Birth Day: Your Baby's First 24 Hours of Life

The Rest of the Day

Hours 4 through 22
You'll spend this time learning how to care for your newborn. You'll probably help a nurse give him his first bath and change his diaper once he passes his first bowel movement, called meconium. You'll also learn how to swaddle and hold your baby, as well as how to handle his umbilical-cord stump and his circumcision site (if he's been circumcised). If you choose to breastfeed your baby, you'll be nursing him every two to three hours. Most hospitals have a lactation consultant who will check in to see how you're doing, even if you've breastfed before, says M. Terese Verklan, Ph.D., a nursing consultant in Houston. If you don't get a visit, ask for one.

Hours 23 and 24
By now your baby will have been formally evaluated by a pediatrician -- unless a problem was discovered at birth, in which case this exam will have been done then. The doctor will assess risk factors for infection, check for malformations, and ensure that your child is feeding and breathing well. She'll be checked for jaundice, which causes yellowish skin because bilirubin isn't being broken down in the liver. Babies with the condition may be exposed to a special kind of light that helps break down bilirubin, and you'll be encouraged to nurse your little one often to help eliminate the substance through her stool. In rare cases, if left untreated, jaundice can lead to brain damage. Additionally, your baby's heel will be pricked to screen for up to 50 different metabolic diseases, depending on your state's requirements, including sickle cell anemia and phenylketonuria (PKU). Performing this test any earlier is useless; blood levels in a baby don't rise until 24 hours after she has begun to drink breast milk or formula, so there can be a higher incidence of a false negative if the test is performed too soon. This evaluation is extremely important -- if your baby has one of these diseases, detecting and treating it early can substantially improve her prognosis.

Just Before Hospital Discharge
You'll stay at the hospital 24 to 48 hours after having a routine vaginal delivery. If you've had a C-section, you'll generally be there for three to four days. Right before you leave, your baby will receive a hearing test, in which he'll wear a pair of headphones and an audiologist will monitor his brain waves in response to sound. He'll also be weighed, and you'll probably notice that his weight has dropped since birth. Don't be alarmed. Fluid is moving from his extravascular system to his blood vessels, increasing his blood pressure and promoting the flow of oxygen to his organs. He's urinating out the excess fluid, which causes a 5 to 7 percent dip in his birth weight, but he'll gain back the weight after a few days of eating, Dr. Verklan explains.

After you've been discharged but before you can drive off, the hospital staff will confirm that you have a car seat, which is required in all 50 states. Once you get the go-ahead and realize that you're on your own, you may feel overwhelmed. "Don't panic," Dr. Brown says. "No one goes home really feeling prepared." Try to relax. Before you know it you'll be parenting like a pro.

Originally published in the July 2012 issue of Parents

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