What to Expect After You've Been Expecting

You’ve read all the books; you’ve spoken to all your friends; you’ve heard from just about every relative, and now “baby time” is quickly approaching. Getting ready for the big day can be exhausting and overwhelming. Information overload can take its toll. So what are you supposed to expect after you’ve been expecting? Knowing what to anticipate after delivery and in the first days of your baby’s life can ease apprehension and help create a smoother and more comfortable experience. 

What happens in the hospital after delivery?

The hours and days after delivery can be filled with excitement, exhaustion and at times angst. Please know there is a tremendous amount of support for parents as they adjust to life with a newborn. The hospitals have very well-trained and experienced nurses available to answer questions.

The post-delivery agenda is as follows: After delivery, your baby will be quickly examined and given Apgar scores, which range from one to 10 and are based on the baby’s respirations, heart rate, color, tone and reflexes. This is a quick snapshot of how the baby is transitioning to life outside the womb. Babies are then brought to Mom to meet her little one and experience the first bonding moment!

Shortly after delivery newborns are given a Vitamin K shot which helps prevent bleeding that can occur in the intestine and umbilical cord as well as from procedures such as circumcision and blood draws.  In addition, an antibiotic ointment is applied to the newborn’s eyes to prevent infection.

When does the pediatrician arrive and what does he/she do?

The hospital will contact your pediatrician’s office to inform them of the delivery and provide all the important information about the baby.  Within the first 24 hours of your baby’s life, your pediatrician will come to the hospital for the first visit. You can expect your pediatrician to visit once a day while you are in the hospital. After reviewing the pregnancy and delivery history, the pediatrician will do a head to toe examination and assess how the baby is feeding, interacting, and generally transitioning to life in the “Big City.”

In addition to the nurses at the hospital, your pediatrician also will help you with any feeding issues. Ideally, most babies will start suckling at the breast within an hour of delivery, and most babies will have their first wet and dirty diapers within the first 24 hours.  

The daily routine and prior to discharge

During subsequent visits, your pediatrician will review the previous day’s feeds and output (voiding and stooling), examine the baby, and address any questions or concerns you may have.

Prior to discharge, the nursery staff will check a baby's bilirubin levels (a marker for jaundice or yellowing of the skin), obtain the first of two state newborn screens, complete a hearing screen, and perform a congenital heart disease screen. Babies also should receive their first Hepatitis B vaccine -- this first dose provides immediate protection from exposure to unknown carriers.

Nearly all babies lose weight in the first few days of life. As feeds progress, weight gain increases at about a half an ounce to an ounce a day. We anticipate that babies will gain their weight back by about two weeks of age.

When is the first visit to the pediatrician’s office?

The first visit to the pediatrician’s office generally occurs one to two days after discharge from the hospital. This is an early opportunity to see how feeds are going, check the baby’s weight, evaluate for jaundice (yellowing of the skin), provide guidance regarding sleep and answer any questions that may arise after parents have spent that first night or two at home with their baby. Additionally, these early visits give us an opportunity to check in on another very important person...Mom. The newborn period is filled with excitement.  But the hormones of pregnancy continue to course through Mom’s circulation, sleep can be a foreign word and worries about the baby can all combine creating a sense of feeling overwhelmed and blue. If this is the case for you, please know that you are not alone and, in addition to your obstetrician, we are here to help.

If everything is going well, the next visit is typically at two weeks of age, but if there are any concerns, the pediatrician may arrange for follow-up sooner. While some newborns take to breastfeeding very quickly, for others nursing can be difficult. Breastfeeding often is a learned skill that takes time and patients. Please know that you are not alone and there is lots of support for you. We are grateful to have two outstanding lactation consultants in the Greenwood Pediatrics family who are ready and excited to help mothers develop this skill.