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The First Hour

What to expect in the first hour of your new baby’s life.

Immediately after the birth, your doctor or midwife will check your newborn thoroughly to see that all is well. Your baby will be weighed and the Apgar Test will be carried out to determine vitality. Named after the American doctor Virginia Apgar, this test is now used worldwide to assess the health of a newborn baby as accurately as possible.
A routine Apgar examination of a baby only takes a few minutes and involves simple assessment of the following:

  • heart rate
  • breathing
  • skin colour
  • muscle tone
  • reflex response

A first test is done at one minute and is repeated five minutes later. Sometimes a third test is carried out at ten minutes. The highest score is ten and most babies usually score seven or higher. Some babies score low the first time and make up points in the second test as systems begin to function more efficiently.

Further assessment may include:

  • checking the abdomen for the positioning of the liver, stomach and intestines
  • assessing physical proportions, symmetry and any obvious oddity or floppiness
  • examining the umbilical cord
  • examining the genital area and anus
  • examining the hips and flexibility
  • checking ears, eyes, nose, lips and mouth
  • checking fontanelles, skull and head size
  • measuring head size

At the same time, a blood sample is taken from the umbilical cord artery to assess acidity (pH) levels. This indicates the level of oxygen that is being supplied to your newborn’s tissues. Blood sufficiently rich in oxygen has a pH value of more than 7.20. A lack of oxygen is considered the most dangerous complication at birth.

In Australia a single dose of vitamin K is routinely given to newborns. Vitamin K is essential to blood clotting and is naturally low in newborns. There are mixed thoughts about whether or not Vitamin K injections are necessary.

In the past, some babies have been prone to haemorrhaging around the brain and administering vitamin K has been seen to reduce this incidence. This type of bleeding could occur any time up until the 26th week of life but is most likely between the fourth and sixth weeks in a baby deficient in vitamin K. Recent studies have raised the possibility of vitamin K injections being linked adversely with childhood cancers, however, this has not been scientifically proven. Most doctors and health professionals consider this a media scare and advise administering Vitamin K to negate a possible risk of a newborn haemorrhaging. As an alternative, a series of oral doses of Vitamin K is available. If you are concerned it would be wise to discuss the issue with your doctor or health professional before your baby is born.

You

Routine checks may be made on your blood pressure, pulse and temperature. Your doctor or midwife may check that your uterus remains hard and firm, and that there is only minimal bleeding, by feeling your abdomen from time to time. You may be encouraged to go to the toilet and pass urine. It is common to pass a lot of urine immediately after birth. A full bladder will relax the uterus and may cause your uterus to start bleeding again. Unless there have been any complications, you will probably be left alone so as you and your baby can get to know one another. 

The First Feed

Most babies will need nourishing within 3-4 hours of birth. Whether you plan to breast feed or bottle feed your baby will benefit from the colostrum, the first feed produced within the breast. This thick liquid contains several essential minerals, vitamins, antibodies and is especially rich in zinc. Antibodies are complex protein substances that help protect your baby against infection in the first few weeks of life.

Breastfeeding is the easiest way for your baby to get the colostrum. If this isn’t possible, you can gently express the colostrum and bottle feed.
Some babies suck strongly immediately though others have to be coaxed.

Newborn Reflexes

Babies are born with reflexes to enable them to adjust to life outside the uterus. Breathing, sucking and swallowing are the most important newborn reflexes.

Others Include:

Rooting

The baby opens its mouth and turns its head, “rooting” for the nipple.

Startle Reflex

Also called the “Moro” reflex, the baby may throw up its arms and tremble.

Hand Gripping

Babies are born with a strong grasping reflex.

Stepping

If you support a newborn in a standing position, it will make stepping movements.

About to crawl

When you place a newborn on its tummy, it will assume what appears to be a crawling position.




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