PART 1: PREGNANCY, CHILDBIRTH AND THE NEWBORN
MANAGEMENT OF THE NEWBORN IN HOSPITAL
At last, the long awaited moment arrives. The doctor announces your baby’s birth.
The doctor or a paediatrician has a quick look at the
baby and places her near your breast. The baby now has direct skin-to-skin contact with your body. The nurse covers
both of you to avoid a chill. The little one opens her eyes, manages to turn her head to one side and seems to be searching for
your nipple. As the doctor attends to you, your baby succeeds
in getting hold of the nipple and starts suckling...
A New Experience
This is an ideal situation and it may be yours —
especially in a baby-friendly hospital. In such a hospital, as soon as you
deliver, your doctor will probably dim the lights in the
room and make sure that the atmosphere is quiet and peaceful. Attendants may avoid any unnecessary talk and noise,
trying to create, as far as possible, the same sort of environment that your newborn had inside your womb. There may be an
instant bonding between your new daughter and you; you may start talking to her.
But be prepared for surprises; no two babies or mothers are alike. You may not even feel excited when you see
your child for the first time, or you may find her
blood-stained face and wrinkled body disconcerting to look at.
It is also possible that you may feel exhausted or
sleepy. Don’t feel guilty if you do. Just go with your body. Remember,
it is your right to smile, cry, burst out with joy or
just go to sleep.
If you were motivated through your pregnancy and if your doctor managed to avoid giving you pain-relieving drugs
or sedatives through labour, it is very likely that you and
your baby will meet each other as if you have been waiting
for this moment for ages.
The baby is wide awake for about 40 minutes after delivery. This is the time to put your arms around her
and experience your first moments of bonding with her; this will probably help make her feel secure all her
life. (Research by Lynee Murray and Liz Andrews for their book The Social Baby reveals that a baby identifies its
mother within a minute of its birth. Within 2 minutes,
it may even strain its neck to study her face. Within half an hour, the baby can recognise the form of a human
face. Random waving of arms and gurgling among newborns may appear incomprehensible to adults,
but is actually a complex system of intelligent communication that the infant possesses. There is a
wired-in programme to help babies lock in to those who are caring for them.)
The baby is wide awake for about 40 minutes after delivery
Accept the child —son or daughter —gratefully, as a
gift from God. This will help you begin a life-long healthy relationship with your child.
REJOICE IN YOUR DAUGHTER
Once considered almost a misfortune, having a daughter
today is more a matter of celebration than grave concern,
though exceptions remain. Rita Sawhney interviewed several
parents in this connection. What has led to this tilting of the
scales in favour of the girl child? The writer also interviewed psychologists, gynaecologists and a teacher of
sociology. It seems that the stand is changing because the myth that
it is easier and safer to bring up a boy has exploded.
Accepting hospitality at a married daughter’s home is no more a
taboo. Besides being more reliable, girls continue to maintain emotional ties and provide their parents their
much-cherished freedom, whereas a boy means long-term babysitting for
the ageing mother. Girls are showing equal and, in many
cases, better business acumen than their brothers to carry on
the family business. Girls are venturing into many a field
that was earlier considered male-dominated. Behaviourists believe
that girls are more demonstrative of their feelings.
Additionally, even health wise, having a baby girl could mean less sleepless nights. Boys outnumber girls 3:l in learning disabilities, and 4:l as stutterers. Haemophilia (a blood disorder) and Duchenne’s Muscular Dystrophy (a serious muscle disease) afflict boys exclusively. Boys are more likely than girls to suffer from Fragile-X Syndrome, one of the causes of mental retardation. The mortality rate of boys is 20% higher than that of girls. This continues as they grow older.
The Kangaroo Position
The kangaroo position is ideal for the newborn. In it, the mother clasps her baby between her breasts, with
the baby’s face just below the mother’s chin. The
baby stays quiet, possibly hearing the mother’s heartbeat
to which she was accustomed while she was in the womb. If the room temperature is low and the baby is
premature, the baby’s head may be covered with a cap. This greatly helps to maintain body temperature.
Doctors and nurses often use the term ‘Apgar scoring’.
It is meant to assess the condition of your baby in certain respects at 1 minute and 5 minutes after birth. Sixty seconds
after the complete birth of the infant, the 5 objective signs
given in the table are evaluated, and each is given a score of 0, 1
or 2. A total score of 10 indicates an infant in the best
possible condition. Most normal babies score 7 to 10 points. An
infant with a score of 0 to 3 requires immediate attention.
|| Less than 100/minute
|| More than 100/minute
Good or crying
Some flexion of limbs
| Active and flexed
Reflex response to catheter placed in
the infant’s nose
|| Minimal grimace
||Cough sneeze or cry
|| Blue or pale
|| Body pink, extremities blue
|| Completely pink
While examining your newborn baby, the paediatrician
will test for certain reflexes like the grasp reflex, the
walking and stepping reflex and the Moro reflex.
For the grasp reflex, the doctor places her finger in
the palm of the baby, who is expected to grasp it firmly. To
test the walking and stepping reflex, the doctor holds the
baby upright so that her feet touch a firm surface. The baby takes a few steps as if she were walking. If the baby’s leg
comes in contact with the edge of a table, she steps up onto the
A newborn baby can see at birth. She can focus at a distance of 15 to 20 cms. Thus, she can see her
mother’s face while breastfeeding. She can also hear and can smell her mother’s milk. She likes body
contact, especially with her mother. She is alert for 40 to 60 minutes after birth. Then she may go to sleep
for a few minutes or for several hours.
Examination Of The Baby
It is not essential that there be a paediatrician at
every delivery. However, most babies should be checked by a paediatrician within 24 hours after delivery. Or a
paediatrician may be called earlier if any problem is noticed. It is normal to worry about your newborn baby. It helps
to remember that many things that may appear abnormal to
you are normal variations in a newborn. (See chapter on NORMAL VARIATIONS IN A
In all baby-friendly hospitals, the baby is given to the
mother soon after delivery, and kept in her room; she is not sent to a separate nursery. This is called rooming-in. Normal
babies kept in a nursery are more likely to contract infection
from the attendants or from other infected babies (if any).
In some hospitals, the baby is unwisely kept in the nursery to allow the mother to rest after the delivery.
Experience shows, however, that the average mother would prefer to have her baby with her, especially if
she knows that this is the best thing for her and her baby. Unless the mother is heavily sedated, she can
keep her baby in her bed (bedding-in).
Immunisation In The Hospital
In some hospitals, it is a routine practice to give BCG (immunisation against tuberculosis) and one dose of
hepatitis B vaccine and oral polio vaccine to all newborn babies
before they are discharged from the hospital. This dose of oral polio vaccine is called the zero dose. This is an extra dose
besides the primary course of 3 to 5 doses about which we shall discuss in detail in the chapter on
If your baby is not given these immunisations at the hospital, they can be given at a later date.
Unless the mother is heavily sedated, she can keep her baby in her bed
7 March, 2016