Some women feel they know their babies intimately by the time they give birth. After all, you've carried this little person inside you for the last nine months, feeling them kick and roll around, and you've even watched their heartbeat on a screen. But at the same time, those first hours with your new baby are a step into the unknown.
There's lots to learn about this new role, and you and your little one will be learning together. But knowing what to expect in the hours immediately after the birth will help prepare you.
What will my baby be feeling?
Birth is a shock to the system, and not just for you! For your baby, the birth has been exhausting, and they are now in an unfamiliar world.
The sense of space around them and the feeling of air on the skin is new and strange. While they were inside you, your baby's oxygen supply came through the placenta directly into the bloodstream.
The moment they emerge into the air, the change in temperature gives the lungs a signal to start working, and they will take their first gasp of air, usually accompanied by the first cry. As soon as your baby starts to breathe, the placenta stops working.
The umbilical cord, which links your baby to the placenta, needs to be cut so your newborn can begin life as a separate being from you. But it has already stopped functioning by this stage, so your baby won't notice that it has been cut. The cord has no nerves, so neither of you will be able to feel the snip.
Newborn tests and procedures
Immediately after the birth, the midwife or doctor will do the Apgar test. This is a quick and painless way of assessing your baby's wellbeing. It looks at five things: heart rate, respiration (breathing), muscle tone, skin colour and reflex response. The test is done a minute after birth and again at five minutes. Each of the five areas is given a mark between one and two, and the scores are then added together to give an overall total.
The maximum mark is 10, and babies who score between eight and 10 are fine, while those with a result of between five and seven may need a little help, such as a good rub to warm them up or a few puffs of oxygen to help their breathing. Newborns who score below five are more poorly and may need to be taken to the special care baby unit for extra help.
You'll also be asked if you're happy for your little one to be given a dose of vitamin K. In very rare cases, newborns don't have enough of this vitamin, which means their blood doesn't clot properly. So all babies are offered an injection (or, occasionally, a dose given by mouth) at birth.
Immediate bonding with your baby
The best way to bond with your baby and make them feel loved, secure and contented, is to spend lots of time touching and cuddling them.
Never be afraid that cuddling your baby too much will 'spoil' them. All creatures, particularly mammals, use physical contact to help their young get used to life outside the womb, and a young animal wouldn't thrive if it were separated from its mother in the first days of life.
Babies crave touch, and you'll notice immediately that picking your little one up calms them if they're crying or unsettled. Sometimes they'll be unhappy for no other reason than they want to be held.
They can't talk, so being physically close is the only way they can express their sociable nature.
If your baby has to be taken to a special care unit, you may not be able to enjoy as much skin-to-skin contact. But rest assured, this shouldn't affect long-term bonding, and there are other things you can do.
Feeding your newborn baby
In the first hours of your baby's life, if not immediately after the birth, you'll be encouraged to offer your baby a feed. Your midwife will ask you if you want to breast or bottle-feed.
For the first 24 hours your breasts will produce colostrum to feed your baby. Colostrum is a rich, fatty food, full of antibodies that protect your new baby. If breast-feeding, you'll be offered help to get your baby latched on. If you've chosen to bottle-feed, the hospital may provide bottles of formula milk.
Don't worry if your little one doesn't seem interested to begin with: he'll be tired from the birth and may just want to sleep. You'll have plenty of opportunity to keep trying over the next day or so. While some babies take to breast-feeding immediately, others need a bit of time and practice. It’s also important to remember that your little ones stomach is currently the size of a small marble, so they will get full easily and may need a break before trying again.
Even if you've successfully breast-fed a baby before, it can be tricky getting a floppy, tiny newborn positioned correctly, and a bit of help from a midwife or your partner can make all the difference, so don't be afraid to ask.
Midwives see breasts every day, and help thousands of women feed their babies, so they don't think twice about giving your nipple a squeeze to get some milk out or pushing and pulling your breast to get it into your baby's mouth.
This can be a bit disconcerting, but unfortunately when you feed a baby your breasts are no longer the private, hidden parts of your body they once were. They become much more functional and public, so you may as well get used to it early on!
You may be encouraged to try a bottle if your baby doesn't take to breast-feeding in the first couple of days. Remember, however, that hospitals have breast pumps and you can ask to be shown how to use one to express your own milk for your baby, so you can persevere with breast-feeding until you both get the hang of it.
Bathing your newborn baby
The nurses at the hospital should give your baby a little clean once you’ve given birth, so you don’t need to worry about giving them a proper bath usually until their umbilical cord drops off.
Once you’ve got your new-born home, you may just want to top and tail them initially. Top and tailing is when you clean around your baby’s face and neck and then around their genitals and bottom with warm water and cotton pads or a flannel. Make sure you dry your baby carefully but thoroughly and if their skin appears to be dry you may want to give them a rub with a little bit of lotion.
The 24 hour check
Within the first day or so, your baby will have a 24-hour check. If you leave hospital quickly, your GP will come to your home to do this. The test is a thorough top-to-toe check, and looks at the following:
- Weight, length and head circumference: These measurements will give you a starting point for plotting your baby's growth over the next months and years.
- Eyes, ears and mouth: The doctor will check for any obvious hearing or sight problems, and for things like cleft palate or tongue-tie (where the tissue joining the tongue to the floor of the mouth restricts movement of the tongue).
- Heart and lungs: The doctor will listen to your baby's heartbeat to check for irregularity or murmurs, and to his breathing.
- Spine: Your baby's spine will be checked for straightness, and their legs are given a wiggle to rule out clicky hips (where the hip joint is too loose and the thigh bone dislocates itself).
- Hands and feet: These will be looked over to check for webbing and talipes (club foot).
- Genitals: Baby boys will be examined to see if both testicles have descended and that the hole where wee comes out is at the end, not round the side. The doctor will also check your baby's bottom and ask if he's done a poo yet.
- Your newborn may also have a separate hearing check, using a small machine that tests how an echo is bounced off the inside of the ear.
- Within the first week, your midwife will give your baby a heel prick test, which involves taking a small amount of blood from his heel using a tiny needle. The blood will then be tested for enzyme or thyroid deficiencies and, in some areas, for cystic fibrosis.
Your midwife will visit you at home for the first 10 days after the birth, so this is the time to raise any concerns you may have about either your health or your baby's.