Why the head comes first

A newborn's head is a large proportion of their body weight and their neck muscles are not yet strong enough to control it. Head control develops over the first months, so until it does, your hand does the job.

The rule is simple and applies every time: support the head and neck whenever you lift, carry, lower or pass your baby. Most parents are shown this once in hospital and then improvise, and improvising is fine as long as the head is not left to drop backwards.

The AAP describes what you are working with: a newborn keeps their arms and legs bent close to their body just as they did in the womb, and it may take several weeks for their body to unfold from that position. Holding a newborn in a curled, contained shape rather than stretched out is both easier and more comfortable for them.

Picking a newborn up

Slide one hand under the head and neck and the other under the bottom.
Lift slowly. Sudden movement, or a head that tips backwards, triggers the startle reflex — the AAP notes that a head shifting position abruptly or falling backwards makes a baby fling their arms and legs out and sometimes cry.
Bring them in close to your body before you move anywhere.
Putting them down: bottom first, head last, keeping your hand under the head until it is resting on the mattress, then leaving your hand there for a moment.

Four holds worth knowing

Cradle hold. Your baby's head rests in the crook of your elbow, their body along your forearm, your other hand supporting their bottom. The everyday hold, and the one that puts their face at roughly the distance a newborn sees best — the AAP puts that at about 20 to 30cm.
Shoulder hold. Upright against your chest with their head resting on your shoulder, one hand supporting the head and neck, the other across the bottom. The HSE's winding advice is built on this position: hold them upright against your shoulder and massage their back.
The HSE's "magic baby hold". Their back against your tummy, their tummy resting on your crossed arms, legs and arms falling gently either side. The HSE suggests it for an unsettled or windy baby.
Skin to skin. Your baby in a nappy against your bare chest, with a blanket over the top. The HSE's guidance on touching and holding describes skin-to-skin contact as helping a baby feel secure, supporting bonding and calming both of you — and it is the single most useful thing to reach for with a newborn who will not settle.

Passing a baby to someone else

The moment things get dropped, and it is worth doing deliberately. Get the other person seated if you can. Keep your hands under the head and bottom until their hands are underneath yours. Say when you are letting go. Do not hand a baby over while either of you is holding a hot drink, and do not pass a baby across a car seat, a bannister or anything else that would be in the way if something slipped.

Things that make holding easier

Sit down. Most newborn holding happens for long stretches, and a chair with arm support saves your back and shoulders. The NHS's washing routine assumes the same thing — hold your baby on your knee to clean their face, and support them over the bowl for their hair, rather than doing any of it standing up.
Warm your hands first. Newborns startle at sudden cold.
Undress and dress on a flat surface, not in your arms. The HSE's guidance on dressing and undressing is to lay your baby down, support the head, and gather clothing before putting it over the head so it passes quickly.
Do not hold a baby while carrying hot drinks or cooking, and do not hold a baby in a moving car under any circumstances. A car seat is the only safe place.
You cannot hold a newborn too much. The AAP's position on responding to newborn cries is that you cannot spoil a baby this age by giving them too much attention, and the NHS's advice for a crying baby is to hold them close.

The thing you must never do

Never shake a baby. Shaking a baby, even briefly, even out of desperation, can cause bleeding and permanent brain injury or death. A newborn's head is heavy and their neck muscles cannot resist the movement.

The NHS's advice for the moment when you cannot cope is specific and is a safe plan rather than a platitude: put your baby down somewhere safe, such as their cot, leave the room, and take a few minutes to calm down before going back. A baby left briefly in a safe cot while you breathe is safe. A baby held by someone at the end of their tether is not.

Then ask for help. Your midwife, health visitor, public health nurse or GP will have heard it before, and persistent inconsolable crying is a reason to be seen rather than a personal failing.

Holding a premature or unwell baby

The HSE's guidance on touching and holding a premature baby is that even when a baby is too small or unwell to be lifted, containment holding — resting still, cupped hands on the head and feet without stroking — is calming, and that skin-to-skin contact is encouraged when the baby is stable enough. Neonatal staff will show you how and when. Their instructions take precedence over anything general on this page.

What holding actually does

The AAP is unusually warm about this: touch is perhaps a newborn's most important sense, and "holding your baby gives them as much pleasure as it does you. It will give them a sense of security and comfort, and tell them they are loved." The AAP adds that research shows close emotional bonding promotes growth and development. It is not passive time.

When to call

Call your local emergency number (999 in the UK and Ireland, 911 in the US and Canada, 000 in Australia, 111 in New Zealand) if your baby:

Has been dropped or shaken, or has had a knock to the head — even if they seem fine.
Is unusually sleepy or hard to rouse, is vomiting repeatedly, or is not feeding after any fall or knock.
Is floppy or will not move an arm or a leg.
Has a temperature of 38C (100.4F) or above, or below 36C (96.8F).
Looks pale, ashen, mottled or blue, or has a weak, abnormally high-pitched or continuous cry.
Is grunting or breathing over 60 breaths a minute, or has a bulging fontanelle, a seizure, or a rash that does not fade under a pressed glass.

Those last items are NICE's red flags for serious illness in young babies.

Speak to your midwife, health visitor, public health nurse or GP if: your baby seems to dislike being held in a particular position, or cries when a particular arm or leg is moved; one arm moves less than the other; your baby's head is always turned to the same side; or you are struggling with constant crying and getting close to your limit. That last one is a reason to ask for help today.

What to let go of

There is no correct hold. Newborns are more robust than they look, and the only rules that matter are supporting the head, moving slowly, keeping them away from hot things and moving cars, and never shaking. Everything else is preference — theirs and yours — and you will both work it out within a fortnight.

How to Hold a Newborn