Newborn Care:
Newborn care in hospital:
After the birth of your baby we encourage you to have uninterrupted skin to skin and snuggle time with baby for at least the first hour. Feel free to take lots of photos! This ‘golden hour’ has many benefits including to help baby transition to life outside of the womb, to regulate their temperature, facilitate bonding and to establish successful breastfeeding.
The initial assessment of baby’s wellbeing can be done while baby is skin to skin with you, including checking baby’s vital signs, color, muscle tone and breathing efforts.
After the golden hour, the doctor will do a thorough physical examination of baby and will weigh baby and check their length and head circumference.
In the first few hours after the birth your nurse will offer two medications for baby:
Erythromycin eye ointment: This is an antibiotic ointment that is applied to your baby’s eyelids and can help prevent eye infections that can be related to exposure to chlamydia or gonorrhea that may have been present in the birth canal. This treatment is not particularly effective and may not be necessary if you have screened negative for chlamydia and gonorrhea in your pregnancy. Many families choose to decline this medication which in my opinion is reasonable
Vitamin K injection: Vitamin K is essential in helping blood to clot normally and babies are born without adequate amounts of it. All babies should receive a vitamin K injection within the first six hours of life to prevent serious bleeding that can be fatal. Vitamin K should be given by injection only as giving it orally/ by mouth is not as effective.
If you choose to breastfeed, you can try to latch your baby sometime in the first hour after the birth. Your nurse will help you to work on establishing an effective and comfortable latch. This is a skill that takes lots of practice! You may have some colostrum (early breastmilk) right away which is highly nutritious for baby. Breastmilk can take 1-3 days to come in, so during these early feeds your baby may only be getting a small amount of colostrum or not much at all. This is completely normal. We expect all healthy babies to lose anywhere up to 10% of their body weight in the first few days of life and this is completely normal. You should continue to try and breastfeed your baby every two to three hours in the first few days after birth. You should wake up your baby to feed if it has been three hours. Frequent latching and sucking at the nipple is necessary to encourage your milk to come in.
Many families will choose to supplement breastfeeding with either pumped milk, donor milk or formula. If your baby has lost more than the expected amount of weight or has jaundice, your doctor may recommend that you supplement breastfeeding with bottled donor milk or formula.
If you would prefer not to breastfeed for any reason your nurse will provide you with formula to feed your baby with.
Your baby will have a blood test sometime after 24 hours of life to check for jaundice (yellowing of the skin and eyes). Most babies have a mild amount of jaundice in the first few days of life which is normal, however if the jaundice becomes severe the baby can become very sick with poor feeding, excessive sleepiness and in severe cases even seizures. Jaundice is completely treatable and luckily it is now extremely rare to see the dangerous consequences of jaundice with our early detection and treatment programs.
Your baby will also have a bloodtest that screens for a variety of medical conditions, this test is called the newborn screen and the results will be sent to your maternity care provider in the first 5 days or so after the birth.
Hearing screening:
Your baby will have a hearing test prior to going home.
Congenital heart disease screening:
Your baby will have an assessment to ensure there are no signs of heart disease. This test involves checking the oxygen saturation on the ankle and wrist.
Car seat:
If you have a car seat, your nurse will help you to strap your baby in properly prior to going home.
After you bring your baby home you should continue to feed your baby every two to three hours until you see your maternity doctor for a check up. You should make a doctor's appointment to have your baby weighed within 5 days of going home from the hospital.
The public health nurse will phone you the day after you are discharged from the hospital. They are a very helpful resource and I encourage you to ask them to come to your home. They can weigh baby and can provide guidance with breastfeeding as well.