Medical Care and Your Newborn

en españolLa atención médica y el recién nacido

By the time you hold your new baby in your arms for the first time, chances are you've already chosen one of the most important people in your little one's early life — a doctor. You and your baby will probably visit the doctor more often during the first year than at any other time.

You may have had a prenatal visit with your baby's doctor-to-be to discuss some specifics, such as when he or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is out of the office, and how the office handles after-hours emergencies. You may have also learned the doctor's views on certain issues.

In this way, you've begun to forge a relationship with your baby's doctor that should last through the bumps, bruises, and midnight fevers to come.

What Happens Right After Birth

Depending on your desires and the rules of the hospital or birth center where your baby is delivered, the first exam will either take place in the nursery or at your side:

• Weight, length, and head circumference will be measured.
• Temperature will be taken, and your baby's breathing and heart rate will be measured.
• The doctor or nurse will monitor skin color and your newborn's activity.
• Eye drops or ointment to prevent eye infections.
• A shot of vitamin K will be given to prevent the possibility of bleeding.

Your baby will be given a first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers give personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.

The Doctor's Visit

The hospital or birth center where you deliver will notify your child's doctor of the birth. If you had any medical problems during pregnancy, if your baby might have a medical problem, or if you're having a C-section, a pediatrician or your baby's doctor will be standing by to take care of the baby.

The doctor you've chosen for your newborn will give your baby a physical examination within 24 hours of birth. This is a good time to ask questions about your baby's care.

A sample of your baby's blood (usually done by pricking the baby's heel) will be screened for a number of diseases that are important to diagnose at birth so effective treatment can begin quickly.

Every newborn should be seen and examined at the doctor's office within 3 to 5 days after birth and within 72 hours after discharge from hospital. If your baby is sent home sooner than 48 hours after delivery, your doctor will want your baby to be brought to the office for a check within 48 hours after discharge.

The First Office Visit

During the first office visit, your doctor will assess your baby in a variety of ways. The first office visit will differ from doctor to doctor, but you can probably expect:

• measurement of weight, length, and head circumference to assess how your baby's been doing since birth
• observation of your newborn's vision, hearing, and reflexes
• a complete physical examination of your newborn
• questions about how you're doing with the new baby and how your baby is eating and sleeping
• advice on what you can expect in the coming month
• a discussion of your home environment and how it could affect your baby (for example, smoking in the house can harm your baby's health in many ways)

Also, if they're ready, the results of screening tests done on your newborn after birth may be discussed with you. Jot down any specific instructions given regarding special baby care, and bring up your questions or concerns. Keep a permanent medical record for your baby that includes information about growth, immunizations, medicines, and any problems or illnesses.

Vaccines

Babies are born with some natural immunity against infectious diseases because their mothers' infection-preventing antibodies are passed to them through the umbilical cord. This immunity is only temporary, but babies will develop their own immunity against many infectious diseases.

Breastfed babies receive antibodies and enzymes in breast milk that help protect them from some infections and even some allergic conditions.

Infants should get their first shot of the hepatitis B vaccine in the hospital within 24 hours after birth. Babies will get more vaccines in the coming months based on a standard immunization schedule.

When to Call the Doctor

Call your doctor if you have concerns about your newborn. Some common difficulties to be aware of during this first month:

• Eye problems can be caused by blockage of one or both tear ducts. Normally the ducts open on their own before too long, but sometimes they remain clogged, which can cause tearing and eye discharge. Call your doctor if you suspect an eye infection.
• Fever in a newborn (rectal temperature above 100.4°F or 38°C) should be reported to your doctor right away.
• A runny nose can make it hard for a baby to breathe well, especially during feeding. You can help ease discomfort by using a rubber bulb aspirator to gently suction mucus from the nose. Call your doctor if you have concerns about your baby's breathing.
• It's normal for newborns to have loose stools (poop) or to spit up after feedings. However, very loose and watery stools and forceful vomiting could mean there is a problem. Call your doctor if your baby has diarrhea, is vomiting, or has signs of dehydration, which include a decreased number of wet diapers, a dry mouth, and lethargy (being very sluggish or drowsy).