Birth is a special moment for mother and child, both physically and psychologically. At the moment of birth, the baby starts its new life outside the womb and begins to adapt to its new conditions. At this point the baby's dependence on the placenta for food and oxygenation comes to an end. The umbilical cord is clamped and cut. From this moment on the baby will have to obtain its own oxygen and food, by breathing and breastfeeding. What is the first care is provided to a newborn baby? Find out about the first things that should be done soon after a baby is born. Optimise breathing capacity While the baby is in the womb, it receives the oxygenated blood it needs from its mother. During this phase, its lungs are not responsible for respiratory exchange of oxygen and carbon dioxide. Therefore, there is limited blood flow through these organs. Upon the birth of the baby and its first independent respiratory movements , pulmonary expansion occurs, air enters the alveoli and the blood circulation necessary for respiratory gas exchange is established. The interruption of the blood circulation that takes place when the umbilical cord is cut means that within a few hours of birth the remaining routes associated with circulation of the foetus are no longer functional. This contributes to the development of pulmonary circulation . Some babies have an excessive amount of liquid in their lungs when they are born, which can interfere with respiratory movements. In such cases it is necessary to encourage the baby to cry or aspirate the upper airways in order to optimise the normal breathing process. Ensuring the baby does not become too cold When the baby has just been born, its thermoregulation (temperature regulation) mechanism is not yet fully developed. As such, it can cool down very rapidly and become hypothermic , which then leads to increased oxygen consumption and resulting respiratory distress. To prevent this from happening, make sure the baby is kept in a warm, dry environment after it has been born. The Apgar test The Apgar test is part of the baby’s first assessment after it is born, and assesses its degree of adaptation to life outside the womb. It is named after anaesthetist Virginia Apgar. The Apgar baby score involves assessment of the following, on a scale from 0 to 10: Heart rate; Breathing rate; Muscle tone; Reflexes; Skin colour. The assessment is done 1 minute and then 5 minutes after birth , and the resulting score allows an assessment as to whether some kind of resuscitation is needed. Brief objective examination The first brief examination is to check everything looks good in terms of the newborn’s wellbeing, and to exclude the possibility of any condition that may need immediate intervention. After this examination, and ideally as soon as possible, it is beneficial for the baby to be with its mother , taking advantage of its natural state of alert to start breastfeeding . Early breastfeeding, in addition to strengthening the bond between mother and child , has the effect of stimulating the secretion of milk and causes a contraction of the mother’s uterus, which helps avoid bleeding. Later, the baby will be observed in more detail by a neonatologist. Administration of vitamin K Soon after birth, vitamin K is administered to all babies. This vitamin is involved in the blood clotting mechanism. It is administered to protect the baby from bleeding as a result of physiological clotting disorder, which can occur during the first few days of life. Eye drops Immediately after birth, drops are applied to the baby’s eyes to treat any eye infections that may have occurred during delivery. Complete physical examination Later, still during the baby’s first day of life, the neonatologist will carry out a full and detailed observation of the baby , together with a brief neurological examination. Administration of the first vaccines On the first or second day of the baby’s life, it can be vaccinated against tuberculosis (BCG vaccine) and receive the first dose of the hepatitis B vaccine (Engerix B). Two to four weeks after administration of the tuberculosis vaccine, a local reaction occurs at the site of the injection in the form of a wound with pus, this will dry on its own and disinfectant should not be applied. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
