Obviously you have a lot of choices and decisions to make when you get pregnant. However, the choices do not end there! There are many choices to make when it comes to newborn procedures. Some of these choices are less of an issue (or not at all) if you are having a home birth or even delivering at a birthing center but some are definitely involved in those birthplaces and they are definitely involved if you have a hospital birth. Many of the newborn procedures to consider have been standard for so long that we have little reason to give them a second thought but it’s always important to think about any medical procedure.
Just as you have the right to refuse or accept any procedure during your pregnancy, you also have the right to refuse or accept any procedure for your newborn. What might some of these newborn procedures be?
Newborn Procedures to Reconsider
Cord Clamping – Everyone knows that you cut the cord after the baby is born but what is often left out is the “when” it should be cut. The standard practice is to cut the cord immediately. The problem with cutting the cord so soon is that your baby is then cut off from almost a third of its blood. When a baby is born their blood is still being transferred from the placenta to baby if you wait until the cord has stopped pulsing (in some cases 10-15 minutes) then the baby will be able to have all of its rightful blood. Delay cord clamping means that baby still receives oxygen (so long as the placenta is still attached to the mother), which is beneficial for babies who take a bit longer to breathe., babies have increased blood volume, which gives babies higher iron levels and possibly higher vitamin K levels and it reduces the possibility of blood mixing if the mom is Rh negative.
Eye Ointment- Standard practice is that all babies have an eye ointment placed on their eyes following birth. The reason for this is that the ointment is to prevent blindness if the mother has gonorrhea. For some reason, it has become the practice to do this for all babies whether their mothers have gonorrhea or not. Now if you have an STD then it’s a good idea to accept the eye ointment. If you are having a c-section this ointment has no purpose, as the baby won’t come in contact with anything that could cause issues. If you do not have an STD then there really isn’t a reason to add to your newborns frustration with the outside world (the ointment causes blurring and generally swelling and irritation) as well as to give your baby antibiotics that could lead to over-antibiotic problems. It should be noted that refusing the eye ointment could be almost impossible in some states. It’s best to make sure you know your state’s laws thoroughly before refusing the eye ointment. Usually you still can refuse but there can be a great fuss and Child Protective Services may get contacted (not that they can do anything about it, it’s more of a safety net for the doctors).
First Bath – Everyone wants to have that perfectly clean newborn but you might want to think twice about that first bath. A bath will remove the baby’s layer of vernix (that cheese-like white stuff that covers many newborns) but vernix actually has a purpose outside the womb. Vernix helps prevent dryness but has also been shown to protect against group B. Streptococcus, K. pneumoniae, L. monocytogenes, C. albicans, and E. coli. It’s recommended to wait at least 24 hours before the first bath for babies to receive all the benefits of the vernix.
Newborn Assessments – It seems that the second a baby is born that they are whisked away to get weighed, measured and given their APGAR score. Now all those things are good, do not get me wrong. However, newborns do not need to be immediately taken from mom just for the sake of a few numbers. APGARs can be done while the baby is still in the mom’s arms and weights and measurements can weight at least a few hours. The reason why you’d want to keep your baby with you for at least the first hour or two is because “kangaroo care” is actually beneficial for the baby. Babies who stay with their mothers actually hold their body temperature better and most babies will actually take the initiative and began nursing on their own. Those first 2 hours are when baby is alert and ready to nurse and bond, after those 2 hours the baby then gets sleepy and things are harder to learn. There really are no risks to kangaroo care so why not take advantage of those first 2 hours?
Hepatitis B Vaccine – Yes, I know I’m heading into dangerous waters by bringing up vaccines but hear me out. The CDC recommends all infants get the Hep B vaccine either at birth or at 2 months. Now no matter what your stance is on vaccines, I think it’s important to realize that since this vaccine can be given at birth or 2 months (if following the CDC schedule, you could obviously delay the vaccine even longer) then why not wait until your baby is 2 months? There is one reason why you would want to get the Hep. B vaccine at birth and that is if you, the mother, have hepatitis B. If however, you do not have hepatitis B then there really is no reason to get the vaccine at birth. Hepatitis B is extremely rare for a child to contract if the mother does not have Hepatitis B and that is because it is a sexually transmitted disease, although it can also be transmitted through blood such as with needle sharing. Last time I checked, newborns weren’t sexually active or sharing needles. Like I said, I’m not going to get into the vaccine debate but even if you are completely for vaccines, waiting until your baby is 2 months will not hurt and it will give your baby time to adjust and grow just a bit more before having a vaccine.
Vitamin K – The vitamin K shot is like a mega dose of well, a vitamin for babies. Why would babies need this? Babies are naturally born with low levels of vitamin K that eventually get to normal range around the 8thday of a newborn’s life. The reason why vitamin K is so important is that with low levels of vitamin K, blood does not clot very well and this can lead to serious issues if a baby were to have anything that would put them at risk (traumatic birth, circumcision, etc). There is also a very rare but potentially fatal disorder that affects around 1 in every 100,000 babies that is caused by low vitamin K levels. The issue that many have with the standard vitamin K shot is that it’s a mega dose at 20,000 times the needed dose, it contains other ingredients like preservatives, some studies have linked the high vitamin K dose with cancer (namely Leukemia) because vitamin K causes rapid cell division, and high vitamin K doses may effect bilirubin which may increase the possibility of newborn jaundice. Some choose to completely opt out of vitamin K, some choose to make sure that the mother ingests high vitamin K foods and/or supplements pre-delivery and postpartum, others choose to use an alternative form of vitamin K such as oral supplement, and some choose to stick with the mega dose in the shot form. (Note: like the eye ointment, this one could be tricky to refuse depending on what state you live in)
As I said, there are a lot of newborn procedures to think about. As moms (both new and veteran) we often don’t realize that there’s more than meets the eye with these standard practices. We assume that since they’ve be the routine way of doing things that they are necessary and completely safe. However, like all things, there seems to be two sides to the decision. I’m not saying you should decide one way or another but I am saying you should read up on your choices. It’s a lot to take in but it’s something I wish I had realized when I was pregnant with my first and so I am now passing it on to you.