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Newborn: What to expect in the hospital

 Newborn: What to expect in the hospital

CONGRATULATIONS on the birth of your new baby!


First a few things to expect while you are in the hospital. 


WELCOME to one of the hardest and most rewarding jobs out there. You will never want to go back to the way it used to be before the baby.  For the first month of your baby’s life, you are going to be exhausted, more tired than you have ever been in your life, rest whenever you can, sleep when the baby sleeps, let the house go, and get some help from family or friends if you can.    


BREASTFEEDING; If you are breastfeeding, feed on demand, BUT it should be every 2-3 hours at the beginning in order to stimulate milk production, I have had a few babies who are sleepy/lazy and will feed every 4 hours, it is not enough calories and they will not gain weight.  WAKE THEM UP AT 3 HOURS (stimulate them, flick their feet, quick sponge bath, whatever it takes, almost). Your milk should be in after 72 hours. You need rest, a good balanced diet, your prenatal vitamins and water! The one thing your body won’t let you do is let you get dehydrated, so if you don’t drink enough water you won’t make enough milk.  You don’t need to drink milk to make milk, but you do need calcium, which you can get from milk, yogurt or cheese. You can get Calcium and Vit D from cow’s milk, soymilk, almond milk, rice milk, coconut milk and hemp milk. Only Soymilk has as much protein as cow’s milk. Call us or the lactation consultant for any questions. 


BOTTLEFEEDING:  All formulas will give good nutrition. They have small differences that they used for marketing.   It doesn’t matter what bottle system you use. Start with one and if not working try another. Technique: It is very important that the baby be tilted up at about 30 degrees, that will keep air at the top of the stomach and make it easier to burp them.  When you go home with your baby they are not taking very much and if you overfeed they will vomit. My recommendation is to offer 2 oz of formula at every feed every 2-4 hours. When they take 2 oz at every feed for a few days offer 2.5 oz when they take 2.5 oz at every feed offer 3 oz, etc.  This way they are telling you when they are ready for more. If you can get them on a good schedule like eating every 4 hours great, but don’t expect it. All babies are different and what works for one baby won’t necessarily work for another. A one old a baby will usually take 4 oz +/_ 1 oz per feed.  


METABOLIC SCREENING TEST:  The lab will draw this but doing a heelstick and soaking up 4 circles on a special paper that will get sent to the state lab.  We will get results back in about 2 weeks and we will let you know the results. They test for about 20 different, what they call inborn errors of metabolism.  PKU disease, hypothyroidism and cystic fibrosis are just a few of the things they look for. 


HEARING TEST:  they will check hearing in the hospital, if it is not normal they will repeat, if it is still abnormal they will refer to get it reevaluated as an outpatient and inform us so we can follow.  


OXYGEN:  They will check the baby’s oxygen (O2SAT) after the first 24hours by that time it should be like ours as the baby has changed from fetal circulation to adult circulation and usually it is over 95.  If not a referral to pediatric cardiology will be made.   


HEPATITIS B VACCINE: it should be given in the first 24 hours.  It is a very safe vaccine. And unlike many vaccines, the younger you get the vaccine the better it works.  I had mine in my 30’s when it first came out and had to get it repeated.  


CIRCUMCISION: Circumcision is the removal of part or all of the foreskin covering the head of the penis in male newborns.  It is usually done with local anesthesia. It is tradition in some religions and countries. Boys who are circumcised get less urinary tract infections that boys who are not, but still the numbers are small.  There are a couple of different methods. One leaves more foreskin that the other. The one that leaves more foreskin supposedly preserves more sensitivity for later years, yet still makes it easy to clean. After the circumcision it usually takes a week for it to heal up completely, until then but A&D to cover the head of the penis so it won’t stick to the diapers.  You may see a yellowish coating on the glans (head) it is simply a wet scab and is not pus.  


FEMALE BABIES: Girl babies have 2 discharges. First there is a grey mucus discharge coming out of the vagina, that often has a pink staining in it that looks like blood and it is blood.  Her uterus has responded to the mother’s hormones and now is having a little withdrawal bleeding, in essence a first period. It is all perfectly normal. Next there is a white discharge between her labia, that is also caused by the hormones from the mother.  For both just use a sterile cotton (Dacron) ball and some warm water and clean her gently from front to back. Eventually it will wear off and she will stop making it.   


JAUNDICE:  Jaundice is a normal phenomenon.  It occurs from babies red blood cell with fetal hemoglobin breaking down and being metabolized into bilirubin.   The babies liver is slow to get rid of it, so it builds up. The hospital does a bilirubin at 30 hours of age along with the newborn metabolic screening.  Sometimes there is a blood type issue. Sometimes there is a hormone in breast milk that interferes with the baby getting rid of the bilirubin via the liver.  It rarely is a problem. If the baby looks very yellow we may do another bilirubin. Sometimes they need a bili-blanket, rarely they need to go back to the hospital.  If it happens, we will explain exactly what’s going on. Keeping the baby in a warm room, with no clothes on except the diaper, not in direct sunlight but right next to it will help get rid of the bilirubin. 

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