1. Immediate Post-Birth Care
Assessment and Cleaning: After birth, the baby will be assessed for vital signs (heart rate, breathing, and muscle tone) using the Apgar score (done at 1 and 5 minutes after birth). If the baby is healthy, they will be gently wiped clean, but newborns don’t require an immediate full bath. The vernix (white, waxy coating on the skin) can be left on as it has protective benefits for the skin.
Cord Clamping: The umbilical cord will be clamped and cut. In some cases, delayed cord clamping (waiting 30-60 seconds before cutting) is practiced to allow more blood to transfer from the placenta to the baby, improving iron stores and overall health.
Skin-to-Skin Contact: If the baby is healthy, immediate skin-to-skin contact with the mother is highly encouraged. This promotes bonding, regulates the baby’s body temperature, and supports early breastfeeding.
2. Breastfeeding or Bottle Feeding
First Feeding: If the baby is alert and ready, the first attempt at breastfeeding can happen right after birth, usually within the first hour. Colostrum, the thick, nutrient-rich early milk, provides vital nutrients and antibodies for the baby. If breastfeeding is not possible immediately, a bottle can be given with formula under guidance.
Feeding Frequency: Newborns feed frequently, about every 2-3 hours. Initially, they will consume small amounts, but as they grow, their feeding volumes and intervals will increase.
3. Vital Sign Monitoring
Temperature Regulation: Newborns have difficulty regulating their body temperature, so it is essential to keep them warm after birth. The baby may be placed under a warming lamp or be wrapped in blankets to maintain body warmth. Skin-to-skin contact with the mother can help regulate the baby's temperature.
Blood Sugar Levels: Some newborns, especially those who are premature or have low birth weight, may need their blood sugar levels monitored in the first few hours to ensure they are stable.
Initial Physical Exam: A pediatrician or nurse will perform an initial physical exam to check for any abnormalities, assess reflexes, and ensure the baby’s general health.
4. Vitamin and Medication
Vitamin K Injection: To prevent vitamin K deficiency bleeding (which can cause bleeding problems), newborns are given an injection of vitamin K shortly after birth.
Hepatitis B Vaccine: Newborns typically receive their first dose of the Hepatitis B vaccine within the first 24 hours of life, especially if the mother is known to be hepatitis B positive.
Eye Care: An antibiotic eye ointment (typically erythromycin or tetracycline) is applied to the baby's eyes shortly after birth to prevent infection, especially from gonorrhea or chlamydia that the baby could have been exposed to during birth.
5. Umbilical Cord Care
- The umbilical cord stump will remain attached to the baby’s abdomen for several days after birth. It typically falls off within 1-2 weeks.
- Keep the stump dry and clean, and avoid submerging the baby in a bath until the stump falls off. Gently clean around the stump with water and a soft cloth. Avoid using alcohol unless recommended by the doctor.
6. Baby’s First Diaper and Stool
- Meconium: The baby’s first bowel movement, called meconium, is thick, dark, and tar-like. It should happen within the first 24-48 hours. If the baby hasn't passed meconium by this time, it may signal a problem and should be checked by a doctor.
- Diaper Care: Newborns should be changed frequently to prevent diaper rash and discomfort. Expect multiple wet and dirty diapers each day.
7. Monitoring the Baby’s Health
Breathing: Newborns may have irregular breathing patterns, but they should not experience any difficulty breathing. If you notice fast breathing, flaring nostrils, or labored breathing, call a healthcare professional.
Jaundice: Newborns often develop jaundice, which is a yellowing of the skin and eyes due to high levels of bilirubin in the blood. This is common in the first few days after birth and is usually monitored by healthcare providers. If the jaundice is severe, the baby may need phototherapy (light treatment).
8. Newborn Screening
- Most newborns undergo various screenings within the first 24-48 hours of life. These include:
- Newborn Metabolic Screening: Tests for rare but serious conditions like phenylketonuria (PKU) and hypothyroidism.
- Hearing Test: A hearing screening is done to check for any hearing impairments.
- Pulse Oximetry: A test to check oxygen levels in the baby’s blood to screen for heart defects.
9. Comfort and Soothing
- Swaddling: Swaddling (firmly wrapping the baby in a blanket) can make the baby feel secure and help them sleep.
- Soothing: Newborns may cry to communicate hunger, discomfort, or the need for attention. Gentle rocking, pacifiers, or playing soft white noise may help soothe the baby.
10. Parental Rest and Recovery
- Rest for the Mother: After delivery, the mother should be given time to rest and recover. The first 24-48 hours are typically spent in the hospital, where the mother can receive care and support, including pain management and help with breastfeeding.
- Support for Parents: It's important for both parents to receive support from family, friends, or healthcare providers to adjust to the new baby and manage the demands of newborn care.
11. Discharge and Going Home
- Discharge: Once both mother and baby are stable, they are usually discharged from the hospital 24-48 hours after a vaginal birth, or a few days after a cesarean delivery, depending on recovery.
- Car Seat Safety: Before leaving the hospital, make sure you have a properly installed, rear-facing car seat for the baby.