Newborns! Part B: The rough and tumble first few months” – with Dr. Tracy Agnese

Bringing a newborn home is one thing. Surviving — and enjoying — the weeks and months that follow is another challenge entirely. In this episode of the Healthful Woman Podcast, Dr. Nathan Fox sits down with pediatrician Dr. Tracy Agnese to talk through what actually happens once you leave the hospital: the strange noises babies make, the sleep schedules that upend your life, the moments that call for a phone call to the doctor, and the ones that don’t. Below are some of the highlights, but as always, we encourage you to listen to the full conversation for all of Dr. Agnese’s insight.

What’s Actually Normal in the First Few Weeks?

New parents tend to worry about things that, according to Dr. Agnese, are perfectly ordinary. Hiccups and sneezing are common in newborns and rarely bother the baby, even if they unsettle everyone else in the room. Nasal congestion is also typical in the first days of life, largely leftover debris from birth, and saline drops paired with a good old-fashioned “snot sucker” can go a long way. Irregular breathing patterns can look alarming to a new parent, but they, too, generally fall within the range of normal newborn behavior.

Sleep is another area where instincts can mislead. In the first two weeks, babies are often extremely sleepy and need to be woken every three hours to feed until they’ve regained their birth weight. Only after that milestone should parents let a baby sleep through a feeding. By two weeks, some babies begin stretching toward four or five hours between feeds on their own.

When Should You Actually Call the Doctor?

Dr. Agnese draws a clear line between normal spit-up and true warning signs. Projectile vomiting, blood in the stool, a baby who is difficult to rouse for feedings, real respiratory distress, or any fever in the first two months of life all warrant a call. That last one matters especially: fever management looks different before and after the two-month vaccines, so knowing the threshold for your baby’s age is essential.

As babies approach the one-month mark, bowel movements naturally become less frequent, and softer stools are a sign of healthy digestion rather than constipation, another common source of unnecessary worry.

What About Colic?

Few things test a new parent’s patience like colic. Dr. Agnese’s advice is refreshingly direct: it passes. Babies change quickly, and no matter how difficult a stretch feels in the moment, it is temporary. She’s also candid about the importance of parental self-care. It’s okay to place a baby safely in the crib and step away for a few minutes if you need to reset. A crying baby in a safe space is not an emergency; a parent running on empty is a real risk.

The Fourth Trimester Is a Family Visit, Not Just a Baby Visit

One of the most valuable points in the episode is how much pediatric visits are really about the whole family. Between the two-day post-discharge check, and visits at two weeks, one month, and two months, pediatricians see new mothers far more often in those early weeks than obstetricians do. Depression screening happens at nearly every one of those visits, and breastfeeding support is built in as well. Dr. Agnese herself pursued an IBCLC lactation certification specifically to help fill that gap. In many ways, your pediatrician becomes the closest thing to a fourth-trimester care team you have.

Choosing a Pediatrician, and Filtering the Noise

Dr. Agnese also offers a helpful reframe for parents choosing a pediatrician: don’t just watch how the doctor interacts with the baby, ask yourself whether this is someone you can trust to talk to about your own concerns. And with so much conflicting advice available online and from well-meaning family members, her guidance is simple: pick one or two people you trust, most likely your pediatrician, and let their advice guide you rather than trying to reconcile every opinion you encounter.

Listen to the full episode of Newborns, Part B: The Rough and Tumble First Few Months with Dr. Tracy Agnese on the Healthful Woman Podcast for the complete conversation.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!