Melania Trump has opened her first big solo international trip as US first lady with a wave, a smile and a baby in her arms, aiming to promote child welfare during a five-day tour of Africa.

She arrived in the West African nation of Ghana after an overnight flight from Washington and quickly made her way to the Greater Accra Regional Hospital.

First lady Melania Trump arrives at Kotoka International Airport in Accra, Ghana
Melania Trump arrives at Kotoka International Airport in Accra (Carolyn Kaster/AP)

The first lady saw how babies are weighed – they are placed in sacks that are then hung from a hook attached to a scale.

She also watched a nurse demonstrate how vitamins are administered to babies by mouth and toured the neonatal intensive care unit.

Mrs Trump also cradled an infant and declared the baby a “beautiful boy” as she handed him back to his mother.

Melania Trump holds a baby at Greater Accra Regional Hospital
Melania Trump holds a baby at Greater Accra Regional Hospital (Carolyn Kaster/AP)

Mothers at the hospital for her visit received gifts of teddy bears nestled in white baby blankets, personally handed out by the first lady, according to her spokeswoman Stephanie Grisham.

The items carried the logo of Be Best, the child well-being initiative Mrs Trump launched last May.

With the Africa visit, the first lady aims to take Be Best and its focus on opioid abuse and online behaviour to an international audience.

First lady Melania Trump visits mothers and their babies at Greater Accra Regional Hospital
Melania Trump visits mothers and their babies in hospital (Carolyn Kaster/AP)

The first lady also had a private tea and gift exchange with her Ghanaian counterpart, Rebecca Akufo-Addo.

They exchanged gifts: a Chippendale silver tray embossed with an image of the White House inside a leather case signed by “First Lady Melania Trump” for Ms Akufo-Addo, and Kente cloth and artefacts for Mrs Trump, according to Ms Grisham.

The first ladies met privately for about half an hour at Jubilee House, Ghana’s presidential palace.

First lady Melania Trump is greeted by Ghana's first lady Rebecca Akufo-Addo
First lady Melania Trump is greeted by Ghana’s first lady Rebecca Akufo-Addo (Carolyn Kaster/AP)

The two first met last week in New York at a reception on the sidelines of the UN General Assembly, where Mrs Trump spoke about her upcoming trip.

Mrs Trump’s visit opened in low-key fashion.

Several Ghanaians interviewed said they knew little about it.

Melania Trump and Rebecca Akufo-Addo watch dancers during an arrival ceremony at Kotoka International Airport in Accra
Melania Trump and Rebecca Akufo-Addo watch dancers during an arrival ceremony at Kotoka International Airport (Carolyn Kaster/AP)

“Did you say President Trump’s wife just arrived in Accra?” street vendor Awo Yeboah asked.

“I don’t think I have ever heard her name, Melania.”

Other locals said they knew about the visit but did not know what Mrs Trump was doing.

Mrs Trump landed in the capital Accra on Tuesday morning after a more than 12-hour journey from Washington.

She was welcomed at the airport with dancing and drumming, schoolchildren waving mini US and Ghanaian flags and the gift of a flower bouquet.

Children wave American and Ghana flags during an arrival ceremony for first lady Melania Trump
Children wave American and Ghana flags during an arrival ceremony for first lady Melania Trump (Carolyn Kaster/AP)

Ms Akufo-Addo was at the airport to welcome her.

Mrs Trump also plans to visit Malawi, Kenya and Egypt.