Wednesday, September 10, 2014

Routine Newborn Procedures: Are They Necessary?

Most mothers that give birth in the hospital prefer that all newborn procedures are done at their bedside.  These include bathing the baby, weighing, measuring, applying eye ointment, doing a newborn exam, a heel stick, and a Vitamin K shot.

Many women object to the routine use of these procedures.  You should know that you can wave them if you sign a release form.   Learn about your constitutional rights to refuse treatment .  Of course, if you are giving birth at home, you will probably not need or want any of these procedures.

Bathing - when the baby is born, it will be covered with vernix, a white cheesy substance.  In the hospital they prefer to clean off the vernix.  At home, mothers often leave the vernix on and massage it into the skin of the baby.  The purpose of the vernix in the womb was to protect the skin like a moisturizer.  It can be massaged in just like lotion.  It is not dirty and does not need to be removed.  In the hospital, you can choose not to have the vernix removed, but you need to request this ahead of time.

Eye ointment - If you had a sexually transmitted disease while pregnant, this can be passed to your baby and cause blindness.  Rather than test for an STD  before applying the ointment, they simply apply it to all infants.  Silver nitrate used to be used, and it stung the baby’s eyes, sometimes causing eye problems later in life.  Now it is more common to use Erythromycin, which does not sting. However, many mothers object to their babies receiving a treatment that is unnecessary, especially if they are in a monogamous relationship and know they don't have an STD, or if they have been previously tested.  This can be dispensed with if you sign a waver.   Click Here  to read the medical research studies which explain why choosing to forgo the ointment is a reasonable decision for parents to make because the treatment does not significantly reduce infection, and many infants who receive the treatment contraction the infection anyway.

Heel stick - to check blood sugar.  If the baby’s blood sugar is low, in the hospital they will often give a bottle of sugar water to raise it.  It is more effective and healthier for the baby to nurse at the mother’s breast to receive colostrum.  If you would rather nurse your baby than allow it to be given a bottle, this must be specified ahead of time in your birth plan.  Sadly, I have known of many instances where a bottle has been given anyway despite clear instructions in the birth plan to the contrary.

Vitamin K shot - given to make sure the baby has enough clotting factors in its blood.  This can be gotten in sufficient amounts from mothers milk.  This shot can also be waved by signing a form.

If you are giving birth in the hospital, there is often a mandatory nursery stay.  If your baby must go to the nursery, please have the baby’s father or the birth partner accompany the baby to the nursery.  At no time should the baby be alone in the nursery with hospital personnel.  If you want your baby to receive only breast milk and no supplementary bottles, you should personally see that no formula is given.  Once the baby is away from you and in the nursery, it is quite common for your birth plan to be ignored if you are not there to oversee its implementation.  Go to the nursery yourself, or if you cannot, have the father of the child or a family member be there at all times.

Why would one want to breastfeed only and not give supplementary bottles? Because babies find it much easier to get milk from a bottle than from the breast. Once they figure out that the bottle is easier, it is difficult to get them to go back to the breast.  This is called nipple confusion.  If you plan to breastfeed, then supplementary bottles only make your job more difficult later on, and can totally sabotage breastfeeding for some mothers and babies.

Before the baby leaves the hospital, state law requires that the baby be given a PKU test.  This is also a simple heel stick.  However, babies must breastfeed for several days before taking the test if the results are to be accurate.  Most babies receive the test before leaving the hospital, on the second or third day after birth.  This is not long enough to see whether or not the breastfed infant has PKU.  So you can also sign a waiver for this test, and tell them you will take the baby to the pediatrician later to receive the test.  PKU is a disorder in which the baby cannot process phenylalanine, an amino acid.  Babies with this disorder may experience brain damage unless they are put on a special diet within a couple of weeks after birth.  Breastmilk has lower levels of phenylalanine, so it takes longer to build up in the blood of the baby.  It is a rare disorder, and most homebirth parents do not even bother to get the test done.

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