Newborn care in the delivery room

What kind of care does your baby get right after birth?

In the minutes after your baby is born, health care providers check him to make sure he’s healthy and stable. The providers: 

Help your baby breathe. Your health care provider clears mucus from your baby’s nose and mouth to help your baby take her first breath. He may rub your baby’s back to help her breathe deeply. Crying at birth is normal and helps your baby get rid of any extra fluid that may still be in her lungs, nose or mouth. Not all babies cry after birth, though. She may just take some quiet first breaths. Some babies, like premature babies (born before 37 weeks of pregnancy) and babies born by c-section, may have trouble breathing after birth and need extra help from their health care providers. A c-section (also called cesarean birth) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

Clamp and cut the umbilical cord. The umbilical cord connected your baby to the placenta in the womb. It carried food and oxygen from the placenta to your baby. Now that your baby’s born, she no longer needs the umbilical cord. Your baby’s provider or your labor partner can clamp and cut the cord. Most providers wait at least 30 to 60 seconds after birth to let the blood from your placenta flow into your baby before clamping the cord. This is called delayed cord clamping.

Keep your baby warm. Your baby can easily become cold after birth. When a baby’s born, he’s wet from the amniotic fluid in the womb. A provider dries your baby to help keep him from getting cold. Your baby may be covered with vernix. This is a white, cheesy, waterproof substance that protects your baby’s skin in the womb. Leaving vernix on a baby’s skin can help keep her warm and prevent problems, like weight loss and jaundice. Jaundice is when a baby’s eyes and skin look yellow. It’s caused when the liver isn’t fully developed or working. Your baby may not get a bath for several hours to help protect the vernix on her skin. 

Take your baby’s Apgar score. Your baby’s provider uses an Apgar score to check your baby’s condition and see how well she’s adjusting to life outside the womb. The Apgar test is done at 1 minute and 5 minutes after birth. 

Apgar stands for:

• A – Activity. Your baby’s provider checks your baby’s muscle tone.
• P – Pulse. Your baby’s provider takes your baby’s heart rate. A strong heart rate has more than 100 beats per minute.
• G – Grimace; reflex. Your baby’s provider places a bulb syringe in your baby’s nose and checks your baby for a response like an upset face, sneeze or cough.
• A – Appearance. Your baby’s provider looks at your baby’s skin color. A baby’s skin may be pale or blue until she warms up and it turns pink.
• R – Respiration. Your baby’s provider checks your baby’s breathing and listens for a strong cry.

The provider grades each category with a score of 0, 1 or 2. He then adds the numbers for the final Apgar score. Most babies have an Apgar score of more than 7, which means they’re in good condition. 

Babies with low Apgar stores may need extra attention or special medical care in the newborn intensive care unit (also called NICU). This is the nursery in a hospital where newborns get medical care. Babies with low Apgar scores may need oxygen or medicines to make their heartbeat stronger if they have problems with their heart or lungs. Premature babies sometimes have a low Apgar score because they may not be fully developed. Some babies have a low Apgar score because of a difficult labor.

When can you first hold your baby?

As soon as your providers make sure your baby is healthy, you can hold her. Holding your baby skin-to-skin (also called kangaroo care) keeps your baby warm and helps your baby get ready for breastfeeding. This is also a special moment to bond with your baby. 

If you had a vaginal birth, your provider places your baby skin-to-skin on your bare chest or belly and covers you both with a blanket. If you had a c-section and were awake during the operation, you may be able to hold your baby skin-to-skin right away. After a c-section, some babies need to spend time in the nursery. Your baby may spend a few hours in an incubator. This is a clear plastic bed that keeps your baby warm. If you had general anesthesia for your c-section, you may not wake up for a few hours after the operation. When you wake up and feel well enough, you can hold and breastfeed your baby. Anesthesia is medicine that helps lessen or prevent pain. 

Most women can start breastfeeding within an hour of giving birth. A nurse or lactation consultant can help you get started. A lactation consultant is a person with special training in helping women breastfeed. 

While your baby is skin-to-skin on your chest, providers:  

• Measure your baby and take his temperature. Your baby’s provider checks your baby’s weight, length and the size of his head to ensure that he is at a healthy range for his age. She also gets her temperature taken.
• Give your baby a vitamin K shot. For a few days after birth, newborns can’t make their own vitamin K, which is needed to help their blood clot. The vitamin K shot protects your baby from developing a rare, serious bleeding problem called hemorrhagic disease of the newborn.  
• Treat your baby with eye drops. Your baby gets antibiotic eye drops or ointment. This protects his eyes from infections that a baby can get during vaginal birth. Your baby doesn’t need the eye drops right away, so you can ask that she get them later.
• Give your baby medical bracelets and take footprints. Babies usually get two identity bracelets (one on his ankle, the other on his wrist). You get a matching bracelet, too. Your baby’s footprints are part of your baby’s first medical record.

Why do babies get a hepatitis B virus vaccine after birth?

The hepatitis B vaccine protects your baby against the hepatitis B virus (also called HBV), which can cause liver problems. Most babies get this vaccination within 24 hours after birth. 

Why do babies get newborn screening tests?

Before your baby leaves the hospital, she has some special tests called newborn screening. Newborn screening checks for serious but rare conditions that your baby has at birth. It includes blood screening, hearing screening and heart screening. 

Your baby can be born with a health condition but may not show any signs of the problem at first. If a health condition is found early with newborn screening, it often can be treated. This makes it possible to avoid more serious health problems for your baby. 

Your baby gets newborn screening when he’s 1 to 2 days old. Some states require that babies have newborn screening again about 2 weeks later. 

Last reviewed: December, 2018