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Typical medical procedures/tests with infant right after birth.

post #1 of 9
Thread Starter 

Experienced Mamas...what tests/procedures are typically done with a newborn before they leave the hospital?  I want to be informed of all of them so I can pick and choose the ones I consent to. 

 

I know they do PKU, vitamin K, eye drops, hearing test...what am I missing?

post #2 of 9
Hepatitis B vaccine
post #3 of 9

PKU should ideally not be done immediately after birth - the byproducts that are being tested for aren't going to be found until the baby has had a chance to eat and digest. Every state recommendation I've looked at says to do it at 24-48 hours for healthy newborns, and again at 7-14 days. So I would question that if they tried to do it in the first few hours after birth. (Though it is done before leaving the hospital - I misread the original question. I'm pretty sure I've seen it done immediately after birth though - anyone know if the timing recommendations have changed in the past 10ish years?)

 

They'll want to test the blood sugar of very large or small babies, and babies from moms with known diabetes.


Edited by ocelotmom - 1/19/14 at 9:23pm
post #4 of 9

As far as I know I think you have them all :)

 

Ocelotmom - For my homebirths the 1st PKU was done by the ped's office usually around 24-48 hrs after birth and the 2nd around 10 days later. I recall reading something to the same effect about the PKU timing. 

 

This link has a good explanation for why 2 tests are done and the timing.

 

"For most babies, checking a PKU within the first 48 hours is too soon for the very reasons you stated in your question. However, because of the high sensitivity of the PKU test, there are some babies with PKU who will have a positive test within 48 hours. Most states feel it is best to test everyone before they leave the hospital because unfortunately not all babies get their two week checkup. Since it is impossible to predict who will get their PKU recheck at two weeks and who won't make it to the doctor, the states choose to test everyone. There are some states that will allow the parents to waive the PKU test in the hospital. Therefore, parents should inquire about this option. But be sure to get the test done within two weeks of age and preferably on the fourth or fifth day of life."

post #5 of 9

This is how it works at my hospital (Baby Friendly, in Indiana):

 

- Erythromycin eye ointment/Vitamin K - at some point within the first 6 hours but after the first feeding, some places do it immediately

- Hepatitis B vaccine, if ordered (not all of our docs do) - some point before you go home

- Hearing screen - ideally after 12 hours for vaginal birth, 24 for C-section

- Bath - We want baby's temp to stabilize, so not earlier than a few hours after the birth

- pulse oximetry screening - new in Indiana starting 2012 - between 24-36 hours after birth, if leaving hospital sooner must come back as  outpatient for this during this timeframe

- Metabolic Screen (PKU) - before you go home. If it is done after 48 hours of age it does not need repeated, otherwise it will be done between 48 hours-5days old.

- We only check blood sugars in certain circumstances (LGA/SGA, preterm, resuscitation, diabetic mom) - we would check at 1/3/9 hours of age (assuming normal values, if low we'd intervene and check more frequently)

 

You can decline anything you want, but the nurse will have to discuss the benefits/risks of declining and have you sign a refusal form. For the metabolic screen, you can decline it overall (religious exemption), but if you want to leave sooner than 48 hours you can't decline the first test but plan to get the second.

post #6 of 9
Thread Starter 

Thanks for all of the replies--this helps a lot! :)

post #7 of 9
Quote:
Originally Posted by Healthy_Baby View Post
 

As far as I know I think you have them all :)

 

Ocelotmom - For my homebirths the 1st PKU was done by the ped's office usually around 24-48 hrs after birth and the 2nd around 10 days later. I recall reading something to the same effect about the PKU timing. 

 

 

Yeah, I was thinking she meant immediately (within 1-3 hours) after the birth, rather than before leaving the hospital. And I'm pretty sure I have seen it done at that time, which makes no sense unless the family is really pressing to leave immediately.

 

With my homebirth, the midwife did it at the visit the next day.

 

Quote:
Originally Posted by JenRN 
 

- pulse oximetry screening - new in Indiana starting 2012 - between 24-36 hours after birth, if leaving hospital sooner must come back as  outpatient for this during this timeframe

It should be mentioned that this is utterly uninvasive and very simple - a probe stuck on the foot, generally - maybe a little annoying, but not painful. It checks oxygen levels in the blood. 

post #8 of 9

thanks for posting this thread! 

post #9 of 9

Cord clamping and cutting (we prefer delayed in order for baby to get more iron).

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