You may not have realised how busy your baby will be during his first 72 hours. Here’s what you can expect – from the cutting of the cord to the last screenings your baby will need before you put him in his car seat and head for home.
Immediately after birth, the umbilical cord, which acted as the baby’s lifeline during pregnancy, will be clamped and cut. The midwife will tell you how to clean the cord stump before you leave the hospital.
Your baby will be stimulated to breathe by being rubbed; dried off; or having the soles of their feet flicked. Before the cord is cut, your baby will be given an identity wrist and/or ankle band, detailing the date and time of the birth; the hospital number; the baby’s sex; and the mother’s name. All the details will be crosschecked with you. The baby will also get a security tag, which is computerised to match their specific hospital number. This is placed on your baby’s leg along with their identity bracelet.
If you and your baby are well after the birth and if you wish, your baby will be placed skin-to-skin (the baby is placed under your theatre gown for comfort, warmth, security and to commence breastfeeding). The World Health Organisation (WHO) recommends 60 minutes of skin-to-skin contact to promote breastfeeding. Skin-to-skin contact also helps to promote bonding, and encourages normal infant breathing and heart rate patterns.
After you have had a few minutes of skin-to-skin contact with your baby, which is the start of the bonding process, they will be weighed, and given a basic examination by the midwife. This will check fingers; toes; the fontanelles (the soft spots on your baby’s skull); the spine; and that the palmer creases, which are two creases that run across the palms of the hand, are there.
Many babies are a little ‘blue’ when they are born, so don’t get a fright; it can take a minute or two for them to turn ‘pink.’ Many babies also have a conical-shaped head when born. This occurs as they navigate their way out of the birth canal and this usually settles in a day or two.
Also, baby’s hands and feet can be slightly pale for up to 24 hours, again this is normal; the circulation improves in a few days.
The APGAR test will also be carried out on your baby. This is a way of checking the baby’s condition and is done one minute after birth and again five minutes after birth. Heart rate; breathing; muscle tone; reflexes; and skin colour are all assessed.
A healthy baby will have a score of seven or higher. A baby with a lower score may need time to recover from the birth. Babies with very low scores will need medical attention.
A paediatrician will carry out a complete check of the baby within a day or two. If it was an instrumental birth or if the baby was in distress during the first or second stage of labour, a paediatrician will be present. They will do a comprehensive check on the baby, looking at head and length measurements.
If a baby needs bloods, it will be brought to the neonatal unit for a septic work-up. This entails the baby going to the intensive care nursery soon after birth, having swab tests, urine samples, blood taken and sometimes a spinal tap to check for infection. They will also give the baby antibiotics intravenously in the nursery for 48 hours, until all the tests come back clear.
As mentioned, skin-to-skin contact is encouraged for the first 60 minutes of a newborn’s life, and the first feed is also encouraged during this time. This causes a reflex that helps the uterus contract, reducing bleeding. However, while some babies need an early feed and can latch on really well, others may be too sleepy to be interested in feeding. Your midwife will help you assess the situation.
The midwife will also review your condition. Your vagina will be checked for tears and sutured after delivery of the placenta. The midwife will also check that your blood loss is not too heavy and that any problems such as a rise in your blood pressure, are quickly identified. You will then be served some well-deserved tea and toast.
A newborn baby should be breastfeeding between eight to 12 feeds during a 24-hour period. On day one, a baby’s stomach capacity is about the size of a shooter marble; by day three, the baby’s stomach capacity is about the size of a ping pong ball, and the size of a chicken egg by day 10. This will make it easier to understand why breastfed babies feed little and often.
It is not unusual to feed hourly in the first few days.
- Your breasts are never empty and you will always have enough for your baby’s needs.
- When breastfeeding well babies do not need formula top ups as this interferes with the natural supply and demand for mum to produce breast milk.
- Lots of breastfeeding and skin-to-skin brings in more milk faster.
- Lots of breastfeeding helps prevent engorged breasts.
- Most mothers can make enough milk for twins, triplets, and more.
- Keep your baby on your body, skin-to-skin for easier feedings and more milk production.
Fiona Rea IBCLC Cuidiú Antenatal Educator/ Tutor. Cuidiú Breastfeeding Counsellor/Tutor. Pre and Post Labour Doula.
Don’t be shy about setting guidelines for visitors. If you are exhausted and need some time, communicate that to potential visitors; or ask your partner to limit the number of people coming into your home, or the length of time they stay. Ask anyone who is ill to wait until they are healthy before visiting.
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