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First Few Days After Birth

By

Deborah M. Consolini

, MD, Thomas Jefferson University Hospital

Last full review/revision Sep 2021| Content last modified Sep 2021
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Mother and baby typically spend a day or two in the hospital during which time new parents are taught to feed, bathe, and dress the baby and become familiar with the baby's activities, cues, and sounds.

Before being discharged from the hospital, parents are taught about routine aspects of care regarding the umbilical cord, circumcision, skin, urine and bowel movements, and weight.

Umbilical cord

The plastic cord clamp on the umbilical cord is removed within 24 hours after birth. The stump should be kept clean and dry. Doctors no longer recommend applying alcohol or other antiseptic solutions to the stump. The stump falls off on its own in a week or two. Rarely, the umbilical cord can become infected, so any signs of redness, swelling or discharge should be checked by the doctor.

Circumcision

Circumcision, if desired, usually is done within the first few days of life, often before the newborn is discharged. The decision about having a newborn circumcised usually depends on the parents' religious beliefs or personal preferences. The main medical reason for circumcision is to remove an unusually tight foreskin that is obstructing the flow of urine. Although circumcised males also have a lower risk of cancer of the penis and urinary tract infections, these risks can be minimized with proper hygiene.

About 2 to 20 boys per 1,000 have some complication, usually minor bleeding or local infection. However, serious infection, scarring, and, very rarely, accidental amputation of the penis tip can occur. Some uncircumcised males require a circumcision later in life.

Circumcision should not be done if the boy has not urinated or has a bleeding disorder or if the penis is abnormal in any way, because the foreskin may be used for any plastic surgical repair that may be needed later. Circumcision must be delayed if, during the pregnancy, the mother had been taking drugs that increase the risk of bleeding, such as anticoagulants or aspirin. The doctor waits until all such drugs have been eliminated from the newborn's system.

Skin

Most newborns have a mild rash sometime during the first week after birth. The rash usually appears in areas of the body rubbed by clothing—the arms, legs, and back—and rarely on the face. It tends to disappear without treatment. Applying lotions or powders, using perfumed soaps, and putting plastic pants over the diapers are likely to make the rash worse, especially in hot weather. Dryness and some skin peeling often occur after a few days, especially in the creases at the wrists and ankles.

Newborns who are otherwise normal may develop a yellow color to their skin (jaundice Jaundice in the Newborn Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells... read more Jaundice in the Newborn ) after the first day. Jaundice occurs because the newborn's liver needs to shift from functioning inside the womb to functioning outside the womb. However, jaundice that appears before 24 hours of age is of particular concern and may indicate more serious problems. If the newborn develops jaundice, the doctors usually do a blood test to measure the level of bilirubin, which is the main pigment in bile. If the level of bilirubin is above a certain number, treatment with phototherapy, in which the newborn is placed without clothes under special lights ("bili" lights Phototherapy or "bili lights" Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells... read more Phototherapy or ), is begun. The lights may be needed for 2 days to a week.

Urine and bowel movements

In the first 2 days, urine produced by a newborn is concentrated and often contains chemicals called urates, which can turn the diaper orange or pink. If a newborn does not urinate within the first 24 hours of life, the doctor tries to find out why. A delay in starting to urinate is more common among boys.

The first bowel movement is a sticky greenish black substance called meconium. Every baby should pass meconium within the first 24 hours after birth. If a baby does not do so, the doctor may do tests to determine whether there is a problem. Occasionally, for instance, a birth defect may cause a blockage of the intestines.

Weight

Discharge From the Hospital

A pediatrician typically discharges infants from the hospital. Before the infant is discharged, parents are given specific information regarding when to call the pediatrician's office. For example, parents should immediately call the pediatrician if their infant has fever Fever in Infants and Children Normal body temperature varies from person to person and throughout the day (it is typically highest in the afternoon). Normal body temperature is higher in preschool-aged children and highest... read more Fever in Infants and Children (temperature should be taken rectally), respiratory distress, loss of appetite, bilious vomiting (vomiting greenish yellow material), or a blue discoloration of the skin (cyanosis Cyanosis Cyanosis is a bluish discoloration of the skin resulting from an inadequate amount of oxygen in the blood. Cyanosis occurs when oxygen-depleted (deoxygenated) blood, which is bluish rather than... read more ).

Once home, having a new baby in a household requires a great deal of adjustment for all involved. For a household that has had no children, changes in lifestyle may be dramatic. When other children are present, jealousy can be a problem. Preparing other children for the new baby and being careful to pay attention to them and include them in caring for the baby can ease the transition. Pets may also need some extra attention to help them adjust to the baby. In some cases, keeping pets away from the baby may be necessary.

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