During the first few weeks after birth your baby is learning to adapt to the external environment (including temperature), and to changes in breathing and circulation.
What we will look at
- Why your baby looks so strange
- A video of baby's first bath
- The Apgar score
- Other check-ups and procedures
- Neonatal jaundice
- Your baby’s first stool
- Cleaning the umbilical cord
- Tips for breast care
- Weight loss
- Bringing up wind
Most parents immediately claim how beautiful their babies are, but let’s be honest: a newborn baby is quite a strange-looking creature.
What are some of the features?
- The baby’s head looks out of proportion. It is about a quarter of his/her total length.
- The skin may be pinkish. If circulation was poor in the early hours of life, it may have a bluish tint.
- The body is covered with yellowish, cheesy-looking vernix caseosa.
- Pre-term babies will probably be covered with lanugo (thin, downy hair).
- Babies who are overdue may be born with dry, peeling skin as the vernix which covered it may have started to dissolve.
- The eyes may appear squinty and may be blood-shot.
- The face may be slightly misshapen for several days. The nose may be flattened and the chin pushed in from being squeezed through the pelvis.
- There may be swelling and bruises on the skull and face from pushing through the birth canal, particularly after forceps or vacuum extraction.
- Breasts and genitals may be swollen.
- The ears may appear crumpled but will straighten out after a few days.
- Your baby may begin to go yellow with newborn jaundice by the second or third day.
Don’t despair, these features will disappear in the next few weeks.
Watch this video clip on how to give baby his first bath:
Your baby’s first test
Straight after birth, your baby will be given the Apgar score, which reflects your baby’s general condition.
Other check-ups and procedures
A doctor or nurse will do the following:
- Clamp and cut the umbilical cord
- Give a vitamin K injection which assists in blood clotting and prevents excessive neo-natal bleeding
Thorough examinations will be done within the first 12 hours of life. These consist of:
- Physical examinations
- Gross and fine motor examinations
Read the developmental guidelines published by the Western Cape Department of Health and Social Services for state-employed doctors. These guidelines are regarded by paediatricians in South Africa as a viable and practical guide to identify developmental defects or growth problems in babies and children early.
The examinations will be repeated at your baby’s six month check-up.
Your baby will be immunised against:
- Tuberculosis (BCG)
- Polio (OPV)
The BCG (Bacille Calmette-Guérin) vaccination is given soon after birth to protect against tuberculosis. It is given transdermally on the right upper arm. After a few weeks a small sore will develop which will start to heal from about four months so that by one year there is only a small scar left. In very few cases the initial sore may continue to increase or else glands may develop in the baby’s right armpit, at which stage medical advice is needed.
Learn more about immunisation.
Jaundice is common in newborn babies. The yellowing (which occurs on the third or fourth day) starts at the head and works its way down to the toes. It comes from the baby’s liver being unable to cope with an excess of bilirubin in the blood.
Bilurubin is a product of haemoglobin which has a yellow pigment. Phototherapy (ultraviolet light) is usually used to treat jaundice. Continuation of breastfeeding is recommended.
Your baby’s first stool
The first stool is called meconium. It is a mixture of the secretions from the alimentary glands together with lanugo, pigment and cells from the wall of your baby’s bowel.
It is a sticky, thick, greenish-black tarry substance and lasts for the first two to three days.
Cleaning the umbilical cord
Use swabs or cotton wool dipped in surgical spirits to clean the umbilical cord. Don’t be scared that you will hurt your baby. This procedure is painless. The umbilical cord should fall off within the first week or two.
Contact your doctor if there is a discharge or if the surrounding skin becomes red and inflamed.
Breastfeeding – the first few days
Breastfeeding is one of the most rewarding experiences of early motherhood.
It is recommended that your baby should be latched onto your breast straight after birth. Even women who have a caesarian should request that their baby be placed onto their chest immediately. Make sure to include this in your birth plan.
For the first few days after birth, your breasts will secrete watery, yellow fluid known as colostrum. This precedes the onset of breast milk. Colostrum provides the huge nutritional requirements of the baby during this period.
You’ve probably heard people saying that the breast milk “comes in on the third day”. This means that the production of mature milk will start any time between the second and fifth day and it is quite normal for the mother’s breasts to increase in size when this happens.
Tips for good breast care
Click here for tips on breast care.
Babies usually lose up to 10% of their birth weight in the first few days. They usually regain their weight within two to three weeks.
Bringing up wind
Far too much emphasis is placed on winding. It is not imperative for a baby to be winded after a feed. If you do, keep it short – two to three minutes will do. If your baby falls asleep after a feed, don’t disturb her – leave her to sleep.
Here are a few methods:
- Put your baby onto your shoulder and gently tap her back
- Lie her face down across your lap and rub her back in a circular motion
- Sit your baby on your knee, with your hand under her chin and gently bounce her up and down
- Put her in a semi-raised position after a feed
- Gently rub the bones behind the ears
- Give her a dummy