If you want to make an old-fashioned quilt, the most obvious approach is to sew the entire thing by hand. Hand quilting has a beautiful, classic appearance that cannot be duplicated. However, quilting by hand is much more time-consuming than using a sewing machine.
Some quilters hold their work unsupported in their lap when they quilt. Most quilters, however, prefer to use some sort of quilting hoop or frame to hold the quilt stretched out. This makes it easier to stitch with an even tension and helps to prevent puckering and tucks.
Use betweens (quilting needles) for hand quilting. The smaller the needle (higher numbers like 11 and 12), the easier it will be to make small stitches. A quilting thimble on the third finger of your quilting hand will protect you from needle sores.
Use no more than 18 inches of quilting thread at a time. Longer pieces of thread tend to tangle, and the end gets worn as it is pulled through the fabric. Knot the end of the thread with a quilter's knot. Slip the needle into the quilt top and batting about an inch from where the first stitch should start. Pull the needle up through the quilt top at the beginning of the first stitch. Hold the thread firmly and give it a little tug. The knot should pop into the batting and lodge between the quilt top and backing.
The quilting stitch is a running stitch. Place your free hand (left hand for right-handed people) under the quilt to feel for the needle as it pokes through. Load the needle with a couple of stitches by rocking the needle back and forth. At first, focus on making evenly sized stitches. Also, make sure you are going through all three layers. When you have mastered that, work on making the stitches smaller on future quilts.