Babies Tale

Besides the Apgar score, which is determined right after birth, a more thorough physical examination of the baby will be done a few hours later. The newborn exam is a thorough check of all the baby’s systems. A midwife, family physician, pediatrician, or nurse practitioner may carry out this exam. You may ask that it be done in your presence, so you can learn more about your baby, from head to toe, the examiner checks such things as the fontanels ["soft spots" at the top and back of the head]; the eyes, ears, nose, mouth, and throat; the ability to suck and swallow; the size of the head; the length and weight; the breathing pattern; the size of the liver and spleen; the heart tones and sounds of the lungs; the genitals; the hip joints; the overall appearance of the baby; and the baby’s reflexes. The baby’s ability to pas urine and move his bowels is also noted. Some babies are further assessed for their actual gestational age; there is a test called the Dubowitz examination that helps determine whether your baby was born early, on time, or late.

In the hospital, babies receive identification bracelets, sometimes on both wrist and ankle, and mothers receive a matching wrist bracelet; this is to prevent mixing up of babies in the nursery. Footprints and handprints are also taken immediately after the umbilical cord is cut, a sample of blood is taken from the cord, labeled and stored, in case it is needed later for blood typing or other laboratory tests. The baby’s temperature, feeding pattern, activity levels, breathing and heart rate patterns, and urination and bowel movement patterns are observed for the next several days. If at home, the parents make these observations after being instructed by their care-giver. In the hospital, nurses usually make these observations.

Within an hour or so after birth your baby will receive vitamin K to help prevent bleeding problems. Vitamin K helps in the clotting of blood; since babies do not have vitamin k in their systems for the first few days after birth, it is considered an important preventive treatment. Vitamin K can be given by injection in the thigh or by the mouth. At present, most doctors prefer to give it by injection.

Your baby will receive a number of laboratory tests. The skin is also examined for any marks or other important signs. A sample of blood is drawn from each newborn at least once within the first few days after birth. The one test given to all newborns is a test called phenylketonuria [PKU], PKU is a inherited disorder that can be very serious if not detected very soon after birth. A baby with PKU cannot properly process protein and needs a special diet that is low in phenylalanine, the component of protein that isn’t handled well. If PKU is detected and the baby receives this special diet, she will grow up normally, If it is not detected and treated, however, PKU can cause mental retardation. Because of the seriousness of PKU, all states and Canadian provinces require that all babies be tested for it. The same blood sample is checked for another condition, congenital hypothyroidism. Some people do not make enough thyroid hormones for normal development. If this condition is discovered early, a baby can be treated and grow up without any problems.

Blood is frequently drawn from newborns for other purposes. If your baby appears to be developing jaundice [indicated by yellowing of the skin and the whites of the eyes] your doctor may draw some blood to analyze its bilirubin. Bilirubin, a yellow substance, forms when red blood cells break down; the presence of excessive amounts gives a yellow tinge to the skin. If the bilirubin reaches a certain level, your doctor may feel it is appropriate to treat the baby to lessen the jaundice. While jaundice in a newborn is rarely a serious condition, it is important to keep track of bilirubin levels in jaundiced babies and to determine the cause. The usual treatment, phototherapy, involves keeping the baby in a brightly lit bassinet except for feedings. On rare occasions, a blood transfusion is done.

Blood glucose [a form of sugar] levels are also checked in some babies-those who are very large or very small, those whose mothers have diabetes, and those with other possible problems.

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