Baby's First Day

Dr. Parang Mehta, MD.

Babies spend 280 days of life inside the womb (uterus).  It is a warm, protected environment, with nutrition, oxygen supply, and other requirements taken care of round the clock by mom.  After this pampering, coming out into the world can be a traumatic experience for baby.

Babies have to adapt to a lot of changes, all at once.  They have to start breathing, learn to feed, digest, excrete, maintain their body temperature, and learn to do without the placenta and umbilical cord, which was both a nutrient source and a way of getting rid of unwanted substances.

What Will Baby Do?

Every baby is different, and hence, unpredictable.  These are some things that are expected.

Most babies are wide awake and alert soon after birth.  They are usually quite interested in feeding also -- if put to the breast, they suck well, and drink the colostrum available.  After a short while, whether fed or not, most babies sleep for some hours.

Warmth, feeding, and sleep - a normal newborn needs little else

A baby may or may not pass urine in the first 24 hours.  Though most will, some pass their first urine on the second day, and this is considered quite normal.  However, if a baby does not pass a motion in the first 24 hours, it should prompt a search for an abnormality in the intestines.  

What Does a Baby Need?

Nutrition: This is a basic need, of course, and must be started soon after birth.  Babies are usually alert and hungry for a short period after birth.  It is best to start feeding at this time, for best results.  

Babies should be fed on demand -- when they cry.  After the first feed, babies often sleep for several hours.  After this, a feed keeps them asleep for 1-2 hours at a time.  Since breast milk is not yet available in adequate amounts, the baby may remain hungry and either not be able to sleep, or may wake at very short intervals for feeding.

Bathing: This should be avoided in the first 24 hours, especially in cold climates.  Hypothermia is a very real danger of undressing and wetting the baby.  

Umbilical Cord Care: The umbilical cord can be a way for infection to enter the baby's bloodstream.  Proper cleaning and dressing should be done to prevent it from getting infected.

Medications and Injections

Not too many drugs are needed by a normal newborn baby, and none should be given unneccesarily.  Among the drugs that are given are:

Besides these, some babies may need specific medication for any problems they may have.

Vitamin K For Babies

Many years ago, we found out that vitamin K prevented hemorrhagic disease of the newborn.  This is a disease in which the child's blood does not clot, and leads to bleeding from various places like the nose, skin, and mouth.  The most serious is bleeding in the brain (intracranial hemorrhage), which can cause seizures (fits), unconsciousness, and even death.  Though this condition is not common (about one child in 500), it was common practice to prevent it by an injection of vitamin K at birth.

Some years ago, an article was published which linked vitamin K administration at birth to childhood leukemia.  This led to a lot of doctors stopping the practice, because of fears of causing leukemia in children.

However, later studies have found vitamin K to be safe, and most professional bodies of pediatricians today recommend that it be given to all babies at birth.  

Babies Need Warmth

A baby spends nine months inside the mother's body.  No matter what the weather outside, inside the womb, things are always peaceful, and the temperature is around 36.5º C, or 98º F.

That is the temperature that babies are used to, and that's what makes them comfortable.  When we set the air conditioning to bring the room temperature down to 22º C, it is cruel to baby.  Babies often develop white or blue hands and feet, a condition called acrocyanosis, when they are cold.  Further cooling will reduce the core temperature of the body, leading to hypothermia.  Excessive cooling is dangerous for the baby, and we should keep the room temperature at warmer levels.

Last Revision: May 12, 2020