What to Expect the First 48 Hours After Birth

Contributing Expert: Nina Alfieri, MD, MS

This post is part of our newborn health and wellness series. For more information from our pediatric experts, visit our Newborn Resources page

The few days immediately following your child’s birth can feel both euphoric and exhausting. You’re getting to know your newborn, often without much sleep. The birthing parent is also still recovering from delivery. It’s a time of excitement and big transition. 

Your baby is going through massive adjustments in those first 48 hours as well. Eating, sleeping, breathing, pooping and peeing, being soothed: it’s suddenly all different for them as they learn to live outside the womb.  

The first few days can be a blur. Here are a few of the milestones and behaviors you can expect during the first 48 hours. 

What Happens Immediately After Delivery 

In a vaginal delivery with no complications, parents have skin-to-skin time with their baby immediately after birth. For parents who give birth by C-section, skin-to-skin happens as soon as possible after delivery as well. Your medical team will dry the baby, cut the umbilical cord and wrap them up to keep them warm as they snuggle against the parent’s chest. This time helps parents and babies bond. 

Other things that happen soon after (or before you leave the hospital): 

  • Apgar test, which measures your baby’s vital signs and activities, at 1 minute and again at 5 minutes, to see if they need any help transitioning into the world. 
  • Measurements (weight, length, head) and footprints. 
  • Eye ointment, which prevent infection. 
  • First bath. 
  • Vitamin K shot, which helps prevent serious bleeding problems. 
  • Hepatitis B vaccine. 
  • Blood tests, to check bilirubin levels, as well the newborn screen.  
  • Hearing screening. 

Learning to Feed  

Parents will get a chance to breastfeed immediately after birth. That skin-to-skin contact helps to promote lactation and gives your baby a chance to practice latching. Your medical team including doctors, nurses and lactation consultants, can offer lots of support as you and your baby work on breastfeeding. 

In the days just after delivery, mammary glands make a substance called colostrum. This is a thick, yellow fluid that is high in calories and antibodies. You can think of it as your baby’s first vaccine. 

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For most lactating parents, milk fully comes in around day 5. Frequent offering of the breast — at least every 4 hours, but every 1 – 3 hours is encouraged — helps milk come in and helps you practice nursing and get a routine established. Lactating parents interested in feeding breast milk through a bottle can also begin pumping after birth to establish their milk supply.  

Babies who are fed formula need the same frequent offering of formula, ideally every 1 – 3 hours. The reason babies need such frequent feeds is because their livers can’t maintain the amount of glucose they need, and they can’t take in very much milk at once. At birth, a baby’s belly is about the size of a marble. 

You can begin to look for signs of hunger in those early hours and days, such as smacking lips, sticking out tongue or rooting (searching for a breast). If they turn their head away, it usually means they are full.  

Newborn Sleep in First 48 Hours 

Newborns are often very alert right after birth. While their vision is still blurry, they often have intent looks on their faces, as if they are taking it all in. And they truly are. 

But the work of coming into the world is exhausting for most newborns. They usually sleep quite a bit for the next few days, with short cycles of being awake. It’s important to wake them every few hours to offer them breast or bottle. 

First Diapers of Newborns 

A newborn’s first poop is the consistency of black tar. This is called meconium. But as they begin feeding, it transitions to a more yellow stool — usually within the first week of life. This is a good sign and shows they are taking in the nutrients they need.  

There is a wide range of normal for baby stools in terms of color and texture. Stools can be yellowish, greenish, brownish and different degrees of liquid versus solid.  

Before You Leave the Hospital  

Those first days can feel overwhelming for parents. If you delivered vaginally with no complications, you’ll be headed home within those first two days. The more support you can have in place before you leave, the better.  

Your baby will get a complete exam before discharge, and you’ll need to select a pediatric practice. For many practices, you can schedule your baby’s first visit to the pediatrician online, before you ever leave the hospital. 

Your medical team will also make sure you understand safety advice for your baby, including car seat safety, sleep safety and signs of illness. Babies must sleep on their back in a crib or bassinette that’s empty (no blankets, bumpers or stuffed animals).  

In addition to expert specialty care, Lurie Children’s offers several primary care locations around the Chicago area for your child's healthcare needs — from infancy through childhood and adolescence. Learn more about our primary care services.  

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