Your baby’s health after birth

When your baby is born, they will be given a head to toe examination to check that there are no major problems that need urgent treatment. Within 72 hours of birth, another more detailed examination will be carried out. Your baby will also have some other routine checks and care.

Guidance for pregnant women and information on what is happening in their regional unit during the coronavirus (COVID-19) outbreak can be found on NI Maternity

Cord care

Shortly after birth, the midwife will clamp the umbilical cord close to your baby’s navel with a plastic clip. They then cut the cord, leaving a small bit of cord with the clamp attached.

The cord will take about a week to dry out and drop off. Use warm water to clean the navel and dry carefully until this happens.

If you notice any bleeding, smell or discharge from the navel, tell your midwife, health visitor or doctor.

Newborn screening

During the first few weeks of your baby’s life, they will be offered a blood spot screening test and a hearing screening test. Getting these tests means that babies and parents can get any support they need.

Medium-chain acyl-coA dehydrogenase deficiency (MCADD)

If a family member has MCADD, tell your midwife and doctor as soon as possible. They will make a record on your notes and refer you to a genetics clinic for further advice.

Tuberculosis (TB)

Tuberculosis is a serious infection that can lead to TB meningitis. It can be prevented with the BCG vaccine, which helps your baby develop immunity to the disease.

You will be asked the following questions during pregnancy and again after birth:

  • are you, your family or your baby’s father’s family from a country with high rates of TB?
  • are you likely to be living for more than a month, or travelling frequently, in a country with high rates of TB?
  • does anyone in your house, or anyone who is likely to have long term contact with your baby, have TB, or has had it in the past, or comes from a country with a high rate of TB?

If you answer ‘yes’ to any of these questions, you will be offered the BCG vaccine for your baby.

Your baby’s appearance

Your baby’s appearance will change in the first few days after birth. This is normal, but if you see anything that worries you, however small, ask your midwife.

Your baby will be examined by a midwife, paediatrician or neonatal nurse practitioner to make sure everything is alright.

The fontanelle

On the top of your baby’s head, near the front is a diamond-shaped patch where the skull bones have not yet fused together.

This is called the fontanelle. It will probably be a year or more before the bones close over. You may notice the fontanelle moving as your baby breathes. Don’t worry about touching it gently or washing the area.

There is a tough layer of membrane under the skin, but be careful not to bump this area accidentally.

Marks and birthmarks

Some babies are born with a swelling and bruises on the head, and perhaps bloodshot eyes. This is just the result of the squeezing and pushing that is part of being born and will soon disappear.

You may find some marks and spots, mainly on your baby’s head and face. Most of them will go away eventually. Ask the doctor or midwife who examines your baby if they should disappear completely.

Some babies have little pink or red marks on the forehead and upper eyelids which fade gradually. It may be some months before they disappear altogether, however. Marks on the nape of the neck can stay for much longer.

Strawberry birth marks are also quite common. They are dark red and slightly raised. They sometimes appear a few days after birth and may gradually get bigger. They take a while to go away.

Spots and rashes are quite common in newborn babies and may come and go.  You should tell your doctor or midwife immediately if you also notice a persistent rash and a change in your baby’s behaviour, for example, if they are not feeding properly, they are very irritable or sleepy.

Your baby’s skin

At birth, the top layer of your baby’s skin is very thin and easy to damage. Over the first month (longer in premature babies), the skin matures and develops its own natural protective barrier.

Vernix is the white sticky substance that covers your baby’s skin in the uterus. It should always be left to absorb naturally. It is a natural moisturiser and gives added protection against infection in the first few days.

Premature babies’ skin is even more delicate. Staff in a specialised neonatal area will advise you on skin care.

If your baby is overdue, their skin may well be dry and appear cracked. This is to be expected, as the vernix has already been absorbed. Creams or lotions may do more harm than good, so wash your baby with plain water only for the first month.

Breasts and genitals

A newborn baby’s breasts can be a little swollen and ooze some milk, whether the baby is a boy or a girl. Girls also sometimes bleed a little or have a white, cloudy discharge from their vagina.

These are a result of hormones passing from the mother to the baby before birth and are no cause for concern.

The genitals of male and female newborn babies may appear rather swollen, but this will settle fairly quickly.

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