Neonatology (NICU)

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Medical Care and Your Newborn

You may have had a prenatal visit with your baby's doctor-to-be to discuss some specifics, such as when he or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is out of the office, and how the office handles after-hours emergencies. You may have also learned the doctor's views on certain issues.

In this way, you've begun to forge a relationship with your baby's doctor that should last through the bumps, bruises, and midnight fevers to come.

What Happens Right After Birth

Depending on your desires and the rules of the hospital or birth center where your baby is delivered, the first exam will either take place in the nursery or at your side:

  • Weight, length, and head circumference will be measured.
  • Temperature will be taken, and your baby's breathing and heart rate will be measured.
  • The doctor or nurse will monitor skin color and your newborn's activity.
  • Eye drops or ointment to prevent eye infections.
  • A shot of vitamin K will be given to prevent the possibility of bleeding.

Your baby will be given a first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers provide personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.

The Doctor's Visit

The hospital or birth center where you deliver will notify your child's doctor of the birth. If you have had any medical problems during pregnancy, if any medical problems for your baby are suspected, or if you are having a C-section, a pediatrician or your baby's doctor will be alerted of the impending birth and be standing by to take care of the baby.

The doctor you have chosen for your newborn will probably give your baby a full physical examination within 24 hours of birth. This is a good time to ask questions about your baby's care.

A sample of your baby's blood (usually done by pricking the baby's heel) will be taken to screen for a number of diseases that are important to diagnose at birth so effective treatment can be started promptly. In some cases, a repeat sample to confirm the results will be taken by the baby's doctor soon after going home.

Every newborn should be seen and examined at the doctor's office within 3 to 5 days after birth and within 72 hours after discharge from hospital. But if your baby is sent home less than 48 hours after delivery, your doctor will want your baby to be brought to the office for a check within 48 hours after discharge.

The First Office Visit

During the first office visit, your doctor will assess your baby in a variety of ways. The first office visit will differ from doctor to doctor, but you can probably expect:

  • measurement of weight, length, and head circumference to assess how your baby's been doing since birth
  • observation of your newborn's vision, hearing, and reflexes
  • a complete physical examination
  • questions about how you are doing with the new baby and how your baby is eating and sleeping
  • advice on what you can expect in the coming month
  • a discussion of your home environment and how it might affect your baby's health (for example, smoking in the house can harm your baby's health in many ways)

Also, if the results of screening tests performed on your newborn after birth are available, they may be discussed with you. Bring any questions or concerns to the doctor at this time. Jot down any specific instructions given regarding special baby care. Keep a permanent medical record for your baby that includes information about growth, immunizations, medications, and any problems or illnesses.

Immunizations Your Baby Will Receive

Babies are born with some natural immunity against infectious diseases because their mothers' infection-preventing antibodies are passed to them through the umbilical cord. This immunity is only temporary, but babies will develop their own immunity against many infectious diseases.

Breastfed babies receive antibodies and enzymes in breast milk that help protect them from some infections and even some allergic conditions.

Infants should get the first shot of the hepatitis B vaccine before they leave the hospital. Since your baby will receive more immunizations over the coming months, you may want to familiarize yourself with the standard immunization schedule.

When to Call the Doctor

Don't hesitate to call your doctor if you have concerns about your newborn. Some common difficulties to be aware of during this first month:

  • Eye problems can be caused by blockage of one or both tear ducts. Normally the ducts open on their own before too long, but sometimes they remain clogged, which can cause tearing and eye discharge. Call your doctor if you suspect an eye infection.
  • Fever in a newborn (rectal temperature above 100.4ºF or 38ºC) should be reported to your doctor right away.
  • A runny nose can make it hard for a baby to breathe well, especially during feeding. You can help ease discomfort by using a rubber bulb aspirator to gently suction mucus from the nose. Call your doctor if you have concerns about your baby's breathing.
  • It's normal for newborns to have loose stools or spit up after feedings. However, very loose and watery stools and forceful vomiting could mean there is a problem. Call your doctor if your baby has diarrhea, is vomiting, or has signs of dehydration, which include a decreased number of wet diapers, a dry mouth, and lethargy (being very sluggish or drowsy).

Reviewed by: Mary L. Gavin, MD
Date reviewed: January 2015