In the first few hours after your baby's birth, you'll be asked to make several important medical decisions for this brand new life you've created. Sound intimidating? It can be—if you haven't educated yourself ahead of time. To the rescue: an OB-GYN and a pediatrician suggest several decisions to talk through with your partner before heading to the hospital. That way you can be sure the only surprise on delivery day is your brand new baby.
Picking a pediatrician for your newborn well in advance is key because you'll be spending a lot of time in the doctor's office during his or her first few weeks of life‚ and it's very likely that your hospital will require you to have a pediatrician picked out for your baby before you leave the hospital.
"We do request that ALL parents have a pediatrician or family doctor decided before they leave the hospital," says Hanna Jaworski, MD, FAAP, Section Chief, Academic General Pediatrics at Helen DeVos Children's Hospital. "We do not require that an appointment be made prior to discharge, but encourage it as we can assist in helping them make that appointment in a timely fashion following discharge."
When you're choosing, things like hospital affiliation and office hours should obviously factor into the decision, but don't forget to consider the pediatrician's bedside manner and health care philosophies, says Heather Bartos, MD, an OB-GYN at Texas Health Denton.
"Many pediatricians will not accept patients who choose not to vaccinate, while others are perfectly fine with a delayed vaccination schedule," Dr. Bartos said. "That's why I want parents to find a pediatrician to marry with them early on." Start the search for your baby's pediatrician during the third trimester so you have plenty of time to meet in person and feel confident your choice is the best one for your family.
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Planning on breastfeeding? Set yourself up for success by taking the time now to learn all you can about the process. Knowing what to expect—and where to get help if you need it—can be key for getting through those first few weeks.
"After birth, make sure you ask about the lactation nurse in case you have any difficulty breastfeeding," said Hansa Bhargava, MD, a pediatrician in Atlanta. "This is a good time to make sure you know how to do it." Ask as many questions as you can—the hospital is likely full of people with answers.
You may have strong feelings about whether your son should be circumcised (surgically removing the foreskin that covers the tip of the penis). But if you're unsure about the procedure, do your son a favor: Ask your doctor about the benefits (slightly lower risk of urinary tract infection, penile cancer and certain sexually transmitted diseases, including herpes and HPV) and risks (infection and bleeding).
The American Academy of Pediatrics (AAP) position states that the health benefits do outweigh the risks, but not to a sufficient degree to recommend it across the board. Bottom line: You should make the decision you think is best for your family.
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Waiting a few extra minutes to cut the umbilical cord after birth and allowing extra blood to flow from the placenta to your baby—aka delayed cord clamping—has been proven to have health benefits for your baby, including a lowered risk of anemia in the first six months.
In fact, the American Congress of Obstetricians and Gynecologists (ACOG) now recommends delayed cord clamping for at least 30 to 60 seconds for all low-risk deliveries. Discuss your preference with your doctor ahead of time, but be aware that — like many parts of your ideal birth plan—delivery day may go differently than expected.
Many parents are opting for cord blood banking—collecting the blood left in your newborn's umbilical cord and placenta, which contains potentially life-saving stem cells, and storing it for future medical use. This decision must be made ahead of time (typically at 35 weeks) because the process requires a kit that the companies send to you that you then bring to the hospital to collect cord blood and the tissue.
You also must decide if you want to donate the blood to a public bank for anyone who needs it or pay to store it in a private bank for your family's use. Research your options—including benefits and cost—and discuss with your doctor in advance.
If you're one of the many moms who wish to consume your placenta after birth, know that different hospitals and birth centers have different policies regarding placenta release, including how it should be removed and transported.
"Again, checking with your hospital will remedy any additional stress on delivery day," said Dr. Bartos.
Before you leave the hospital, your newborn will get an antibiotic ointment (usually erythromycin) in his or her eyes. This is to protect from any bacteria they are exposed to during birth that could cause blindness or other eye issues.
Your baby will also receive a vitamin K injection in his or her thigh to protect against vitamin K deficiency bleeding—a serious bleeding disorder that can cause babies to hemorrhage because they don't have enough vitamin K to clot their blood.
Can you refuse either medication? Laws vary by state, so discuss any objections you have with your doctor ahead of time.
Babies usually receive their first dose of vaccination (hepatitis B) along with the vitamin K shot. This is the first in a long line of recommended childhood vaccinations. If you're choosing not to vaccinate your child or wish to delay the schedule, despite the AAP recommendations and statements regarding the safety and importance of vaccines, talk to your pediatrician ahead of time.
Still feeling overwhelmed? Taking a hospital tour and prenatal class are great ways to be reminded of all the little details you may encounter on delivery day. You don't have to be an expert on medical issues—that's what the hospital staff is there for!—but you do have to be prepared to confidently make decisions for the brand new little person—on the first day of his or her life and for years to come.
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