Newborn babies: the first hours after birth

Your baby is about to come into the world! You’ve endured morning sickness and other discomforts typical of pregnancy, and you can’t wait to welcome the newest member of your family. Obviously you’re a little nervous and wondering what to expect. Let’s see what happens after the birth.

The first exams at the newborn baby

As soon as the baby is born and breathes for the first time, it will be the object of a lot of attention.

After cutting the  umbilical cord  and aspirating the mucus and liquids from your nose and mouth, the staff will evaluate your  Apgar indicators  and your  vital signs  to monitor your health.

The Apgar index  is a score, which results from some checks that are carried out immediately after childbirth; checks that take into account the heartbeat, breathing, muscle tone, reflexes and color of the skin and mucous membranes as indicators of the child’s state of health.

The Apgar test is usually done one minute after birth, and then five minutes later.

The nursing staff also takes care of weighing the child, measuring the length and size of the head, and putting drops in the eyes.

Also, to help blood clot, all newborns are given an injection of vitamin K.

Your child may also be given the hepatitis B vaccine.

The time has come to establish a bond with him

Then, once the baby is wrapped up in a blanket, you can finally get to know him, and you can start breastfeeding the newest addition to your family.

Assuming your baby is healthy, you can begin to bond with him right away.

Newborn babies are usually alert, even during the very early stages of their lives.

Don’t be surprised that he stares at you, cries a little and wants to eat.

You may notice that your baby has a slightly pointed head – don’t worry, it will round out over time.

Since you’re exhausted, sleep: you’ve had some tiring moments. After you rest, you will have plenty of time to be with your child.

When can you start breastfeeding your baby?

Since babies tend to be very alert soon after delivery, if you both want it, now is a good time to start breastfeeding.

It is recommended that those newborns who are born to term regularly are immediately kept in contact with the mother’s skin, immediately after delivery, and until the first feed is completed.

Don’t worry if your baby seems to have trouble finding the nipple or staying attached to the breast – at first he may just lick it.

If allowed to do so, most babies only start feeding within an hour of birth.

Don’t feel embarrassed about asking the nurse or doctor to help you while you’re still in the delivery room.

Later, when you’re in the postpartum rooms, there may even be a person there to give you “lessons” on breastfeeding.

In this regard, even before entering the hospital, you can inform yourself about the resources that the hospital places at your disposal in this regard, and make sure you can receive all the assistance you will need later. 

What happens to the child who has had problems during delivery

In case your baby had problems at birth, he will need further treatment: sometimes even resuscitation.

He will be dried, and the doctor will cut his umbilical cord. Then he will be placed inside a warm incubator in the delivery room.

This way he can be left naked without catching cold, while doctors can perform the necessary operations to help him complete his transition to life outside your bump.

If the baby needs further care after being stabilized, it may be taken to the appropriate intensive care area of ​​the neonatology.

If, on the other hand, it does not require further care, it will be wrapped in a blanket and brought to you, so that you can get to know each other, cuddle each other, and so that you can breastfeed it. 2 )

What happens to him after a cesarean delivery

If you had a caesarean section, your baby will be taken to a nurse or doctor soon after birth, and placed in a warm incubator.

He will be dried, his airways will be aspirated, and he will be tested for Apgar, so he can get all the care he needs.

If your baby is healthy, in many hospitals your baby will be wrapped up in a warm blanket and taken to your partner, who will sit next to you.

Your partner can then hold the baby while they’re stitching you up, and you can admire and kiss your baby while you’re still in the operating room.

Afterwards, the baby will be taken to the hospital room where you are being treated.

If you plan to breastfeed, now will be the right time to do so. 

When it will be washed and visited

After the baby’s temperature has remained stable for at least a few hours, the nurse will bathe the baby with sponges, and wash his hair if necessary.

Usually the bath is done in the  nursery , where the baby is kept in the warm incubator, but you can ask that the baby be washed in your room, and placed in contact with you once wrapped in a blanket.

The child will then undergo a comprehensive pediatric exam.

Like the bath, the exam is also usually done in the  nursery , but can also be done in your room.

Some mothers prefer that their children be kept in the nursery for some time so that they can rest.

Others never want to be separated from their baby, even during regular exams and procedures.

Let the staff who support you know what your preferences are.

Keep in mind that if you want to breastfeed, it makes more sense to keep the baby in your room so that you can bring him to the breast every few hours.

Newborn screenings

By law, as part of preventive medicine programs, all babies are subjected to some free tests that allow early identification of the existence of any congenital diseases.

The  national law n° 104 of 05/02/92  foresees a free neonatal screening  for phenylketonuria, congenital hypothyroidism, cystic fibrosis and adrenogenital syndrome.

This screening is usually performed between 48 and 72 hours after delivery: a sample of your blood will be absorbed on a special paper and then sent to the reference newborn screening center in your area.

Together with your blood, the newborn screening center will be provided with all the information necessary to identify the baby, including the personal data of the two parents and any other information useful for carrying out the test. 

For about fifteen years, an expanded neonatal screening has also been available  ,  a technique that allows the simultaneous analysis of acylcarnitines and amino acids in a few microliters of blood dried on paper.

It allows – with a single analysis – the early identification in the neonatal period of more than 40 hereditary metabolic pathologies which include organic acidurias, amino acid pathologies and defects in the β-oxidation of fatty acids.

  • phenylchetonuria,
  • iperfenilalaninemia benigna,
  • tetrahydrobiopterin colator biosynthesis deficiency,
  • tetrahydrobiopterin colator regeneration deficiency,
  • medium chain acyl CoA dehydrogenase deficiency,
  • glutaric acidemia type I,
  • isovaleric acidemia,
  • maple syrup urine disease,
  • type I tyrosinemia,
  • carnitine transport deficiency,
  • long-chain hydroxyacyl CoA dehydrogenase deficiency,
  • trifunctional protein deficiency,
  • very long chain acyl CoA dehydrogenase deficiency,
  • 3-Hydroxy 3-methyl glutaric aciduria,
  • beta-ketothiolase deficiency,
  • methylmalonic acidemia (CblA),
  • methylmalonic acidemia (CblB),
  • acidemia metilmalonica (Mut),
  • propionic acidemia,
  • methylmalonic acidemia (CblC),
  • acidemia argininosuccinica,
  • type I citrullinemia,
  • homocystinuria (CBS deficiency),
  • type II tyrosinemia,
  • carnitine palmitoyl transferase II deficiency,
  • multiple carboxyl deficiency,
  • acidemia metilmalonica (CblD),
  • argininemia,
  • citrullinemia type II,
  • hypermethioninemia,
  • type II tyrosinemia,
  • deficiency of carnitine palmitoyl-transferase (L),
  • glutaric acidemia type II,
  • short-chain acyl CoA dehydrogenase deficiency,
  • Carnitine/acyl-carnitine translocase deficiency,
  • lack of 3-methyl crotonyl-CoA carboxylase,
  • 2-methyl butyryl-CoA dehydrogenase deficiency,
  • 3-methyl glutaconic aciduria (types 1, 2, 3, 4 and 5),
  • isobutyryl-CoA dehydrogenase deficiency,
  • battered aciduria,
  • dienoyl reductase deficiency,
  • medium/short chain 3-OH acyl-CoA dehydrogenase deficiency,
  • 2-Methyl 3-hydroxy butyric aciduria,
  • rtilmalonic encephalopathy,
  • ornithine transcarbamylase deficiency,
  • methylene tetrahydrofolate reductase deficiency,
  • ornithine transcarbamylase deficiency.

In some Birth Centres, a pediatrician is also present during the delivery, and he himself visits the baby.

In other Centers, tests and prophylaxis are performed by the midwife.

In any case, breast attachment control is the duty of the midwife or nurse on duty: it is performed every 8 hours during the first day and, subsequently, whenever needed.

In other words, you’re in good hands so you can relax and rest: in a few days you’ll be home, and you’ll have less time to do it.

The end of your hospital stay, and when you will be home

After a natural birth, you can usually leave the hospital with your baby after 48 hours.

Before being discharged from the Birth Centre, a health worker will take a few drops of blood by pricking the newborn’s heel. 

Once home, start your new life with the newest little member of the family.

With all the things that have happened, and with all there is to do, don’t forget to take care of yourself anyway.

It will be easier to be a good mom if you also pay attention to your health.

If you’re a new mom, don’t be afraid to ask questions and ask for help if needed. It’s a new experience for you and your baby.

You are about to embark on a journey that could be one of the most rewarding of your life.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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