Normal Care After Birth

Question 1

What are the immediate steps after birth?

Answer 1

• Skin to skin
• Clamp the umbilical cord
• Dry the baby
• Keep the baby warm with a hat and blankets
• Vitamin K
• Label the baby
• Measure the weight and length

Question 2

What is the role of vitamin K after birth?

Answer 2

Babies are born with a deficiency of vitamin K. Vitamin K is an important part of normal blood clotting. Standard practice is to give all babies an intramuscular injection of vitamin K in the thigh shortly after birth. This can have the helpful side effect of stimulating the baby to cry, which helps expand the lungs. Vitamin K helps to prevent bleeding, particularly intracranial, umbilical stump and gastrointestinal bleeding. Alternatively, vitamin K can be given orally, however this takes longer to act and requires doses at birth, 7 days and 6 weeks.

Question 3

What are the benefits of skin to skin contact?

Answer 3

Skin to skin contact involves putting the baby against the mothers chest immediately after birth. This has several potential benefits:

• Helps warm baby
• Improves mother and baby interaction
• Calms the baby
• Improves breast feeding

Question 4

Once mum and baby out of the delivery room, what things need to be considered?

Answer 4

Once mum and the baby are out of the delivery room, there are a few things to consider:

• Initiate breast feeding or bottle feeding as soon as the baby is alert enough
• The first bath is usually delayed until this baby is warm and stable
• It can wait days without any issues
• Newborn examination within 72 hours
• Blood spot test
• Newborn hearing test

Question 5

When is the heel prick conducted?

Answer 5

It is taken on day 5 (day 8 at the latest) after consent from the parent.

Question 6

Briefly describe the role of blood spot screening

Answer 6

This is a screening test for 9 congenital conditions. It is taken on day 5 (day 8 at the latest) after consent from the parent. A heel prick is used to provide drops of blood. The screening card requires four separate drops. This screens for nine congenital conditions:

• Sickle cell disease
• Cystic fibrosis
• Congenital hypothyroidism
• Phenylketonuria
• Medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
• Maple syrup urine disease (MSUD)
• Isovaleric acidaemia (IVA)
• Glutaric aciduria type 1 (GA1)
• Homocystin

Results take 6-8 weeks to come back.