First Few Days
Immediately after a normal birth, the mother and father are encouraged to hold their newborn. Breastfeeding may be initiated at this time if the mother plans to breastfeed. Some experts believe that early physical contact with the newborn helps establish bonding. However, parents can bond well with their newborn even when the first hours are not spent together. Mother and baby spend a day or two in the hospital during which time new parents are taught to feed, bathe, and dress the baby and become familiar with the baby's activities and sounds. In the United States, discharge from the hospital within 24 hours is common.
The plastic cord clamp on the umbilical cord is removed within 24 hours after birth. Some doctors recommend that the stump be moistened daily with an alcohol solution to speed drying and reduce the chance of infection; an antibiotic ointment should not be used because it can prolong the drying process. The stump falls off on its own in a week or two.
Circumcision, if desired, generally is performed within the first few days of life before the newborn is discharged. The decision about having a newborn circumcised usually depends on the parents' religious beliefs or personal preferences. The main medical reason for circumcision is to remove an unusually tight foreskin that is obstructing the flow of urine. Although circumcised males also have a lower risk of cancer of the penis and urinary tract infections, these risks can be minimized with proper hygiene. Circumcision can result in infection, excessive bleeding, scarring, and very rarely in accidental amputation of the penis tip. About 2 to 20 boys per 1,000 require a minor surgical procedure later to correct various problems resulting from circumcision. An equal number of uncircumcised males require a circumcision later in life.
Circumcision should not be performed if the boy has not voided, or if the penis is abnormal in any way, because the foreskin may be needed for any plastic surgical repair that may be needed later. Circumcision must be delayed if, during the pregnancy, the mother had been taking drugs that increase the risk of bleeding, such as anticoagulants or aspirin; the doctor waits until all such drugs have been eliminated from the newborn's circulation.
Most newborns have a mild skin rash sometime during the first week after birth. The rash usually appears in areas of the body rubbed by clothing--the arms, legs, and back--and rarely on the face. It tends to disappear on its own without treatment. Applying lotions or powders, using perfumed soaps, and putting plastic pants over the diapers are likely to make the rash worse, especially in hot weather. Dryness and some skin peeling often occur after a few days, especially in the creases at the wrists and ankles.
Newborns who are otherwise normal may develop a yellow color to their skin (jaundice) after the first day. Jaundice that appears before 24 hours of age is of particular concern.
The first urine produced by a newborn is concentrated and often contains chemicals called urates, which can turn the diaper pink. If a newborn does not urinate within the first 24 hours of life, the doctor tries to find out why. Delay in starting to urinate is more common in boys.
The first bowel movement is a sticky greenish black substance (meconium). Every baby should pass meconium within the first 24 hours after birth. Failure to pass a bowel movement is usually caused by a hardened plug of meconium inside the baby's intestine, which can usually be removed by one or more gentle enemas. A birth defect may cause a more serious blockage.
After a few days in the hospital, the newborn is able to go home. Having a new baby in a household requires a great deal of adjustment for all involved. For a household that has had no children, changes in lifestyle may be dramatic. When other children are present, jealousy can be a problem. Preparing other children for the newcomer and being careful to pay attention to them and include them can ease the transition. Pets may also need some extra attention to help them adjust to the baby. In some cases, keeping pets away from the baby may be necessary.
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