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.
Special medication will be given to ward off infection.
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 provide personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.
The hospital or birth center where you deliver will notify your child's doctor of the birth. If you have had any medical problems during pregnancy, if any medical problems for your baby are suspected, or if you are having a C-section, a pediatrician or your baby's doctor will be alerted of the impending birth and be standing by to take care of the baby.
The doctor you have chosen for your newborn will probably give your baby a full physical examination within 24 hours of birth. This is a good opportunity 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 taken to screen for a number of diseases that are important to diagnose at birth so effective treatment can be started promptly. In some cases, a repeat sample to confirm the results will be taken by the baby's doctor soon after going home.
Find out when the doctor would like to see your newborn again. Most healthy newborns are routinely examined at the doctor's office at about 1 to 2 weeks old. But if your baby is discharged home less than 48 hours after delivery, your doctor will want to have your baby come 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 total physical examination to check for any abnormalities of the body or organ function
questions about how you are 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 might affect your baby's health (for example, smoking in the house can negatively affect your baby's health in many ways)
Also, if the results of screening tests performed on your newborn after birth are available, they may be discussed with you. Bring any questions or concerns to the doctor at this time. Jot down any specific instructions given regarding special baby care. Keep a permanent medical record for your baby that includes information about growth, immunizations, medications, and any problems or illnesses.
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.
At birth or shortly after, some infants receive their first artificial immunization, a hepatitis B vaccine (HBV) that is given in three doses. There are combination vaccines, however, that include HBV and are given at the 2-month visit. So other babies will receive no immunizations until 2 months of age.
Since small problems can indicate big problems for newborns, don't hesitate to call your doctor if you have concerns. Some difficulties to be aware of during this first month:
Excessive drowsiness can be hard to spot in a newborn since most sleep so much. But if you suspect your infant is sleepier than normal, call the doctor. Sometimes this could be a sign of infection.
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 mucus-like tearing of the eyes. The white discharge can crust up on the eyes and make it difficult for your baby to open them, and the blockage can lead to infection. If you suspect a serious infection, such as pinkeye (conjunctivitis), call your doctor immediately. If your baby has an infection, the doctor will need to perform an exam and may prescribe antibiotic drops.
Fever in a newborn (rectal temperature above 100.4°F or 38°C) should be reported to your doctor right away.
Extreme floppiness or jitters in a baby could be a sign of underlying problems. Report them to the doctor immediately.
A runny nose can make it difficult for a baby to breathe, especially during feeding. You can help ease discomfort by using a rubber bulb aspirator to gently suction mucus from the nose. Be sure to call your doctor — even a common cold can be dangerous for a newborn.
While breastfed newborns generally have loose, mustard-colored stools, very loose and watery stools could indicate illness. The danger here for a baby is dehydration, which can show up as a dry mouth and a noticeable reduction in urine output (fewer than six wet diapers in 24 hours). Call your doctor if your newborn's stools seem watery or loose or often occur at other times besides after feeding.