Tessa Quinn
Newborn care in the hospital is an essential service that helps babies transition to life outside of the uterus and supports them in their first days after birth. This care includes urgent medical intervention, screenings, examinations, and surgical procedures if necessary. Most babies are born without any major medical issues, but some require immediate medical attention, such as those born prematurely, with birth defects, or following a difficult delivery. Hospitals provide newborn screenings, evaluations, and treatments to ensure babies are healthy and ready for discharge. This includes the Apgar test, vitamin K shots, eye drops, hearing tests, and vaccinations. Additionally, hospitals guide parents through the early stages of newborn care, including breastfeeding, skin-to-skin contact, and essential nursery supplies. Leaving the hospital with a newborn can be exciting but overwhelming, and parents often benefit from support groups and resources to navigate the first weeks with confidence.
| Characteristics | Values |
|---|---|
| Newborn care in the hospital | To help babies transition to life outside of the uterus |
| Medical intervention | Urgent medical intervention if necessary |
| Screenings | Apgar test, Hearing test, CCHD screening, Metabolic screening, Blood spots |
| Examinations | Weight, length, medicines |
| Surgical procedures | Circumcision, Vitamin K shot, Hepatitis B vaccine |
| Essential newborn care | Delayed cord clamping, thorough drying, skin-to-skin contact, early initiation of breastfeeding |
| Newborn care at home | Nursery supplies, diapers, wipes, bottles, laundry detergent, healthy meals, car seat, clothing, safe sleep place |
| Newborn care for parents | Overnight nurse or newborn care specialist, support groups, rest |
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What You'll Learn
Skin-to-skin contact and breastfeeding
Skin-to-skin contact is a practice where a baby is dried and laid directly on the mother's bare chest, with both covered in a warm blanket and left for at least an hour or until after the first feed. This contact can also take place whenever a baby needs comforting. It is important for the baby and mother to develop a close, loving relationship and to initiate breastfeeding.
Skin-to-skin contact, also known as kangaroo care, is a method of holding your baby against your chest for skin-to-skin contact. This type of touch is a special experience that can help you and your baby bond and has medical benefits, particularly for babies with a low birth weight or babies born preterm.
To perform kangaroo care, the baby should be in an upright position with their head resting to one side against the mother's chest. The baby should wear only a diaper, a hat, and socks to help stay warm. Once settled, drape a blanket over the baby's back to keep them comfortable.
Breastfeeding is the optimal feeding and caring method for the health of both the baby and the mother. There is substantial evidence that implementing the Ten Steps to Successful Breastfeeding significantly improves breastfeeding rates. The Baby-Friendly Hospital Initiative was launched by UNICEF and the World Health Organization to encourage health facilities worldwide to better support breastfeeding.
Breastfeeding can be much harder than you'd think, but there are many resources to help make the transition easier.
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Medical tests and screenings
Newborn screening tests are crucial in detecting health conditions that are not always apparent at birth. These tests are usually carried out within the first 24 hours of life and include blood, hearing, and heart screenings. Here is an overview of the medical tests and screenings performed on newborns while in the hospital:
Apgar Test
The Apgar test is a routine evaluation performed immediately after birth to assess the newborn's health and transition to life outside the uterus. It involves evaluating the baby's breathing, heart rate, muscle tone, reflex response, and skin colour.
Blood Screening
Blood screening is a simple procedure where a few drops of blood are collected from the baby's heel and sent for testing. This test screens for rare but serious health conditions, including genetic, hormone-related, and metabolic disorders. Examples of conditions screened for include phenylketonuria (PKU), congenital hypothyroidism, congenital adrenal hyperplasia (CAH), and medium-chain acyl-CoA dehydrogenase deficiency (MCAD).
Hearing Screening
Hearing screening is conducted to detect hearing loss. During this test, tiny earphones are placed in the baby's ears, and special computers are used to evaluate their response to sound.
Heart Screening
Heart screening, also known as critical congenital heart defect (CCHD) screening, is performed to identify potential heart issues. A non-invasive test called pulse oximetry is used, which measures the oxygen levels in the blood.
Other Tests
In addition to the standard screenings, hospitals may perform additional tests based on regional guidelines and the baby's specific needs. These can include screenings for sickle cell disease, cystic fibrosis, amino acid disorders, and fatty acid oxidation disorders. Some tests may require a certain amount of time after birth, such as the screening for congenital heart defects, which is typically done after the baby has received at least 24 hours of breast milk or formula.
It is important to note that newborn screening tests can vary by state, and results may take around 5 to 7 days to be available. If a positive result is detected, further tests will be conducted to confirm or rule out the diagnosis, and early treatment will be initiated if necessary.
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Circumcision and other surgical procedures
Circumcision is a surgical procedure that involves removing the foreskin, a fold of skin that covers the glans (head) of the penis. It is a religious rite or a ceremonial tradition in many cultures, most notably in the Jewish and Islamic faiths. In the United States, newborn circumcision is an elective procedure, meaning parents can choose whether or not to have their child circumcised. It is typically performed one to two days after birth, before the mother and baby leave the hospital, but it can also be done on older children.
The circumcision procedure usually involves the following steps:
- The baby is placed on a special table, and a local anesthetic is applied to the penis to numb the area.
- The penis and foreskin are cleaned with an antiseptic solution.
- The foreskin is gently loosened from around the head of the penis, and a small slit is made in the foreskin.
- A special clamp is attached to the penis, and the foreskin is cut and removed.
- Gauze or a dressing with petroleum jelly is placed over the wound to protect it and promote healing.
While circumcision carries some risks, including bleeding, infection, and scarring, complications are rare and generally less likely when the procedure is performed by a trained professional in a medical setting. Parents considering circumcision should carefully weigh the potential benefits and risks and discuss any concerns with their healthcare provider before making an informed decision.
In addition to circumcision, other surgical procedures may be performed on newborns while in the hospital. These procedures are typically done within the first few days of life and include:
- Vitamin K shot: Newborns are given a vitamin K injection to promote healthy blood clotting and prevent bleeding disorders.
- Eye drops: Antibiotic eye drops are administered to prevent neonatal conjunctivitis, an inflammation of the eye that can lead to blindness if left untreated.
- Hearing test: A hearing screening is conducted to identify any potential hearing impairments.
- Hepatitis B vaccine: This vaccine helps protect newborns from hepatitis B, a serious liver infection.
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Nursery essentials and safe sleep spaces
Preparing for a newborn's arrival can be an exciting yet tricky task, especially for first-time parents. Here is a detailed guide on nursery essentials and safe sleep spaces to help you care for your newborn in the hospital and once you get home:
Nursery Essentials:
- Crib or Bassinet: A crib or bassinet is essential for your newborn's sleep. Ensure that the crib is sturdy, safe, and placed next to the adult bed to facilitate room sharing, which reduces the risk of SIDS and makes feeding and comforting easier.
- Mattress: Choose a crib mattress that prioritizes safety and comfort for your baby. Avoid soft mattresses and opt for a firmer option.
- Rocking Chair or Glider: A comfortable chair is essential for feeding and soothing your baby. A rocking chair helps soothe your baby and can be used for reading and cuddling as your baby grows.
- Nightlight: A nightlight helps you navigate the nursery during late-night feedings and can also help your baby associate dimmer lighting with bedtime.
- Storage: Design an organizing system using storage bins or baskets to keep baby essentials easily accessible and clutter-free. Place them near the rocking chair and changing area for convenience.
- Books: Books are essential for your baby's development. Hang a wall-mounted bookshelf to save space and decorate the nursery with picture books.
Safe Sleep Spaces:
- Room Sharing: It is recommended that babies sleep in the same room as their parents, in their own sleep space (crib, bassinet, or portable play yard). This reduces the risk of SIDS and sleep-related infant deaths and makes it easier for you to monitor your baby.
- Avoid Soft Surfaces: Do not let babies sleep on soft surfaces such as couches, sofas, waterbeds, memory foam, or adult mattresses. These surfaces increase the risk of SIDS and accidental suffocation.
- No Pillows or Blankets: Remove pillows, blankets, and unfitted sheets from the baby's sleep area to reduce the risk of suffocation and strangulation.
- Avoid Bed Sharing: While skin-to-skin contact is important, avoid bed sharing as it increases the risk of SIDS and sleep-related deaths. If you fall asleep while feeding or comforting your baby in bed, move them to their own sleep area as soon as you wake up.
- Car Seats and Strollers: While car seats and strollers are essential for travel, they are not recommended as regular sleep spaces. Always move your baby to their regular sleep space as soon as possible.
Remember, creating a safe sleep environment is crucial in reducing the risk of SIDS and other sleep-related infant deaths. By following these guidelines, you can ensure your newborn's sleep space is as safe and comfortable as possible.
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Emotional support and self-care
The birth of a child is an exciting but overwhelming time. It is important to remember that you are not alone and that many new mothers experience similar emotions. Postnatal care is available to help you through this transition, and you should not be afraid to ask for help.
Emotional Support
The early days of parenthood can be hectic and exhausting, and it is essential to care for your health first. Make sure to eat and drink, and don't forget to ask for help if you are feeling overwhelmed. Call a friend or family member if you need emotional support or a break during the day. Don't feel obligated to have visitors if you aren't feeling up to it—it is okay to say no and delay their visit.
Self-Care
Consider signing up for a breastfeeding or new parent support group, either in person or online. These groups can provide information and helpful tips, as well as a way to connect with other new parents who can offer support. Enlist help from friends, neighbours, or coworkers, and don't be afraid to hire extra help if you can, such as an overnight nurse or newborn care specialist, a housekeeper, or a babysitter.
Mental Health
Postpartum depression (PPD) and postpartum anxiety are common, affecting about 15 to 20 percent of women who give birth. If you are experiencing negative feelings towards yourself or your newborn, or having thoughts of self-harm or suicide, it is crucial to seek urgent help and support. Support groups, therapy, and medication can help you through this period. Regular physical exercise can also be beneficial if you are experiencing mild depression.
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Frequently asked questions
Doctors and nurses will help you navigate the many steps before you can go home. Your baby will receive a vitamin K shot, eye drops, screening tests, a hearing test, and a hepatitis B vaccine. Your baby will also have their footprints taken and be placed on your chest for skin-to-skin contact.
Skin-to-skin contact, also known as "kangaroo care", is encouraged to start the bonding process and improve breastfeeding for mother and baby.
You will need plenty of diapers, wipes, bottles, and laundry detergent. You should also have clothing that is easy to put on and remove, such as onesies, sleep sacks, and pajamas with feet. Infants should sleep in an empty crib, bassinet, or portable play yard.
Newborns don't always give a lot of signs when they are sick, but trust your instincts. Call your baby's healthcare provider if your baby has a rectal temperature of 100.4 degrees or higher, unusual crying or irritability, sleeping too little (less than 12 hours a day) or too much (more than 22 hours a day), forceful or projectile vomiting, disinterest in eating, or weakness and no energy to cry.
Newborn care in the hospital includes urgent medical intervention if necessary, as well as screenings, examinations, and surgical procedures. Hospitals provide formula for your baby during your stay.
