Assessing the newborn

The exact moment of birth occurs when the fetus, having left the uterus through the cervix, passes through the vagina to emerge fully from its mother’s body.

In most cases, babies automatically make the transition from taking in oxygen via the placenta to using their lungs to breathe air.

Consequently, as soon as they are outside the mother’s body, most newborns spontaneously cry. This helps them clear their lungs and breathe on their own. While assessing the newborn who have difficulty making the transition to life outside the uterus require special help at once.

Apgar Scale

Apgar scale is a standard measurement system that looks for a variety of indications of good health while assessing the newborn. The newborn infant first undergoes a quick visual inspection. Parents may be counting fingers and toes, but trained health-care workers look for something more. This helps identify babies that have difficulty breathing or have other problems that need further care. 

Developed by physician Virginia Apgar, the scale directs attention to five basic qualities, recalled most easily by using Apgar’s name as a guide:

1. Appearance (color),
2. Pulse (heart rate),
3. Grimace (reflex irritability),
4. Activity (muscle tone),  
5. Respiration (respiratory effort).

Using the scale, health-care workers assign the newborn a score ranging from 0 to 2 on each of the five qualities, producing an overall score that can range from 0 to 10. The vast majority of children score 7 or above. The 10 percent of neonates who score under 7 require help to start breathing. 

It may indicate problems or birth defects that were already present in the fetus.

At various junctures during labor, the fetus may lack sufficient oxygen. Lack of oxygen for a few seconds is not harmful to the fetus, but deprivation for any longer may cause serious harm.

Newborn’s medical screening

Just after birth, newborns typically are tested for a variety of diseases and genetic conditions.

The American College of Medical Genetics recommends to screen all the newborns for 29 disorders, ranging from hearing difficulties and sickle-cell anemia to extremely rare conditions such as isovaleric acidemia, a disorder involving metabolism.

These disorders can be detected by a tiny quantity of blood drawn from an infant’s heel. It permits early treatment of problems that might go undetected for years. The exact number of tests that a newborn experiences varies drastically from state to state.

Physical appearance.

In addition to assessing the newborn’s health, health-care workers deal with the remnants of the child’s passage through the birth canal. The thick, greasy substance (like cottage cheese) that covers the newborn. This material, called vernix, smooths the passage through the birth canal; it is no longer needed once the child is born and is quickly cleaned away. 

Initial encounters.

After being cleansed, the newborn is usually returned to the mother and, if he is present, the father. The importance of this initial encounter between parent and child has become a matter of considerable controversy. Some psychologists and physicians argued that bonding, the close physical and emotional contact between parent and child during the period immediately following birth, was a crucial ingredient for forming a lasting relationship between parent and child (Lorenz, 1957).

Their arguments were based in part on research conducted on nonhuman species such as ducklings. This work showed that there was a critical period just after birth when organisms showed a particular readiness to learn, or imprint, from other members of their species who happened to be present (Lorenz, 1957).

According to the concept of bonding applied to humans, a critical period begins just after birth and lasts only a few hours. During this period, actual skin-to-skin contact between mother and child supposedly leads to deep, emotional bonding. The corollary to this assumption is that if circumstances prevent such contact, the bond between mother and child will forever be lacking in some way.

Although immediate mother–child bonding does not seem critical, it is important for newborns to be gently touched and massaged soon after birth. The physical stimulation they receive leads to the production of chemicals in the brain that instigate growth.

Consequently, infant massage is related to weight gain, better sleep–waking patterns, better neuromotor development, and reduced rates of infant mortality.

Learn about the birth process, click here.

References,

1. Robert. S. Feldman. (2017). Development Across the Lifespan. (8th ed.). Pearson Education.
2. Laura. E. Berk. (2018). Development Through the Lifespan (7th ed.). Pearson Education.