Immediate care of your baby after birth
Congratulations on the birth of your baby!
Immediately after birth, your baby will be dried and placed on your chest and tummy in direct contact with your skin and you will both be covered with a blanket. Skin to skin contact allows you to look closely at your baby and to touch them for the first time. Skin to skin contact also comforts your baby as they stay close to you. We recommend you put a hat on your baby’s head to help them keep warm. At the Rotunda, we aim to allow uninterrupted skin to skin contact for at least 60 minutes. If you are going to fall asleep during skin to skin contact or anytime your baby is lying prone (on their tummy) make sure there is somebody close by to check on your baby.
The timing of the first breastfeed depends on when your baby is ready to feed and it will usually start within 30 minutes of the birth. Your midwife will help you to latch your baby onto your breast and your baby can enjoy their first feed. Early feeding has been shown to help with the successful establishment of breastfeeding. These first precious moments are a very special time and allow you and your partner to welcome your new baby and to decide whom they look like!
Although the majority of babies cry at birth, some babies will need a little help to take their first breath. If the midwife or doctor has any concerns about the baby, a paediatrician will attend the birth. Babies who need help to breathe in the first few minutes usually recover quickly and can be placed skin-to-skin once they are crying and breathing themselves. Occasionally, babies may need ongoing care and observation by the midwife and paediatrician. In this case, your baby will remain under the radiant warmer in the birth room. Should your baby need to be admitted to the neonatal unit, the paediatrician will give you a detailed explanation of the reasons.
Identification and security
Identification bands will be put on your baby’s wrist and ankle. These bands will contain your details and those of your baby, including its sex. The details on the band will be checked with you before the bands are put on. It is important that the identification bands stay on your baby for as long as you are both in hospital. The midwife will also place a security tag on your baby’s ankle. The baby tag helps us to keep your baby safe while in hospital. If you notice that either the identity band or the security tag fall off your baby, please inform a member of staff immediately, so that the band or tag can be replaced.
Physical examination
The first question parents ask once the baby’s sex has been discovered is “what’s the weight”? The midwife will weigh your baby before transfer to the postnatal ward. The midwife will also carry out a physical examination of your baby including counting fingers and toes. This first physical examination will confirm that your baby appears to be healthy and well. The baby’s temperature will also be checked.
Vitamin K
The Rotunda Hospital recommends that all newborn babies receive an injection of vitamin K following birth. Your midwife will discuss this with you during labour. Vitamin K is important for blood clotting and newborn babies don’t have any stores of the vitamin in their bodies. Babies make vitamin K as they start feeding and their gut matures over the first 3 – 6 months. The injection offers protection until your baby produces sufficient amounts of vitamin K
Newborn Screening Tests
Newborn Bloodspot Screening Test
This test is also known as the ‘heel-prick test’. It identifies babies who may have rare but serious inherited conditions, which are treatable if detected early in life. Early treatment can improve their health and prevent severe disability and even death. The conditions are phenylketonuria (PKU), maple syrup urine disease, homocystinuria, classical galactosaemia, cystic fibrosis and congenital hypothyroidism.
When your baby is due to have the heel prick test, you will be given information and asked to sign the newborn screening card to confirm that you have received information about the programme, that the information about your baby is correct and that you consent to the test being done.
Screening your baby for these conditions is strongly recommended, however it is not compulsory. The test is done between 72 and 120 hours after your baby is born, so it may be done by a midwife or else by the public health nurse. The midwife will prick your baby’s heel using a special device to collect some drops of blood onto a special card, which is then sent away for testing. Occasionally a second blood sample from your baby’s heel will be required. If the test results show that your baby does not have any of the conditions, you will not be contacted.
Newborn Hearing Screening
All babies born in the Rotunda are offered newborn hearing screening before they are discharged. This will screen for congenital nerve deafness. The test takes place at the bedside for well babies and in the neonatal unit for babies admitted there for more than 48 hours. The test takes just a few minutes. A failed test in either or both ears does not necessarily mean your baby has a serious hearing loss, but may be due to the ear canals being full of fluid following birth. If your baby fails three tests they will be referred for a more advanced specialist hearing assessment.
If you are discharged home before the screening test an outpatient appointment will be arranged for your baby to have the test. For the small number of babies who have nerve deafness, early detection means they can be fitted with hearing aids as early as three months. This reduces the long-term speech and social interaction difficulties that come from not having hearing in the normal range. Without newborn hearing screening most of these babies would not be detected until close to three years of age. If your baby passes the test but there is a strong family history of nerve deafness or you have concerns regarding your baby’s ability to hear you will be offered specialist screening around nine months of age.
Immediate care of you after birth
Your beautiful newborn baby will seem to have the attention of everyone in the room, but you are also very important! Following the birth, the midwife or doctor will examine your vaginal area to see if you need any stitches. If you do, your perineum will be numbed with local anaesthetic (unless you have an epidural) and the stitches will be put in. Usually, one continuous stitch is used to repair the skin edges, which is more comfortable. The stitches dissolve over the next six weeks and do not need to be removed.
The midwife will also check your blood loss and will feel your tummy to make sure that your womb stays contracted. The midwife will check your temperature, pulse and blood pressure and will make sure you are comfortable and pain free.
Once you have finished feeding your baby, you will be offered a refreshing wash and you can change into some fresh nightclothes. If you’ve had an epidural, the midwife will remove the epidural tube from your back. The drip in your arm will be left in place until you have passed urine. You can try to pass urine before you are transferred to the postnatal ward. If you have a catheter in place, this may be removed.
You and your partner will then be given tea and toast, before you and your baby are transferred to the postnatal ward, which is usually within two hours of birth. Skin to skin contact can continue as you are transferred. The midwife will come with you to the ward, introduce you to the ward staff and give them a summary of your labour and birth details. The identification of your baby will be checked with you, your partner and the ward midwife.