Your Baby's First Day

You've been waiting in excitement for the day when you can actually meet the baby you've been carrying for nine months - and the day has arrived. You are the proud parents of a new baby! What happens now?

Immediately Following Delivery

As soon as your baby's head is delivered, the mouth and nose will be suctioned so the baby can breathe easier. The baby will start to breath on its own and will become pink. Other procedures will begin the minute you deliver.

figure 1

The first is an APGAR score to assess your baby's health at 1 minute and then again at 5 minutes. The purpose of this test is to measure the baby's condition in five areas (fig. 1):

• Heart rate
• Breathing
• Muscle tone
• Reflexes
• Skin color

Each area is assigned a number from 0-2. The APGAR score is the total of those numbers. Most babies score between 7-10. If the score is lower than 7, the baby may need some extra measures (such as oxygen).

APGAR is a good tool to assess how the baby is doing at the time of birth, but it does not necessarily show how well the baby did before birth or how it will do in the future.

The umbilical cord will be clamped and cut after the baby is delivered. There will be a remaining stump that shrivels and falls off within 7-10 days. It is important to keep the cord area clean to avoid infection.

Other procedures that will go on immediately after birth include:

• Measuring weight
• Measuring length
• Measuring head circumference
• Giving eye drops to help prevent infection
• Getting a blood sample from the umbilical cord to measure the balance of chemicals in the blood (sometimes)

Procedures after that vary, but it is likely you will be allowed to hold the baby after she has been dried off and wrapped in a blanket for immediate bonding. You may even get to breastfeed. (This will not be milk but a watery liquid called "colostrum" that has antibodies and nutrients in it.) You and the baby will be given identification bracelets.

After the bonding period, the baby is usually taken to the nursery for more tests and further evaluation. You will be taken to the recovery or birthing room so that you can rest and recover from the labor and delivery.

What Happens To The Baby?

The baby will be given a bath and an injection of Vitamin K to help its blood to clot. It is likely the baby will also receive a dose of hepatitis vaccine, depending on the doctor's recommendations.

Other tests that will be done within 48 hours include blood tests for sugar levels, PKU (phenylketonuria) and congenital hypothyroidism. The blood is taken from the baby's heel. A nurse will also do a general newborn assessment of the baby.

You will know before you have the baby whether the baby will stay in the same room with you. The baby may be brought to you at intervals and then go back to the nursery while you are in the hospital. It may depend on how you feel after labor and delivery -- some women want the baby in the room the whole time, and others want some time to sleep and rest before they leave the hospital (when they know their sleep and rest will be limited).

Baby's Appearance

Some new parents are surprised by the way their baby looks right after birth. The reason is that television and magazines usually show babies that are 1-3 months old as being newborn.

Most of the things you may notice will disappear within a few days or weeks after the baby has adjusted to its new environment. Counting fingers and toes is common for most parents.

figure 2

Remember, your baby has just taken a huge journey from being inside your body to the outside world, and it was a hard and strenuous journey to make. As a result, your baby will be tiny, wet, and have a slightly pointed head after passing through the birth canal (fig. 2).

There are two soft spots on the baby's head where the skull bones have not completely grown together yet. These remain flexible for about 6 months, then the skull will harden.

The baby's arms and legs will appear "scrunched up" because they were positioned that way in the uterus. The baby's face and genitals may look swollen. Some babies have a greasy, whitish coating (vernix) that protected their skin from the constant exposure to amniotic fluid.

You may also see fine hair (lanugo) on the baby's back and shoulders that will disappear in days or within a week. You may notice little white spots or blotches, and the skin may look delicate and wrinkly. All of these things will disappear within a week or two (and the baby will continue to change on a day-to-day basis).

Baby's Behavior

It is not unusual immediately after birth for babies to be alert. Your baby may hold onto your finger with his tiny hand and he may also want to try breastfeeding.

Some babies are quiet and calm while others may cry intensely. Within about the first hour, your baby will want to sleep (short naps for short periods of time). Some babies don't sleep as much as others. This is where the uniqueness of your baby begins.

If It's A Boy. . .

If you have a baby boy, you will be asked about whether you want your son to have a circumcision performed before you leave the hospital. A circumcision is the surgical removal of the foreskin of the penis. It is most often done within 2 days after birth. There is no medical reason to recommend a circumcision. The decision is usually influenced by your cultural background. This is a decision that will be yours, so you may want to think about this matter before your delivery.

GET SOME REST AND ENJOY THIS VERY SPECIAL TIME!

Review Date: June 29, 2001
Reviewed By: Peter Chen, M.D., Obstetrics and Gynecology, University of Pennsylvania School of Medicine. Review provided by VeriMed Healthcare Network.


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