A newborn baby is a child from the moment of birth up to 28 days of life. These first four weeks are some of the most important — and most closely monitored — of your child’s entire life. In Canada, your newborn will go through several medical checks, feeding routines, and developmental milestones. This guide walks you through what to expect, step by step.
The Newborn Baby Medical Exam in the First Week
During the first week of life, your newborn baby receives a thorough physical examination. In Canada, this is typically performed by a paediatrician or your family doctor before you leave the hospital. The exam covers many body systems to catch any potential issues early.
Heart and Breathing Checks
The doctor listens to your baby’s heart and lungs using a stethoscope. This helps confirm a normal heart rate and breathing pattern. The doctor also checks for any unusual sounds, such as a heart murmur or signs of breathing difficulty.
In addition, the femoral arteries — found in the groin area — are felt carefully. This helps rule out certain cardiovascular problems that may not be visible on the outside.
Skin Examination
Your baby’s skin is examined closely for any unusual markings or colour changes. For example, the doctor looks for purpura (small red or purple spots caused by bleeding under the skin) or angiomas (small red birthmarks made of blood vessels). Yellowing of the skin, called jaundice, and a bluish tint, called cyanosis, are also checked.
Jaundice is very common in newborns and usually resolves on its own. However, severe jaundice needs prompt medical attention.
Physical Structure and Organ Check
A detailed physical exam checks your newborn baby from head to toe. A soft tube may be gently passed through the nose and into the esophagus to make sure there are no blockages. Another soft probe checks the anal opening to rule out malformations.
The doctor also checks the nasal passages, the roof of the mouth (palate), and the lower spine. These checks help identify conditions that may not have shown up on prenatal ultrasound. Furthermore, the skull, collarbone, and limbs are examined — especially if labour was difficult — to detect fractures or unusual shaping.
Fingers and toes are counted and checked for abnormalities. The hip joints are also assessed for signs of developmental dysplasia, a condition where the hip socket does not fully cover the ball of the thigh bone. Health Canada supports early screening programmes to catch these issues as soon as possible.
Eye Examination
Your newborn baby’s eyes are checked to confirm they respond to light. The doctor looks to see if the eyes can follow a high-contrast object, such as something black and white, horizontally. Pupils are checked to ensure there are no abnormal reflections, which could signal a serious eye condition.
The doctor also looks for conjunctivitis, which is a redness or swelling of the eye. If your baby’s eye is frequently stuck shut with discharge, the tear duct may be blocked. This is common and often clears up on its own within the first year.
Abdominal and Genital Exam
The belly is gently pressed to assess the size of the liver and to check the umbilical cord stump. A healthy cord stump contains three blood vessels. The doctor confirms this during the exam.
For baby boys, the penis should measure at least two centimetres in length. Both testicles should have descended into the scrotum. For baby girls, the vaginal opening should be clearly visible. A whitish or occasionally blood-tinged vaginal discharge around day five is considered normal and requires no treatment.
Neurological Assessment
The neurological exam is one of the most important parts of the newborn baby check. The doctor observes how your baby moves spontaneously. Healthy newborns show asymmetrical limb movements, alternating between bending and straightening their arms and legs, and opening and closing their fists.
Muscle tone is also tested. This involves gently checking how well your baby can hold up their head and trunk. In addition, the doctor checks for primitive reflexes — automatic responses that are normal only in newborns. These include the grasp reflex (curling fingers when the palm is touched), the sucking reflex, and the stepping reflex (making walking motions when held upright). These reflexes gradually disappear as your baby’s nervous system matures.
Newborn Screening Tests
As part of routine newborn care in Canada, your baby will have a heel prick blood test. A few drops of blood are collected from the baby’s heel, usually within the first 24 to 48 hours after birth. This is called the newborn screening programme.
The test screens for several serious but treatable conditions. These include phenylketonuria (PKU), a rare inherited disorder where the body cannot properly process a protein building block called phenylalanine. Congenital hypothyroidism — a condition where the thyroid gland does not produce enough hormone — is also screened. Both conditions can cause serious developmental delays if left untreated, but they respond very well to early treatment.
According to the World Health Organization, early newborn screening programmes save lives and significantly improve long-term health outcomes for children worldwide.
Feeding Your Newborn Baby
Feeding is one of the most important parts of newborn care. In the first day of life, your newborn baby needs about 60 millilitres of breast milk or formula per kilogram of body weight per day. By the end of the first week, this increases to about 150 millilitres per kilogram per day.
It is completely normal for newborns to lose some weight in the first three days of life. This happens mainly because feeding quantities are still small and the body is adjusting. In most cases, babies regain their birth weight by day eight. After that, expect your baby to gain an average of 25 to 30 grams per day.
Whether you choose to breastfeed or formula-feed, both options can support healthy growth. However, breastfeeding is recommended as the first choice by most Canadian health authorities. For support with feeding, speak to your family doctor or a registered lactation consultant.
Hygiene and Daily Care for Your Newborn
Skin and Diaper Care
Your newborn baby should be cleaned and have their diaper changed after every feeding. If the bottom area looks slightly red or irritated, apply a gentle moisturising cream to protect the skin. Always pat the area dry before applying cream.
The umbilical cord stump needs daily disinfection until it falls off. On average, the cord stump drops off around day eight of life. The first full bath is usually given after this point. Until then, sponge baths are the safest option.
Safe Sleep Guidelines
Safe sleep is critical for your newborn baby’s health. Your baby should sleep in a firm-sided crib or bassinet with a firm, flat mattress that fits the full surface area. Do not use a pillow or soft bedding.
A sleep sack or wearable blanket is the safest option instead of loose blankets or quilts. This keeps your baby warm without the risk of covering their face. Your baby can sleep on their side, but placing them on their back to start is the safest position recommended by Canadian paediatric guidelines.
If weather permits, your full-term newborn baby can have their first outdoor outing as early as day 15 of life. Dress them in layers and avoid direct sun exposure. Always check the weather before heading outside with a very young infant.
Emotional Development and Bonding With Your Newborn
Beyond physical care, your newborn baby needs emotional connection to thrive. Early and frequent skin-to-skin contact with both parents supports healthy brain development and emotional security. The warmth and love you provide in these early weeks lays the foundation for your child’s lifelong wellbeing.
Talk to your baby often, make eye contact, and respond to their cries promptly. Research shows that responsive parenting in the newborn period builds trust and helps regulate your baby’s nervous system. As a result, babies who receive consistent, loving care tend to develop better emotional and social skills over time.
Both parents play an equally important role in early bonding. Fathers and non-birthing parents who engage actively in newborn care report stronger emotional connections with their children. For more information on infant development, visit the Mayo Clinic’s newborn health resource centre.
When to See a Doctor
Most newborn care concerns can be addressed by your family doctor or paediatrician at your scheduled post-birth follow-up appointments. In Canada, your provincial health plan covers these early well-baby visits. If you do not have a family doctor, a walk-in clinic can help with non-emergency concerns.
However, some signs require urgent attention. Contact your doctor or go to the emergency department right away if your newborn baby shows any of the following:
Jaundice that spreads quickly or covers most of the body
Difficulty breathing, such as rapid breathing or bluish lips
Fever of 38°C or higher in a baby under three months old
Refusing to feed or showing signs of dehydration
Unusual limpness or a significant change in behaviour
Persistent vomiting or green-coloured vomit
Umbilical cord stump that looks infected (red, swollen, or has a foul odour)
Always trust your instincts as a parent. If something does not feel right, it is always better to seek medical advice sooner rather than later. This article is for general information only — please consult your family doctor or a qualified healthcare provider for advice specific to your newborn baby’s health.
Frequently Asked Questions About Newborn Babies
How much should a newborn baby sleep each day?
A newborn baby typically sleeps between 14 and 17 hours per day in short stretches of two to four hours. Sleep patterns are irregular at this stage because newborns need to feed frequently. Most babies begin to develop more predictable sleep patterns around three to four months of age.
Is it normal for a newborn baby to lose weight after birth?
Yes, it is completely normal for a newborn baby to lose up to seven to ten percent of their birth weight in the first few days of life. This weight loss happens because feeding quantities are still building up. Most newborns regain their birth weight by around eight to ten days of age.
When should I give my newborn baby their first bath?
It is generally recommended to wait until your newborn baby’s umbilical cord stump falls off before giving a full bath, which is usually around day eight of life. Until then, sponge baths are the safest and gentlest option. Speak to your family doctor or nurse if you have questions about bathing technique.
What reflexes does a newborn baby have at birth?
A newborn baby is born with several automatic reflexes, including the grasp reflex, the sucking reflex, and the stepping reflex. These are called primitive or newborn reflexes and are a sign of a healthy nervous system. They gradually disappear over the first few months as the brain continues to develop.
What is the newborn heel prick test in Canada?
The newborn heel prick test is a routine blood screening done within the first 24 to 48 hours after birth in Canadian hospitals. A few drops of blood are taken from the baby’s heel to screen for serious but treatable conditions, including PKU and congenital hypothyroidism. The test is covered under provincial health plans across Canada.
How often should I feed my newborn baby?
A newborn baby typically needs to be fed every two to three hours, or eight to twelve times in a 24-hour period. Whether breastfeeding or formula feeding, watch for hunger cues such as rooting, sucking on hands, or fussiness. If you have concerns about your newborn’s feeding, your family doctor or a lactation consultant can help.
Key Takeaways
A newborn baby is defined as a child from birth to 28 days of age.
A thorough medical exam in the first week checks the heart, lungs, skin, eyes, nervous system, and more.
The heel prick newborn screening test checks for PKU and congenital hypothyroidism — both covered under Canadian provincial health plans.
Newborns need 60 ml/kg/day of milk at birth, increasing to 150 ml/kg/day by end of week one.
Weight loss in the first three days is normal; most babies regain birth weight by day eight.
Safe sleep means a firm mattress, no pillows, and a sleep sack instead of loose blankets.
Early bonding with both parents supports healthy emotional and neurological development.
Seek care from your family doctor, paediatrician, or walk-in clinic if you have any concerns about your newborn’s health.
