Thank you for reading about what to expect during your first postpartum home visit for the mom! Now, it’s time to look at what that first visit looks like for the baby. During the pregnancy and after baby’s arrival, I remind my clients that I am not a pediatrician. The law does allow for midwives to care for babies for up to six weeks, but I encourage the parents to find a pediatrician and discuss how soon they should be seen. Most often, I am still the first one to see the baby by this 24-48 hour home visit window.
Lots of things happen during this visit for the baby. It is important to do a nursing check and help if there have been any difficulties with latch. If nursing is going well, then not as much time is needed there. We check baby’s vital signs including his/her heart rate, respirations, temperature, and review the chart that the parents have been using to track how baby has been doing in the time the midwife was gone. We review how many wet and dirty diapers that the baby has had, how much indirect sunlight the baby is getting (this helps to break down bilirubin levels and can help to prevent jaundice), and how baby is sleeping.
This is the ideal window to collect that first sample for the newborn screening and to perform the CCHD (Critical Congenital Heart Defect) screening. The baby is of course weighed, and we discuss how much weight loss is okay versus too much, as it is NORMAL for the baby to have dropped weight during this time. Because I do not have the equipment to perform the hearing screen, I remind the parents they will need to have this done either by their pediatrician or through another provider I refer.
As mentioned in the previous post, following baby’s checkup, he/she may be brought into the herbal bath with mom. If the baby will be in the bath, we delay applying the cord care powder to the umbilical cord until after the bath. I also use this time, if we didn’t already review it during the first herbal bath following the birth, to show the parents how easy bathing a newborn while in the tub with them can be. You’d be amazed at how overwhelming it can seem to bathe a new baby! I want everyone to feel comfortable and confident in this time! The baby is dried, diapered after applying olive oil to his/her bottom (GREAT tip for helping that tar-like meconium to slide right off!), the cord is examined and treated, and the baby is dressed and wrapped or ready for skin-to-skin with mom or dad.
Similar to my departure following birth, I like to leave mom and baby resting comfortably together in bed, well attended and nourished.