Out of Hospital Birthers... « Back to Group Discussions

[meesh933]

Are you taking baby for some of the routine newborn tests? (As in, to see a doctor, hearing test, etc.) My MW does a basic newborn exam and the heel prick, but her standard policy is to recommend the baby see an actual MD within a few days. We took DS the day after he was born, and I really loathed having to leave the house. Not to mention, our family doc tried to retract his foreskin at 18 hours old! (She doesn't see the kids anymore...) I also drove the kids 90 minutes to the closest in-network audiologist that could do an infant hearing screen. Miserable. Both trips seemed to be a complete waste of time. The MD didn'd do anything the MW hadn't done, and DS was responding to noise, so I wasn't actually worried about his hearing.

So my first thought is to just skip both of those unless there seems to be a problem. I was just wondering what everyone else was doing, and if maybe there was some compelling reason to go that I haven't thought about.

[birdhappy85]

I honestly don't know what kinds of routine exams are performed on a newborn by a pediatrician, as this is my first. But my midwife performs all of the standard early tests and hearing screen. My husband and I are interviewing a "pediatrician" (integrative family health practitioner) in a few days. Her practice is just a mile up the street from us and she does home visits within the first few days of birth! I'd be stressed about having to drag our baby out somewhere after just a few days too.

Interested in hearing other people's recommendations since I don't really know what a pediatrician typically does that early in the baby's life. Are vaccinations administered that early? I feel so in the dark here, yikes. lol

[IwannaBanRN]

I'm going to be taking the baby in at 2-3 days of age, depending on the day I have him. I'm really hoping I have him between the days of Sunday and Wednesday, so that there's adequate time to get an appt. He's not going to be having any routine vaccinations, but I will let them do the PKU test.(REALLY difficult to refuse the PKU test in this state as far as CPS goes) Of course, I could just have them do a urine sample for PKU testing. He won't be getting the hearing screening, either. I don't see the point. If he's deaf, he's deaf. If there's another cause for a lack of hearing, then it'll be found in other ways. My DD has a well checkup tomorrow and I'll be talking to her pedi about all that stuff and telling him I plan on using him for my son's care. He's done so well with my daughter's care. I also want to make sure he won't try to retract the foreskin.

[Jaimee]

Most peds want to see a newborn within 72 hours of birth, so no need to rush off the next day.  Most mw's will perform the basics that are necessary and the heel prick doesn't need to be done until baby has actually digested some milk a few days-week later.  So again, your mw could do that or your ped could do that, but it doesn't have to be done right away. 

The hearing screen really doesn't have to be done right away or even in the first few months, IMO.  With my first I went when she was 2 weeks old, I think and with my second I didn't go at all.  Be warned, though, you may start to get letters from the state that you need to go get the test.  They are real sticklers about it.  But then we moved!  Ha!  Joanie, I'm not so sure that your mw can perform the real hearing screen- it involves special equipment that I would doubt she has, but I could be wrong.  Typically you need to go to a specialist and this is something your ped would refer you to.

My plan is to play it by ear.  If I feel up to seeing the ped or I feel there is a good reason to go, I will.  Otherwise, I'll set up an appointment a bit later on just to initiate his/her file and build rapport with the ped for anything that could occur in the future.  In general, though, I avoid the doctor in the winter- talk about an office full of germs!

[birdhappy85]

My memory is so shotty these days, I could totally be wrong about the hearing screen. I'll have to ask my midwife next week to remind me what tests she performs. Might be another test I'm mixing it up with... Anywho, I think I want our baby to have the hearing test selfishly to calm my own nerves. I'm so paranoid about having gone to one concert and a really loud Omnimax movie during my pregnancy. I'm sure that's so silly to be worried about, but it weighs on my mind! I never should've read up online about loud sounds during pregnancy. Just fueled my fire. lol

But if our baby is anything like me, she'll have impeccable hearing. DH joked that she could stand to lose a little of her hearing ability. Last time I was tested, the audiologist said I could hear tones that very few people can ever hear. I'm like --- oh great, no wonder I get annoyed by sounds so much. I'm picking up way more sounds than the average person!

[jbk21]

My MW does home visits on days 1, 2, 3 but I'm unsure yet of what newborn procedures she does at that time.  I guess I need to speak to my Ped about when he'd like to see him as well.  That's good info about the hearing test, too.  Maybe we'll just delay that until we feel up to it if it's not necessary.

birdhappy85- in a hospital they'd administer Hep B along with vit K, so a ped might want to do that.  I asked my old ped in Ohio why they did that to such young babies and she said "Because they can."  There's no reason for a newborn to have a hep B vaccine (if you do plan to get it at some point, you can wait until your child is much, much older.  It will only become a concern if they need a blood transfusion, or will be having sex or using IV drugs.)  

[IwannaBanRN]

Joanie, I have never heard of a baby having impaired hearing from loud noises while the mother is pregnant. They are so well cushioned in there from sound that they can only hear the mom as a mumbling noise. They can hear from the inside, but it's really muffled. It'd be like someone talking to you with a hand over their mouth.

[Abraisme]

I will go to the ped within 2-3 days pp if my baby needs her tongue clipped (both of my kids have needed it so far). Tongue-tie made breastfeeding really hard with my ds, so I will take any preventive that will make things easier. They will also do a newborn exam, which is the same stuff that my midwives do.

[Lula's Mom]

We will take the baby in to our family doctor, probably in about 3 days unless I have reason to suspect anything is wrong.  We UC, so seeing the doctor shortly after birth feels like a must, to cover our butts.  Plus we just really like our doctor and want to show her the baby!  We've done the PKU test with 2 of our 3 kids, but I haven't decided this time.  I think it's not a likely disorder for our kids to have... I have read that blond, fairskinned, light-eyed children are most susceptible to it.  My husband is Puerto Rican, so our children aren't particularly fair (though they do have lighter hair and eyes than DH).  I know the test actually covers a lot of other metabolic diseases though, so I'm not completely decided yet.  I've never done a hearing test with any of them.

[meesh933]

Yeah, the only reason we rushed to take DS in to the MD was that he was born on Thursday, so it would've been 3-4 days if we didn't go the day after he was born. I honestly don't feel the need this time, unless something is wrong. We waited until he was 3 mo to do the hearing screen, and it was actually much more difficult (nearly impossible) because he didn't sleep the whole time. So if you are planning on doing the hearing screen, I'd recommend doing it during the early newborn sleepy stage.

The only time the big kids go to the doctor is if they're really, really sick, or in DS's case, he has some eye issues that required surgery, so we see the ped every once in a while to keep his referral to the opthalmologist up to date. Our current ped has never even seen my 4 yo. I just don't see the point in traipsing a brand new baby through an office full of sick kids to be told that he's perfectly healthy...

[mcacat]

Here in Canada (well Alberta), the midwives do not transfer care of the mom and baby until 6 weeks so we didn't go to see our family physician until our daughter was about two months old.  Also, we cannot see a pediatrician without a referral from a family physician.  Honestly, it was so nice to not have to leave the house during the first two weeks and then only to go to the midwives office. 

[jbk21]

I think this is my MW's office policy.  It rings a bell, but I'll double check with her.

Originally Posted by mcacat 

Here in Canada (well Alberta), the midwives do not transfer care of the mom and baby until 6 weeks so we didn't go to see our family physician until our daughter was about two months old.  Also, we cannot see a pediatrician without a referral from a family physician.  Honestly, it was so nice to not have to leave the house during the first two weeks and then only to go to the midwives office. 

[meesh933]

Originally Posted by mcacat 

Here in Canada (well Alberta), the midwives do not transfer care of the mom and baby until 6 weeks so we didn't go to see our family physician until our daughter was about two months old.  Also, we cannot see a pediatrician without a referral from a family physician.  Honestly, it was so nice to not have to leave the house during the first two weeks and then only to go to the midwives office. 

My MW does do well baby checks for the first 6 weeks, but she still recommends seeing an MD. I think it's mostly a CYA thing for the parents, honestly. In many ways, the birth/childcare environment around here is pretty progressive, but in other ways it's really, really not. (I had a friend who was investigated by CPS after UCing, and they kept her care open for well over a year.) MWs are readily available here, and are becoming a more popular option, but we still don't have the benefits of places where they are fully integrated into the system. My MW is legal, and regulated by the state, but without the benefit of being able to easily transfer patients to the hospital or an OB. It's really frustrating, and ends with women who have to transfer being treated poorly by hospital staff. (There is a birth  center nearby where the CNMs have hospital privileges, which makes transfers go really smoothly, but they are the exception to the rule.) Sadly, stuff like that makes me more likely to take my kids in to the MD for the occasional well visit, just in case CPS ever comes knocking.

[willsmomm]

I'm going to play it by ear. My MW does a couple of checks in including a 1 weeks so I'm not sure when I'll take him in. We have to go meet with his surgeons (cleft lip possible palate) between 1-2 weeks so I'm not sure how important it is that we see the regular ped right away. Just sounds like alot of appointments to me which I'm not jazzed about. We'll see what we feel like we need and what we're up to when he gets here. His ped does want to make sure he's gaining adequate weight which can be a concern with cleft affected babies but we'll see what the situation with that is when he's here.

[xakana]

Yes, but we do well baby exams regularly. Anything my midwife does not do, I'll have DD's pedi do.

[2011mama]

My family doctor offered to be my baby's doctor and I really like her and she's really close to our house so I figured OK. She said to bring the baby in within 3 days. I talked to my midwife about this and she seemed fine with that. She actually seemed happy I have a family doc rather than a pediatrician, said they don't push vax as much. This is my first so it's all new to me. The idea of leaving the house after 3 days though makes me want to cry! Thank God it's close by! I am having a home birth and I took a home birth class and was told to stay in bed and/or do as little as possible for 7 days so thinking about bundling up a baby to go out 3 days later does not sound fun. But...I guess at this point that is what I'm going to do.

Edited by 2011mama - 10/14/11 at 10:32pm

[Krystal323]

This is one area I need to read up on a bit more, esp. with UC.  I dunno what the "usual" tests they conduct are, even if I do want to refuse most of them, heh.  

We don't vax, but I would like baby to get looked at by a doc, if for no other reason but to have tangible "proof" that s/he/(they!?) are fine, should I ever need it.  However, all the docs I'm familiar with around here are obnoxious, with the exception of one who's 1.5 hrs away and doesn't accept insurance of any sort.  So I'll have to pay out of pocket to see her, and I have no idea how much something like that would cost.  So I have some phonecalls to make.  

[LiLStar]

Hmm, I'm assuming my midwife will do the heel stick, but I'll ask her about that tomorrow. In OR where ds was born, I was supposed to order a testing kit from the health dept and forgot..oops! But midwives had a spare and did it for me. We'll see the ped, but idk how soon. I'll probably call soon after birth like, "hey, just had a baby, when should we come in?" Thats what I did last time. They said 2 weeks.. I didn't mention it was a home birth though or I bet they would have wanted us in immediately! I don't mind doing wbv because our ped and the staff don't hassle us the teeniest bit about vaxes. Its in the chart, and they respect it :) Once ds had a raging tummy bug when he was scheduled for a wbv, and the nurse was like, "lets see, so it looks like since he's sick we won't be doing any..OH! We're not doing shots anyway!" and moved on. And the ped is very AP friendly, an AP mama herself! Hearing test.. hmm.. I have NO IDEA how easy or difficult that will be to obtain. In Portland, there's a free newborn hearing screening every few months (at least it used to be, I haven't lived there in over a year so this may have changed!) Usually corresponds with a free infant craniosacral clinic for students to get practice :) So that made it super easy and convenient. but idk about here. I really don't want to go through hassle/expense for it, but it is nice to know. dd has a friend who has a moderate hearing loss and wears aids, and they didn't know until she was 4! Born at home, so wasn't screened at birth. We met them a few months before she got her hearing aids and she could speak clearly enough to be understood. So responding to sound, and even speaking doesn't mean hearing is fine. So.. idk. If its convenient, I'll do the hearing screening. I sign with my babies anyway so at the very least, even if I have a completely deaf child and don't notice until they're over a year old, there'll be some language development :P and look at Leah from Signing Time! Her deafness wasn't caught until over a year and it didn't hold her back a bit. 

[1love4ever]

I will be taking baby to a family practice Dr who did some of my prenatal care to get the PKU test around day 8 or after.  PKU tests done within the first few days are not accurate and baby needs to digest some real breastmilk before the test can be accurate, and it must be done before day 12 I believe.  I didnt even think about the hearing test, but if deafness or partial deafness is found, can they even do anything about it?  If not, I dont see the point.  It'll be discovered sooner or later!  Other than these things I dont know what other newborn tests are done.  My MW does a newborn exam, and says its up to me when I see the Dr.  She recommends the PKU but still says its up to me and she wont push it any farther than just says that she recommends it.

[heket]

I believe for birth certificate purposes, our county recorder paperwork says something like "must be see by a pediatrician within 10 days of birth" (amongst many other things we need to "prove" that this child really is ours. )  So we're just planning to go to our current ped.