Postpartum With a Newborn in the First Week: A Warm, Evidence-Based Guide
The first week home with your newborn is a time of profound change—your body is healing, your baby is adapting to life outside the womb, and your family is finding a new rhythm. You are doing something extraordinary. This guide offers practical, evidence-based tips to help you navigate the early days with confidence and care.
What to Expect From Your Body in Week One
Vaginal bleeding (lochia) is normal and typically starts bright red, then gradually lightens in color and flow. You may pass small clots; large clots or heavy bleeding are not normal. Cramping (afterpains) is common, especially during breastfeeding as your uterus contracts back to its pre-pregnancy size. Fatigue and night sweats are also normal as your body sheds extra fluid. If you had a vaginal birth, your perineum may be sore; if you had a cesarean birth, your incision will be tender as it heals. Source: American College of Obstetricians and Gynecologists (ACOG); World Health Organization (WHO)
Perineal Care (Vaginal Birth): Step-by-Step
1) Use a peri bottle: After each bathroom trip, gently rinse with warm water from front to back. Pat dry—do not rub.
2) Soothe swelling: Apply a cold pack or chilled witch hazel pads to the perineum for 10–20 minutes at a time during the first 24–48 hours.
3) Keep comfortable: Use a cushion or “donut” sparingly; sit on a soft surface and change positions often.
4) Pain relief: Acetaminophen and ibuprofen are generally safe for most postpartum people, including those who are breastfeeding. Always follow your clinician’s guidance. Source: ACOG; NIH LactMed
Cesarean Incision Care: Step-by-Step
1) Keep it clean and dry: Wash hands before touching the incision. Showering is usually fine; pat the area dry afterward.
2) Watch for trouble: Call your clinician if you notice increased redness, warmth, pus, separation of the incision, fever, or worsening pain.
3) Support your core: When you cough or laugh, brace your abdomen with a pillow. Avoid lifting anything heavier than your baby until cleared.
4) Pain plan: Use prescribed medications as directed; acetaminophen/ibuprofen are compatible with breastfeeding for most people. Source: ACOG; NIH LactMed
Bladder, Bowels, and Hemorrhoids
It’s common to feel hesitant about the first bowel movement. Aim for gentle regularity: drink to thirst, eat fiber-rich foods (fruits, vegetables, whole grains), and consider a stool softener if recommended. For hemorrhoids, use warm Sitz baths, witch hazel pads, and avoid straining. If you have burning with urination, severe constipation, or inability to pass urine, contact your clinician. Source: ACOG; WHO
Moving Your Body and Pelvic Floor Care
Short, frequent walks support circulation and mood. Pelvic floor contractions (Kegels) can begin when comfortable, but stop if you feel pain. Avoid strenuous activity, heavy lifting, and high-impact exercise until your clinician clears you. Source: WHO; ACOG
Emotions: Baby Blues vs. When to Seek Help
Up to 80% of new mothers experience “baby blues”: tearfulness, irritability, and feeling overwhelmed that peaks around day 3–5 and resolves within two weeks. If symptoms persist beyond two weeks, or include intense anxiety, panic, hopelessness, difficulty bonding, or thoughts of self-harm, reach out immediately. You are not alone, and effective help is available. Call your clinician, text/call 988 (Suicide & Crisis Lifeline in the U.S.), or contact Postpartum Support International (PSI) at 1-800-944-4773 (call) or 800-944-4773 (text HELP). Source: CDC; ACOG; PSI
Urgent Warning Signs (Call Your Clinician or Seek Emergency Care)
- Heavy bleeding that soaks through one or more pads in an hour, passing clots the size of an egg or larger, or feeling faint.
- Severe headache, vision changes, shortness of breath, chest pain, swelling of face/hands, or right upper abdominal pain (possible postpartum preeclampsia).
- Fever of 100.4°F (38°C) or higher, foul-smelling discharge, or severe incision/perineal pain (possible infection).
- Red, painful breast with fever (possible mastitis).
- Calf pain or swelling (possible blood clot). Source: CDC “Postpartum Warning Signs”; ACOG
Feeding Your Newborn: Getting Started
Newborns typically feed 8–12 times in 24 hours, day and night. Early, frequent feeding helps establish milk supply and supports blood sugar and jaundice prevention. Watch your baby, not the clock: early cues include stirring, hand-to-mouth movements, and rooting; crying is a late sign. Source: AAP; WHO
Breastfeeding Basics: Step-by-Step Latch
1) Get comfy: Support your back and arms. Place baby tummy-to-tummy with you, nose opposite your nipple.
2) Aim and wait: Brush your nipple to baby’s upper lip to encourage a wide-open mouth.
3) Bring baby to you: In one swift movement, bring baby to the breast (not breast to baby) so the chin and lower lip touch first.
4) Check latch: More areola visible above the top lip than below; cheeks are rounded; you feel a deep pulling, not pinching; you hear or see swallows.
5) If it hurts, break the seal gently with a clean finger and try again.
Signs baby is getting milk: relaxed hands, rhythmic sucks and swallows, and increasing wet/dirty diapers—by day 4–5, many babies have at least 6 wet diapers and 3–4 yellow stools daily. Seek help early if you have pain, nipple damage, or concerns about supply or baby’s intake; a lactation consultant can make a big difference. Source: AAP; WHO; Academy of Breastfeeding Medicine
If You Are Using Formula (Exclusively or in Combination)
Feed on demand based on hunger cues. Prepare formula exactly as directed, using clean water and sterile bottles. Discard any formula left in the bottle after one hour of the feed. In the first week, amounts vary; your pediatrician can guide you based on your baby’s weight and growth. Responsive feeding (pausing for breaks, not pressuring to finish a bottle) helps prevent overfeeding. Source: CDC; AAP
Tracking Feeds and Diapers: A Simple System
1) Keep a small notebook or phone note.
2) For each feed, jot down time, side (if breastfeeding), and duration or volume (if bottle-feeding).
3) Tally wet and dirty diapers daily.
4) Bring the log to your pediatric visit. This helps your clinician assess intake and hydration. Source: AAP
Newborn Sleep, Crying, and Soothing
Newborns sleep a total of about 14–17 hours spread across the day and night, often in 2–4 hour stretches. Frequent waking to feed is normal. Crying increases over the first few weeks and often peaks around 6–8 weeks; in the first week, most crying signals hunger, discomfort, or a need for closeness. Source: AAP
Soothing Steps You Can Try
1) Skin-to-skin contact: Place baby in just a diaper on your chest, covered with a blanket.
2) Swaddle: Use a snug, hip-safe swaddle; stop swaddling when baby shows signs of rolling.
3) Side/stomach hold for soothing only (never for sleep), with supervision.
4) Shush/white noise: Gentle, consistent sounds can be calming.
5) Sway/rock: Small rhythmic movements while supporting the head and neck. Source: AAP
Safe Sleep in Week One
Always place baby on their back for every sleep, on a firm, flat surface in a safety-approved crib, bassinet, or play yard. Share a room (not a bed) for at least the first 6 months. Keep soft items and loose bedding out of the sleep area. Avoid inclined sleepers. Consider offering a pacifier for sleep once breastfeeding is going well. Do not smoke or vape around your baby. Source: American Academy of Pediatrics (AAP) 2022 safe sleep policy
Diapering, Cord Care, and Circumcision Care
Diaper changes: Wipe front to back, especially for girls. Let skin air-dry when possible. A barrier ointment (like zinc oxide) helps prevent diaper rash.
Umbilical cord: Keep it clean and dry; fold the diaper below the stump. Sponge baths are fine until it falls off. Call if you see redness spreading, pus, bad odor, or fever. Do not apply alcohol unless your clinician advises it.
Circumcision: Keep the area clean and apply petroleum jelly if recommended to prevent the penis from sticking to the diaper. Mild redness and a yellow film are normal as it heals; call for significant swelling, bleeding, or fever. Source: AAP; WHO
Jaundice and the First Pediatric Visit
Most newborns are seen by their pediatrician within 3–5 days of birth (earlier if discharged early, if late preterm, or if there are feeding or jaundice concerns). Watch for yellowing of skin or eyes, sleepiness that interferes with feeds, or poor feeding—call promptly if you notice these. Early feeding and follow-up help prevent complications. Source: AAP
Medications and Pain Relief While Breastfeeding
Acetaminophen and ibuprofen are compatible with breastfeeding for most people. Many antibiotics and anesthetics used around delivery are also safe. Avoid aspirin unless specifically advised. Always check with your clinician or consult the NIH LactMed database if unsure. Source: NIH LactMed; ACOG
Nutrition, Hydration, and Rest
Eat regular, balanced meals and snacks; your body is healing and, if breastfeeding, making milk. Drink to thirst—keep water nearby. Iron-rich foods and your prenatal vitamin (if advised) can help recovery. Rest whenever you can: brief naps and shared night duties make a difference. Say yes to help with meals, laundry, and pets. Source: WHO; ACOG
Sex, Birth Control, and Pelvic Healing
It’s common to wait until bleeding has decreased and perineal or incision discomfort has eased before resuming sexual activity—usually after a postpartum check, but timing varies. Discuss birth control early: ovulation can return within weeks, even if breastfeeding. Options compatible with breastfeeding include condoms, progestin-only pills, IUDs, and implants. Your clinician can help tailor a plan. Source: ACOG
A One-Page First-Week Plan
Morning: Do skin-to-skin after the first feed. Take prescribed meds and have a nourishing breakfast. Take a short walk indoors or outside if safe.
Midday: Nap when your baby naps. Take a Sitz bath or shower. Check your bleeding, incision/perineum, and write down feeds/diapers.
Afternoon: Call your pediatrician or lactation consultant with any feeding or jaundice questions. Confirm your newborn visit date (ideally day 3–5).
Evening: Set up your night station: water, snacks, diapers, burp cloths, peri bottle, and phone charger.
Support: Assign one person to handle meals and laundry, one to triage texts/visitors, and one to do a daily supply check (pads, diapers, wipes). Post emergency and clinician numbers where you can see them.
When to Call the Pediatrician Urgently
- Fever of 100.4°F (38°C) or higher (rectal) in a newborn.
- Fewer than expected wet diapers or poor feeding, limpness, or lethargy.
- Yellowing of skin/eyes that is worsening, or baby too sleepy to feed. Source: AAP
Encouragement for the Journey
Your first week will be a patchwork of tiny wins and new challenges. You are learning your baby, and your baby is learning you. Ask for help early and often. Celebrate small victories—a good latch, a 20-minute nap, a shower. With time and support, the long days become more familiar and manageable.
Important Note
This guide is for general education and support; it is not a substitute for care from your own healthcare professionals. If you are worried about your health or your baby’s health, call your clinician or seek emergency care.
Sources and Helpful Resources
ACOG. Postpartum Care and “Optimizing Postpartum Care.” https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care and patient FAQs: https://www.acog.org/womens-health/faqs/postpartum-care
ACOG. Postpartum Preeclampsia. https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy
CDC. Postpartum Warning Signs. https://www.cdc.gov/hear-her/index.html
WHO. WHO recommendations on maternal and newborn care for a positive postnatal experience (2022). https://www.who.int/publications/i/item/9789240045989
AAP. Safe Sleep Recommendations (2022) and parent resource. https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/a-parents-guide-to-safe-sleep.aspx
AAP. Newborn Jaundice and First Office Visit (3–5 days). https://www.healthychildren.org/English/ages-stages/baby/Pages/Jaundice-in-Newborns.aspx and https://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Your-Childs-First-Office-Visit.aspx
NIH LactMed Database. Medications and Lactation. https://www.ncbi.nlm.nih.gov/books/NBK501922/
Academy of Breastfeeding Medicine. Protocol #36: The Mastitis Spectrum (2022). https://www.bfmed.org/protocols
CDC. Infant Formula Preparation and Storage. https://www.cdc.gov/nutrition/InfantandToddlerNutrition/formula-feeding/preparation-and-storage.html
Postpartum Support International. HelpLine 1-800-944-4773. https://www.postpartum.net/