🏠 Week 1

The First Week Home

The most disorienting, beautiful, exhausting week of your life. Here is exactly what to expect - Hour by hour, day by day - So nothing catches you off guard.

Day-by-Day: What's Normal

Day 1 Birth & first hours

Baby is assessed with APGAR score at 1 and 5 minutes after birth
BCG and first Hepatitis B vaccine given in hospital
Hearing screening performed
Skin-to-skin contact strongly encouraged - Regulates baby's temperature, heart rate, and breathing
Colostrum only - Breast milk hasn't come in yet; this is normal
Baby sleeps 16–18 hours total; wakes to feed every 1–3 hours

Days 1–4 Weight loss & jaundice watch

Most babies lose 7–10% of birth weight - Completely normal due to fluid loss and meconium
Meconium stools (black, tarry) transition to yellow-green by day 3–4
Physiological jaundice typically appears day 2–3 - Skin and whites of eyes appear yellow
Polyclinic will arrange first visit; some hospitals send a nurse for a home visit
Breast milk supply starts building - Engorgement common at days 3–5

Days 4–7 Milk comes in, rhythm begins

Mature breast milk 'comes in' - Breasts become fuller, sometimes uncomfortably so
Baby feeding frequency may increase as they adjust to larger milk volumes
Wet nappies increase: aim for 6+ per 24 hours by day 5
Jaundice typically peaks around day 3–5 and begins to resolve by day 7–10
Baby starts to have brief alert periods between sleeps - This is your interaction window
Umbilical cord begins to dry and darken

Days 7–14 Finding your feet

Baby should have regained birth weight by day 10–14
Feeding becoming slightly more rhythmic - Though still demand-led
Umbilical cord typically falls off within 1–3 weeks
First social smile may appear as early as 6 weeks - But not yet
Your own sleep debt is real; accept all help offered
Polyclinic 1-month check approaching - Note any questions

Bringing Baby Home

🌡️ Room Setup

Set air-conditioning to 24–26°C - Singapore's humidity can cause overheating even indoors
Position cot away from direct aircon airflow - Avoid chilling baby's face
Firm flat mattress in cot or crib - No pillow, no bumpers, no loose bedding
Changing station near feeding spot minimises disruption at night
Dim night light is fine; complete darkness is not required for newborns

🤝 Visitors & Helpers

Limit visitors in week 1 - Newborn immune systems are naive; anyone sick should stay away
Ask visitors to wash hands before holding baby
If you have a confinement nanny, establish feeding preferences clearly from day 1
Accept help with cooking, cleaning, and older siblings - Not baby holding
Traditional confinement practices: discuss with your OB what is safe and what to avoid

Normal Newborn Weight Changes

Period	Expected Change	Why	Action needed?
Days 1–4	Lose 7–10% of birth weight	Fluid loss, meconium, feeding establishment	None - Completely normal
Loss >10%	More than 10% below birth weight	May indicate feeding problem	See paediatrician today
Days 4–7	Weight stabilises	Feeding rhythm establishing	Monitor wet nappies
Days 7–10	Weight begins recovering	Milk supply established	None if feeding well
By day 14	Back to birth weight	Full milk supply, efficient feeding	Confirm at polyclinic
Month 1+	+150–200g per week	Active growth phase	Track at 1-month visit

Umbilical Cord Care

✓ What to do

✓Keep the stump dry - This is the most important rule
✓Fold the nappy down below the stump so it stays exposed to air
✓Clean once daily with a cotton bud dipped in cooled boiled water
✓Allow it to air-dry after cleaning
✓Give sponge baths only until the cord falls off
✓Expect it to fall off naturally between 1–3 weeks

✗ What to avoid

✗Do not pull or twist the stump - Even if it looks loose
✗Do not apply alcohol, antiseptic powder, or herbal paste (traditional practice)
✗Do not cover with a bandage or tape
✗Do not submerge in water for a bath

See a doctor if: The skin around the base looks red, swollen, or warm; the stump has a foul smell; pus is present; there is bleeding beyond a few drops when the cord separates.

Singapore Newborn Screening

All babies born in Singapore hospitals undergo the Newborn Metabolic Screening (NBS) - A mandatory heel-prick blood test performed at 48 hours of age.

This screens for 25+ treatable conditions. Results are usually available within 2 weeks and sent to your polyclinic.

Conditions screened include:

Phenylketonuria (PKU)
Congenital hypothyroidism
G6PD deficiency (very common in Singapore)
Galactosaemia
Congenital adrenal hyperplasia (CAH)
Maple syrup urine disease (MSUD)
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
20+ other metabolic disorders

Other in-hospital screens:

Hearing screening (AABR/OAE)

Performed before discharge. If a referral is given, it does not mean hearing loss - Many babies pass on the second test.
Pulse oximetry

Screens for critical congenital heart disease. Painless oxygen sensor on hand and foot.
Jaundice monitoring

Bilirubin checked via skin sensor or blood test if jaundice appears.
Physical examination

Hips, eyes, heart, genitalia, palate checked before discharge.

Nappy Output: Your Best Feeding Feedback

Day	Wet nappies	Stool colour & consistency
Day 1	1+	Meconium: black, thick, sticky - Normal
Day 2	2+	Meconium transitioning to dark green
Day 3	3+	Transitional: green-brown to yellow-green
Day 4	4+	Yellow-green; may start to look 'seedy'
Day 5+	6+	Breastfed: bright yellow, loose, seedy. Formula: pale yellow, more formed

Fewer than 6 wet nappies per 24 hours after day 5 is a reason to contact your polyclinic. Use the Diaper Calculator to estimate monthly diaper costs.

Continue reading the Newborn Guide:

Feeding → Sleep & Safe Sleep → Bathing & Daily Care → Doctor Visits & Vaccines → Warning Signs → Emotional Wellbeing →

Medical disclaimer: This guide is for general educational purposes only. Always consult your paediatrician or polyclinic for concerns about your baby's health.