BABY

Newborn Care

After Birth What Happens?

Once your baby is born, his placenta (umbilical cord) will be cut by the doctor/midwife/nurse, he will be dried, wrapped in a blanket and handed over to you. Some hospitals may wait a little while before cutting the umbilical cord due to new research which suggests that this might help prevent newborn anaemia (red blood cell/iron deficiency). It is believed that a vital amount of blood still flows from the placenta (umbilical cord) to the baby in the minutes following delivery. It won’t hurt to find out what your hospitals policy is on placenta (umbilical cord) cutting and care. If you have had a normal delivery your baby should be handed over to you immediately otherwise he will be handed over to your spouse/partner.

Skin-To-Skin Contact (SSC)

Your new baby has had months of warmth from you, the temperature outside the womb is definitely colder than your womb so he needs as much warmth as he can get (be careful not to overwrap him though). One way to keep your baby warm is by placing him on your chest so that his body rests on yours and putting a blanket over him (as well as a cap on his head) to keep him warm. In addition to keeping your child warm, this helps with skin-to-skin contact. Research conducted by the World Health Organisation (WHO) on over 2177 women  and their newborns1 found that Skin-to-Skin contact (SSC) after birth is very beneficial. Skin-to-Skin contact also called Kangaroo Care and it helps:

  • Increase mother-to-baby interaction
  • Reduce fussiness, crankiness and crying in babies.
  • Babies sleep better.
  • With brain development. Can be highly beneficial to babies who are born prematurely.
  • Prevent postpartum depression
  • Improve cardiorespiratory stability
  • Stabilize glucose levels in the baby
  • Babies conserve energy (which would have otherwise been lost to fighting off cold) thereby helping them gain weight.
  • Aid breastfeeding and increase lactation: Newborns have a keen sense of smell and they can wriggle around to seek out a nipple to suck (if placed properly). It can also help with milk flow. If you have trouble getting started with breastfeeding, ask for help from your midwife/nurse/ caregiver.
  • Can help babies bond with their dads too since babies learn to recognize voices while in the womb.

Baby’s First Assessment

After your baby is born, the hospital will carry out an assessment on your baby. Most hospitals will typically take the baby away to carry out the after birth assessment but they can also be carried out while your baby is on your tummy (to aid skin-to-skin contact). The assessment carried out by your medical practitioner will vary from hospital to hospital.

Apgar Score

The Apgar score is an assessment method developed by an anaesthologist (Virginia Apgar) in 1952 for evaluating a newborn’s state of wellbeing. Some hospitals use the Apgar test to determine if a child can be given a clean bill of health. This assessment is carried out in the first and fifth minute after birth. It measures the heart rate, muscle tone, respiratory activity, reflex and colour of the newborn.  The rating for all these measured conditions in the Apgar Check is from 0 – 2. It evaluates the baby’s:

Activity (Muscle activity, movement, muscle tone).

  • A score of 0 is given if no sign of physical activity or movement is observed.
  • A score of 1 is given if slight physical activity or movement is observed.
  • A score of 2 is given if the baby is agile and physical activity is observed.

Pulse (Heart rate).

  • A score of 0 is given if no heartbeat is detected.
  • A score of 1 is given if the heartbeats recorded are less than a hundred per minute.
  • A score of 2 is given if the heartbeats recorded are more than a hundred per minute.

Grimace (Measure of the newborn’s reflex responsiveness).

  • A score of 0 is given if there is no reaction from the newborn during suctioning of the airways (removal of excess fluid).
  • A score of 1 is given if the newborn makes a face (grimaces) during suctioning of the airways (removal of excess fluid).
  • A score of 2 is given if the newborn makes a face (grimaces) and tries to withdraw his head, cough or sneeze during suctioning of the airways (removal of excess fluid).

Appearance (Look, colour and presentation).

  • A score of 0 is given if the newborn looks pale or blue (anaemic, jaundiced or sickly).
  • A score of 1 is given if the newborn makes a face (grimaces) during suctioning of the airways (removal of excess fluid).
  • A score of 2 is given if the newborn makes a face (grimaces) and tries to withdraw his head, cough or sneeze during suctioning of the airways (removal of excess fluid).

REFERENCES:

  1. RHL The WHO Reproductive Health Library, Early skin-to-skin contact for mothers and their healthy newborn infants apps.who.int/rhl/newborn/cd003519/en/

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