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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
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.
Erythromycin 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).
Here is even more information on erythromycin eye ointment.
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. (source) It’s recommended to wait at least 24 hours before the first bath for babies to receive all the benefits of the vernix.
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.
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.
I like this post – it gives a good, concise heads up for some things that have been aware of but not had the time to organize.
If you can, would you please provide your sources for the information you have provided? I feel more comfortable consulting on these issues with my doctor when I can reference original studies or reputable sources with the information I bring into the office.
Thank you for this post. I'm done having children, but like you, there were so many things that I just did because they were "standard procedure". In retrospect–if I was more informed, I would have made different choices…Thanks again, Lori
Megan – Here's a similar post by a fellow blogger and she has her sources at the bottom. http://blindedbythelightt.blogspot.com/2012/10/newborn-procedures-to-reconsider.html
I'm still currently working on a list of studies and will hopefully get them up soon.
Brittany, this is a great post. I needed this information to give to my sister. I'm sure she'll be happy with it. Thanks for sharing! Btw, regarding vitamin K, is it certain that newborns will have this vitamin on their 8th day? My sister and I are actually debating whether or not she'll give her soon-to-be-born baby boy this shot.
It looks like vitamin K really kicks in on the 8th day (and some have said that the 8th day is the one time it will actually exceed 100%) However, it also sounds like it can take up to 6 weeks for vitamin k levels to get to where they "should" be. Generally, I would say the only time the shot is a good thing is if there's trauma during birth (bleeding, use of vacuum/forceps, bruising,etc or if the baby is going to be circumcised. Otherwise, the oral option or no vitamin K can probably be used. It is of course a tough decision to make.
I found your blog through the Healthy Home Economist today. I gave birth to two children in two different states. One of which (CO) was great about respecting my right to refuse all interventions, the other (TX) made a big deal out of the Erythromycin ointment in the eyes. It is state law and the hospital absolutely refused to let us have a say in that. We had to speak with a hospital social worker and then later were approached by my OB, the charge nurse and the social worker and basically forced to administer the ointment. They bullied us into it by threatening to call the police – which is terrifying when you've just given birth. Hindsight, I should have fought it more and called their bluff. My advice, if you live in a state where these interventions are mandated, I suggest you contact the hospital ahead of time and let them know that you plan to refuse that way you can get a lawyer involved if needed. Better to argue about it BEFORE you're vulnerable and full of hormones!
I just want to respond to the Vitamin K issue. Please be very careful if you decide not to do this shot. My 3rd child and only son was born in a water tub at home. We did the delayed cord clamping and no shots. His birth was peaceful and beautiful. I had a gorgeous baby boy. At 5 weeks of age, he had a major bleed on his brain. He ended up with brain surgery and a 1% chance to live. He ended up with massive brain damage. The doctors did numerous tests and it was determined that the bleed was caused by Vitamin K Deficiency Bleed or Hemorrhagic Disease of the Newborn. He had no underling blood disorder or liver problem. So now my son has massive brain damage to more than 50% of his brain. At 8 years old, he is still like an infant and is total care. He is precious and the light of my world but I do not want any other family to have to experience the pain of having your child hurt so bad. Our brain is so much of who we are.
It is just a vitamin shot. I know some of the ingredients are not ideal but it could save your child's life. Doctors still do not know why some children just don't make enough. I had a very good healthy diet. It is nothing I did wrong. My son was circumcised after 8 days and he did ok. He had late on-set VKDB.
It is also known that baby boys have a higher risk of VKDB, especially breast fed babies. Also the study that showed a link between vitamin K shot and leukemia has since been refuted. And besides if you ask me I would rather my child have cancer than brain damage. Most children now survive cancer and there are whole hospitals just for that. At this time, there is nothing that can totally or partially repair a damaged brain.
So please consider at least the shot or drops. But in Australia they did the drops for a while and the incidents of VKDB were higher.
This is a horrible thing to have happen to your child and it's so preventable and while the chances are 1 in 10,000 when it happens to your child its not rare. Please think about the shot. Thank you.
I wholeheartedly agree with Jenny. I’m a neonatal nurse and midwife for 20 years and get so frustrated when I read your watered down explanation on the vitamin k injection. Brain bleeds are real and devastating. People are reading your blog and taking it as gospel when you have written a “biased opinion” rather than evidence based information. I implore to edit this.
We are lucky here in Australia because a lot of these procedures are optional, so the patent always gets asked before it’s done. Or it’s not done at all, the ointment over the eyes… never heard of that! We put off the hep b until he was 6 weeks i think it was. Its common practise here that the babies never get bathed until after 1 to 2 days after birth. That’s hospital procedure. And it’s also hospital procedure that baby gets put on mum as soon as they are birthed for skin to skin and a feed. They don’t take the baby until mum is ready. Unless of course there are complications. I took it for granted these options and procedures are given to us!
Circumcision should be added ASAP.
I also agree 100%. I hope it is added to the list at some point. I never did this with my son and would never to it with any future children.
Why is circumcision not on this list?