The Safest Start

by Karen Horsch

The Safest Start

All about the medical care your newborn should receive

For months, your obstetrician has helped keep you and your baby healthy. But once your child is born, a pediatrician or family physician will take over. Here’s how to make sure the transition goes smoothly:

Your baby receives his first physical exam in the delivery room shortly after he’s born, explains Steven Shelov, M.D., a pediatrician and chairman of the department of pediatrics at Maimonides Medical Center, in Brooklyn, NY, and coeditor of the American Academy of Pediatrics’s Caring for Your Baby and Young Child: Birth to Age 5. This exam, called an Apgar test, includes a measure of his vital signs (pulse rate, temperature, and respiration) and an assessment of his coloring, reflexes, and activity level.

During the next few hours, your child will also be measured and weighed, his footprint will be taken, and he’ll receive eye drops (to prevent infection) and a vitamin K injection (to promote blood clotting). He’ll also have his first bath, at which time his umbilical cord will be treated to prevent infection. At some point during his stay, he’ll receive a metabolic screening test, may have his hearing checked, and be given his first hepatitis B vaccination. If you choose, he may also be circumcised.

If you’ve had a vaginal birth and a full-term baby, both of you will likely stay in the hospital for about two days. This gives you time to heal and enables the medical staff to monitor your baby. If you’ve had a c-section or a preterm baby, your stay will generally be longer.

Ideally, says Dr. Shelov, you should select a pediatrician before you deliver. Most will visit mother and baby once a day during their hospital stay. Your pediatrician will make sure your baby is eating, urinating, and passing stools as expected; work with the hospital staff to address any health concerns; and help support you with newborn care. She may also handle the transfer of your newborn’s medical records to her office.

If you haven’t chosen your baby’s doctor yet, the hospital pediatric staff will monitor your child. (And if your selected physician can’t make it to the hospital, have her contact the attending pediatrician after your birth.) The hospital will give you your child’s medical paperwork to bring to your pediatrician; some may also mail or fax the records for you.

Before you leave the hospital, schedule your baby’s first office visit — usually this occurs when he’s between 2 and 4 weeks old, or earlier if there are concerns or if your pediatrician did not see him in the hospital. Leaving the hospital’s support system can be anxiety-provoking for most new parents, but you shouldn’t hesitate to call your baby’s doctor for help and advice. “Your pediatrician knows that you’re new at this,” explains Dr. Shelov, “and she expects you to call with questions or concerns.”