Alright, you’ve left the hospital with your brand new baby and you’re wondering what’s next. Feeling left out in the cold and vulnerable, you wonder how on earth you’re going to raise this new being in the household. In your mind, you inevitably ask yourself, “what IS next?”
As pediatricians, we won’t ever leave you in the cold. Most practices want to see a newborn within 48 hours of discharge, depending on what happened while you were in the hospital. For example, if your infant had jaundice, they might want to see you sooner. The standard, however, is 48-72 hours.
What exactly do they do?
At this visit, you should expect your baby’s weight to be down and their bilirubin, the jaundice-causing compound in their body (eh hem, jaundice = carrot baby), to be up. This is normal, and I discuss that in another post.
The practice will collect information about you and about your new baby. It’s handy to bring any discharge paperwork with you, especially if the doctor isn’t affiliated with the hospital where your baby was born. They will weigh your baby naked on a scale to get the most accurate weight possible. They will then check the bilirubin usually transcutaneously with a wand looking device or will ask you to get a blood draw (which is more accurate and necessary if your baby had phototherapy [the blue lights]). Then, the provider will see you and your baby.
There are no vaccines at this visit, as your baby should have gotten their hepatitis B and Vitamin K shots immediately after birth.
De-mystifying the Exam
The provider will do a head to toe assessment of your child to make sure there’s no abnormalities or things that would require further evaluation. Some of the big things we are looking for at this visit are murmurs, signs of trouble breathing, or excessive jaundice. We also check reflexes such as the Moro reflex (my favorite!) and their hips to make sure they don’t have any laxity. We expect newborns to sleep most of the time, usually only waking to feed or during diaper changes. They aren’t too alert at this age!
As long as their weight isn’t more than 10% down from birthweight and their bilirubin isn’t too high, we usually schedule another follow up visit in 2-4 days to recheck the weight and bilirubin to make sure the weight is starting to trend up and the bilirubin is decreasing. If there is excessive weight loss, we might schedule an appointment sooner. If the bilirubin is too high, we might have to admit your child to the hospital for phototherapy or send you home with a “bili blanket”.
Once your baby has demonstrated weight gain and a stable bilirubin, you’re all clear for the 2 week appointment! The big milestone at that appointment is being back at birthweight, so keep on feeding your child and relish in the fact that you’re a new parent. You’ve got this!
Tips for this Visit
1) Write down questions that you have, because I guarantee you:
- Will be tired
- Will forget to ask whatever it is you wanted
- Will be wondering “what have I gotten myself into?”
Don’t be afraid to feel like you don’t know what’s going on, we’re here to help you and your new baby thrive!
2) Plan on leaving yourself plenty of time to get there. It will take longer than expected.
3) Bring a blanket to wrap your baby in after they are weighed because they usually remain undressed for the provider to do an exam. This can serve two purposes- keeping baby warm while you wait as well as a good cozy and familiar thing to lay on during the exam.
4) Keep your baby covered in the waiting room as they are bound to be sick kids in the same location. If you’re provider’s office is lucky, they’ll have a “Well Baby Waiting Room” where young infants at risk of serious illness can hang out while they wait for their appointment to minimize exposure.
If you have questions about the newborn visit, make sure to share them below!