first 72 hours
Labour & birth

The first 72 hours

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.

After birth

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.

Skin-to-skin

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.

Baby check

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.

Medical tests

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.

First feed

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.

Mother’s health

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.

Newborn feeding.

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.

Remember:

  • 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.

Top Tip

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.

More like this:

Life in the fourth trimester
Coming home: your 6 week survival guide
7 top tips for designing a nursery

ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….

YOU MIGHT ALSO LIKE

Beating pregnancy fatigue

Consultant dietitian Sarah Keogh has the lowdown on which foods will give you an energy lift that lasts.

MUST READ

ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….