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Common concerns after birth

There is a chance your baby will become unwell. See below for more information about common concerns that parents have with newborns.

If you are worried about your child, take them to a doctor or an emergency department.

Common concerns


Crying is a way babies communicate. Sometimes, it can be frustrating trying to work out why your baby is crying.

For information on how to cope with a crying baby, take a look at this information leaflet on coping with a crying baby.

Small for gestational age (small baby)

Some babies do not grow as expected during pregnancy. This is called Small for Gestational Age (SGA). Sometimes this is normal; other times it is because the placenta (the part that supplies food and oxygen to the baby) is not working as well as it should.

It is good that we have detected this because small babies have a higher risk of problems during pregnancy. We will work together with you and your Lead Maternity Carer (LMC) to increase the checks we do on you and your baby.

Small babies may have these problems:

  • Low blood sugar - so you need to feed your baby in their first hour of life, and your baby will need tiny blood tests to check their sugar level. Breast milk is the best food for small babies.
  • Getting cold - so they may need an incubator
  • Jaundice (yellow colour) - so they may need to lie under a special light

Some small babies may need to be assessed by our baby doctors and sometimes be admitted into the Neonatal Intensive Care Unit (NICU).

Your baby will need to stay with us until all the checks have been done. Sometimes they may even need to stay longer than you do.

You may have an increased chance of having another small baby in your next pregnancy. Please see your GP or book with a midwife as soon as possible when you know you are pregnant, so they can ask early for specialist advice.

Baby's head shape

It is normal for your baby to have an unusual head shape after birth. This is caused by pressure when the baby was moving through the birth canal. It will soon correct itself.

Sometimes there is soft swelling on one or both sides of the head (cephalhaematoma). This can take up to a few months to disappear. To reduce the risk of SUDI (sudden unexplained death in infancy), your baby should sleep on his/her back - this may cause temporary flattening at the back of the head. This will not cause problems to the brain growth or development.

Soft spots (fontanelles)

Your baby has soft spots, known as fontanelles, on top of his/her head. These are normal and allow for the rapid growth of the head. They are where the skull bones have not yet fused together. You will not hurt the baby by gently washing or touching the head.

Sometimes you will notice a pulse in the fontanelles; this is nothing to worry about. If your baby is dehydrated (not drinking enough), the fontanelles might be sunken. If you notice this, please seek medical advice.


Babies can see after birth, but they have to learn to make meaning of the images around them. Your baby will already be familiar with your voice and smell, so will connect with your face to know you as mum or dad. You can sometimes see a relaxed newborn watching people and their surroundings intently.

Your baby's eyelids can be swollen and puffy for a couple of days after the birth from the pressures of being born. This will disappear by itself.

Your midwife will check the eyes within the first two weeks for cataracts, which can change the colour of the pupils to grey or white. She will shine a light into the eyes and look for the red reflex, a red appearance that you sometimes can see on photos.

As baby's tear ducts are often narrow, it is not unusual that you see sticky eyes with a white or yellow discharge. You can gently clean the eyes with a clean cloth or cotton wool and pre-boiled warm water. Carefully wipe the eye from the inside to the outer corner.

Your LMC, midwife, Plunket nurse or GP can take a swab to check for infection if it seems to persist. Breast milk has antibiotic properties - you can squeeze a few drops into the eyes after feeding.

Your baby's skin

At birth your baby's skin is covered in a creamy substance called vernix. This protects the skin and is a good moisturiser. It does not need to be wiped off and will absorb gradually over the first few days.

Dry skin

Overdue babies often have dry, cracked skin - especially on their feet and hands. This may persist in the first few weeks. Massaging baby's skin with a non-complex oil, such as olive or almond oil, is a nice way to bond with your baby and care for his/her skin.


Hormone spots may range from a few spots to an acne-type rash on the face, head and upper body. These are generally caused by hormones from the mother and will resolve by themselves without treatment. If they become crusty or infected, see your doctor.

Septic spots are commonly caused by bacteria that are normally present on the skin and may present as blisters or pus filled spots, especially in the neck and arm creases or nappy area. Contact your midwife or doctor.

Stork marks or bites

Many babies have these birthmarks or coloured areas (dark red or pink patches) on the back of the neck, eyelids or the bridge of the nose. These will fade over the first few months.

Strawberry naevus

These marks grow from red dots to form a reddish lump, which then begins to shrink and fade. By the second year, these marks are usually gone.

Port wine stains

These flat purple birthmarks are present at birth and are permanent. They can be treated with laser therapy by a dermatologist.


Jaundice is the medical term for the yellowing of the skin and the whites of the eyes. The yellow colour is caused by bilirubin, a normal product from the breakdown of red blood cells.

What causes jaundice?

When babies are born they have a high number of red blood cells. When these cells are no longer needed they are broken down and bilirubin (a waste product) is produced. Before a baby is born, the mother's liver breaks down the bilirubin but after birth the baby's liver has to adjust to breaking it down itself and can't always process the bilirubin quickly enough. This is why they become jaundiced.

Is jaundice harmful?

For most babies jaundice is completely harmless, no treatment is required and it fades after a week or so. If the baby becomes very yellow or sleepy and slow to feed, a simple blood test maybe required to measure how much bilirubin is present in the baby's blood. This result tells us if we need to treat the jaundice. Premature, small or very unwell babies almost always become jaundiced and will need treatment.
Prolonged jaundice is where the jaundice persists for more than two weeks. Further investigations need to be done as there are rare conditions that can cause jaundice to persist.

What is 'breast milk jaundice'?

Jaundice is quite common in babies who are breast feeding. It is called 'breast milk jaundice' and is not harmful or a reason to stop breast feeding. If the jaundice lasts for more than two weeks, which is common, it is important to take the baby to see a doctor.

How is jaundice treated?

If jaundice is mild, it is important that your baby receives adequate amounts of fluids. A good supply of breast milk is all the baby needs. Advice will be given to expose the baby to natural light, but you must not leave baby in the direct sun as this can cause skin damage.

If your baby is jaundiced on the first day of his/her life, or the level becomes higher after this, then treatment will be required in the form of phototherapy. Phototherapy means exposure to fluorescent light, which alters the bilirubin in the skin making it easier for the liver to process it.

Phototherapy can be managed in the hospital or at Birthcare if jaundice isn't severe. Regular blood tests are done to check that the levels are reducing. Your baby can be taken out for breast feeds and cuddles, but needs to stay under the light as much as possible for the treatment to work in a shorter period of time.

Bladder and bowels

A healthcare professional can tell a lot about the condition of your baby by looking at the urine and bowel movements. The colour, amount and smell all provide essential information. If you're not sure about your baby's urine or stools (poos), save a nappy for your midwife or LMC to look at.

Babies normally pass small amounts of urine in the first day. This changes to at least six to eight really wet nappies a day. If your baby hasn't passed urine for a while, they may leave an orange/pink powdery deposit on the nappy. Though these urates are quite common, they are an indication to make sure the baby has regular feeds. Let your LMC or midwife know.

If your baby hasn't passed a first bowel movement (meconium - a black/green sticky tar-like substance) in the first 24 hours following birth, please inform your LMC or midwife. Babies usually have meconium poos for the first three to five days following birth. This colour gradually changes from black/green to brown, then becomes a bright mustard yellow.

Breastfed babies

Breastfed babies usually poo at least once a day. It is normal for the baby to pass yellow watery poos (with pieces that look like sesame seeds) that have very little smell. Most breastfed babies poo at each feed; this is normal.

As baby grows, breastfed babies can go as long as seven to 10 days without having a bowel motion. Again, this is normal as baby produces very little waste when digesting breast milk.

Formula fed babies

Babies that drink formula usually poo every day or every second day. Poos tend to be more solid than breastfed babies, and there is a slightly more noticeable smell. Poos are yellowish in colour.


A baby's motions should always be soft. When a baby gets constipated, it has difficulties passing stools. Your midwife or Well Child provider will give you the appropriate advice.

There are many different things that can affect your baby's poos, most of which are of little concern. Sometimes the poos are still green four to five days following birth; if this happens you need to inform your LMC. This may be caused by a feeding problem, illness or mother's medication.

If the baby starts to pass white/grey cottage cheese like stools, please inform your LMC or midwife and make an appointment to see your family doctor.

Umbilical cord (belly button)

After birth the umbilical cord is clamped and cut. The clamp is removed a couple of days later, when the cord is dry and beginning to shrink. Separation of the cord from the belly button usually occurs within seven to 10 days. A small blood loss from this area is normal, but contact your midwife if you are concerned.

Bathing and drying the base of the belly button and the umbilical cord will not cause your baby any pain - this area has no nerve endings.

A red sticky, smelly umbilicus may be a sign of infection. Inform your LMC or midwife who will check and advise you.

It is normal for a separating cord to smell, as the process is caused by gangrene. Once separated, it can have the appearance of not being completely closed.

Breasts and genitals

The breasts in newborn boys and girls may be slightly swollen. This is normal and due to the effects of mother's hormones in the blood. The girls may also have a little milk secretion. This is also normal. Action may be required if the swollen breasts start to look red. See your doctor if this is the case.

Another normal hormonal effect on little girls is a blood-stained, mucousy vaginal discharge. This is also caused by the mother's hormones. Just wash gently. If there is some residual vernix (the white waxy substance on some babies at birth), this can be left. Vernix is good for the skin and will eventually be absorbed.

With boys, your LMC will observe for undescended testes. Usually testes descend during the seven to nine months of pregnancy, but they may also descend up to six weeks after birth. It is important for the testes to descend from the abdominal cavity, to protect the function and development of the sperm made after puberty.

If testes haven't descended before your LMC discharges you from his/her care, baby will be referred to your family doctor. If surgery is required, it is usually done between eighteen months and three years.

Penis care

Newborn boys have some skin at the end of the penis called the foreskin. This doesn't need to be pulled back (retracted) for cleaning. By the age of three to five years, the foreskin will be able to be pulled back for cleaning and this should be encouraged for health reasons.

You will need to see your doctor if the urine just dribbles or stops and starts; the foreskin is swollen when he wees; or if there is blood or pus coming out of the end of the foreskin.