Newborn arrival & newborn assessment
First time motherhood is a lifetime of an experience and while many of the expecting moms are looking forward to this day, here is an experience from a first time mom. Following this we give you some very basic but essential knowhows of newborn assessment. Absolutely important for parents!
It of course is a very different experience personally, I thought it might be an interesting read to some, especially the expecting parents. For parents who have toddlers, preschooling age, school going or teenager kids, this experience may remind you of your own!
Newborn assessment-Take 1
It was an evening and we went for my due checkup with absolutely no sign of pain or contractions but obviously the 40th week huffing and puffing.
The doctor declared that she can’t wait anymore and will induce me next morning.
There I am ready with my bag and scared to death.
All those movie clips of the moms in labour haunting me.
After the regular hospital formalities, we were given a room.
I was asked to sleep for a while as they would take sometime getting me to the labour room.
I was kind of relieved for a while that I could buy some more time postponing this event.
But to my surprise a nurse entered our room , gave me the hospital clothes and asked my husband to wait outside.
While she was “preparing” me for the delivery, she asked me all about the pain and other details and kept monitoring my baby with a machine.
Then at about 3 am I was ready to go!! Not having pain seemed to be a crime for the first time ever in my life.
The doc arrived and she was a cool lady with years of experience.
Then she started inducing me and trust me it was the most horrendous and gross procedure that I ever came across so far.
She gave me some instruction, showed me the calling bell to call the nurse if I need and informed that she will be around to monitor my progress.
Even after few hours my pain was not anything near unbearable (as I had seen in the movies).
There were slight contractions but that’s it.
I knew inside that its going to be a long long day.
I was feeling impatient and weird that my pain was within my threshold…motherhood you see!!
The nurse came in without me ringing the bell and monitored something on the machine.
I could feel that she was a bit nervous.
She went in to call the doctor.
Here comes the cool lady again with a smiling face and relieving me that nothing went wrong.
I tell you, the doctors poise in such times is all you need.
She looked at the monitor and asked the nurse to call my husband.
Now I felt nervous again.
Few minutes later, the man came in.
Looking quite overwhelmed and tensed.
The doctor spoke. It looks like the baby is getting little uncomfortable inside and his heart rate is a tad bit higher than usual.
It is a sign of stress on the baby.
Both of us shocked didn’t know what to do!!
The doctor didn’t bother much though.
She said there is still some time.
Either I wait for my pain (which means dilution of the cervix) to the required extent or we could go for a c-section.
We didn’t want to wait.
It is amazing how parents can get so overwhelmed with their child’s slightest discomfort even when it is yet to be born.
So we wanted a C-section.
Secretly, I was relieved that I do not need to scream my lungs out with pain.
Newborn assessment - Take 2
Inside an OT for the first time ever in my life.
Television and movies and the internet are all amazing.
They sometimes prepare you well for rare situations.
I kind of knew what to expect.
After the initial preparation of positioning me and the instruments and a cover below my belly that didn’t allow me to see down below, the anesthetist got to her work.
One syringe on my back somewhere and started with her round of questioning.
I believed it is to see the effect of the anesthesia and to keep track.
I was completely in senses but felt half of my body just did not exist.
Newborn assessment – Take 3
“What is it, A boy or a girl?” I asked.
The doctor in the middle of the procedure merrily said I am yet to get half the baby out of your system darling.
May be a minute later she declared, It’s a boy.
Frankly, that point was just curiosity.
I was relieved figuring out that all is OK.
They showed my first born.
It was like the tinniest of humans I have ever seen so closely and his twinkling eyes looked at me with a blank look (Eyesight of a newborn).
My husband who was observing the happenings quietly, whom I had almost forgotten for a while, came and asked me to smile and took our first pic.
That was a moment to cherish and I still clearly remember this moment somehow.
That was it. I am a new born mother!!
Newborn assessment - Basic knowhow for parents
The first neonatal care of a newborn starts with holding the baby wrapping the baby. The hospital nurse will most likely be helping you with few things. Even then you should be prepared for the basics of chid care and newborn examination.
1.The newborn Hold
Hold your newborn baby in a position which holds her neck with strong support. The opposite side of your elbow or your palm is the best to hold a newborn.
For the first few weeks, I suggest do not try to hold her vertically on your shoulders. That will take few more days. It takes just a day for the mother to be used to holding her baby. The father usually gets accustomed within next couple of days.
2. The Swaddle
The newborn baby is used to the warm environment inside your womb. The outside world may initially discomfort him. Swaddle the baby tightly in a sterilized sheet without any of the body parts part from face and hands being exposed apart from face.
Take care not to over tighten also. First few days you should cover his head with a cotton cap as well depending on temperature conditions of the room. The idea is to keep the baby warm and comfortable.
3.The newborn FEED
The mother’s milk that her body makes in the first few days of giving birth known as colostrum, is the most nutritious food that a baby should get. This time the milk is thicker and yellowish.Feeding this to your baby will take her a long way. So don’t miss giving her this stuff.
Some babies don’t latch well during the first few days (I had this problem with my first born). Some newborns also have a very tiny mouth and cannot actually latch.
In such cases the mother’s expressed milk can be given with a dropper or baby spoon. You can find various breast pumps in the market.
I wouldn’t advise you to buy one before hand but in case you find that natural feeding is a problem with your baby for whatever reason, you should invest in a good pump.
There is no substitute to early days mothers milk and the newborn should no way miss this.
Mothers milk will provide immunity to your newborn for a long while, actually their entire life.
Later you may consider top feed depending on your situation and I feel feeding formulae is at least a relief to the mother in many ways, but DO NOT miss the early colostrum in any way.
Newborn assessment also should involve checking the breastfeed intake of baby.
Burping the baby is yet another activity that has to be riligiously followed after every feed irrsespective of what you are feeding. There are various reasons why you should never miss this step and also various ways how you can make baby burp.
4.The newborn SLEEP
In my experience of two kids, I realized that each newborn baby has their own sleep patterns and no one can actually tell you this before.
You will find suggestions all over with feeding the baby and putting them to sleep. Trust me, for newborns the pattern of sleep changes in no time.
I used to write down the feed and sleep time along with how long the bay sleeps. This gives you an idea and be better prepared.
This way you can also predict to an extent, how long the newborn baby sleeps and when are you expected to feed. You can also predict the change of pattern with some experience.
5. The newborn POO
Be prepared for the poop schedule of the infant….actually be prepared for endless no schedule poop first few weeks of the newborn baby. They poop out few drops at times as well.
Diaper change is going to be a day long activity first few weeks. You may try liners in cotton nappys. It worked well for me. I thought changing so many diapers a day a total waste of money, specially for a few drops at times.
Writing down the infant schedule is the best way. Practice this from the start and you are better prepared throughout the day.
5 TIPS on newborn assessment
As newborn parents, there are a few things that you should know. Though your hospital has a regular routine for checking the essential, you should have knowledge of the basics.
THE BIRTH WEIGHT
Here you can see the newborn baby weight chart,On an average the birth weight of a newborn baby is approximately around 3.5 Kg (5.5LB). Anywhere above 2.5 kg is all fine.
The genes also obviously determine the birth weight and generally speaking the baby boy weigh a little bit more than the baby girl.
The weight after about 5 days of birth ( The weight is expected to drop from birth weight) – Approximately around 4 to 5 days after birth the newborn baby will loose some weight and its completely natural. Do not fuss.
They will gain back this weight by the time they are 15 days old or so.
Loosing around 250 grams is normal.
If the baby is full term, you can expect the length (height that is) to be somewhere around 20 inches.
However anywhere between 18 inches to 22 inches is fine.
Its good to know that within the first month itself your baby will be around 2 inches longer. Amazing!
THE HEAD CIRCUMFERENCE
The head circumference of a newborn baby is between 13 inches and 14 inches at birth.
The brain of your newborn grows very rapidly during this time. As a result of this, the head circumference also increases rapidly as this time.
By the time your newborn baby is around a month old you may see the head circumference increasing to 15 inches.
During your regular visit to the doctor, they will monitor your newborn’s head circumference.
THE HEAD SHAPE
A cone shape baby head is just normal. Specially if you have given birth normally. So do not fret at the weird baby head shape.
The birth is not only painful for the mother physically, but it is very exhausting for the baby as well. It needs to push through the birth canal.
The result is very often a conical head that will get into a normal shape soon after birth.
Use a head shaper that you get easily in baby shops these days.
Just make sure it is good quality. Traditionally, many like to use the mustard seed filled head pillow for the tiny newborn. You can make this very easily at home.
It is common in newborn babies and this needs neonatal care. If you notice yellow tinge in your newborn’s skin or eyes, do go for a checkup.
Normally within a day or two is required for phototherapy that handles this problem medically. However it is always a good idea to keep the baby in mild sunlight specially the early morning sunlight.
As parents just keep in mind that your baby needs attention if jaundice occurs. As a part of newborn assessment procedure, detection of jaundice if any has to be done in the first few days after birth.
There is nothing to worry but it should not persist long.
In case a baby is born before 37 weeks, it is a premature baby. With todays medical support, this has become much easier to handle and in most cases not a cause of major issue.
For a premature baby, the care will completely depend on how much preterm the newborn is. Some issues in premature babies occur because their internal systems may not be fully ready to handle the atmosphere outside the womb.
You will be given special care by the hospital if your baby is premature.
The doctor and the paediatrician will time and again monitor the baby and instruct you.
Just go by that and you are good to go in most cases.
However I am always in favor of being informed.
Depending on your baby and how many days premature she is, its good to just read up and be well informed along with the doctors guidance.
Some very common problems that may arise in premature newborn babies are breathing troubles, trouble in digestion, prone to infections, heart issues, anemia, jaundice and many more.
But trust me all can be handled and in most cases you need not worry too much. But yes, you need to be extra cautious and observant in such cases.
TIPs for parents - Watch these closely
Infant or newborn constipation
Constipation of an infant can be worry some to parents. But it is also difficult to know when your baby has constipation. Keep in mind the fact that a newborn diet and baby food assimilation in the body is not like adults.
It is absolutely normal for your little one not to pass motions for a few days. This does not mean she is constipated. The symptoms of newborn constipation is discomfort, crying while passing motions or hard stool. Newborn assessment should address these symptoms.
Since brestmilk is mostly absorbed by the baby’s system, there is not much for the body to eliminate. She is not required to pass motions every day.
After seeing few babies I realized that each baby is different and their schedule is also very different. You need to use your parental instinct and observations to determine if the bay is actually constipated or not.
So in case she is constipated what can you do as a parent?
1. In case your baby is formulae fed, you can try a different brand
2. You can try massaging the baby’s tummy in soft circular motions. Make sure you are gentle. You can make out the pressure you can put.
3.You can check with your doctor and give her few ounces of sterilised water .
4. Do not do anything if the problem is not too much or too persistant. Check with your doctor first.
Generally you do not have a fussy baby just after birth. It takes a while before any baby turns fussy. The reason can be many.
If you find your baby crying and you can not make out why, do see a doctor. If all is fine, you need to check why she is getting fussy. Some common reason for a newborn baby’s turning fussy can be,
- Too much milk
- Too less milk
- Diaper rash
- Growth spurts
- Colic ( Home remedies for Colic)
What can you do to comfort a fussy baby?
- Carry her to another room – Change of place helps.
- Try feeding
- Try putting him tummy down on your arm and swaddle gently.
- Give a gentle massage
- Check his diaper
- Keep him without diaper for a while
- Try to find out if newborn is uncomfortable with the temperature around. Change his clothing accordingly.
- Give her a warm water bath
Throwing up is common in infants. The most common is reflux. This means that his food passage is yet to develop fully and the milk is coming backwards.
This gets better with time. If you notice that the newborn or infant is vomiting after every feed, most probably it is reflux. Make sure you burp the baby before laying him. This might take several minutes but do it.
Only if you see some of the below rare symptoms, You should immediately take the infant to see a doctor
- Repeated vomiting which is forceful
- Blood in vomit
- Greenish vomit
- Signs of dehydration
Most of the time there is no reason to worry but if you are not comfortable do check with the pediatrician.
The most important thing at this time is to remember that the mother needs as much care and love and nutrition as the newborn baby. Just think you had it hard physically for the last nine months and now this overwhelming bundle of joy has arrived that needs your undivided attention throughout the day.
The most important person for the baby is the mother. All that hormones will take time to settle itself. You might find yourself tearful at times. Do not shut yourself out from the world during these days.
Do meet friends, call them home, watch good movies, pamper yourself with a massage and most importantly share the parental responsibility with your husband. It is important that he gets trained too. This is your time to prepare your relationship for the future.
Many newborn mothers try to do it all by themselves. Then comes a time when they get physically and mentally tired. But if you have not shared your parental responsibility with the man, it might become difficult later.
Then your relationship might suffer. So please share responsibility. One of the most important thing that makes a family happy and peaceful is sharing. With the arrival of the baby , this will become absolutely essential.