You had a baby, now what?!!

Since you found out you were pregnant, you have been going to all your prenatal visits and all the classes. You and your OB have discussed the action plan and what to expect once its time to have the baby. You have read up on “What to Expect, When you are expecting” books and blogs.

Do you know what happens to your newborn however once he or she arrives?

It’s important to know what will happen to your child, and to understand why certain treatments are provided.

  1. Delivery room assessment: The obstetrician hands over the baby to the neonatal team, which usually consists of a registered nurse and respiratory technician. A pediatrician maybe called if any complications are anticipated. How soon the obstetrician hands over the newborn to the neonatal team depends on how well the baby is doing. The job of the team is to assess the newborn. This is done by assigning an Apgar score. This score helps describe how the baby was doing at 1 minute, 5 minutes and 10 minutes after delivery. This score however does not predict how well the baby will do in the long run.
  2. Vitamin K: After delivery your baby will have a few treatments. First is a Vitamin K injection. Infants are born with  premature livers, which is where vitamin K is utilized for blood clotting. By giving Vitamin K in the immediate newborn period, we are preventing a disease known as “ Hemorrhagic disease of the Newborn”. This is a disease in which a baby can start bleeding spontaneously due to vitamin K deficiency.
  3. Eye antibiotic ointment: This is pretty straight forward, babies born via vaginal delivery or who had a mom go into active labor, there is an increased risk of bacteria in the vaginal area entering  the birth canal. Some types of bacteria can cause eye infections and lead to blindness. By applying this antibiotic ointment, we can prevent this horrible complication.
  4. Blood work: You may notice that your child is returned to you with small slits on the heel. This is because every child born in the united States is tested for multiple inherited disorders. They are tested for illnesses that wouldn’t necessarily be picked up by a normal exam a doctor would do. We are talking about things like sickle cell disease and cystic fibrosis. In Florida, babies are tested for 150 different disorders. This is called the State Infant Screen. The state lab is usually pretty good about notifying all parties involved if there are any abnormalities detected.
  5. Jaundice: Almost all babies are born with some degree of jaundice. Jaundice is the yellowing of the skin. For the most part, the majority of infants have “ physiologic” jaundice – which is normal for newborns. A few babies develop higher degrees of jaundice that may require treatment. This usually occurs if the baby has risk factors, such as blood type incompatibility, prematurity or the baby is otherwise sick with an infection amongst others. Testing for jaundice utilizes a device that utilizes light to measure jaundice of the skin or a blood test.
  6. Weight checks: Most newborns can lose up to 10% of their body weight the first week of life. While in the hospital your baby will be weighed daily to monitor their weight.
  7. Ins and Outs: By the time the baby arrives majority of new moms have made a decision as to what they will feed the baby, i.e: breast milk or formula. There is a steep learning curve when it comes to breastfeeding. You can ask for help from a lactation consultant while in the hospital. What goes in must come out. While in the hospital you will be asked to keep a log of all your babies dirty diapers. If a baby does not pass urine in the first 24 hours, or have a bowel movement in the first 48 hours, this could indicate a problem.

Most of these treatments and assessments will occur while your baby is in the nursery. Remember its important to stay informed, and if you are not comfortable with any treatment or assessment, don’t be afraid to voice your concerns.

Were you aware of all these interventions? What has your experience been?

5 TIPS TO SOOTHING A FUSSY BABY..

Babies cry. Its their thing. Sometimes as a parent, you can figure out why, other times, not so much. Lets say your baby is crying; she just fed, her diaper is clean, yet she is still upset. What do you do now?

Father and Baby Girl Crying Caucasian2

Here are five tips that may help. If your baby is still inconsolable, you may want to call your doctor to make sure she’s ok.

  1. Swaddling: This is especially effective for newborns under 1 month of age. They love to be snug, the thought is that swaddling mimics the confined intrauterine environment that they have been hanging out in for 40 weeks, give or take. However, once your child gets a little bit older, they tend to like their space more.
  2. Sucking: Babies love sucking – not in the “you suck” kind of way, but more of the “ here suck on this” type of thing. Sucking on a pacifier, or mom’s breast is very soothing for infants. Many new parents think that the baby is hungry when anything goes near their mouth and they elicit the sucking reflex. But that’s exactly what it is, a reflex. Babies have a very strong suck reflex. It is basic survival mechanism. Try it at home, touch the cheek of your baby  close to the corner of her mouth, and watch what happens. Most of the time, she will turn towards that side and pucker her lips ready to suck on something. If you’re child had a good meal, and she is still fussy, try to offer her a pacifier, see if it helps.
  3. Shushing( yes, I know its not a real word, but stay with me!): White noise! This is what newborns have been listening to during the entire pregnancy, its like their gestational soundtrack. You can recreate this by saying Shhhh loudly in baby’s ear – but please spare her the spit shower. Turning on a fan or vacuum cleaner would do the same. But lets not forget that in this day and age, there is an App. for that!
  4. Swinging: By gently rocking your baby, you are sure to help soothe her as well. You can be very gentle with this, you don’t need to go off the wall. Just gentle head bopping works well, like a rapper.
  5. Singing: Infants love the voices of their parents. So go ahead and sing your guts out, there are no judges here.

These recommendations are based on Dr. Karp’s Happiest Baby on the Block, and in my opinion, he provides good advice. Having said that, if your child is not responding to any of these soothing techniques, or you have a gut feeling that her cry is excessive and out of the norm, definitely talk to your pediatrician and get her checked out.

Have you had any luck with these techniques? What do you do to soothe your fussy baby?

Inadequate milk supply? Try fenugreek

One of the frequent problems I encounter in everyday practice is that new moms don’t always produce enough breast milk. This is usually problematic, especially in the first few days when breastfeeding needs to be established. The mother is exhausted and in pain, and baby won’t stop crying because she is hungry. Sounds like a recipe for disaster, doesn’t it!

Fortunately, there is a solution that has been around for centuries. It is a little natural herb that can be safely taken by breastfeeding mothers. Fenugreek is a known supplement in many parts of the world, and there is clinical evidence and science to back it up.(link : http://online.liebertpub.com/doi/abs/10.1089/acm.2010.0090 )

Fenugreek is what is known as a galactogague herb. That means it helps increase breast milk production. It mimics the estrogen precursor. In the United States, it is available as capsules or tea. You can also find the natural seed in some ethnic food stores.

Where I grew up, it is served to new moms as a pudding. I ate a ton of it during the first few days after I had my daughter. I recommend it to all the new moms in my practice, and they rave about it.

If you want to try it, scroll down for the recipe of Fenugreek Pudding (Madidat Hilba – مديده حلبه). This is by far the tastiest way to enjoy it in my opinion!

Be warned however, fenugreek has a musty / maple syrup odor to it, and it is excreted in sweat. Once you achieve adequate levels, you will smell a little musty! But have no fear, that goes away in a few days.

Fenugreek is known to lower blood sugar. Please make sure to talk to your doctor before you try any new supplements or medications.

Have you tried fenugreek? What is your experience with it?

Fenugreek Pudding Recipe:

Ingredients:

2 cans evaporated milk .

4 tbsp sugar (you can vary this according to taste) – I have a sweet tooth!

1/4 cup Fenugreek seeds.

1 Tbsp corn starch

1 Tbsp flour

1/4 cup cold milk

In a medium sauce pan, pour the 2 cans of evaporated milk , fenugreek and sugar and bring to a boil. While that is going, in a bowl dissolve the the flour and cornstarch in cold milk. Once the ingredients in the saucepan are starting to simmer, turn down the heat to medium low, then add the cold milk/flour/starch mix to the pan and keep mixing constantly with a whisk. You want to mix it frequently so it doesn’t clump. It should develop the thick pudding consistency. You may need to add more milk/starch/flour to the mix if you are not getting it to be thick enough. This should take about 10-20 minutes. Once you are happy with the consistency, pour your yummy pudding in bowls and let it cool.

Enjoy!

Moving In!

I am very excited to share with everyone the great news, we have finally moved in to our brand new office.  Please feel free to stop by and say hi. We can register your child and get him or her established with us. So far the insurances that we are currently accepting are :

– straight Medicaid

-Cigna

-Aetna

and some Tricare.

Please be patient with us as we sort out all the red tape we have to go through to become providers with your insurance providers. Whats your insurance company? Let us know so we can become providers!