Friday, May 4, 2018

Well, your baby is born! Knowing what to expect in the first few minutes after giving birth will make your recovery easier and help you understand your newborn baby's needs faster.

The first minutes after the birth of a child

The moment of the birth of a baby can be both magical and stressful for his mother. What happens immediately after birth will depend directly on the very process of childbirth, the complications that have arisen, the well-being of the child, etc.

Vaginal delivery

Most babies start breathing and crying within seconds of being born. If the baby has begun to breathe on its own, the doctor will place the baby on your chest or stomach immediately after birth. Skin-to-skin contact helps keep the newborn warm and is also the trigger for breastfeeding. The midwife will dry the baby and cover you with a warm blanket or towel.

Obstetric forceps and vacuum

If your baby is born with forceps or a vacuum, he may start breathing on his own a little later than usual. In this case, the midwife or doctor will conduct a quick examination of the general condition of the baby. As soon as the newborn begins to breathe properly, it is dried, covered in a warm towel and returned to you. You can then hold the baby or lay it on your stomach for skin-to-skin contact, warm with your warmth and breastfeed.

C-section

Most babies born by caesarean section begin breathing on their own and crying immediately after birth. The midwife or doctor will dry the baby and check that he is breathing properly. The baby will then be wrapped in a warm blanket and given to you while you are on the operating table (unless you had general anesthesia). Sometimes a woman in labor may need additional medical attention, so the first hugs will have to wait.

Umbilical cord cutting

After the baby is born, the umbilical cord must be clamped and cut. The cord connecting mother and baby is quite strong, but its circumcision does not cause pain to the woman and the child. If desired, your birth partner can cut the umbilical cord after uncomplicated vaginal and caesarean births. If the baby needs emergency care immediately after birth, or the mother has any complications (such as heavy bleeding), a midwife or doctor will clamp and cut the umbilical cord.

How your baby will look and act after birth

Some important changes take place in your baby's body as it moves from the comfort of the womb to the outside world. “Blue or purple color is quite physiological and natural for the baby in the first few minutes after birth,- says Mary Ann Jackson, MD in Missouri, "A newborn baby's skin color will gradually turn pink within 7-10 minutes after birth, but his arms and legs may remain blue for up to 24 hours."

If your baby seems ready, you can breastfeed within a few minutes of birth. The midwife will help you put the baby to the breast.

Newborn Apgar score

The Apgar score measures how well your baby has made the transition from life inside the womb to the outside world. This helps the doctor or midwife decide if the baby needs more medical care right after birth. The Apgar score does not diagnose any specific disease and does not indicate whether a baby needs resuscitation at birth.

The doctor conducts the first evaluation of the baby within 30 seconds after his birth. If the baby is breathing on his own at birth, has a heart rate above 100, and moves his arms and legs, he will get an Apgar score of 7-10. Don't worry if your baby doesn't score 10 - many babies don't have rosy skin the first few minutes after birth, so they can't score 2 for skin color.

If the child needs help to breathe or maintain heart rate and circulation, they will receive an Apgar score of less than 4. In this case, the baby will be given extra oxygen, and some children may need a breathing tube.

If a baby needs medical attention and gets a low Apgar score within the first five minutes or more of birth, they are sent to the neonatal intensive care unit for further evaluation and a thorough evaluation.

Blood circulation between the heart and lungs in a child before birth is not carried out.

Immediately after birth, the midwife will clean your baby's mouth and nasal cavities with a special catheter so that nothing interferes with his normal breathing.

The physical bond between mother and newborn is broken when the doctor or midwife clamps the umbilical cord and cuts it. Immediately after this, the blood from the baby's heart begins to flow into the lungs, enriched with oxygen there. Blood circulation is established between these organs, and the pulmonary artery opens, and those channels through which the child's blood flowed, bypassing the lungs, during the prenatal period of development, are closed.

The baby's skin quickly turns pink, but his heart still contracts very quickly - twice as often as in adults - 120-130 times per minute. His breathing can still be quite uneven and frequent, he takes more or less deep breaths.

The respiratory rate of healthy full-term babies in the first week of life is usually 30-50 breaths per minute. In premature and underweight babies, breathing is more frequent (up to 80 per minute) and uneven.

Your first meeting

If the medical staff assesses your baby as normal, immediately after birth, he will be placed on your stomach. You and the father of the child, if he is present at the birth, will be able to stroke the newborn and examine him. These moments, during which the baby and his parents first see each other, are considered very important, so discuss with your doctor in advance the possibility of such early contact. Skin-to-skin contact with mom will keep your baby warm and help strengthen your bond with each other. Perhaps the baby will already be able to suck a few drops of colostrum from your breast, but if this does not happen - do not worry, you will have the opportunity to feed him in the next half hour.

During the time the placenta is being born, the doctor examines you, checks the integrity of the cervix, and, if necessary, stitches. Your baby will be treated by a pediatrician. First of all, he will clean the mouth and nose of the newborn from mucus, drip special disinfectant drops into his eyes, and then wash him.

In some maternity hospitals, the father may help with the first bath of the newborn.

Important indicators

Your child will then be weighed and measured. The average weight of newborns is about 3.3 kg, however, deviations from this figure in both directions can be quite significant. So, perfectly healthy babies weighing from 2.5 to 4 kg are often born.

The average height of a newborn child is 50 cm, but even here deviations of 2-4 cm are possible.

By measuring the circumference of his head, the doctor will receive a figure that ranges from 32.5 to 37.5 cm. On average, babies born have a head circumference of about 35 cm.

After assessing the general condition of your child, the doctor will begin to examine him more closely. After carefully examining and feeling the head of the newborn, he will check the condition of his fontanelles - places in which the bones of the skull have not yet fused. He can shine a special flashlight into his eyes to make sure that his lens is not clouded.

Looking into the baby's ear canals, the doctor will see if they are properly formed. He examines the child's mouth to make sure that his palate does not have developmental anomalies.

By running his hands over the neck and body of the baby, he will check if the collarbone has been fractured during childbirth, since this injury is not uncommon when a child passes through the birth canal of the mother.

Careful listening to the heart of a newborn helps the doctor establish the absence of abnormal murmurs, which may be a sign of congenital malformations of this organ. Your baby's breathing will also be checked with a stethoscope.

Through the thin muscle layer of the baby's tummy, his internal organs are well felt. The doctor examines them to make sure they are of normal size and location.

Due attention will be paid to the genitals of the child. It is very important for a boy that both of his testicles have already descended into the scrotum by the time of birth - this is considered one of the signs of the maturity of the newborn. After making sure that there are no inguinal hernias, the doctor will put a finger on the newborn's groin and check the femoral pulse.

Breeding the child's legs to the sides in the hip joints allows you to determine whether he has a congenital dislocation of the femoral head, which is easy to cure in infancy and much more difficult at an older age. The child's feet will also be examined very carefully, as this will make it possible to identify changes that require urgent intervention.

reflexes

After assessing the physical condition of the baby, the doctor will proceed to assess his neurological development. For this, the degree of expression of some reflexes in the newborn is checked.

Walk reflex

If you grab the baby under the armpits, put your feet on a flat hard surface and slightly tilt his body forward, the child will begin to move with his feet, trying to "walk". This reflex is congenital and will spontaneously die out after five to six weeks.

grasp reflex

If you touch the baby's palm with your finger, he tightly wraps his fingers around it. In fact, the strength of his grip is now such that you can lift him into the air and hold him for a few seconds. This reflex (if it is not developed) fades away in 3-4 months. Stimulation by the parents of the grasping movements of the baby serves as a factor accelerating his psychophysiological development.

Sucking reflex

Occurs when the baby's lips are touched and helps him receive milk from the mother's nipple, but also in combination with the search reflex provides the opportunity to perform the "search movements" necessary for the correct capture of the nipple in the mouth and appearing if you touch the cheek or corner of the mouth baby. This reflex is combined with the proboscis reflex, which occurs when a finger is lightly tapped on the lips of a newborn: the baby's lips stretch out in the form of a proboscis.

plantar reflex

It occurs if you draw along the outer edge of the baby's foot. When pressing with the thumb on the balls of the foot, all the fingers are bent. At the same time, the baby's legs can make a flexion movement in the hip and knee joints, and the contraction of the muscles of the entire body of the child will also increase. Remains up to 3-4 months.

"Heel" reflex

This reflex, well developed in physiologically mature newborns, consists in the baby's reaction to a slight pressure on his heel. At the same time, he unbends his arms and legs, screams, and a grimace of “crying” appears on his face.

Crawl reflex

Putting the baby on his stomach, the doctor will put his hand to his feet. Normally, the child pushes off this support with his feet, moving forward a little.

Typically, these reflexes are tested in the first minutes of a baby's life, but the doctor will likely repeat the test when they come to see your baby in the postpartum ward.

Often a young mother thinks that immediately after the birth of a baby, her body will return to its previous state, but this is a delusion. Ahead is the recovery phase.

The first minutes after childbirth

Before being transferred to a regular ward, a woman remains under the supervision of a doctor. The doctor is obliged to conduct a study of the state of the uterus, to make sure of its density. If it turned out that she is relaxed, an external massage is necessary. It is performed in order to remove blood clots accumulated in the uterine cavity and restore the muscle's ability to contract.

The obstetrician applies ice to the lower abdomen and perineum for 20 minutes to activate the process of contraction of small blood vessels.

In the first minutes after childbirth, you need to urinate. Otherwise, you may encounter such unpleasant phenomena as urological infections.

Bed rest is supposed to be observed in maternity hospitals for the first six hours after the baby is born. Walking around the ward is fraught with dizziness and fainting, which can lead to a fall and injury.

Caesarean section is a special case. In the first 24 hours after the operation, the woman is in a special ward (the so-called intensive care unit). There, she is compensated for blood loss, antibiotic therapy is carried out to prevent infectious complications, as well as stimulation of the intestinal tract.

First days after childbirth

A natural phenomenon after childbirth - lochia. This is the name of the discharge, consisting of the remnants of blood vessels, mucus and tissues of the uterus. In the first three days, they are usually very plentiful, often reminiscent of menstruation.

Often in the process of breastfeeding, women complain of abdominal pain, reminiscent of light contractions. This is due to the work of the uterus: contracting, it compresses the vessels that have torn during childbirth, and returns to its previous size.

Pain in the perineum. Even if ruptures and episiotomy (perineal incision) were avoided during childbirth, the muscles were strongly stretched, squeezed, this area of ​​the body was injured.

Initially, colostrum is secreted from the breast - a thickish yellow liquid. Milk appears only for 2-3 days. During lactation, the mammary glands become more sensitive, pain in the nipples is felt. In some cases, the doctor recommends limiting the amount of fluid consumed, if this does not help, they resort to the pumping procedure.

A woman may experience problems with stool. Most often, the reason is psychological in nature - it's scary that the seams will open. And in order to avoid problems with physical defecation, it is necessary to enrich your diet with fiber: eat more bread, fruits and vegetables, prunes, drink plenty of fluids. It is also helpful to move more if allowed by the doctor.

After a caesarean section, you can drink only water with lemon for the first 24 hours. After 48 hours, the woman is transferred to the postpartum ward. There she begins to get up, walk, feed the baby.

First week after childbirth

This period is characterized by vaginal discharge: first pink, then brown, then yellowish white. They can last a couple of weeks, and may end only on the 8th week after birth. If their volume has increased, an unpleasant odor has appeared, the color has changed, the temperature has risen - you need to urgently inform the doctor. Such symptoms can be observed in the presence of remnants of the placenta in the uterus. In this case, urgent hospitalization and curettage is required.

The seams must remain dry and clean. They are treated with antiseptic solutions (iodine and brilliant green), bandages are changed regularly.

The birth of a child is a test for a woman not only physically, but also psychologically. Many women experience frequent mood swings, become dull, apathetic; do not feel the joy of having a baby. Advice - more walks, rest, positive emotions.

On average, the recovery of the body after childbirth takes up to 8 weeks. But for some this period is longer, for others it is less. Just like the symptoms: if one of the mothers observes a complete list of unpleasant symptoms after childbirth, the other can only complain about a couple of them.

Here comes the long-awaited moment! A happy mother hugs her baby to her chest. The stressful months of pregnancy and childbirth are over. Mother sees a tiny and helpless creature, for whom she is now the whole world. What the baby feels in the first minutes and hours of life, the mother needs to know so as not to worry once again.
The first seconds after birth, the baby does not feel anything, there is no muscle tone and no reaction to light, sound and pain stimuli. This is due to "generic catharsis", that is, "purification". This can be called a protective reaction of a newly born organism. The fact is that in the process of childbirth, the child experienced many sensations unknown to him before.
Passing through the birth canal, the fetus feels a huge load on the bone skeleton and soft tissues. Having passed such a test, the baby will be ready for new living conditions, to which he will have to adapt in a few minutes. The habitat has changed, weightlessness has been replaced by gravity. Now it is surrounded by air a little colder than the temperature that it was before. Instead of the usual darkness and silence, now there is a lot of light and sounds. Such a protective state does not last long, until the first breath. This is one of the key moments in the birth of a child.
During childbirth, the child's oxygen content in the blood decreases, impulses enter the respiratory center of the brain, signaling hypoxia, and the baby begins to scream, while taking its first breaths. At the moment when the lungs open, the pulmonary circulation begins to function. During pregnancy, oxygen was supplied through the umbilical cord and blood circulated through the opening between the aorta and the pulmonary artery. As soon as the child began to breathe, the need for an oval window disappears, but continues to exist and grows in the first days of life. This explains the slight cyanosis of babies in the first hours after childbirth. Thus begins the circulation of blood and the process of respiration in newborns. Due to the restructuring of the circulatory and respiratory systems, the first 15 minutes the baby is in a state of intense stress.
Just at this time, the child is laid out on the mother's stomach, which for both means the completion of childbirth. The hard way has been passed. And the baby begins to calm down, feeling his mother. For a child, this is a critical moment that determines the further ability to love and feel affection, which is why tactile contact is so important. This is the so-called "imprinting" process, complex and mysterious. It is at this moment, having gone through birth stress, that the child must feel the love of his mother, otherwise, this can become the basis for the formation of childhood neuroses, which are very difficult to treat.
Of particular importance is the attachment of the child to the breast. The mother's first colostrum is a kind of immunization for the baby, as it contains beneficial bacteria and various antibodies, which is necessary for the formation of immunity. Since a child is born with a sterile intestine and an immature immune system.

It is very important in the first minutes of a child's life to warm. Given that the air temperature in the delivery room is much lower than the temperature that was in utero, a newborn baby can quickly become overcooled. This is very dangerous not only for his health, but also for life. A decrease in the child's body temperature to 36.4ºС is already a serious stress for him. This can lead to respiratory distress, decreased sucking reflex, increased susceptibility to infection, and neurological disorders.

How to warm the baby after childbirth?

International experts of the World Health Organization have formulated the following 10 main steps (conditions) for ensuring the heating chain in the maternity hospital:

• it is the responsibility of the hospital staff to provide a warm, clean delivery room, where the air temperature would be 25º-28ºС and there were no drafts;
• immediately after the birth of the child must be dried immediately. To do this, use warm diapers, which quickly, gently, but thoroughly wipe the baby's skin dry with blotting movements. At the same time, he lies on his mother's stomach.
• here, on the mother's stomach, after wiping, a pre-prepared and warmed cap and socks are put on the child;
• mother and child must be covered with a warm blanket;
• contact of the child with the mother's body "skin to skin" should last at least 30 minutes, and if possible - up to 2 hours, before the transfer of the mother and child to the ward of joint stay. If the birth occurred by caesarean section, skin-to-skin contact can be made by the father of the child or another person close to the family who was present at the birth;
• transportation to the joint ward should provide for all the necessary conditions for maintaining thermal comfort for the child;
• It is extremely important for mother and baby that the first attachment to the breast is carried out no later than 30 minutes after birth:
• procedures such as weighing and bathing the baby can wait. They can be carried out a few hours after birth, while observing all the necessary conditions for thermal comfort. After bathing, the child should be changed into clean underwear, a vest, sliders, or swaddled loosely.
• in the future, it is necessary to control the temperature of the child's body, and not allow it to cool down during swaddling, washing, examinations and procedures. A body temperature of 36.5º-37.5ºС is considered normal for a newborn baby.
• the mother and her child must be together all the time, in the joint room. Ideally, this ward would be designed for one pair of "mother-child";

Compliance with these conditions will allow the newborn to keep warm and quickly adapt to new temperature conditions for him.
In the above list of steps, there are points that, as well as creating thermal comfort, are important for the child.

Many researchers have proven the fact that skin-to-skin, eye-to-eye contact has an important biological and psychological significance for the mother and for the newborn child. Such close contact of the cub with the mother immediately after birth is found in every species of mammals. Let's remember what a cat does as soon as she gives birth to a kitten? That's right, she licks him, examines him, helps him find a vital nipple for him. And what does a kitten do as soon as it comes to its senses?

He finds this nipple and, kissing, sucks for a long time until he is satisfied. And mind you, no one teaches this to a cat or a kitten. And why? Because it is a biological program developed throughout the evolution of biological species. In other words, this is an instinct, thanks to which mammals, including humanity, have not yet become extinct. This means that such contact immediately after childbirth is fateful, both for the mother and for the child. And it must definitely take place in the delivery room. And voluntary or involuntary interference in the natural course of events is a gross violation of the laws of nature, for which one has to pay dearly.

Recently, there have been many publications about the phenomenon of imprinting and its role in the psychological relationship between mother and child. Scientists have proven that the degree of affection and love for each other between mother and child largely depends on how the first hours and days passed after the birth of this couple.

Unfortunately, in some cases, early contact between mother and child is not possible. Either the mother needs to recover from surgery or complications, or the baby needs special care. In such cases, the period of separation should be reduced to a minimum. As soon as the mother feels better, she needs to start taking care of the child.

If the birth occurred by caesarean section, and the mother feels confident enough, a joint stay with the child in the same room is possible from the first day. The woman should be assisted in the care by the hospital staff, perhaps so that relatives are also involved in this matter.

Skin contact and being in the same room with the child play another significant role - this is exactly what a newborn needs. This is protection against infections. It is very important that your newborn baby receives the microorganisms that inhabit your skin. Then his body will be able to actively resist the surrounding pathogenic bacteria and viruses.

Early attachment of the baby to the breast after childbirth

Early attachment of the child to the breast is also a vital condition for the normal adaptation of the child to new living conditions. It should take place within the first hour after birth. Usually, newborn children immediately after childbirth rest for a while, sneeze out the liquid that is in the spout, and behave calmly. But after 15-20 minutes, they begin to show a search instinct, crawl along their mother's belly in search of a nipple.

It is at this moment that you should be helped to attach the baby to the breast. And he should suck as much as he wants. It is impossible to tear off the baby from the breast. This is his reward for just winning the first victory in his life. Colostrum, which the baby receives at the same time, is an absolutely indispensable food for him. It is rich in immunoglobulins, hormones, vitamins that provide protection and normal adaptation to extrauterine life.

For you, early attachment of the baby to the breast is also of great importance. Stimulation of the nipple by the baby promotes good contraction of the uterus, due to the production of oxytocin. Also, it has the most positive effect on lactation. Absolutely proven is the fact that the earlier the baby is attached to the breast, the greater the chance of successful breastfeeding.

It would be very good if in the first minutes of your baby's life his father was next to you (this is possible if you make a choice in favor of partner childbirth). His love and support will be greatly needed by you!