Parent guide

Keep the stump clean and dry and fold the diaper below it. Do not apply alcohol, powders or other products unless specifically advised. Spreading redness, pus or a strong foul smell, fever, or bleeding that does not stop need prompt medical advice.

Mild jaundice is common in the first days of life, but severity cannot be judged reliably by skin colour alone. Jaundice in the first 24 hours, rapid worsening, poor feeding, marked sleepiness, very dark urine or very pale stools need early assessment. Sunlight should not be used as treatment.

Crying normally increases during the first weeks and may be more intense in the afternoon or evening. Check feeding, diaper, temperature, overstimulation and the need for comfort. Fever, lethargy, breathing difficulty, green vomit, a distended abdomen or crying that is completely different from usual needs assessment. Never shake a baby.

Small spit-ups are very common when a baby feeds well, gains weight and remains comfortable. Smaller feeds when appropriate and a calm upright period after feeding may help. For sleep, the baby should still be placed on the back on a firm, flat surface. Green or bloody vomit, projectile vomiting, poor weight gain or marked distress need assessment.

For every sleep, place the baby on the back on a separate, firm and flat sleep surface. Keep pillows, loose blankets, bumpers and toys out of the sleep space. Sharing the same room is preferable to sharing the same bed. If a baby falls asleep in a car seat, swing or stroller, move them to an appropriate flat sleep surface as soon as practical.

Newborns commonly nurse 8–12 times per 24 hours. By day 5–7, at least 5–6 wet nappies, pale urine, audible swallowing and steady weight gain are more useful than a fixed feeding duration. Pain, poor weight gain, marked sleepiness or fewer wet nappies need prompt review.

Follow hunger and fullness cues rather than forcing a fixed volume. Bottle-feed responsively, pause often and stop when the baby shows fullness. Weight gain and wet nappies are better indicators than comparison with another baby.

Newborns may sleep around 16–17 hours in short periods; regular cycles usually develop after about 4 months. Always place baby on the back on a firm, flat separate sleep surface, without pillows, loose bedding, bumpers or toys.

Frequency varies widely. Breastfed babies may stool after most feeds in the first month and later go several days while remaining normal if stools are soft and growth is good. White stools, blood, black stools after the first days, or distension with vomiting need review.

Clean bottles and parts after every use. Daily sanitising is especially important under 2 months, after premature birth or with immune problems. For an older healthy baby, careful washing, full air-drying and clean storage are usually sufficient.

Breastfed infants commonly need 400 IU vitamin D daily unless advised otherwise. Introduce solids at about 6 months when developmentally ready while continuing milk feeds. No honey before 12 months and no whole nuts because of choking risk.

Usually around 6 months, when the baby shows developmental readiness such as good head and trunk control, supported sitting and interest in food. Breast milk or infant formula remains an important part of nutrition. Texture should progress gradually with the child’s skills.

Once complementary feeding has started, common allergens generally do not need to be delayed without a reason. Offer them in an age-safe form and small amount, introducing foods in a way that makes a reaction easier to recognise. For babies with severe eczema or a known food allergy, introduction should be individualised with the pediatrician.

Gagging is a protective reflex and usually involves noise, coughing or active efforts to clear food. With true choking, the child may be unable to cough, cry or breathe. Offer foods in an age-appropriate shape and texture, avoid whole nuts and other hard or round foods, and caregivers should ideally know choking first aid.

Picky eating is common, especially in toddlers. Keep offering a variety of foods without pressure, bribery or chasing the child with a spoon. The parent decides what and when food is offered; the child decides how much to eat. A very restricted diet, chewing or swallowing difficulty, weight loss or major family conflict around meals needs assessment.

Once complementary foods begin, regularly include iron- and protein-rich foods together with fruit and vegetables. The need for supplements depends on gestational age, feeding pattern, growth and other individual factors rather than one routine dose for every child.

Most first teeth appear between 6 and 12 months. Teething does not cause a true fever over 38°C. Use a cool teether or gentle gum massage; avoid amber necklaces, homeopathic tablets and numbing gels. Brush from the first tooth with a rice-grain smear of fluoride toothpaste.

Start when the child shows readiness, not at a compulsory age. Avoid pressure and punishment; accidents for months can be normal.

Night dryness matures later and wetting is common up to about age 5. Do not blame the child. New wetting after six dry months, pain, excessive thirst, constipation or loud snoring should be assessed.

If breastfeeding, wait until feeding is established. Never attach a pacifier to the neck or cot. Gradually limit it after the first year; persistent strong use after age 3 deserves discussion.

Keep a predictable routine and turn screens off at least one hour before bed. Babies learn from talking, play and face-to-face interaction, not passive screen exposure.

Children vary, but loss of a skill is never something to watch indefinitely. Concerns about movement, speech, hearing, interaction or behaviour should be raised early.

Assess appearance, breathing and hydration, not the number alone. A baby under 3 months with 38°C or more needs urgent medical assessment.

Fluids, saline and honey only after age 1 may help. Breathing difficulty, chest indrawing, fast breathing, wheeze, blue colour or cough beyond 3 weeks need assessment.

Offer small frequent amounts of oral rehydration solution and continue breastfeeding. Very little urine, dry mouth, no tears, drowsiness, blood, green vomit or inability to keep fluids down need urgent advice.

A rapidly spreading rash, purple spots that do not fade under pressure, breathing difficulty or swelling of the face/tongue is an emergency.

Repeated vomiting, increasing drowsiness, confusion, unsteady walking, worsening headache, seizure or unusual behaviour need urgent assessment.

Ear pain can occur with a cold, middle-ear infection or irritation of the ear canal. Do not start antibiotics without an examination of the eardrum, and avoid ear drops when the eardrum status is unknown unless advised. Severe pain, drainage from the ear, swelling behind the ear or worsening general condition needs assessment.

Most sore throats in children are viral and do not need antibiotics. Age, accompanying symptoms and examination determine whether testing for group A streptococcus is appropriate. Breathing difficulty, inability to swallow saliva, dehydration, severe one-sided pain or a very unwell child need urgent assessment.

With constipation, stool hardness and painful bowel movements matter more than the number of days between stools. Fluids, fibre, activity and a regular toilet routine help many children. Severe or localised pain, green vomit, abdominal distension, blood in stool, weight loss or pain waking the child from sleep needs assessment.

Pain with urination, frequency, new daytime accidents, unusually strong-smelling urine or unexplained fever can be associated with a urinary tract infection. When possible, obtain an appropriate urine sample before antibiotics. In babies and young children, symptoms may be nonspecific.

Sit the child slightly forward and pinch the soft part of the nose continuously for about 10 minutes without repeatedly checking. Do not tilt the head back. Frequent nosebleeds, heavy bleeding, easy bruising or bleeding that does not stop should be assessed.

A child should always travel in an approved restraint that is appropriate for height and weight and correctly installed. Infants and toddlers should remain rear-facing for as long as the height or weight limits of their specific seat allow. Never travel with a child unrestrained, even for a short trip.

Prefer shade, light protective clothing and a hat, and avoid the strongest sun exposure. Use sunscreen correctly on exposed areas according to age. Never leave a child alone in a parked car, even for a few minutes.

Supervision must be continuous and by an adult close enough to intervene immediately. Never leave a baby or young child alone, even briefly, in a bath, pool or near water. Flotation aids do not replace active supervision.

Keep medicines, detergents, refill liquids, button batteries and chemicals locked and out of sight. Do not call medicine “candy”. If a possible ingestion occurs, do not induce vomiting; seek immediate medical or poison-centre advice and keep the product packaging available.

Home and car should be smoke- and vape-free. Smoking in another room or by a window does not remove exposure. Avoiding smoke exposure is particularly important for infants and for children with asthma or recurrent wheeze.

From the first tooth, brush twice daily with a very small age-appropriate amount of fluoride toothpaste. Avoid frequent sugary drinks and bottles of milk or juice throughout the night. Early preventive dental care helps identify problems before they become painful.

Use a family media plan, clear limits and keep phones out of the bedroom overnight. Ask for help when media displaces sleep, school, exercise or relationships, causes major conflict, secrecy or cyberbullying, or the teenager cannot cut down.

Assess BMI-for-age and the growth trend, not appearance alone. Rapid gain, loud snoring, exercise breathlessness, excessive thirst, dark thickened neck skin or significant distress deserve review. Treatment should involve the family and never shame the child.

Review breast development before 8 in girls or testicular enlargement before 9 in boys, especially if rapidly progressive. Also assess no pubertal signs by 13 in girls or 14 in boys, or stalled progression.

Early cycles may be irregular. Seek advice for very heavy bleeding, more than 7 days, dizziness/pallor, disabling pain, gaps over 90 days or no first period by age 15.

Falling performance, school refusal, persistent fear, withdrawal, sleep/appetite change or recurrent unexplained physical symptoms deserve discussion. Self-harm, hopelessness or thoughts of death need immediate help.

Keep a short diary. Morning headache with vomiting, waking from sleep, neurological symptoms, confusion, stiff neck, progressive worsening or headache after significant injury needs urgent assessment.

Call immediately for severe breathing difficulty, blue colour, unresponsiveness, prolonged seizure, severe allergic reaction, uncontrolled bleeding or sudden major deterioration.

Seek prompt advice if the child looks very ill, cannot drink, urinates very little, has persistent pain, blood in vomit/stool or fever with a stiff neck—or whenever your concern is significant.