Pre-birth conversation with Pediatrician?

[murphysaangel]

I am going to have to "interview" a pediatrician for when we deliver. The one I use currently (and LOVE) does not have an association with the hospital I'm delivering at. Last time I didn't have a choice as to who my ped was, my son was in the NICU after a hb transfer and subsequent c-section and I was so out of it and unprepared that I didn't get to make too many choices. I was pretty lucky we managed to escape with my son's penis intact!

I did get a recommendation from my current ped from the list of them at this new hospital. So hopefully they are somewhat natural-minded as mine is. And they're actually on my insurance list!

I'm planning on asking them if they'll use the oral form of Vitamin K instead of the injection. I don't have much hope that it'll work but I'm going to try anyway. I live in NY State so refusing that or the eye goop is impossible. I'd also like to hear what they say about the eye goop since my DS had a horrible allergic reaction to it when he was born. Maybe they could at least to a "test spot" before applying it fully?

What else should I be asking? And should I tell them of my plans to avoid circ and vax's now, or just let that go and tell them (and all nurses) after the delivery? (BTW the hospital is VERY baby-friendly so I won't have to fight too hard about them letting baby stay with me at all times, refusing a bath, or delaying cord cutting, which I am assuming the ped really doesn't have much to do with anyway. It's one reason I'm going there instead of the one that my current ped is affiliated with.)

[elanorh]

Could your actual Pediatrician write a note about the eye goop and your eldest, and the allergic reaction, asking that it not be used? Couldn't you have your OB also provide test results to show you have not tested positive for whatever the disease is that they preventatively require the eye goop?

I would tell them that you prefer that your own pediatrician give all vaccinations etc. -- ALL of them -- not the hospital. Maybe that would get you out of any vax attempts at the hospital itself (probably not the eye goop and Vit. K but everything else).

Hopefully someone from NY will post with more experience from NY itself.

Good luck!

[AlexisT]

No dice on oral vit. K. The law specifies a "parenteral" dose--i.e. injection:

"12.3 Precautions to be observed for the prevention of hemorrhagic diseases and coagulation disorders of the newborn and infants related to vitamin K deficiency. It shall be the duty of the attending physician, licensed midwife, registered professional nurse or other licensed medical professional attending the newborn to assure administration of a single parenteral dose of 0.5-1.0 mg. of natural vitamin K(1) oxide (phytonadione) within one hour of birth."

There are no exceptions for the eye ointment and no provisions for medical exemption. Find out what your DS had, because they don't specify which drug has to be used, just that it be effective at preventing disease:

"12.2 Precautions to be observed for the prevention of purulent conjunctivitis of the newborn. It shall be the duty of the attending physician, licensed midwife, licensed nurse or other authorized provider in attendance at a delivery to place into the eyes of the infant, on delivery, an agent effective for preventing purulent conjunctivitis of the newborn, such as tetracycline or erythromycin eye preparation or a one percent solution of nitrate of silver."

[murphysaangel]

Well that sucks. I knew I wouldn't be able to get out of it completely, but I was hoping at least they'd concede to oral vit. k. It's so horrible that you do not get a choice here in NYS. I'd chance the possible CPS visit if I knew I'd be one of the lucky ones who gets overlooked for something more important - but with my luck they'd have a slow day and come for my kid.

It says "single parenteral dose of 0.5-1.0 mg. of natural vitamin K(1)" - does that mean I could at least request the minimal dose of 0.5?

[jecombs]

I can't believe the laws in your state! Talk about the nanny-state! Okay, just had to get that out of my system.

My ped also was not associated with my hospital, so she didn't see my DD until a few days after we came home. The hospital ped was not a big deal. She just came in, listened to DD's heart and lungs, checked her jaundice levels, palpated her abdomen to feel her organs, felt her soft spot, and flexed her hips. Not invasive, not a big deal. The nurses were the ones who were responsible for administering the Hep B vax, eye ointment, and Vit. K. We did get the Vit. K and eye stuff (kinda wish I hadn't now), but we declined the Hep. B. It wasn't a big deal. The nurse came in, ready to give the Hep B and I told her we were waiting to let our ped do it. She got me a waiver and that was it!

Since your oldest did have a reaction to the eye goop, you might want to ask your ped for a note or something. The eye stuff is supposed to be administered within an hour after birth and the nurse usually does it... so you probably need to have something worked-out with the hospital ahead of time about what will or will not be applied to LO's eyes. That would probably be a good thing to discuss with Head of the Pediatrics Dept. at the hospital.