A clean, warm, and dry place should be provided for moms and babies. A nesting box is essential for better health and survival. The nesting box should be:

• located in a quiet, secluded, warm, and draft-free area
• just tall enough to prevent the kittens from wandering away but low enough that mom can come and go easily (without needing to jump out of the box)
• large enough for the mom to comfortably lie away from the litter if she chooses, but small enough for the newborns to easily reach her

The bottom portion of a plastic dog or cat kennel (measuring about 24” x 20” and 10” high) works well as a nesting box and easily can be cleaned and disinfected.  

A temperature-controlled, draft-free area is extremely important because a kitten's body temperature can quickly drop to dangerous levels. A few more tips for creating a quality nesting box:

• Line the box with a layer of clean newspaper to absorb any moisture or odor. 
• Clean towels, blankets or mattress pads should go on top of the newspaper. Towels and blankets should be free of any holes or frayed edges as little heads or paws could easily get caught or entangled. Do not use deep, loose bedding such as straw, hay or shavings which might obstruct breathing or be inhaled and lead to respiratory infections.
• Place a heating pad set on low under the blankets or towels. Kittens are unable to regulate their own body temperatures until 3 weeks of age, so the temperature in the nesting box should be between 85 and 95 degrees F. Check the heating pad often to be sure the babies are not overheating. Electric blankets should not be used — they can become too hot and easily cause burns.
• Do not place cardboard nesting boxes directly on concrete, which can draw large amounts of heat from the kittens.

Kitten care tips
If a kitten seems cold, place hot water bottles wrapped in towels nearby. Turn the baby often to encourage breathing. When the baby begins to warm up, encourage them to take in some food such as warmed gruel, baby food, or milk replacer. Monitor hydration by checking the moisture of the gums, skin elasticity, and color of the urine. Healthy kittens have moist gums, elastic skin, and colorless urine when they are adequately hydrated.

Young kittens can also suffer from what is called “fading kitten syndrome.” A “fading” kitten is one that appears healthy at birth but fails to survive beyond 2–12 weeks of age. Deaths generally occur due to one of the following:

• congenital defects
• low birth weight
• nutritional disease (caused by inadequate diet for mom)
• infectious diseases
• neonatal isoerythrolysis (mom’s antibodies transferred through nursing  destroy the infants blood cells)
• diminished immunity
• or other causes such as severe intestinal parasitism

Loss of a “fading” kitten is common and mostly unavoidable. Please remember that 15-40 percent of all kittens born alive will not survive to the age of 12 weeks. Most of these losses will occur before 2 weeks of age.

Closely monitor the health of both moms and nursing kittens. Watch to be sure that mom is nursing the kittens and caring for all of them. A kitten neglected or rejected by the mother may show signs of health issues. This is a very vulnerable age for kittens and illnesses can become quite severe in a very short time. Some of the most typical signs of illness in neonatal kittens are:

• frequent crying
• restlessness
• weakness
• hypothermia (low body temperature)
• diarrhea
• dehydration
• altered respiration (labored or shallow)
• cyanosis (white or bluish color of the gums)
• hematuria (blood present in the urine)

Immediately contact your veterinarian If you notice any of these signs.

Animal Humane Society veterinarians and staff cannot legally treat or recommend treatment on animals that are owned and have not been surrendered to our organization. If you are having a medical problem with your kittens and you can not afford treatment, you may surrender the kittens to AHS at any time.

Neonatal period: Birth to 2 weeks of age
All of their time is spent sleeping and nursing. Newborns' eyes begin to open about 7–10 days after birth (sometimes up to 16 days). It takes about two or three days for both eyes to fully open. Even though the eyes are open, the newborn’s sensory system during this time is dominated by stimulation through temperature, touch, and hearing.

• If the eyes fail to open and the lids look sticky, gently wipe the lids with a damp cotton ball to clear any crust. Apply a small amount of petroleum jelly on the lid to ease their opening. The eyelids should never be pulled apart. If they have not opened by 14 days, contact your veterinarian.
• When the eyes open the iris is usually a gray-blue color, which gradually changes to normal adult coloring after about five weeks.

Transitional period: 2–4 weeks of age
This marks the beginning of locomotion and sensory development which allows the babies to interact with their environment. Teeth will start to erupt just before 2 weeks of age and will continue until the kitten is about 5 weeks old. The sense of smell is present from birth and will become fully developed by 3 weeks of age. Vision does not play a major role in guiding behavior until about three or four weeks after birth. By the end of the third week, the baby is able to use visual cues to locate and approach its mother. Visual orientating and following will develop between two and four weeks. Response to depth perception, guided paw-placing and obstacle avoidance all develop somewhat later, between three and five weeks.

Socializing
The sensitive period for a kitten to become comfortable with human handling starts at 4 weeks old and begins to close at 7–8 weeks old. It's very important that different people gently handle and play with kittens starting at 4 weeks old. Studies show that just 5–15 minutes of handling per day is sufficient to aid in socialization at this age.

Social play with mom and littermates becomes prevalent by 4 weeks of age. Playing with objects begins a bit later as the kitten starts to develop the eye-paw coordination — around 7–8 weeks after birth.

Play changes a lot near the end of the weaning period (about seven weeks after birth). Social play becomes more associated with predatory play patterns such as pawing, pouncing, stalking, and biting. Continued positive interactions with people are critical at this stage.

To help them develop, the environment should be mentally stimulating for kittens. Acquaint the young kittens with different sights, sounds, and textures. Kittens enjoy things like paper bags, wads of crumpled paper, and ping-pong balls. Avoid toys with strings and small pieces as they can be chewed off and swallowed. Make sure all toys are safe, appropriate, and large enough so that the kitten cannot choke on them.

Exposing kittens to a variety of unusual sounds helps them get used to these noises and minimizes fearful, nervous reactions. To help stimulate them, make noises by blowing whistles, clapping hands, jingling bells, or turning on the vacuum cleaner throughout the day. Encourage the kittens to explore, sniff and investigate the noise makers. Praise kittens for positive reactions but do not punish them by forcing them to approach. Do not comfort a kitten that shows fear —  it shows them that there is something they should be afraid of.

At around 4 weeks of age, encourage the kittens to be handled individually by different people — men, women, and supervised children of varying ages.

Combine simple play with restraint exercises. This will familiarize kittens to having their paws and ears touched, mouths opened, and muzzles held. Combining this with regular grooming sessions and body massages helps prevent aversion to touch.

Much time and effort is needed to properly socialize kittens between the ages of 4 and 12 weeks old. Daily sessions are very important in shaping the animal’s future personality and emotional growth.

Weaning time depends on the size of the litter, condition of the mother, and availability of the mother’s milk. Generally it is best to start weaning kittens at about 4 weeks of age. Weaning is a gradual process and should be completed by 6–7 weeks of age.

Milk replacement
Read all instructions carefully when using milk replacer. The powdered form is only good for 24 hours after reconstituting with water, even if it is kept refrigerated. Mix no more formula than you think you will use in a day. Canned milk replacer can be easier to use but it must be kept refrigerated. The label on the can will tell you how long the product is good for once it is opened. It is critical to the health of kittens that only fresh, wholesome milk replacer is used. Cow’s milk, goat’s milk, or any other type of dairy product is not an acceptable substitute. The digestive system of kittens is not designed to digest other types of animal’s milk and it can cause serious issues which could include diarrhea, constipation, gas, and vomiting.

The weaning process
Begin by introducing kittens to a semi-solid gruel made from one part kitten chow and three parts milk replacer, three to five times daily. Mash the food really well or use a blender or food processer. Canned food can also be used in place of the dry chow to mix with the milk replacer. The gruel should be served at body temperature, about 98–100 degrees. Offer the mash to the kittens in a shallow pan, like a pie plate, with lots of newspaper under it. They are very messy eaters at this age. If a kitten doesn’t get the idea of eating after a few tries, dip your finger into the gruel and gently smear a small amount on the baby’s lips — be careful not to get any in the animal’s nose. Encourage them to lick the food from your finger.

Once the babies know how to eat some of the gruel, stimulate their appetites by removing them from their mother for an hour or two before feeding time.  Mom will likely appreciate this break by this time anyway. Allow them to eat the gruel for about 15–20 minutes, and then return them to mom. Some kittens take longer than others to acclimate to the weaning process. Watch the litter at feeding time to be sure everyone gets enough food. Check tummies after feeding to see if they are full.  Weigh each baby regularly to ensure they are all gaining weight.

This is also the time to teach kittens how to drink water from a bowl. Be sure to have fresh, clean water available in shallow bowls. The first few tries will probably result in water up the nose and lots of sneezing. Put newspaper down under the bowls as it can get messy.

As the kittens grow, mix less of the milk replacer with the dry food mash. Healthy weaned animals are able to consume dry food only by the age of 7 or 8 weeks old. Dry food (not mixed with formula) should always be made available during the weaning process for the kittens to experiment with.

The gradual weaning process outlined above also helps mom by gradually decreasing the amount of milk she produces. Even with gradual reduction, sometimes moms develop a painful engorgement of the mammary glands after the young are completely weaned.

To prevent this from occurring (and to treat the condition) cut mom's food to half of her normal intake amount. She'll be hungry but the reduced calorie intake will cause her body to produce less milk.

If she does become engorged and is still in pain after 24 hours of reduced food, begin restricting her fluid intake by half as well. The fluid restriction should only be in place for 24 hours but it can dramatically decrease the amount of milk in the mammary glands. Warm or cold compresses may make her feel more comfortable. Place the compresses on the swollen tissue for 20 minutes. Do not rub compress over the area, this can cause irritation. Do not allow the young to nurse in hopes that it will reduce the milk; mom will just produce more to replace it. If any of the mammary glands turn rock hard, bright red, or are painful, call your veterinarian. This means mom may have developed mastitis and requires antibiotics in addition to food restriction. Three or four days of restricted food is usually enough to reduce the engorgement.