Newborn Tests

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 Q: What newborn care is given typically at the time of birth and what are the tests and checks done on a healthy newborn during our hospital stay?

Dr. Kibler

Dr. Elise Kibler, Capital Pediatric Group, Austin

Response from Elise Kibler, M.D., Capital Pediatric Group

A:  When a baby is born, the healthcare providers should allow time for immediate skin-to-skin between mother and baby.  Skin-to-skin time is the best way to warm and comfort a baby, encourage bonding, and stimulate milk production.  They should assist the new mother in establishing a good latch and supporting breast feeding.

Two injections are given to the baby shortly after birth – the vitamin K and Hepatitis B vaccine.  The vitamin K prevents bleeding in the newborn period.  The Hepatitis B vaccine prevents a liver infection that can affect newborns.

When at the hospital, the infant has its breathing and temperature monitored by the nurses periodically and is checked daily be the pediatrician.  A pediatrician will look at the baby from head to toe.  We check to make sure the eyes developed well, soft spots are open and in good position, check the heart and lungs, and also look at the hips to ensure that the ball and socket joint developed well.  We also look for rashes, tongue-tie which can affect a latch, and other congenital abnormalities.

During the second day of life, hospital staff will check the newborn’s hearing.  This is required by state law.  It will not be done at a home birth and is usually not done in a birthing center.  If that is the case, it should be arranged later by the child’s pediatrician.

During the second day of life, the hospital staff will also check the newborn’s jaundice level.  Jaundice is caused by the buildup of bilirubin which is a protein in the blood stream.  It is typically flushed out by the liver once the child’s gut matures and starts eating and stooling at full speed which is usually starting on the 5th day of life.  The level of jaundice should be checked by the hospital before the baby leaves and then followed up by the pediatrician between one and three days after discharge (depending on the level).  Getting outdoors helps clear this jaundice and can be beneficial in allowing the newborn to make vitamin D as well.  Ask your pediatrician more about vitamin D and the best way to make sure your child will get enough.

A heel prick to obtain blood sample will also be done on the newborn.  This is called the newborn screen or metabolic screen test.  It tests for 30 different congenital and metabolic abnormalities that are important to pick up in the newborn period.  It is done on the second day of life and repeated when the baby is two weeks old.

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