Although your obstetrician tracks your fetus throughout pregnancy via ultrasound, blood tests, and amniocentesis, some things can't be assessed until after your baby is delivered. So only seconds after your newborn enters the world and takes his first gulp of air, he'll start on a round of tests and procedures that protect his health. Here's a cheat sheet on what to expect.
What he'll get: Apgar scores
How they're done: A doctor or nurse will check your baby's appearance, pulse, grimace, activity, and respirations (the first letters spell Apgar), each of which is scored from 0 to 2. A 10 is perfect, but most healthy babies score in the 8 to 9 range.
Why your baby needs them: The scores evaluate your baby's heart and lungs and assess how well he's making the adjustment from life inside your womb to life in the outside world. A baby who gets a score of 3 or less needs immediate medical attention.
When they're done: One minute after birth and then again five minutes later.
Side effects: None.
What he'll get: Hearing screening
How it's done: Doctors will insert a probe into your baby's ear or put earphones on him. They'll then put monitoring devices on his head to record his brain waves as he responds to sounds sent through the probe or the earphones.
Why your baby needs it: Because hearing loss is hard to detect in a baby in the first few months of life, many states require this test. It can pick up any congenital hearing loss.
When it's done: Usually in the first 48 hours of life.
Side effects: None.
What he'll get: Metabolic-disorders screening
How it's done: A few drops of blood from your baby's heel are sent to a lab for analysis. Doctors can perform multiple tests on that tiny sample.
Why your baby needs it: Although relatively rare, metabolic disorders can cause mental retardation, stunted growth, and even death. But if caught early, potential health problems can be prevented and even reversed. Your baby will be screened for anywhere from three to 50 different disorders, depending on which state he's born in. At the very least, he'll be screened for phenylketonuria (a condition that makes it impossible for the body to break down certain food substances), galactosemia (an inherited, genetic condition in which the body lacks the enzyme that breaks down a certain sugar), and congenital hypothyroidism (a disease caused by an underactive thyroid gland). But the Department of Health and Human Services is considering a requirement that at least 30 tests be done by all states.
When it's done: In the first 24 to 48 hours of life.
Side effects: Usually none. Your baby may feel a slight pinch in her heel. The puncture is covered with a bandage.
What she'll get: Hepatitis B vaccine
How it's done: The vaccine is injected into the thigh.
Why your baby needs it: In the U.S., there are 1 million carriers of hepatitis B, a disease that can cause chronic liver problems -- so all babies receive the shot as a precaution. In addition, because of the mix of maternal and fetal blood during delivery, mothers with hepatitis B are likely to pass the illness along to their babies during birth.
When it's done: Babies born to hepatitis B-positive mothers receive the vaccine and antiserum -- which contains infection-fighting antibodies -- within the first 12 hours of life. Those whose mothers tested negative may receive the vaccine before being discharged from the hospital or within the first few weeks of life.
Side effects: Possible redness or swelling at the injection site.
What she'll get: Vitamin K shot
How it's done: A vitamin K injection in the thigh is given to all newborns to prevent bleeding disorders.
Why your baby needs it: Although it's rare, some infants are born with a vitamin K deficiency. That can prevent blood from properly clotting, putting these babies at risk for excessive bleeding. Rather than performing tests and waiting for results, doctors err on the side of caution and give all newborns an injection of vitamin K.
When it's done: Usually in the first 30 minutes of life.
Side effects: Generally none. As with all injections, though, there is a slight risk of infection.
In addition to the many tests your baby will get, the American Academy of Pediatrics (AAP) recommends screening all newborns for jaundice -- a common but serious condition in newborns that causes the skin and the whites of the eyes to turn a yellowish color. About 50 to 60 percent of newborns have jaundice, which occurs when bilirubin -- a natural blood-breakdown product -- builds up in your baby's bloodstream. Bilirubin is normally eliminated by the liver, so once your baby's liver is working efficiently, her yellow tint should disappear. But don't take any chances. Because high levels of bilirubin can cause deafness, cerebral palsy, or brain damage, the AAP recommends you schedule a follow-up visit with your doctor when your baby is between 3 and 5 days old -- when bilirubin levels reach their peak.
Originally published in the February 2007 issue of Parents magazine.