AND YOUR BABY
First Impressions
Before I became a father, I’m quite sure that I believed that my children—even right after their birth—would be stunningly gorgeous. Well, chalk up another victory for the ad execs. The fact is that in most cases, babies look a little strange. If your baby was born vaginally, the trip through the birth canal may have made her look like she just got beat up—cone headed, mushed, and bruised. She came out covered in white cheesy-looking stuff, her eyes may be swollen and cross-eyed, and her hairy back and shoulders might have you worrying about what’ll happen when the moon is full.
Take it easy. Within a few weeks her nose will pop out, and her head will get rounder (C-section babies usually look a little better). The cheesy stuff is called vernix, and it’s a natural moisturizer that protects the baby’s skin while she’s in the womb. The puffy eyes are most likely the result of the antibiotic ointment the medical staff put in her eyes after birth to prevent infection, and that fuzz on her back is called lanugo, and it’ll fall out pretty soon.
But for a lot of new dads, the biggest shock is the condition of their babies’ skin—all those splotches (especially on the neck and the eyelids), strange-looking birthmarks, and tiny zits can be a little disconcerting. But before you grab your cell phone and call a dermatologist, take a minute and read about some of the more common, and perfectly normal, conditions:
• Acne. These cute little pimples are usually confined to the baby’s face and are either the result of your partner’s hormones continuing to swim through the baby’s system or of her underdeveloped pores. Either way, don’t squeeze, poke, pick at, or scrub these pimples. Just wash them with water a few times a day, pat them dry, and they’ll go away in a few months.
• Blisters. Pictures taken of babies in utero have shown that long before birth they frequently suck their thumbs—or any other part of their body they can reach. Sometimes they suck so hard, they raise blisters.
• Jaundice. If your baby’s skin and/or the whites of her eyes seem a little yellow, she may have jaundice. This condition is the result of the baby’s liver being unable to adequately process bilirubin, a yellowish by-product of red blood cells. It affects about 25 percent of newborns (and a higher percentage of preemies), appears within the first five days of life, and is usually gone a few days later.
• Splotches, blotches, and birthmarks. They can be white, purple, brown, or even yellow with white bumps in the center, and they can appear on the face, legs, arms, and back. In most cases, they’ll go away on their own if you just leave them alone. But if you’re really worried, check with your pediatrician.
• Cradle cap (or, more informally, “cradle crap”). Also called seborrheic dermatitis, this stuff looks like flaky, yellowish, sometimes greasy dandruff. It usually shows up on the head, but it can also work its way into baby’s eyebrows. It’s not a serious condition and will bother you much more than it does the baby. It’s also not contagious, and regular shampooing with a baby shampoo may help it go away.
Let the Tests Begin
Your baby’s first few minutes outside the womb are going to be a time of intense physical and emotional release for you and your partner. She may want to try nursing the baby (although it’s going to be mostly for bonding purposes; most newborns aren’t hungry for at least the first twelve hours or so), and you’ll probably want to stroke her brand-new skin and marvel at her tiny fingernails. But depending on the hospital and the conditions of the birth, your baby’s first few minutes could be spent being poked and prodded by doctors and nurses instead of being held and cuddled by you.
One minute after she’s born, your baby will be examined to give the medical staff a quick take on her overall condition. (You may have thought that the first test your child would really have to worry about passing would be the SAT, or maybe the exam they give kids before they get accepted into exclusive preschools. But oh, no—it starts waaaay sooner than that.) The Apgar test (named after anesthesiologist Virginia Apgar, who first started using the test in the early 1950s) measures your baby’s Appearance (skin color), Pulse, Grimace (reflexes), Activity, and Respiration. The nurse or midwife will chart your baby’s Apgar score at one minute and five minutes after birth. The score sheet looks something like the following chart. Keep in mind that the scores are used by the medical staff to help them determine how much intervention (if any) the baby needs. Although the scores have absolutely nothing to do with IQ or future earning power, and college admissions committees never ask for them, they do give new parents a handy (but completely useless) way of comparing their children.
The theoretical maximum score is 10, but anything between 7 and 10 at one minute is a sign of good health. Almost no baby gets a 10 (unless she’s the child of someone on the medical team) because most of them are born with slightly blue toes and fingers. This means that the baby needs only routine care. A baby who scores 4–6 may require some medical intervention such as oxygen or suction to remove mucus from the throat or lungs. A score of less than 4 may indicate the need for resuscitation. However, a low score could be the result of pain medication given to the mother or of the baby being born prematurely. The test will be done again at five minutes after birth to assess the effectiveness of the interventions. If the score is still low, the test will be repeated at five-minute intervals.
At the same time as the tests are going on, your baby will be weighed, measured, given ID and security bracelets, bathed, diapered, footprinted, have some antibiotic ointment applied to her eyes, get a quick injection of Vitamin K (to prevent bleeding and help her blood clot properly), and be wrapped in a blanket. She may even get her first picture taken. If your baby was delivered by C-section, or if there were any other complications, she’ll have her little lungs suctioned before returning for the rest of the cleanup routine.
| APGAR TEST | 2 POINTS | 1 POINT | 0 POINTS |
| A-Appearance | The entire body is pink from head to toe | Body is pink but arms and/or legs may be bluish | Body is entirely blue, pale, or gray |
| P-Pulse and heart rate | Above 100 beats per minute | Fewer than 100 beats per minute | Not detectible |
| G-Grimace (reflexes) | Loud cry when reflexes are stimulated | Moderate crying or whimpering when reflexes are stimulated | No response |
| A-Activity | Lots of movement of the arms or legs | Some movement of the arms and legs | No movement at all |
| R-Respiration | Big breaths and lots of crying mean those little lungs are working well | Slow, weak, or irregular breaths | No breathing |
Quality Time Starts Now
Most hospitals now encourage “rooming in”—keeping the baby in the same room as the new mom and dad. Some don’t have nurseries at all, except the ones for babies with serious health problems. Others still have nurseries but offer unlimited access for the parents.
If your hospital does have a nursery, you may want to take advantage of it. You may be tempted to have the baby room with your partner, but depending on how the birth went, she might really need to rest. Ask the nursing staff to bring the baby to your partner at feeding times. You, on the other hand, can spend as much time as you want with the baby. Of course, if your partner would prefer to have the baby nearby—plenty of new moms want exactly that—don’t bother arguing with her.
And while we’re on the subject of rest, you may have to get tough with the staff to make sure your partner gets enough. The nurses will tell her that she needs to sleep as much as possible, but if you don’t ask them to give her a break, they’ll be in every hour or two to check her vital signs.
The Placenta
For some reason, before my first child was born I’d never really thought very much about the placenta, which had been my daughter’s life-support system for a lot of the pregnancy. But whether you think about it or not, it’s still there—and it has to come out.
After the baby is born, your partner will continue to have mild contractions for anywhere from five minutes to about an hour until the placenta is delivered. The strange thing about this stage of the delivery is that neither you nor your partner will probably even know it’s happening—you’ll be much too involved with your