Guest Post by Christina Szrama
Getting to the birth of your child took a dozen medical decisions at least, some small, some large. Well, your baby’s been born, you’re recovering, and the decisions just won’t let up. Welcome to parenthood! :)
Let’s walk through each of the 10 decisions you will probably be asked to make before leaving the hospital, birthing center, or at your child’s first pediatric visit (if you delivered at home). I’ll present each issue, ask the questions “Why would you want this?” “Why might you decline this?” and then offer several options.
1. Cord Clamping
At some point between your child’s dramatic exit into the world and his first bath, you’re going to have to physically sever the link that kept him alive in your womb for so long: the umbilical cord. Many doctors or midwives don’t think twice about clamping and cutting it within the 2 minutes of birth, often sooner for a baby struggling to breathe. There is also the new pressure to collect your child’s “cord blood” stem cells, either for your family’s use or for donation to others.
Why might you want to cut the cord early?
Stem cells in umbilical cord blood carry the potential to treat several forms of cancer, blood, immune & metabolic disorders. To obtain enough blood to harvest these stem cells, the cord must be cut & clamped very soon after birth. If a family member has these diseases (and your child doesn’t) this is an option you may want to explore. This is from the AAP's 2007 statement on the topic:
Cord blood donation should be discouraged when cord blood stored in a bank is to be directed for later personal or family use, because most conditions that might be helped by cord blood stem cells already exist in the infant’s cord blood (ie, premalignant changes in stem cells). [...] Although not standard of care, directed cord blood banking should be encouraged when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) that could potentially benefit from cord blood transplantation. (emphasis mine)
Why might you want to wait?
Cord blood is actually the baby's blood, usually about 1/3rd of the baby's total blood volume- throughout pregnancy the baby's blood is filtered through the placenta/umbilical cord and then pumped back into the baby. After birth, the blood is flowing back into the baby as long as the cord is pulsating (a safeguard in case the baby doesn't breathe right away- the placenta is still oxygenating their blood for them).
Delaying the cord clamping 4-10 minutes, or until the umbilical cord stops pulsating, offers many benefits to the baby, while early cord clamping can be very harmful to the child- particularly if the baby has been born early or is on the small side. As this article points out "delaying the cut could protect against anemia and irregular breathing for weeks and months after delivery." Dr. Sarah Buckley outlines the risks of early cord clamping here. Other parents opt for a "lotus birth," never cutting the cord at all, but instead treating the placenta with salt, wrapping it in a bag and allowing the cord to dry up and fall off at the belly button on its own. Please note that all of these options ARE equally available for mothers delivering by cesarean (you just have to state your wishes).
Your options: cut & clamp immediately for the purpose of cord blood harvesting/donation, delay the cord severing for 5 minutes, delay the cord severing until it stops pulsating (indicating that the vast majority of the baby's blood is back in his body), delay the severing until the placenta is delivered, or allow the cord/placenta to fall off on its own in a matter of days.
2. Washing, Weighing, Swaddling Immediately v. Kangaroo Care
In many hospitals, the norm is to take the baby after birth over to a scale to be weighed, rubbed down, assessed using the APGAR scale at 1 & 5 minutes old, swaddled & hatted, and then returned to the mother.
However, this has lately been challenged and "kangaroo care" is the new buzzword. Many mothers are now encouraged to hold their babies skin-to-skin immediately after birth, covered with a clean blanket to keep them warm. The APGARs can be done in the mother's arms, the baby can be rubbed clean & dry, and will usually attempt to breastfeed on his own soon after birth.
Why might you want the standard care?
If you require many stitches after birth (or any emergency measures), if you've had a particularly exhausting labor, or if a c-section means you are heavily medicated, you may not be physically able to keep a good hold on your child. In this case, the father or other family member could step in, often holding the baby at your head near your eye level, allowing the baby to see you and smell you.
Why might you want to opt out in favor of "kangaroo care"?
Many new moms don't want to let their babies, the prize of their labor pain, go! I think I probably would have bit, scratched or punched anyone who tried to take my daughter from me that first hour after she was born! A 2007 pilot study indicated that babies placed skin-to-skin with their mothers held their body temperature better, and most "crawled" to their mother's breast & began nursing on their own within 75 minutes of birth.
Most newborns are quietly alert and eager to nurse, learn their mother's face, and bond with her for about 2 hours after birth, becoming sleepy (usually for the next 2 weeks) after this unique "sensitive window" is passed. Baby (and mom!) have just gone through tremendous changes and Mom's familiar smell, heartbeat, and voice are tremendously comforting to this new little person who is suddenly being asked to breathe, maintain body heat, pump blood, eat, digest and poop on his own for the first time.
Your options: Honestly, kangaroo care has so many benefits (and no drawbacks) that if you are unable to perform it yourself after birth, it would be recommended that your husband would hold the baby skin-to-skin on his chest, comforting and speaking to his baby until you are able to do so.
3. Prophylactic Eye Ointment
You're probably familiar with the pictures of newborns in those striped hats, eyes smeared with some kind of clear goop. That "eye goop" is usually administered within 1 hour of all births, and is generally either erythromycin or tetracycline (both antibiotics), or the older silver nitrate solution.
Why might you want this?
The intention of the eye ointment is to prevent newborn blindness from infection after birth ("opthalmia neonatorum"). If the mother has gonorrhea, it can be passed on to the baby during a vaginal delivery and can cause blindness if left untreated (chlamydia is similar, as well as herpes). To avoid this, states passed laws throughout the 1900s mandating that all newborns receive silver nitrate, assuring that any infections would be caught & treated. This eye-irritant is still administered in some hospitals, but most now use the gentler antibiotics. If you know that you have an STD and you deliver vaginally, you will want to protect your babies eyes. In this case, you can request the gentler tetracycline drops.
Why might you opt out of this?
For one, having a C-section negates the need for this completely. Anything placed in a baby's eyes interferes with his vision, blurring it and usually causing swelling & irritation. Blurred vision interferes with the "sensitive window" right after birth when baby is alert & awake, so crucial in mother-child bonding as well as the establishment of breast-feeding.
Silver nitrate is only effective against gonorrheal infections, and is such an eye-irritant that it can actually cause chemical infections (read a good paper here). It has mostly been replaced by less-painful antibiotics, however these antibiotics carry their own risks. As this study showed, babies actually need the bacterial exposure they receive from their mother's birth canal to correctly populate their digestive tracts and build up their immune systems:
"In a sense, the skin of newborn infants is like freshly tilled soil that is awaiting seeds for planting -- in this case bacterial communities," said Fierer of CU-Boulder's ecology and evolutionary biology department. "The microbial communities that cluster on newborns essentially act as their first inoculation."
Antibiotics upset the bacterial balance in our bodies, wherever they are administered (we've all heard about the dangers of over-using antibiotics). If a mother is known to be disease-free, there seems little reason to administer any ointment at all. A randomized 1993 trial in Washington State states
"The results suggest that parental choice of a prophylaxis agent including no prophylaxis is reasonable for women receiving prenatal care and who are screened for sexually transmitted diseases during pregnancy." (emphasis mine)
Your options: Be tested for STD infection in your 3rd trimester (this is state law anyway). If positive, find out if intravenous treatment can eliminate risk of transmission to the baby during birth, and/or choose the eye ointment best suited to your infection. If negative, you may delay administration of the eye drops until after the sensitive 2 hour period, choose the gentlest eye-ointment you can, or refuse the ointment completely. (Note: in my state, KY, hospitals are required by law to administer an ointment of some kind, and some try to threaten parents with Child Protective investigations, etc. However, when I made my own calls to various hospitals as well as our Child Safety office, I found that these were 100% intimidation tactics. Research the penalties & state laws in your own state) Have others wash their hands when touching your baby to minimize exposure to external bacteria.
4. Hepatitis B Vaccine
The CDC recommends that all infants receive the Hep B vaccine before leaving the hospital after birth, then receiving 2 more doses.
Why might you want the shot?
If you have hepatitis B, which is a serious infection of the liver, you probably want to do everything you can to avoid passing it on to your child, including a special hepatitis B immune globulin shot as well as the HepB vaccine.
Why might you want to opt out?
Unless you have hepatitis B, it is almost impossible for your child to contract it. It is a sexually transmitted disease (also transmitted through blood, as in needle sharing) for which babies are not at risk. The hepatitis B vaccine has many side effects, and newborns are extremely fragile. (Read ThinkTwice!'s info page here.) It makes little sense to submit a developing nervous & immune system not at risk of infection to such an attack.
Your options: If your child is not at risk for Hep B, you can delay the vaccine until later, or refuse it all together (it is not required for school entry in many states).
5. Hearing Test
For most babies, a hearing test is the first test they'll ever have (and quite likely will pass with flying colors). All states require that parents at least be given the option of having their child's hearing screened, and most have a policy of universal screening.
Why might I want this?
Hearing loss is one of the most common birth defects, affecting ~3 out of 1000 babies. The screens are non-invasive and inexpensive ($10-$50), and if hearing loss is caught and treated early, long-term consequences such as language delays can be minimized.
Why might I opt out?
You may want to simply observe your child for hearing loss on your own. In 14 states this is a simple matter of parental preference. During some types of tests babies may be given a mild sedative to which you may object. Also, some may be responsible for paying for the test and find the cost prohibitive.
Your options: Have the test done after the "sensitive window," when your baby is sleepy and unlikely to need a sedative-- perhaps right after a good feeding. Or, if your child has no risk factors for hearing loss, opt out of the test and be especially vigilant for any signs of hearing deficiencies (this checklist is a helpful in this).
To be continued on Saturday...
This is only helpful if you are super earthy and have never had a baby before. Otherwise it is complete crap. Get educated by real people please!!! They cut the cord right away for medical reasons. Seriously. Your baby doesn't care and won't remember if you held her in the first 4 minutes or the first 14 minutes.
I opted out of giving both of my sons the Erythromycin eye ointment . I live in Oklahoma and it was extremely hard to find out what the state laws where. I called the State Dept but they we no help. I called the hospital I wanted to deliver in and they told me I had no choice but to give my son the eye antibiotic and that it was state law. I finally contacted our state representative office and the secretary was nice enough to look up the law and email it to me. It stated that I could sign a waver at the hospital. So I did. Once I told the hospital that it was my right to sign a waver they were compliant. I was 100% positive I was not carrying any STD's that could harm their eyes so the ointment was not necessary. I am glad I went through the trouble of not letting the hospital give it to them.
Good review of each side on all topics!
It drives me crazy that all these medicines are required for ALL newborns, even if the mother has never had an STI in her life! Ridiculous!
I found the article super helpful about a variety of topics I've been recently researching myself. My one push would be to encourage parents to get their child's hearing tested. I work with young children with hearing loss (teaching them to speak and listen) and it's VERY important that a hearing loss be detected early. More than 90% of children born with hearing loss (which is a range from mild to profound) are born to parents with normal hearing. Many families have no other family history of hearing loss either. A child's brain is amazing, but cannot learn spoken language without hearing it. Babies that have a severe to profound hearing loss continue to coo and babble until about 6 months or so, even though they cannot hear conversational speech. Not being able to hear language delays language development immensely. Due to newborn hearing screening and early intervention, many children who are identified and get early services, are able to catch up to their normal hearing peers and start kindergarten or first grade in their neighborhood school. Without newborn hearing screening, it often takes parents at least a year or so to realize their child may have a hearing loss- at that point (say 12 months) the child has possibly lost a whole year of developing language. Even children with a mild to moderate hearing loss, who would respond to loud speech and noises, often miss specific speech sounds that convey the most meaning in our language, causing trouble in understanding directions, developing contexts, and of course later academic issues. My thought is parents have a lot of decisions to make (hence there is a part two to the article!) at birth and throughout their child's life. The decision to have your child's hearing screened will help identify whether there is less to worry about or if there is something you can do to be sure you child doesn't fall behind in their development. I see it as a completely proactive thing considering the repercussions to not having it done.
I realize months have gone by since this comment was written, but as a mother of a 2 year old with hearing loss that was detected through newborn hearing screening, I felt compelled to comment. Our family has ZERO history of hearing loss or any known risk factors and yet our beautiful baby was born with moderate to severe hearing loss that quite possibly be still unidentified if we didn't not live in a state with mandatory newborn hearing screening. Hearing screening SHOULD NOT be optional. Meg, thank you so much for your very well written response and explanation regarding the immense importance of newborn hearing screening.
Thanks to newborn hearing screening my daughter was fitted for her first hearing aids at 3 months of age and now at 2 years and 2 months she is making progress and hitting ALL of her developmental milestones like a typical hearing child. She has no sign of delay in any area. Why anyone would ever consider declining hearing screening is unimaginable to me!
I am also a mother of a child with hearing loss and definitely agree with both Meg and April. My daughter was identified at birth and we have no history of HL in our family. I would add that it is also important to follow through with subsequent screenings and not "blow off" the failed newborn screening. It's better to be safe than sorry.
I must agree with these ladies on the importance of hearing loss testing. i was not tested at birth. I was very fussy and wouldn't cooperate so the doctors asked to sedate me. My mom refused, thinking it was unnecessary. As a result, my hearing loss went undetected. By the time I was started in the therapy and fitted for hearing aids at 23 months, I was severely behind. Now as a mother of two, I still have problems with my speech and rely heavily on sign language to communicate because I get so self conscious and flustered when people can't understand me speaking to them. I had both of my kids tested, of course. My daughter's loss was recognized then and she was fitted at 4 1/2 months with ehr first set of hearing aids. She has had some speech delay but nothing that has greatly impacted her. She signs fluently to communicate with me, which the doctors say could have caused the delay in speech. I urge all moms to test their babies. I have seen and lived the difference. its worth it.
What a great article! Thank you so much!!
I would be very interested in an article like this about the other vaccines children are "required" to get. You have done an amazing job breaking it all down to clear pros and cons. I wish everything was this simple to understand!
This is SOOO, SOOO, SOOO helpful!!! It's our first and my hubby and I are going through these blogs line-by-line together :)
Number one is a biggie for me. We always keep the cord attached for as long as possible. My cords usually pulsate for about an hour. My last baby (born at home) was in my arms for about an hour while her cord pulsed. She didn't nurse (which wasn't normal for my babies) and we didn't know why until after her cord was cut. She had immature lungs (even though she was full term) and the pulsating cord kept her oxygenated for a while. Thankfully, we were able to get her to the hospital in time. But I wonder how she would have been had we cut her cord immediately. We are so thankful to the Lord for keeping her and giving us wisdom.
I would recommend keeping the cord attached until it stops pulsating to everyone!
Great list!
Wonderful article. Amazing how different experiences are around the world. Here in my state in Australia, eye antibiotics are only given to genuine risk cases. Most parents have never even heard of it. Circumcision is now considered barbaric by a large section of the population and if you choose to do it, it is very hard to find a doctor who will do it. Some families have to drive hrs to find a doctor who will perform it. There is pressure for Vit K and Hep B....and of course kangaroo care is prioritised and valued. The hearing test is done in front of the parents some time before they leave hospital, or a little while after. Breast milk is becoming more and more valued, including breast milk banks being established to help premmies and other special need babies.
This is interesting. The laws/protocol is different though where I live. For example they do not do the Hep B shot at birth, but I think its at 2 months for those who wish to do it.
We've always delayed the weighing and such and also the bathing (bathing was done many hours after with one and the next day with the other).
The eye ointment issue I was just discussing with my midwife. THe problem is that I was told its actually illegal to refuse it, although my midwife said she would not do it if that was what I wanted considering my past and current history. However my husband brought up the issue that essentially my midwife would have to sign that she DID do it and so in that sense he doesn't feel comfortable lying about it. However we have always delayed this procedure as well.
We did the delayed cord clamping with our second baby and it worked out well. I will be doing that again when this baby arrives.
I'd dig a little deeper on the ointment (if it matters to you)-- in some states the penalty is a $5 fine. In all stated you are free to sign a waiver stating that your care giver offered the treatment and you went "against medical advice" and opted out. Find out if colostrum is a viable alternative, or if anyone will even ask if the midwife remains silent on the topic (doesn't say either way). A final option is to allow the drops to be administered and immediately wipe them off! I've heard of some nurses aiming poorly in order to respect parental wishes. There are almost always options!!
with our last baby we decided to both forgo the eye ointment (i do not have stds nor any risk for them) and chose delayed cord clamping. i was very happy with both of our decisions (that was with our 4th child). we have a great hospital we deliver at that really prioritizes bonding, so they don't do any of the washing, measuring, etc or even visitors for the first 2 hours. our hospital and our pediatrician also do not do any vaccinations at the hospital, and we have decided as a family to not vaccinate (at least for now - and my oldest is 8).
personally i think the hearing test is really important and non-invasive to the baby. i have a cousin, who is now 35, who was born with severe deftness and it wasn't detected or noticed by my aunt and uncle until he was 2 or 3. he learned to talk and was an amazing lip reader, so there was a lot of frustration with what they thought was a disobedient child that wasn't really the case. i think it is worth knowing if there is a problem, even a slight one, because even with very attentive good parents it isn't always that simple to detect on your own since kids are amazing at adapting.
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This is a great summary--I've passed it along to an expecting friend. I had a great birth coach who was focused on natural birth and gave us a lot of info on these choices. We waited for the cord to stop pulsing before clamping, did kangaroo care with me and then my husband while I showered (I had a water birth), and they actually never "washed" our baby, but let the vernix just soak in, said no to the eye ointment and the Hep B vaccine, and no to the hearing test as we could tell she could hear us right away by the way she calmed at our voices.
Looking forward to part 2!
What a great list. I did not know that about the Hep B shot (I get the Hep shots all confused) I will definitely pass on that one this time around.
I see some others have mentioned the Vitamin K shot. It seems to me that the shot (or liquid form) is needed due to the many interventions given, a preventative against possible risks, or if you are planning to circumcise your newborn in the hospital, since it helps with blood clotting.
I believe that God made babies perfect. The baby's Vitamin K increases on the 8th day after birth (it's no coincidence that God told the Hebrews to circumcise infant boys on that day!)
We skipped it with my last baby and instead I opted to eat foods rich in vitamin k near the end of the pregnancy.
Thanks for the info! On the choices you've given so far, the one I didn't know about was the hearing test. My Bradley instructor went over the others though, so I knew what to expect. Unfortunately, my husband forgot about the no bathing part even though he was there with the baby the whole time, and my little guy (wouldn't you know it, has his Daddy's super-sensitive skin) had a rash on his face & his eyelids were inflamed. I felt so bad - and of course, Daddy felt worse. Next time, we'll remember, and opt out of the hearing test.
We discuss all of this on our Delivery video because it is so important for new parents to consider. I remember being in a birth class and being told about the vitamin K. I wasn't going to be vaccinating and had never heard about the Vit k...The nurse brushed off my questions about it and said "it's just a vitamin". Well, I didn't believe that for a second! I did my research and refused everything known to man except the hearing test which I didn't realize I could refuse until reading this...probably would have refused that too since it is just a way for the state to gather info. Oh well...neither seemed bothered by it. And we didn't clamp the cords for like 30 minutes or until I delivered the placenta. With the bath I got smarter and we didn't do that until 11 hours later when we left the hospital
One of the top 10 decisions (if not THE biggest decision) for those having boys (or unknown gender) is whether or not you will circumcise. Research ahead of time-- this procedure has NO MEDICAL BENEFITS and is PUSHED on parents right after giving birth-- if you can't decide in the hospital-- just take your perfect, intact boy home and take more time to research/think about it. This decision will impact your child the rest of his life and any partners they may have in the future!
We will cover circumcision in Part 2. However I do think it's quite a stretch to say it's THE most important decision. Many others carry far more risks and benefits, while it is completely possible to have a healthy boy whatever you do with this rather cosmetic surgery. There are benefits to both sides, with doctors split about 50-50 on the issue. Hep B or cord clamping is potentially a lot more dangerous, and the blood screening & hearing tests are potentially a lot more helpful!
I agree Christina- we are due to deliver our son any day, and we have decided to not circumcise him- however my husband MAY change his mind once our son is here. We have researched and discussed my hopes for our son and my husband doesn't have a deep inclination either way since it really isn't "damaging" either way, in our opinion. We find the hep B to be much more of a fighting issue :)
We did choose to have vitamin K with our daughter since she was a cesarean delivery, and we were taught in our class to get it if you have a "traumatic birth" or plan to circumcise.
Just realized this is only part one. Looking forward to part two!
We had home births with our last three so we had no procedures done, and they have not had any vaccines. They have been way, WAY more healthy than my older two who were born in the hospital and had done whatever they offered as well as routine vaccinations.
Great post! I'm definitely sharing it!
I think this is all great advice. I do like the Kangroo method. However just becuase you do not do this method or are not able not able to hold your child during this "sensitive window" does not mean that you will not bond with your child. I had a c-section and was not able to hold my baby for 3 hours and we bonded wonderfully. He also took right to breast feeding and we were seperated during that "sensitive window".
True! Many adoptive moms have discovered the same thing!!
Thank you SO much for this article. I had a nurse in charge of vaccines at an immunization clinic tell me that if a baby doesn't get a Hep B vaccination within a certain time frame that they will never be immune to it (this was in response to my point that if I don't have Hep B, why should my baby receive it?). Does anyone know if you can indeed delay vaccination (maybe getting it age 2, instead of infancy) and it still be effective? Trying to research before I have my little one this summer
I had 3 Hep B shots at age 14 before going to boarding school. Why would they bother offering it to everyone if it doesn't 'take' past infancy? The reason they vaccinate newborns against this is that it is the best way to 'catch' those sections of the community who will probably neglect to vaccinate their children and probably already have Hep B and probably will pass it on to their children.
The nurse lied to you.
Totally false! When I was a kid, hep B vaccines were just new (here at least) and I got mine in grade 6. Adults can get the vaccines too.
You absolutely can be fully immunized against Hep B later in life. I was immunized as an adult when I was working in a job where I had to snake toilets (alas rare to get Hep B in that situation but I chose to get vaccinated at my employers expense). One thing the article doesn't address is that if you plan to place your child in daycare (especially a larger facility) they may have more exposure to Hep B, as children of course have been known to share their poop. Definitely do your own research and best wishes this summer!
I was vaccinated for Hep B in grade 7. I can't remember when they do it now where I live. I think I said in another comment its part of the 2 month schedule...but now that I think of it, I think its actually still done in grade 7.
It's interesting to read this, in the uk the system is different. I have not encountered eye drops at all - I guess because all my screening tests were clear it was never mentioned. They do give vitK but you can opt out, and hepB is only given if the mother has it - I only received that vaccine via my employers when I was working with troubled kids and at risk of being bitten. They do not give hearing tests until baby is several days old.
I'm a maternity RN in Canada, and things are done very different here too. I believe the article was written was based on practices in the US.
So interesting! Thank you.
Very interesting article - I wish I had known more of this with my first child - especially as it relates to the Hep B vaccine given at birth....my little one is fine, and I'm probably a bit overprotective, but baby #2 won't be getting Hep B that early.... :) Thanks for sharing!
I had a birth plan in place but the nurses only followed it when the doctor was around. If I could prove that not following my birth plan, which was more "Kangaroo" than hospital, messed up my child (which I absolutely believe it did) - let's just say, I wouldn't be sitting here right now in poverty.
Thanks for this Christina (from one doula to another!). I wanted to make a comment on the eye ointment issue. I live in North Carolina and it is not as easy as opting out of it verbally. If you choose not to have the erythromycin put on your baby's eyes then you are required to meet with a social worker. This is even if you are beyond sure that you have no chance of having had an STI at any point. I recently had my own little one and had to go through this just so she didn't have to have it. It may be different in other states, but that is NC for ya. I look forward to the rest of your post!
That's interesting. I'm also in NC and have never heard of anyone having a problem opting out. All you have to do is sign a waiver. It may be different per hospital, but I've never had any issues with social workers. Sorry you had so much trouble!
I'm so glad you're posting this. Before my first was born I had no idea that they would do a hearing test on her! (I was also peeved that it cost over $50 to do it too!) No one asked if I was okay with this, whether or not she'd be sedated for it or anything. Next time I'm going to be a lot more critical of the things they do to my baby and ask a lot more questions.
I also don't understand why WHILE I WAS PUSHING they hand my husband a binder full of information about the eye drops, vit K and hep B shots and ask him what we want done. SERIOUSLY?!? Why wasn't that part of what they did oh I don't know....when I had to pre-register or while they asked us/me a ton of questions after admitting me or hey! even better! AFTER she was born!!! Is a few minutes after her birth too much to ask to wait to answer this so-not-important questions???
That's b/c they wanted him to just agree so he could turn his focus back to you!
Thank you for sharing this important information!! I didn't know much of this for my first baby, and just went with the norm. With our second baby, I had learned so much more and so we chose kangaroo care, delayed cutting the cord, and refused the eye ointment and vitamin K shot. I'm especially glad we did kangaroo care - I'm forever grateful for such a beautiful bonding time with my baby! I know it's not possible for every mom to do (with C-section or preemies), and I'm so glad I could.
Since we have our babies at home, that changes the playing field a little bit. With our son, we did very few (if any) "procedures" right after his birth. His cord was left in tact for 3-4 hrs (we asked the midwives to cut it before they left), did skin to skin, no shots or ointments, etc. With our daughter (due in less than three weeks!) the only thing we plan on doing differently right after her birth is giving her a vitamin K shot, due to some health issues I had throughout my pregnancy. And while we didn't vaccinate our son (except DTaP later on), we are vaccinating our daughter according to Dr Sears' alternative schedule.
I look forward to the second half of this series!
Great informative post! I have a question that is slightly off topic and would love some input.
My sister recently gave birth to my nephew in September. She has never been health conscious or made the connection between food and health. Her diet during this pregnancy was very concerning to me, fast food for every meal, coffee, soda, candy you name it and she was eating it. I, although very passionate about health and nutrition, didn't want to push my agenda on her so i never said anything.
Now, my sweet nephew, is 35 lbs possibly more. He has problems with his "male parts" and is constantly suffering from gas, painful belly aches, and also is spitting up. I completely understand there are mothers out there who have big breastfed babies and are healthy, some babies are just big and trust me i am quite fond of a squishy chubby baby. That isn't the case here, he isn't just "chubby" he looks unhealthy and knowing what and how she eats makes it all the more concerning.
So, what do i do? I love my nephew and would love him to have a great healthy life, but Im worried its not my place to say or do anything. Any input is appreciated!
Alix,
How old is your nephew. My 4 1/2 yr old is 35 lbs and just hit that a couple months ago. She's tall and thin, but still if your nephew is 35 lbs and less than a year or even less than 2 years old, you have a right to be concerned and so should your sister, as not long ago the government removed an obese child from his mother's care because it was seen to be a form of abuse.
I don't think going to your sister and gently talking to her about your concerns with your nephews weight and asking if she thinks it's his eating or if there's something else going with him that's caused such a weight gain. Also breastfed babies do often gain weight faster than formula fed babies, but once they start moving they normally slim down and then on average stay slimmer, when fed a healthy and well rounded diet.
I'd be prepared that your sister may get angry with you, feel very defensive...as Momma's that's often the case when you feel someone's "attacking" your parenting, even when coming from a loving place, so be prepared for that reaction. Hopefully though when she calms down she'll understand you're coming from a loving stance.
Wow! This is a great article!
Thank you for both sides to the arguments and all of the information! It looks like I have a lot of reading to do this morning from the links within the writings -and probably then some :)
Can't wait for the rest of it! So excited to read it on Saturday:D
As someone due to give birth in June, these decisions have been on my mind a lot. The eye goop and Hep B were ones that I hadn't read about yet. Both will go on my list of decisions to have pre-made before I go to give birth. Thank you for the very informative post!
I just wanted to say that another alternative to antibiotics in the newborns eyes is a couple of drops of colostrum from the mother's breast. I found this out from my midwife. This is really common among the Amish, and I know it is a legal alternative in OH and WV, but I'm not sure about other states. It's worth looking into though!
Totally a wonderful idea!! I don't know why I've never heard of that before, but it makes complete sense!! Thank you!
Yes, thank you I will have to look more into that!
I think these are important issues for parents to consider when coming up with a birth plan. I just want to also have mom's be wary if a pediatrician orders you to supplement your baby without good cause. I work in a maternity unit as RN and IBCLC and have to sometimes convince the doctors to hold off the supplements when there's a good nursing relationship already. Also, supplements can be done at the breast with supplemental feeder to prevent nipple confusion if it's still necessary.
Yes, yes, YES! Thank you! Pediatricians and new moms alike are quick to jump in with the supplements because we worry that our babies aren't getting enough. It's so hard to tell when you've never nursed before. My first pediatrician was not incredibly pro-breastfeeding, but I appreciated that he respected my desire to nurse, so he gave us a window: "If she's not nursing well and gaining by ___day, we'll need to put her on a high calorie formula because she's dropping weight so fast." I was finally able to get the help I needed from two different lactation specialists and breastfeeding was a breeze from then on out.
We had to switch peds with my second child because our first passed away. One priority was to find a ped who was very pro-breastfeeding. I'm so glad I did! When the baby was born, we had no idea that he would end up having emergency surgery as a newborn! When he was released, the surgeon instructed us to supplement to help him make up for the weight he'd lost during recovery. I disagreed but lost the argument, so I pretended to comply until we got home. Our pediatrician agreed with me and we went against the surgeon's advice. I nursed on demand, around the clock, and my baby was able to bulk up in no time. Here's the story if you're interested http://mamagab.blogspot.com/2011/08/following-those-mommy-instincts-wbw.html, but the bottom line is that the baby really can completely dictate his needs and mommy's body will respond.
My kids have always struggled with jaundice and my milk usually takes a solid four or five days to come in. Finally, with my fourth baby my midwife was able to give me herbs and a prescription that helped my milk come in on day two. The pediatrician was still telling me that I needed to supplement with formula (I love walking out of the ped's office with boxes of formula. What a joke!). Anyway, I was confident enough with my fourth child to ignore the advice of the doctor, especially because I was so engorged that I would have had to pump and dump the good stuff to give her formula. When we would go back for the billirubin tests I told his nurse that I wasn't supplementing and she called me later that day to tell me that the doctor wanted to STRESS that I supplement with formula. She was gaining 2 ozs a day and I'm sure they thought it was because of the formula. It was all breastmilk.
I'd like to point out that Éowyn passed her hearing test with flying colors... just bummed we couldn't make music requests for the super cool headphones. I like to think she would've turned out a little better if we'd had some Led Zeppelin in there or something.
We had a home birth and chose to delay cord cutting doing skin to skin right away, no eye treatment or Hep B vaccination. We are very blessed to have a supportive pediatrician who actually visited the house after the birth to do an official checkup. We did decide to do the newborn blood screening within the first week since those diseases and conditions can be treated and the quality of life can be drastically altered (for the better) if caught and treated early on. It was reassuring that she slept through the foot pricks. We decided to get a hearing test later (months later) because I was “iffy” on some of the general ways you can check yourself.
Thanks for sharing! And as I tried to show, there are good reasons to choose almost every one of these procedures, depending on your situation. As the pictures indicate, we chose to have our daughter's hearing tested while she was full & sleeping, with no sedative, and no negative effects whatsoever!