Every baby’s welcome to the world is important and unique. Some newborns come earlier than expected, some with a twin, some by vaginal delivery and others by cesarean birth. We are here to help you and your new baby get off to the best start possible.
It is not unusual for many newborns to need a little extra help adjusting to life outside of your womb. He or she might need to spend a short time on the warming examination table in the delivery room or in the Newborn Intensive Care Unit (NICU). If that happens, your nurses and doctors will keep you informed about your baby’s condition and how he or she is doing.
Baby’s Vital Signs
Your baby’s heart rate and breathing will be measured and their temperature will be taken, and this can be done while your baby is skin-to-skin. In addition, your baby will be weighed and measured prior to transfer to your room on the postpartum floor.
Apgar Score
The Apgar score is a measure of your baby’s condition at one and five minutes after birth. This score will be determined after your baby is born.
Learn more about the Apgar Score.
Medications
Shortly after birth, your baby will have an antibiotic ointment, erythromycin, applied to their eyes to prevent eye infections. The baby will also be given a shot of Vitamin K in the thigh, because some babies have low Vitamin K at birth and this supplement helps prevent life-threatening internal bleeding. The shot of Vitamin K is safe and it completely protects your baby from this problem.
After your labor and delivery care is completed, you will be moved to the postpartum floors (Floor 9 or 10 in the Center for Women and Newborns). Your postpartum nurses will be your coaches as you learn to care for your new baby. They will help you learn about feeding your baby and will ask you to keep track of the baby’s feedings and “pees and poops.” After your baby has adjusted to being born, they will be given their first bath, if you choose.
Your baby will be examined by a pediatrician within the first 24 hours of life and throughout your baby’s stay. During the first visit, the pediatrician will review your obstetric care and discuss your health history and your family’s health history. Your baby will then have a complete physical exam and their hospital care plan will be discussed with you. You will have the opportunity to ask questions.
The hepatitis B vaccine protects your baby against the hepatitis B virus which can cause severe liver disease. The vaccine is given as a series of three doses: at birth, one month and six months of age. The first dose is recommended to be given within the first 24 hours after birth.
Learn more about the hepatitis B vaccine.
Massachusetts Mandatory Testing
All Massachusetts born babies are provided with newborn screening services. This public health program helps prevent serious health problems that can develop in some newborns. This testing is mandatory. Massachusetts also offers optional newborn screening services using the same blood sample. Between 24-48 hours of life, a few drops of blood will be taken from your baby’s heel. This blood specimen will be sent to the New England Newborn Screening Program for testing. Any concerning results will be reported to your baby’s primary care provider for further testing.
Hearing Screen
All newborns also undergo a hearing screen prior to discharge.
Critical Congenital Heart Defect Screening
Your baby’s blood oxygen level will be checked by using a soft probe placed on the skin to screen for a serious heart condition.
If you developed a fever or other signs of possible infection during delivery, your baby might need to be checked for signs of infection. During this evaluation they will be cared for in the NICU on the sixth floor of the Center for Women and Newborns. A blood culture may be performed to monitor for any signs of bacteria growth over 48 hours. Your baby may also have an intravenous (IV) line inserted and be started on two antibiotics--usually ampicillin or gentamicin. Your baby will be returned to you as soon as this evaluation is completed.
Your pediatrician will continue to monitor your baby for signs of infection and will determine when antibiotics may be discontinued. Most babies evaluated for infection are ready to go home with their mothers.
Your baby will be carefully evaluated daily for jaundice (yellow skin color). It is normal for newborns to become jaundiced in the first few days after birth. Jaundice is caused by a substance called bilirubin, which is a breakdown product of hemoglobin, the substance found in red blood cells. Most newborns will have mild jaundice, which is not a health problem. Some babies, however, are at risk to develop serious jaundice that, rarely, can cause hearing loss or brain damage if not treated.
Your baby will be screened for jaundice with a skin test. In some cases, a blood test may also be done. When treatment for jaundice is required, your baby will be placed under “phototherapy” lights. These are blue lights that help your baby’s body decrease the jaundice levels quickly. Your baby will be placed under this blue light therapy at all times except when feeding. This treatment will be continued until the jaundice level is safe for your baby.
If you decide to breastfeed, we want to help you to get the best start possible. We will encourage you to spend as much time as possible with your baby “rooming-in.” Your baby will feel more secure, feed better and more often, sleep better and cry less if rooming-in with you.
Being skin-to-skin with you is the best possible place for your baby, especially during the first few days when they are learning to breastfeed. Skin to skin, and latching your baby to your breast, helps let your body know to start producing breastmilk for your baby. Certified lactation consultants are available to meet with breastfeeding mothers and their newborns to provide information and hands on practice. Your care team will make sure that you and your baby both know how to breastfeed before you return home, and lactation consultants will provide resources for after you go home.
If your baby has arrived earlier than 37 weeks gestation or is smaller than expected, he or she will require extra special attention. Your baby may have more trouble staying warm, needing to stay close to you, or in an incubator while you are asleep. He or she also may have a harder time feeding, at the breast and/or bottle. Your care team is very experienced at helping you learn to care for your early arrival and prepare for their care at home. It is also important to remember that if your baby is under 5 pounds, you will need a car seat that fits the baby properly and is specifically designed for a baby under 5 pounds.
Breastfeeding Tips for You and Your Baby.
Learn more about the care of preterm infants.
Read about car seat safety.
Circumcision is a surgical procedure that removes the foreskin that covers the glans of the penis. Whether or not to circumcise your baby boy is largely a personal choice.
Reasons for Circumcision
Reasons against Circumcision
If you choose to circumcise, lidocaine injections will be used to reduce pain your baby may experience. Skin to skin care after the procedure will also help your baby feel less pain. Your obstetrician or pediatrician will explain the details of the procedure and perform the circumcision. Your nurse will teach you how to care for the area as it heals. Learn more about circumcision:
Your care team will help you prepare to bring your newborn home. To make sure your needs are met, we encourage you to ask questions. Our goal is for you to feel comfortable feeding, bathing, diapering and caring for your baby before going home. You will need to have an approved car seat of an appropriate size for taking your baby home. If your baby is under five pounds, you will need a car seat that is specifically made for babies less than 5 pounds.
You also will need to choose a primary care provider (pediatrician or family medicine doctor) before the baby is 24 hours of age. Before your baby is discharged, you will need to make an appointment for the day your hospital pediatrician recommends, usually 1-2 days after discharge. Your baby’s hospital record will be sent by fax to your primary care provider and you will be provided another copy to bring with you to your appointment. Our social work staff is always available if you have any special concerns.
Learn more about caring for your baby once you get home: A Guide for New Parents.
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