All babies receive the following screenings or treatments before going home. Most are required by state law. Many of them can prevent serious illness or death.
Eye antibiotics
All babies are treated with antibiotic eye drops or ointment to prevent bacterial infection with gonorrhea. Before this treatment was started, this disease was a common cause of blindness or permanent eye damage. The treatment is effective and usually has no side effects, though occasionally, the drops may irritate the eyes for several hours. This is mild and temporary. There do not appear to be any long term side effects or risks of this treatment.
Vitamin K
All babies are at risk of bleeding due to low vitamin K levels in the first 2 weeks of life. It can be severe; we still see deaths in babies with low vitamin K levels. Premature and breast-fed babies are at a higher risk. Vitamin K deficiency does not have any symptoms until a bleeding problem develops, the first sign is often a stroke which causes serious injury or death. All babies get a shot of vitamin K to prevent this serious bleeding. The shot is very effective at preventing the disease and has no known side effects.
Hepatitis B vaccine
The hepatitis B vaccine is recommended after birth to prevent transmission of hepatitis B from the mother to the baby during birth, and possible transmission to the baby from other family members or close contacts. It is an especially serious disease in babies and can cause liver failure, cancer, and death. The vaccine is very effective and has no known side effects. Moms are tested for hepatitis B prenatally; if she has hepatitis B, additional medications will be given to decrease the baby’s chances of becoming infected. The vaccine is safe and has no known side effects.
Baby’s first bath
Your baby’s first bath will be in the hospital. If your hospital is up-to-date on current, evidence-based guidelines, this will be different than perhaps you and definitely your baby’s grandparents remember. Until recently, the baby was bathed shortly after delivery. Research now shows that there are many benefits to delaying your baby’s first bath until 8 or more hours after delivery.
These benefits include keeping your baby warmer, allowing the vernix (the sticky coating of newborns) to stay on, keeping the skin healthier and helping prevent infection, allowing the baby to have skin to skin contact with the mother right after delivery, and allowing the baby to breastfeed right after delivery. The best care for healthy babies right now is for the baby to be dried off briefly after delivery and laid on the mother’s chest and abdomen right after delivery, covered with a clean, warm towel or blanket. Procedures, including the bath, can wait or can be done right there with the baby lying on the mother.
Research shows that delaying the baby’s bath does not affect the baby’s overall body temperature or prevent the baby from getting too cold. The World Health Organization recommends delaying the baby’s bath for 24 hours, or if this is not possible for hospital or cultural reasons, to wait at least 6 hours after delivery. The nurses will usually do the bath, hopefully in the room with you. You can watch and learn how to give a sponge bath.
Your Baby’s First Exam
Every baby gets a complete physical exam from a doctor (or a nurse practitioner or PA) before leaving the hospital. Parents often ask what we are looking for or doing. The answer: Everything! We are looking to be sure every body part is there and formed properly, and that there are no extra parts, from head to toe and everywhere in between. We are especially looking at muscle tone and body movements to be sure your baby’s brain and nervous system are formed and functioning properly. We look for any conditions that might be caused by problems with the pregnancy or delivery as well.
We are also looking for any signs of illness or infection, as well as genetic conditions or syndromes. Other things that are especially important are the eyes to be sure there are no cataracts or tumors, and the hips to be sure they are formed properly. We will let you know if we find any issues or problems.
Babies are usually examined in the first 24 hours. If your baby’s doctor is on staff at the hospital, the hospital will notify their office when your baby is born and someone from their office will see your baby. If your pediatrician does not see babies at this hospital, then a pediatrician on call for the hospital will see your baby. In some hospitals, there are pediatricians or the NICU doctors or nurse practitioners who see all newborns. Either way, a clinician will thoroughly examine your baby within the first 24 hours. They will also review your baby’s records and answer any questions you may have. Your baby will need to see a pediatrician within 1-3 days after you leave the hospital.