Newborn Infants
From Encyclopedia of Sex and Sexuality
Immediately after birth the newborn baby is still attached to the placenta by the umbilical cord. The cord is usually tied with two plastic or metal clamps placed about three inches apart, approximately ten inches from the cord’s meeting point with the baby’s belly. The portion between the clamps is then cut within thirty seconds of the baby’s birth.
Many years ago, babies were lifted by the feet by the obstetrician and slapped on their back. This practice has been abandoned, largely because lifting a baby by the feet may cause problems to its hip. Instead, the baby is now usually placed with its face up in a warmed-up crib so that it can be examined immediately after birth. If the infant has no problems, the baby may also be placed on the mother’s abdomen, usually with its belly down.
Immediately after birth, the baby is still covered with a grayish slippery coating called the “vernix,” which represents old skin. It may also be covered with mucus and blood. The baby’s head may not yet have its normal round shape and may be pointy and elongated. The skin of the baby should be dried or covered after birth, to prevent loss of energy and to keep its temperature from dropping.
The baby’s status is checked right after birth to see if there are any immediate problems. This is done at one minute and five minutes after birth by scoring the baby according to a system called the Apgar score, named after Dr. Virginia Apgar, the doctor who developed it. There are five separate vital signs in the Apgar score, each with an assigned value of 0, 1, and 2. Zero is the worst and 2 is the best. The five scores are then added up for the total. The five characteristics are:
- The baby’s heart rate;
- The baby’s breathing;
- The baby’s muscle tone;
- The baby’s reflexes;
- The baby’s color.
An Apgar score of between 8 and 10 indicates that the baby needs no additional help, while a baby with an Apgar score below 4 needs more intensive care.
Only a small number of newborns (fewer than 1 out of 100) require intensive care at birth. This is called “newborn resuscitation,” and it follows strict guidelines, known as the ABCs:
- A Establish the Airway
- B Begin Breathing
- C Maintain Circulation.
If the baby has problems breathing, fluid and secretions are suctioned out of the mouth, nose, and other airways with a small bulb syringe or a plastic catheter attached to a suction device. A mask is then placed over the baby’s nose and mouth, and air and oxygen are pressed into its lungs using a bag connected to the mask. In rare cases, if the baby still does not breathe by itself, a plastic tube is placed into the baby’s windpipe to bring a better supply of air to the its lungs.
Most babies are healthy and stay in the newborn nursery. However, if the baby has any problems or if she or he is too small, the baby may be brought to the neonatal intensive care unit for further care. Babies brought there include those who are too small either because they are premature or because they have not grown enough inside the womb, babies with infections, and those with congenital malformations.
