Healthy newborns (age birth to 1 month) and infants (age 1 month to 1 year) need many different types of care to ensure their normal development and good health.
During childbirth, the fetus, which is immersed in amniotic fluid and totally dependent on the placenta for nutrition and oxygen, makes a major transition to a newborn baby that breathes air and takes in nutrition by mouth. Immediately after a baby is delivered, the doctor, midwife, or nurse gently clears mucus and other material from the mouth, nose, and throat with a suction bulb. The newborn is then able to take a breath and no longer needs to receive oxygen through the umbilical cord. Two clamps are placed on the umbilical cord, and the umbilical cord is then cut between the clamps.
After a vaginal delivery Overview of Labor and Delivery Although each labor and delivery is different, most follow a general pattern. Therefore, an expectant mother can have a general idea of what changes will occur in her body to enable her to deliver... read more , the newborn may be laid carefully on the mother's abdomen for skin-to-skin contact or wrapped in a blanket for the mother to hold. After a cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more , if the other parent or another support person is present, the newborn may be given to that person to hold. The mother can see the newborn and then hold the baby after the cesarean delivery is finished.
Not all deliveries follow a standard pattern. For example, some women have complications of labor and delivery Introduction to Complications of Labor and Delivery Usually, labor and delivery occur without any problems. Serious problems are relatively rare, and most can be anticipated and treated effectively. However, problems sometimes develop suddenly... read more . In some cases, the newborn requires some special attention by the medical staff after birth.
Cutting the Umbilical Cord
Soon after a baby is born, two clamps are placed on the umbilical cord, and the cord is cut between the clamps. The clamp on the cord's stump may be removed when the cord is completely dry. The stump should be kept clean and dry. The stump falls off on its own in a week or two.
The doctor or midwife examines the newborn for any obvious abnormalities or signs of distress. A full physical examination Physical Examination of a Newborn A newborn is usually given a thorough physical examination by a health care professional within the first 24 hours of life. The examination begins with a series of measurements, including weight... read more comes later (typically within 24 hours of birth). The newborn's condition immediately after birth is recorded at 1 minute and at 5 minutes after birth using the . The Apgar score is used to assign points for heart rate, effort to breathe, muscle tone, reflexes, and color. A score of 7 to 10 is considered normal, 4 to 6 is intermediate, and 0 to 3 is low. A low Apgar score is a sign that the newborn is having difficulty and may need extra assistance with breathing or blood circulation. The Apgar score does not predict anything about the baby's health after the first few minutes of life.
Once the newborn is stable, the nurses obtain the head circumference Head Circumference Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more , weight Weight Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more , and length Length and Height Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more (see also Physical Growth of Infants and Children Physical Growth of Infants and Children Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more ).
Keeping a newborn warm is critical. As soon as possible, the newborn is wrapped in lightweight clothing (swaddled), and the head is covered to reduce the loss of body heat.
Immediately after birth, parents are encouraged to hold their newborn. Some experts believe that early physical contact with the newborn helps establish bonding. However, sometimes a newborn needs medical care or there is another reason that contact with parents is delayed. Parents can bond well with their newborn even when the first hours are not spent together.
The mother and newborn usually recover together in the delivery room. Mothers who are breastfeeding Breastfeeding Breast milk is the ideal food for newborns and infants. Although babies may be fed breast milk or formula, the World Health Organization (WHO) and American Academy of Pediatrics (AAP) recommend... read more put their newborn to their breast within the first 30 minutes after delivery. Breastfeeding stimulates oxytocin, a hormone that helps the mother's womb heal and promotes development of the milk supply. If a newborn is cared for in a nursery, it is placed on its back in a small crib and kept warm.
After birth, the doctor or nurse does a few tests and gives the newborn a few treatments to check for and prevent certain diseases, including the following:
A small amount of an antibiotic, such as erythromycin, tetracycline, silver nitrate, or, in some countries, povidone iodine, is placed into the eyes to prevent infection from any harmful organisms that the newborn may have had contact with during birth.
Hepatitis B vaccine Hepatitis B Vaccine The hepatitis B vaccine helps protect against hepatitis B and its complications ( chronic hepatitis, cirrhosis, and liver cancer). Generally, hepatitis B is more serious than hepatitis A and... read more is one of the routine vaccinations recommended for all children. All newborns, whether or not infected with hepatitis B, should be given the first dose of hepatitis B vaccine before they are discharged from the hospital.
Because all babies are born with low levels of vitamin K Vitamin K Deficiency Vitamin K deficiency is most common in infants, especially those who are breastfed. The deficiency can cause bleeding; therefore, all newborns should be given a vitamin K injection. Bleeding... read more , an injection of vitamin K is given to prevent bleeding (hemorrhagic disease of the newborn).
About 6 hours or more after birth, newborns are bathed. The nurse tries not to wash off the whitish greasy material (vernix caseosa) that covers most of the newborn's skin because this material helps protect against infection.