Birth of a newborn is an amazing feeling. While on one hand, the newborn’s parents try to put maximum efforts to understand the needs of her little one, on the other, this transition to life outside the mother's belly is quite challenging for the baby too. In addition, nothing is comparable to the comforting, safe and secure environment of the womb. Outside the womb, the environment is precarious, making her vulnerable to diseases and infections. Moreover, her ability to regulate her own body temperature doesn’t fully mature until she turns a year old and that adds to her existing challenges.
As soon as the baby gets delivered, the umbilical cord is cut, making an initial impact on the newborn. With this ends the newborn’s dependency on the placenta for oxygen as well as other vital nutrients. With the first breath, air moves into the lungs for the first time redirecting the blood flow. Many a times, excess fluid enters the babies' lungs, making them cry. Give your baby a gentle massage and stroke her to help bring the fluid up.
Immediate care for the newborn
After performing a brief, physical examination to check for obvious signs that the newborn is fit and healthy, hospitals should ensure immediate care as follows:
1) Sterility – The baby has come out from a conditioned environment and is exposed to all possible infections. The baby is extremely vulnerable to infections from the outside environment. In such a situation, using sterilized cloth for wiping the baby and sterilized baby clothes becomes extremely critical.
2) Providing warmth to the newborn – Upon birth, the baby is completely covered with amniotic fluid and, therefore, can easily become cold. Drying the baby with a soft, preferably sterilized towel, and using warm blankets and heat lamps can help prevent heat loss. Kangaroo care (method in which the infant is held in skin-to-skin contact with the mother, for as long as possible) is what is required soon after birth, so that the baby gets the desired warmth from the mother. This not only reduces crying but also helps in successful breastfeeding. Caregivers must ensure that the head and toes of the newborn are covered all the time, since maximum heat loss happens from these areas.
3) Immediate health assessments of the newborn – One of the first medical examinations required to be conducted by any hospital is the Apgar test. This test evaluates the condition of the newborn at one minute and five minutes after birth. The following signs are evaluated: muscle tone activity, pulse rate, appearance or skin color, grimace or reflex irritability and respiration. A score of 7 to 10 is considered normal.
Physical examination of the newborn
Physical examination includes measurement of the temperature, heart rate and respiratory rate. Measurement of weight, length and head circumference helps determine if a baby's weight and measurements are normal. Small, underweight babies and very large babies may call for special care. A few important considerations are: a) Cord care - The baby's umbilical cord stump must have a clamp. It should be kept absolutely clean and dry. b) Bath - Once the newborn’s temperature gets stabilised, she is ready for her first bath. Footprints of the newborn can also be recorded.
Once the baby is ready to leave the delivery room, identification bands with identical numbers should be placed on the baby's and mother’s wrists. Babies often have two, one on the wrist and one on the ankle. These should be checked every time the baby leaves or comes back to your room.
The first hour or two after birth is also the best time to begin breastfeeding. Babies have an innate ability to begin nursing immediately after they are born. This initial feeding helps arouse breast milk production. It also causes contraction of the mother's uterus which can help prevent excessive bleeding.
Newborn babies who need intensive care are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU). The NICU has all advanced medical equipments and trained medical practitioners to provide specialised medical care or nursing care required by these little ones.
The author is Founder Director at Baby Essentials Pvt. Ltd.