Newborn Routine Practices and Tests

The moment your baby is born can be one of life’s most amazing moments. It can be both magical and stressful at the same time. What happens straight after birth will depend on your labour, how your baby is born, and how quickly your baby adapts to life outside the womb.

Most babies breathe and cry within a few seconds of being born. If it’s clear that your baby is breathing well, baby will be placed naked, skin-to-skin, on your chest or belly straight after birth. Skin-to-skin contact keeps your baby warm, helps to steady your baby’s breathing and heart rate, and lets you and baby bond physically straight away. It’s also a trigger for an early and strong start to breastfeeding. The umbilical cord is clamped and cut. You will have the chance to spend some quiet moments with your baby, cuddling and getting to know each other and spend quiet time together as a family.

Health assessments and procedures

A brief, physical exam is done to check for obvious signs that the baby is healthy and other health assessments of the new baby start right away.

The Apgar Scoring Test is one of the first checks completed. The Apgar test is a scoring measure of how well your baby has made the transition from life inside the womb to life outside. A score of 0, 1 or 2 is given for each of these five criteria: your baby’s heart rate, breathing, muscle tone, response to stimuli and skin colour. A score of 7 to 10 is considered normal. A score of 4 to 6 may mean that the baby needs some help and careful monitoring. A score of 3 or below means that the baby needs rescue breathing and lifesaving techniques.

If baby is having difficulty breathing, suctioning of a baby’s nose and/or mouth may be necessary to clear the baby’s airways to help them to breathe

Other procedures will be done over the next few minutes and hours. These may be done in the delivery room, in the nursery, or in your room, depending on the hospital policy and the condition of the baby.

Some of these procedures include:

• Before a baby leaves the delivery room, identification bands are attached to your baby’s wrist and ankle. You will receive a matching arm band.
• A newborn exam and head to toe physical assessment is completed. This will include a measurement of temperature, heart rate, respiratory rate, weight, length, and head circumference. These measurements help find out if a baby’s weight and measurements are normal for the number of weeks of pregnancy. Small or underweight babies and very large babies may need special attention and care.
• Bacteria in the birth canal can infect a baby’s eyes. Your baby will be given antibiotic or antiseptic eye drops or ointment either right after delivery or later in the nursery to prevent eye infection.
• All newborns are born with a low level of vitamin K, which is responsible for preventing bleeding by enhancing the blood’s clotting ability. A vitamin K Injection is given to prevent the possibility of bleeding.
• Bathing baby can take place when baby is more than 24 hours old and has a stabilized temperature. Delaying the bath until after 24 hours has many benefits for baby such as bonding, reduced infections, stabilization of blood sugar and improved temperature control.
• Newborn Screening Test, sometimes called PKU Screening, is a blood test to screen for rare but treatable conditions. Screening babies at birth allows for early identification, care and management of these conditions, and if treated early, can prevent more severe health problems. The test is usually done about 24 hours after birth, or before hospital discharge. For this test, your baby’s heel is pricked to get a small amount of blood,  which is spotted onto a card. The lab then tests your baby’s blood spot card. Your medical practitioner will inform you if any of these tests require further follow-up.
• Before leaving the hospital, universal newborn hearing screening is performed to a check a baby’s hearing. Soft sounds are directed into your baby’s ears while a computer measures the ears’ reactions. The test is safe and doesn’t hurt your baby.
• Umbilical cord care is initiated from the time that the cord is clamped following delivery and ongoing until the cord is ready to fall off.

Services related to this information:

• Contact your public health nurse
• 811 HealthLine (Newfoundland & Labrador) – Call 811 or 1-888-709-2929 / TTY 1-888-709-3555