5 things nurses always do before holding a newborn baby
Insider spoke with Lily Steeg RN, a labor and delivery nurse based in Georgia, on how she cares for a newborn immediately after delivery.
Nurses clean vernix, a "cheesy" white substance, off a newborn and make sure it isn't "floppy" before holding the baby.
Steeg said nurses must check for a number of physical cues to make sure the baby appears healthy after delivery.
Nurses check the color of the baby right after birth.
Lily Steeg, a labor and delivery nurse based in Georgia who shares tips for new parents on her TikTok, revealed to Insider what nurses always check for prior to handling a newborn. Exact protocol may vary from hospital to hospital, Steeg said, but much of the general process is standard among labor and delivery nurses.
The nurse said one of the first things nurses check for after delivery is something new parents might also notice right away: the color of the newborn.
Babies are typically blue or very pale immediately after delivery, which may worry parents, Steeg said.
"I think that a lot of parents see that, and it's scary, but it's not necessarily uncommon because usually once they're stimulated, wiped off and start crying and taking their first breaths is when they start to pinken up," the nurse added.
If the baby does not pinken up almost immediately after delivery, the nurses might need to give the baby more oxygen, Steeg said.
Nurses check to see if a baby isn't "floppy."
Almost immediately after a baby is delivered, nurses check to see if a baby has good "muscle tone," or if they have are flexing their arms and legs, and having reflexive reactions to being touched.
A baby with poor muscle tone might have hypotonia, or "floppy infant syndrome." Newborns with this condition appear limp and rag doll-like after birth, according to Cleveland Clinic, meaning they have trouble lifting their head and do not bend their elbows or knees.
Steeg said babies could appear limp for a number of reasons, including whether the mother was taking certain medication and if there were complications during delivery. "Floppy" babies are often cut from the umbilical cord immediately and taken for further testing.
While the baby is still attached to the umbilical cord, nurses clean the "cheesy" white substance off.
You may have noticed a baby coming out of the womb covered in a white, waxy substance. The "cheesy" layer, as Steeg describes it, is called "vernix caseosa."
Vernix is a biofilm that protects the fetus' skin starting in the third trimester of pregnancy, according to the National Institutes of Health. After birth, vernix acts as a natural antibiotic that protects the baby from bacteria and keeps its skin moist.
While a newborn is still attached to the umbilical cord immediately following delivery, nurses wipe down some of the vernix with towels but they do not wash it away completely, as Insider previously reported removing vernix completely increases a baby's risk of infection and cracked skin.
If the newborn is healthy, nurses clamp and cut the umbilical cord about a minute after delivery.
Nurses often keep babies attached to the umbilical cord for around 1 to 3 minutes, Steeg said, which is called "delayed cord clamping."
Steeg said keeping the baby on the umbilical for a little bit after birth ensures it has enough blood, and the amount of time the baby is kept on the umbilical cord depends on hospital policy. Nurses will then clamp and ask the supporting partner if they would like to cut the umbilical cord to detach the newborn from its mother.
Nurses make sure the newborn is warm before placing it on a mother for skin-to-skin contact.
Finally, right before the nurse can finally hold the baby, she might place a hat on the newborn's head to make sure it stays warm, Steeg said. Newborns cannot regulate their body temperature as well as adults, and lose heat quickly.
Nurses will also place warm blankets on the mother and newborn right after birth, and place the baby on the mother for skin-to-skin contact. Steeg said nurses maintain hygiene by wearing clean surgical scrubs when handling the newborn.
While the baby rests on the mother, nurses will check the newborn's vital signs, apply an ointment to their eyes to prevent infection, and sometimes inject vitamin K to help with blood clotting. Steeg will also take the newborn's head, height, and weight measurements shortly after delivery.
A nurse recommends washing your hands before holding your newborn.
Steeg recommends caregivers wash their hands before holding the newborn, but her hospital does not have formal protocols in place. If the newborn has to stay in the neonatal intensive care unit, however, the hospital has specific guidelines about hygiene, including mandating visitors wash their hands thoroughly with soap and water.
"It's hard to learn all of these new things when your body is going through a pretty major experience delivering a baby and you're trying to process everything that's being said," Steeg said. "We're gonna be there holding your hand and helping you get through it."
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