Newborn, the first checks at birth

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Catherine Le Nevez
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First birth checks

The baby was born, what a joy! Let's see if it's all right: let's evaluate the l'index of Apgar in two different times, we do the pediatric visit and see how much it weighs ... Gods first birth checks and we talk about the first evaluations of the newborn with Costantino della cittagnoli, Professor of Neonatology at the Catholic University of S. Cuore of the city, Director of Neonatal Intensive Care at the Gemelli Polyclinic and President of the Del Paesena Society of Neonatology.





In this article

  • He was born: a deep breath and then the cut of the umbilical cord
  • After 1 minute from birth: the first Apgar test
  • Finally in mom's lap
  • Early attachment to the breast
  • After 5 minutes: the second Apgar Index, then the visit and dressing
  • The importance of rooming in (if possible)
  • What if there was a caesarean?
  • Weight control until discharge

He was born: a deep breath and then the cut of the umbilical cord

As soon as the baby comes to light, is raised to show it to mom and dad, but immediately afterwards there are some important passages, albeit fast, which the new mother doesn't even notice.



First the airways are cleared with a tube, after which, even before clamping the umbilical cord, the baby is expected to perform at least two or three breaths.

Cittàgnoli's prof explains:

It is an important wait to be respected, which allows the placental blood to pass to the baby and to oxygenate it at its best, preventing ailments such as neonatal anemia or blood pressure drops. In fact, in the mother's belly the lung does not receive blood, but it is only with the first breaths that the lungs expand and the blood can supply them effectively. To facilitate the flow, the newborn is placed on a slightly lower surface than the mother, even if the uterine contractions themselves pump the blood towards him



After 1 minute from birth: the first Apgar test

One minute after birth, the first Apgar Index is evaluated, with which the well-being of the newborn is verified through five parameters:

  • heart rate,

  • respiratory rate,

  • the reflections,

  • muscle tone

  • the complexion.

Each parameter is assigned a score from 0 to 2: The optimum is a total result equal to or greater than 7.

Who Performs the Apgar Index?

The ideal would be if the neonatologist did it, however the midwife also has the skills to check the five parameters and evaluate when the intervention of the neonatologist is necessary.

Finally in mom's lap

After these operations, which in all last a few moments, the baby is dried, wrapped in a cloth and finally placed on the mother.

It is very important that the baby is dried and covered. It is in fact known that the child comes out wet from an environment where the temperature was around 38 degrees and suddenly finds himself in a room where no more than 24-25 degrees are reached, so the temperature difference is considerable: contact is fine. skin to skin, but always adequately protected

points out prof. of the citygnoli.

Read also: The first hours of the baby's life

Early attachment to the breast

Once in the mother's lap, the baby can be attached to the breast. della cittàgnoli specifies that in the first half hour of life the newborn is generally very active, after which a physiological phase of relaxation follows after the stress of childbirth, in which it is normal for him to fall asleep. 

This is why the 20-30 minutes after birth are the ideal ones in which to start breastfeeding, to immediately stimulate milk production and promote the mother-baby bond (without considering that sucking stimulates uterine contractions that favor the scaling of the baby's breast. uterus and avert the risk of bleeding)

observes the neonatologist.

After 5 minutes: the second Apgar Index, then the visit and dressing

Even if the baby is still in the mother's lap, after five minutes it is necessary to evaluate the second Apgar Index, with which we check the same parameters again as before and confirm that everything is fine.

After a few more minutes, the baby is taken to be washed, weighed and examined by the neonatologist, who checks his breath more accurately, feels his heart, palpates his belly, checks his nose, mouth, ears and genitals; finally, the cord is treated, the baby is dressed and a special bracelet is applied to him, with a numerical code identical to that applied to the mother, in order to avoid confusion.

In the meantime, the mother remains on the cot in the delivery room for the afterbirth and for the suturing of any lacerations.

The importance of rooming in (if possible)

After two hours from the birth, and after the necessary checks for both of them, the mother goes back to the room and, if rooming in is provided, the child is brought to her.

Rooming in is certainly the best choice to facilitate the good start of breastfeeding, but we must not forget that the needs of mother and child must always be placed first. If the woman has had a caesarean section, she has had a particularly difficult birth and is unable to take care of the baby, it is perhaps better that she has some moments of rest, reassured by the fact that there are those who take care of her baby in the nursery.

highlights of the city

The same applies if the newborn needs treatment, such as phototherapy in case of jaundice. It is true that some hospitals are equipping themselves with special fiber optic covers that allow phototherapy to be carried out in the room, but, regardless of the costs - not sustainable by all structures - that this expense entails, it is not always the most practical solution. In short, it is right that you choose from time to time with the well-being of both as the goal.

What if there was a caesarean?

The practice does not change much if the woman gave birth with a caesarean. The only difference is that it is unlikely that the mother will be able to hug or attach her child to her newborn breast, since she has an IV in one arm and is much more limited in her movements; she usually approaches the baby for the first eye contact and also for a kiss and then the surgery is completed, while the neonatologist carries out the visit.

And from the point of view of the lung function of the newborn are there any differences?

No, if the woman still went into labor. In fact, labor activates a complex hormonal mechanism that stops the passage of fluid from the lung to the airways and allows the passage of air at the moment of birth. This is why, if possible, it would be advisable to avoid a scheduled caesarean, which prevents the physiological initiation of these adaptation processes. Finally, if the caesarean is performed, as in most cases, with spinal anesthesia, there are no side effects that can occur with general anesthesia, such as respiratory depression and reduced reactivity.

Weight control until discharge

After birth, the baby has a noticeable loss of fluids, due to breathing, thermal dispersion, the emission of urine and the first feces. For this reason, in the first two to three days of life, a slight weight loss is considered physiological.

To restore fluids it is important to attach it to the breast often, even if the colostrum produced while waiting for the milk to rise is a substance very rich in proteins, fats, vitamins, mineral salts, antibodies, but low in water. In any case, after a few days the child recovers part of the weight lost without problems: only if the decrease is greater than 10% can the need to resort to a temporary addition of liquids or milk be evaluated.

TAG:
  • first year
  • first health checks
  • apgar index
  • newborn weight
  • newborn 0-3 months
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