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.