Your Newborn’s Baby First Days On Earth

Finally the wait is over – your baby has arrived, and it’s time to put everything you’ve learned into practice. Knowing what to expect can make it easier for you to relax and get to know your baby in the first hours and days of life.

The first minutes

The moment your baby is born can be both magical and stressful. What happens straight after birth will depend on your labour and how your baby’s delivered.

Uncomplicated vaginal delivery
You might get to hold your naked newborn on your chest or belly straight away. This skin-to-skin contact keeps your baby warm and gives you the opportunity to bond physically with each other. You’ll see and feel your baby move and cry. The midwife might wrap your baby in towels to keep her warm. If your baby’s slow to respond, the midwife might also give your baby a good rub on the back to stimulate breathing.

You’d normally discuss with your midwife or doctor before the birth how you want your baby delivered. Once breathing is established, it’s recommended that your baby’s placed straight onto your chest for immediate skin-to-skin contact. This promotes bonding, a trigger for breastfeeding, and keeps your baby warm. The midwife might also put a warm blanket over you both.

Forceps or vacuum delivery
The midwife, obstetrician or sometimes the paediatrician might take your baby to a special warming station where they can make sure he’s OK. Once they know your baby’s breathing properly, he’ll be dried, wrapped up for warmth and returned to you. Then you can hold him and have skin-to-skin contact for bonding and warmth.

Caesarean section
Once your baby’s born, the midwife or paediatrician will take your baby to a special warming station and immediately check that your baby’s breathing. Your partner might still cut the remaining cord if all’s well with the baby. The midwife or paediatrician will dry and continue to check your baby, then wrap and give your baby to you while you’re on the table (so long as you didn’t have a general anaesthetic). Some hospitals provide for skin-to-skin bonding when you’re in theatre, and you can ask for this to happen if you wish.
Sometimes you might need further medical attention, so that first cuddle might have to wait. Your birth partner can take care of your baby until you get back to the maternity ward.

Cutting the cord
After the birth of your baby, the umbilical cord will be clamped and cut. Cutting the cord isn’t painful for you or your baby. The cord is quite tough to cut and looks gelatinous.
Sometimes, mothers ask for the cord not to be cut and clamped immediately, so they can wait for the cord to stop pulsating. This can happen only if the birth has been uncomplicated. If your partner’s present at the birth, he or she will often be invited to cut the umbilical cord – but there’s no pressure for your partner to do it.

How your baby looks

Some important changes happen in your baby’s body as he moves from the comfort of your womb to the outside world. As he cries and takes his first breaths, oxygen and blood flow through his lungs as they expand. The fluid inside them clears.

It’s normal for your baby to look blue in the initial few minutes after birth. Her colour will usually change from blue to pink, but her hands and feet might stay blue for a few hours or longer. The blood vessels to her hands and feet are very small, and it takes longer for the colour to change to pink as the blood circulates around her body.

Your baby’s skin colour, and how much your baby moves or cries, depends on how tired he is after labour. After some initial crying, it’s normal for babies to fall asleep. But some babies might stay awake and want to feed. Because skin-to-skin contact promotes bonding and breastfeeding, it’s essential at this stage.
You can breastfeed your baby as soon as she seems ready, even within the first hour of birth. The midwife will help you with breastfeeding and will listen to your baby’s heartbeat, count breaths and take your baby’s temperature regularly to make sure she’s OK.

The once-over

Doctors and midwives will check your baby’s condition at birth. The Apgar score is used to describe your baby’s condition at birth.
Within the first hour of birth, the midwife will make sure everyone knows who your baby is by putting two name tags on him.

Your baby will also be weighed sometime in the first few hours. When weighing your baby, the midwife will do a quick physical check and see whether she’s done a poo or a wee. Your baby will usually do first poos and wees within the first 24 hours. After the weigh-in, the midwife will put on your baby’s first nappy.
You’ll be asked if you give consent for your baby to receive one or two injections into his thigh muscles after birth, either immediately or within a few hours. The injections are:

• vitamin K – this can help prevent a bleeding disorder caused by a vitamin K deficiency (‘haemorrhagic disease of the newborn’)
• hepatitis B immunisation – this is the only immunisation required at birth, and is given as part of Australia’s universal immunisation program. 

The first week

Appearance
Your baby’s appearance will change over the first week.
If your baby’s head is a bit cone-shaped after her journey down the birth canal or a vacuum delivery, it’ll return to normal.

Any swelling in your baby’s face, including his eyelids, will go down within a few days. If your baby’s face or head has been bruised – for example, after a forceps delivery – the bruising will disappear.

Your baby’s umbilical cord will gradually dry, become black and then fall off, usually within the first 10 days.
Your baby might have one or more birthmarks, either at birth or developing later. Many common birthmarks don’t usually require medical evaluation. These include Mongolian spot, Café au lait spot and Salmon patch (Stork bite). Others sometimes need checking out by a doctor, including birth mole (Congenital melanocytic naevus), haemangioma (Strawberry naevus) and port wine stain.

Feeding and sleeping
Your baby spends her first week of life adapting to her new environment. She needs warmth, peace, security – and lots of cuddles and holding. You can give her all of these.
Your days and nights will be dictated by your baby’s cycle of sleeping and feeding. He’ll sleep most of the time, waking up every few hours for a feed. It’s unlikely he’ll sleep through the night, especially on the first few nights of being home from hospital.

Most babies need feeds between 2-4 hours apart, and have around 8-12 feeds every 24 hours. It’s not uncommon for each feed to last an hour, especially if your baby’s breastfeeding.

Your baby will usually wake herself when she needs to feed. But some babies might need to be woken for feeding – for example, babies who’ve lost a lot of weight, who are very small or who have jaundice.
These are general guidelines, and it’s likely to be a while before you see a pattern or routine of feeding and sleeping.

In the first few weeks, looking after yourself is important. This means sleeping when your baby sleeps, which will help you catch up on sleep and cope better with your newborn. You also need to keep up your fluid intake if you’re breastfeeding and eat a healthy diet.

Development
Your baby will close his hands involuntarily in the grasp reflex and will startle at sudden loud noises. He’s also likely to have sudden jerky movements while asleep. In addition to these physical developments, attachment and bonding between you and your baby is the other major area of development. 

Connecting and communicating with your baby
Babies often recognise your voice – after all, your baby has been listening to you from inside your womb for the past nine months! You can communicate with your newborn using your voice, touch, sight and smell, and your baby will have her own ways of telling you what she needs – even though she’s not up to smiling just yet! During this first week, you’ll start getting to know your baby’s body language.
You can learn more about the bonding process in our article on connecting with your newborn.

Common problems in the first week

Weight loss
It’s normal for your baby to lose weight during the first five days of his life, as he loses excess fluid. This weight loss shouldn’t be more than 10% of his birth weight, though. Most babies regain their birth weight after 1-2 weeks. If your baby has lost too much weight, he might have to stay in hospital with you for a little longer to make sure he’s feeding enough.

Sticky eye
It’s common for babies to develop sticky or discharging eyes during the first few weeks of life. The most common cause is blocked tear ducts, and this usually gets better by itself. Gentle eye cleansing and massage will help. But it’s best to have a doctor or nurse check your baby’s eyes if they’re sticky.

Rashes
Newborn babies can develop all sorts of rashes, which usually aren’t serious. But if your baby has a rash, it’s best to have a doctor or nurse check it. Common rashes include cradle cap, nappy rash, heat rash and eczema.
Dry skin and jaundice are other common problems for newborns.