Newborn babies are usually changed around six to eight times a day, their first stools are sticky and greenish-black before turning yellow, and the cord stump is kept clean and dry until it drops off. Most of what appears on newborn skin in the first weeks is ordinary, and a small number of signs are not. This page is health information for learning and it is not medical advice about your baby. Anything about your own baby's skin, cord or nappies belongs with a midwife, health visitor, paediatrician or emergency service.

Nappies

NHS guidance says newborn babies usually need changing around six to eight times a day, and that a nappy is cleaned fully whether it is wet or dirty.

Clean the whole nappy area gently, including inside the folds of skin. Girls are cleaned from front to back. For boys, clean around the testicles and penis, and there is no need to pull back the foreskin.

Nappy-free time on a mat helps, when the room is warm enough, because a nappy worn constantly makes nappy rash more likely. Wash your hands before and after every change.

What is in the nappy

The first poo, meconium, is sticky and greenish-black, and may come during the birth or in the first 48 hours. NHS guidance says it changes to yellow or mustard after a few days.

Breastfed babies' poo is runny and does not smell much, and these babies may poo at nearly every feed in the early weeks. Formula-fed babies' poo is firmer, darker and stronger smelling, and some formulas turn it dark green.

Straining and crying while pooing is common. What needs advice is a hard, pellet-like poo, blood in the nappy, or a baby who seems unwell with it. Wet nappies matter too, and a clear drop in them, or none for 12 hours, needs urgent care. Feeding your newborn covers how feeding and nappies are read together.

Nappy rash

Nappy rash is common. NHS advice is to change wet or dirty nappies as soon as possible, keep the skin clean and dry, pat rather than rub, leave the nappy off when you can, make sure nappies fit, and clean with water or fragrance-free, alcohol-free wipes.

The same guidance says not to use soaps, baby lotion or bubble bath on the area, not to use talcum powder or antiseptics, and not to fasten nappies too tightly.

A pharmacist can advise on a barrier or nappy rash cream. See a health visitor or doctor if the rash does not go away, spreads, gets worse, or comes with a fever or a baby who seems very uncomfortable.

The cord stump

The stump shrivels, dries and drops off in the first weeks. NHS guidance is to wash around it only if it is dirty with pee or poo, using cotton wool and warm water, then patting it dry. AAP guidance adds that alcohol is not needed on the stump, and that folding the nappy below it keeps pee off.

WHO's postnatal care recommendations describe clean, dry cord care as the standard approach, and recommend applying chlorhexidine to the stump in settings where newborn deaths at home are common. Which applies to you depends on where you gave birth, so follow the advice your own service gives.

A few drops of blood around the time the stump comes away are expected. Active bleeding is not.

Signs that need to be seen are redness of the skin around the base, a bad smell, yellowish discharge, or a baby who cries when the cord or the skin near it is touched. With a fever or an unwell baby, that becomes emergency care. AAP guidance also says a stump still attached after three weeks needs a check.

Newborn skin

Newborn skin is often dry and peeling in the first weeks, especially on the hands and feet. Small white spots, blotches that come and go, and blocked sweat glands in warm weather are all common in newborn babies.

NHS guidance on washing says plain water is enough, or a liquid cleanser suitable for babies, and that a daily bath is not required. Never leave a baby alone in the bath, not for a second.

Some skin signs are urgent rather than cosmetic: a rash that does not fade when pressed, skin that is blue, grey, pale or mottled, skin that is peeling or blistered without an explanation, or yellow skin or eyes. See newborn warning signs.

When to see a doctor

Seek urgent care for any sign in the box below, and for a cord that bleeds actively or a cord infection in a baby who also has a fever.

Seek same-day or same-week advice for a cord stump that smells, leaks or has red skin around it, for nappy rash that is spreading or not settling, for a hard poo or blood in the nappy, and for any rash you cannot explain. Your newborn in the first two weeks sets out what is usual, and your baby's first checks and vaccinations covers when a clinician will be looking anyway.

Seek care now: Contact your local emergency services or go to your nearest emergency department if a baby under three months old has a temperature of 38C or higher, is breathing fast, working hard to breathe or grunting, has blue, grey, pale or mottled skin, is floppy, is difficult to wake, is refusing feeds, has far fewer wet nappies or none in the past 12 hours, has a bulging or sunken soft spot on the head, has a rash that does not fade when you press it, or has a fit. Femio cannot assess a baby.

Frequently asked questions

How many wet nappies should a newborn have?

Guidance does not give a single number that fits every baby and every day. What matters is a clear drop from your baby's usual pattern, and none for 12 hours is urgent.

Can I bath my baby before the cord falls off?

NHS guidance describes ordinary washing and bathing while the stump is still attached, washing around it only if it gets dirty. Ask your midwife if you were given different advice locally.

What does an infected cord look like?

Red skin around the base, a bad smell, yellowish discharge, or pain when it is touched. That needs to be seen, and urgently if the baby has a fever or seems unwell.

Are baby wipes safe for a newborn?

NHS guidance names cotton wool and warm water, or fragrance-free and alcohol-free wipes, for the nappy area.