Editing Maternal and Newborn Nursing (section)

=== Routine prophylaxis and screening ===

* '''Vitamin K (phytonadione) IM in the vastus lateralis''' shortly after birth to prevent vitamin K deficiency bleeding. Newborns are deficient because the gut is sterile at birth and little vitamin K crosses the placenta.
* '''Erythromycin ophthalmic ointment''' to both eyes to prevent gonococcal ophthalmia neonatorum. It may be delayed up to about an hour to allow initial bonding and eye contact.
* '''Hepatitis B vaccine'''; if the mother is HBsAg positive, the infant also receives '''hepatitis B immune globulin''', ideally within 12 hours of birth.
* '''Newborn metabolic screening''' by heel stick, typically at 24 to 48 hours of age, for conditions such as phenylketonuria, congenital hypothyroidism, galactosemia, sickle cell disease, and cystic fibrosis. Adequate feeding before the screen matters for accuracy. Use the '''lateral heel''' to avoid the calcaneus, and warm the heel first.
* '''Hearing screening''' and '''pulse oximetry screening for critical congenital heart disease''' (right hand and either foot, usually after 24 hours).