Appearance & Skin:

• Jaundice: Yellowish skin/eyes in first week (common, usually resolves). What to do: Feed frequently (8-12x/day) to help flush it out, expose baby to indirect sunlight near a window for 10-15 min, 2-3x/day. Call doctor if: Jaundice after day 3, spreading to arms/legs, baby too sleepy to feed, or deepening yellow/orange color.
• Peeling skin: Totally normal, especially on hands/feet. No lotion needed.
• Baby acne: Tiny red bumps on face (resolves on its own by 3-4 months)
• Cradle cap: Scaly, crusty patches on scalp (harmless, can gently brush out)
• Swollen genitals/breasts: From maternal hormones, resolves in a few weeks
• Crossed eyes: Eye muscles still developing (usually resolves by 3-4 months)

Sounds & Behaviors:

• Sneezing: Normal reflex that clears nasal passages (not usually a sign of illness)
• Hiccups: Super common, no need to "fix" them
• Grunting: While straining or learning to poop (normal unless struggling to breathe)
• Irregular breathing: Fast, then slow, then pause (normal unless turning blue or pausing >10 seconds)
• Startle reflex (Moro): Arms fly out when startled (goes away by 3-6 months)
• Shaky movements: Jerky arms/legs, especially when crying (immature nervous system)

Sleep & Crying:

• Day/night confusion: Totally normal first 6-8 weeks
• Won't sleep in bassinet: They were in a tight, warm space for 9 months. Safe sleep still required, but this is SO common.
• Cluster feeding: Eating constantly for hours (usually evenings), normal growth pattern
• Peak crying at 6 weeks: Fussiness peaks around 6 weeks as baby's brain develops faster than their ability to self-soothe, improves by 12 weeks. Look up PURPLE crying period.

Normal timeline: Falls off between 1-3 weeks (some take up to 4 weeks)

Care instructions:

• Keep it dry and exposed to air (fold diaper down below cord)
• Sponge baths only until cord falls off
• Don't pull it off - let it fall naturally
• A little blood when it falls off is normal
• Small amount of clear/yellow discharge is normal

⚠️ Call doctor if: Red/swollen skin around base, pus, foul smell, or bleeding that doesn't stop with gentle pressure

This is the hardest part. Here's what you need to know:

• No sleep training before 4 months. Their brains aren't ready. Right now it's all about survival.
• Wake windows don't apply yet. Newborns sleep/wake unpredictably. "Eat, play, sleep" doesn't work - sometimes it's "eat, sleep immediately."
• Night wakings are biological. Newborns can't sleep 8+ hours yet - their stomachs are too small. They'll wake naturally every 2-4 hours to eat. Once back to birth weight (and doctor approves), you don't need to wake them - but they'll wake on their own.
• Contact naps are survival. If baby only naps on you - that's developmentally normal. Safe sleep still applies at night.
• Day/night confusion is real. Can take 6-8 weeks to sort out. What helps: Keep days bright, noisy, and stimulating during feeds. Keep nights dim, quiet, boring, with minimal interaction.

Safe sleep (AAP guidelines):

• Back to sleep, every sleep
• Firm surface, fitted sheet only
• Nothing else in sleep space (no blankets, pillows, toys, bumpers)
• Room sharing (not bed sharing) for at least 6 months
• Stop swaddling when baby shows ANY signs of rolling

You're not doing it wrong. This is just hard. It gets better around 3-4 months when sleep patterns mature.

Days 1-3 (Colostrum phase):

• Baby's stomach is TINY (size of a cherry, then walnut, then ping pong ball)
• Colostrum is thick, yellow, small amounts - this is PERFECT
• Feed on demand, 8-12+ times per day (every 1-3 hours)
• It's normal for baby to lose up to 10% of birth weight in first few days

Days 3-5 (Milk coming in):

• Breasts may become full, hard, even painful (engorgement)
• Baby may cluster feed (eat constantly) - this is NORMAL and helps establish supply
• Some babies are extra fussy days 2-3 (the "second night syndrome")
• You might feel emotional (baby blues) - hormone crash is real

Signs baby is eating enough:

• 6+ wet diapers per day (after day 5)
• Poops transitioning from black → green → yellow by day 5
• Back to birth weight by 2 weeks
• Swallowing sounds during feeds
• Some periods of contentment between feeds

💡 See the Feeding Guide in Quick Ref for amounts, schedules, and more!

Call immediately if baby has:

• Fever: Rectal temp 100.4°F (38°C) or higher (ALWAYS call for fever in babies under 3 months)
• Extreme lethargy: Won't wake for feeds, floppy, hard to rouse
• Breathing issues: Blue/grey lips or skin, wheezing, flared nostrils, retractions (sucking in between ribs)
• Dehydration: Fewer than 6 wet diapers/day after day 5, dark urine, sunken soft spot, no tears when crying
• Vomiting: Forceful/projectile vomiting (different from normal spit-up)
• Blood in stool: Red or black tarry stools (after meconium phase)
• Severe crying: Inconsolable for 2+ hours, or a weak/different-sounding cry
• Bulging soft spot: When baby is sitting upright and calm

Also call if you notice:

• Yellowing skin getting worse after day 5 (jaundice check)
• Not gaining weight or back to birth weight by 2 weeks
• White patches in mouth that won't wipe off (could be thrush)
• Redness/swelling/discharge around umbilical cord or circumcision

Trust your gut. You know your baby best. If something feels off, call. That's what your pediatrician's nurse line is for.

The fourth trimester (0-3 months) is called this because babies need 3 more months outside the womb to develop to where other mammals are born. Your job is to recreate womb conditions: warmth, movement, feeding on demand. This is about survival, not perfection.

You're doing better than you think. Even on the hardest days.

This phase is temporary. You will sleep again. It gets easier. Usually around 12 weeks, you'll turn a corner and things will click.

Common Reasons (Check in this order):

1. Hungry - Even if they just ate. Growth spurts and cluster feeding are real.
2. Tired - Overtired babies cry more and have harder time falling asleep
3. Uncomfortable - Diaper, too hot/cold, clothing tag, uncomfortable position
4. Overstimulated - Too much noise, light, or activity
5. Gas/tummy trouble - Burp needed, gas pain, or need to poop
6. Just needs comfort - Sometimes babies cry just to be held

When it might be more:

• Cry sounds different than usual (high-pitched, weak, or sounds like pain)
• Inconsolable for 3+ hours
• Accompanied by fever, vomiting, or other symptoms
• Your gut says something is wrong

→ Trust your instincts. Call your pediatrician.

The 5 S's (Dr. Harvey Karp):

These mimic the womb and can calm most crying babies:

1. Swaddle - Snug wrapping (arms down, hips loose)
2. Side/Stomach position - Hold baby on their side or stomach (never sleep this way)
3. Shush - Loud "shhhh" sound close to baby's ear
4. Swing - Gentle, rhythmic motion (not vigorous shaking)
5. Suck - Pacifier, breast, or clean finger

Other techniques that work:

• White noise - Loud as a shower, played continuously
• Skin-to-skin - Place baby on bare chest
• Walk and bounce - Gentle bouncing while walking
• Car ride or stroller - Motion can be magic
• Warm bath - Calming for some babies
• Change of scenery - Go outside, different room
• Babywearing - Carrier or wrap for hands-free comfort
• Different caregiver - Sometimes baby just needs a fresh set of arms

It's okay to:

• Put baby down safely in the crib and take a 5-10 minute break
• Call a friend, partner, or family member for help
• Cry alongside your baby - this is hard and you're doing your best
• Feel frustrated - you're not a bad parent for feeling overwhelmed

Never, ever shake a baby. If you feel yourself getting overwhelmed, put baby down in a safe place and step away.

Remember:

• This phase is temporary (peaks at 6-8 weeks, improves by 3-4 months)
• Fed, safe, clean, and held is enough - you don't have to "fix" every cry
• Some babies cry more than others, and it's not your fault

What is colic?

Crying for 3+ hours/day, 3+ days/week, for 3+ weeks in an otherwise healthy baby. Usually peaks 6-8 weeks and resolves by 3-4 months.

PURPLE crying pattern (totally normal):

• Peak of crying (6-8 weeks)
• Unpredictable
• Resistant to soothing
• Pain-like face (even when not in pain)
• Long lasting (can go on for hours)
• Evening clustering (worse 5-11pm)

This is a developmental phase, not something you caused.

Overtired babies are harder to soothe. Watch for sleepy cues:

• Yawning
• Rubbing eyes
• Staring into space
• Fussiness
• Jerky movements

Wake windows by age:

• 0-6 weeks: 30-60 minutes
• 6-12 weeks: 60-90 minutes
• 3-4 months: 75-120 minutes

→ See Wake Windows card in Quick Ref

• Fever in baby under 3 months
• Crying sounds like pain or is high-pitched
• Won't eat or is eating significantly less
• Fewer wet diapers than usual
• Vomiting (not just spit-up)
• Seems limp or lethargic
• Your gut tells you something is wrong

• 6+ wet diapers per day (pale yellow urine)
• Consistent weight gain (5-7 oz/week in first 3 months; slows after that)
• Content after feeds, relaxed body
• Swallowing sounds during nursing

• Watch for fullness cues - pause during feeding
• Formula takes longer to digest than breast milk
• Bottle-fed babies more prone to overfeeding
• Follow "prepared formula" guidelines on packaging

Newborns (0-6 weeks):

• Breastfed: 3-12+ poops per day (some poop after every feed!). After 6 weeks, can drop to once every few days or even once a week - totally normal if soft when it comes.
• Formula-fed: 1-4 times per day, usually more regular schedule

After 6 weeks - 6 months:

• Breastfed: Can vary WILDLY - anywhere from multiple times daily to once every 7-10 days. As long as poop is soft/mushy when it comes, baby is comfortable, and gaining weight well, it's fine!
• Formula-fed: Usually at least once daily, up to several times

After starting solids (6+ months):

• Frequency and consistency will change! Usually 1-3 times per day
• May become firmer, smellier, and more "adult-like"
• Color varies based on what they eat (beets = red, blueberries = dark, etc.)

⚠️ Call doctor if: No poop for 5-7 days AND baby seems uncomfortable, straining with hard pellets (constipation), or sudden change from normal pattern with other symptoms

Small amounts of blood in baby's stool can have several causes:

Common causes:

• Tiny anal fissures: Small tears from straining or hard poop. Usually bright red streaks on outside of stool. Often resolves on its own.
• Food protein allergy (CMPA/MSPI): Most common in breastfed babies, usually to cow's milk protein in mom's diet or formula. Blood may be mixed throughout stool or appear as mucusy, bloody streaks. Baby may also have eczema, reflux, or seem uncomfortable.
• Swallowed blood: From mom's cracked/bleeding nipples (breastfeeding) - harmless to baby but worth addressing for mom's comfort

When to call the doctor:

• ANY visible blood in stool warrants a call to pediatrician
• Persistent blood over multiple diapers
• Large amounts of blood
• Blood accompanied by diarrhea, vomiting, fever, or baby seems unwell

💡 Food protein allergy note: If suspected, doctor may recommend eliminating dairy/soy from breastfeeding parent's diet or switching to hypoallergenic formula. Most babies outgrow this by 12 months.

When to burp:

• Bottle-feeding: Burp every 2-3 ounces or halfway through the bottle
• Breastfeeding: Burp when switching breasts or after feeding
• If baby seems uncomfortable: Try burping even if they haven't finished eating

Three burping positions:

💡 Tips: Some babies burp easily, others take longer. Try for 5-10 minutes. If no burp comes, that's okay - not every feeding produces a burp. If baby seems comfortable, you can stop trying.

Signs of gas:

• Pulling legs up to chest
• Arching back
• Clenched fists
• Fussiness during or after feeding
• Passing gas frequently

What helps:

Note: If breastfeeding, sometimes foods in your diet (dairy, caffeine, spicy foods, cruciferous veggies) can cause gas in baby. Consider keeping a food diary if baby seems persistently uncomfortable.

• Feed smaller amounts more frequently - Overfilling stomach makes spit-up worse
• Burp frequently - After every 2-3 oz for bottles, or when switching breasts
• Keep baby upright - Hold upright for 20-30 minutes after feeding
• Avoid bouncing or active play right after eating
• Don't overfeed - Watch hunger cues, stop when baby pulls away
• Check nipple flow - Too fast = baby gulps air
• Elevate head during sleep - But NEVER use pillows or positioning devices. Some parents safely elevate one end of the crib mattress by placing a towel under the mattress (outside the crib). Check with pediatrician first.

Remember: Most spit-up is laundry problem, not a medical problem. If baby is gaining weight and seems happy, spit-up is messy but normal.

• Projectile vomiting (especially if it happens repeatedly)
• Green or yellow vomit (could indicate bile or blockage)
• Blood in vomit or stool (red or coffee-ground appearance)
• Extremely hard, swollen belly
• Inconsolable crying for 2+ hours with no obvious cause
• Fever with vomiting (especially under 3 months old)
• Signs of dehydration (no tears, very dry mouth, fewer than 6 wet diapers in 24 hours)
• Refusing to eat for more than 8 hours

Around 6 months is the ideal time to introduce solid foods. Baby should show these signs of readiness:

• Can sit upright with minimal support and hold head steady
• Has lost the tongue-thrust reflex (doesn't automatically push food out)
• Shows interest in food, reaches for it, opens mouth when food approaches
• Can bring hands and objects to mouth

Two main approaches:

Purées: Smooth, spoon-fed foods. Start with single ingredients (sweet potato, avocado, banana) and gradually increase texture. Good for introducing flavors and getting baby comfortable with eating.

Baby-Led Weaning (BLW): Baby feeds themselves soft, appropriately-sized finger foods from the start. Skips purées entirely. Foods should be soft enough to squish between your fingers, cut into finger-length pieces (use your pinky as a guide).

You can do both! Many families combine approaches—offering both purées and finger foods. There's no "right" way.

Important: Breast milk or formula remains the primary source of nutrition until 12 months. Solids complement milk feeds, not replace them.

Before 12 months:

• Honey (risk of infant botulism)
• Cow's milk as a drink (ok in small amounts in food like yogurt)
• Added salt or sugar

Choking hazards (until age 4+):

• Whole grapes, cherry tomatoes (cut lengthwise into quarters)
• Hot dogs, sausages (cut lengthwise into thin strips, not rounds)
• Whole nuts, popcorn, hard candy
• Raw hard vegetables (carrots, celery—cook until soft)
• Thick nut butters (thin with water/breast milk, or spread thinly)
• Large chunks of meat or cheese

Current guidelines recommend EARLY introduction of common allergens around 6 months (or 4-6 months for high-risk babies). Research shows early introduction can reduce allergy risk by up to 81%.

Top allergens to introduce: Peanut, egg, cow's milk, tree nuts, soy, wheat, fish, shellfish, sesame

High-risk babies (severe eczema or existing egg allergy) should:

• Consult pediatrician before introducing peanut
• May need allergy testing first
• First introduction may be done under medical supervision

How to introduce allergens safely:

• Introduce one new allergen at a time
• Start with small amounts (½ teaspoon)
• Offer at home, early in the day when baby is healthy
• Once introduced successfully, keep in regular rotation (2-3x/week)

Signs of allergic reaction:

• Hives, rash, or swelling (especially face/lips)
• Vomiting or diarrhea
• Difficulty breathing, wheezing
• Symptoms typically appear within 10-15 minutes

⚠️ Call 911 immediately if baby has trouble breathing, swelling of lips/face, or multiple symptoms together.

6-8 months: 1-2 meals per day. Focus on exploration, not quantity.

8-12 months: 2-3 meals per day, can add 1-2 small snacks.

12+ months: 3 meals + 2 snacks per day. Solids become primary nutrition.

Remember: Milk feeds continue throughout! Don't reduce milk until baby is eating solids well.

• High chair: Must have: footrest for support, upright positioning (not reclined), easy to clean
• Suction plates/bowls: Prevents dumping. Look for divided sections to separate foods.
• Soft-tipped spoons: Gentle on gums (for spoon-feeding purées)
• Open cup or straw cup: Introduce water with meals around 6 months
• Sleeved bibs with pocket: Covers arms, catches dropped food
• Splat mat (optional): Makes floor cleanup easier

This is CRITICAL to understand. Many parents confuse gagging (normal, safe) with choking (emergency).

Remember: "Loud and red, let them go ahead. Silent and blue, they need help from you."

Helpful videos:

• Solid Starts: Gagging vs Choking (with videos)
• AAP: Infant CPR & Choking

⚠️ Always supervise meals. Baby should sit upright in high chair. Never leave baby alone while eating.

A sleep "regression" is really a developmental progression disguised as chaos. Your baby's brain is making huge leaps - learning to roll, crawl, walk, talk, understand object permanence. All this mental and physical development temporarily disrupts sleep.

Why it happens:

• Brain development: New neural pathways forming, processing new skills even during sleep
• Sleep cycle maturation: Baby's sleep cycles are maturing and changing (especially around 4 months)
• Physical milestones: They want to practice new skills (rolling, crawling) even at bedtime
• Separation anxiety: Around 8-10 months, they realize you exist when you're not there

The good news: These are temporary. Your baby is growing and developing exactly as they should.

Not every baby experiences every regression. Some skip them entirely. These are just common windows:

During the regression:

• Stick with your routine: Bedtime routine provides consistency even when sleep is chaotic
• Offer extra comfort: More cuddles, longer bedtime routine - they need reassurance
• Practice new skills during the day: If they're learning to stand, give lots of standing practice during awake time
• Earlier bedtime if needed: Overtired makes everything worse
• Safe sleep still applies: Don't introduce new sleep props (like bed-sharing) that you don't want long-term
• Naps might be messy too: Contact naps, car naps, whatever works to avoid overtiredness

What NOT to do:

• Don't start sleep training mid-regression (wait until it passes)
• Don't abandon all routines - consistency helps
• Don't assume every bad night is a regression - could be illness, teething, or just a bad night

Timeline: Most regressions last 2-6 weeks. If sleep doesn't improve after 6 weeks, may be worth evaluating schedule, environment, or checking in with pediatrician.

This is temporary. Even the brutal 4-month regression eventually ends. Sleep will improve again.

It's a sign of healthy development. Your baby's brain is doing exactly what it's supposed to do. They're learning and growing.

You're not doing anything wrong. This isn't because you created "bad habits" or failed at sleep training. This is normal biology.

Survival mode is okay. Do what you need to do to get through - extra feeds, contact naps, earlier bedtime, tag-teaming with your partner. There's no award for suffering through it "properly."

Ask for help. Sleep deprivation is no joke. Accept offers for help, nap when you can, lower your standards for everything else.

You will sleep again. Not tonight, maybe not this week, but you will. And when you do, you might not even remember how bad this felt.

• Fighting naps that used to work - resisting sleep for 20-30+ minutes
• Taking forever to fall asleep - clearly not tired at usual nap time
• Shorter naps than usual - waking after 20-30 minutes when they used to sleep longer
• Early morning waking - suddenly waking before 6am
• Cranky but won't sleep - tired signs but refuses nap
• Bedtime becomes a battle - fighting bedtime or taking long to fall asleep

Important: These signs need to happen consistently for 1-2 weeks. One or two bad nap days doesn't mean it's time to transition!

Week 1-2: Testing Phase

• Offer all naps as usual - see what happens naturally
• If one nap consistently fails, try dropping it
• Don't force it - let baby's cues guide you

During Transition (2-6 weeks):

• Move bedtime earlier - temporarily shift 30-60 minutes earlier to compensate for lost daytime sleep
• Offer quiet time - even if nap doesn't happen, rest time helps
• Be flexible - some days baby may need the old schedule, especially if teething/sick
• Expect inconsistency - 2-6 weeks of wonky schedules is totally normal
• Watch wake windows - adjust based on how baby's handling the change

Signs It's Working:

• Baby goes down for remaining naps more easily
• Bedtime is smooth again
• Mood improves during awake times
• Night sleep consolidates (fewer wakings)

This is a phase. Your baby's schedule was perfect before, and it will be perfect again. You'll get through it. 💜

Milestones are ranges, not deadlines. A baby who rolls at 3 months isn't "ahead" and a baby who rolls at 6 months isn't "behind" - they're both completely normal.

Skills emerge in different orders. One baby might walk early but talk late. Another talks in sentences before taking their first steps. Both are developing beautifully.

Social media lies. You're seeing highlight reels. For every baby walking at 9 months that gets posted, there are dozens walking at 13-15 months who don't make Instagram.

Trust your pediatrician. They see hundreds of babies. They know what's typical, what's worth monitoring, and what's concerning. If they're not worried, you don't need to be either.

Your baby is on their own timeline. And that's exactly how it should be.

These are BROAD ranges from CDC and AAP. Many babies fall outside these windows and are perfectly fine.

These are signs to bring up at your next appointment or call sooner:

• Missing multiple milestones across different areas (gross motor, fine motor, language, social)
• Losing skills they once had (true loss for weeks, not just inconsistent while developing)
• Significant asymmetry - only using one hand, only kicking one leg, favoring one side
• Very stiff or very floppy muscle tone
• Not responding to sounds or not making eye contact by 6 months
• Not babbling by 12 months or no words by 16 months
• Not walking by 18 months
• Your gut feeling that something is off

Early intervention works. If you're worried, talk to your pediatrician. They'd rather check and reassure you than miss something.

All 50 states have free/low-cost Early Intervention programs (birth to age 3) for babies with developmental delays. Your pediatrician can refer you, or you can self-refer directly. No diagnosis needed - just concerns. The earlier support starts, the better the outcomes.

If your pediatrician isn't concerned, you don't need to be either.

Early/late doesn't predict intelligence, athleticism, or future success. Einstein walked late. Mozart walked early. Neither of those facts mattered.

Your baby will get there. And when they do, you won't even remember if it was at 10 months or 16 months - you'll just remember the joy of watching them take those first wobbly steps.

Remember: These are averages. Some babies get their first tooth at 4 months, others at 12 months. Both are completely normal!

Total: Most children have all 20 baby teeth by age 3. These will eventually fall out around age 6-12 to make room for permanent teeth.

Common signs (these can start weeks before tooth appears!):

• Excessive drooling - can cause chin/neck rash
• Chewing on everything - fingers, toys, your shoulder
• Swollen, tender gums - may look red or have a bluish bump where tooth is coming
• Irritability/fussiness - especially if molars are coming in
• Disrupted sleep - waking more at night
• Pulling on ears - pain can radiate (but also sign of ear infection - check with doctor if concerned)
• Refusing food or preferring cold foods - gums are sore
• Low-grade temperature - slight rise (under 100.4°F) can happen

⚠️ What teething does NOT cause:

• High fever (≥100.4°F) - this is illness, not teething. Call doctor.
• Diarrhea or vomiting - these are signs of illness
• Severe rash (beyond drool rash on chin)
• Persistent crying for hours - could be something else

💡 The myth: Teething gets blamed for a LOT. If baby seems truly unwell (high fever, lethargic, not eating/drinking), don't assume it's "just teething" - check with pediatrician.

Safe, effective methods:

❌ What to AVOID:

• Teething gels with benzocaine - FDA warns against these (can cause serious side effects)
• Homeopathic teething tablets - some recalled for inconsistent ingredients
• Amber teething necklaces - choking and strangulation hazard, no proven benefit
• Rubbing alcohol on gums - dangerous!
• Aspirin - never give to babies/children (risk of Reye's syndrome)

Why it matters: Baby teeth hold space for permanent teeth, help with eating and speech, and cavities in baby teeth can affect permanent teeth.

💡 Make it fun: Sing songs while brushing, let them "brush" your teeth or a stuffed animal's teeth, use a toothbrush with their favorite character. The goal is to build a positive routine!