Baby Care: First Year

Lesson 2: Newborn Care: Getting a Good Start

Newborn Procedures and First Checkup

Newborn Procedures

You may ask the hospital (if this is where you give birth) to delay the following routine procedures until after you've spent time bonding with your newborn.

Vitamin K: Your baby receives this injection to promote normal blood clotting and to lesson his risk of abnormal bleeding into vital tissues. Studies have shown that the same dose of vitamin K given orally is just as effective in healthy, full-term babies.

Eye ointment: The antibiotic ointment, erythromycin, is put into your baby's eyes to protect against germs that may have entered his eyes during his passage through the birth canal. This ointment may temporarily blur his vision so it's best to put it off until you've had time to look at each other.

Blood tests: A sample of your baby's umbilical cord blood is taken to determine his blood type and Rh factor. Several drops of blood are taken from his heel for screening for hypothyroidism, phenylketonuria (PKU), and galactosemia. The PKU test will be repeated before your baby's third week.

hypothyroidism: This condition, in which your baby has an inadequate thyroid gland, if undetected and untreated, may cause mental retardation.

phenylketonuria: This inherited enzyme deficiency, if untreated, can result in brain damage.

galactosemia: This disorder, which prevents the metabolism of galactose, if untreated, results in vital organ damage.

Jaundice: If your baby develops this yellowing of the skin caused by the buildup in his blood of a yellow pigment called bilirubin, his bilirubin level may be measured by taking a few drops of blood from his heel.

First Checkup

Your baby receives his first checkup within twenty-four hours of his birth. It is done either by the pediatrician or family practitioner that you have chosen or by the pediatrician on duty at the hospital. The doctor forms his first impression of your baby's general health by looking at him. Then he checks your baby's head, eyes, nose, mouth, ears, and body.

Head: The doctor checks your baby's head for any abnormalities. Most lumps and bumps are normal. The fontanel should be soft and flat. His head circumfrence should be in proportion to his height and weight.

Eyes: The doctor shines a light into your baby's eyes to determine if he has any cataracts or internal eye problems. He checks your baby's eyes for normal size. Any ruptured blood vessels clear up within a few weeks.

Nose: The doctor makes sure that your baby's nasal passages are open enough to allow air through.

Mouth: The doctor checks that the front of your baby's tongue is not attached too tightly to the floor of his mouth. This could prevent good latch-on during breastfeeding. This too-tight tongue tip (called tongue-tie) usually loosens in time. The doctor also checks that the roof of your baby's mouth (the palate) is fully formed.

Ears: Your baby's ears may be pinned to his head, folded over, or sticking out. His earlobes may be bruised. This is normal. The outer appearance of his ears may change. The doctor shines a light into his ears to determine if they are correctly formed on the inside.

Neck: The doctor checks your baby's neck and collarbone to make sure there are no abnormal lumps or fracture.

Heart and Lungs: The doctor moves his stethoscope over your baby's chest to make sure that his heart beat is normal and that air is properly entering and leaving his lungs.

Abdomen: The doctor feels for your baby's liver, spleen, and kidneys to determine their size and correct position.

Genitals and Groin Area: Your daughter's vulva or your son's testes may be swollen due to hormones and extra fluid accumulated at birth. Your daughter may have a white, or blood-tinged vaginal discharge. This is normal. The doctor checks that your daughter's vaginal opening is normal, or that your son's testicles are descended, and that his anus is open and properly located. He moves your baby's thighs around the hip joints to determine if he has dislocatable hips, a condition easily treated in a newborn. He also feels for your baby's strong femoral pulse in the center of his groin which indicates that the blood vessel coming out of his heart is large enough.

Legs and Feet: Your baby's legs are normally bowed and his feet are slightly curved in. He may have inherited webbed, oversized, or overlapping toes.

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