Perinatal is the time just before, during, and just after birth. It is a busy time for both you and your baby. Here is a quick peak at what you may expect.

After Delivery

A bulb suction is used to clear mucus from the baby’s airway just after birth. As soon as it is clear, you will hear your baby's first cry.

The umbilical cord is clamped and cut. The baby is then dried and placed on your tummy or chest for a greeting. The baby is often placed against bare to skin to improve contact with parent. This may help with temperature regulation and bonding. A blanket may be used to keep the baby warm. Keeping the body temperature stable is important for the baby.

Early Evaluation

The baby will be checked immediately after birth. A quick look is done to see if there are any obvious issues. Next is the Apgar score. This is a measure of the baby’s health based on color, heart rate, breathing, reflexes, and muscle tone. Each section is given a score. The scores are all combined into one total score. The total score is taken at 1 minute after birth and again 5 minutes after birth. The score often increases with time. A sick baby may be checked again at 10 minutes. A total score of 7 to 10 is normal; 4 to 6 is intermediate; and 0 to 3 is low. The baby's weight, length, and temp will also be measured.


Special care or tests may be needed for babies born early or very late. Babies that are underweight or have medical issues may also be taken to a special medical unit for newborn babies.

Early Protection

To help the baby get a healthy start the care team may do the following:

  • Give eye drops or an antibiotic ointment to help to protect the eyes.
  • Give an injection of vitamin K—to boost the body's ability to clot. Low levels of vitamin K can cause bleeding disorders in newborns.
  • Treat the umbilical cord is with a solution to prevent infection.
  • Carefully swaddle the baby and put on a knit hat to help keep the baby warm. An infant warmer will be used if the baby’s temperature drops below 96°F (35.5°C).

The baby will be returned to you for cuddling as soon as possible. Breastfeeding will be encouraged to start soon after birth.

Nurses can help with infant care and teach you about feeding, diaper changing, bathing, and other caretaking duties. They can answer any questions and provide support.

Monitoring and Evaluation

The baby may be sent to the nursery so you can sleep, or can stay in the room with you. The baby's vital signs wil be checked about every 8 hours. When your baby has fed at least once and has normal vital signs, he or she will be given a bath. A mild soap is used that will not remove all of the baby’s vernix. This is whitish greasy material that covers the baby's body and gives a natural protection against germs.

Your baby will have a full exam within 12 to 24 hours after birth.

Screening

Screening tests look for signs of health issues before any symptoms start.

Newborn Screening Tests

Newborn screening tests check for diseases that can appear early in life. These diseases are not common, but need to be treated early to prevent severe problems. Blood is drawn from the baby’s heel within the first 24 hours of life. This is called a heel stick.

The diseases that are screened are determined by local health department. All states screen for hypothyroidism and phenylketonuria (PKU). Both of these conditions can cause intellectual disability if they are not treated. Many states also test for the following:

Other tests will be done if the screening test is positive to confirm the health issue.

Hearing Screen

Some hospitals will check your baby’s hearing. This test is painless and can be done while your baby is sleeping. It takes only a few minutes. If your baby passes the test, there is no hearing problem at this time. If your baby does not pass, further tests may be done.

Oxygen Saturation Screening

Oxygen saturation refers to the amount of oxygen in your baby’s blood. It is a measure of how well your baby’s heart and lungs are working. A tiny red light is attached to the outside of your baby’s hand, foot, or wrist. It is painless. The measure will be done at least 3 times. Ideally, the level will be greater than 94%.

Jaundice

Some babies have a slight yellow tinge to their skin and eyeballs. This is a sign of jaundice. Jaundice is caused by a pigment called bilirubin that is usually removed by the liver. It may happen in newborns because:

  • A newborn’s liver is still learning how to remove bilirubin. Many babies may appear jaundiced in first 2 to 5 days.
  • Breastfed babies are not getting enough milk. This condition usually clears within 2 weeks without treatment.
  • Fewer bowel movement—Bilirubin leaves the body in the stool. Feeding infants more often may increase bowel movements.

Artificial light can help to break down bilirubin in the baby’s skin. A special light may be used over the baby's crib.

At Home

Most will leave the hospital about 1 to 3 days after birth. It is normal for your baby to lose weight. Most newborns lose about 5% to 7% of their birth weight within the first few days of life. Breastfed babies gain this back by 2 weeks of life. Formula fed babies will often regain their weight sooner.

The umbilical cord stump will need some care. Look for signs of infection such as redness or drainage with eah diaper change.

Call the pediatrician’s office if you have any questions or concerns about the baby. Follow the appointment schedule for well-baby checkups as laid out by the pediatrician. You will have these checkups regularly during the first year. The timing will be based on the baby's health.

Caring for Your Baby

The first days or weeks home can feel overwhelming. Try to stay calm. Trust your instincts. Ask for help when you need it. There are many guidelines for how to care for your baby, but it is not an exact science. You are doing your job as long as you give your baby with warmth, love, food, and cleanliness. With time and patience, you and your baby will figure each other out. Remember to enjoy this time. Despite those nights that seem unending, these early weeks will go by very quickly.

RESOURCES:

Office on Women's Health
https://www.womenshealth.gov

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
https://sogc.org

Women's Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

Apgar scores. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/pages/Apgar-Scores.aspx. Accessed January 29, 2021.

Circumcision. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/circumcision.html. Accessed January 29, 2021.

Jaundice in healthy newborns. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/jaundice.html. Accessed January 29, 2021.

Newborn screening. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/newbornscreening. Accessed January 29, 2021.

Newborn testing. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/newborn-testing. Accessed January 29, 2021.

Last reviewed September 2020 by EBSCO Medical Review Board  Last Updated: 1/29/2021