Newborn

The care of your baby is very important. The most important elements of your baby's care are those things that you will be providing; warmth in the form of skin to skin contact, food in the form of colostrum and breast milk and love. We will be carefully observing your baby when it is born and if there is any need for us to intervene we will. We are trained in neonatal resuscitation and advanced

life support. If your baby needs help taking those first breaths we will help.We have oxygen and resuscitation equipment on hand at every birth. We are required by law to administer Vitamin K to your newborn unless you sign a waiver instructing us not to. Nearly 99% of our clients sign these waivers. We also are able to apply the antibiotic ointment Erythromicin, in the baby's eyes and we will do so if you instruct us to….this ointment is only effective on Chlamydia and Gonorrhea. If you do not have either of these infections, the antibiotic for your baby's eyes is unnecessary. If your baby contracts an infection they will need to be treated with a full course of antibiotics and this one time dose will do little to protect them. Nearly 100% of our clients sign these waivers. When the baby is born, we will not cut the umbilical cord until the placenta has been delivered. We usually leave the placenta and baby attached for about 2 hours after the birth. This gives the baby that much time to

remain undisturbed with mom, learning how to nurse and adjusting to life outside the womb in the safety and warmth of moms arms, hearing her familiar voice and Wheartbeat. There is no rush to remove the placenta and by leaving it attached, the baby is able to get all of the blood it is meant to have from the placenta. We will discuss all of these benefits during our prenatal visits. When the time comes to cut the cord, we will put a sterile band on the cord stump. If the parents choose to, we can also burn the cord to sever it. Now we will weigh the baby. Take a quick listen to the heart and lungs and baby goes right back to mom. We save the measuring for the next day. Again, if we find any abnormalities we will inform the parents of what we have discovered and take appropriate action to correct what we can or transfer the baby to the hospital if conditions require this. We perform a complete newborn exam and a gestational age assessment right around 24 hours. At this time we will place the baby's footprints on a special keepsake certificate. We will complete the baby's birth certificate and file it with Oregon Vital Records. A Social Security number will be assigned to the baby when the Vital Records Dept receives the completed form. The baby's measurements are taken now. We will measure length, head, shoulder, chest and abdomen circumference. During the measurements, we will be looking at the baby's body and checking for any abnormality. We will be charting our findings. There are a variety of specific criteria that we check during the gestational age assessment and the baby gets a score for each component. The scores are added up and then compared with a results chart to ascertain the age of the baby in weeks of pregnancy. We will also complete the Newborn Screening Test which is a special blood test that is done by taking 4 drops of blood from the heel of the baby. This test is then sent to the State Public Health Laboratory. There it will be tested for 27 different metabolic disorders including thyroid function and cystic fibrosis. It is a very valuable test and we do recommend that you have it done for your baby. If any abnormal results are confirmed to be an actual disorder, there are wonderful treatments available for them that can spare your child permanent damage and/or death from an undetected problem. The consequences of some of these disorders can cause damage or death far past infancy. A little prevention goes a very long way when any of these is found. We can provide you with specific information regarding these conditions and the test so you can be fully informed of the risks and benefits or performing these tests. You may waive them if you prefer and we will have a waiver for you to sign if so. Nearly 100% of our clients have the tests done. We will weigh the baby at each appointment to track how much weight is being gained or lost. We will help with breastfeeding and try to answer all of your questions. At two weeks it will be time to do the second Newborn Screening Test. Hopefully this is the last time we will have to poke your baby's heel. If tests are normal, this will be it. If any abnormality is found they ask for a retest first before they make a diagnosis. I have never had a baby in my service that had any of the disorders when we ran the follow up test after an abnormal finding. We beg you not to have your sons circumcised. This is a completely medically unnecessary procedure. We can educate you on the care of an uncircumcised penis. It is very easy and the foreskin is part of the baby's body that protects the glans, they are actually one piece for the first several years of the boy's life, fully retracting after 3 or 4 years of age. We ask that you watch videos of the procedure and fully inform yourself on this painful and unnecessary surgical procedure. The rates of circumcision are dropping every year. The US in 2010 has a rate of around 68% not being circumcised. European countries do not circumcise nor does Canada. We will continue to visit with you until your baby is 6-8 weeks old. We are available to answer any questions that you have concerning your baby during this time. You will not have to take your baby to a physician until the 2 month well baby check. At this time the physician will want to begin immunizations. Do your research. Be informed. Making choices for your baby are very difficult in this day and age. There are so many opinions and so much advice. Only you can truly choose what you feel is best for your child. You will be the ones who have to live with whatever consequence will come of each decision. It is a big responsibility. It is also a big joy, to watch this little child who was formed in your womb, continue to grow and mature and learn. It is truly amazing and wonderful, frustrating and tiring, and the most important "job" you will ever have. May God Bless you and keep you. May His face shine upon you and give you peace.

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