Newborn Care Choices

Although parenting begins as soon as you discover you are pregnant, your parenting choices begin most dramatically at birth. In those first few hours and days, and the days and weeks leading up to them, you must make many decisions about your baby’s care. In hospital births, there are procedures that are often done routinely, which you may want to consider refusing. Even in home births, you must make decisions about how you want your baby treated immediately after birth.

As you prepare for your baby’s birth, you may want to consider writing a Baby Care Plan to give to your care providers, which will help ensure that your wishes are known and respected. You can learn about creating a Baby Care Plan (as well as a Birth Plan) in any Better Birthing online course.

As you create your Baby Care Plan, here are some newborn care choices to think about:

Cord Clamping

In many hospitals (and with some birthing center and homebirth midwives) the umbilical cord is clamped and cut almost immediately upon birth. Unfortunately, this practice deprives babies of a large percentage of the blood volume they could receive through the cord. That blood is rich in oxygen, as well as iron, which is important for babies in their first year of life since breastmilk is naturally low in iron. Allowing the baby to stay attached to the cord until it stops pulsing gives them their best chance at optimal health. As long as the baby doesn’t need to be resuscitated, or have some other life-saving procedure done immediately, there is no reason to clamp the cord prematurely.

Eye Ointment

After birth, it is common procedure to treat newborns’ eyes with erythromycin ointment. This is done to prevent blindness as a result of an infection caused by gonnorhea transmission from the mother to the baby. If the mother has gonnorhea, or doesn’t know if she has it, then this might be a good idea—although it is still not the only option. Transmission of the virus is not guaranteed, and even if it does happen, babies can be treated for infection with antibiotics. The reasons for refusing this treatment may be as simple as wanting to avoid unnecessary medications for your baby. There are also concerns about the blurriness caused by the ointment interfering with the immediate bonding time between mother and baby. A bigger concern may be the use of other types of eye ointments, for the same purposes, which have not been proven as safe.

https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/

Bathing

Cleaning newborns shortly after birth is another common practice. The benefit, I suppose, is that the baby is “clean.” The drawbacks are that it isn’t necessary, takes the baby away from the mother at an optimal time for bonding, and it removes a protective substance called vernix from the baby’s skin. Although it may look gross, that white cheesy substance may benefit the baby by protecting against harmful bacteria, helping regulate body temperature, and keeping the skin moisturized. (For me, it wasn’t something I even noticed because I was so enthralled with my new baby.)

Hep-B Immunization

A vaccination for Hepatitis B is usually given to babies at birth, or shortly after. This prevents babies from becoming sick from Hep-B, which can be contracted from mothers who have the virus. If a mother has Hep-B, or if she doesn’t know if she does, then this vaccination is beneficial to protect the baby. However, if a mother does not have Hep-B, and knows that for sure, then this vaccine is completely unnecessary. Like any vaccine, there are certain risks to receiving it; however, like most vaccines, this one is statistically safe.

Circumcision

As far as I know, circumcision is not a standard procedure anymore, meaning hospitals don’t just do it automatically. However, if you have a baby boy, you will need to decide whether you wish to have him circumcised. Currently, there is no medical or health reason supporting the practice. It is more of a personal choice, or for some a matter of religion. While it is a minor surgical procedure, it is a surgery, and it shouldn’t be taken lightly. Babies absolutely do feel pain and if circumcision is performed, an anesthetic is mandatory.

https://evidencebasedbirth.com/evidence-and-ethics-on-circumcision/

Vitamin K 

Babies are given vitamin K injections at birth to prevent a condition called Vitamin K Deficiency Bleeding. This condition is rare, but can happen without warning and have severe outcomes, such as brain damage or even death. Essentially, young babies can become deficient in vitamin K, for various reasons including the fact that breastmilk is low in it, and the body doesn’t store it easily or manufacture it. Since vitamin K is responsible for blood clotting, being deficient in it can result in uncontrolled bleeding, particularly internally. The vitamin K shot given at birth offers almost complete protection from this disorder, and there has been no evidence of harmful side effects from the injection. The only drawback is that the injection may be painful for the baby. Oral Vitamin K is an alternative option, which can be nearly as effective depending on the schedule used to administer it.

https://evidencebasedbirth.com/evidence-for-the-vitamin-k-shot-in-newborns/

Feeding

One parenting decision that must be made early on is how to feed the baby. Breastfeeding is an amazingly beneficial option. If the mother is able and willing, she should allow her new baby to start nursing as soon as either she or the baby desires after birth. Often, mom and baby might need a little guidance from an experienced care provider, such as a nurse, midwife, or lactation consultant. If choosing to breastfeed, make sure you avoid artificial nipples such as bottles or pacifiers, and have any care providers do the same. These things can disrupt the nursing learning process. Even if you wish to formula feed long-term, you might consider breastfeeding in the early days, weeks, or months. If this is not an option for you, you and your partner can still feed your new baby with love and care, through a bottle. Use this time to bond with your precious little one!

Skin-to-Skin Contact

Whether bottle-feeding or nursing, skin-to-skin contact immediately following birth is a very special experience. I would encourage all parents to postpone any newborn procedures, including weighing, cleaning, examination, and so on, until after an hour or so of skin-to-skin time with the baby. Mom can be cared for and cleaned up with her baby on her chest, as long as both are in good condition.

Rooming In

Rooming in is another option parents can choose, to support optimal bonding with their newborn. Although many hospitals have nurseries and can take the baby away for some time to allow parents to rest, it is also becoming more common for hospitals to offer or even insist on babies rooming-in with their parents. Not only does staying together encourage breastfeeding, it protects the special time of bonding. To combat exhaustion, parents should take advantage of the fact that newborns spend most of their time sleeping, and use that time to catch up on sleep themselves! Sharing responsibility for the baby’s care between the parents, and perhaps other visiting family and friends, can also help make this time easier.