Rethinking Your Baby’s First Few Minutes of Life

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Rethinking Your Baby’s First Few Minutes of Life

Rethinking Your Baby’s First Few Minutes of Life

Think back to when your babies were born—what happened in those first 5-10 minutes of life?  Did you hold your baby?  Were you encouraged to breastfeed your baby?  Or did someone take your baby away from you?

These days most babies go directly to a health care provider for evaluation, or, if the baby is breathing and appears well, the mother will get to look at or hold the baby for a minute or two before someone whisks the baby away for “necessary” medical care.

Things are changing.  We are rethinking how a baby should spend his or her first few minutes of life.

As a hospital-based pediatrician, I have been attending deliveries regularly for almost ten years, and I love it.  I never tire of witnessing the joy of new parents.  I feel privileged to take care of babies in their first few seconds of life.  St. Gianna, a pediatrician who also attended deliveries, expressed the same thoughts in her writings.  But those first few minutes of life are not meant to be spent with me.  Those precious few minutes are meant for bonding between baby and parents.

With the support of the Best Fed Beginnings program and Baby Friendly USA, my local hospital in St. Louis (BJH/Washington University) has started giving babies directly to mothers as soon as they are delivered, provided they are breathing and appear healthy.  Newborns go “skin-to-skin,” meaning that we place the baby, unwrapped, on mom’s bare chest, between her breasts.  We usually place a warmed blanket over the baby.

Babies can be evaluated by a pediatrician and/or nurse on mom’s chest, if needed.  If a baby is in distress and needs medical care, obviously we do whatever is necessary.  But most of the time babies are fine.  They do not need a pediatrician in the first few minutes of life.  We can even do skin-to-skin at cesarean sections.

And then something amazing often happens: babies start breastfeeding.  All by themselves.  They just find the breast and latch right on.  And usually when they are less than ten minutes old.

If you’ve ever struggled to breastfeed a newborn, you know how hard it can be to get them to latch on to your nipple.  Breastfeeding can become a stressful burden on a very tired mother.  But babies who breastfeed in the first hour of life—and preferably in the first 30 minutes—have a much easier time learning how to latch.  Why? Because when the baby is inside mom’s uterus, she is constantly and rhythmically sucking in amniotic fluid and swallowing it.  At birth she cries, breaths air, and starts to forget how to suck and swallow.  If you wait more than an hour to breastfeed, babies can have a hard time latching, sucking, and swallowing.  If you breastfeed right away, the baby still remembers how to suck and swallow.  If you put a baby skin-to-skin between mom’s bare breasts at delivery, she will be warm, soothed by mom’s voice, find the breast herself, latch right on and start nursing.

The moms giggle and cry.  They are so happy.  This is how the first few minutes of life are meant to be. In the sentiment of Blessed John Pau II’s Theology of the Body, these first few minutes are a total  self gift of mother’s body to the baby, from the uterus to the breast.  And with total self-gift comes incredible joy, even through pain.

What did the nurses and doctors used to do when they took babies away from moms at delivery?  Here’s what we used to do, and how we do it now:

  • Check baby to be sure she is healthy: Pediatricians and/or nurses used to take babies away from moms to be sure baby is breathing well and healthy.  We still do this, just on mom’s chest.  Later, when mom is ready to rest, we do a complete physical exam on baby.  We also weigh the baby, measure length and head circumference, and get footprints.  But all this can be done when the baby is one or two hours old—it doesn’t need to be done in the first ten minutes of life.
  • Draw blood tests: If necessary, we would draw blood for tests, usually to check babies for infection.  Now we do any needed tests a bit later, when we do the baby’s physical exam.  Occasionally it is still necessary to get tests right away, but usually only on very sick newborns.
  • Give baby a shot of vitamin K: Vitamin K deficiency can cause serious bleeding and death in newborns under two weeks old.  This uncommon condition can be prevented by a shot of vitamin K in the first few hours of life.  The Vitamin K shot is recommended by the American Academy of Pediatrics and is standard newborn procedure in most hospitals.  We still give vitamin K shots to newborns, but after mom and baby have bonded and breastfed. 
  • Put antibiotic ointment in baby’s eyes:  All babies get antibiotic ointment in their eyes shortly after delivery to prevent serious newborn eye infections.  The ointment does blur baby’s vision.  Now we wait an hour or so before giving the ointment, so that baby can breastfeed and bond with mom. 
  • Give baby a bath: Babies are born covered in vernix, a white substance that coats them in the uterus.  Usually babies get a bath to remove vernix, at least within the first few hours of life.   There is no reason for a bath in the first few minutes of life.

So go skin-to-skin with your baby, talk to her, nurse her.  Everything else can wait.  If you are currently pregnant, don’t be afraid to express these wishes in your birth plan.  Be sure to discuss these methods of infant care with your OB/Gyn and the nurse who admits you to Labor and Delivery.

Copyright 2013 Kathleen Berchelmann, MD

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3 Comments

  1. For mothers-to-be in the Northeast Missouri area, check out Hannibal Regional Hospital- everything stated in this article is standard procedure at HRH, and it’s Missouri’s ONLY hospital that has earned the distinction of Baby Friendly Hospital (because of things like skin-to-skin; VERY limited staff interaction with mother/baby in the first few moments of life to increase bonding; no government funding for formula, etc.)!!! Babies, even with limited visual acuity, can often find mother’s breast, make their way to it, and latch for breast feeding. Amazing! Thank you, Dr. Berchelmann- fantastic article!

      • Marlene Waechter on

        As a Catholic midwife of more than 30 yrs, I have nothing to “rethink”! My routine is for baby to be put skin to skin on moms chest, w an encouraging word about nursing helping the placenta out. I then start my clean-up, leaving family to bond, with words of, “let me know when that placenta is ready to come out.” as I leave the room to fix her a meal. Of course this assumes everything was normal at delivery. If there is any sx of a problem, I would stay with them until resolved. Placenta is delivered, mom fed, mom’s bottom & baby are examined, cleaned up & cord cut all w/o any separation.
        I am very discouraged that I get all kinds of Amish, Mennonite, German Baptist, & non-denominational Christians, yet rarely get a Catholic client!

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