Common Newborn Procedures

Procedures commonly done to your newbornI know that HypnoBirthing® primarily focuses on the birth of your baby. However, it’s also a good idea to familiarize yourself with the common procedures that a hospital will perform on your baby right after birth. Here are some common ones to expect:

  1. APGAR testing at 1 and 5 minutes after birth
    • This one is pretty non-interventionist, and you won’t even notice it’s going on. Your caregiver is measuring the responsiveness of your baby. APGAR stands for Appearance, Pulse, Grimace, Activity, and Respiration.
  2. Measuring & weighing
  3. Vitamin K injection
  4. Eye treatment – erythromycin drops to prevent conjunctivitis caused by chlamydia & gonorrhea
  5. Hepatitis B vaccine injection – if you are Hepatitis B positive, you will pass this virus on to your baby through your breastmilk. Populations that are more susceptible to being Hepatitis B positive include prostitutes and IV drug users. If you don’t fall into this category, and have been tested and know for certain that you are Hepatitis B negative, you can delay this vaccination. The state of California requires that your child receive three doses of the Hepatitis B vaccine before attending a public school kindergarten.
  6. Heel prick blood test (testing for PKU and several congenital issues)
  7. Jaundice evaluation and treatment
    • Jaundice is common in babies born before 38 weeks of gestation, as well as with babies that are having difficulty with nursing. In the full-term baby, jaundice will commonly show up in the first 3-7 after birth as the bilirubin levels are peaking. Also, jaundice can show up in babies with underlying health issues that need to be treated.
    • How can you tell if your baby is suffering from jaundice?
      • The skin and whites of the eyes will be a yellowish tint
      • The baby will be lethargic and drowsy
      • The stool will be a pale yellow color
      • Their urine will be dark
    •  Nursing on demand every 2-3 hours or so after birth and making sure you have a good latch and excellent breastfeeding support will help immeasurably. For yourself, remember to hydrate well. Drink at least 12 glasses of water a day to support your milk supply. Also, sunlight can help clear away newborn jaundice. You can place a naked newborn inside next to a well-lit window for 10 minutes twice a day. Never place your newborn in direct sunlight. Babies that are extremely jaundiced will need to come to the hospital for treatment for phototherapy and additional support.
  8. Bathing
    • Since those first hours after birth are precious and so important for bonding with your baby, it’s ok to delay your baby’s first bath. The vernix on a newborn has antibacterial properties and doesn’t need to be washed off. You can spot clean your baby with a soft washcloth if you’d like — otherwise, keep the newborn attached to you at all times.
  9. Hearing test
  10. Circumcision

So, now that you know the common newborn procedures, do some research on them. Google them. Talk to your caregiver about them. Examine the benefits and risks of each procedure and decide if you think each one is appropriate and medically necessary for your child. Some of them have more risks than others. But it’s ultimately up to you to decide what is best for your child.

Here’s an article from verywellfamily.com about the most common newborn procedures.

Planning in Advance for Your Birth

Consider doing each of these things ahead of time to make your transition from pregnancy to birth easy.

  1. Pack your birth bag at week 34 (you can get everything out and stage it, but the birth companion should pack it so they know where everything is). Keep it in your car. Here is a blog entry I wrote about what to pack in your birth bag.
  2. Keep the baby car seat in the car, along with a shower curtain or garbage bags and extra towels to sit on. Learn how to install the car seat as well as how to adjust the straps. Here’s the DMV website on installing child car seats.
  3. Arrange for baby-sitting & household help, if needed.
  4. Choose a pediatrician or family practice physician for your child. Interview several.
  5. Research the vaccinations your baby will receive. Vaccinations begin at birth with the Hepatitis B vaccine, but they really get underway at the 2-month well-baby checkup, so do your research ahead of time and be informed parents. Three great books to prepare you are: “The Vaccine-Friendly Plan,” by Paul Thomas, M.D., “The Vaccine Book,” by Robert Sears, and “The Vaccine Guide,” by Randall Neustaedter (you only need to read one). You have options other than getting all of the recommended vaccinations all at once. You can space out vaccinations so your baby receives each one at a time. You can delay vaccinations, and you can also say no. A baby who will be attending a day care and is drinking formula needs vaccinations much more than a baby who will be staying at home and who will be exclusively breastfed. Children in California must have the minimum doses of certain vaccines in order to attend school. Here is the link for the required vaccines.
  6. You will get a Group B Strep test at week 35-37. As a prevention measure, consider taking a daily, high dose, enteric-coated probiotic. Also keep in mind that semen kills Group B Strep. Group B Strep is an opportunistic bacteria that comes from the rectum, so remember to wipe from front to back, and cut out the foods that would feed it (white sugar, white flour, white rice, processed foods) and eat the foods that discourage its growth (plenty of vegetables and whole foods).
  7. Take a breastfeeding class and a care of the newborn class. The Santa Rosa Birth Center offers both.
  8. Arrange for diaper service or stock up on diapers. Tidee Didee and Diaper Wagon are the two diaper services we have in Sonoma County. YouTube videos are great for learning how to diaper.
  9. Prepare food in advance and freeze it in individual serving containers(chicken soup is great!). You can also request frozen meals at your baby shower, and a phone tree of friends who bring meals to you is great. It doesn’t have to be dinner: they can bring you food any time of day in exchange for seeing you and the baby.
  10. Read about the Fourth Trimester. Two great books that I recommend are, “The Happiest Baby on the Block,” by Harvey Karp, and “The Attachment Parenting Book,” by William and Martha Sears.
  11.  GET A LOT OF SLEEP. DO NOT burn the candle at both ends right before birth. Your birth will go much better if you are well-rested ahead of time. If you don’t sleep well at night, take naps during the day. Be a sleep magnet.

Book Review: “The Happiest Baby on the Block”

One of my clients recommended this book to me, and I filed its title away in my mind for future reference. And then when I was six months pregnant, I suddenly became very interested in what the heck I was going to do with this baby once she was born. I loved this book. I not only read it, I read it TWICE. It was THAT GOOD.

This book should be required reading for every single new parent out there in the universe. It focuses entirely on the “fourth trimester” — those first three months of the baby’s life outside the womb. The author of the book, Harvey Karp, is a pediatrician in Hollywood, and his premise is that because babies’ brains and skulls are so big, they are born at a time when their heads still fit through their mothers’ birth paths but before they’re actually ready to be outside in the world. In essence, they’re still fetuses for three more months. And they miss life inside the womb. A lot. He says that “colic” doesn’t actually exist — the symptoms of “colic” in a baby are simply the baby wanting to be soothed exactly like it was when it was warmly and comfortably tucked inside mom. The whole book is about recreating that womb experience for new babies so that they can be calm and well-adapted to life in the outside world.

Harvey Karp describes five techniques that recreate the womb experience, what he calls the “5 S’s”: swaddling, side-lying or stomach-lying, shhhhhh-ing (or white noise), swinging and sucking. Swaddling creates a nice pressure all around the baby where the baby is inhibited in its limb movements. My husband thought that this looked like our baby was in a straight jacket. But when you think about it, babies are extremely limited in their movements for 40ish weeks. It’s not a “straight jacket” for them — we’re just anthropomorphising their experience. For the first four to six months, babies have a “startle reflex,” where, if they are lying on their backs (either in bed or in your arms), they feel as though they are falling backwards. To catch themselves, they throw their arms back, and instantly wake themselves up. Swaddling inhibits the startle reflex, and I can’t overemphasize how wonderfully well it works. It doesn’t calm the baby, but it sets up the baby to be soothed by the other four techniques. And by firsthand experience, I can tell you that a baby that wakes herself up every five minutes because of the startle reflex is a very unhappy baby (and her parents probably aren’t getting much sleep).

Ok, now that your baby is swaddled, the other four techniques will finish the job of soothing her. Side-lying or stomach-lying(when you’re holding her) prevents her from experiencing the startle reflex. Only babies who are on their backs will startle. Good to know. So, you’re holding your baby either on her side or facing the floor. Next, you start making a loud “shhhhhhhhhhhhhhhh” sound. This is a white noise that replicates the loud noise of the blood flowing through your blood vessels when she was inside (kind of like when you are lying in the bathtub and you dunk your head under the water. The water amplifies all of the sounds of your house’s plumbing.). Harvey Karp explains that babies love white noise. It’s the peace and quiet that disturb them. So, air conditioners, fans, white noise machines, and “shhhhhhhhhhhh” sounds calm them down. Adjust the volume of the “shhhhhhh” to match your baby’s volume if she’s crying.

Next, start swinging your baby from side to side. This mimics the lovely hammock-like swinging and swaying they experienced when mom was walking around every day. During my pregnancy, I never really noticed my baby moving around when I was in motion, but she really moved around at night. Maybe she was thinking, “Hey, mom! How about a little movement out there! It’s a little too still and peaceful for me to get to sleep!” You can do little jiggly movements or turn your body back and forth like a top-loading washing machine agitator.

Sucking is last, and Harvey Karp calls it “the icing on the cake.” Babies can either suck their thumbs, your fingers, or a pacifier. This satisfies their hunger, calms them, and soothes them in a fantastic way. Harvey Karp says that if you use a pacifier, the best time is between two to three weeks of age (so that breastfeeding goes well to prevent nipple confusion) and four to five months. Around four months, babies learns to stick their own thumbs in their mouths (sometimes both at once) to soothe themselves, and the pacifier is no longer needed. With some creative swaddling, you can also swaddle your baby so that her thumb is directly next to her mouth, and she can soothe herself at an early age. And now that your baby is soothed, you can put them down to sleep (on their back).

The last few chapters of the book continue with the theme of creating happy babies. One chapter goes into more details about some other tried and true “colic” remedies like infant massage, walking outside with baby, keeping them warm to soothe them, preventing food allergies, treating constipation, troubleshooting feeding problems, dealing with actual acid reflux (which is rare amongst babies), and using alternative medicine like chiropractic, homeopathy, herbal teas, and osteopathy. The last chapter is about baby sleep patterns, weaning your baby off the 5 S’s, techniques for helping babies sleep better, room sharing, co-sleeping, techniques to help prevent SIDS and suffocation, and answers to frequently asked questions.

In conclusion, the contents of this book saved my life, it probably saved my marriage and definitely saved my sanity in my first three months of parenting.

For even more information (and for all of those visual learners out there), Harvey Karp’s techniques are featured on YouTube videos, like this appearance on Dr. Phil: