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After your child's birth, your baby will experience many important medical procedures, many of them mandated by law. But as long as your child is healthy (and 90 percent of full-term newborns are), we recommend requesting that all tests (except the Apgar evaluation, which must be performed immediately after the birth) be delayed for at least the first hour of your child's life. This will preserve a very special time for you and your partner to bond with your child immediately after the birth.
The following tests and procedures may be performed: Apgar evaluation, eye prophylaxis, vitamin K injection, newborn metabolic screening, blood sugar testing and hepatitis B vaccine.
Apgar Evaluation
This score (named for its creator, Virginia Apgar) helps evaluate your baby's general condition at birth. The test is performed at one and five minutes after birth by evaluating the infant's heart rate, breathing efforts, muscle tone, reflexes and color and assigning a score of 0, 1 or 2 to each category. A total score of 10 is the highest, and most babies will rate between seven and nine by five minutes.
Eye Prophylaxis
This consists of either drops or an ointment routinely applied directly to the baby's eyes within two hours of birth. The purpose is to protect newborns from serious eye infections caused by exposure in the birth canal to gonorrhea or chlamydia, which may be asymptomatic in the mother. Medications used may be tetracycline, erythromycin or silver nitrate, which is becoming less common. Because the eye treatment can sting or blur the baby's vision temporarily, this is a procedure you especially may wish to postpone until you have fed and bonded with your baby.
Vitamin K Injection
Vitamin K is essential for clotting and is usually produced by humans in their intestinal bacteria. For reasons yet to be discovered, the normal newborn has very low levels at birth. It is standard practice in the United States to give infants a vitamin K shot to help prevent a serious bleeding condition known as Hemorrhagic Disease of the Newborn (HDN).
Newborn Metabolic Screening
This test is performed in all 50 states. Routinely, blood is drawn from the baby's heel before being discharged. The disorders screened for vary widely from state to state, but all states test for phenylketonuria (PKU) and congenital hypothyroidism.
- PKU is present when the infant does not have an enzyme necessary for the metabolism of essential proteins. Untreated, PKU can cause a healthy newborn to degenerate both mentally and physically with serious lifelong results.
- Hypothyroidism occurs when a child does not have enough thyroid hormone. Without adequate levels, babies may have mental retardation, growth failure, deafness and neurological abnormalities. The condition is treated through diagnosis of the cause and by giving the baby supplemental thyroid hormone.
