Testing and other things immediately after the birth...

[etwahl]

I just did my hospital tour tonight, which was good to get to know where things are and how they work.

I do have a question though. I have already told them I want an hour with the baby (to nurse and bond) right after the birth before they do any tests, etc. However, I'm wondering if there is anything I should be refusing to have done or request not to be done? Or is all the normal routine stuff good? I also found out that my hospital does hearing tests right away, and also that an orthopedic doctor checks the hips to make sure there is no displacement (more common in girls apparently?)

But just wondering if there's anything I should be concerned about them doing and wanting to reconsider?

Tammy,
Mom-to-be Mar 8, 2003!

[Melanie]

Well, there are two sides to everything, but here's what they do and my opinion:

Eye Drops-They say they don't hurt anymore, but they do blur their vision. I believe they are against some type of infection b/c we women are so dirty. :P Anyway, I allowed them, not sure if I would again w/out more research.

Vitamin K Shot - This is to promote blood clotting. Something abot birth possibly causing some vessels in the baby's body to burst and IF they are born deficient to clotting they could hemorage. I allowed this.

Hepatitus B Vaccine - This is an STD and aas long as you don't have it and aren't at risk for getting it while breastfeeding, why submit your poor baby's new body to this? Our ped. does these at 1 month, but I'm immune, so Ds hasn't had this. The hospital where he was born wanted to do it on Day 1.

Circumcision - Well, I'm sure you know by now this is a hotly-debated subject. My son was born perfect and I left him that way. If you decide otherwise, I'd make sure they give your perfect little newborn some sort of anesthesia and you are there to comfort him. I've heard horror stories...

The hearing test was totally painless and rather fascinating even though the tech. had no clue how it actually worked so she couldn't explain much. It sounds like the hum of bumble bees. They do stick something to your baby, but it was a light adhesive. I had this done, obviously.

Blood Sugar Testing: Prick of the heal to test their blood sugar. The nurses like to do this so they can make new nursing mom's nervous about breastfeeding and allow them to give formula or sugar water to the baby. I had Gestational Diabetes and produced no milk until day 4. My son still didn't low blood sugar. I allowed the test b/c they were pricking his heal already for bilirubin levels as he was jaundicing.

Bilirubin test: If your baby looks like they are starting to jaundice for blood type incompatibility (like we had I am O+ he is B+) they may draw blood to check their levels. Anything below 20 is not cause for the ultra-violet treatment and can be treated by having them take in food and exposing them to sunlight. My son got up to 16 before my milk came in, then got better right away.

I don't know about the hip test, except the pediatrician did lift his legs up to check his hips in the hospital and first few visits. It's not painful to them, just annoying.

My big regret: The PKU test. This was awful horrible terrible. I live in California, too, so yours would probably be conducted the same way. It's processed by the state for some reason. One of the diseases it tests for MIL has, so I allowed it. They poked my little Angel's foot and squeezed and squeezed until they filled something like 5 HUGE circles on a cardboard with his blood. He cried and cried and cried. Get this: I never got the freakin' results from the state, just a bill! FURTHERMORE it was totaly inaccurate because he had not taken in any food yet! (you can see the link below if you don't believe me)


Here's a link which basically tells you about the tests I just did:
http://pregnancy.about.com/library/weekly/aa012599.htm

Mommy to Jonah

Disclaimer: These are the opinions of a mother and not a medical professional.

[cinrein]

I was told by 2 different L&D nurses and my childbirth educator that the eye drops are required in all 50 states and must be administered within 1 hour of birth. They protect the baby from STDs. The eye drops do blur the baby's vision, so most nurses will wait until the end of the hour to administer them. Just be sure to let them know you don't want it done right away.

Cindy
edd 2/14/03

[egoldber]

If the hospital was receptive to that idea, then why not? If they would make a big stink out of it when you're there, my purely personal opinion is that it's not worth the effort. The things they do immediately after the birth (APGAR, weighing, vitamin K and eye drops) really do only take a few minutes.

I would ask your hospital what their standard tests are. Also, which ped you choose has a great deal to do with how your baby's post-delivery care is managed. Virginia also does hearing tests as standard, but they didn't do ours until day 2 in the hospital. They did a heel prick for glucose test. I would have this done because newborns can be born with low glucose which can be very dangerous, but I would ask your ped how this would be managed if it were to occur.

At least in my case, I know that my ped was the one who said what things got done and when. The day after your baby is born, if your ped has privileges at the hospital you deliver at, they will come around and examine your baby. My day nurse was convinved Sarah was jaundiced and wanted a lot of testing. My ped intervened, said she fine and told the nurse to leave us alone. During his exam, he did examine her hips, but this is not an invasisve tests and baby barely knows it is happening.

In general, I would be familiar with all the practices at your hospital. We had rooming in, but I wouldn't be shy about sending your baby to the nursery if you need sleep, espcially since DH won't be with you. At least at my hospital, the breastfed babies had big signs in their layettes saying "I'm A Breastfed Girl! (or Boy!))" and the nurses were NOT shy about bringing you the baby to feed if they seemed hungry.

And I will say that I had a lot of trouble breastfeeding initially, did give Sarah a few ounces of formula in the hopsital (mainly so I could get some sleep), and we went on to breastfeed just fine. We always had some trouble, but that was due to a physical issue that Sarah has which causes a poor suck, not because I gave her a few ounces of formula. According to my ped (who is VERY pro breastfeeding and was very supportive in the early days when she was slow to gain) while nipple confusion is a real problem for some babies, it is not for the vast majority.

In general, make sure you choose a ped whose philosophies are similar to your own. They will be your ally in the hospital if necessary.

HTH,

[Rachels]

Nothing is so urgent it can't wait an hour, unless your baby is in distress. If you're worried about ABO blood incompatibility (we were, because I'm O and Clay is AB), ask them to test the baby's cord blood. They don't have to stick her for that. Wait on the eye drops until after the baby has a chance to stare at your face for a while. She's not going to lose weight or get jaundiced instantly, so those things can wait, too. We did allow Vit K, but refused the Hep B. PKU will be totally inaccurate if the baby has been feeding for less than 24-48 hours, so don't allow that immediately. We did the hearing screening at ten days, which is what was recommended by our hospital. There's no rush. If the baby has a hearing impairment, a few hours isn't going to make a difference.

Just remember that this is YOUR baby, and all of these things are your choice. A lot of this stuff is scheduled for the convenience of the hospital, not the needs of a new mother and baby. Your baby needs you immediately after birth. Sure, she will recover just fine if they take her and weigh her and whatever else, but there is quite a difference in the distress exhibited by babies who are in skin-to-skin contact with their moms immediately after birth vs those who are taken to a warming table across the room. For me, it felt important to make my baby's transition as peaceful as possible. Also, I was exhausted and overwhelmed, and I needed to hold her as much as she needed to be held. Again, though, be very clear with your midwife and doula about what you want. You won't be in much of a position to advocate for yourself.

-Rachel
Mom to Abigail Rose
5/18/02

[dogmom]

There are actually very few things they have to do after birth, but some things will need to be done in the hospital before you go home.

Depending on how you baby looks at birth they can certainly allow some bonding time before the pediatrician exams him/her. I hand a good 15 minutes with my baby on my chest before they even examined him. The eye drops were given right during the exam. Because of my baby's size (big) they did 3 blood sugar tests, not for gestational diabetes but because babies on either end, small or large, can have trouble regulating their blood sugar right after birth. I certainly didn't feel like they were trying to make me paranoid about breast feeding. They did draw some blood for blood type because I was Rh -, but they did that in the time I was waiting to go to the postpartum floor. They did the Vit. K at the same time.

There are tests mandated by state law that you have to have, like PKU. I had them give the Hep B vaccine at the same time they did the PKU, just cluster all the unpleasantness. That way the second vaccine can be given at the one month point. You don't have to. They did that the day he went home.

They never did a bilirubin test on him because he never looked jaundice.

I didn't get him circumsized, which almost all the staff thanked me for. My pediatrician thinks it's barbaric.

The last thing is, YOU DON'T HAVE TO BE THERE FOR THE TESTS. Which I know many people would disagree with me on, but I've seen babies get PKU tests, I didn't need to be there for my son's. The nurse took him to the nursery, did the test and the vaccine, gave him a "sweetie drops" that gives them a little sugar boosts and soothes them, and brought him back to me all happy. I certainly don't believe in holding your baby during a painful procedure. Let the nurse do that, and then hand him to you to comfort afterwards. I don't need him associated me with pain. Like a said, some people would do it differently, but you're not a bad mom if you would rather not see the blood drawing.

Overall I felt like the staff gave me all the time with my son that I wanted. They were very supportive of my "bonding" time.

J.M.
One week down, 18 more years to go.

[COElizabeth]

James didn't have his first sponge bath until about 7 hours after birth (the next morning). I don't know if it was because he was born in the middle of the night or if that is standard procedure there, but it was nice that he wasn't taken away for anything besides weighing until we had spent that first night together (the eye drops, etc. were done in the room with me, but the scale was down the hall since the hospital just had one, ultra-expensive scale - DH and my sister accompanied him for that, and DH went for the bath, too). You might ask if the bath can be delayed.

Having said that, I think it's important not to get your heart and mind set on what will and won't happen. I had at least 2 medical conditions that might have cost me or my baby our lives if we'd been in a century without modern medical care, and there were at least 3 others that could have turned out to be major problems. All of these things meant interventions, including some blood tests for both of us, that weren't fun, but to me they were worth it. And all of these problems and potential problems were NOT terribly uncommon. I am not trying to be scary. I actually found it really reassuring that even with so many issues that sounded scary, everything went very well and seemed almost routine, especially with good doctors who kept very calm. I think it's good to ask questions and be involved in decision-making, but if you or your baby have to have interventions that you might not have planned, try to keep it in perspective. A LOT can happen and still have you both end up happy and healthy, which is all that really matters.
Elizabeth
Mom to James
9-20-02

[twins r fun]

I couldn't agree with you more, Elizabeth. I know a lot of you guys are into doing things naturally and please don't read this post thinking that I am critisizing or judging your choices! Just as someone who pretty much owes her children's lives to the doctors and nurses in the NICU and some drastic measures post birth, I just wanted to offer the other view and give an acknowledgement to all those essential medical personnel.

I had my babies by c section at 33 weeks. When they pulled them out I got to see Jaocb's foot and not a thing of Caleb. I had no idea what they were doing to my babies, except that they were making sure they lived. Nor did I care what they did as long as my babies survived. I know this isn't the typical birth experience and I wouldn't wish it on any mom to be, but it was not that bad! I didn't see my babies for 24 hours, didn't hold them for 48, didn't even try to breastfeed them for almost a week. But I want to say the staff at the NICU was so supportive of my husband and I bonding-they'd wait to do procedures if we were visiting, they'd hold off feeding them if they thought I was on the way in, they'd take polaroid pictures while we weren't there, they'd reassure you, let you cry, stay out of your way-whatever they thought would help you. And most importantly they eventually let you go home with a baby that was alive and healthy. I guess this is just my tribute to all the hard working nurses and doctors who get a bad rap sometimes!

Nicole

[etwahl]

I definitely plan to have them not do anything until I've had the baby for an hour (especially the eye drops -- I want those little eyes to see me!)

As far as the Hep B goes, I assume if neither of us has it, the baby should have no risk either? But is there a guarantee that we don't have it? Neither of us has ever done anything that would put us at risk that I know of, but I'm wondering if we need to be tested to be sure? Admittedly I don't know a lot about Hep B.

The PKU test - why do hospitals do it right away if it's inaccurate? I guess that's where I get confused. If everyone knows it's not accurate right away, why do they continue to do it? It seems so strange to me.

Tammy,
Mom-to-be Mar 8, 2003!

[jojo2324]

I don't know if it varies state to state, but in NY there is no need for the Hep shot at birth if the mother is not infected. Immediately after Gannon was born he was placed on my chest and he suckled for a bit. Honestly, I was the one who needed to be taken away...I was beat! I had an idea that there was this scrumptious warm baby on my breast, but man, I was tired. After awhile they took him to be weighed and Shawn accompanied the nurse to do all the stuff while I passed out.

I understand it's critical, those first few moments. And I had read all the literature too: No Sugar Water signs, No Pacifiers, Breastfed Baby, Room In, make sure the nurses aren't secretly keeping the baby from you because they think he is so precious, make sure the nurses aren't giving him formula so you can sleep, etc. It got me a little paranoid about the hospital, but all for naught. When I asked if any of these issues ever arose during the hospital tour, the nurse looked at me like I was insane. And it certainly didn't seem like they wanted me to sleep because they kept wheeling him in to me.

I guess I just wanted to agree with the last couple posts. I respect (and am slightly envious) of those who labored drug-free, at home, with no intervention, etc. But don't completely embrace the idea that all of the medical personnel is out to sabotage your birth experience. Not to say that my experience was bliss: the nursing staff STANK. But we made due, and in the end we both came home healthy. And we still are, knock on wood.

Just a note about circumcision: I was so adamantly opposed to this, but Shawn's 60-year old uncle had to undergo a circumcision about 5 years ago because of lifelong afflictions, infections, problems, pain, etc. His uncle said it was the worst pain he had ever experienced (the cicumcision). So Shawn won, because I knew it was really important to him; he didn't want our boy to possibly face that one day. And newborns experience pain, I don't doubt that for a second, but they don't remember things for a reason...Growing is painful! But I still wanted to kill Shawn when they brought Gannon back to me and he was whimpering. Anyway, our insurance got messed up somehow and we were sent the bill...$350!!! I couldn't believe it. For maybe 3 minutes of snipping....I was floored.

[nohomama]

"I certainly don't believe in holding your baby during a painful procedure. Let the nurse do that, and then hand him to you to comfort afterwards. I don't need him associated me with pain."

Either Lola's father or I have held her for every shot and painful procedure she's ever had and I don't believe she associates me with physical pain or discomfort. At the very least, holding her and being right there to comfort her afterwards has made ME feel better.

Also, there was recently a large study done (in Canada, I believe) that showed newborns exhibit fewer signs of pain during and "recovered" more quickly from heal sticks when they were allowed to be held AND NURSED by mom during the procedure. Food for thought.

[newbelly2002]

I have to agree with the last few posts. I had, in many ways, the best of both worlds. I was in a hospital, but they were incredibly amenable and open to alternative and noninterventionist proceedures (Shannon can attest here, it was Martha Jefferson). While I too wanted to bond right away and I had heard all the stories, after 18 hours of hard, hard labor, and oxygen for the last part of it for me, they put Dante on my chest for about 2 minutes and then whisked him away because they needed to "bag" him ASAP. I was still a little woozy from the pushing but he was both blue and not crying. Those nurses were my saviors. They brought him to me as soon as that was over and he was a nice healthy, shrieking pink. He popped on the boob (wouldn't do that again for about 3 days!) and I don't think that missed time made either of us the worse off. As with everything else about the birth and pregnancy, have your plan, but be flexible.

And Tammy, watch your mailbox (chagrined look down. Talk about the weak link here. . . ). Off to read the little one good night.

Paula

[Rachels]

Sarah and Nicole are both right. Research clearly shows that babies who are held and nursed through painful procedures exhibit less stress and recover more quickly. We always hold Abigail. It's very hard for me especially. Given the choice, though, I'd rather suffer a little if it helps my baby suffer less. And Nicole, the situation with your birth and your babies is EXACTLY what obstetrics and its associated technology is made for! I'm so glad we have both for those reasons. Where I get concerned is with the overuse of major technology for healthy moms and babies with normal pregnancies, when research demonstrates again and again that that actually causes problems to develop.

-Rachel
Mom to Abigail Rose
5/18/02

[Melanie]

"Just remember that this is YOUR baby, and all of these things are your choice."

That IS RIGHT!

"There are tests mandated by state law that you have to have, like PKU."

Maybe it's different where you live, but here we absolutely do not have to allow them to do anything to our babies that is not lifesaving.

"The PKU test - why do hospitals do it right away if it's inaccurate? I guess that's where I get confused. If everyone knows it's not accurate right away, why do they continue to do it? It seems so strange to me."

I don't know why they still do it if it's totally inaccurate, a good question for the Chief of Staff I suppose. I found it quite strange many months later when I learned of this, too. I was very angry b/c it was a tortuous event for Ds & I. I didn't hold him, but I stroked him and tried to comfort him. I don't believe it actually hurts beyond the tiny prick, but they don't understand the sensation so it's scary. The World is new to them and I believe in giving them the most gentle welcoming as possible.

"As far as the Hep B goes, I assume if neither of us has it, the baby should have no risk either? But is there a guarantee that we don't have it? Neither of us has ever done anything that would put us at risk that I know of, but I'm wondering if we need to be tested to be sure? Admittedly I don't know a lot about Hep B."

Well, you may have already been tested, I would ask your care provider. You may also have been vaccinated against it, if so, they test at the end of the series to check for immunity. To my knowledge, it's an incurable disease which attacks your liver. Here's what WebMD has to say: http://my.webmd.com/content/pages/1/1680_50001.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

As my son gets older, I will allow this vaccine assuming it is still proven safe. However, since I am immune and I/my husband do not carry on at-risk activities, I feel the risk of Ds getting it via breastmilk was negligible. According to my ped. basically babies don't need it if they aren't breastfed, but that you can't ADVERTISE that b/c it would be anti-breastfeeding.

Take Care, You Both will Do Fine!

Mommy to Jonah

[COElizabeth]

Tammy,

I don't know the complete answer to the PKU test question, but I do know that hospitals test for other diseases as well as PKU with that blood from the heel prick. Different states require testing for different conditions. Some of the conditions are ones for which very early detection can save the baby's life or prevent serious damage. It is true that some of the results may not be completely accurate at the beginning (I am not sure which ones, though apparently PKU is one of them, per others' posts). We had to take James back to the hospital for a second test sometime when he was about 11 days old just in case the first test missed something, and this was standard procedure, nothing unusual in our case (some pediatric practices draw blood for the second test in the office).

The results in our state get mailed to the pediatrician. Our doctor said they often don't get the results for a few months (!) if they are normal because the state health department is very slow with the paperwork, but I think they are notified quickly if there is an abnormal result, and then the ped calls the parent.

Anyway, there might be some window during which the hospital can give the first test, and you might be able to request that it be delayed as long as possible, but the potential for critical early detection of other conditions may explain why the test is done early even though it has to be repeated. I'd ask your ped for a more complete explanation. This whole topic is reminding me that I forgot to ask our ped yesterday if they had received James' results. I am sure we would have been notified by now if something were wrong, but I just wanted to double check!


One more note - I am all for delaying the eye drops a little while if you want to, but from what I have read, it's the senses of smell and touch that are working best for the baby at birth. I even read that babies are soothed by having a little amniotic fluid left on the mom! So don't worry if you guys are not too cleaned up right away - it can actually help!
Elizabeth
Mom to James
9-20-02

[brubeck]

The main thing is to find a hospital that thinks the way you do. My hospital had rooming in (all the tests were done in my room and the baby never left the room without me, even at night!) and strongly encourages breastfeeding. This gets around many of the issues these other posters are talking about. After your hospital tour you should know if your hospital feels the same way you do on these issues.

Also, I'll speak up as someone who had her baby circumcized and had a (relatively) good experience. It was done in the hospital on Day 2 in a special operating room just for babies. I liked that it was in the hospital because if (God Forbid!) there were problems the special care was right there. Also the sooner the better, why subject your baby to more pain later on? They gave my son topical anesthesia beforehand and then a shot after that had started to work. He did cry during the procedure but frankly he cried way more at the heel blood tests (biliruben test and filling in the 5 circles on the card). Afterward we went back to the room, nursed, and he slept for 4 hours. He was fine afterwards and the circumcision was healed long before the cord stump fell off.

Since we're on the topic of painful 'optional' procedures, I want to ask, how many people had their babies' ears pierced? I have seen babies less than 6 months old with pierced ears.

[Melanie]

"Since we're on the topic of painful 'optional' procedures, I want to ask, how many people had their babies' ears pierced? I have seen babies less than 6 months old with pierced ears. "

I totally don't understand that one either! Why torture the girl when it's something she will beg for in a few short years. I think in some cases it is a Cultural thing.


Mommy to Jonah

[Zansu]

Please remember that some of us have religious/cultural reasons for circumcision, and would appreciate it if you would modulate your tone when discussing a very "sensitive" (pun intended) topic.

Thanks
Suzanne

[mama2be]

Suzanne,

THIS IS EDITED TO ADD THAT I FULLY SUPPORT ZANSU (SUZANNE'S) POST TO REMIND EVERYONE THAT WE ARE ALL IN DIFFERENT SITUATIONS. SHE TOOK IT OTHERWISE, WHICH IS SADDENING... AND THAT COULD NOT BE FURTHER MISCONSTRUED THAN MY INTENTIONS. I THINK MY FIRST LINE IMPLIES THAT BUT WANTED TO CLARIFY...

I think this is very well said...everyone needs to be careful about describing something as "barbaric" etc...we all are doing what we think is best for our children and I hope that these boards will continue to give us each advice BUT do think that we all need to becareful with opinions that are strong and question eachother. We have a very nice community here we are lucky to have that. There are debate boards on ParentsPlace if folks feel the need to be heard that much. I am tempted to put this in a separate post on it's own and know some will "snuff" me but I stand by my words and don't hide from my thoughts...

To each his own...when someone asks for our advice we need to give them the advice they are asking for...if we choose to have different points of view then I can only suggest that it might be best you not answer them. If being heard is that important and it triggers some of us to feel like awful people than my advice is to head to the debate boards...what a sad life to have to go around debating with people who are only trying to do what is best for them, we never know someones situation and many decisions are between mommy and daddy...

This is difficult to write but I do believe it needs to be said. For the record if anyone tries to get upset with me for taking this stance I will not respond so I won't carry this any further than this...

Let support eachother and if someones views are that differnt and insult you so much the great news is that is up to you and you can ignore the post, think to yourself "how awful", turn to your friends or DH and complain...but to bring it here is not fair and mostly just not nice!!!

[Zansu]

Neve,

I'm concerned by your post. My comment was to address what I saw as (unintentional) insensitivity in a post. Your post seems to say that I was being mean in doing so.

I was not trying to start a debate; I was reminding people that there ARE different opinions out there and that we need to be aware of how our posts can be read.

I agree that the BBB board is not a place for heated debate. It is also not a place for intolerance.

Therefore, I will NOT be silent if I think someone is posting something that I feel is insensitive to other cultures. If I stay silent when I read something anti-Jewish or anti-Muslim, then I am more at fault than the person who posted the comment.

[mama2be]

WOW I am very suprised that you took it that way at all!!! I was supporting you (or people in general here) to the fullest and rereading it think it shows that entirely!!!! Infact I think I started it out by saying "well said" so I really don't know how that got misconstrued.

I do not feel this a place for someone to tell us that they think a circumsion is barbaric or cruel etc...

I did not look at your response at a debate...AT ALL...I looked at several post recently thru out the board as triggering debate...I think what ever post you were responding to was triggering a debate...that THAT post was triggering a debate!!!! I think what you said was simple to the point and well said (which I had said)...

MIne is not simple, BUT I feel strongly enough about this position that I am willing to lay it out on the line. I for one am having my baby circumsized, not breast feeding and don't regret my decision one bit...and it is no ones business BUT mine and my hubby's...I do not feel I should come to these boards for advice and support and read that someone thinks it is barbaric for me to do somehting to my child. I doubt the Fields want these boards set up that way.

[nohomama]

I'm glad you clarified Neve. I misunderstood your post too. I did want to say, however, that I disagree with your feelings about debate taking place on these boards. I think one of the wonderful things about this "community" is that it's a place where debate can occur without the rancor (for example the thread from some weeks back regarding immunizations). Everyone is entitled to express their views and to openly disagree with a differing opinion. It's when its done with intolerance and without respect that it becomes mud slinging and useless bickering rather than valuable discourse.

[mama2be]

I think for folks to say they are doing something is great...to even say why is great. But when I read the post saying that soemone (and I don't know who and am not going back to address that individual...for all I know it is someone who I really respect the opinion of)...BUT when I read soemone say they think a procedure that maybe 50% of us is doing is BARBARIC...to me that is a debate issue and that is not necessary...I mean to put that thought in my mind is not nice. It's simply not nice...

I am always preaching choice and our views as women to have them...the immunization thread was a great thread it helped me sort out what I am going to do. But if someone said it is barbaric that is a very strong word. Thus I think that word is "without respect"...

Many people (who I email back and forth with) lately have said they are afraid to post because they will get lectured as to what is "cruel" etc...I just have the nads to say "let's be tolerant of eachother" again if someone disagrees that I am wanting to circumsize my son then by all means turn to your friend and say what an awful person I am but to come here to a place I go to that I feel comforted by and to say it is barbaric is just not fair, nor needed.

To educate is differnt than to label. Let's be honest I have heard "studies say...." over and over and over again...well studies exist until the next study comes along and blows it out of the water. And studies and statistics can be arranged in a way to make just about any outcome possible. I don't mind hearing about what studies say, it can be educational and I can take what I want and leave the rest on the table if I so choose (and I do often). BUT when people get mean about other peoples choices it is not nice. WE certaintly don't want mothers feeling bad for their choices do we???? there is no need...no need at all for any of us at the end of the day to second guess such decisions amoungst a group like this is...

And in defense of Suzanne's post when you are saying something against an issue that could be religious or cultural it should not be tolerated here.

I'm just sick of people, me included, being judged by decisions to/for our children...(if you haven't gathered that already). It really does ruin the experience for someone I am sad to admit...

[Rachels]

Yikes. I'm the one that's usually citing research. But I took seven courses in research and statistics, and I both understand what I'm reading and look pretty critically at the methodology. A well-designed study that's replicated five or six times is pretty convincing to me. I feel pretty comfortable quoting it, and I'm careful NOT to quote the stuff that has shabby design. And I learned while writing my dissertation that there's a TON of research that is pretty much ignored by the American medical system when it comes to women and babies. I have never been so astonished in my life. So I quote a lot of studies because of that experience.

I think you're free to make whatever choice feels right to you, and like Sarah said, I think it's important for us to discuss them without rancor. But I do believe STRONGLY that you have the right to make INFORMED choices, which sometimes means hearing about some literature that contrasts with what you thought. It's tricky stuff. But I worry a lot when women are expected to just kind of follow the crowd or follow the culture without really knowing what that means for the well-being of themselves and their babies.

-Rachel
Mom to Abigail Rose
5/18/02

[egoldber]

I also really enjoy these boards as a place where people can usually discuss opposing viewpoints in a way that is thoughtful and sensitive. We have managed to build a really diverse, yet supportive community that I think is pretty unique.

I know I always enjoy coming here KNOWING that people don't agree with all the things I believe and feeling that I can learn about different viewpoints in a safe environment. There are other message boards that I read a lot, but very seldom post knowing I am not "welcome" in that community because of various things I believe. But that's fine, I read and learn and move on.

I must admit that the circumcision issue is one that has me personally very divided. Intellectually I am on one side of the fence and culturally I am on another. I must admit I was secretly (and guiltily) VERY relieved when the ultrasound tech said we were having a girl.

[Rachels]

Me too, me too! We debated a lot for the same intellect-vs-culture reasons. We never came to an answer. We're an interfaith couple, to add mud to the mix, so history and tradition and culture settled differently with each of us.

Most of these decisions are not easy. Neither is the bulk of parenthood, from what I can gather. I agree that having a place to talk and learn and even disagree is incredibly valuable. I appreciate that we tend to do it respectfully.

-Rachel
Mom to Abigail Rose
5/18/02

[Melanie]

"I think you're free to make whatever choice feels right to you, and like Sarah said, I think it's important for us to discuss them without rancor. But I do believe STRONGLY that you have the right to make INFORMED choices, which sometimes means hearing about some literature that contrasts with what you thought."

I could not agree more! It's the uniformed decisions that I have made, or have been made for me, which upset me so. I think if you have knowledge in a subject, that it's important to share it with others, so they, too, can make informed decisions.

For example, let's take circumcision (ducking). There are many people who make an informed decision to circumcise their son and do not regret this, because it was an INFORMED decision. I know people who knew of no other choices or way of doing things, and now they regret it and we all know it's not something you can take back. Had they been informed of their choices, they would be at peace today.


Mommy to Jonah

[etwahl]

Speaking of which, can anyone point me in the direction of some good research on this topic? While we "think" we're having a girl, I don't want to be totally unprepared, because we "know" it could be a boy :)

Tammy,
Mom-to-be Mar 8, 2003!

[jubilee]

Some folks were stating that you don't have to undergo any of the state mandated tests, etc... and I thought I'd state something about that. Yes, it's true you don't have to submit to anything, however if you don't comply with regulated tests (which are very few) then your insurance is not obligated to pay for the services you did use, because you or your baby left the hospital "against medical advice". And with insurance companies getting more and more difficult to deal with, you might check into it prior to refusing services. Not that you are thinking of doing that, but I'd thought I'd throw this in, since I used to work with Regence Blue Cross. (And I don't want to start a debate :) again, I'm not for or against your decision to go with any tests- your decision, not mine- but just check first! You don't want the delivery to not be paid because of that.)

[jojo2324]

I hope that I didn't offend anyone with my post about circumcision. I certainly never intend to offend ANYBODY here....You have all brought me such comfort, knowledge, friendship, and support.

I just wanted to add that every time a shot has been administered to Gannon, I have nursed him. This includes all the heel pricks we faced because of jaundice and vaccinations. He has honestly cried only once, at his four-month shots, with the last injection. But then he just got back down to business and was content to suckle. (Well, if you saw the size of him, you'd see that he's content to suckle just about all the time. ;)) I know some here are not BFing, so maybe the closeness and use of a pacifier or finger during such procedures will be less nerve wracking for both mama and baby...oh, and papa too...Let's throw them a bone! :D

[mama2be]

This is so true!!! From my experience I would never ever sign a form that is an "AMA" form...leaving Against Medical Advice...many insurances will decline payment saying "then you really didn't need to be there". I have no experience with the "baby world", so trust Julie's experience 100% here, of these documents BUT am just thinking if you are ever in the Emergency Room and just sick and tired of being there and they might have drawn your blood but now you want to leave "feel better", "they're taking to long", "the ER is too busy"...I've seen it happen many many a time...

Again my experience is not baby related, just info if you are ever in an ER and in that situation...

[Melanie]

hehehe...well, I can send you to some links which will tell you why not to do it...as far as the American Acadmey of Pediatrics they are no longer recommending it, but they are not speaking against it, either.

Dr. Sears "Deciding whether or not to circumcise your boy"
http://askdrsears.com/html/1/t012000.asp

Circumcision Information & Resource Pages
http://www.cirp.org/

National Organization of Circumcision Information Resource Centers
http://www.nocirc.org/

American Academy of Pediatrics statement on Circumcision
http://www.aap.org/advocacy/archives/marcircum.htm

Baby Center Life Story
http://www.babycenter.com/essay/8298.html

Good Luck, it's SUCH a decision, let me tell you. I can only recommend it be a private one between you and your husband, unless you're looking for advice from people you know. It's not like most people have a reason to know anyhow. EVERYONE is going to tell you their opinion on it, and some won't be pretty. I think what is most important is to be secure in what you decide.

Take Care!

Mommy to Jonah

[Melanie]

Whenever possible, papa is the shot holder in our family. He handles it much better, but I still stay there too.


Mommy to Jonah

[egoldber]

Hmmm. I have some questions about this AMA stuff, but I am going to post it in another thread.

[sweetbasil]

When the nurses took DS for the hearing tests (on day 2), I thought I'd go crazy without him in the room with me. Really, I found myself pacing the room and finally, at the nurses' desk begging to see him. It's amazing how easy it was to slip into protective, questioning mommy mode that first time!

Oh, and we had DS circumsized. My dad stayed with DS and said that there was a doctor performing the procedure with two interns watching. One, a young, 6' guy, almost passed out watching, while DS just gurgled the whole time. The doctor performing the procedure said he wouldn't have feeling down there for another few days, so it was good to get it over with. I stressed for weeks before about procedure techniques, but the guy doing the circs that day didn't do plastibell (the procedure I'd studied and preferred), so he did what he knew, and DS turned out fine.

Here's a funny story: the nurses told us that to put a new piece of cotton gauze on DS's penis between changings to help it heal, but that we had to get it damp before changing diapers, or we'd tear the healing skin and it'd have to scab over again. So the first diaper change comes along, and DH is doing it, I'm watching, and see that the gauze is stuck to DS's little penis. I start freaking out--- "DON'T PULL IT OFF, YOU'LL TEAR HIS PENIS! HOW DO WE GET THE GAUZE WET?...." DH gets all nervous too (the nurses just said get it wet, not- "have a cup of lukewarm water close by" or anything like that (and this was our first time, so we weren't really thinking ahead). Anyway, all the commotion makes DS potty all over the gauze and it comes right off by itself. ha. Just another illustration that things have a way of working themselves out (despite DH & my shortcomings)! :)

[dogmom]

Sorry I haven't been checking the board frequently lately. My son was born 1/16 and I haven't had much time to log on. I responsed to the post earlier because I thought my mind was still fresh and could contribute something. I try not to post much since I don't have much experience.

I was the one that used the "barbaric" quote about circumcision, but what got lost is it was what the pediatrician said and believed, not me. I always figured it was up to the parents. I actually got pressured to circumsize him before his birth, the OB office kept asking me the last 4 visits if I wanted him circumsized and I kept saying no. I guess I should have put in the background, but I was sleep deprived. I was suprised when I got to the postpartum floor that the people there have a very different attitude. I'm sure the fact the pediatrician was from Europe had something to do with her attitude. I don't think she would have tried to talk me out of it, but who knows.

As far as the not holding your baby during painful procedures, I said other people would probably disagree with me. I think I also got a lot of pressure about "make sure those evil health care providers don't do something to your baby when you're not looking." Sometimes it seems people assume that the nurses, MD, etc. are out to hurt your child. I realize I'm biased because I'm in healthcare, even though I've never practiced with children and am not an expert. All the nurses I dealt with were wonderful, and I can't think they would want to do something bad to my baby.

I just wanted to point out it's OK not to want to hold your child during the actually procedure. You can wait to after to comfort your child and not be a bad parent. Bringing my non-crying baby back to me after his PKU test and having him nurse and fall off to sleep with me was much less stressful for both of us. I certainly don't think I did anything wrong by choosing that route. I know moms who do it both ways.

I'm sorry if I offended anyone.

By the way, whatever anyone decides about the Hepatitis B vaccine for the infant I hope you will revisit the issue when your child is older. Hep B has become a sexually transmitted disease and teenagers can be at risk. To make sure that immunity is established a titer should be drawn at some point to make sure the vaccine "worked." I know people who have gone through more than one series before they established immunity. Which may be a good reason to wait until your child is older. I do think one of the reasons the recommend it is in case there is transmission from mother to child.

[sntm]

Looked up some stuff for everyone:

RE: PKU (from an article in American Family Physician in 1999)
--essentially says PKU test is accurate between 12 and 24 hours. Couldn't find any discussion as to whether baby not taking in any feeds would affect the accuracy of the test, though general recommendation is that it should be repeated if baby shows sign of mental retardation. PKU has really horrible consequences if the diet is not started early but mental retardation can be completely prevented if patients avoid the appropriate foods.

TABLE 1 -- Follow-up Testing in Response to the Initial Results of Newborn Phenylketonuria Screening Infant's age at initial testing Follow-up testing
<12 hours Repeat the test regardless of the results on initial screening.

12 to 24 hours Repeat the test if McCamon-Robins fluorometric assay was used.

If Guthrie inhibition assay was used, repeat the test if the results were positive; repeat testing is not required if the results were negative.

>24 hours Repeat the test if the results were positive; repeat testing is not required if the results were negative.

RE:Hepatitis B
Hep B is an STD but also bloodbourne, so there are risks from blood transfusions and needle sticks (most health care workers are encouraged to get the vaccine.) Nasty disease.

RE:Eye drops
Mostly for gonnorhea and usually erythromycin. Some people argue against these if they have been previously tested but there will always be that baby out there who goes blind because mom or dad cheated.

RE:hip dystocia test
Just a manipulation of the joints to check for hip click. Can lead to death of the bone if not corrected.

RE:Circumcision
I posted on this once before, just about the medical info on it. Basically, noncircumscised men have higher rates of penile cancer (which is a very very rare cancer to start off) and their partners have higher rates of cervical cancer. There is evidence to suggest that proper hygiene reduces or may eliminate this increase. They also have higher rates of urinary tract infections. Some men later on may require circumcision for things like phimosis (difficulty with retraction of the foreskin usu 4-6%). It's a little more difficult to do later on. There can be complications from circumcision but they tend to be rare and most just require revision (few cause permanent defects.)
Religious and cultural concerns are, of course, separate.

My research on the matter (I did a presentation in med school) does show that lack of pain control is an issue -- vital signs change during the procedure indicating pain which is decreased with analgesia and babies who were circumcised without pain control cried longer during routine vaccinations as toddlers, suggesting a sensitivity to pain. My recommendation is at least comfort (sugar-dipped pacifiers, being held by mom or dad) and preferably topical or injected anesthetic.

RE:AMA
Insurance justifies refusal of payment usually because failure to comply with recommended care may put you at higher risk of complications; in other words, if I say you need IV antibiotics and you refuse, then develop a worse infection that requires surgery or long-term care, you have encurred higher costs than you would if you had followed medical advice. Of course, that never applies to patients that keep smoking or don't exercise or don't take their medication regularly!


Anyway, just some thoughts...

shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03

[mama2be]

I am tempted to email Tammy directly with this but thought others might benefit from the info...and also thought our "board Doctor Shannon" could shed some light on the topic for us...

I told the midwife today that we are having Tristan circumsized 7 days (I think it's 7) after birth. Since we are having him at the birthing center they do not do this thus we have hired a Moher (pardon me if I got that wrong)...but a doctor who normally performs circumcisions at a babies Bris (did I get that right????) for babies of the Jewish religion. I loved this man when i spoke with him and must say I have been worried about waiting 7 days...I don't know why but you know we always second guess our selves...

She said "PLEASE WAIT..." (and I don't know if this is true just passing it along) that the babies don't produce Vit K immediatly which is a clotting factor...thus if you wait then you do get this clotting factor. She also said she'd rather him be "bulked up" with breast milk or formula before the procedure...

So I feel better with my decision and thought to pass it along...Shannon if you are there what do you think about this???? Not circumsion as a whole BUT about the "waiting period"....

[brubeck]

My son was circumcised about 36 hours after birth (in the hospital, by a doctor who had done a thousand of them) and had no problems healing. His penis was healed a week before the umbilical cord stump fell off.

They give babies a Vitamin K shot at birth to help supplement that need.

My son clotted immediately. In fact, on Day 2 (after the circumcision) they gave him the blood tests and they had to prick his heel multiple times because the wounds clotted so fast they couldn't get everything they needed.

[KathyO]

Just an add-on on the subject of circumcision - I am coming to this thread late because life has been crazy.

Shannon has quoted the current research on circumcision's benefits. Not like she needs any help from me, but I was going to add that I read a fascinating historical paper on the subject which statistically confirmed, against current thinking in our society, the health benefits of the procedure; it also pointed out that the two religious groups which practice it, Judaism and Islam, both have origins as desert cultures. In such an environment, water for regular washing is/was hard to come by, and an uncircumcised man was at much higher risk of diseases like balinitis, which would leave him sterile and/or in constant pain... if the infection didn't go systemic and kill him.

I realize that few of us here dwell in deserts now, but I found it fascinating to realize that the folks who originated this practice did not pluck it out of thin are, but had, in fact, damned good reasons for it at the time.

Cheers,

KathyO

[C99]

Who said anything about EITHER Muslims or Jews?

[nigele]

NEVE:

I assume the birthing center does not give babies Vitamin K shots after birth?? Hospitals usually do this. You need to talk to Dr. N. before you give birth to see if he should give Tristan the shot and ask his advice on the timing of the circumcision. You might also consider having Dr. N. do the circumcision - I don't mean to interfere or make you worry I just want you and Tristan to be in safe hands.

[C99]

>was up to the parents. I actually got pressured to
>circumsize him before his birth, the OB office kept asking
>me the last 4 visits if I wanted him circumsized and I kept
>saying no.

Omigod, me too! I had read some things about circumsicion and had talked at length with a friend about it. Then we asked my OB/GYN and he countered everything I had read or thought about it (without knowing our position). We got asked like 15 times in the hospital if we wanted him circumsized (because, as a preemie, he was in there for 8 days), even though our wishes were written in his chart.

Caroline

[Rachels]

My birth center did vitamin k.

-Rachel
Mom to Abigail Rose
5/18/02

[mama2be]

I need to check if they do that...I don't know...anyway was just mentioning it for educational purposes regarding VIT K as a clotting factor.

I feel safe that if Tristan is done by any doctor he will be in good hands at whatever time they medically think necessary (they are MDs)...just passing on the info to all since it was said and kind of interesting...

Lisa it never occured to me to see if Dr N would do it...but I think that is an excellent idea...I'll email him....

Call me tomorrow after after your appt :)....

[nohomama]

Neve,

I'm really interested your post because it mirrors a lot of Daniel's and my thinking on the subject of circumsicion. I am Jewish and Daniel isn't, and though I would describe my family as being VERY secular, I found myself leaning towards circumsicion if we had a boy. Basically, Daniel and I never came to a firm decision one way or the other (and obiviously never had to...we're still on the fence). We figured if we had a boy, we had eight days to decide (In Judiasm, circumsicion is performed on the eighth day in the ceremony called the Bris. In Islam, circumsicion is preformed on the seventh day).

The one decision we did make about it, is that if we chose to have our son circumsized, we would have it done by a mohel (pronouced "moil" or "mohail" ). In the area we live in and in this country as a whole, circumsicion is becoming less common (I beleive the rate is around 60%). If, for arguments sake, you say a pediatrician gets 100 new patients a year and of those, only half are boys, and of those fifty, only half are circumsized with some undoubtedly being circumsized by a mohel, that ped with a 100 new patients in a year is only performing circumsicions 10 or 15 times during the course of that year. A mohel may do that many in a week. We just figured we'd go with a "specialist."

Vitamin K also came into our thought process around circumsicion for exactly the reason your midwife mentioned. Babies don't produce vitamin K on there own for *about a week* (another indication, as Kathy O said, that the people who originated this practice had a darn good reason for doing it the way they did). If you do decide to use a mohel and have Tristan circumsized when he's eight days old, blood clotting should NOT be a problem.

Lola didn't receive a vitamin K shot at birth but we did have it on hand. There are things that can occur during birth that can cause cerebral bleeding, and it those cases a vitamin K shot is a life saving measure. Because of this, I would bet that your birth center at least has vitamin K on hand, or requires you to get a prescription filled, even if they don't administer it to the baby.

I appologize for being so long winded. As I said, I found your post interesting. I hope something my response proves helpful.

[Melanie]

As well as many of their other traditions such as the different pots, pans & preparation surfaces... Being as I married into a Jewish family I find many of the traditions fascinating, because at one time they had real health purposes.

>
>I realize that few of us here dwell in deserts now, but I
>found it fascinating to realize that the folks who
>originated this practice did not pluck it out of thin are,
>but had, in fact, damned good reasons for it at the time.
>
>Cheers,
>
>KathyO

Mommy to Jonah

[mama2be]

That has been one of my biggest gripes in this pregnancy...that for the most part all of my desires are not only in the chart written in balck and white...BUT are there several times in several places. There is NO excuse for them to walk in your room without reviewing the chart. If it's not in there that's one thing but to be asked personal questions each time you go in and it's there is just not right...

[flagger]

Based on this thread, I had a discussion with our OB at our last appointment. We were told that the hospital is very good when it comes to allowing bonding. Because our pedi will be involved, we will have an advocate for our beliefs.

The only thing he mentioned about the Hep shot is that it does provide some protection for coming in contact with someone (read that poorer) who was never vaccinated. Strange though, NC gives has a free vaccination program, but getting the word out to those who don't speak English or fear deportation is difficult.

[sntm]

Vitamin K stores last more than a month and the clotting factors made from it last up to a week. The post-birth Vitamin K shot will give him plenty and I don't think waiting will affect him in any way.

My mentor in medical school was a pediatric surgeon who also worked as a mohel (or moyel, I forget how to spell it too, though his vanity license plate spelled it out!)

p.s. always glad to help with medical questions! take 'em at least with a small grain of salt. I am still training!

shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03

[sntm]

That's a really cool observation. It reminds me of these programs my mom watches on the Discovery channel or something where archeologists try to determine the origins of stories in the bible and other religious documents. And there was this article in USA Today about a whole new genre of books on the historical background of random things like ice (for drinks) or longitude or buttons or whatever. One on circumcision would be fascinating.

shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03

[cara1]

Regarding circumcision in the Jewish tradition, just wanted to mention that most mohelim (plural of mohel) are not physicians. They may not even be rabbis, but they do have special training in circumcision. Their surgical techniques are frequently different from those of the physicians that perform circumcisions. As for the MDs who circumcize, often it is the OB, not the pediatrician, but there is a lot of variability. That being said, there are also many physicians with religious training (usually reform Jews) who have been trained as mohelim, and may use either technique. We ended up using a urologist who is also a mohel. (My OB, who is a mohelette (female mohel) was unavailable the day of the bris).

The 8 day waiting period, I believe, is a leftover tradition from way back in the days when many babies didn't even survive that first week, so the thinking was why bother doing the circumcision. In fact, the baby isn't even supposed to be named until the circumcision for the same reason (a lot of superstition).

Since non-Jewish babies are circumcised in the hospital (if they are), and others are usually done on Day 8, it seems to me that your midwife's concerns are largely unfounded. I don't think there are many bleeding complications from circumcision! HTH.

[Zansu]

Dogmom's post on 24 Jan 03 included the statement "I didn't get him circumsized, which almost all the staff thanked me for. My pediatrician thinks it's barbaric."

I pointed out that some faiths/cultures practice male circumcision, and that the doctor's comment could be insulting to members of those groups.

The best-known faiths that practice male circumcision are the Abrahamic faiths: Judaism and Islam.

HTH
Suzanne

[KathyO]

If you're interested, and have (ha ha!) spare time, check out the book "Honey, Mud, Maggots and Other Medical Marvels" (two authors, both named Root-Bernstein).

The book does in-depth investigations of "old wives tale" traditional medical techniques which have been shown to be based on very sound science, and in many cases are being rediscovered today. It includes things like therapeutic baths, the use of maggots and leeches, various wound treatments, etc. The point of the book is NOT that every "home remedy" is good - it's about the ones that can be demonstrated to actually WORK, and in some cases work as well or better than the modern "best practices".

I believe that the article on circumcision is included in this collection (can't tell right now, my copy is out on loan). The authors grudgingly conclude that, in fact, circumcision does have demonstrable benefits, even today, in spite of the current thinking against it. This is borne up by the experience of a co-worker of mine, whose uncircumcised son developed chronic balinitis in spite of her best efforts, and of two friends who were circumcised as adults for the same reason.

Am I advocating circumcision myself? Nope. I haven't even made up my OWN mind. Add it to the list of "individual choices" we all have to make here!

Cheers,

KathyO