Great Expectations


Great Expectations

Great Expectations

Know what to expect on that very special first day with baby at the hospital!

For nine months you’ve dreamed about and planned for your baby’s arrival. The nursery is furnished and filled with all of the anticipated necessities. Your bag is packed for your stay at the hospital. Perhaps you are feeling nervous or anxious. Or perhaps your thoughts are filled with visions of idyllic, post-natal bliss. Either way, do you really know what to expect during the first 24 hours after baby is born?

Planned Parenthood

Maybe you’ve written or discussed a birth plan with your obstetrician. Birth plans list your ideas regarding the delivery, the care of your newborn during your hospital stay and how you’d like possible unexpected events to be handled. Many people have the misconception that birth plans are a sort of law that the doctors and hospital staff have to follow. However, it is important to be aware that a birth plan is really just a guideline, a list of your preferences.  Each labor is unique and follows its own path, which requires flexibility. The course of labor can never be predicted. Remember this if you are faced with sudden changes, and don’t become too disappointed if your labor doesn’t follow the scenario you’ve laid out in your head.

Aside from the details of how you would like your labor and delivery handled (for example pain medication or natural childbirth, episiotomy, your mobility during labor, etc.), birth plans also address many issues regarding the care and treatment your baby receives. Subjects such as where you’d like your baby to sleep, the administration of glucose, bottle feeding, circumcision and even ear piercing can all be addressed in a birth plan and should be discussed with your obstetrician prior to delivery.

However, do not rely on previous conversations with your doctor to be remembered and communicated sufficiently to the nursing staff. And do not assume you or your husband will be able to communicate your wishes after the delivery. You may have an unexpected event during labor that prevents this. There are steps you can take to assure that your wishes are respected. If you want your baby to be under your supervision, you can arrange to have him sleep in the room with you. This allows you (and your husband) to be present whenever a nurse checks on your baby and also allows you to feed your baby at all hours. But, if your baby is not sleeping with you in your room, you can write down your wishes and attach them to baby’s cot. For example, attach a sign reading, “No Pacifier,” “No Bottle-Feeding,” “No Glucose Feeding,” or “No Ear Piercing.” This way, whenever the busy nurses attend to your newborn they will have a visual reminder of your instructions.

Swept Away

Right after your baby is born, his mouth and nose will be suctioned so that he can breathe easier. Then, an Apgar score is given to assess your baby’s health at one minute and again at five minutes. This routine test measures a baby’s responsiveness and vital signs. The five factors checked are: heart rate, breathing, muscle tone, reflexes, and skin color. The baby is then given a score of zero to two in each category, and the resulting five numbers are added together. This total is called the Apgar score. This quick and easy test is given mainly to see if the baby needs help breathing. A score of 7 to 10 is generally considered normal, and if your baby receives this score, no special actions usually need to be taken. A lower score means some extra measures, such as giving the baby oxygen, may be needed initially. Your newborn will go through a few other quick procedures. The procedures will likely include:

• Measuring weight,  head circumference, and length.

• Giving eye drops to prevent infection.

Procedures after that vary from one hospital to another, but it is likely that after your baby has been dried off and wrapped in a blanket, you will be allowed to hold him for immediate bonding. You may even get to breastfeed. After the bonding period, the baby is usually taken to the nursery for more tests and further evaluation. You will be taken to your room so that you can rest and recover from the delivery. If you’ve had a C-section, the nurses will take your newborn to the nursery for the remaining tests while the doctors close your incision.

While you are resting, the baby will be given a bath and a measured dose of vitamin K to help his blood clot properly. Your baby may receive a dose of hepatitis vaccine, according to the doctor’s recommendations. Other tests vary from one hospital to another. If you have a baby boy, you will be asked whether you want your son to be circumcised before you leave the hospital.

Got Milk? If you’ll be bottle feeding your baby, you can usually begin within the first few hours of life. If you will be breastfeeding (and you had a normal labor and delivery), you can begin as soon as your baby is born. Babies are often alert and interested in breastfeeding during the first hour after they’re born. A nurse can help you so the baby latches on properly and can get some colostrum. Colostrum is a watery liquid made in the breasts during the first few days after birth. It provides protection for your baby against infection. Your baby’s sucking triggers the release of hormones that tell your body it’s time to produce milk. Initially, you will probably be feeding your baby about every two to three hours around the clock. Discuss with the hospital staff whether they administer glucose (sugar) to babies. If this is fine with you and you are worried about nipple confusion, you can ask that they do it with a syringe or spoon instead of a bottle. If you don’t want your baby to have glucose, make sure that you inform the staff and nurses. Breast milk is in fact the best nourishment for a baby and the only food a newborn needs.

The Parental Bond Bonding is the intense emotional attachment that develops between you and your baby, and is one of the most enjoyable parts of becoming a parent. Most babies are ready to bond immediately. However, every parent reacts differently. Many parents may have mixed feelings. Having a baby is a major, life-changing experience. While many parents feel a deep connection within the first minutes or days after their baby’s birth, for others it may take a bit longer. Remember, bonding is a complex and personal process, not something that takes place within minutes and not something that is achieved in a determined time frame.

You may have difficulty bonding with your newborn because you are exhausted and in pain following a prolonged or difficult delivery. Hormones can also significantly affect the bonding process. However, if you feel that you’re having some trouble bonding by the time you take your baby to his first doctor’s visit, you might want to discuss it with him. It may indicate that you are suffering from postpartum depression, and the sooner a problem is identified, the better for you and your baby.

Beginning while you are still in the hospital, there are some things you can do to encourage and strengthen the bonding process. Cradle, caress and rock your baby. Babies respond to skin-to-skin contact. Make eye contact with your baby. Although their vision is blurry, babies can see you, and anything up to about two feet away. Speak, sing, and coo to your newborn because babies prefer human voices and respond to their mother’s and father’s voices, even in the uterus.

Congratulations on the newest member of your family! Now that you know what to expect, relax and take the time to enjoy that first day with your baby and all of the unique experiences it brings.