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Baby's Care in the Delivery Room

Picture of a newborn

The birth of a baby is one of life's most wondrous moments. Few experiences can compare with this event. Newborn babies have amazing abilities, yet they are completely dependent on others for every aspect--feeding, warmth, and comfort.

Amazing physical changes occur with birth. When the baby is delivered, the umbilical cord is cut and clamped near the navel. This ends the baby's dependence on the placenta for oxygen and nutrition. As the baby takes the first breath, air moves into the lungs. Before birth, the lungs are not used to exchange oxygen and carbon dioxide, and they need less blood supply. The fetal circulation sends most of the blood supply away from the lungs. When a baby begins to breathe air at birth, the change of pressure in the lungs helps close the fetal connections and redirect the blood flow. Now, blood is pumped to the lungs to help with the exchange of oxygen and carbon dioxide.

Some babies have excess amounts of fluid in their lungs. Stimulating the baby to cry by massage and stroking the skin can help bring the fluid up where it can be suctioned from the nose and mouth.

Providing warmth for the newborn

A newborn baby is wet from the amniotic fluid and can easily become cold. Drying the baby and using warm blankets and heat lamps can help prevent heat loss. Often, a knitted hat is placed on the baby's head. Placing a baby skin-to-skin on the mother's chest or abdomen also helps keep the baby warm.

Immediate care for the newborn

Health assessments of the new baby begin immediately. One of the first checks is the Apgar test. The Apgar test is a scoring system designed by Dr. Virginia Apgar, an anesthesiologist, to evaluate the condition of the newborn at one minute and five minutes after birth. The doctor and nurses will evaluate the following signs and assign a point value:

A

Activity; muscle tone

P

Pulse rate

G

Grimace; reflex irritability

A

Appearance; skin color

R

Respiration

A score of 7 to 10 is considered normal. A score of 4 to 6 may indicate that the baby needs some resuscitation measures (oxygen) and careful monitoring. A score of 3 or below indicates that the baby requires immediate resuscitation and lifesaving techniques.

Physical exam of the newborn

A brief physical examination is performed to check for obvious signs that the baby is healthy. Other necessary procedures will be done over the next few minutes and hours. These may be done in the delivery room or in the nursery, depending on several factors, including the condition of the baby. Some of these procedures include the following:

  • Temperature, heart rate, and respiratory rate

  • Measurements of weight, length, and head circumference. These measurements help determine if the baby's weight and measurements are normal for the number of weeks of pregnancy. Small or underweight babies as well as very large babies may need special attention and care.

  • Cord care. The baby's umbilical cord stump will have a clamp. It needs to be kept clean and dry.

  • Bath. Once a baby's temperature has stabilized, the first bath can be given.

  • Footprints. Footprints are often taken and recorded in the medical record.

Before a baby leaves the delivery area, identification bracelets with identical numbers are placed on the baby and mother. Babies often have two, one on the wrist and one on the ankle. These should be checked each time the baby comes or goes from your room.

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