As expecting parents, chances are that you’re gearing up for your new arrival by packing a bag for the hospital, getting your home ready for your new baby and learning as much as you can about parenting a newborn.
Understandably, you may have a lot of questions! Here, Dr. Angela Dangvu, a pediatrician in CHOC’s primary care network, explains what happens right after your baby is born. She shares about newborn assessments and vaccines, and answers common questions about both.
A tiny head-to-toe exam for babies after they’re born
Moments after a baby is born, they receive their “welcome to the world” exam.
“The first thing we’re looking for is to make sure the baby is breathing fine and looks well,” says Dr. Dangvu.
While the exam is brief, it’s thorough, starting with checking the shape of the head, looking to see if there is any bruising and that the baby’s soft spot (the space between the bones of the skull where bone formation isn’t complete) is open and feels appropriate.
“Most babies are totally fine,” she explains, “but some could have difficulty breathing or aren’t transitioning from the in-utero environment to the outside world.”
Eyes, ears and mouth
After checking the infant’s head, the eyes come next.
“We check the eyes to make sure the pupils are normal, and we also look for a good light reflex to ensure the back of the eyes are normal,” says Dr. Dangvu.
After that, it’s on to an ear inspection for proper formation and then the mouth, to make sure the baby’s tongue is not tied. “A lot of what we’re doing is making sure they were formed properly in the womb,” she notes.
Heart and hip check
“The next thing is to listen to the heart for any murmurs and then the lungs, as well as the abdomen, checking for a soft feel and making sure no masses are present,” says Dr. Dangvu. “Also, examining the hips is a really important part of the process,” she adds, “to rule out dislocation.”
Your baby’s first exam may also include:
- Measuring their weight, length and head circumference.
- Taking your baby’s temperature.
- Measuring your baby’s breathing and heart rate.
- Watching skin color and your newborn’s activity.
- Giving eye drops or ointment to prevent eye infections.
What other exams can parents expect?
Parents can expect their bundle of joy to receive other tests and treatments before heading home, including:
- Hearing screening.
- Congenital heart disease screening.
- Hepatitis B vaccine and vitamin K injection.
- California newborn screening.
This will only be the first of many checkups for your baby. Choosing the right pediatrician for your family before your baby is born is important. Then, you’ll visit your pediatrician for well checkups as your baby grows. Get a checkup schedule for kids and tips for what to bring to your first appointment from CHOC.
Are vaccines necessary for babies?
Yes. Vaccines are one of the most important ways to protect infants from serious infectious diseases. Usually, a baby will have some natural immunity that they receive from their parent through their umbilical cord, but they will need to build their own immunity once they are born.
Vaccines work by stimulating the immune system to recognize and fight specific germs, such as bacteria or viruses, that can cause serious or even life-threatening illnesses.
Vaccines have been extensively tested for safety and effectiveness before being approved for use. Not only will they protect your baby from getting sick, but they will also help protect your community from illness through herd immunity.
By following the U.S. Centers for Disease Control and Prevention (CDC)’s recommended immunization schedule, parents can ensure that their babies receive vaccines at the appropriate ages to maximize protection. Get more information on vaccines from CHOC’s immunizations guide.
Apgar scores for newborn assessments
The Apgar score is a test performed on newborns shortly after birth. A doctor, midwife or nurse will check the baby’s heart rate, muscle tone and other signs to determine if they require additional medical or emergency care.
Typically, the Apgar score test is done twice: one minute after birth and again at five minutes. If there are any concerns, the baby may undergo further testing.
The Apgar score evaluates five key factors:
- Appearance (skin color): The baby’s skin color is assessed, with a score of 0 for blue or pale and 2 for a normal, healthy color.
- Pulse (heart rate): The baby’s heart rate is checked, with a score of 0 for no heartbeat and 2 for a strong, regular heartbeat.
- Grimace (reflex irritability): The baby’s response to stimulation, such as a gentle pinch, is observed. A score of 0 indicates no response, and 2 indicates a strong cry or vigorous movement.
- Activity (muscle tone): The baby’s muscle tone and activity level are assessed, with a score of 0 for limp or floppy and 2 for active movement and flexed limbs.
- Respiration (breathing): The baby’s breathing is evaluated, with a score of 0 for absent or weak breathing and 2 for strong, regular breathing.
Each of these factors is assigned a score of 0, 1, or 2, and the scores are added up to obtain the total Apgar score. The maximum Apgar score is 10, with 10 being the best possible score.
The Apgar score is a useful tool to quickly assess a baby’s immediate well-being and determine if any additional medical attention or support is needed for them. It helps healthcare providers monitor the baby’s condition and make prompt decisions regarding their care right after birth.
Frequently asked questions about newborn baby exams
Babies need a vitamin K shot soon after birth to prevent a condition called vitamin K deficiency bleeding (VKDB). This condition can cause serious bleeding, including bleeding in the brain.
When babies are born, they have low levels of vitamin K, which is important for blood clotting. The shot gives them a boost of vitamin K to help their blood clot properly and prevent bleeding problems. Even if a baby is breastfed, the shot is still recommended because breast milk has low levels of vitamin K.
The vitamin K shot is a safe and effective way to protect newborns from bleeding issues. It is a routine practice in many countries and is strongly recommended by doctors to keep babies healthy and safe.
In general, a newborn and their parents can go home between 24 to 48 hours after birth. If delivered via C-section, the parents and newborn can go home after 72 hours.
Yes. A baby may lose 10% of their body weight in the first few days of life, which they should gain back within two weeks. Your pediatrician will monitor your baby’s weight at their checkups, and will make sure they are gaining it back.
Yes. For babies born in California, state law requires a blood sample to be taken from a newborn’s heel from 12 to 48 hours after birth to check for serious, but treatable genetic disorders. Medi-Cal and most other insurance companies cover the NBS Program about 99% of the time. Parents who want their baby’s blood spot destroyed after newborn screening can contact the program and request this. Visit The California Department of Public Health for more information.
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From babies to teens, pediatricians from CHOC’s Primary Care Network partner with parents to offer immunizations, sick visits, sports physicals and more.