Normal neonatal behaviors and transitional findings can be distinguished from concerning symptoms by their timing and by feeding, hydration, urine output, and weight gain.
Weight loss and crying around urination
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Small gestational-age infants have less weight loss than their appropriate counterparts.
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A full bladder may cause discomfort and crying before urination; the neonate usually quietens when micturition starts.
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Crying during micturition, rather than before it, may indicate urinary tract infection.
Bathing and skin products
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Only sponging is recommended during the first week until the cord falls off; sponging can begin after the first 24 hours of life.
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Later, bathing every 2–3 days is sufficient. Use a warm room without draughts, warm water, and a quick bath to prevent cooling.
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The head has a large surface area and should be washed and dried immediately. Inspect the cord, eyes, and skin for discharge, rash, or redness during bathing.
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Minimize cosmetics because neonatal skin is sensitive. Use mild, non-perfumed, non-medicated soap.
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Any oil except mustard oil may be used for skin application or massage. Avoid sprinkling talcum powder because it can be inhaled, and avoid boric acid-containing products.
Regurgitation and stool transition
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Small amounts of curdled milk regurgitated soon after feeding are normal when the neonate gains weight and passes urine 6–8 times daily.
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Breastfed neonatal stools change from black-green to yellow by the end of the first week. Loose transitional stools and increased stool frequency may occur during this change.
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Transition from black meconium to yellow-green stools by the end of the first week is an important indicator of adequate breastfeeding.
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A small stool after feeding may reflect the gastrocolic reflex. Frequent stools are not concerning when the neonate remains hydrated, has no signs of sepsis, feeds well, passes urine 6–8 times daily, and gains weight.
Breast enlargement
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Boys and girls may develop breast hypertrophy and milk-like secretion, called witch milk, because of transplacentally transmitted hormones.