FIRST 24 HOURS AFTER BIRTH - WHAT HAPPENS TO YOUR BABY
Published - January 31, 2026 Last Updated - January 31, 2026
My son was placed on my chest exactly 47 seconds after
birth. I know because my husband was recording. What I didn't know then—and
what nobody tells you—is that the first 24 hours after birth would be
the most medically intense, emotionally overwhelming, and utterly exhausting
day of my life. Here's what happens.
Understanding what to expect during the first 24
hours after birth helps you feel prepared rather than overwhelmed. This
first day is just the beginning—check out our complete newborn health guide for everything that comes next.
What Happens in the Delivery Room During the First 24 Hours After Birth
The delivery room moves fast. One moment you push, the
next you're holding your baby. But in those first 60 minutes of newborn care on the first day, medical staff are quietly assessing your newborn and
completing critical procedures.
Apgar Score Explained (1 and 5 Minutes)
At exactly one minute after birth, someone calls out a
number: "Apgar’s are 8 and 9." This is the Apgar score, measuring
five vital signs:
- Appearance (skin color):
Pink = 2; blue extremities = 1; pale = 0
- Pulse (heart rate):
Over 100 bpm = 2; under 100 = 1; absent = 0
- Grimace (reflex):
Vigorous cry = 2; weak cry = 1; no response = 0
- Activity (muscle tone):
Active = 2; some flexion = 1; limp = 0
- Respiration (breathing):
Strong cry = 2; slow breathing = 1; not breathing = 0
Scores are tallied at 1 and 5 minutes. A score of 7-10
is normal. Most healthy babies score 8 or 9 (not 10) because blue hands and
feet are common initially.
The "Golden Hour" and Skin-to-Skin Contact
Immediately after weighing or bathing, your baby should
be positioned on your bare chest. This "golden hour" during the first
24 hours after birth provides crucial benefits:
- Regulates baby's temperature better than any warmer
- Stabilizes blood sugar levels
- Promotes bonding and reduces postpartum depression
- Helps the baby find the breast for the first feeding
- Colonizes baby's skin with healthy bacteria
Your body actually warms or cools by up to one degree
to match your baby's needs.
Delayed Cord Clamping Benefits
Providers now typically wait 30-60 seconds before
clamping the umbilical cord. This allows blood transfer from the placenta to the baby,
providing increased iron stores and better cardiovascular stability. The
American College of Obstetricians and Gynecologists recommend this practice for
both vaginal and cesarean births.
Medical Procedures in the First 24 Hours After Birth
After the golden hour, nurses complete several routine
procedures during newborn care on the first day.
Vitamin K Shot - Why It's Recommended
Your baby receives a vitamin K injection in their thigh
to prevent Vitamin K Deficiency Bleeding (VKDB), a rare but serious bleeding
disorder. Babies are born with low vitamin K and can't produce it yet. The shot
has been standard since the 1960s and has nearly eliminated this condition.
The injection causes brief discomfort (10-15 seconds of
crying) but prevents potentially catastrophic internal bleeding, including
brain hemorrhages.
Eye Ointment Application
Shortly after birth, your baby receives antibiotic
ointment (erythromycin) in both eyes. This prevents eye infections from
bacteria encountered during delivery, specifically gonorrhea and chlamydia,
which can cause blindness. Many hospitals now apply this after the golden hour
to allow initial bonding and eye contact.
First Bath (or Why It's Often Delayed)
Many hospitals now delay bathing for 24 hours or more.
Learn more about when to give
your baby's first bath and why timing matters. The white, waxy vernix
coating protects the baby's skin, helps regulate temperature, and guides the baby to
the breast through scent. When bathing does occur, it's typically a gentle
sponge bath.
Newborn Screening Tests During the First 24 Hours After Birth
Before discharge, your baby undergoes several screening
tests during the newborn's first 24 hours of care to detect rare but serious
conditions.
Hearing Screening
A painless test using either Otoacoustic Emissions
(OAE) or Auditory Brainstem Response (ABR) checks your baby's hearing. About
1-2% don't pass initially, usually because of fluid in the ear. True hearing loss
affects about 1-2 per 1,000 babies. Early detection allows intervention before
critical language development windows close.
Critical Congenital Heart Disease Screening
A pulse oximeter measures oxygen levels in a baby's hand
and foot. This simple test detects serious heart defects affecting about 1 in
100 babies. If oxygen levels are low, your baby will have an echocardiogram to
check for problems.
Blood Tests (PKU and Others)
The "heel stick" blood test screens for 30+
rare metabolic and genetic disorders, including PKU, congenital hypothyroidism,
sickle cell disease, and cystic fibrosis. The heel stick heartsease and your baby
will cry, but early detection prevents serious complications. Most abnormal
results are false positives requiring confirmation.
Feeding in the First 24 Hours After Birth
Feeding during the newborn's first 24 hours of care looks
different from what you expect—and that's completely normal.
When Will My Baby Eat?
Most babies are alert and ready to feed within the
first hour. After this, many fall into a deep sleep for several hours. Offer
feeding every 2-3 hours, even if the baby is sleepy. If you're planning to
breastfeed, our breastfeeding
basics guide walks you through latching and positioning.
Breastfeeding Colostrum vs. Formula
Breastfeeding babies receive colostrum—thick, yellow,
concentrated substance packed with antibodies. It comes in teaspoons (not
ounces), perfectly matched to your baby's cherry-sized stomach, holding about
5-7 ml.
Formula-fed babies typically take 1-3 oz every 2-3
hours, totalling about 8-12 oz in the First hours after the baby is born.
How Much Should They Eat?
Breastfed babies - Nurse
8-12 times in 24 hours. Each feeding lasts 10-40 minutes.
Formula-fed babies - Take
1-3 oz every 2-3 hours.
Signs of adequate feeding: at least 1-2 wet diapers, at
least 1 dirty diaper (meconium), baby seems satisfied after feeding.
From hour one, follow safe sleep
practices by placing baby on their back in a bare crib.
What Your Baby Looks Like After Birth
Newborns don't look like babies in ads. During the first
24 hours after birth, your baby might have:
- Vernix caseosa - White, waxy coating
- Lanugo - Fine hair on the shoulders and back
- Swollen genitals - From maternal hormones
- Moulding - Cone-shaped head from delivery
- Blue hands and feet - Normal initially
- Skin peeling - Especially in overdue
babies
Baby acne and rashes are harmless, common
newborn skin conditions.
Bruising and swelling
- Caput succedaneum:
Scalp swelling, resolves in days
- Cephalohematoma: Blood collection
under the scalp, takes weeks
- Subconjunctival hemorrhage: Blood
spots in the eyes, harmless
Sleep Patterns in the First 24 Hours After Birth
Your baby is exhausted from being born. Expect a 1-2
hour alert period after birth, then deep sleep for several hours. You might
have brief alert periods later, but lots of sleep is normal.
If the baby won't wake for feedings -
- Undress them
- Change their diaper
- Rub their back or feet
- Try skin-to-skin contact
Safe sleep from hour one -
- Back to sleep always
- Bare crib (no blankets, pillows, toys)
- Firm surface with fitted sheet only
- Room sharing, not bed sharing
- Room temperature 68-72°F
When to Worry - Red Flags in the First 24 Hours After Birth
Most newborn quirks are normal, but some symptoms
during the First hours after the baby is born require immediate attention.
Not sure if something requires immediate attention? Our guide on when to call
your pediatrician helps you distinguish emergencies from normal behaviour.
Breathing Problems
Normal: 40-60 breaths per minute, irregular
pattern, occasional sneezing.
Call for help if
- Persistent fast breathing (over 60/minute)
- Chest retractions (ribs sucking in)
- Grunting with each breath
- Blue or gray colour that doesn't improve
- Pauses longer than 10 seconds
Feeding Difficulties
Normal: Sleepy babies, small amounts,
learning to latch.
Call for help if
- Baby won't wake despite stimulation
- No feeding within the first 6-8 hours
- Projectile vomiting
- Choking with every feed
Temperature Issues
Normal: 97.7-100.3°F (rectal)
Emergency if
- Over 100.4°F (go to ER immediately)
- Under 97°F and won't warm up
- Extreme lethargy
Other red flags: excessive jitteriness, seizure-like
movements, no meconium by 48 hours, and yellow skin in the first 24 hours.
The Hepatitis B vaccine is often given before
discharge—see the full vaccination
schedule for what comes next.
What Comes Next
The first 24 hours after birth are intense, but
they're just the beginning.
Before discharge
- Schedule a pediatrician appointment (3-5 days after birth)
- Get after-hours doctor contact
- Understand feeding expectations
- Receive screening results or timeline
Expect in the coming days
- Milk "coming in" around day 3-5
- Continued weight loss, then gain
- More alert periods
- More frequent feeding
- Possible jaundice peaking day 3-5
Give yourself grace. You're doing better than you
think.
Frequently Asked Questions
Q: Why does my baby have a cone-shaped head?
A: This is moulding from passing through the birth
canal. Skull bones overlap during delivery, creating an elongated shape. It is
resolved within days to a week. C-section babies usually have rounder heads.
Q: Should I wake my baby to feed?
A: Yes, in the first 24 hours, offer feeding every 2-3
hours even if the baby is sleepy. After day one, most healthy full-term babies
can feed on demand.
Q: What is the white coating on my baby's skin?
A: That's vernix caseosa, a protective coating from the
womb. It moisturizes, has antimicrobial properties, and doesn't need washing, fitting naturally.
Q: Is it normal for my baby to lose weight?
A: Yes, in the first week, newborns
typically drop 7–10% of their birth weight, then return to it by the second
week. Loss over 10% requires evaluation.
Q: When will my baby poop for the first time?
A: Most babies pass meconium (black, tarry stool)
within 24-48 hours. If not by 48 hours, notify your pediatrician—it may
indicate intestinal blockage.
Ready to learn what happens after you leave the
hospital? Read our guide to your baby's first week at home.
Medical Disclaimer: This article provides general
information and is not a substitute for professional medical advice. Always
consult your pediatrician.
Reference
1.
American
Academy of Pediatrics (AAP)
Key Resource:
https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/default.aspx
Newborn Care:
https://www.healthychildren.org/English/ages-stages/baby/Pages/default.aspx
Apgar Score
https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Apgar-Scores.aspx
2.
World
Health Organization (WHO)
o Newborn Health:
o https://www.who.int/health-topics/newborn-health
3.
American
College of Obstetricians and Gynecologists (ACOG)
Postpartum Care:
https://www.acog.org/womens-health/faqs/postpartum-care
4.
Centers
for Disease Control and Prevention (CDC)
Infant Care: https://www.cdc.gov/parents/infants/index.html
