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Essential newborn care

Newborn Care Counselling

Practical, family-centred guidance for the first days and weeks of a baby's life — including feeding, warmth, skin-to-skin contact, cord care, hygiene, screening, immunization, danger signs and timely follow-up.

Newborn danger signs
WHO-aligned framework

What essential newborn care covers

Essential newborn care starts at birth and continues throughout the newborn period. Counselling should be practical, respectful and adapted to the baby’s condition and the family’s ability to provide care.

Warmth & skin-to-skin

Keep the newborn warm and support close skin-to-skin contact when appropriate.

Breast milk feeding

Support early breastfeeding and responsive feeding, with help for feeding difficulties.

Infection prevention

Promote hand hygiene and hygienic cord and skin care.

Health assessment

Watch for breathing, temperature, feeding, movement and jaundice concerns.

Screening & prevention

Support recommended newborn screening, immunization and preventive care.

Timely referral

Recognize danger signs and seek urgent professional assessment when present.

Important: A healthy newborn still needs planned postnatal contacts. WHO recommends a minimum of four postnatal contacts, while additional contacts are needed when the baby has health risks or the family needs additional support.
Follow-up

Minimum newborn postnatal contact schedule

The timing below follows the WHO postnatal-care framework. The number, timing and content should be tailored to the newborn's health and the family's needs.

Within 24 hours

First newborn postnatal contact

Assess the newborn, support feeding, maintain warmth and skin-to-skin contact, review breathing and other health concerns, and counsel the family on care and danger signs.

48–72 hours

Early follow-up

Reassess feeding, warmth, jaundice and other concerns; review cord and skin care; reinforce danger-sign recognition and the plan for seeking care.

7–14 days

Second-week review

Review feeding and growth-related concerns, assess for problems requiring additional care and support the caregiver’s confidence in newborn care.

Week 6

Six-week follow-up

Complete the appropriate newborn assessment, review growth, immunization and developmental concerns, and arrange additional care when needed.

At birth and first hours

Immediate essential newborn care

Immediate care should be provided by appropriately trained health workers according to the baby's condition and local clinical protocols.

Keep the newborn warm

  • Thoroughly dry the baby after birth and avoid unnecessary exposure to cold.
  • Support skin-to-skin contact with the mother when clinically appropriate.
  • Continue attention to thermal protection during transfer, examination and routine care.
  • Small or preterm newborns may require additional thermal support and kangaroo mother care.

Assess breathing and condition

  • Assess breathing and the newborn's general condition immediately after birth.
  • Provide newborn resuscitation when required using trained personnel and appropriate equipment.
  • Continue observation for breathing difficulty, abnormal movement, poor feeding and other danger signs.
  • Arrange timely referral or higher-level care when additional care is needed.

Start and support feeding

  • Support early initiation of breastfeeding when clinically appropriate.
  • Help the mother and baby achieve comfortable, effective feeding.
  • Observe and address feeding difficulties rather than assuming poor feeding is normal.
  • Provide individualized feeding advice for small, preterm or sick newborns.

Protect from infection

  • Perform hand hygiene before handling the baby.
  • Use clean practices for cord and skin care.
  • Recognize signs that could indicate infection and seek care promptly.
  • Avoid unclean substances or unnecessary products on the cord or skin.
Feeding

Breastfeeding and newborn feeding support

WHO recommends support for breast milk feeding as part of essential newborn care. Exclusive breastfeeding means giving only breast milk, without additional food or drink, including water, for the first 6 months.


Help the mother and baby start breastfeeding as early as possible after birth when clinically appropriate.
Support exclusive breastfeeding for the first 6 months when possible; breast milk is the recommended sole source of food and drink during this period.
Keep mother and baby together when clinically appropriate and allow feeding in response to the baby’s cues.
Observe a feed when there are concerns about latch, milk transfer, maternal pain, poor feeding or inadequate output.
If the baby is not feeding well, is unusually sleepy, has repeated vomiting or shows another danger sign, seek prompt medical assessment.
Do not delay medical assessment of a sick newborn while trying home feeding remedies.

When feeding needs extra help

Feeding difficulties may be a sign that the newborn needs assessment. Support should include observation of the feed and assessment of the baby's overall condition.

  • Baby does not latch or suck effectively.
  • Baby stops feeding or feeds much less than usual.
  • Baby is unusually sleepy or difficult to wake for feeds.
  • Repeated vomiting or another concerning symptom is present.
  • The caregiver is worried that feeding is not going well.
Thermal protection

Warmth, skin-to-skin contact and kangaroo mother care

Newborns can lose heat quickly. Thermal protection is an essential component of newborn care, with skin-to-skin contact playing an important role.

Everyday thermal care

Dry the baby thoroughly after birth and maintain a warm environment.
Skin-to-skin contact helps provide warmth and supports bonding and breastfeeding.
For a small or preterm newborn, prolonged skin-to-skin contact and kangaroo mother care may be recommended when the baby is clinically stable and appropriate for this care.
Avoid unnecessary exposure to cold air and unnecessary separation from the caregiver.
Seek professional advice if the baby feels unusually cold, has a temperature concern, is lethargic or is otherwise unwell.

For small or preterm newborns

Kangaroo mother care can improve thermal control and support feeding and bonding for appropriate preterm or low-birth-weight babies. It should be implemented according to the baby's clinical condition and the health facility's protocol.

If a small or preterm baby is unwell, unstable or has a danger sign, urgent clinical assessment takes priority.
Clean care

Umbilical cord, skin and hand hygiene

Hygienic cord and skin care helps reduce infection risk. Families should receive simple, consistent instructions and know which findings need medical assessment.

Umbilical cord care

Keep the umbilical cord clean and dry.
Wash hands with soap and water before handling the baby or cord.
Do not apply household substances, powders, oils, ash, mud or unprescribed products to the cord.
Watch for redness spreading onto the surrounding skin, swelling, pus/discharge, foul smell or other signs of infection.
Seek medical assessment promptly if cord infection is suspected.

Hand and skin hygiene

Wash hands before touching or feeding the newborn and after changing diapers or handling body fluids.
Use clean equipment and clean hands for newborn care.
Keep the baby’s skin and surroundings clean and dry.
Avoid smoke exposure and keep the newborn away from people with contagious illness where feasible.
Do not share unclean feeding equipment or other items that come into contact with the baby’s mouth.
WHO advises keeping the umbilical cord dry and avoiding application of substances such as ointments unless a specific product has been recommended by an appropriate health professional for a defined clinical reason.

Bathing and keeping the baby clean

WHO public guidance advises delaying the first bath for at least 24 hours. Keeping the newborn warm and avoiding unnecessary heat loss are important. Follow local clinical advice if the baby has a medical condition or requires special care.

Mother and baby together

When clinically appropriate, keeping mother and baby together supports feeding, bonding, warmth and responsive care. Families should receive clear guidance before discharge and know where to seek help if the newborn becomes unwell.

Prevention & follow-up

Newborn screening, immunization and assessment

Preventive newborn care varies by country and health system. Families should follow the current national immunization and newborn-screening programme and the baby's healthcare team.

Newborns should receive appropriate clinical assessment after birth and during postnatal contacts.
Families should ask about recommended newborn screening available in their setting, including eye and hearing assessment where provided.
Jaundice should be assessed, particularly when it appears early or is becoming more pronounced.
Weight, length and head circumference are important parts of follow-up at the appropriate visit.
Immunization should follow the current national schedule and the advice of the newborn’s healthcare team.
Small, preterm or sick newborns may need additional monitoring, investigations or referral.
For India: vaccination and newborn screening should follow the current Government of India / National Immunization Schedule and applicable state or facility protocols. This page intentionally does not replace the current national schedule.
Jaundice awareness

Understand newborn jaundice

Jaundice is common in newborns, but some patterns require prompt assessment. Families should not rely only on visual observation when a newborn appears significantly yellow or unwell.

Ask for assessment

A healthcare professional should assess significant or worsening jaundice and decide whether bilirubin measurement or other evaluation is needed.

First 24 hours matter

Jaundice appearing during the first 24 hours of life is a danger sign and requires prompt medical assessment.

Do not delay care

If the baby is yellow and also feeding poorly, unusually sleepy, feverish, cold or otherwise unwell, seek urgent professional assessment.

Urgent newborn safety

Newborn danger signs

Families should be taught to recognize danger signs and know exactly where to seek care. A newborn with a danger sign needs prompt professional assessment.

Not feeding well

The newborn stops feeding, feeds poorly or cannot breastfeed effectively.

Fast or difficult breathing

Breathing is very fast, there is severe chest indrawing, grunting or obvious breathing difficulty.

Convulsions or abnormal movements

The baby has convulsions, repeated abnormal movements or becomes unusually unresponsive.

Marked sleepiness or no spontaneous movement

The baby is unusually difficult to wake, floppy or is not moving normally.

Fever or low temperature

A newborn has a temperature concern. WHO guidance uses ≥37.5°C for fever and <35.5°C for low temperature in newborn assessment.

Jaundice in the first 24 hours

Yellow discoloration appearing during the first 24 hours requires prompt medical assessment.

Yellow palms or soles

Marked yellow discoloration involving the palms or soles at any age requires assessment.

Other serious concern

Any rapidly worsening condition, severe infection concern, poor colour, repeated vomiting or caregiver concern that the baby is seriously unwell needs professional assessment.

When to seek urgent care

If a newborn is not feeding well, has difficult or fast breathing, has convulsions, is unusually unresponsive, has a significant temperature abnormality, develops jaundice in the first 24 hours, has yellow palms or soles, or otherwise appears seriously unwell, seek urgent medical care. Do not wait for the next routine postnatal visit.

Family-centred counselling

How newborn counselling should be delivered

WHO emphasizes information, reassurance and support for women, newborns, parents, caregivers and families as part of a positive postnatal experience.

Teach, then demonstrate

Use simple language, demonstrate practical care and ask the caregiver to explain or show the key steps back to you.

Build confidence

Reassure parents that questions are welcome and explain which normal newborn behaviours can be expected and which findings require care.

Include the family

Partners and other caregivers can support feeding, warmth, hygiene, transport planning and recognition of danger signs.

Respect the family

Provide respectful, person-centred counselling and discuss cultural practices without shaming the family. Explain clearly when a practice could place the newborn at risk.

Plan for access

Before discharge or the end of a contact, confirm where the family should go if the newborn becomes unwell and how they will reach care.

Before going home

Newborn discharge counselling checklist

Before discharge, the family should understand routine care, feeding, follow-up and urgent warning signs and should have a practical plan for accessing care.

Topic What the family should understand When to act
Feeding How to feed, how to recognize feeding difficulties and where to get breastfeeding help. Prompt assessment if the baby feeds poorly or stops feeding.
Warmth Skin-to-skin contact and protection from cold exposure. Seek care if the baby feels unusually cold or is otherwise unwell.
Cord care Keep the cord clean and dry and avoid unsafe substances. Assessment for redness, swelling, pus/discharge, foul smell or other infection concerns.
Jaundice Know that significant or early jaundice requires assessment. Prompt assessment for jaundice in the first 24 hours or worsening jaundice.
Danger signs Recognize poor feeding, breathing difficulty, convulsions, abnormal temperature and other serious signs. Urgent medical care; do not wait for the next scheduled visit.
Follow-up Know the date and location of the next postnatal contact. Attend the scheduled contact and arrange earlier review if concerns arise.
Prevention Know the plan for immunization and any newborn screening recommended locally. Follow the current national/local schedule and clinical advice.
When routine counselling is not enough

Newborns who may need additional care

Not every newborn follows the same care pathway. Additional assessment, monitoring or referral may be required when a newborn is small, premature, sick or has a concerning clinical finding.

Preterm or low-birth-weight newborns
Newborns who are sick or have feeding difficulties
Newborns with suspected infection
Newborns with jaundice requiring assessment
Newborns needing resuscitation or advanced care after birth
Newborns with congenital or other clinical concerns
Families with barriers to follow-up, transport or access to care
The management of serious newborn illness, neonatal sepsis, severe jaundice, respiratory distress, resuscitation and advanced neonatal conditions requires appropriate clinical protocols and trained health personnel. This educational page focuses on counselling and recognition, not treatment.
Practical teaching

What parents and caregivers can practise before discharge

A counselling session is more useful when caregivers can demonstrate the key actions themselves.

Feeding support

Show the caregiver how to position the baby safely for feeding and how to recognize when feeding is not going well.

Warmth

Demonstrate safe skin-to-skin positioning when appropriate and explain why warmth matters.

Hand hygiene

Ask caregivers to demonstrate handwashing before handling the baby and before feeding.

Cord care

Ask the family to explain how they will keep the cord clean and dry and what changes should prompt review.

Danger signs

Use teach-back: ask the caregiver to name the signs that require urgent medical attention.

Follow-up plan

Confirm that the family knows when and where the next newborn contact will occur and how to reach care sooner.

For midwifery & health-professional education

Newborn counselling learning framework

Students and educators can use this page as a structured checklist for communication, assessment and family education. It should be used alongside the applicable clinical guideline, local protocol and supervised skills training.

Knowledge domains

  • Essential newborn care and immediate care at birth.
  • Breastfeeding support and recognition of feeding difficulty.
  • Thermal protection and skin-to-skin contact.
  • Cord and skin hygiene and infection prevention.
  • Recognition of jaundice and newborn danger signs.
  • Postnatal contact schedule and referral pathways.
  • Parent-centred communication and teach-back.

Observed counselling skills

  • Introduces self and confirms caregiver understanding and concerns.
  • Uses simple, respectful, non-judgmental language.
  • Demonstrates newborn care and observes caregiver practice.
  • Explains danger signs clearly and checks understanding.
  • Provides a documented follow-up and referral plan.
  • Escalates abnormal findings promptly rather than treating counselling as a substitute for assessment.
Frequently asked questions

Newborn care FAQs

Short, practical answers based primarily on WHO newborn and postnatal-care guidance.

What does essential newborn care include?

WHO describes essential newborn care as including immediate care at birth, thermal care, resuscitation when needed, breast milk feeding support, nurturing care, infection prevention, assessment for health problems, recognition of danger signs and timely referral when needed.

How long should a newborn be kept skin-to-skin?

Skin-to-skin contact should be supported as part of essential newborn care when clinically appropriate. The exact duration and continuation depend on the baby’s condition and the care setting. Small or preterm newborns may benefit from more prolonged skin-to-skin or kangaroo mother care under appropriate clinical guidance.

Should a newborn receive water along with breast milk?

WHO defines exclusive breastfeeding as breast milk only, without additional food or drink, including water, for the first 6 months. If a newborn has a feeding problem or a medical condition, the family should follow individualized advice from the healthcare team.

What should I do if my newborn is not feeding well?

Poor feeding is a newborn danger sign. Seek prompt medical assessment rather than relying only on home remedies. A health professional can assess feeding, breathing, temperature and other possible causes.

When should newborn jaundice be checked?

Jaundice should be assessed by a healthcare professional. Yellowing in the first 24 hours is specifically a danger sign requiring prompt evaluation, and worsening or marked jaundice should also be assessed.

How often should a healthy newborn receive postnatal follow-up?

WHO recommends a minimum of four postnatal contacts: within 24 hours after birth, between 48–72 hours, between 7–14 days and during week 6. Additional contacts may be needed according to the baby’s condition and family needs.

Can a small or premature newborn receive kangaroo mother care?

Kangaroo mother care is recommended for appropriate small or preterm newborns. The newborn’s clinical condition and the local protocol determine how it should be started and supported.

Continue learning

Related maternal & newborn services

Explore related pages on The Vatsalyam for continuity of care across pregnancy, birth and the postnatal period.

Antenatal Care Pregnancy care, preparation and referral. Normal Labour & Birth Support Supportive care during labour and birth. Postnatal Care Maternal and newborn care after birth. Breastfeeding Support Practical breastfeeding education and support. Respectful Maternity Care Respect, dignity, communication and person-centred care. Birth Preparedness Planning for birth, emergencies and timely referral. Maternal & Newborn Danger Signs Recognition, counselling and escalation. Maternal Health Follow-up Continuity of care after childbirth.
Guideline references

Primary sources used for this page

The page is designed around WHO essential newborn-care and postnatal-care recommendations. Local/national protocols should be followed for implementation.

WHO — Essential newborn care.
Immediate care at birth, thermal care, resuscitation when needed, breast milk feeding, nurturing care, infection prevention, recognition of danger signs and referral.
WHO Essential Newborn Care
WHO — Recommendations on maternal and newborn care for a positive postnatal experience (2022).
Consolidated recommendations for routine postnatal care of women and newborns.
WHO guideline
WHO — Newborn postnatal-care interventions.
Newborn assessment, skin-to-skin contact, early breastfeeding, feeding difficulty assessment, physical assessment, growth, immunization and developmental assessment.
WHO newborn interventions
WHO — Caring for a newborn.
Practical public guidance on warmth, first bath timing, cord care, rooming-in, feeding and danger signs.
WHO newborn care advice
WHO — Essential Newborn Care Course, second edition (2025).
Training resource covering immediate newborn care, resuscitation, breast milk feeding, thermal care, infection prevention and danger-sign recognition.
WHO Essential Newborn Care Course
WHO — Early Essential Newborn Care Clinical Practice Pocket Guide, second edition.
Practical guidance for skilled health workers caring for newborns in the first hours and days.
WHO EENC Pocket Guide
Medical education and safety disclaimer: This page provides general health education and newborn-care counselling information. It is not a substitute for examination, diagnosis, treatment or individualized advice from a qualified health professional. Newborns can deteriorate quickly. If a baby has a danger sign or appears seriously unwell, seek urgent medical assessment rather than relying on this page. Clinical management should follow current WHO guidance, national guidelines, facility protocols and the newborn's individual clinical condition.
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