Baby’s first 24 hours

What will my newborn baby look like?
When your baby is born, their skin might be blue and mottled. They are likely to be covered in amniotic fluid, blood and vernix, which is a cheesy white substance. This is normal.

Their skin will start to become pink as they start to breathe – which is about a minute after birth. Your baby’s hands and feet may still appear blueish for several hours.

The amniotic fluid and the vernix are there because they were there in the womb. They are important for your baby to be able to smell and taste after birth. These familiar things help your baby to feel secure outside the womb.

Birth of the placenta and cutting the umbilical cord
After you have given birth to your baby, you will have more contractions that will help you deliver the placenta. Once this happens, the umbilical cord, which is connected to the placenta, will be clamped in two places and cut. Your support person might be invited to cut the cord.

Skin-to-skin contact
After a normal vaginal birth, your newborn baby will be put on your chest for skin-to-skin contact. Your baby needs sleep and food, and they need to feel secure and warm, so they need to feel your skin.

Doing this simple thing:

reduces newborn crying
helps start and sustain breastfeeding
helps maintain your baby’s body temperature
After this first contact, they will be weighed, measured and observed to make sure they are healthy.

If you have a caesarean section, ask your midwife to make sure your baby has skin-to-skin contact with you as early as possible. It may be possible for you or your partner to hold your baby-skin-to skin in theatre and in recovery.

Weighing and measuring
After skin-to-skin contact and the first breastfeed, your midwife might offer to weigh your baby, and measure your baby’s length and head circumference. Your baby doesn’t need to be washed for at least 24 hours.

Vitamin K
At the time of weighing, your midwife will also offer to give your baby a vitamin K injection to prevent bleeding from vitamin K deficiency.

Cord blood collection if you are Rh negative
If your blood group is Rh negative, some blood will be taken from the umbilical cord to determine whether your baby’s blood group is compatible.

Feeding
Babies start to show signs of wanting to feed soon after birth and usually attach and suck at the breast about 50 minutes after birth. They may then breastfeed for an hour or more. Put your baby against your chest, and they will probably find your breast and start feeding. If that doesn’t happen, you can ask your midwife or a lactation consultant for help.

The first milk you make is called ‘colostrum’. It’s thick and often yellowish, rather than pure white. It’s the ideal milk for your baby. Normally a small amount is produced – your baby’s tummy is just the size of a marble.

If they haven’t fed an hour or so after birth, try again a couple of hours later. You can also express some colostrum to feed to your baby on a spoon.

Sleeping
Your baby will stay with you so you can bond and respond easily to their needs. They’ll probably sleep soon after their first feed, and that might last 6 hours or so. They will probably sleep for more than half of their first day in the world.

Apgar scores
One of the main observations made after birth is called an Apgar score. It assesses your baby’s adjustment to life outside the womb. The Apgar score is measured at 1 minute and 5 minutes after birth while the baby is on your chest. Sometimes it is measured again at 10 minutes after birth.

It records your baby’s heart rate, breathing, colour, muscle tone and reflexes. The maximum score is 10. A score of 7 or above usually means your baby is doing well. It is not an ability or intelligence test, and it doesn’t predict your baby’s health later in life.