Newborn Procedures After Birth: A Guide For New Parents

Congratulations on your new arrival! Those first hours and days with your newborn are precious, and while hospitals typically offer certain procedures for all babies, you have the right to make informed decisions about each one. Let’s dive into some of the most common newborn procedures and the evidence-based reasons they’re offered, so you can feel confident in making the best choices for you and your baby.

1. Apgar Score

The Apgar Score is a quick, routine assessment done at 1 and 5 minutes after birth to check your baby’s heart rate, breathing, muscle tone, reflexes, and skin color. Each category is scored from 0 to 2, with a maximum score of 10. Research shows that while Apgar scores aren’t a long-term health predictor, they can provide useful information on how well your baby handled birth and whether they may need any immediate medical support. This test is non-invasive and usually happens while your baby is with you.

2. Skin-to-Skin Contact

Immediate skin-to-skin contact has significant, evidence-backed benefits. Studies show that skin-to-skin helps regulate a newborn’s temperature, heart rate, and breathing. It also promotes bonding and helps with the release of oxytocin, which is important for breastfeeding and calming both you and your baby. If any procedures are needed, most hospitals will respect your request to delay them for skin-to-skin time, as this contact can provide a great start for both parent and baby.

3. Vitamin K Injection

Vitamin K is essential for blood clotting, and newborns naturally have low levels of it. Without it, they’re at risk of Vitamin K Deficiency Bleeding (VKDB), which can lead to serious health issues. The American Academy of Pediatrics and other health organizations recommend the injection because it provides a one-time dose that helps prevent VKDB until the baby’s own levels naturally rise. While there are oral alternatives, the injection is often preferred due to its immediate, reliable protection. You can discuss options if you’re interested in alternatives or want more information.

4. Erythromycin Eye Ointment

Hospitals often apply antibiotic eye ointment to prevent conjunctivitis, or eye infections, from bacteria the baby might encounter during birth. This is especially important if the birthing parent has a bacterial infection (like chlamydia or gonorrhea), as these can cause serious eye infections. However, if these risks don’t apply, you can consider delaying or declining the ointment. Many parents choose to weigh the pros and cons based on their unique circumstances.

5. Newborn Screening Tests (Heel Prick Blood Test)

Within 24 to 48 hours of birth, a small blood sample is taken from your baby’s heel to screen for various genetic, metabolic, and hormonal conditions. Each state or country has its own screening list, but common conditions include phenylketonuria (PKU), hypothyroidism, and sickle cell disease. Early detection can make a significant difference in managing these conditions, which is why most healthcare providers recommend this screening. However, the test is optional, so if you have concerns, you can discuss them with your provider.

6. Hearing Screen

About 1 in 500 babies is born with hearing loss, which is why hospitals offer early hearing screening. This quick, non-invasive test measures your baby’s response to sound through small sensors or earphones. Evidence shows that identifying hearing issues early can lead to better language, social, and academic development for children with hearing loss. You can choose to accept, delay, or opt out of this screening, and some parents prefer to wait until a later date.

7. Cord Blood and Cord Gas Testing

Cord blood and cord gas testing are sometimes done right after birth to measure oxygen and pH levels, which can provide information on how well the baby tolerated labor. Cord blood can also be collected for private or public storage if you wish to preserve stem cells. While this testing is optional, it’s generally offered if there were concerns during labor or if you’re interested in banking the cord blood for potential future medical use.

8. Weighing, Measuring, and Physical Check-Up

In the hours after birth, your baby is typically weighed, measured for length and head circumference, and given a basic physical exam to establish their baseline health. This provides a starting point for tracking their growth and identifying any immediate concerns. If you’d prefer to delay these procedures or have them done in your room, most hospitals will be flexible to accommodate your wishes.

9. Hepatitis B Vaccine

The first dose of the Hepatitis B vaccine is often offered in the hospital as part of a three-dose series. This vaccine is recommended by the Centers for Disease Control and Prevention (CDC) as a preventative measure, especially in cases where a parent has Hepatitis B or there’s a risk of transmission. However, some parents choose to delay this until their baby is a bit older. Your healthcare provider can offer more guidance based on your family’s health needs.

10. Umbilical Cord Care

In the hospital, your care team may provide information on keeping the umbilical cord stump clean and dry until it naturally falls off. It’s a simple but important part of newborn care. Some studies show that dry cord care, without applying any topical ointments, tends to be most effective in reducing infection risks. If you have any questions or prefer a different approach, ask your care team for support.

11. First Bath

Current research suggests that delaying the first bath for at least 24 hours helps babies maintain body temperature, prevents drying of their skin, and preserves the natural vernix (a protective layer on newborn skin). Hospitals are increasingly supportive of this practice, and many parents prefer to wait until they’re home for their baby’s first bath. If you’d like tips for bathing at home, your care team will be happy to help.

Remember: It’s All Your Choice

Every birth experience is unique, and so are your choices as parents. Whether you want to go ahead with all procedures, delay some, or skip others, you’re in control of what feels right for you and your baby. Your care team is there to support you, so don’t hesitate to ask questions, voice any concerns, or adjust timing as you see fit.

These first days with your baby are special and fleeting. Understanding what’s ahead can help you focus on bonding and enjoying each precious moment with confidence!