Choices at hospital for newborn

[SweetTooth]

Hello,
I am scheduled to be induced on Friday. I have been meaning to research the things most hospitals offer for newborns and what choices I have. However, I don't have time to search! If any of you mamas have info/advice and/or links to previous threads, that would be great.

I am wondering about the following:
Letting the umbilical cord pulsate before clamping & cutting.
Eye drops given to newborns.
First bath - I think I remember reading that the vernix is good for the baby's skin so to postpone the first bath?
First vaccines?

Any pros/cons/info on the above would be great. Also, any other things you can suggest I think about would be so helpful.
Thank you in advance,

[MoJo]

Have you picked your hospital? If so, I'd ask them about their normal procedures, so then you know what you may want to ask them to vary on. (My hospital/midwife were willing to accomodate some things.)

1) Waiting on the cord: I've heard that's good, and I've heard it doesn't really matter. If you have a preference, be sure to put it in writing and make sure anyone attending the birth with you knows as well as the medical staff (because for them, some of this is so routine, they forget.)

2) My hospital said the new eye drops given to newborns aren't the same as the ones (with silver nitrate?) that you read bad things about. They also allow breastmilk (seriously!) as a substitute.

3) I heard that's good. We were actually more concerned about injuries during the bath after a video we saw in childbirth class. It turned out my midwife was essentially cleaning my baby as she was being born, and then they took her away for her real bath while I was being stitched up. Baby was fine, but if there's one thing I could change, it would be that "taking the baby away and giving all the care instruction to my husband" while I couldn't see or hear very well because I was several yards away.

4) I think we had lots of bloodwork and other tests, but no vaccines at the hospital. If that's usual for you, then you have a couple more weeks to figure that out!

I hope everything goes well for you and your new LO! I'm sure others will have more helpful info.

[misshollygolightly]

You probably already know this, but some of your other big choices at the hospital include:

-how baby will be fed (breastfeed exclusively, bottle, etc.)
-whether you want to offer baby a pacifier (not usually a good idea if you want to breastfeed exclusively)
-whether baby will "room in" with you or go to the nursery some
-circumcision or no, if it is a boy

[JTsMom]

Some of it will depend on where you live, and which hospital you use. Some are very easy going about declining things, some aren't. Your doctor/midwife may also have her/his own opinions, so I would try to check into that before you get there as well.

Usually, delayed cord clamping isn't a big deal. It's something I would prefer. The eye drops are not necessary if you don't have an STD. I decline those as well. IIRC, NY is a state where they DO treat it as a big deal.

The bath- shouldn't be a big deal either- I'd decline that as well. You can do it yourself later, or you can wait until you get home. One other reason to decline it is that it often brings the baby's temp down, then they want to put him/her under the warmer, and you end up seperated.

Vaccines- depending on you area, they may or may not do Hep B at birth. In some places, they do it at the first ped visit. I would decline this as well, but that's something you really need to research and decide for yourself on. Look into how Hep B is contracted and decide if you feel that it's important to vax at birth for it or not.

NOT a vaccine, but other procedures involving needles are the Vitamin K shot and the PKU. You really have to look into both on your own here too, b/c they are a bigger deal, IMO. Some feel that Vitamin K isn't necessary in most cases, and could be harmful. Some feel it is vital. You can also do it orally, but that has it's own pros and cons, and you probably don't have time to track it down at this point. The PKU is a metabollic screening. It tests for rare, but very serious metabollic disorders. I can't get behind declining it, although delaying it I can se.

Hearing screening is another. It's not a big deal, but some delay it until they go see their ped b/c some hospitals remove the baby from the room to do it. Others do it right in the room. My personal feeling is that it should be done at some point, b/c if there is an issue, you want to find out early on, and b/c it's not an invasive or stressful test.

[SnuggleBuggles]

1. Cord- I waited for it to be done pulsing. Most all I read indicated that it was good to give baby all that the cord had to offer (stem cells, blood, oxygen). I read only one little thing (not sure the study's sample size) that said that babies might be at higher risk for jaundice if the cord clamping is delayed. However, I chose to do it b/c the benefits outweighed the risk, for me. I delayed with both boys. Ds1 did have a slight case of jaundice that required no treatment and ds2 was fine.

It's all a matter of making informed choices and weighing risks/ benefits for your own conclusions. :)

2. eye ointment- if you are 100% sure you are free of STDs then you can skip it. You can skip if you have a c-section in most cases too since the baby isn't exposed to the birth canal. Had it with ds1 just b/c they did it without me asking (though they did delay it, per my birth plan). Ds2 did not have it.

3. First bath- we waited with both boys. This is an important one in some cases, btw, not because of the vernix but b/c of hospital policy. I know some cases where babies wound up going to the nursery b/c their body temp dropped after the bath so moms and baby were separated. At some hospitals you can give the first bath so it's worth asking if you are interested.

4. No vaccines in the hospital for either boy. Hep B is what is given and I did not feel that they were in danger of getting it. I skipped it with the consent of the pediatrician.

I know you didn't mention it but PKU (or whatever they are calling the heel prick blood screening now)- I had this done at the pediatrician's office once my milk was in because if feeding is not established the results might not be right. Oh, and when you have it done, put hot compresses (a diaper soaked in hot water, for example) on the heel first b/c it makes the stick much easier!

Beth

[JBaxter]

We skipped eye ointment
We skipped Vit K shot
We skipped HepB shot
I bathed Jack the next morning. I asked to bath him the nurses bathed all my others. The staff is not allowed to touch the baby without gloves in our hosipital until the baby is bathed.

Jack had meconium so letting the cord stop pulsing was not an option. He need to be out and with the NICU doc to get suctioned. I had him back a few minutes later to nurse.

[DebbieJ]

You probably want to write a birth plan and give it to the nursing staff to be included in your chart if you want anything out of the ordinary done or not done. I can forward mine to you if you want.

We declined Vit K, Hep B, eye ointment, and circ and after reading our birth plan, the hospital had us sign a waiver as well. Our son ended up having a bath because he went to the NICU (even though we had put on there to avoid bathing), but that was no biggie. I had an emergency section, so his cord was cut immediately too.

You can make your choices and let your wishes be known, but just be ready to compromise if you need to.

[MamaMolly]

You also need to check into the laws of your state. IIRC in Virginia you cannot decline the eye drops or maybe it was the vitamin K? I honestly don't remember but I know there was one you didn't get a choice on if you had your baby in a hospital setting.

Because DD was in the NICU there were some screenings she wouldn't be discharged without, like the hearing one and the HOUR long carseat stress test (which is the baby sitting in your car seat while hooked up to monitors making sure they could take the stress of sitting in that position.)

DD came 4 weeks early, so I didn't have a good plan in my head for what I wanted. I'd have done things very differently in hindsight. You'll be glad you took the time to take care of this stuff now!

[catsnkid]

Was not asked about bath, umbilicaL cord thing.
He was bathed after my c-section. We had the nurse do a bath demo with us before we went home.
He got the Hep shot at the hospital, had to sign something.

[dragop21]

I would personally decline all of the above. I would also wait on the cord thing, even if you just wait a minute, it can transfer a lot of blood back into the baby where it belongs. :)

oh yeah and I would not skip the PKU test, its not very invasive and could definitely be life saving!

[HannaAddict]

Wish we had been offered a PKU test with my first. It would have saved us a trip to the NICU two days later and three weeks of NICU monitoring. He needed glucose and had nothing causing the low blood sugar after exhaustive screening except not being a chubby guy and being more stressed than he had let on with his 9 and 9 apgar scores. We spent 1+week in actual NICU, mostly just being monitored without any meds, etc. and on breast milk from my pumping round the clock and then nursing (for 2.5 more years). Luckily I was a Holstein. Additional time b/w step-down unit and pediatric unit (where he could stay with me) just waiting for him to quit having one or two crazy low blood sugar readings every 24 hours. It was a surreal experience, where you don't leave the hospital for days. Asked to have #2 tested and blood sugar was slightly low for no reason so nursed and gave her a small bit of formula after nursing while we were in the hospital and no NICU stay. Just make sure they know what you would like but remain flexible and don't get too upset if things that aren't life or death don't go exactly as planned. Congratulations.