Welcoming a baby—especially through surrogacy—is a moment filled with anticipation and joy. For many intended parents, particularly those traveling from outside the U.S., understanding what happens in the hospital during the first 24–48 hours can bring clarity and peace of mind.
This guide explains the routine newborn procedures performed in American hospitals, why they matter, and what intended parents should expect when their baby arrives.
Key Takeaways
- Surrogacy newborns receive the exact same routine medical procedures as any other infant born in the United States.
- Standard newborn care includes Vitamin K injection, eye ointment, Hepatitis B vaccine, jaundice screening, heel-prick metabolic screening, hearing screening, and congenital heart screening.
- Newborn screening requirements vary by state; for example, California performs one heel-prick test, while Arizona requires two.
- A normal bilirubin (jaundice) test result is a key requirement for newborn discharge.
- Hospitals require parental consent; when intended parents are not physically present, a Power of Attorney (POA) authorizing a representative to sign newborn care forms is essential.
- Understanding these procedures helps intended parents feel more confident during their baby’s first hours of life.
💉 Vitamin K Injection
Shortly after birth, newborns in the U.S. receive a single intramuscular Vitamin K injection. According to the Centers for Disease Control and Prevention (CDC – Vitamin K for Newborns), babies are born with naturally low vitamin K levels, which places them at risk for Vitamin K Deficiency Bleeding (VKDB). VKDB can cause severe internal bleeding, including intracranial hemorrhage.
The Vitamin K shot has been the standard of care since the 1960s because it is safe, effective, and life-saving. It provides long-lasting protection until the baby’s natural vitamin K levels gradually increase.
👶 Erythromycin Eye Ointment
Within the first hours of life, hospitals apply erythromycin antibiotic eye ointment to prevent bacterial eye infections acquired during birth. The American Association for Pediatric Ophthalmology (AAO – Eye Prophylaxis Guidelines) notes this medication significantly reduces the risk of blindness caused by gonococcal or chlamydial conjunctivitis.
The ointment is quick, painless, and widely required by state public health laws.
💉 Hepatitis B Vaccine
The first dose of the Hepatitis B vaccine is recommended within 24 hours of birth. According to the CDC (CDC – Hepatitis B Birth Dose), administering the vaccine immediately provides powerful early protection—even when the birth mother (surrogate) is hepatitis-B negative.
Documentation of the vaccine is included in the newborn’s hospital discharge packet.
🦵 Heel-Prick Blood Spot Screening (Newborn Metabolic Screening)
Between 24–48 hours, newborns receive a heel-prick test to screen for dozens of metabolic, genetic, hematologic, and endocrine disorders. These conditions are rare but serious—and early detection is critical.
U.S. newborn screening varies by state:
- California requires one newborn screening (California Department of Public Health – Newborn Screening Program).
- Arizona requires two screenings: the first before discharge and a second at 5–10 days of life (Arizona Department of Health Services – Newborn Screening).
Most states screen for 30–60 conditions, including:
- PKU
- Congenital hypothyroidism
- Sickle cell disease
- Cystic fibrosis
- MCADD
This test is one of the most essential public-health interventions in newborn medicine.
🌞 Jaundice Screening (Bilirubin Test)
Newborn jaundice is common due to elevated bilirubin levels in the first days of life. Hospitals perform a bilirubin test—either a transcutaneous scan or a blood test—to ensure bilirubin levels are safe.
The American Academy of Pediatrics recommends universal bilirubin screening before discharge (AAP – Hyperbilirubinemia Guidelines).
Why this test matters:
- Detects babies at risk for severe jaundice
- Prevents bilirubin from reaching dangerous neurological levels
- Ensures timely phototherapy when needed
- A normal bilirubin result is one of the key medical requirements for a baby to be cleared for hospital discharge
This test typically occurs at 24–36 hours of life.
👂 Newborn Hearing Screening
More than 98% of U.S. newborns undergo a hearing screen before discharge (CDC – Hearing Screening & Early Detection).
Two painless methods are used:
- OAE (Otoacoustic Emissions)
- AABR (Automated Auditory Brainstem Response)
Early detection of hearing differences allows timely referral to pediatric audiology and early-intervention services, which significantly improves outcomes.
❤️🩹 Critical Congenital Heart Defect (CCHD) Screening
Around 24 hours after birth, hospitals screen for critical congenital heart defects using pulse oximetry—a painless sensor placed on the baby’s hand and foot. According to the CDC (CDC – CCHD Screening), this test has reduced early deaths from congenital heart disease through early identification and referral.
🧼 Delayed First Bath
Many U.S. hospitals delay the newborn’s first bath for 12–24 hours. The World Health Organization and AAP note that delaying bathing helps stabilize temperature and blood sugar and preserves protective vernix on the skin (WHO – Newborn Thermal Care).
Parents may observe or participate in the newborn’s first bath when it occurs.
❤️ Skin-to-Skin Care
Skin-to-skin care (kangaroo care) helps regulate a newborn’s temperature, heart rate, breathing, and stress levels. It also promotes bonding and supports early feeding.
In surrogacy births, hospitals coordinate skin-to-skin time as soon as the baby is medically stable.
🧾 A Note About Consent
U.S. hospitals typically require the legal parents to sign consent forms for routine newborn care, vaccinations, and screenings.
If intended parents are not physically present at the time of birth—common in international or long-distance surrogacy—a Power of Attorney (POA) must be documented in advance so a designated representative (often a trusted companion or agency liaison) may legally sign newborn care authorizations.
Ivy Surrogacy ensures the hospital has the correct legal documents so all medical decisions are made promptly and appropriately.
FAQ: Routine Newborn Procedures in U.S. Hospitals
1. What happens if my baby does not pass the hearing screening?
A “refer” result is common and does not necessarily indicate permanent hearing loss. Newborns often don’t pass due to fluid in the ears, movement, or congestion. Hospitals schedule a repeat screening within 1–2 weeks. If the baby does not pass the second test, a pediatric audiologist performs a full diagnostic evaluation. Early detection ensures early intervention when needed.
2. If only the father is present, can he do skin-to-skin contact with the baby?
Absolutely. Fathers can provide highly effective and meaningful skin-to-skin care. Studies show that father–baby skin-to-skin contact:
- Stabilizes the baby’s temperature and heart rate
- Reduces crying
- Boosts bonding and oxytocin release
- Increases confidence in early caregiving
- Supports emotional attachment during the first days of life
Hospitals are very familiar with this scenario—especially in international surrogacy—and will gladly facilitate skin-to-skin for the father immediately or as soon as the baby is medically stable.
3. Do surrogacy newborns receive different medical procedures?
No. Babies born via surrogacy receive the same evidence-based, standardized newborn care as all other infants in the U.S.
4. What if I’m unfamiliar with American newborn care?
Hospital staff will explain every procedure and answer all questions. Your Ivy Surrogacy team will also walk you through each step so nothing feels unexpected.
5. Will I receive the newborn’s medical records?
Yes. Intended parents receive vaccination records, screening results, bilirubin levels, hearing-screening documentation, and the newborn discharge summary.
Ready to Begin Your Journey with Ivy Surrogacy?
Ivy Surrogacy is here to guide intended parents through every milestone—from the surrogacy match process to being present for your newborn’s earliest medical care.
Our team ensures you feel prepared, supported, and empowered as you welcome your baby into the world.
Start your journey with Ivy Surrogacy today — we’re here for you every step of the way.
References
- CDC – Vitamin K for Newborns
- CDC – Hepatitis B Vaccine Birth Dose
- CDC – Newborn Hearing Screening & Early Detection
- CDC – Critical Congenital Heart Defect Screening
- American Academy of Pediatrics – Management of Hyperbilirubinemia
- American Association for Pediatric Ophthalmology – Eye Prophylaxis & Newborn Care
- WHO – Immediate Newborn Care & Delayed Bathing
