salt safely.

Babies can learn how to chew even before they develop their teeth. Introducing solids that gradually go from soft puree to lumpier textures will help babies practice chewing, which will become easier and more efficient once their teeth arrive.

Getting used to different textures helps to develop oral-motor skills. This means they can:

• bite and chew a wider range of textures, increasing their jaw stability and range of movements
• accommodate new tastes, flavours, and textures by reducing their gag reflex
• take food from a spoon and keep it in their mouth at around ten months old by improving their lip control
• increase the range of motion of their tongue
• be more accepting and adventurous with different foods.

Children learn to coordinate their lips, tongue, and jaw as they develop their oral-motor skills. This can help with speech development and self-feeding behaviours.

Babies can develop communication and social skills during mealtimes by interacting with parents, carers, or siblings. 

They can communicate through:

• crying
• gestures
• eye-contact
• facial expressions
• babbling
• actions
• words
• playing with food.

Parents or carers can also enhance their child's development by making mealtimes more enjoyable. 

Some simple ways to do this include: 

• encouraging interaction during mealtimes by asking questions, even if your child doesn't respond with words. 
• giving your child enough time to explore their food. 
• providing a supportive feeding environment where your child can see you 
• not forcing your child to eat or clear their plate 
• helping your child when they need it.

Babies learn through play and exploration. By touching and feeling their food, they are learning about the foods:

• temperature, such as if it is hot or cold
• texture
• consistency
• colour
• shape
• gravity.

Allow your baby time to explore their food. Although it may be messy, they will start to become more familiar with food and learn cause and effect, especially if they are throwing, dropping, or squishing food.

Babies learn by playing and exploring. They can learn a lot of information about their food by touching and feeling it, including:

• temperature
• texture
• consistency
• colour
• shape
• gravity. 

It may get messy, but giving babies time to explore their food is important for their development.

This will help them become more familiar with food and learn about cause and effect, particularly if they throw, drop, or squish their food while exploring.