After birth & Measuring Health

Transition to Newborn

• Birth process also puts stress on the baby.

• The newborn rapidly goes from a warm, quiet, and dark prenatal environment into a bright, noisy, and cold postnatal environment. Fortunately, babies are physiologically well prepared to handle the stress of being born.

  • The skull of a baby is malleable to fit in birth canal
  • Vernix caseosa (a skin grease) protects the baby against heat loss before and during birth.

• The mother’s production of stress hormones during labor triggers the
  production of stress hormones in the baby

  • Prepares the lungs to begin breathing, send additional blood to the baby’s brain and vital organs, and make the baby alert right after the birth.

Moments After Birth

• Oxytocin causes the breasts to “let down” milk, heightens the mother’s responsiveness to baby
• Fathers also show hormonal changes that are associated with positive emotional reactions to infants.
• Today, hospitals offer rooming in, in which the infant stays in the mother’s hospital room all or most of the time.

Measures of Neonatal Health and Responsiveness

• Right after birth the newborn is weighed, cleaned up, and tested for signs of any developmental problems.
• Apgar Scale: a widely used method to assess the health of newborns at one and five minutes after birth.
  • Evaluates infants’ heart rate, respiratory effort, muscle tone, body color, and reflex irritability.

The Apgar Scale

• Baby assessed at 1 minute and again at 5 minutes after birth
• A newborn is rated 0, 1, or 2 on each measure, for a maximum score of 10.
• Heart rate
  • 0 = absent
  • 1 = slow; less than 100 beats per minute
  • 2 = fast; 100-140 beats per minute
• Respiratory effort
  • 0 = not breathing for more than 1 minute
  • 1 = irregular and slow
  • 2 = good breathing with normal crying
• Muscle tone
  • 0 = limp and flaccid
  • 1 = weak, inactive, but some flexion of extremities
  • 2 = strong, active motion
• Body color
  • 0 = blue and pale
  • 1 = body pink but extremities blue
  • 2 = entire body pink
• Reflex irritability
  • 0 = no response
  • 1 = grimace
  • 2 = coughing, sneezing, and crying
• A score of 7 to 10 indicates the baby is in good to excellent condition.
• A score of 5 to 7 may mean the baby needs help to establish breathing, and the test should be repeated every 5 minutes up to 20 minutes.
• A score below 5 is rare and may reflect a variety of problems.

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