SSM Cardinal Glennon Children's Medical Center
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The First Day of Life

You've been waiting for this day for months: Finally you get to meet your new baby. But like many new parents, you might not have a clear idea of what that meeting will be like.

Wondering how your baby will look and what he or she will do after arriving? Read on.

What Your Newborn Looks Like

Although you may have visions of a robust bouncing baby, reality may not match that image. Many newborns are tiny, wet creatures when they first emerge. Often their heads are slightly pointed as a result of passing through the birth canal. This is only temporary — the head will take on a rounded appearance within a few days. It may surprise you that a newborn's head is so big compared with the rest of the body.

Your baby also may look scrunched up since the legs and arms have been kept bent at the knees and elbows while in the womb. After months of growing in ever-tightening close quarters, this is perfectly normal. The limbs will straighten out as your baby grows.

Look at your baby's tiny fingers and toes. You'll notice the paper-thin — and sometimes long — nails.

Your baby's skin may have one of several possible appearances, looking somewhat red, pink, or purple at first. Some babies are born with a white coating called vernix caseosa, which protects their skin from the constant exposure to amniotic fluid in the womb. The vernix is washed off with the baby's first bath. Other babies are born very wrinkled. And some, especially premature babies, have a soft, furry appearance because of lanugo, a fine hair that develops while in the womb. Lanugo usually comes off after a week or two.

Rashes, blotches, or tiny white spots also are common on newborns. These generally clear up over the first few days or weeks after birth. The doctor will examine your baby within the first 12-24 hours of birth and make sure that any rashes or spots are normal.

Remember, your baby's appearance will change dramatically over the next weeks as he or she grows. The limbs will extend, the skin tone will probably change, and the blotches will disappear.

Newborn Tests

Immediately after birth, your baby will be evaluated through an Apgar score to determine his or her state of health. This routine test measures a baby's responsiveness and vital signs. Five factors are checked: heart rate, breathing, color, activity and muscle tone, and grimace reflex response.

The baby is given a score of 0-2 in each category, and the five numerical results are added together. This total is called the Apgar score. The evaluation is done again at 1 minute and again at 5 minutes. This quick and easy test is given mainly to see if the baby needs help breathing. A score of 7-10 is generally considered normal, and if your baby receives this score, no special actions usually need to be taken at that time. A lower score means some extra measures, such as giving the baby oxygen, may be needed initially.

Your newborn will go through a few other quick procedures, which may include:

  • clearing the nasal passages with a suction bulb
  • weight, head circumference, and length measured
  • eye ointment or drops given to prevent infection

The medical staff will dry your baby and place a blanket around him or her. All of this happens very quickly, and before you know it your baby is in your arms for some special bonding time. After a first breastfeeding attempt, it's time for a few more procedures, usually after about 10-30 minutes.

While the mother rests in either the birthing or recovery room, the baby is taken to the nursery to receive a thorough bath. Usually the father is allowed to come along. Your baby will be given vitamin K, by injection, to help the blood clot properly. Your baby may also receive a dose of hepatitis B vaccine, with your consent.

Other tests vary from one hospital to another. Your newborn may be given a blood test to check blood sugar levels. If the level is too low or other problems are discovered, the baby may require immediate medical attention.

Also, a newborn screening blood test will be drawn before the baby leaves the hospital to look for PKU (phenylketonuria), congenital hypothyroidism, and other diseases that need to be diagnosed early in infancy to ensure successful treatment. It is recommended that all babies have a hearing screen before leaving the hospital so possible problems can be picked up early on.

With a vaginal birth, the average newborn stay is about 48 hours. With a cesarean delivery, it is about 96 hours.

What Your Baby Does on the First Day

Many parents are surprised to see how alert a newborn really is. Right after birth, a newborn's eyes are open quite a bit and babies spend a lot of time studying faces — especially their parents'. Your baby may turn or react to the sound of your voices. Your baby is using all of the senses, including smell and touch, to further identify and become attached to you.

Your newborn will cry, sleep, and at times will look directly into your eyes. Although the vision is blurry, your baby can best see something (such as your face) that is about 8 to 15 inches away. Your baby will grab onto your finger if you place it in his or her palm. And of course, your baby will want to eat.

After initially being very awake, most newborns get sleepy for about the next 24 hours. It's important to wake them to feed every 2 to 3 hours so they get used to the process and start to get something to eat. If a mother is breastfeeding, this is also the best way to encourage milk to come in.

Breastfeeding or Bottle-feeding

If a mother has decided to breastfeed, she can begin as soon as her newborn is placed in her arms. Although your milk probably won't fully come in for another day or two, especially with first-time mothers, the baby does receive nourishment from your colostrum, a precursor to actual breast milk. For some women colostrum is thin and watery; for others it is thick and yellowish. As your baby sucks on your breast, this action triggers hormones to tell your body that it's time to produce milk. These first feedings are great practice runs for both mom and baby.

Some babies (especially premature and smaller babies) have a hard time latching on or getting enough suction to nurse from your breast. A nurse, breastfeeding counselor, or lactation consultant can help you and your baby overcome any hurdles. Even if breastfeeding is going smoothly from the start, it's still helpful to learn as much about it as you can from a breastfeeding specialist.

Initially, you will probably be feeding your baby about every 2 to 3 hours around the clock. If you will be bottle-feeding your baby, you can usually begin within the first few hours of life.

Your Feelings

Having a baby is a major, life-changing experience. Don't be surprised to find that you go through a broad range of feelings. You may experience everything from elation to concern to anxiety to unrestrained joy. And your feelings may change suddenly and unpredictably. In addition, the mother has just been through quite a bit physically. There's a good chance she'll be exhausted, and both parents may start feeling the effects of sleep deprivation.

Every parent reacts differently. Some mothers "forget" the difficulties of labor as soon as they catch a glimpse of their newborns. Some feel high levels of energy driven by the excitement of finally having the baby. Still others feel sad and may experience baby blues or the more serious postpartum depression.

A physician, nurse, or counselor can help parents understand their emotions after the baby arrives.

Friends and Family

Although you want to share your good news with the world, a good rule of thumb is to keep the first day simple. Make calls to close friends and family members, and ask them to pass the news along to other friends and relatives. Having a network of callers will free you to spend more time with your newborn.

It's fine to have your loved ones meet the baby the first day. Grandparents or siblings can meet the newest family member and start to bond right away. But avoid a parade of visitors in and out of the room to keep the baby's first day tranquil and low-key. Parents and baby need plenty of rest and quiet bonding time.

It's also wise to limit visitors in the first few weeks because of the possibility of exposing your baby to infection. Whenever visitors come, make sure they are not sick, and have everyone wash their hands before touching the baby.

If There's a Problem

If your baby is born with a problem or arrives prematurely, this can be a difficult time. The hospital's medical team is trained to offer professional recommendations and discuss options. If you're not up to talking with a doctor yet, don't be afraid to ask your partner or another close relative to do so. The medical staff will be sensitive to your needs.

For many parents, talking with a counselor or clergy member brings some comfort. Many support groups are available to give you the emotional backing you'll need. Don't hesitate to ask for help.

When your baby is born, you'll enter an entirely new phase of your life. Take the time during your baby's first days to savor this new beginning.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: November 2011