Breastfeeding Benefits

This is a good checklist of all the benefits that breastfeeding provides and the
risk of using any kind of subtitutes. Thanks to the California Dept of Health for
creating the poster. Gloria

Your Newborn Baby—What’s Normal?

    Parents’ Guide to the Newborn

Keep your caregiver informed of any concerns about your baby.
Phone number of dr., public health nurse, midwife, or other provider Name_______________________Phone_____________________

Your baby’s breathing

Noises such as snuffles, grunts, wheezes, etc are not a concern by themselves. Babies can be noisy breathers. They have small amounts of mucous in their airways from the birth process and they are adjusting to air breathing. It is normal for the breathing to be irregular—sometimes rapid and then followed by slow, deep breathing. When your baby cries vigorously, he/she will become redder in the face and take deep, gasping breaths. This is normal.

Concerns about breathing to notify your caregiver about are:

1. Chest retractions–if your baby draws the chest wall in noticeably when breathing and you can see the outline of the breast bone with every breath.

2. Prolonged rapid breathing–the rate of breathing in a healthy calm newborn should be about 30 to 40 breaths per minute. If the baby is doing a panting breathing when calm (60 or more breaths per minute) for more than 15 minutes, have your caregiver check.

3. If your baby seems to have worrisome breathing and blueness around the mouth, call your caregiver.

FEEDING Within 8 hours of birth, the baby should be waking to feed every two hours and latching on to the breast well. Demanding to be fed is a very good sign of health in a newborn. Your baby needs only what is in the breast, do not feed water. If baby seems lethargic and doesn’t wake to feed for 4 hours, call your caregiver immediately. This behavior might mean the baby has a serious infection.

COLOUR A small amount of blueness and coolness in the extremities (hands and feet) is normal. Some mottling of the chest and tummy is normal. Many parents are alarmed by the baby’s whole body going dark red like a strawberry, this is a normal result of changing blood circulation in the newborn. Generalized blue or gray colouring (rare) would be alarming.

4 Days old and the milk is in. Continuous skin to skin in bed with mother.

4 Days old and the milk is in. Continuous skin to skin in bed with mother.

TEMPERATURE Only take your baby’s temperature under the armpit. Digital thermometers can be purchased for about $12 at the pharmacy. If the temperature falls below 36.1 degrees Celsius (97 F) or goes above 37.2 degrees Celsius (99F), look to see if you have bundled the baby too warmly or if the baby needs more covering. Adjust the baby’s garments and recheck the temperature in 15 minutes. Call your caretaker if abnormal temperatures persist. The usual rule of thumb for baby covering is to look at what the adults are wearing and then add one more layer for the baby. The baby being skin to skin with the mother is a good way to help the baby have a normal temperature and breathing rate.

URINE The baby may only have one wet diaper per day for the first two days. Once the breast milk is in, the baby should have at least 6 very soaked diapers in 24 hours. Urine should be colourless. Some babies have crystals in their urine (orange staining that looks like face makeup) and this is not a concern in the first 3 days. After the third day, that orange staining can be a sign that the baby is dehydrated. Increase the time at the breast and advise your caregiver. Little girls may have a spot of blood in their diaper which is their first menstrual blood, this is normal. By the fourth day, the baby should have at least 6 very wet diapers per day (the diaper will feel heavy in your hand).

BOWEL MOVEMENTS In the first 24 hours of life, the baby will pass meconium (blackish, tarry stools). Next, the stools will be brownish, greenish and quite soft. Once the milk is fully in (around day 3 of life) the baby’s stools are the colour and consistency of yellow mustard. The baby should have two poops the size of a loonie (silver dollar) as a minimum every day. A well fed baby usually has much more than the minimum.

UMBILICAL CORD Fold diapers down away from the drying umbilical stump. The cord will be dry and blackened within 24 hours and the clamp can be removed. The stump usually rots off by 5 to 10 days after the birth. Don’t put peroxide or alcohol on the cord. It heals best if left alone. Because it is rotting flesh, there is usually a foul odor when it is ready to fall off and it can be quite goo-ey looking. If there is redness on the abdominal skin surrounding the belly button area, notify your caregiver.

EYES The policy in hospitals is to treat the baby’s eyes with an antibiotic cream called “Erythromicin”. If you do not want your baby to receive this antibiotic, let your caretaker know in advance and sign a waiver. Newborns can have plugged tear ducts which cause discharge to accumulate in their eyes. Bring any discharge concerns to the attention of your caregiver.

INTACT PENIS Keeping your son’s penis intact is now the recommended policy of physicians’ groups. There is no special cleaning that needs to be done. Simply bathe your baby in a warm bath and leave the foreskin alone. The foreskin is attached to the glans in babies (much like the fingernail is attached to the finger) and the separation process may take years to complete. Only the boy should retract his own foreskin, this should not be done by parents or medical professionals. For more info on caring for your intact son, there is a handy free brochure at this link http://www.nocirc.org/publish/pamphlet4.html

JAUNDICE Yellowing of the skin of the newborn in the first 24 hours of life is unusual and should be called to the attention of your caregiver.
After Day 2, some yellowing is normal. Usually the face and chest are the most yellow places on the body. The baby may be sleepier than normal with jaundice and you may have to wake the baby to feed every two hours. It’s important that the baby remains well hydrated in order to get rid of the yellow cells from the body. Let your caregiver know if you are having trouble waking/feeding the baby or if the yellowness extends out to the hands and feet.

Slightly jaundiced newborn

Slightly jaundiced newborn

Gloria Lemay, Vancouver, BC
March 2016

Vaccines and babies in NICU

Journal of the American Medical Association

JAMA Original Investigation | June 01, 2015
Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants FREE ONLINE FIRST
Stephen D. DeMeo, DO1; Sudha R. Raman, PhD2; Christoph P. Hornik, MD, MPH1,2; Catherine C. Wilson, DNP, NNP-BC, FNP-BC3; Reese Clark, MD4; P. Brian Smith, MD, MPH, MHS1,2
[+] Author Affiliations
JAMA Pediatr. Published online June 01, 2015. doi:10.1001/jamapediatrics.2015.0418

Importance Immunization of extremely low-birth-weight (ELBW) infants in the neonatal intensive care unit (NICU) is associated with adverse events, including fever and apnea or bradycardia, in the immediate postimmunization period. These adverse events present a diagnostic dilemma for physicians, leading to the potential for immunization delay and sepsis evaluations.

Objective To compare the incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death among immunized ELBW infants in the 3 days before and after immunization.

Design, Setting, and Participants In this multicenter retrospective cohort study, we studied 13 926 ELBW infants born at 28 weeks’ gestation or less who were discharged from January 1, 2007, through December 31, 2012, from 348 NICUs managed by the Pediatrix Medical Group.

Exposures At least one immunization between the ages of 53 and 110 days.

Main Outcomes and Measures Incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death.

Results Most of the 13 926 infants (91.2%) received 3 or more immunizations. The incidence of sepsis evaluations increased from 5.4 per 1000 patient-days in the preimmunization period to 19.3 per 1000 patient-days in the postimmunization period (adjusted rate ratio [ARR], 3.7; 95% CI, 3.2-4.4). The need for increased respiratory support increased from 6.6 per 1000 patient-days in the preimmunization period to 14.0 per 1000 patient-days in the postimmunization period (ARR, 2.1; 95% CI, 1.9-2.5), and intubation increased from 2.0 per 1000 patient-days to 3.6 per 1000 patient-days (ARR, 1.7; 95% CI, 1.3-2.2). The postimmunization incidence of adverse events was similar across immunization types, including combination vaccines when compared with single-dose vaccines. Infants who were born at 23 to 24 weeks’ gestation had a higher risk of sepsis evaluation and intubation after immunization. A prior history of sepsis was associated with higher risk of sepsis evaluation after immunization.


Conclusions and Relevance
All ELBW infants in the NICU had an increased incidence of sepsis evaluations and increased respiratory support and intubation after routine immunization. Our findings provide no evidence to suggest that physicians should not use combination vaccines in ELBW infants. Further studies are needed to determine whether timing or spacing of immunization administrations confers risk for
the developing adverse events and whether a prior history of sepsis confers risk for an altered immune response in ELBW infants. http://archpedi.jamanetwork.com/article.aspx?articleid=2300376&utm_source=silverchair+information+systems&utm_medium=email&utm_
campaign=jamapediatrics%3aonlinefirst06%2f01%2f2015

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Source: this blogpost http://www.jeffereyjaxen.com/
blog/new-jama-study-confirms-nurse-whistleblowing-routine-hospital-vaccine-damage-happening-to-infants

Birth without borders

I’ve been on a bit of a rant lately about “Keep those damn hats off babies”, “Take off those wet sports bras”, “Get everyone skin-to-skin, dark, private” and I get told that “We have to choose our battles”, “It’s important to meet people where they are and not overwhelm them with picky details”, and other variations of advice to STOP IT!

These things are HUUUUUGE to me. I only want to speak into the ears of those who want perfect births. I had a perfect birth. What is a perfect birth? It’s a birth that you look back on when your child is 30 years old and you wouldn’t change a single thing about it. . . every smell, touch, taste, word spoken and beam of light goes to the grave with you as a top of the mountain of life experience. It’s an experience that makes up for so much of the day to day b.s. that is part of living in a human body. It helps to salve the losses and the heartaches and gives you a glimpse of the bliss that’s possible when all the stars align on a really, really good day. That’s what I want for every birthing woman. When I saw this little video clip (I think it’s from Russia), it made my heart sing as I prayed that no one would enter the frame and interfere with this woman’s bliss (no one does). Unfortunately the sound is missing but I love it that someone turns off the lights so baby could transition to this bright world in a slow way. I also love it that the toddler comes in with questioning eyes to see what the heck is happening in his world and looks to the Dad with questioning eyes and is reassured that “Yes, this is different but it’s all good, sweetie.” I just made that up but I love my own version of things. Enjoy.