Last updated on Feb 16th, 2021 at 11:04 am
After finally meeting, holding and feeding your precious newborn baby, he will be taken from you, in order to perform some vital routine health checks. These are to make sure that your little one is healthy, and to determine whether there are any underlying problems.
When: Right after birth.
What they’re doing: Weighing your baby, which is very important. Babies under 2.5kg at birth are called ‘low- birth-weight’, while those over 4 kg are considered big. This is still ‘normal’ for that particular baby, but babies at the low- or high-end may have problems with low blood sugar or temperature control, and may need extra monitoring and sometimes extra support. Usually, the head circumference and body length are also checked to obtain a serial measurement that is then used to monitor your baby’s growth and development.
The Apgar test
When: Within one minute, then at five minutes, and again at 10 minutes after birth.
What they’re doing: Looking at 5 specific things to check how well your baby is adapting to the outside world: his colour, heart rate, breathing, and response to stimulation and posture. Each is equally rated, and within 10 minutes, most babies score 9/10. It’s the routine way of picking up problems.
When: Within 72 hours
What they’re doing: Assessing the health of your baby’s eyes and looking for any abnormalities of the eyeball, cornea and retina. They’re also checking for the ‘red reflex’ – a reflection from the retina when a light from an ophthalmoscope is shone into the eyes. Any other colours may require a referral to an ophthalmologist.
Heart and lungs
When: Within minutes of delivery, once stabilised, and every time your baby is seen by a professional afterwards.
What they’re doing: Making sure there’s no fluid in his lungs while monitoring his breathing pattern. They’re also measuring the amount of oxygen in his blood via a non-invasive probe.
When: Within 72 hours
What they’re doing: Checking her bones, joints, muscles, nerves, brain function, sucking, rooting and swallowing reflexes, ability to grasp, and his Moro reflex (his reaction when his head is gently ‘dropped’ downwards). The normal response is a ‘startled’ one, with arms and legs moving outwards and brought back in again.
When: Within the first few days after delivery.
What they’re doing: Testing the cochlear function, the part of the inner ear that receives and processes sound. A good screening test is the OAE (oto-acoustic emissions) where a miniature earphone and microphone are placed in the ear. Sounds are then played and the response is measured.
When: At birth
What they’re doing: Looking for birthmarks, usually benign, like Mongolian spots (blueish marks usually on the spine and butt), stork bites (on the back of the neck) and angel kisses (red marks on the forehead or nose), are common and fade. Strawberry birthmarks are blood vessels under the skin and are usually not dangerous unless they bleed or are close to the mouth.
When: Prior to discharge, as the result becomes more reliable the longer your baby has been out of the womb and has been fed.
What they’re doing: Taking blood from your newborn child for metabolic screening such as blood glucose, and to look for evidence of a genetic problem such as phenylketonuria (PKU) and congenital hypothyroidism especially if there’s a family history.
When: after delivery
What they’re doing: Making sure that your baby has enough of this very important vitamin via an intra-muscular injection that helps the blood to clot. Newborns lack this vital vitamin and a deficiency may lead to bleeding, especially from the umbilical cord. This may lead to severe blood loss, which can be dangerous for him.
When: Immediately after birth
What they’re doing: Ensuring that your baby’s spine is symmetrically aligned and normal, and that he doesn’t have spina bifida, which is fortunately becoming very rare. It’s also checked for little indentations that may indicate an underlying problem when a spinal ultrasound or MRI may be requested.
When: After delivery
What they’re doing: Two tests are done to ensure that your baby’s hips are moving smoothly without any clicks or clunks, and that the ball of the hip is neatly aligned in the socket. If not, he may have congenital hip dysplasia which, if picked up early, is treatable and your child will be able to walk normally. If it’s missed and left untreated, he may struggle with walking and with his hips for the rest of his life. Babies who are breech, or twins and triplets, are at an increased risk of hip displasia.
When: After delivery
What they’re doing: Checking to see whether your baby is a boy or girl, for starters! With boys, it’s important to check that the penis is straight and that the urethra is on the tip of the penis, not along the shaft. If not, the little boy may need surgery in the first year or two of life to correct this. A little white mucousy discharge or a few drops of blood from the vagina is normal in little girls. Very rarely, the genitalia are not clearly male or female, which is when further tests need to be done.
More about the experts:
Dr Kathy Krige graduated from Stellenbosch University and did part of her community service year at the paediatric ward of Helderberg Hospital in Somerset-West. She completed her studies at Cape Town’s Red Cross War Memorial Children’s Hospital and the University of Cape Town. She was admitted as a Fellow of the College of Paediatricians in 2006 and has been in private practice at Thriving Kids since 2007. Read more about Dr Kathy Krige here.
Dr Gary Reubenson is currently the head of the Clinical Unit at the Rahima Moosa Mother and Child Hospital in Joburg. He is an infectious diseases paediatrician who has been full-time employed at Rahima Moosa Mother and Child Hospital since 2004. Read more about Dr Gary Reubenson here.