Your newborn will be given gentle suctioning with a rubber bulb to remove fluid from the mouth and nose. Everyone will be waiting for your baby to breathe, the most important, first step of surviving in this world. After what may seem like an eternity, at last you will hear sputtering, gasping, and then if all’s well, the lusty, high-pitched screams of new life.
As tiny, helpless, and vulnerable as your newborn may appear, he will arrive with a powerful drive to survive. Most babies will breathe within a few seconds after birth, and everyone will heave a collective sigh of relief. Until birth, your baby’s lungs were collapsed, and he got all of his oxygen from the blood being pumped through his umbilical cord from the placenta. Once his lungs fill with air, the valves in and near his heart will shut off permanently so that blood will pass directly into his lungs for oxygenation. Prolonged crying delays permanent closure of the baby’s heart valves, so don’t let your baby’s crying go unanswered for more than one to two minutes.
When your baby starts to breathe, he will go from being bluish to a bright, purplish-red as his lungs start functioning and he cries. The cries of land-born babies will be pretty vigorous, while a water-birthed baby’s are apt to be quieter.
Flash Fact: Weighing In
The average weight for newborns is 7½ pounds, and only 5 percent of babies fall outside of the 5½-to-9½-pound range. On the average, boys weigh a half pound more than girls. Most babies lose about a tenth of their weight during the first 3 days after birth. The lost weight will be regained in about 10 days. Your baby will put on an average of 7 ounces each week for the first month. By 5 months of age, your baby will have doubled his birth weight, and by one year of age, he will be three times heavier than when he was born.
Your baby will be given three Apgar scores, one at a minute after birth, another at 5 minutes after birth, and if necessary a third 10 minutes after your baby’s birth. The Apgar score helps your doctor or midwife assess the baby’s appearance, tone, breathing, and other vital signs. A score of 7 to 10 means everything’s going well. A score of 4 to 7 may mean the baby needs extra help, and a score of 3 or less signals that the baby needs immediate care.
SKIN-TO-SKIN CONTACT
Even moments after birth, your baby is already able to respond to the environment and arrives endowed with an immense capacity to stimulate a loving response from you. Most newborns have a 30-to-90-minute period of maximum alertness right after birth—that is, as long as medications you’ve been given to make you more comfortable have not crossed your placenta and entered into your baby’s bloodstream during labor. All medications given to the mother during the birth process cross to the baby, including epidurals, which have been shown to cause babies to be groggy, to interfere with their ability to orient, and to make the baby’s movements less organized than babies whose mothers had no, limited, or only last-minute medication.
If your baby is healthy, you can request that he or she be given to you immediately after birth and placed naked against your chest with a blanket over the two of you. This technique is called kangaroo care after the way that kangaroo babies stay nestled inside their mothers’ pouches to nurse after birth.
The kangaroo position is great for holding your newborn: Place your baby between your breasts with his face just below your chin. The warmth of your body and your heartbeat and breathing are exactly what your baby remembers from being inside you, which will calm and reassure him, and his body temperature will stabilize almost immediately.
Your smell will be reassuring, and your baby will be immediately drawn to the aroma of your nipple. If left undisturbed on your belly for an hour, most babies are capable of crawling to the breast, finding the nipple, and expertly initiating nursing.
Flash Fact: Skin Recommendations
In February 2005, the American Academy of Pediatrics issued a policy statement that all healthy babies should be placed and remain in direct skin-to-skin contact with their mothers immediately after birth until the first feeding is accomplished. It states that an alert, healthy newborn infant is capable of latching onto a breast without specific assistance within the first hour after birth. It recognized that a baby’s mother is the optimal heat source for the baby and that any initial physical assessment, cleaning and drying of the baby, or assigning the baby an Apgar score should be done while the baby is in physical contact with its mother. The Academy also recommended that routine procedures, such as weighing, measuring, bathing, needle-sticks, and eye medications should be delayed until after the baby has had its first feeding at the breast and, unless there are unusual circumstances, the newborn should be allowed to stay with its mother throughout the recovery period following birth.
[SOURCE: American Academy of Pediatrics Section on Breastfeeding (2003—2004). “Policy statement: Breastfeeding and the use of human milk.” Pediatrics, Vol. 115, No. 2, February 2005, pp. 496—506.]
It’s impossible to overestimate the sensations that you’ll feel when you stare into your baby’s eyes for the first time, and you have the right to some time of peace and quiet together as a new family.
Tip
Studies show that full-term newborns who are given skin-to-skin contact with their mothers seldom cry during the first hour and a half of life, but those who are placed in a nearby bassinet will cry 20 to 40 seconds out of every 5 minutes over the same amount of time. If the baby is carried farther away, he will sound long, wailing cries thought to be human distress calls.
GETTING CLEANED UP
Your baby will be examined, and the doctor or midwife will make sure he’s breathing normally. Heart rate will be checked: A normal newborn heart rate is 100 beats per minute or more. He will be weighed and measured, his temperature taken, and antibiotic gel or drops will be placed in his eyes.
Your baby will also be bathed to clean the goo off him—a mixture of vernix (a creamy white substance that protects the baby in utero), blood, fluid, and possibly meconium (the newborn’s first bowel movement)—have his heel pricked for a blood screen, and be given a shot of vitamin K to help his blood clot. If your baby develops jaundice with a yellowish tint to his skin, the doctor or midwife may check a bilirubin level to assess whether he needs to be placed under bili lights to help his body process bilirubin.