The first few days of a newborn's life are filled with blue (or pink) balloons, bubblegum cigars, visits from family and friends, and heated debates about whose nose he has. But more important, those first days are critical to mom's and baby's short-term and long-term health, requiring a variety of tests, screenings and checkups, not to mention a few prods, pokes and (possibly) snips. In the post-delivery haze, everything can be a bit confusing. So here's a quick breakdown of what's to come.
The First Hour
Shortly after baby makes his debut, he'll have to take his first exam, usually in the delivery room, explains pediatrician Steven Shelov, M.D., associate chief of staff at Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, and editor-in-chief of the American Academy of Pediatrics' Caring for Your Baby and Young Child: Birth to Age 5. Called an Apgar test, it evaluates newborns at one minute and five minutes after birth in five distinct areas: heart rate, breathing, reflex response, skin coloration and muscle tone. Each test is given a score between zero and two, and then the five numbers are added together. If baby's score is a seven or more, he's in good shape. Scores below that could indicate respiratory or heart issues, and doctors will give your baby extra medical attention.
The Rest of Day One
During the next few hours, your little busybody will have quite the schedule. She will be measured and weighed, and her footprint will be taken. (Ask for a copy as a keepsake.) She will also receive eye drops (to prevent infection) and a vitamin K injection (to promote blood clotting). She'll also enjoy her first spa bath--OK, maybe not a spa bath, but her umbilical cord will be treated to prevent infection. Let's not forget the metabolic screening test and her first hepatitis B vaccination.
If you have a boy, you'll need to decide whether to have him circumcised. It's a good idea to decide this before his arrival, so you're not debating the topic amid your post-delivery exhaustion and elation.
The Next Few Days
The length of your stay depends on how you delivered. If you had a vaginal birth and a full-term baby, both of you will likely stay in the hospital for two days. If you had a C-section, expect to stay in the hospital for about four days. A premature delivery, which occurs in about 13 percent of pregnancies in the U.S. and a majority of multiple births, means your stay will be even longer.
Hearing tests have become common practice in most hospitals. While only two to three of every 1,000 babies are born with some degree of hearing loss, the AAP recommends all babies receive newborn hearing screening before they go home because early intervention gives baby the best chance for normal language development. In most states, screenings are mandated by law. Visit asha.org, the website of the American Speech-Language-Hearing Association, to see if your state is on the list. If not, the website offers information about testing centers and audiologists near you.
Most pediatricians visit both mom and baby once a day during their hospital stay. These are usually quick visits where the doc makes sure baby is eating and otherwise behaving as expected. If you haven't chosen your baby's doctor yet, the hospital pediatric staff will monitor your child.
The Next Couple of Weeks
For months, your obstetrician kept healthy tabs on your pregnancy, but when baby greets the world, the pediatrician takes over. Before you leave the hospital, schedule your baby's first doctor's visit--the AAP advises that every infant be evaluated within 48 to 72 hours after discharge to follow up on feeding and jaundice. Monthly well visits will follow. Leaving the hospital's support system can be anxiety-provoking, but that's what the doc is there for--to answer your questions, however random you think they sound. "Your pediatrician knows that you're new at this," explains Dr. Shelov, "and she expects you to call with questions or concerns."