Straight after the birth
There’s a huge amount to get used to in the first few days with your baby. There is the excitement of getting to know your baby, but you will also be tired and your body will be recovering from labour and the birth. It’s a very emotional time for you and there is lots to learn and do.
When your baby is born, they will have a quick physical examination to check there are no major problems that need urgent treatment. Within 72 hours (three days) of birth, another more detailed examination will be carried out.
This includes screening of your baby’s heart, hips and eyes (and testes in boys), plus a general physical examination. The test can be carried out by a baby specialist or specially trained midwife. It doesn’t have to be done before you leave hospital.
Your baby will also have some routine health checks and care.
We all need vitamin K to make our blood clot properly so that we will not bleed too easily. Some newborn babies have too little vitamin K, which can result in a rare bleeding disorder called haemorrhagic disease of the newborn that can cause dangerous bleeding into the brain. Your baby should be offered an injection of vitamin K to prevent this. If you prefer that your baby doesn’t have an injection, oral doses of vitamin K are available.
Newborn hearing screening
A small number of babies are born with hearing loss. Your baby will be given a quick and simple test to check their hearing. Identifying hearing loss early means that babies and parents can get the support they need and help the development of the child’s language and social skills. Find out more about the NHS Newborn Hearing Screening Programme.
Newborn blood spot screening (heel prick test)
When your baby is between five and eight days old, your midwife will ask to take a sample of blood from their heel. This is used to test for rare but potentially serious illnesses. All babies are tested for the metabolic disorder phenylketonuria (PKU), cystic fibrosis, sickle cell disorders, and congenital hypothyroidism, a thyroid hormone deficiency. Some babies are also tested for medium-chain acyl-CoA dehydrogenase deficiency (MCADD), an inherited problem with metabolism. Find out more about the NHS Newborn Blood Spot Screening Programme.
Hepatitis B and C
Some people carry the hepatitis B virus in their blood without having any symptoms. If a pregnant woman has hepatitis B she can pass it on to her baby. The baby may not be ill, but has a high chance of becoming a carrier and developing liver disease later in life.
All babies born to mothers infected with hepatitis B should receive a course of immunisation to prevent them getting hepatitis B. If you have hepatitis B, your baby will be offered immunisation shortly after birth and at one, two and 12 months old. Your baby should be tested at 12 months to check that immunisation has worked. Find out more about hepatitis B immunisation.
If you are infected with hepatitis C, when your baby is born there is a small risk that you could pass on the infection. Your baby will be tested at an appropriate time.
Find out about looking after your baby as he or she grows up, including screening tests available.
Getting to know your baby
You will probably spend a large part of the first few days looking at your baby. You’ll notice every detail – the colour and texture of their hair, the shape of their hands and feet, and the different expressions on their face.
If you notice anything that worries you, however small, ask your midwife. Your baby will be examined by a midwife, paediatrician or neonatal nurse practitioner to make sure everything is all right.
Umbilical cord care
Shortly after birth, the midwife will clamp the umbilical cord close to your baby’s belly button (navel) with a plastic clip. They then cut the cord, leaving a small bit of it with the clamp attached. The cord will take about a week to dry out and drop off. Keep the baby’s navel clean and dry until this happens. If you notice any bleeding or discharge from the navel, tell your midwife, health visitor or doctor.
On the top of your baby’s head near the front is a diamond-shaped patch where the skull bones haven’t fused together yet. This is called the fontanelle. It will probably be a year or more before the bones close over. You may notice the fontanelle moving as your baby breathes. You shouldn’t worry about touching or washing it because there’s a tough layer of membrane under the skin.
Bumps and bruises
It’s common for a newborn baby to have some swelling and bruises on the head, and perhaps to have bloodshot eyes. This is just the result of the squeezing and pushing during birth and will soon disappear. But if you’re worried, you can ask your midwife about it.
Birthmarks and spots
Once you begin to look closely at your baby, you’ll probably find little marks and spots, mainly on the head and face. Sometimes there will be larger marks. Most of these birthmarks will go away eventually. Ask the doctor who examines your baby if they will disappear completely.
Most common are the little pink or red marks that some people call stork marks. These V-shaped marks on the forehead and upper eyelids gradually fade, though it may be some months before they disappear. Marks on the nape of the neck can last for much longer, but they will be covered by hair.
Strawberry marks are quite common. They’re dark red and slightly raised. They sometimes appear a few days after birth and gradually get bigger. They may take a while to go away, but normally they eventually disappear. Spots and rashes are very common in newborn babies, and may come and go. But if you also notice a change in your baby’s behaviour – for example, if your baby isn’t feeding properly or is very sleepy or very irritable – tell your doctor or midwife immediately.
Your baby’s skin
At birth, the top layer of your baby’s skin is very thin and easily damaged. Over the first month (or longer in premature babies), your baby’s skin matures and develops its own natural protective barrier. Vernix (the white sticky substance that covers your baby’s skin in the womb) should always be left to absorb naturally. This is a natural moisturiser and it protects against infection in the first few days.
Premature babies’ skin is even more delicate. Staff in the neonatal unit will advise you on skincare. Find out more about care for babies who need special care.
If your baby is overdue, their skin may be dry and cracked. This is because all the protective vernix has been absorbed. Do not use any creams or lotions as they may do more harm than good. The top layer of your baby’s skin will peel off over the next few days, leaving perfect skin underneath. Wash your baby with plain water only for at least the first month.
Breasts and genitals
Quite often, a newborn baby’s breasts are a little swollen and ooze some milk, whether the baby is a boy or a girl. The genitals of male and female newborn babies often appear swollen, but will look in proportion to their bodies in a few weeks. Baby girls also sometimes bleed a bit or have a white, cloudy discharge from the vagina. All this is caused by hormones passing from the mother to the baby before birth. It is no cause for concern.
When they’re about three days old, many babies develop mild jaundice. This will make their skin and the whites of their eyes look a bit yellow. This usually fades within 10 days or so, but more severe jaundice may need treatment. Find out about treatment for newborn jaundice.
What a newborn baby can do
Babies are born knowing how to suck. During the first few days they learn to co-ordinate their sucking with their breathing. Newborn babies also automatically turn towards a nipple or teat if it’s brushed against their cheek, and they’ll open their mouths if their upper lip is stroked. Find out about breastfeeding.
They can also grasp things (such as your finger) with hands and feet, and they’ll make stepping movements if they’re held upright on a flat surface. All these automatic responses, except sucking, disappear within a few months, and your baby will begin to make more controlled movements instead.
Newborn babies can use all their senses. They look at people and objects, especially if they’re near, and particularly at people’s faces. They enjoy gentle touch and the sound of a soothing voice, and they react to bright light and noise. They also know their mother’s unique smell quite soon after birth.