Tests and checks for newborn babies
Immediately after your baby is born, a series of checks will be performed on him, just to make sure everything is working properly.
The Apgar test is performed at one and five minute intervals after your baby has been delivered. The test was developed by Dr Virginia Apgar, but also stands for the signs that the medical team will be looking for to assess your baby.
A stands for appearance, so your baby’s skin colour will be checked to see if it is a healthy pink colour, if not your baby’s skin may be rubbed to help the blood start circulating.
P stands for pulse – a good pulse reading is normally anything over 100.
G stands for grimace, so any cries, coughs or sneezes are good responses to stimulation.
A stands for activity – the more your baby moves around the better.
R stands for respiration, so a good healthy cry means your baby has clear airways and his lungs are working.
Once the Apgar test has taken place, your baby’s fingers and toes, spine, anus and facial features will be checked, along with his head and length measured. His hips will also be checked. Breech babies may need extra checks on their hips because of the position they lay in the womb, so ask your midwife or health visitor about this is you were not offered one at the hospital.
All babies are born with lower levels of vitamin K than adults and vitamin K is needed to help with the blood clotting process. A small number of babies (about 1 in 10,000) suffer from vitamin K deficiency bleeding or VKDB, a rare disease that usually happens in the first week of life, where babies’ blood may not clot properly and can result in bleeding of the brain which in turn can lead to brain-damage or in some cases death. This is why the Vitamin K injection is offered to newborns, usually within the first hour after they are born.
Your baby will be weighed immediately after delivery, and will then be weighed regularly in the hospital, or by your midwife if you have a home birth. Your health visitor will visit you once you have brought your baby home, to check his weight and that he and you are doing well. Babies usually lose a bit of weight straight after they are born; until they master feeding, but they should gain it back by the time they are a week old.
The heel prick test
Some babies have to have a test where blood is taken from their heel, to check thyroid function and also for a rare disorder called phenylketonuria. Your baby’s heel will be pricked and a small amount of blood taken for the test. This should not hurt your baby.
When each test is being performed on your newborn, make sure you ask what the test it and why your baby needs it. It is your right to know what is happening to your baby at all times, and medical staff will be happy to answer any questions.
The first nappies
Your baby’s first stool is called meconium and is black or green looking; it is mostly made up of digested mucus and is totally normal. It is normally passed within the first twenty-four hours and the next bowel movement can be up to two days later, especially if you are breastfeeding. Your baby should also have several wet nappies in a day, as newborn babies cannot hold urine for any length of time and it is usually passed after a few minutes. If your baby’s urine is stained pink or red, don’t worry, this is also normal for a newborn and will return to a normal clear colour in a few days.
After your baby has passed meconium, the next stools will probably be greenish-brown, then a yellowy colour. Bottle-fed babies stools will be a little more solid, but a similar yellow colour.
Don’t worry if your newborn baby girl has a small amount of clear or white vaginal discharge in her nappy, or even a bit of vaginal bleeding. This is perfectly normal and is left over from the hormones circulating around your body and passed to your baby. Show your midwife or doctor if you are worried.
Hearing and sight tests
Newborn babies cannot see very far, and can focus at about 8-12 inches away. Reassuringly for mothers, this is approximately the same distance between you and your baby when you are holding her at your breast, so she will stare at you intently whilst you hold her. Don’t be alarmed if your baby looks cross-eyed at first, this is just her eyes getting used to using her eye muscles and will stop after a few weeks.
Your baby’s hearing is well developed when she is born and she may turn to look at a loud sound or at a familiar voice she recognises (mummy). Some babies are offered hearing tests in the hospital, but this depends on the hospitals newborn hearing-screening programme. Ask your health visitor what the hearing test procedures are in your area if your baby did not receive one in hospital, most are offered one at around 6-8 months.
Six week check
After six weeks, you and your baby will be checked by your GP to make sure that you are healing well from the birth, that feeding is going well and that your baby’s weight is steadily gaining. The GP will also perform a physical examination on you to check that your uterus has moved back to its pre-pregnancy position. It might be a good idea to write down any concerns or questions you have over the first six weeks so you can bring them up with your GP at the six-week check.