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Newborn Procedures

2K views 21 replies 19 participants last post by  Mummoth 
#1 ·
Hello, all! I have a few things to throw out and wanted some opinions. I am fairly new to "questioning the system" and am trying to get all my ducks in order before our newest member arrives in early Feb.

I e-mailed the Charge Nurse in the nursery at the hospital where I am to deliver and she sent me the following reply to my question (edited)

Quote:
Apgar scores are assigned at 1 and 5 minutes of age...Vital signs are taken again at 45-60 minutes of age. Infant remains with mom in labor and delivery room for approximately 1-1 ½ hours then... admitted to nursery for a thorough head to toe exam by nursery nurse. If the baby is warm enough (>98 degrees) a bath is given at that time. Also vitamin K and erythromycin eye ointment are administered at the time of admission. After the bath, the baby will remain in the nursery under an infant warmer for at least an hour (depends on how quickly the baby warms back up).
I know I need to research the eye drops, but have already done my VitK research and decided against the shot unless I have a c/s or if there is an obvious need. My ped is OK with this.

I have also spoken with the Director of The Birthplace and the baby will be able to be admitted in my room as long as h/she is stable. In the event I end up with another c/s the baby will be able to be with me in Recovery (at the time my DD was born, this was not routine).

Now about the bath. I realize this will make the baby cold. What can we do to ensure that h/she stays warm? Forego a bath - do people do that (sorry to be ignorant). I really don't want the baby away from me at any time, although DH will go with the baby if I am in a position where I can't go. Can the baby not be adequately warmed by skin-to-skin - perhaps covered with warm blankets?

Quote:
If the baby is larger or smaller than average, or if mom is diabetic, the infant will have heelstick blood sugar testing to assure adequate glucose levels. (each hour X 4 and before eating x2)
I doubt we'll have this issue, but seem to remember reading about this somewhere. Anyone have thoughts on this?

Quote:
A PKU blood test is done on all babies after 24 hours of age (usually done in the morning after the 24 hr mark is passed.
I think I read that this is not accurate until after 24 hours of breastmilk - not colostrum. If so, I need to look further into this. It is a test I absolutely want done, but don't want my child stuck any more than necessary.

I'd really appreciate input on this. I am also slowly searching archives and such and just wanted to say what a blessing this site and the forums have been to me. I also post on a more mainstream site and it boggles my mind how little most moms know (including myself). Places like this are a godsend!
 
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#2 ·
Well, I can tell you about the bath. It's not necessary at all. Our little man was born at home, and put right on my bare chest and then a couple warm receiving blankets were put on top of us, and he stayed there for hours (except the 25 min. DH got to hold him while I got stitches). We wiped off some of the goo, from places we could reach, like his head, arms, etc., but it was really no big deal.

Also, I'm pretty sure the eyedrops are just in case you have certain STDs. I can't remember which ones, I'm sure somebody else has more info. But we didn't have him get that either. He's had several eye infections since, but they're totally unrelated to his birth. They're just blocked tear ducts.
 
#3 ·
I would definitely forego the bath - it is so unnecessary! Why seperate mom and babe for that?!? Unless there are extraordinary cicumstances, the baby's best bet for temperature control is skin to skin with mom
I would also question the validity of taking the baby from mom for a thorough examination. Good for you for taking charge of this, though! I'm giving birth without midwives this time
and you've reminded me that I better find out about my hospital policies!
 
#4 ·
I had my son in a hospital setting (a private room, waterbirth, w/ nurse-midwives & a doula).
He was not given a bath or eye ointment. He also never left the room. Not once. I stayed there for 2 additional days and he never left the room. He was given a foot pricking for the blood test, but I asked that it be done in the room and they obliged.
After my son was born and the placenta was passed and the cord was cut, we left the birthing tub. I went to my bed and was "cleaned up" a bit. My son was administered the apgar test right next to my bed, then wiped clean, sthen layed on my chest w/ blankets...
 
#5 ·
I totally agree the bath is unnecessary. If you wanted them to give your babe one, just wait until the last minute before you leave. There is certainly no rush.

As for the PKU, it was done after 24 hours of age for my babes, but we left the hospital prior to 24 hours of age both times, so our midwife did it a few days later (once at our house, once in her office). I nursed while the prick was done.

Regarding the eye ointment, I am not sure and will be interested to see other replies on that. We declined Vit K both times. We also declined the glucose tests. both babes nursed immediately and well, although they were "large" according to the hospital's policy. It is subjective- had my babes been born at another hospital, they may not have been considered large. We also declined the hepatitis vaccine.

We had to sign release after release! We also had to sign a paper saying we did NOT want to have our ds's foreskin removed! Seems like you'd have to sign something if you DID want it removed. ??

Neither babe left the room, ever.

I am looking forward to our homebirth this time!
 
#6 ·
I'm planning a HBAC this time, and I'll decline all of those except the PKU (a few days after birth)

Last time, I had a c-section. My son was taken away with my dh in tow to be wiped clean, weighed, Vit K given, eye goo (even though its not nessesary with a section, just POLICY)
He was brought to me in recovery, and I nursed him there, he then never left the room - they bathed him a day or so later, in the bathroom connected to my room it was more like a wipe down - they never dunked him into the water completely, with both dh and I in the bathroom with the nurse and ds.

I don't think I'd be too happy with them taking the baby away to be bathed and then put under lights to warm up..... I'm sure they could wait, what difference would it make to them anyway?

Good Luck
 
#7 ·
Quote:
If the baby is larger or smaller than average, or if mom is diabetic, the infant will have heelstick blood sugar testing to assure adequate glucose levels. (each hour X 4 and before eating x2)
This would scare the crap out of me - if you have a large or a small baby (what's "average," anyway) they're going to stick the poor thing 4 times an hour and twice before eating? That's just sick and wrong. I would refuse this. The best thing to do IMO is not to be separated from the baby AT ALL and nurse, nurse, nurse.
 
#8 ·
I was taught in my prenatal breastfeeding class that babies can "smell" the amniotic fluid, and that nipples/colostrum smell the same way. We were advised to postpone a bath for as long as possible to aid breastfeeding (this from a certified lactation consultant). So we did.

My son was large (9# 5.5oz), and we got the stupid heel pricks for blood sugar, too. Finally, a wonderful, wonderful, highly competant neonatal nurse told us after seeing how much they were distressing us and ds, "You know, you have the right to refuse those." So we did after that, and they didn't make a big deal out of it, because he was getting fed.

I realized after having ds that if you give birth in a hospital, the quality of your midwife or ob only matters so much; the l and d nurses, postpartum nurses, and neonate nurses plus the policies will really determine how things go.

Kristine
 
#9 ·
TY all so much for your replies. I guess the little one won't get his/her first bath right away after all! I'd rather do it myself (with DH of course) anyhow. I recently read the same thing as KKmama about the ammniotic fluid on baby...interesting.

As for the glucose testing - I guess that's one more thing I have to research. Does it ever end (
I actually like the researching)?

It's a good thing I have about 18 weeks left!
 
#10 ·
I think we are skipping eye ointment...I don't have stds and neither does dh....funny thing is my ds was c/b (i've learned a new term
) and still got the ointment...he was no where near my vagina or anywhere you would find the type of std that it "protects" from.....

As for the bath. Our son had one but it was int he sink in our room and baby was int he water and out in about 2 minutes and right on my chest with warm blankets. He was also measured and weighed in the recovery room. He was NEVER out of site....except for his circ (
)

A friend of mine had her babe jsut after ds at a different hospital and the babe was born and 35 minutes later everyone left. they did everything...bath, weighed, measured. They had no idea what to do with NO explination. she was vbac because of a breech twin! She was like...um, I was imobile and almost unconscious for 2 days...I have no idea what to do!
 
#11 ·
I'm sure the bath is not necessary, but one option you have if do want the bath is to get in with the baby.

When my dd was born, my mw ran a warm bath for the both of us that had sort of an her tea made of stuff that was good and healing for both of us. I think it also had salt and garlic to kill any germies. Anyway, we both got in together, dd was lowered in so her entire body was under water except for her face and my dh and I gently washed her. It was really lovely. The moment we got out, we were both wrapped in warmed towels. Dd never cried, I don't think she ever got cold at all.

I'm not sure you'd be allowed to do this in a hospital setting, but maybe you could do it as soon as you got home.

peace, Beth
 
#12 ·
i've been confused about the eye ointment, as well. as per policy at my original insurance (dropped it during the second trimester), i was tested for all stds (which is a yearly thing, anyway, at the gyno) and don't have any-- not a surprise to me, of course. i can't understand why my babe would need eye ointment to protect her against something that won't even be there! we'll be declining that most definatly.
 
#13 ·
another vote to skip the bath--some babies come out squeaky-clean and goo-free, too!

As for the eye goo, my homebirth mw who was an rn & also acts as a 'doula' to hospital-birthing moms mentioned a good point:

If baby is going to be handled by hospital staff, covered in germs, maybe the eye antibiotic isn't such a bad idea. I don't know how long-lasting the effects are, but I thought I'd mention another perspective.

My boy had his PKU 8 days old--I figured, why have baby endure the trauma of the heel stick before the test can do it's job? I do want to have the test serve its purpose.
 
#14 ·
I wouldn't let them do ANY of that crap. It really makes my blood boil just reading all of it. Especially the part about leaving the baby under a warmer for an hour. The best place for your baby to be kept warm is in your arms. If I gave birth in a hospital (which I never would) I would insist on the baby being put in my arms the moment it was born, and then I would simply never let the baby out of my arms for any reason. "but we need to take the baby and go do ________" Sorry, this is my baby, not yours. You can't have it. I would be firm. What are they going to do, wrestle the baby out of my arms? I don't think so. They can argue all they want. I am not letting go of that baby. NONE of that crap they want to do is necessary AT ALL, in fact most of it is bad for the baby. Taking the baby out of its mother's arms and interrupting bonding is bad for the baby. Sorry, but this is a REALLY hot issue for me.
 
#15 ·
About the eye ointment....I finally had to call someone at the state level just to get them to admit that I did have the right to refuse it.

I was told that (obviously) I can refuse it. It's given in case Mom has certain STDs (yes, those STDs you were tested for and were negative for). Even with a negative result, my state (NC) still wants to give the ointment b/c "you don't know if your husband is infected or not". When I replied that DH was, in fact, negative, I was told that "you don't know if he's monogamous or not". When I said that, yes, I do know that he is, I was told that "well, there's no way for the hospital to know that, and besides, you could be infected the night before you go into labor".

So basically, in NC, the eye ointment is b/c the state doesn't trust me (or DH) not to be out sleeping around. Thanks anyway.

The bath....no, you don't have to give the baby a bath. Lots of women rub the vernix into baby's skin. Personally, I wouldn't want my babe's first bath to be administered by anyone but myself or DH, at home. I had DS by c/s and he was in the NICU for the next 2.5 days, and I wouldn't let them bathe him. We waited until we had been home for a couple of days (maybe even a week).

Warming the baby....how in the world did babies ever survive w/out warmers in the rooms?
: Had DS not been c/s, I would have hugged him on my chest and covered us both w/blankets. Skin-to-skin contact is sooo much better than isolation in a warmer.

What else...PKU. We actually brought DS back to the lab when he was almost a week old. We wanted to make sure he had been getting plenty of milk (not colostrum).

Again, had DS not been a c/s (and had to go to NICU), he would not have been away from me for one minute. Any exams that need to be done can be done while you hold your babe. NC requires a newborn hearing test (and in our hospital, the babe has to go to the nursery for this - parents can't go). DH allowed this while I was occupied. Next baby - no way. Like another MDC momma said, the babe's hearing will be tested at home by our dog.


One other thing. Not sure if you are planning to vax or not, but in NC newborns are given the Hep B vax. We declined it (we're not vaxing, but would have declined this anyway). I can't see the point of giving a newborn this vax. Just one more thing for you to check out (it never ends).

Good luck in your decisions. You know, since finding MDC and starting to question "routine" medical procedures, I have realized how little information we (as patients and parents) are GIVEN. I have had to search like mad for every bit of info I've found (with the obvious exception of MDC, whose members are overflowing with info). Like with the eye ointment - I called my county health department first, and was told that I could NOT refuse it, that my child would be taken away
: . I had to go all the way to the state level before I could get anyone to admit what I knew - I had the right to refuse.

It's ridiculous to me that those who take it upon ourselves to become informed consumers have to fight in order to make our choices. I guess it's true that "Ignorance is bliss". If I didn't know that I had the right to refuse the HepB vax (for example), I would blissfully watch the nurse carry away my baby for the vax.

However, I do know my rights, and now I actually have to *think* about DS's healthcare. *I* have to make decisions, instead of following doctor's orders. It's scary sometimes, and it's a huge responsibility, but it's what all parents should do. I know it's hard and it seems an unending task, but it's worth it to me to know that *I* have made the best choices for my family, not just followed the herd.
 
#16 ·
So much depends on where you give birth and what nurse you end up with. We refused the eye ointment (for the reasons already stated), the nurse said fine, just sign here. We did, she said the hospital gives us the option of Hep B now, we said no, didn't even have to sign anything. We did get the Vit K, dh really felt more comfortable getting it, and as it turns out she was posterior and ended up with a pretty bruised forhead so I would have done it in the end anyway.

The hospital that we gave birth in is very room in / breastfeeding friendly, in fact basically "forces" you the best they can to make sure that this happens, the nursery isn't set up to hold babies, it's really there for the "routine" procedures and that is it. Which when I asked to have them done in room, they did easily.
 
#18 ·
There's no reason to take the babe away for the hearing test, either. Tell them to get off their duffs and bring the equipment to you. We're going to have DH give the babe first bath, and delay the eye ointment until after that, which will be at least an hour or two after the birth--and wouldn't do the eye ointment at all if we were doing this at home. I requested oral vit K instead of the injection, if they don't have it then we won't take it unless the baby's bruised from the birth for some reason or a c-sec. The hospital I'm going to does everything there in the room, not away in the nursery, and they're not progressive by far for this area...
 
#19 ·
I had a c-section for DS and they did everything right next to me in the recovery room. He had all the tests, shots and the clean up under the warm up light next to me as they were cleaning me up.

Do not completely negate a glucose test just as standard. In fact, if they had given him the test, DS would not have had to leave my side at all.

My Story (or DS's)-

DS was born at 36 1/2 weeks. The pediatrician requested a glucose test because he was a "border-line" premie. The nurse didn't read the chart and because he was not "officially" considered premie did not do the glucose test. Unfortunately, they did not offer him to me to feed him until after they had cleaned him up. By that time his blood sugar level was so low that he wouldn't nurse or even take a bottle. 90 is standard, he was at 25. The ped was pissed. So DS (with DH in tow) ended up in the nursery with a tube for the first 4 hours until he could eat on his own.
 
#20 ·
With or without a glucose test, they should have given you the child immediately, before cleaning him up and giving him shots and tests (or *without* cleaning him up and giving him shots and tests). You'd think that would be obvious to them, especially when the child is a premie.
 
#21 ·
>If the baby is larger or smaller than average, or if mom is diabetic, the infant will have heelstick blood sugar testing to assure adequate glucose levels. (each hour X 4 and before eating x2)

This would scare the crap out of me - if you have a large or a small baby (what's "average," anyway) they're going to stick the poor thing 4 times an hour and twice before eating? That's just sick and wrong. I would refuse this. The best thing to do IMO is not to be separated from the baby AT ALL and nurse, nurse, nurse.<

This is somewhat of a misinterpretation. They aren't going to stick the baby four times an hour; it means that they are going to stick the baby every hour for four hours (not much better, I know). And once before each nursing session for two nursing sessions.

I can't remember the exact numbers. I know the lower parameter is 2500 grams, which I think is about 5 1/2 pounds, and the upper parameters are 9 pounds, 15 ounces, I believe (give or take an ounce, I can't remember exactly).
 
#22 ·
We got the PKU, Vit K and the eye goo about 3 days after DS was born. The MW told Kevin to take off his shirt(!) He cuddled Roland tummy-to-tummy while she did it all. Roland didn't cry or anything! The MW just let him move however he needed to, and just moved the PKU swab (or whatever it was she collected it on) with him. For the eye goo, but it wasn't as big of a deal to me on the 3rd day, once we had gotten lots of bonding time in, for his eyesight to be extra fuzzy for a bit. I would have refused it if she tried to do it right away.

I wasn't there for Rolands' initial weighing. I went to have a shower, and DH helped the MW weigh & measure Roland, and put him in a diaper, and dressed him. That was ok with he, because DH was there with him. DH wouldn't let anyone else hold Roland (not even me! until it was time to nurse him!) He walked and showed Roland around the house! They had to do some bonding, too!

It doesn't ever end, the researching. It calms down a bit. I'm always looking something up, and he's nearly 2! I find the older he gets, the less reading I need to do. I trust my gut feelings ALOT more, now.
 
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