Overview of your newborn’s first 24 hours after birth
Congrats! You just gave birth to your new baby and are probably wondering what to expect in your newborn’s first 24 hours after birth. While you will spend those 24 hours recovering from giving birth, your baby will have several tests and procedures done. The two of you will also have a lot of time to bond. You will learn how to feed your baby, swaddle your baby and change your baby’s diaper.
If you have a hospital birth, you will likely stay in the hospital for 24-48 hours, depending on if you had a vaginal birth or a c-section.
The appearance of a newborn baby
Skin color
When your baby is first born, their skin will likely be a dark purple or red color. As they start to breathe in air, the skin will turn more red. This redness will fade within a few hours to a few days and your baby’s pigmentation will begin to show.
Your baby’s extremities may appear to be blueish in color. This is normal for hands and feet due to the underdeveloped circulatory system. However, if your baby’s skin is blue in any other part of their body, they should be checked by a doctor.
If your baby has yellow coloring of the skin and eyes, they may have newborn jaundice. This is a common occurrence that happens when there is an abundance of bilirubin in the newborn’s blood. In older babies and adults, the liver will remove excess bilirubin; however, a newborn’s liver may not be mature enough to effectively remove it. Jaundice will usually go away as the baby starts to eat and as the liver matures. Your doctor should monitor any jaundice to ensure there are no underlying issues.
Lanugo
You may be surprised to see that your baby is covered in soft, thin hairs all over their body. This is the lanugo that developed when your baby was in the womb. It protected their skin from the amniotic fluid by binding to vernix. The more premature your baby is born, the more lanugo they will have. Not to worry, though, these hairs will fall out within the next few days.
Vernix
Vernix caseosa is a creamy, white substance that covers your baby’s body in the uterus. It protects your baby’s skin from amniotic fluids, keeps skin moisturized, and helps to regulate body temperature. Once your baby is born, they are likely to still be covered in vernix. It is recommended to keep the vernix on your baby, and delay bathtime, for a minimum of 6 hours, and ideally up to 24 hours. Leaving the vernix on your baby has health benefits, such as temperature regulation, proving immune support, and keeping skin moisturized.
Cone shaped head
The most shocking thing that you may notice about your baby after birth is the shape of their head. If you gave birth vaginally, your baby will likely have a cone-shaped, or elonged head shape. This is due to being pushed out of the vaginal canal. The bones in your baby’s head are soft and malleable. They are able to overlap each other. This is how your baby is able to fit through the vaginal canal. Therefore, during birth, these bones overlap and get bent out of shape. This is why your baby may seem to have an odd-shaped head after delivery. Not to worry, though, the bones will move back into position and your baby’s head will be in a normal shape soon.
Swollen genitals
Both male and female babies may be born with swollen and red genitals and breast tissue. This is caused by an increase in hormones in the mother’s body that are passed from her into the baby. Once your baby is able to regulate those hormones and levels decrease, the genital swelling will go down.
Skin-to-skin
Your newborn’s first 24 hours should be filled with as much skin-to-skin time as possible. Since you likely will be stuck in a hospital with no other responsibilities during this time, there will be ample opportunity for this beneficial bonding time with your baby.
Ideally, your baby will be placed directly on your chest immediately after birth. However, sometimes this will be delayed if the baby needs specialized care or you give birth via c-section.
Having your naked baby on your bare chest has many benefits for both parents and the baby. It helps the two of you bond and it promotes breastfeeding. Being skin-to-skin will also help your baby to regulate their body temperature and their breathing.
Feeding in a newborn’s first 24 hours
Breastfeeding
If you choose to breastfeed, you will be encouraged to attempt feeding as soon as possible, usually within the first hour after birth. The nurses at the hospital will be able to help you with positioning and getting your baby to latch. Make sure to take advantage of this time and get all the help you need to be able to effectively feed your baby.
The first milk you produce is called colostrum, which your baby will be drinking for the first few days of their life. It is usually yellow in color and thicker than typical breastmilk. Colostrum is nutrient dense and high in antibiotics which will help your newborn get the nutrition and immune support they need.
Since your newborn’s digestive tract is still under development and they have a small stomach, you will have to feed your baby every couple of hours. Breastmilk is also easily digested, which makes your newborn hungry more often. Frequent feeding will also help your body produce more milk, as it will have to keep up with the high demand. Expect to feed your baby 8-12 times during the first 24 hours after birth, and continue to feed that much for at least the first month of life.
Formula feeding
If you decide to formula feed your newborn, make sure to let the hospital staff know. They should bring you some pre-mixed formula and sterile bottles and nipples. Most hospitals will provide these things during your stay after birth, but be sure to check with your healthcare provider prior to giving birth to ensure there will be food for your newborn.
There are several different forms of formula to choose from – powdered, pre-mixed, or concentrated liquid. The pre-mixed and concentrated liquid forms are considered sterile and the best choice for the first month of a baby’s life. You should consult with your doctor or pediatrician about the best brand and form of formula to feed your newborn.
Your newborn’s stomach is very small; therefore, it will take only a small amount of formula to fill it up. Start by only offering your newborn 1-2 ounces of formula at a time, every 2-3 hours. Most newborns will feed 8-12 times each day. You will likely have to wake your baby for feedings to ensure they are getting enough nutrition.
How much will a newborn sleep in the first 24 hours?
You may be surprised to learn that your baby will sleep for 18-20 hours of their first 24 hours of life. However, do not expect your little one to sleep for more than 2-3 hours in one stretch. Since your baby’s stomach is so small, they will need to be fed often. After the long process of being born, it is likely that your newborn will be awake and alert after birth, but will fall asleep soon after. Being born is a lot of work, so your little one will need lots of rest (along with you!) to recover. In fact, they may be so tired for the first few days that you will have to wake them and attempt to keep them awake in order to feed them.
Tests and procedures performed in a newborn’s first 24 hours after birth
Weight, length & head circumference
After your baby’s birth, they will have their weight, length, and head circumference measured. These measurements will allow you and your doctor to know how big your baby is compared to the national average. It will also be used to track your baby’s growth throughout the first years of their life.
Apgar test
The Apgar test is a simple and quick test done by your doctor, midwife, or nurse 1 and 5 minutes after your newborn’s birth. It measures your baby’s skin color, heart rate, muscle tone, reflexes, and breathing. Each category is given a score from 0-2, with a maximum total score being 10. The higher the score, the better your baby is adjusting to life outside the womb. Low Apgar scores will not indicate the health of your baby. It is only used to determine how your newborn is adjusting to their first few moments of life. Usually, low scores will mean that your baby’s airway needs to be cleared or oxygen needs to be given.
Vitamin K shot
Your baby will receive a vitamin K shot within their first six hours of life. Babies are born with low levels of this vital vitamin, which is why this shot is recommended for every newborn. Vitamin K helps your baby’s blood to clot and prevents bleeding in your baby’s brain.
Eye ointment
An antibiotic eye ointment is given to newborn babies within the first hour of their life. It is given by placing a small amount of ointment into your baby’s lower eyelid. The ointment will protect your baby from any infections that may have been passed along through the eyes during birth.
Newborn screening
The newborn screening test screening for 24 rare conditions, such as metabolic disorders, endocrine disorders, blood disorders, and cystic fibrosis. It is a blood test that is typically done 24 hours after your baby’s birth, or before being discharged from the hospital. To complete this test, your newborn’s heel will be pricked and a small amount of blood will be collected on a card and sent to a lab for testing. The lab will test the blood for all 24 conditions at the same time. These conditions are treatable, however, this early screening will help to identify and manage these disorders and may prevent more serious health conditions in the future. If your baby’s screening results are positive, it does not mean your baby will have any of these disorders but will need more testing to be sure.
Hearing screening
Your baby may have their hearing checked before they leave the hospital. If you leave early, it can be done at a local clinic. If you do not get your newborn’s hearing checked after birth, there are no obvious signs to indicate hearing loss at such an early age. In order to perform this test, soft music and sound will be played into your baby’s ear, while a computer measures the reaction from the ears.
Critical congenital heart defect screening
To ensure your baby was not born with major heart problems that may have been missed in pregnancy, a simple test is done to check for low levels of oxygen in your baby’s blood. Low levels of oxygen in the blood can be a sign of critical congenital heart defects. A device will be placed on your baby’s hand that will measure blood levels. This test will then be repeated on your baby’s foot. The numbers recorded from each test will be compared; if they are more than 3% of each other, more tests will have to be done.
Post-partum care
Bleeding
Whether you have a vaginal birth or a c-section, you should expect to have period-like bleeding for up to 6 weeks. Now that you have given birth, your body must rid itself of the excess blood, mucus, and tissues that have accumulated over the last nine months. Bleeding will be its heaviest right after birth and last for 3-10 days. After that, bleeding will transition to lighter bleeding or spotting, which will last for the next 4-6 weeks. Bleeding may stop for a few days and return. Do not use tampons during this time. Contact your doctor if you experience very heavy bleeding or the passing of large clots.
Bowel movement
The thought of having your first bowel movement after giving birth may seem terrifying. You may think that you may injure yourself more down there, pop a stitch out or you may be constipated, leading to a painful bowel passage. So when should you expect this first poop after birth to happen? Every woman and every labor is different. You may find that you poop that same day, however, for some women, it may be 3-5 days later.
If you want your first poop to go well, talk to your doctor about stool softeners and how to increase your fiber intake. Plus, make sure you are drinking plenty of water, especially if you decide to breastfeed. However, the most important thing you can do is to listen to your body. Go when you need to go, and if you can’t get anything out, don’t force it.
Emotions
If you thought your emotions were all over the place during pregnancy, just wait until after giving birth. It is normal during those first few days to find yourself crying for the smallest reasons, and sometimes no reasons at all. There are a lot of changes happening both inside your body and outside. You are adjusting to the role of motherhood. You are also learning how to care for a tiny human and you may feel lost and overwhelmed most days. Hormonal changes will also play with your emotions.
While these feelings of sadness and overwhelmedness may be normal, if they persist or worsen, you should consult with your doctor regarding postpartum depression. Postpartum depression can affect up to 1 in 5 women after giving birth. If you experience feelings of not loving or not wanting to care for your child, seek help as soon as possible. There is help out there for you and you can overcome these feelings.
