Updated: Apr 3
Before we get started... did you create your birth plan yet?? Read more about birth plans in this blog.
Did you know: the birthing person isn't the only one who needs a birth plan! When you give birth, there's more than one person involved: the birther and the baby/babies. This is especially true for hospital births where they treat parents and babies as two separate patients (two separate bills too, but that's a topic for a different blog post), but even in birth center or home births, there are still decisions to be made for the baby's plan of care.
Medical Newborn Interventions to Consider:
1. UMBILICAL CORD: Will you delay cord clamping, or clamp immediately? Will you bank cord blood, or not?
Delayed cord clamping: there is general consensus that babies benefit from allowing blood to flow through the umbilical cord post birth. ACOG promotes waiting 30-60 seconds to clamp the cord and the WHO promotes waiting 1-3 minutes. Other groups encourage longer delay, and suggest waiting until the cord has turned from purple to white.
Cord blood banking is the process of collecting stem cells from the umbilical cord and storing them for future use. Learn more from ACOG: here.
2. HEPATITIS B: Will you give your baby the Hepatitis B vaccine at the hospital? Delay, and give at the pediatrician's office during baby's first visit? Forgo it completely?
The CDC recommends vaccination. Read more about their considerations here.
The Hepatitis B vaccine is required for school in all 50 states - though there are vaccine exemptions.
3. VITAMIN K SHOT: Vitamin K is given to babies as a preventative measure, to avoid rare but life-threatening bleeding. Vitamin K doesn't cross the placenta well during pregnancy, so babies are born deficient.
Will you give your baby the standard Vitamin K shot, will you seek out an alternative like oral drops, or will you decline completely? Check out this article from Evidence Based Birth to weigh your options (for the TL;DR version, scroll to the summary at the bottom).
Note: the Vitamin K shot has recently been swept up in the anti-vaxx movement, but it is not a vaccine.
4. EYE PROPHYLAXIS / EYE OINTMENT: This antibiotic is applied topically to baby's eyes as a preventative measure, to avoid potential infection if gonorrhea and/or chlamydia are present in the birther's vagina. If infected, babies risk blindness.
Will you agree to the standard antibiotic ointment (Erythromycin) on your child's eyes, or opt out?
Pros and cons from Evidence Based Birth: Evidence on Erythromycin
Most states have laws requiring Erythromycin (Minnesota has a law, but allows for parents to decline). The American Academy of Pediatrics recently called for reevaluating state laws, and suggested preventative screening and testing for gonorrhea and chlamydia instead.
5. MALE CIRCUMCISION: Will your child be circumcised, or remain intact? If circumcised, will it happen at the hospital, or at the pediatrician's office within baby's first two weeks? (Cost is a consideration - it is often cheaper at the ped's office). Learn more about the evidence and ethics of circumcision here.
6. INFANT FEEDING:
How will you feed your baby? At the breast/chest, pumped human milk, donor milk, formula...?
If your baby needs supplementation, will you use formula or donor milk? Are you going to harvest colostrum in late pregnancy, to use as a supplement if needed?
Non-Medical Newborn Interventions to Consider:
7. BULB SUCTIONING: Babies are routinely suctioned post birth to clear amniotic fluid out of their respiratory system. Recent studies show this standard practice isn't necessary.
8. HAT AND BLANKET: We've all seen the classic newborn hospital hat used to keep babies warm post-birth. While this may seem harmless, hats can actually affect bonding and breast/chestfeeding. New parents need to be able to smell their baby's heads as they're snuggling, to trigger the hormones needed to produce milk. Consider opting for skin-to-skin instead.
9. BATH: During a hospital birth, babies are routinely bathed after birth. However, studies show that delaying the first bath by a minimum of 12 hours (or more!) increases breast/chestfeeding success, and baby's temperature stays more stable.
10. PACIFIER: A pacifier can be a great tool for soothing a baby, but if your goal is to breast/chestfeed, then the breast/chest should always be offered before the pacifier. Check out this breastfeeding-friendly pacifier option.
11. SWEETUMS / SWEET-EASE: This is a sugar solution intended to help keep babies calm. In hospitals, it is often placed on a pacifier for baby to suck on during medical procedures (example: during 24-hour screenings). There is conflicting evidence on the efficacy of sugar water in reducing infant pain.
A lot to consider...
Parenting starts before birth, and this can be stressful! But have confidence in following your intuition for YOUR baby. We can all look at the same data and make different decisions ❤️