Your baby’s first 24 hours: What to expect once you give birth

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  • You've waited for this moment for months and now you're a mum! So what do the next few hours and days hold for you?

    Some women feel they know their babies intimately straightaway after 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 after birth with your new baby are a step into the unknown.

    There’s lots to learn after birth about this new role, and over the next few weeks you and your little one will be learning together. But knowing what to expect in the hours immediately after birth will help prepare you.

    Everything you need to know about after birth

    What will my baby be feeling?

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    Labour and 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 after birth 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 after birth, 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.

    Apgar score

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    Immediately after birth, the midwife or doctor will do a test to find out your baby’s Apgar score. 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.

    Establishing a baby bond

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    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.

    Newborn feeding

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    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 breastfeed 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 breastfeeding, you’ll be offered help to get your baby latched on. If you’re going 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: they’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 breastfeeding immediately, others need a bit of time and practice. It’s also important to remember that your baby’s 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 breastfed 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 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 breastfeeding in the first couple of days. Hospitals have breast pumps and you can ask to be shown how to use one to express your own milk for your baby and persevere with breastfeeding if you wish to.

    Bathing a newborn

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    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 newborn 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, being careful to dry in between any folds of skin. You should avoid using soaps or lotions on your baby’s skin until they are at least a month old.

    The 24-hour check

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    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.

    Over to you!

    After such a busy beginning, your baby can really start to enjoy settling in to his new world. It’s also the perfect time for you to spend time bonding and getting to know your child. Enjoy…