Upon Arrival

What happens in the hospital after they whisk your baby away

The first meeting of mother and child can only be described as magical. Both stranger and close confidant, your baby blinks and stares at you as though he’s surprised to finally meet you, as you are to meet him. After waiting 40 weeks for this moment, you’ll be understandably anxious for some quality time together. But your baby’s caregivers will be equally eager to make sure your child is healthy. Luckily, doctors have found a way to make everyone happy.

“One of the complaints parents had in the past was the inability to spend time with the baby immediately,” says David Wells, M.D., corporate medical director for Pediatrix Medical Group of South Carolina in Greenville. “Today, lots of places will have the mother put the baby to the breast initially and let her spend time with him rather than whisking him away to do procedures.”

The first thing the birth attendants must do right away, says Wells, is guarantee the infant is breathing well and has a normal heart rate. Then the infant should be dried and kept warm. “The baby is dried at delivery because there’s a tremendous evaporative heat loss when the baby is wet,” he explains. (The need to stay warm is also why newborns wear those adorable little hats.)

Knowing what to expect when it’s time for you and your baby to separate can go a long way toward making you feel comfortable when the big day arrives. Here’s a look at some of the most common tests and procedures your little one will undergo in the first few days of life.

Apgar scores These scores rate newborns on a scale of to 2 for five criteria — heart rate, respiration, activity, reflexes and color — with a maximum score of 10. “It is principally a means of evaluating the baby at the time of delivery so that everybody understands his condition,” explains Wells. “It is not meant to give you an indication of any short-term or long-term problems the child may or may not have.”

Eye ointment Almost immediately after birth, your baby’s eyes will be treated with an antibiotic ointment to prevent eye infections that can be passed from mother to baby from diseases such as chlamydia and gonorrhea. (The latter was a leading cause of blindness until the early 20th century, when treatment of babies’ eyes became standard practice after birth.)

Vitamin K injection “Vitamin K is very important for coagulation, or blood clotting,” explains Ann R. Stark, M.D., clinical director of newborn medicine at Children’s Hospital in Boston. “Because newborns often have low levels of vitamin K, this shot prevents the rare possibility that your baby would be so deficient that serious bleeding would develop.”

Heel prick During this test, done within the first 48 hours of birth, three or four drops of blood from the baby’s heel are put on a filter paper. The paper is then sent to the state health department, where it is screened for rare conditions such as phenylketonuria. Circumcision If you plan to have your son circumcised at the hospital, be sure to consult with your pediatrician and obstetrician about the procedure beforehand. “There are a number of different techniques to remove the foreskin and different approaches to pain management,” explains Stark.

First physical Your pediatrician will make arrangements to give the baby his first physical. Wells suggests that one of the parents be present to ask questions. Bilirubin test Jaundice — a yellowish discoloration of the skin and eyes — develops when bilirubin, produced naturally by the body, builds up faster than a newborn’s liver can break it down. Mild to moderate jaundice occurs in about 50 percent of term babies and 90 percent of preterm babies. In most cases, it will simply disappear. Your doctor may, however, perform a blood test — while you’re still in the hospital — to determine how elevated your baby’s bilirubin levels are, since there is a very slight risk of hearing impairment or brain damage if levels are extremely high.