new parents Questions with a pediatrician for our new parents.
When will I see the pediatrician? We know you’ll be anxious for your little one to get checked out after delivery. A pediatrician will perform a history and physical exam on your baby within 24 hours of life. Most pediatricians make rounds in the morning, though some do it later in the day. The pediatrician will see your baby and talk to you every day until you and your baby go home. We do not attend deliveries, but the neonatologist in-house is available for any urgent care or concerns. Who will circumcise my baby and what are the benefits? Either your OB or your pediatrician will circumcise your baby. Not all doctors do circumcisions, so if your OB or your pediatrician does not, one of the other pediatricians will. The American Academy of Pediatrics released a policy statement in August 2012 that the health benefits of circumcisions outweigh the risks, and therefore, there is a medical reason for the procedure, but ultimately the parents should decide. Benefits include better hygiene, lower incidents of urinary tract infections in boys under age two, much lower incidence of penile cancer in adult males and lower incidence of cervical cancer in women whose sexual partners have been circumcised. In addition, circumcision lowers the transmission of sexually transmitted diseases. In the United States, 70-80% of baby boys are circumcised.
Rowena Baumgartner, M.D. 6160 South Yale Avenue
John Lukeman, D.O.
10506 South Memorial Drive
When do I bring my baby back to the pediatrician after leaving the hospital? We generally like to see your baby in the office one to three days after discharge from the hospital. We will be examining your baby, checking your baby’s weight, feedings, jaundice and address any concerns and questions you may have. All babies lose weight the first few days until the mother’s breast milk comes in. Babies can lose up to 10% of their birth weight. Breast fed babies should get back to their birth weight by 10 to 14 days. Bottle fed babies take seven to 10 days, since they don’t have to wait for the mother’s breast milk to come in. What supplements will my baby need? The mother’s breast milk has everything the baby needs. However, the American Academy of Pediatrics recommends all breast fed babies receive 400IU of vitamin D daily to ensure good vitamin D levels. There are several different brands and your pediatrician will discuss this with you at the office visit. Formula fed babies do not need additional supplements. The formula has everything the baby needs. Do not give your baby any extra water, since this may throw off his/her electrolyte balance. If your baby needs supplements, your pediatrician will discuss this with you.
new parents
Questions with a pediatrician for our new parents.
What immunizations will my baby receive? Your baby will receive the first Hepatitis B immunization within the first 24 hours as recommended by the American Academy of Pediatrics. The reason is 90% of babies with Hepatitis B infection will become chronically infected versus only 10% of adults who get Hepatitis B infection. The next vaccines are given at two months old. Your pediatrician will review the recommended vaccine schedule from the CDC. Why is the vitamin K shot given at birth? Vitamin K is given to prevent a serious bleeding problem called hemorrhagic disease of infants, which can occur hours to several months after birth. This can cause brain bleeds and internal bleeding. In 2015, four babies in the Nashville area had brain bleeds and stomach bleeds. The parents had refused the Vitamin K shot after being led to believe it can cause leukemia. Vitamin K does not cause leukemia. Do immunizations cause autism? Immunizations do not cause autism. There are numerous scientific studies showing no association between vaccines and autism. The controversy started with Dr. Andrew Wakefield in England who published a study in 1998 in the British medical journal, The Lancet. However, after extensive review, in 2010 The Lancet retracted the paper due to misinformation and lies about the data Wakefield presented. The British medical panel concluded that ”Dr. Wakefield has been dishonest, violated basic research ethics rules and showed a ‘callous disregard’ for the suffering of children involved in his research.” Dr. Wakefield lost his medical license in England and was later sanctioned. He then went on to give anti-vaccine lectures and speeches in the United States.
What screening tests will my baby have in the hospital? Your baby will receive a hearing test called the ABR (Auditory Brainstem Response) within the first 24 hours. The nursing staff will put “headphones” on the baby and check for brain wave response to sounds through electrodes pasted to the baby’s scalp. The baby will also have a congenital heart disease screen by checking his oxygen levels using a pulse oximetry on the fingers and toes. There will also be a small blood sample taken from the heel at about 24 hours of age. This will check for bilirubin, which can cause jaundice and the newborn metabolic screen, which tests for over 25 different conditions. What is jaundice and bilirubin? Bilirubin is the product of red blood cell breakdown. Elevated levels of bilirubin cause jaundice, or yellowing of the eyes and skin. Risk factors for high bilirubin include blood incompatibility between the mother’s and the baby’s blood, heavy bruising, prematurity less than 35 weeks gestation, sibling who had high bilirubin, family history of a genetic condition called G-6-PD deficiency, jaundice noticed before 24 hours old, not getting enough breast milk or formula and excess weight loss. Extremely high bilirubin levels can cause a condition called kernicterus, which can lead to brain damage. Frequent feeds help babies to naturally excrete bilirubin through pooping and peeing. Jaundice can be treated with phototherapy, and in severe cases, a blood exchange transfusion. Your pediatrician will monitor risk levels to assure there are no complications from elevated bilirubin.
new parents
Questions with a pediatrician for our new parents.
Should I have my baby’s cord blood saved at a cord blood bank?
What is delayed umbilical cord clamping and why is this done?
There are private and public cord blood banks. The likelihood of a child needing his/her own stored cord blood stem cells is about one in 1,000 to one in 200,000. Public banks do not charge the donor for collection. Private banks are for profit and may charge several thousand dollars for collection and several hundred dollars in annual storage fees. Public banks adhere to stringent federal standards, but private banks are not required to adhere to the same standards. The American Academy of Pediatrics discourages private cord banking. However, private banking may be considered if there is an older child with a genetic immune deficiency who may need cord blood stem cells.
Delayed umbilical cord clamping is done about 3 minutes after birth. This allows more cord blood to enter the baby. A study of 540 babies in Nepal found it reduced the likelihood of developing anemia by 11% and lowered the odds of having iron deficiency at 8 months by 42%. This was published in the medical journal, JAMA Pediatrics 2017. Doctors generally do delayed cord clamping at Saint Francis.
Who in the household should be immunized? All household members should be vaccinated against influenza (the flu) every year and with Tdap/DTaP which includes pertussis (whooping cough) every 10 years. Pregnant women should receive the Tdap at each pregnancy between 27 and 36 weeks. Live vaccines (MMR, Varivax/ Chickenpox, nasal flu, HPV) should not be given during pregnancy.
Articles: Characteristics of Newborn Babies; Barton D. Schmitt, M.D., FAAP Rashes and Birthmarks on Newborn Babies; Barton D. Schmitt, M.D., FAAP Resources: American Academy of Pediatrics website for parents: healthychildren.org Your Baby’s First Year by The American Academy of Pediatrics: healthychildren.org Oklahoma Breastfeeding Resource Center: obrc.ouhsc.edu Oklahoma Breastfeeding Hotline: 1-877-271-6455 (MILK) or text OK2BF to 61222 Saint Francis Hospital Lactation Consultations: (918) 494-6455 (MILK) saintfrancis.com
How should babies be put to sleep? Remember the ABCs! Babies should always be placed ALONE, on their BACK in a CRIB, bassinet or play yard to sleep. Since the American Academy of Pediatrics (AAP) starting making the recommendation for babies to sleep on their backs studies found it reduced the incidents of sudden infant death syndrome (SIDS) by 50 percent. You should also make sure there is nothing in the baby’s crib besides a tightly fitted sheet on a firm crib mattress and a pacifier. Other items like swings, car seats, rockers and loungers are not safe for even supervised sleep. If your baby falls asleep in any of these, move them as soon as possible.