Normal care after birth

• Immediately after birth:

  • Skin to skin
  • Clamp the umbilical cord
  • Dry baby
  • Keep warm with hat and blankets
  • Vitamin K
  • Label baby
  • Measure weight and length
• Vitamin K:

  • Babies are born with a deficiency of vitamin K - important part of normal clotting
  • Babies given IM of vitamin K shortly after birth - has helpful side effect of stimulating baby to cry, helping to expand the lungs
  • Helps to prevent bleeding - intracranial, umbilical stump and GI bleeding
  • Can be given orally but this takes longer to act and requires doses at birth, 7 days and 6 weeks
• Out of the delivery room:

  • Initiate breast feeding/bottle feeding as soon as the baby is alert enough (may be less alert if mother had opioids during birth)
  • First bath delayed until baby is warm and stable - can wait days without issues
  • Newborn examination within 72 hours
  • Blood spot test
  • Newborn hearing test
• Blood spot screening:

  • Screening test for 9 congenital conditions - taken on day 5 (8 at latest)
  • Heel prick - need 4 separate drops of blood
  • Sickle cell disease
  • Cystic fibrosis
  • Congenital hypothyroidism
  • Phenylketonuria
  • Medium-chain acyl-CoA dehydrogenase deficiency
  • Maple syrup urine disease
  • Isovaleric acidaemia
  • Glutaric aciduria type 1
  • Homocystin
  • Results take 6-8 weeks
• Community midwife appointments:

  • Day after returning home - first visit - postnatal health check, feeding assessment
  • Day 2-3 - call to support with feeding and ask about jaundice
  • Day 5 - visit or clinic appointment - postnatal checks, baby weighed, blood spot screening
  • Discharge from day 10 onwards - if baby has regained weight - care usually transferred to health visitor
• Midwife checks:

  • Jaundice - checked with transcutaneous bilirubinometer - if raised blood test will be done
  • Infection of the umbilical cord or eyes
  • Oral thrush
  • Hearing screening test before 5 weeks