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Understanding What Happens in a Baby’s First Hours

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A Look at What to Anticipate and What Can Go Wrong During the First 24 Hours with a Newborn

After laboring and finally delivering your child, you would be surprised how much there is yet to do. The hospital staff or midwife wants to ensure that your baby is breathing well and thriving, so they will assess your baby’s overall health. What happens in the first few minutes of a baby’s life depends on the pregnancy, labor, and delivery. The post-delivery happenings after a vaginal birth may differ from those of a cesarean, especially an unplanned one. The delivery length and complications may affect the newborn’s health, so understanding what to anticipate in your baby’s first hours, what signs may indicate a potential medical problem, and the types of tests, checks, and steps that medical providers need to take to best support your baby’s health and ability to thrive is invaluable.

The Immediate Aftermath of Labor and Delivery

The first order of business is to check for the baby’s breathing and clear the baby’s nose and mouth of obstructions like amniotic fluid or mucus. The classic breathing sign is the baby’s first cry. That sound assures medical staff and parents alike. However, to a medical professional, the baby’s cry determines what is next. A quiet baby or a weak cry may indicate that the baby needs help breathing, which will be the priority. Otherwise, a breathing newborn may spend the first few minutes enjoying skin-to-skin bonding with their mother, maybe breastfeeding. Sometimes, the baby is cleaned and wrapped before placement in a parent’s arms, which may be when the mother needs post-delivery attention delivering the placenta, repairing skin tears, or other medical care and recovery time.

You Give Birth, Then What is Done Right After?

Within minutes of birth, the doctor, midwife, or parent may cut the umbilical cord, clamping it shut to stem the bleeding. Depending on the mother and baby’s health, the cord cutting and clamping may occur before, during, or after the initial skin-to-skin bonding and feeding. When either of them needs medical attention, the cord-cutting occurs right after birth. Also, within the first minute of life, the overseeing healthcare provider assesses the baby’s Apgar score. Each of the five categories measures the baby’s vitals, such as heart rate, breathing, muscle tone, reflexive irritability responses (grimaces, pulling away), and skin color or appearance. The total score is 10, with zero, one, or two assigned to each category. An Apgar score of 7 or higher means the baby is healthy and does not require immediate life-saving assistance. The opposite is also true.  An Apgar score rating occurs one, five, and ten minutes post-delivery.

When the baby’s Apgar score is high, and they do not need immediate care, the nurses or midwife may then clean and wrap the baby in a blanket after the mother’s first hour with the baby, followed by taking a Ballard score: weighing, measuring length, head, abdomen, and chest circumference to confirm the baby’s gestational age. A doctor or midwife may also take the baby’s pulse and temperature, check for fingers, toes, and genitals; check feet, arms, legs, eyes, ears, and skin; record the first bowel movement; and administer a vitamin K shot and antibiotic eye drops, the latter two for preventing vitamin K deficiency bleeding and eye infection, respectively. A physical examination of the musculature and motor responses also occurs when a doctor tests joint and muscle flexion, spinal carriage, and limb reflexes. They may check for hearing problems.

The medical staff also takes a blood sample to check for diseases by pricking the baby’s heel. Blood tests may be performed to scan for diseases like sickle cell, phenylketonuria, hypothyroidism, galactosemia, or other conditions that cause blindness, organ problems, and cognitive deficiencies. The infant may also get a hepatitis B vaccine, which can also wait until the first check-up with a pediatrician at two weeks. However, the newborn of a mother with a history of Hepatitis B or an unknown Hepatitis B status requires a vaccination within 12 hours of birth or they are at increased risk of severe illness and death. t hearing loss and brain damage.

Common Aspects of a Newborn’s Appearance After Delivery

Your baby’s skin may first appear blue, red, or purple until breathing regulates the skin tone to its normal color when fully oxygenated in about five to ten minutes. The baby’s extremities may stay blue until the blood circulation reaches the furthest points from the heart and through the small blood vessels of the hands and feet. The baby’s face may be bruised or swollen, and its bald or hairy head may be misshapen from a vaginal birth. The skin may be sticky with a protective coating, red blotchy skin, and swollen genitals.

Possible Signs of Trouble in a Baby’s First First Hours to Be on the Lookout For

A newborn that suffered a long, hard vaginal or emergency cesarean section birth is more prone to needing respiratory assistance with a breathing mask or respirator in the neonatal intensive care unit. Also, babies born with specific birth defects or pregnancy-induced disabilities may need breathing help, too. Lethargic, inactive babies or ones with irregular, slow, or fast heartbeats may also need medical attention. A baby that is too small or big may also suggest problems. A tiny baby may suffer respiratory and feeding problems or suffer severe jaundice. In addition, a lower Apgar score may indicate the newborn needs medical care. For example, a score of zero for muscle tone or activity means the newborn’s muscle tone or action is absent. The baby may be lethargic and motionless. A score of one indicates some movement in the feet or hands, and a two means the baby is moving and active.

In addition, neonatal hypoglycemia that goes undetected and untreated within the first 24 hours can lead to cognitive delays, seizures, personality disorders, and heart troubles. And untreated newborn jaundice allowed to linger can cause serious problems, such as bilirubin encephalopathy and kernicterus, which could cause permanent hearing loss and brain damage.

Kinds of Medical Errors that Can Happen Soon After a Baby is Born

The timing of the initial blood tests is critical for accurate results. A blood test taken too early or too late can skew results, missing important information about the newborn’s health. The blood draw should take place within 24 to 48 hours of birth. Thus, a physician who tests too early or too late, misreads the blood test results, or fails to vaccinate a newborn who is at risk in a timely manner can be responsible for a child’s disability throughout their life and for the parents’ emotional distress and financial losses. When physicians lapse and deliver substandard care to a newborn in the critical first hours of life, such negligence forms the basis of a medical malpractice claim. Those who suffer at the hands of incompetent practitioners, whether such subpar performance is temporary or habitual, may receive compensation for their economic and non-economic losses.

What Types of Compensation Can a Child Receive for Medical Malpractice in the First Few Hours of Life? What Goes into this Calculation?

When an infant has permanent health damage due to medical negligence, those damages may be extremely high. A valid claim includes compensation for current and future medical expenses, including not only doctor and hospital visits, but therapeutic, rehabilitative, and nursing care for children who need special education, speech therapy, seizure medications, and special equipment and home modifications, like wheelchair ramps, to complete daily care tasks and activities. Parents may claim financial losses due to employment loss due to caring for a special needs child and emotional losses for their child’s suffering.

Let our NJ Medical Malpractice Team Assist with Exploring Your Legal Options when You Suspect Post-Birth Medical Negligence

The total dollar figure of damages, both financial and emotional, may be difficult to calculate without the help of a knowledgeable birth injury and medical malpractice attorney, such as those on our legal team. Meeting deadlines, compiling damages proof, and dealing with opposing parties, their evidence, and experts are all essential parts of what our medical malpractice and birth injury lawyers do on a regular basis. We can work with you in first attempting to settle your child’s claim with an insurance company or the negligent party or parties, and if a favorable settlement cannot be reached, we can prepare and argue zealously on your child’s behalf at trial to obtain full compensation. With our background and experience handling the investigation of medical negligence claims surrounding the labor, delivery, and childbirth process, and our dedication to the lengthy preparation and tactical skill involved in successfully handling birth injury claims, our New Jersey lawyers are fully prepared to assist with your case.

If you believe that medical negligence occurred in your baby’s first few hours of life, and this subsequently caused or contributed to their development of injuries or further health issues, contact us for a free case evaluation today at 866-708-8617. Our attorneys are standing by to answer your questions and explore your legal options.

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