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Part 4-The Newborn

Labor may take many paths and delivery may occur in many ways, but there is one thing common to all deliveries. After the practitioner's cry of "It's a boy" or "It's a girl," every parent asks the same question: "Is my baby okay?" Most parents first concern is whether all the body parts are present and accounted for. "Are there ten finger and ten toes?" is usually the parents' second question. But obstetricians, midwives, and pediatricians are concerned not just about body parts, but whether the baby can make the virtually instantaneous transformation from being supported by the placenta to surviving on its own.

During the first few minutes after birth, miraculous changes take place in the baby's body. The lungs, which are partially collapsed when the baby is in the uterus, must expand and begin to absorb oxygen. The circulation must change from one that includes and is dependent upon the placenta to the normal circulation, which is self-supporting. These changes, described in Chapter 28, are often virtually completed within the time it takes for the baby to draw its first few breaths and give a lusty wail.

There are a variety of factors that obstetricians and pediatricians take into account when evaluating the newborn's efforts to adjust to life outside the uterus. Each factor can be scored with points, and the total score gives a fairly good approximation of how well the baby is doing. This scoring system is known as the Apgar score, and it is discussed in detail in Chapter 29.

Although the newborn's ability to meet its oxygen requirements shifts from dependence on the mother to self-sufficiency, there is little else that it can do for itself. Indeed, it is designed to continue receiving all nutrition from its mother in the form of breast milk. Breast-feeding provides the perfect food for the newborn. Colostrum, which is secreted in the hours immediately following delivery, transmits important antibodies to the baby, providing additional protection from the common diseases of early childhood. Breast milk itself is always available, always the right temperature, and always present in the perfect quantity.

Although breast-feeding is a natural function, neither a new mother nor a brand-new baby knows exactly how to begin. The art of breast-feeding must be learned through trial and error; but with a bit of patience on the mother's part (babies are never patient), this skill can usually be mastered in a few days. Chapter 30 details the process of breastfeeding and the necessary steps to begin the nursing partnership.

Regardless of whether you breast-feed or bottle-feed, your newborn baby is dependent on you for love and care. The end of pregnancy represents a new beginning, filled with new joys and fears and new excitements and responsibilities.