Baby’s first 24 hours after birth
After months of waiting (and labor hours!), a mother can finally get to the moment she has been waiting for nine months; meet her baby!
There is no doubt that meeting this precious little one for the first time is an incredible experience. But at the same time, after giving birth, new mothers can’t just get back to the same life they had before having a baby. Much happens immediately after a baby is born, especially in the first 24 hours.
Later, a newborn baby undergoes a physical examination, followed by plans to prevent serious health problems.
Finally, there is an educational component for the whole family, as well as a different assessment before your baby leaves the hospital. So let’s look at some important things that happen to a newborn baby after birth.
Care in the Delivery Room Immediately after Birth
Immediately after delivery, a newborn is dried and a nurse separates secretions from the baby’s airways. Then, if there were no severe complications at birth, as quickly as possible, the baby is placed skin-to-skin on his mother’s chest right after birth. Holding your baby skin-to-skin helps keep your baby warm and lets you bond with each other. The babies feel more relaxed on their mother’s chest since they hear their mother’s heartbeats that sound familiar to them. This is the moment when you can try to breastfeed your baby for the first time.
The umbilical cord connects your baby to the placenta in the womb. It carries food and oxygen from the placenta to your baby during nine months of pregnancy. After the baby is born and before the placenta is delivered, the umbilical cord is clamped in two places and cut between the clamps. Most providers wait at least 30 to 60 seconds after birth to let the blood from your placenta flow into your baby before clamping the cord.
Then, the placenta should be expelled from your body, usually about 5 to 30 minutes after your baby is born. This is called the third stage of labor. After the baby is born, you will continue to have mild contractions. You will have to give one more push to deliver the placenta. Sometimes your abdomen will be massaged or you will be given an injection of oxytocin and the umbilical cord will be gently pulled to help deliver the placenta.
If you have a cesarean section, the doctor will remove the placenta at the same time.
Once the placenta is delivered, the provider will check if the whole placenta is out. If any fragments of the placenta stay inside, it might put the mother at risk, therefore, they will have to be surgically removed to prevent bleeding and infection.
After the baby was placed on his mother’s chest for a few minutes or sometimes even before the baby is given to the mother for the first time, the Apgar test or Apgar score is performed. This allows doctors to know how the baby goes after birth. This assessment is made one to five minutes after birth. The Apgar score consists of five evaluations, all with a value between 0 and 2. The Apgar score is done based on the following five assessments:
- Appearance (skin color)
- Pulse (heart rate)
- Grimace response (reflexes)
- Activity (muscle tone)
- Respiration (breathing rate and effort)
The highest score is 10, babies with lower scores may need additional care, including 1% of newborns who require significant resuscitation support immediately after delivery. Find more information about how the Apgar Score is measured and what it means here.
Skin on skin
When the mother and baby are ready, once the baby is born, this is the best time to start breastfeeding. If the baby is healthy and there is no need for any medical intervention for him or the mother, he will probably be placed on the mother’s breast again, directly on her skin, until the first food session or as long as she wants.
Skin to skin is a simple act but very powerful and beneficial for the baby and his mom or dad. A few of these benefits are:
- Helps to calm you and your baby.
- Helps the baby cry less.
- Releases hormones that relieve stress and stabilize baby’s temperature, breathing rate, heart rate, and blood sugar.
- Releases a hormone that lowers mom’s stress and promotes healing.
- Creates good connections between you and the baby.
- Helps your colostrum (the first milk that is full of nutrients that protect the baby) to flow more easily.
- Helps to start breastfeeding.
- Boosts the baby’s immune system.
- Helps the baby gain weight faster.
- Lowers mom’s risk of postpartum mood disorder and depression.
Keeping the baby warm
Your baby can quickly lose 2° to 3°F right after birth. Therefore it’s extremely important to warm and dry your baby right away using warm blankets and skin-to-skin contact. Another source of warmth, such as a heat lamp or over-bed warmer are common and may be used.
Then your baby is placed in an open crib or bassinet in your delivery room next to a heated radiator if necessary.
Your baby will likely be dressed in a gown or T-shirt, a diaper, and possibly a hat. Often a blanket or sleep sack is wrapped securely around the baby.
Once your baby is stable and can maintain his or her own body temperature, they will turn off the added heat.
Your baby will be tired after the efforts of being born. As well as adjusting to their new life outside the womb, they are on a tremendous growth spurt and will need plenty of sleep to fuel this. Your baby will probably sleep for more than half of his or her first day in the world. It’s important to wake them to feed every 2-3 hours, depends on their birth weight, so they get used to the process and start eating well.
What if there were problems at birth
If your baby isn’t breathing properly after birth and needs help to breathe, has a low heart rate (below 100 beats per minute), or is floppy, they will move to the warming station. Staff will decide what sort of extra medical help your baby needs.
If your baby has problems at birth requiring other observation or CPR (or something in between), your baby will be taken to an intensive care day nursery or NICU for further assessment and close monitoring.
In case of breastfeeding
If you are planning to breastfeed, you should know that a number of health organizations, including the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the World Health Organization (WHO) – recommend breastfeeding as the best choice for babies.
You will produce colostrum immediately after birth. Colostrum is the first nutrient-rich, high-antibody milk that ensures the needs of your baby until your milk arrives. In the few first weeks of life, breastfeeding should be “on-demand” (when your baby is hungry), which is about every 1 to 3 hours. So don’t worry, you cannot overfeed a breastfed baby, and your baby will not become spoiled or demanding if you feed them whenever they’re hungry or need comfort.
In case of bottle-feeding
If you’re not planning to breastfeed your baby, you can ask your doctor for a medicine that dries and stop milk production. Talk to your doctor, midwife, or nurse if you would like more information about these drugs.
If you’re only bottle-feeding your baby, you should obviously start right after birth. According to What-to-Expect, a very rough general rule of thumb is to take your baby’s weight and multiply it by 2.5 – that’s the total number of ounces to feed your baby over the course of a 24-hours period. So, if the baby weighs 10 pounds, he or she would be drinking roughly 20 to 25 ounces per day – or about 3 to 4 ounces every four hours. To get more guidance, it is recommended to consult a lactation consultant or a pediatrician and check how much exactly your baby should drink.
If you’re planning to breastfeed and bottle-feed your baby, it’s recommended that you wait for two or three weeks to introduce a bottle. This way is easier to establish a breastfeeding routine.
As mentioned above, newborn babies tend to sleep a lot especially the first 24 hours. You should know that your baby may sleep for up to 18 hours over the course of 24 hours, which is completely normal. Therefore, not all babies will want to feed as soon as they are born. Hence, you should not be worried if your newborn baby is not eating much in the first 24 hours.
Checks and medications in the first 24 hours
Within the first hour of birth, the midwife will put two name tags on your baby (usually one on the arm and one on the leg).
In addition to the Apgar test that performed right after birth, your baby will be also weighted at some time in the first few hours, and a few more times before you go home. A healthy newborn is expected to lose 7% to 10% of the birth weight but should regain that weight within the first 2 weeks or so after birth. Babies are born with some extra fluid, so it’s normal for them to drop a few ounces when they lose that fluid during their first few days of life.
Baby first poop
Meconium is a newborn’s first poop. This sticky, thick, dark green poop is made up of cells, protein, fats, and intestinal secretions, like bile. The midwife will record when your baby first poos and wees. This is usually within the first 24 hours after birth. Click here to reach the newborn’s poop color guide to know if your baby poop color is normal.
Some babies pass meconium while still in the womb during late pregnancy. If meconium is present during your labor and birth, you will be watched more closely for signs of fetal distress.
In addition to these checks, you’ll be asked to give your permission for your baby to have one or two injections; vitamin K and hepatitis B.
Vitamin K shot
This can help prevent a bleeding disorder caused by vitamin K deficiency (hemorrhagic disease of the newborn).
Hepatitis B shot
Your baby must receive his first dose of hepatitis B vaccine before he leaves the hospital. If you have hepatitis B or if your status is unknown, your baby must be vaccinated within 12 hours of birth.
You can talk to your doctor before you get birth to get further information about these shots.
Baby bath in the hospital
Newborn skin is often bluish-red and covered in residual vernix caseosa, the cheesy coating that keeps a baby’s skin protected in the amniotic bath of your uterus. Babies born earlier tend to have more vernix than those born later. After birth, the vernix can continue to protect your baby’s skin by helping it retain moisture and stave off bacterial infections. This is one of the reasons why the World Health Organization (WHO) recommends delaying the baby’s first bath until 24 hours after birth or waiting at least 6 hours if a full day isn’t possible for cultural reasons.
In all likelihood, your hospital will delay bathing your baby, especially if you’re at a “baby-friendly” establishment. But, not hospitals are in line with this practice. A few hours after the baby is born, the nurse may come to take your baby back to the nursery for some testing and a bath. So, if you want to wait more with your baby’s first bath, make sure you ask.
Furthermore, you should know that before a baby is bathed, they placed under a warmer. And only when their temperature is steady, they are given the bath. Read more about how to bathe your baby for the first time.
Does the baby have a circumcision?
If you have decided to circumcise your little boy (and later not plan a ritual circumcision), this is usually done a day or two after birth. Read more about circumcision in baby boys here.
When can we go home?
Finally! The moment when all new mothers were waiting – taking their babies home!
Once the hospital has confirmed that their mother and baby are healthy, they may return home. Before they leave, new parents may need to follow an exit class. An employee looks at all forms that new parents must take care of, such as collecting a social security card a birth certificate as well as any insurance questions. Once the green light has been given, the new family can go home!
What should your newborn wear when leaving the hospital?
Dress your baby as you would dress yourself. So, if you would be too warm in a knitted hat during the summer, your baby probably will be, too. In warm weather, dress your baby in a T-shirt with long sleeves and light cotton pants. You can cover him or her with a blanket over care legs. If it’s cold, put on footie pants, a hat, gloves, and cover your baby with a warm blanket.
Click here to find out how long before you can bring a newborn out in public.