The newborn at home: cord care, bathing, safe sleep, feeding cues and the warning signs
- Safe practice
Before discharge the nurse teaches cord care, bathing, feeding, stools, sleep and the danger signs, and checks the newborn visit is booked.
What it is
Discharge teaching prepares the family for the first weeks at home. In Colombia a healthy newborn can go home after 24 hours, and after 48 hours after a caesarean or when there are risks. The family needs to know how to care for the cord and the skin, how to recognise that feeding is going well, what normal stools look like, how to keep the baby safe while sleeping, and which signs mean going to a health service at once. They leave with written material, the child health card and a check-up booked within 3 to 5 days. Safe sleep is covered in full on the injury-prevention page.
What it requires
- Healthy newborn: discharge after 24 hours if it meets the criteria; after 48 hours after a caesarean or with risks such as hypoglycaemia or difficult breastfeeding.
- First stools are dark green and sticky (meconium); on days 3 to 5 they become looser; then yellow and soft, often after feeds.
- Signs that feeding is enough: a moist mouth, heavy nappies and a soft breast after the feed.
- The baby feeds on demand, about 8 to 12 times a day; it needs no water or other fluids.
Components
- Feeding and feeding cues.
- Cord, bath and skin care.
- Safe sleep (see injury prevention).
- Danger signs and where to go.
- Follow-up: newborn check, vaccines, screening results and civil registration.
How it is applied (and why)
- Before discharge, watch a feed and confirm the baby has passed urine and stool — these are discharge criteria.
- Show cord care: clean with boiled water, dry well, keep it outside the nappy — moisture and friction favour infection.
- Explain the bath: mild unperfumed soap, no additives, lotions or medicated nappies; clean the nappy area with water — protects the skin.
- Teach on-demand feeding, without schedules or water, and the signs of a good feed — supply follows frequent, effective sucking.
- Describe normal stools and the colours that are not normal — families can tell what needs a visit.
- Teach safe sleep: on the back, on a firm surface, smoke-free — details on the injury-prevention page.
- Go through the danger signs with the family and tell them where to go — early care saves lives.
- Confirm the check-up in 3 to 5 days, the BCG and hepatitis B vaccines, the screening results to collect and civil registration.
- Ask about the mother's mood and support — sadness that lasts beyond 2 weeks or deepens needs a visit.
In nursing practice
- Redness or a bad smell around the navel: the family should seek care at once.
- White, black or blood-streaked stools, or no stool in the first 24 hours: medical review.
- Temperature above 37.5 °C, fast breathing, vomiting after every feed or a baby who does not wake: prompt medical review.
- People with a cold should avoid close contact, or wear a mask and clean their hands; a mother with a cold keeps breastfeeding.
- Do not put the baby in the sun to treat jaundice: it is not enough and can burn and dehydrate.
Common mistakes
- Covering the cord with the nappy or tying a belly band.
- Giving water, teas or other fluids to a breastfed newborn.
- Using sunlight for jaundice.
- Discharging without booking the newborn check-up or explaining where to go with a danger sign.
- Teaching only orally, without the written material the facility must give.
Test yourself
Think of the answer, then tap the question to see it.
How is the umbilical cord cared for at home?
It is kept clean and dry, outside the nappy, cleaned with boiled water and dried well.
Which temperatures are danger signs in the newborn, according to WHO?
37.5 °C or more (fever) and below 35.5 °C (low temperature).
When should the newborn check-up take place after discharge in Colombia?
Within the first 5 days, ideally 3 to 5 days after discharge.
What does a family do if the baby has jaundice in the first 24 hours or yellow palms and soles?
Takes the baby to a health service at once.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Resolución 3280 de 2018: lineamientos técnicos y operativos de la Ruta de Promoción y Mantenimiento de la Salud y de la Ruta Materno Perinatal (Anexo 10: recomendaciones de salida) (Ministerio de Salud y Protección Social de Colombia, 2018); Newborn danger signs at each postnatal contact (WHO recommendations on postnatal care, 2014; maintained in WHO 2022) (Pan American Health Organization, BIGG-REC database, 2022); Guía de práctica clínica del recién nacido sano: para padres y cuidadores (Guía No. 02) (Ministerio de Salud y Protección Social de Colombia, Colciencias, 2013).
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Representative model, for educational purposes only.