Choices for newborn baby care procedures begin immediately at birth. The best preparation is to have considered them and decided beforehand what procedures you desire (or don't want) for your newborn. For a hospital birth, there are numerous routine procedures which can be administered, delayed or even refused. Unfortunately, first time parents are often unaware that many of these routine procedures are not grounded in evidence-based practice, but are rather the product of ease and access for staff.
Many parents don't realize the impact that these procedures can have on their newborn child. Once you have decided what procedures you prefer and whether you want them performed immediately or on a delayed schedule, the best way to communicate them to staff/caregivers is to include a Newborn Baby Care section in your birth plan. This will ensure that your preferences are on paper before the birth and remove any doubt as to your wishes for your new child after birth.
Another critical point to remember is that you can and absolutely have the right to receive information about each and every procedure that will be performed, as well as the right to either request the procedure be performed in your room or that a parent/guardian accompany the newborn for each one. This includes weighing, measuring and the pediatrician's evaluation of the baby - all can be performed right there in the mother's room. Remember, your first responsibility is to the welfare of your child, not to the comfort of the hospital staff nor arbitrary hospital policies.
The most commonly performed routine newborn baby care procedures to consider are:
- Delayed Cord Clamping Vs. Immediate Cord Clamping
- Newborn Vitamin K Injection
- PKU Test
- Silver Nitrate or Antibiotic Eye Ointment
- Hep B Vaccine
- To Bathe or Not to Bathe
- Circumcision
Cord Clamping
The next and perhaps most critical newborn baby care decision to be made for your baby's welfare is cord clamping - immediate or delayed. The benefits of
delayed cord clamping, which is defined as waiting until the cord has stopped pulsating until clamping or cutting it, are well-documented. Once the baby is born, its entire circulatory system undergoes an amazing transformation to allow the baby to receive oxygen via its lungs rather than through the umbilical cord - a valve in the heart closes, the lungs perfuse with blood and eventually a first breath is taken. When this delicate balance is interrupted by prematurely severing the child's lifeline, its umbilical cord, numerous undesirable side effects can occur.
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Newborn Vitamin K Injection
All newborns are born with a low level of Vitamin K which is responsible for preventing hemorrhage by enhancing the blood's clotting ability. In a small percentage of newborns, cerebral hemorrhage can occur which spurred the universal practice of
newborn vitamin K injections in the United States. There are, however, some points to ponder when considering this intervention, especially the alternative of an oral dose.
PKU Screening
Certain metabolic disorders, including a
PKU test, are routinely screened for at birth through a heel stick blood sample. These disorders have devastating effects that are best handled with early detection and treatment to ensure the best possible outcomes. This is the least controversial newborn baby care procedure since the benefits do outweigh the risks.
Hep B Vaccine
The
Hep B Vaccine, a disease that is transmitted via infected blood and sexual intercourse, is given at birth in the hope of catching as many people as possible. It is not required for administration at birth and may be given at any time in childhood or adulthood. In low-risk families, it may be advisable to delay the administration to the weeks after birth, rather than injecting a minutes-old baby, causing pain as one of its first experiences outside the womb.
Silver Nitrate or Antibiotic Eye Ointment
To prevent the chance of blindness due to gonorrhea from an infected mother, hospital-born babies are given
silver nitrate or other antibiotic drops in their eyes, even if the mother previously screened negative for this or other STDs in her pregnancy. Silver nitrate causes pain, burning, swelling and blurred vision for the first days of life and in the vast majority of cases, is not needed when the mother is known to be free from infection.
To Bathe or Not to Bathe
If there is one newborn baby care procedure that many families never consider, it's
bathing a newborn. However, this may indeed be something a new family decides to decline. The vernix which coats the baby's extremely sensitive skin is the best natural moisturizer available and will protect it from infection when massaged into the skin. Additionally, a bath can cause a baby's body temperature to drop, thus necessitating further interventions to regulate it.
Circumcision
Male circumcision, and female circumcision, for that matter, are very controversial subjects. Some religions require circumcision. However, there are no proven medical benefits to the procedure and significant drawbacks. It is now considered a cosmetic procedure and its routine performance is being phased out in many areas. The American Academy of Pediatrics no longer supports it. In Australia, public hospitals are no longer performing routine circumsions.
-Courtesy of GivingBirth
You can check out my birth plan post
here. It is still a work in progress and I have to add a few more things but feel free to check it out.