When you are pregnant, there is plenty to think about. Not only do you have to be educated on pregnancy and your birth options, but you have decisions to make when your baby is born.
In the first few hours of your baby’s life, you will need to make a number of choices about newborn care procedures.
It’s a good idea to consider these procedures before the birth and make a decision about which procedures you will or won’t have.
That way, on the day, you can simply enjoy meeting your new baby.
12 Procedures You Need To Decide On For Your Newborn
Here are 12 things you need to consider when your baby is born:
In many hospitals it’s routine procedure to suction the baby’s mouth and nose when the head appears but before it’s fully born. A deep suction hose or bulb syringe is used to remove any mucus or meconium present.
It’s rare for babies to require suctioning at this point, as they are unlikely to have taken their first breath until they are fully birthed. If the cord is left intact and is pulsating, the baby is still receiving oxygen via the placenta. Suctioning can be delayed until after birth or if there is clear evidence the baby is struggling to clear her own airway.
#2: Delayed Cord Clamping
Many hospitals now recognise the importance of leaving the umbilical cord intact after birth, and waiting for it to finish pulsing before clamping and cutting. However, in many places, standard practice involves immediate cord clamping, usually within the first 60 seconds of birth.
Waiting just 1-3 minutes after birth before clamping the cord allows the placenta to continue to supply blood to your baby. This extra blood from the placenta can be as much as 30% of your baby’s total blood volume. This extra blood can prevent iron deficiency occurring in the first six months of life.
Find out more about the importance of delayed cord clamping.
#3: Skin to Skin Immediately After Birth
There are many benefits to holding your baby skin to skin straight after birth, even if your baby is born via a c-section. Your baby experiences less stress, her temperature is more stable and normal, her heart rate and breathing stay normal, and her blood sugar level is more stable.
As well as these benefits, your baby can establish breastfeeding early, which helps to colonise her gut with more of the good bacteria she is absorbing from your skin.
These benefits are not just for healthy, full term babies. When premature babies have skin to skin and kangaroo care with their mothers, it reduces their need for oxygen and even shortens the time they must rely on special care.
Find out about the risks associated with interrupting immediate skin-to-skin contact after the birth.
#4: Cord Blood Banking
Cord blood banking has become increasingly popular with new parents. The term ‘cord blood’ is misleading: the blood is collected from the cord but it is, in fact, the same blood the baby is receiving from the placenta.
This blood is a rich source of stem cells, which scientists are using to try to treat a wide range of disorders, such as cancer, autoimmune diseases and arthritis. As a result, many parents choose to have their baby’s blood retrieved from the umbilical cord after birth, and stored in case the child becomes ill in the future.
While cord blood treatment is exciting, there is no conclusive evidence to suggest it works, and it’s unlikely research will reveal results in the next decade or so. Delayed cord clamping isn’t possible with cord blood collection. Some cord blood collection companies say it is, however they often want to clamp the cord after only one minute, when a minimum of two is recommended.
#5: Antibiotic Eye Treatment
To prevent the risk of blindness in babies born to mothers infected with gonorrhoea or chlamydia, antibiotic drops or silver nitrate can be applied to newborn’s eyes. Whether this procedure is available depends on the country or hospital in which you give birth.
If the mother has been screened for gonorrhoea and other sexually transmitted diseases during pregnancy, and has negative results, she might consider this procedure unnecessary. Silver nitrate can cause pain and swelling, burning, and blurred vision for several days after application. The latest medications don’t cause burning, but can still make your baby’s eyes blurry for a few days.
#6: Vitamin K
Babies are born with low levels of vitamin K, the vitamin responsible for normal blood clotting.
Many years ago, when forceps were commonly used to assist birth, vitamin K was given to newborns to prevent bleeding in the brain because of the higher risk of damage associated with forceps use. Today, bleeding of the brain (haemorrhagic disease of the newborn) is a rare occurrence.
There are different opinions about current recommendations for newborn babies being given vitamin K. Some health professionals are concerned about the effects of unnaturally high levels of vitamin K after injection. There are also other substances in the solution which could be of concern. And there is the possibility of vitamin K causing blood clotting in newborns.
Depending on the laws in your area, you might have the option to use an oral dose or an injection, to postpone administration of vitamin K for several hours, or to refuse vitamin K altogether.
If it’s not a mandatory procedure in your area, you might decide to refuse Vitamin K unless your baby experiences a traumatic birth.
Circumcision is the clamping and cutting of the foreskin of the penis.
The foreskin is loaded with around 20,000 nerve endings, compared to a clitoris, which contains about 8,000. The foreskin is also rich with blood vessels and sebaceous glands, which provide natural lubrication during sexual activity. While it might just look like a small bit of skin on a baby, for an adult, the foreskin has on average 30 to 50 square centimetres of protective, lubricating, pleasure-creating, tissue surface area.
Some parents choose circumcision for cultural, religious or personal reasons.
Rates of newborn circumcision have declined over the past 30 years, as experts agree it’s a medically unnecessary procedure, and research shows there is no link between circumcision and improved health.
Most circumcisions are done with no anaesthesia as it can cause swelling, which makes the surgery more difficult and can lead to further complications. It’s important to be informed about the procedure and the options for pain relief for your newborn baby boy.
There is also the option of delaying circumcision until later in the child’s life, if there are medical concerns which might be rectified as your child grows and develops.
Some men report being unhappy and even angry about being circumcised without their consent – some even practise the lengthy process of foreskin restoration.
Therefore, an increasing number of parents are choosing to allow their son to decide what they want to do with their own bodies.
Breastfeeding is usually something most women will assume happens naturally after they give birth.
Early breastfeeding, initiated by your baby soon after birth, is the best way to begin your breastfeeding relationship.
Breastfeeding is not always smooth sailing, however, and it can help to do a breastfeeding class while you are pregnant.
This can give you the confidence to spot the ways in which breastfeeding can be derailed, and how to seek help and support when and if you need it.
In some hospitals, your baby will be wiped and even bathed soon after birth.
Most babies are born with some vernix covering their skin. This waxy, white substance coats your baby’s skin and protects it, as well as acting as a natural moisturiser.
It’s not necessary to bathe your baby after birth, unless this is your preference.
A bath can lower your baby’s temperature too far, and then special care will be required to restore it to normal. Some parents prefer to leave bathing for at least a week after birth.
When your baby is born, the midwives will assess her for certain signs to ensure she is adjusting to life outside the womb. This is an Apgar test and is done at 1 and 5 minutes after birth, while your baby is skin to skin with you (unless there is a medical emergency).
Any other checks, such as weight and measurements, can be delayed until several hours or even a day or two after birth. Most hospitals prefer to weigh babies within several hours, so they can keep an eye on any weight loss which happens naturally after birth. You can ask for these measurements to be delayed until you and baby are ready.
#11: Hepatitis B Vaccine
Hepatitis B is a disease which is spread through sexual contact, infected blood, and needles.
A newborn is highly unlikely to contract hepatitis B through any of these means, so you might decide to opt out of this vaccine.
The disease can be passed to a baby from a mother who has the virus, so you can be screened for hepatitis B, and be informed about the vaccine if you are positive.
In some countries, newborns are routinely given the hepatitis B vaccine within the first 72 hours following birth.
In other countries, hepatitis B vaccine is only given to at-risk babies, where the mother, caregiver or other relative are positive for hepatitis B.
For more information, see our article, Hepatitis B Vaccination For Babies – Is It Really Necessary?
#12: Newborn Screening Test
Newborns are routinely screened for a number of rare genetic disorders within 40-72 hours after birth.
This test is commonly known as the ‘heel prick test’, as a few drops of blood are collected from your baby’s heel and sent for testing.
Early detection of these disorders can mean fast treatment and management, ensuring best possible outcomes and preventing severe complications or developmental delays.
If you decide to have the newborn screening test done, to make the test as quick and easy as possible, warm your baby’s foot up for 5 minutes beforehand. Hold your baby upright and make sure she is calm and relaxed. The midwife will need to hold the foot firmly, which causes some babies to protest. You might prefer to wait until your milk is in and your baby is well hydrated.
Making choices for your newborn’s care begins as soon as you give birth. Many first time parents are not aware most care procedures exist as part of the routine, and for the convenience of hospital staff, and are based on policies rather than evidence based research.
The best way to prepare for newborn care is to be informed about routine procedures and the pros and cons of each. You might decide to have some and opt out of others. Many decisions are personal, such as delayed cord clamping and breastfeeding, and have long-term benefits as well as being immediately beneficial.
Recommended Reading: 7 Huge Benefits of An Undisturbed First Hour After Birth.