Newborn Assessments in the Postnatal Period: What I Check at Every Visit

The first days and weeks after your baby arrives are full of checks, cuddles, and a steep learning curve. As an independent midwife supporting families across London, Essex, and Hertfordshire, one of the questions I'm asked most often is simply, what are you actually checking for when you come to see us? This is separate from the newborn physical examination (NIPE) carried out shortly after birth, which is done by a doctor or specially trained practitioner. These newborn assessments in the postnatal period happen at every postnatal visit, building a picture of how your baby is settling over time. Here's a look at what that ongoing assessment covers, and why each part matters.

What Newborn Assessments in the Postnatal Period Involve

Observing Feeds

Whether you're breastfeeding, paced bottle feeding, or a mix of both, I like to sit in on a feed rather than just ask how it's going. Watching helps me see the things that are easy to miss from the inside of the experience: how your baby is latching, whether they're swallowing effectively, how they come off the breast or bottle, and whether feeds are comfortable for you. If you're expressing, I'll talk through timing, storage, and how to build supply if that's a goal, and troubleshoot anything that feels tricky.

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Cord Care

Your baby's umbilical cord stump needs a little attention while it heals and separates, usually within one to two weeks. I'll check it's drying out as expected, look for any signs of infection such as redness, swelling, or an unpleasant smell, and talk you through simple, fuss-free care so you feel confident with it at home.

Baby's Weight

Weighing your baby isn't about chasing a number. It's about tracking the pattern. Most newborns lose a small percentage of their birth weight in the first few days and then begin regaining it, typically being back to birth weight by around two to three weeks. I'll plot this against your baby's individual growth chart and talk you through what the trend is telling us, rather than focusing on any single weigh-in.

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Wet and Dirty Nappies

Nappy output is one of the simplest and most reassuring windows into how feeding is going. I'll ask about the number of wet and dirty nappies, and what they look like, since this changes quite predictably day by day in the first week. It's one of those things that feels small but tells us a lot.

Alert Periods

Newborns move through distinct states, from deep sleep through to quiet alertness and active crying. I'll talk with you about your baby's alert periods, the calm, wide-eyed windows when they're most ready to feed, connect, and take in the world around them, and how to recognise and make the most of them.

General Wellbeing Check

Alongside all of the above, I'll do a gentle visual check of your baby's overall wellbeing, skin, tone, and general responsiveness, and have a look in the mouth to check for tongue tie if feeding suggests it might be relevant. This sits alongside, rather than replaces, the formal newborn physical examination (NIPE) carried out by a doctor or specialist practitioner shortly after birth. My role is to keep watching over time and flag anything worth a closer look between those formal checks.

Jaundice Watch

Mild jaundice is common in the first week and usually resolves on its own, but it's still something I keep a close eye on. I'll check your baby's skin and eyes, ask about feeding and nappy output, and let you know what to watch for at home between visits.

Temperature and Warmth

Newborns aren't yet great at regulating their own temperature, so I'll check your baby is warm enough without overheating, and talk through practical tips for dressing baby for the season, whether that's a chilly Hertfordshire morning or a warm London flat.

Safe Sleep and SIDS Awareness

Safe sleep is something I talk through with every family, because it's so important to have up to date SIDS and safe sleeping advice. I always signpost my families to the Lullaby Trust for extra support too.

I'll always cover the basics together with you, baby on their back to sleep, feet at the foot of the cot, a clear sleep space with no loose bedding or soft toys, room sharing for at least the first six months, and keeping baby's environment smoke-free. I'll also cover room temperature, how many layers baby should be wearing, smoking in the house or by visitors, and safe co-sleeping. That way, you'll have all the up to date information you need to feel safe and confident at home with your baby.

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Newborn Screening Tests

I'll also make sure you're supported through the standard screening checks, including the newborn blood spot test around day five and the newborn hearing screening, explaining what each one involves and when you'll hear back.

General Advice and Signposting

Not everything I cover at a visit is a formal check. A good chunk of the time is spent talking through the questions that come up as you go, things like whether vitamin D drops are appropriate for your baby, practical ways to ease congestion if baby's a little snuffly, and how to manage sticky eyes if they crop up. I'll also check in on the wider picture: has your health visitor been in touch, and have you got the eight week check and first immunisations booked in. It's all part of making sure nothing falls through the cracks in those early weeks.

Continuity Through the Postnatal Period

What I hear again and again from families across London, Essex, and Hertfordshire is how reassuring it is to have the same midwife checking on baby's progress visit after visit, rather than starting from scratch with someone new each time. Having continuity means I get to know your baby's own pattern, which makes it much easier to spot when something is simply their normal, and when something's worth a closer look.

And of course, it's never just about baby. Your own physical and emotional wellbeing is woven into every single visit too, because how you're doing matters just as much as how your baby is doing.

Get in touch, if you'd like to talk through what postnatal support could look like for you and your baby, I'd love to hear from you.

Read my Postnatal Essentials Checklist Blog, for some good ideas of what's important to have ready for both you and baby, when the time comes.