Newborn Procedures
Immediately after birth, the baby’s nose and mouth are typically
suctioned to remove fluids, and to make sure his breathing is well-established.
They may pass him up to lay on your chest at this point, as he is wiped off. At
this time, your baby’s general condition is observed to see if he needs any
assistance.
If he is not breathing well on his own yet, they may give him a
little oxygen before returning him to your arms.
Apgar scores: Caregivers will check baby’s heart rate, respiratory effort (is
he breathing slowly and irregularly, or breathing well and crying lustily),
muscle tone, reflexes and skin color. These are added up to an Apgar score,
which gives a snapshot of the baby’s condition at 1 minute after birth and 5
minutes after birth. Caregivers generally don’t mention the scores to parents,
these are more for record-keeping. A thorough exam will be done sometime in the
first 24 hours.
Cutting the Cord: Shortly after birth, the umbilical cord is clamped and cut.
(Often the father can cut it if he would like to. To some fathers, this is a
very significant symbolic event. To others, it doesn’t interest them.
The blood from the umbilical cord can be collected, and then
donated to a blood bank, or stored for later use by the family. Although
research into the area of stem cells is fairly new, these cells show a great
deal of promise for treatment of a variety of medical disorders. To find out
more, ask your doctor or contact a blood bank early in your pregnancy.
Beginning Breastfeeding: see here.
Newborn eye care: Within one hour after the baby’s birth, the baby’s eyes are
treated with erythromycin, tetracycline ointment, or silver nitrate eye drops
to prevent infection and possible blindness if the newborn is exposed to
chlamydia or gonorrhea during birth. Silver nitrate can cause redness,
swelling, and eye discharge. All these treatments cause blurry vision for a
short period of time. If the baby is very bright and alert after birth, it is
ideal to wait until the end of the first hour for these treatments to allow the
parents the bonding time, and allow breastfeeding to begin without
interruptions. If the mother has had a c-section, and is not able to nurse
right away, it may be best to request the eye treatment early so the baby’s
eyes are less blurry when mom is ready to start nursing.
This treatment is required in almost all states. Some will allow
parents to sign a waiver to avoid it.
Blood Tests
Test for PKU. Blood is obtained by a heel prick and tested for high levels of
phenylalanine. PKU is a rare disease, only affecting 1 in 10,000-25,000 babies.
However, it’s consequences can be severe retardation, which is easily
preventable if the disease is detected early. Therefore, it’s required in all
50 states. Babies are usually tested twice for PKU, once near birth, and once
at about 1-2 weeks of age.
Test for hypothyroidism. After 12 hours of age, blood is taken and tested for hormone
levels. Incidence is 1 in every 3600-5000 newborns, but long-term effects are
severe if it goes untreated, so again this test is required. Babies are
re-tested between 2 weeks and 6 weeks.
Test for galactosemia. Blood is taken after breastfeeding or formula feeding, and tested
for elevated galactose content, which indicates the baby is not able to digest
milk sugar. Incidence is 1 in 60,000-80,000, but galactosemia is fatal unless
treated. Test is required in many states.
Test for Jaundice: If the baby’s skin and the whites of his eyes are yellowish, then
a heel prick is done to draw blood for a lab test to see if his bilirubin
levels are high. If they are high enough to warrant treatment, the treatment
involves placing the baby under special lights to lower the levels of
bilirubin.
Test for hypoglycemia. Performed if the baby is over 8 pounds 13 ounces, or under 5
pounds; if baby is pre-term or post-mature, if the baby is thought to have low
blood sugar (can happen when mother is diabetic, or when mother received a
large amount of dextrose IV fluids during labor.) Treatment is frequent
breastfeeding or formula feeding, or IV dextrose in severe cases.
Test for sickle cell anemia and beta thalassemia. Blood is taken any time
after birth and tested for the presence of abnormally shaped red blood cells.
Test is performed if medically indicated, generally in people of African
descent, Arabic, East Indian, Middles Eastern, and southern European descent.
Source: Pregnancy, Childbirth, and the Newborn by Simkin,
Whalley, and Keppler, 2001. There is more information in the book about these
tests and the related conditions.
Compiled by Janelle Durham
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