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Baby's First Tests
What You Can Expect During Your Hospital Stay
By Erin Gifford
After nine long months of waiting for your baby to make his first appearance, he's finally here. But before you take him home to the nursery you've lovingly prepared, how do your doctors make sure he's ready to come home? Among Apgar scores, antibiotic eye ointment and vitamin K injections, your doctors and nurses will take good care to make sure your baby's transition to the outside world is a healthy one.
"The initial evaluation and management of the newly-born infant assures a healthy and smooth transition from in utero to extra uterine life," says Dr. Alan Meltzer, general pediatrics division director at Morristown Memorial Hospital in Morristown, N.J.
Within one minute of birth, your baby will be given an APGAR score from 0 to 10 based on an evaluation of heart rate, respiration, muscle tone, reflexes and color. A score of 0, 1 or 2 will be assigned for each category. For example, a limp baby will receive a 0 for muscle tone, while a baby who actively moves his arms and legs will receive a 2. This evaluation is repeated at five minutes after birth, and most babies score between 7 and 9.
"The Apgar score helps with communicating the condition of the newborn in the first minutes of life," says Dr. Meltzer. Once your baby's Apgar score is recorded, he will be given back to you to hold and bond with for several minutes before being weighed and measured.
Most babies are born with very low levels of vitamin K, which is essential for normal blood clotting. It is therefore standard practice to give newborns a vitamin K injection in the upper thigh, usually within the first hour of life. This injection prevents a serious bleeding condition known as hemorrhagic disease of the newborn (HDN).
To prevent serious eye infection caused by exposure in the birth canal to gonorrhea or chlamydia, both of which can be asymptomatic in the mother, the antibiotic ointment erythromycin will be applied to your newborn's eyes soon after delivery. However, because the eye treatment can cause puffiness and temporarily blurred vision, you may want to ask your doctor to delay treatment at least until you've had time to feed and bond with your new baby. "I specifically wrote in my birth plan that I wanted the eye ointment and any shots delayed as long as possible after birth," says Terri Lindeman, mother of two from Hercules, Calif. "I was glad I did, as I felt like I had ample time to hold and look at my babies."
Some hospitals also give newborns a hepatitis B vaccine in the hospital, but most will hold off until the first visit to the pediatrician. "As long as Mom does not have the disease, we are in no hurry to give the vaccine," says Dr. Tanya Remer Altmann, a pediatrician in Westlake Village, Calif., and a clinical instructor at UCLA. The American Academy of Pediatrics (AAP) recommends that newborns whose mothers either are infected with the hepatitis B virus or who have not been tested get their first shot in the three-dose series within 12 hours of birth. All other babies can get their first shot by 2 months of age.
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