Baby's first 24 hours

It can be hard to think past the birth of your baby. This article explains what you can expect from your baby during the first day of their life. It has general information, when you've had a healthy, full-term pregnancy.

The Apgar score is a measure of your baby's condition just after birth. It measures your baby's:

• heart rate
• breathing
• colour
• muscle tone
• reflexes

The Apgar score is measured at 1 minute after birth, 5 minutes after birth and sometimes 10 minutes after birth. The maximum score is 10. A score of 7 or above usually means your baby is doing well.

It assesses your baby's adjustment to life outside the uterus.

It doesn't predict your baby's health, intelligence or developmental outcomes later in life.

After your baby is born, your midwife will:

• weigh your baby
• measure their length
• measure their head circumference

These measurements will be taken regularly at your baby's health checks and recorded on growth charts. This helps you and your healthcare team know that that your baby is healthy and growing well.

Skin-to-skin contact is encouraged in the first hour after giving birth. This can help:

• promote bonding
• with breastfeeding
• keep your baby warm
• stabilise your baby's heartbeat
• regulate your baby's breathing

It can also help you to bond with your baby.

If you have a caesarean section, you should still be able to have skin-to-skin contact after delivery.

When your baby is born, they may have blood and vernix on their skin. Vernix is a white, sticky substance that protects their skin in the uterus.

If you had an assisted delivery, your baby may have some swelling and bruising on their head. This will soon disappear.

If your baby was overdue, their skin may be slightly dry and cracked. This is because the vernix was absorbed before they were born.

Your baby may have small pink or red marks on their forehead, eyelids or neck. These are birthmarks. They are sometimes called stork marks or salmon patches. These marks on the face will fade gradually.

After you have given birth to your baby, you will have more contractions that will help you deliver the placenta. This is the third stage of labour.

Once this happens, the umbilical cord, which connects your baby to the placenta, will be clamped. Your support person may be asked to cut the cord, but you can also do it yourself if you want.

A small amount of the cord will stay attached to your baby's tummy button. This is called the cord stump.

Make sure that you know how to care for your baby's umbilical stump to stop infection.

If your blood is Rh negative, a small amount of your baby's blood will be taken from the umbilical cord. This will be tested to find out your baby's blood group.

If your baby is Rh positive, you will be offered an anti-D injection. This stops your body from developing antibodies.

Vitamin K is needed to help blood clot. This stops bleeding.

Newborns often don't have enough vitamin K for the first 8 days of life. This puts them at risk of developing a rare disorder called Vitamin K Deficiency Bleeding (VKDB). This can cause a brain bleed and can lead to death.

It's recommended that all babies are given a vitamin K injection within a few hours of birth.

This injection will only be given with your permission.

If you have chosen to breastfeed, you may have your first breastfeed during skin-to-skin time. Your midwife can help check your positioning and attachment.

You can still breastfeed your baby if skin-to-skin time is delayed. If necessary, your midwife will show you how to express breastmilk until your baby is ready to breastfeed.

The first milk you make is called 'colostrum'. It is thick and yellow in colour. You will only make a small amount of colostrum. This is perfect for your baby as their tummy is very small.

Your baby may want to feed quite often to start with — it may be every hour. As a rough guide, they may feed 8 to 12 times or more over the first 24 hours. This number of times will lessen as your milk comes in (your breasts start to feel full).

When your baby is hungry, they will:

• get restless
• suck their hands
• make murmuring sounds
• turn their heads and open their mouths

If you want help with breastfeeding, talk with your midwife or a lactation consultant.

Most newborns will sleep between 14 to 17 hours in a 24-hour period. This may be broken up into 6 to 8 periods of sleep. Each sleep can last from 2 to 4 hours.

Make sure that you know how to put your baby to sleep safely. This can help to lower the chance of sudden infant death syndrome (SIDS).

Your baby's first poo is black and sticky. This is called meconium. Your baby's poo will change colour to greenish-brown over the next few days before turning yellow.

Your baby should also have at least one wet nappy within 24 hours of their birth.

Your baby has been listening since before their birth. They will be familiar with your voice and the sounds of your house.

Talking to your baby will help them develop. Soft noise can help calm your baby.

Newborns can see things that are close. But things that are further away appear blurred. Their eyesight will develop over the next few months.

You may notice that your baby's eyes sometimes wander in different directions. This should stop by the time they are 3 months old. If you are concerned, see your doctor and child health nurse.

Your baby's eye colour may change over the next few months.

For more information and advice, you can talk with your doctor or midwife.

For help with breastfeeding, you can call the Australian Breastfeeding Association on 1800 686 268.

COPE provides online support for new parents.

Visit the Perinatal Anxiety and Depression Australia (PANDA) website for information and support. You can call the PANDA national helpline on 1300 726 306.