Baby's First Hours

The big day is finally here: After all those hours of labor, you'll see your newborn for the first time. And while you've probably read up on what will happen to you after giving birth, you may not have realized how busy your baby will be during his first 48 hours. Procedures vary from one hospital to the next, but here's what you can expect -- from the cutting of the cord to the last screenings your baby will need before you put him in his carseat and head for home.

When your baby is born, her first cry will kick-start her lungs. The obstetrician will suction her mouth and nose to clear away any mucus or amniotic fluid and make sure both nostrils are fully open. Your newborn will be put onto your body, cord intact, and covered with a blanket. If you have a C-section, the doctor will lift your baby up so you can see her; then she'll be cleaned up and given to your spouse to hold. If your baby is born prematurely or is in respiratory distress, she will be taken immediately to the neonatal intensive care unit for examination. Large babies (those weighing more than 8 pounds, 13 ounces) may need to be taken for a heel-stick blood test, since they are at risk of having low blood-sugar levels during the first few hours of life.

• Cutting the cord. The cord is usually cut within the first few minutes. After the doctor clamps it in two places, the baby's father is often given the honor of snipping it. Your doctor may also take a blood sample from the cord for later screening. If you've elected to donate cord blood to a blood bank, it will be collected now.
• Testing, testing. One minute after birth, and again five minutes later, your newborn will receive an Apgar score, an evaluation of his vital signs and physical responsiveness. During this test, the nurse will listen to his heart and lungs to make sure his respiratory and circulatory systems are making the transition from life in utero to the world outside, says Ann Stark, M.D., former chair of the perinatal pediatrics section of the American Academy of Pediatrics. Then he's weighed, measured, and checked for signs of illness.
• Protective measures. All newborns receive an injection of vitamin K, which clots blood, to prevent excessive bleeding. At birth, a baby's liver, which makes vitamin K, is immature. "We give newborns a boost to tide them over until their system turns on," says Susan Wright Aucott, M.D., medical director of the neonatal intensive care unit at Johns Hopkins University Hospital, in Baltimore. In addition, an antibiotic ointment or drop is applied to the eyes to protect against infection.

Next, your infant will be diapered, wrapped, and capped. If you're up to it, you can breastfeed. If not, you can still hold your little bundle. Babies are usually quite alert after birth -- the perfect time to begin bonding.