If your daughter is born in a hospital, her first screaming wail as she enters the world and announces her arrival will be a test of her overall health. The details vary from hospital to hospital, but the basics of what happens after that remain the same. One minute after her birth, your daughter will take her first test, called an Apgar evaluation. This rating system is named after its originator, Dr. Virginia Apgar, and is used to evaluate how well she adapts to the outside world. Dr. Apgar’s name is now used as an acronym for five areas of evaluation: A: appearance (especially skin color) P: pulse rate (number of heartbeats per minute) G: grimace (a baby’s response to annoying stimulation, such as a tap or a finger flick to the body) activity (muscle tone is tested through observation and by flexing and feeling the tension in the baby’s arms and legs) R: respiration (how well the baby can breathe and cry on her own) Each of these factors is rated on a scale of 0 to 2, with 2 being the most desirable, making for a perfect score of 10. A score of 7 or more indicates the baby is in good condition. A score under 7 indicates the baby is in some kind of distress and needs careful observation or medical attention. The test is repeated five minutes later. A low score is not cause for panic—most babies with low scores turn out to be normal and healthy. In between Apgar evaluations, your daughter will receive routine newborn care. The doctor or nurse draws a tube of blood from the placental umbilical cord, which is used to identify the baby’s blood type and Rh group and may be used for umbilical cord blood banking. At that point, the medical staff or midwife generally will: ■ Clear her nasal passages with a bulb syringe so she can breathe easily. ■ Weigh your daughter, measure her length and head circumference, take her temperature, and estimate her gestational age. ■ Put antibiotic ointment or drops in her eyes to prevent infection.Take her footprints or palm print for identification, and give both baby and her mom ID bracelets or anklets. The nurse will check these IDs each time the child is brought to you after being out of your sight. (Although some hospitals are now using new blood typing techniques for this identification, the foot- and fingerprinting routine is still common.) ■ Dry her, wrap her in a blanket, put a tiny knitted cap on her head, and perhaps place her in a warmed bassinet (or on the mother’s chest), to prevent heat loss. (Newborns cannot regulate their temperatures as well as adults.) The order in which these things get done vary. If your daughter is born in a hospital, these tasks may be done right in the delivery room or in the nursery. Either way, you will probably be given one more chance to hold your daughter before you are moved to the recovery room and she heads to the nursery. Savor and enjoy this moment. It is one you will want to remember forever. With these tests behind her, your daughter will have some time to rest and adjust to her world before the next test begins. Within the first twenty-four to forty-eight hours of her life, she will be given the newborn screening test (NBU)—also called the heel-stick test—to screen for various diseases or conditions, such as phenylketonuria (PKU) and congenital hypothyroidism (which strikes girls twice as often as boys), for which early treatment can prevent physical and developmental delays, or even death. The test is performed by pricking your daughter’s heel and putting a few drops of blood on a special filter paper. The paper is allowed to dry and then sent to the newborn screening laboratory where several different tests will be performed. All states require a newborn screening test, but each state screens for different disorders. Although the NBU is capable of screening for more than fifty disorders, most states screen for less than eight. You can find out which tests your state screens for from Save Babies Through Screening Foundation on the website at www.savebabies.org. This site will also tell you how to send a blood sample to a private lab for a complete screening if you choose.
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