Newborn Care in the Hospital
What is newborn care in the hospital?
Newborn care in the hospital helps your baby transition to life outside of your uterus. Most babies are born without any major issues and need little or no support. But some babies require some sort of medical intervention immediately after delivery. Newborn care in the hospital also includes screenings, examinations and vaccinations. Healthcare providers want to make sure your baby’s first day or two go smoothly before sending you home.
What kinds of tests show the physical condition of newborns in the hospital?
After your baby is born, a healthcare provider will perform a series of tests to determine your baby’s health. They’ll use a routine evaluation called the Apgar test to identify whether your baby needs urgent medical care. Then, they’ll give your baby a vitamin K shot, eye drops and newborn screening tests. Your baby may also receive a hearing test and a hepatitis B vaccine.
What does Apgar stand for?
In 1952, Dr. Virginia Apgar developed a scoring system to quickly assess a newborn’s health after birth. The Apgar acronym uses her name as a helpful way to remember the five criteria it stands for: appearance, pulse, grimace, activity and respiration. During an Apgar test, a provider will measure your baby’s:
- A — Appearance (skin coloration).
- P — Pulse (heart rate).
- G — Grimace (reflex response).
- A — Activity (muscle tone).
- R — Respiration (breathing).
The provider will evaluate these five signs at one minute after birth and at five minutes after birth. Each test is given a score between zero and two, and the five scores are added together to make up the Apgar score. The ability of your infant to maintain their temperature and sustain a normal heart and respiratory rate is a general indicator for a successful transition.
What does the Apgar score mean?
If your baby has an Apgar score of seven or more, they’re probably in good physical condition. A baby rarely scores a perfect 10 because their skin color may be slightly blue until they warm up. A low Apgar score may indicate problems with your baby’s heart or lungs. It may also be the result of difficult labor. Your baby may be in good physical condition but have a low score immediately after birth. Premature babies also may score low because of immature development in your uterus. Keep in mind that the Apgar score doesn’t predict your baby’s future health.
Why does my baby need a vitamin K shot?
Babies typically have low levels of vitamin K when they’re born. They need vitamin K for blood clotting. So, your baby will usually receive a vitamin K shot immediately after birth. This will help prevent a rare but serious bleeding problem known as hemorrhagic disease of the newborn.
Why does my baby need eye drops?
Your baby will receive antibiotic eye ointment or eye drops to prevent bacterial infections they may pick up at birth.
What are newborn screening tests?
Healthcare providers screen all newborns in the United States for certain conditions that aren’t visible at birth. With early detection, providers can prevent or treat these conditions. Your baby’s provider will prick their heel and take a sample of their blood to test for many different conditions, including:
- Phenylketonuria (PKU).
- Congenital (from birth) hypothyroidism.
- Sickle cell disease.
- Cystic fibrosis.
Why does my newborn need a hearing test?
Hearing screening of all newborns is the gold standard of care across the U.S. Early treatment of hearing loss can prevent future speech and language problems. Your baby’s provider will place a small earphone or microphone in your baby’s ears to see how their brain responds to sounds. Your baby needs to be asleep for this test to be accurate. If your baby doesn’t pass, it doesn’t mean they have hearing loss. But their provider will repeat the test.
Why does my newborn need a hepatitis B vaccine?
The hepatitis B vaccine protects your baby against the hepatitis B virus, which can cause liver damage. The hepatitis B vaccine is a series of three shots. Your baby will usually receive the first shot shortly after delivery and the next two shots by 18 months of age.
What is newborn screening for critical congenital heart disease (CCHD)?
Critical congenital heart disease (CCHD) is a group of heart or circulatory problems present at birth (congenital). About 11 out of 10,000 babies are born with CCHD. The condition may be life-threatening and require intervention in infancy.
To improve the early detection of CCHD, providers recommend screening for it with other newborn screening tests before discharge from the hospital. They can use a pulse oximeter (pulse ox) designed for newborns to screen for CCHD. The provider will wrap one sensor around your baby’s hand and place another sensor on their foot. Pulse oximetry screening can identify CCHD in some newborns before they show signs of the condition.
What else will happen while my baby’s in the hospital?
If your baby is born without any complications, a healthcare provider will hand you your baby shortly after birth to establish skin-to-skin contact (sometimes known as “kangaroo care”). Skin-to-skin contact can:
- Help improve your baby’s transition.
- Increase milk production.
- Make breastfeeding (chestfeeding) more effective.
Before you go home, healthcare providers want to make sure your baby can feed well. Breastfeeding can be much harder than you’d think, but there are many resources to help make the transition easier. If you plan on breastfeeding, find out about the availability of lactation consultants in the hospital. Don’t be afraid to ask for help if you’re struggling. Your pediatric provider can be a resource to help as well. Before you and your baby are discharged from the hospital, a provider will ensure your baby is wetting at least three or four diapers over a 24-hour period.
A provider will make sure your newborn passes meconium within 24 to 48 hours after birth. Meconium is a black, sticky substance that your baby poops for the first one to three days.
A provider will also check your baby for jaundice, a yellowish tint to their skin. Most newborns have some visible jaundice, a condition that occurs when bilirubin builds up in your baby’s blood. But a provider may perform a bilirubin screening to measure your baby’s serum levels before leaving the hospital.
Within one to two days of birth, you may decide to have your baby circumcised. Circumcision is a surgical procedure that removes the foreskin from your baby’s penis. Babies get circumcised for medical, religious and cultural reasons. The procedure takes place before you leave the hospital.
How long do you stay in the hospital after birth?
Most healthy newborns can leave the hospital after two or three days. If you or your baby experiences any complications or has any medical issues, you may need to stay in the hospital longer.
How do I care for a newborn?
Leaving the hospital with a newborn can be exciting but scary at the same time. Most people feel unprepared when it comes to taking care of babies. Newborns have many needs, and caring for an infant can be nerve-wracking. Your baby’s needs are simple but crucial. It’s important to provide loving care during the first month of your baby’s life.
You can take steps to help get ready for the transition home. You may want to consider taking a newborn care class during your pregnancy. While a class can’t always prepare you for the real thing, it can help you learn about topics such as:
- Changing your baby’s diaper.
- Bathing your baby.
- Dressing your baby.
- Feeding and burping your baby.
- Cleaning your baby’s umbilical cord stump.
- Caring for your baby’s healing circumcision.
- Soothing your baby.
- Taking your baby’s temperature.
- Recognizing signs of illness or infection.
When can I take my newborn outside?
There aren’t any hard and fast rules about when you can take a newborn outside. As long as your baby is healthy, you can take them out as soon as you’d like. However, use caution. Keep your baby away from anyone who may be ill. Their immune system is still developing, so they may have trouble fighting off infections. In addition, ask anyone who wants to hold your baby to wash their hands first.
You may want to wait until your baby is a few months old before taking them into crowded, public areas. After a few months, they’ve been able to get their first round of vaccines, and their immune system is starting to build up to fight off potential germs.
When should my newborn get their first bath?
The World Health Organization recommends waiting 24 hours before giving your baby their first bath. Providers used to bathe newborns shortly after delivery. But research has discovered that delaying your baby’s first bath:
- Helps regulate their body temperature.
- Prevents dry skin.
- May lead to more success with breastfeeding (chestfeeding).
Some providers recommend waiting a week to bathe your newborn. This is because their umbilical cord stump usually falls off within a week or two. However, you can bathe your baby with a sponge to keep their umbilical cord dry.
Frequently Asked Questions
What can I do about my postpartum dry skin?
During pregnancy, hormones such as estrogen and progesterone fluctuate, which can change your skin’s texture and cause dryness. The decline in these hormones can contribute to dry skin postpartum (after birth), as well. To find some relief:
- Use a gentle cleanser on your skin.
- Apply an oil-free moisturizer that won’t clog your pores.
- Don’t take long, hot baths or showers that can strip your skin of its natural oils.
- Drink plenty of fluids.
- Use a humidifier.
What do hospitals do with the placenta after birth?
After your baby is born, you’ll deliver the placenta. This is known as the third stage of labor. Most hospitals treat the placenta as medical waste. They’ll place it in a biohazard bag and discard it. Some hospitals keep the placenta for a short time in case it needs to be tested for any reason.
A note from Cleveland Clinic
Newborn care in the hospital helps babies transition to life outside of the uterus. Most babies are born without any major medical issues and don’t need any extra support. However, some babies require medical intervention immediately after delivery. Healthcare providers also perform newborn screenings and evaluations to ensure your baby is ready to leave the hospital. From there, you can take your newborn home to provide the care they need to begin their life.
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