Newborns and hats

[cjanelles]

Can someone please explain to me what the resistance towards putting knit caps on the babes right after birth is all about?

I've seen it mentioned in the forums before...about how silly or crazy it is for ob's or peds to want to put caps on the babies...as if it was the most ridiculous thing in the world.

I've seen it mentioned a lot in midwife blogs--moms who are having home births refusing caps, etc...

And while I can reconcile a lot of the non-mainstream ideas I see here on MDC, I don't understand this one about the cap...Don't get me wrong--I'm not criticizing, I just can't figure out the reasoning...

So, can someone clue me in?

Thanks!

[pamamidwife]

I have a few reasons:

1 - first and foremost, I believe that there should be no touching of the baby after the birth unless absolutely necessary!

2 - most hats are polyester - these do not keep baby heads warm. they are thin and snug and could affect how the plates of the skull go back on their own

3 - I believe there is something BENEFICIAL about the amount of cooling down a baby does at birth. Not that the baby should never be covered, but that going through all the motions of what WE deem to be comfortable could be messing with nature's plans.

4 - When babies heads are covered, mothers do not touch them or kiss them. Since I've stopped using hats at births, I see more and more mothers kiss their newborns heads/faces in the minutes after birth than ever before

5 - I think it's a routine intervention that allows a provider to step into a mother's birth bubble - a time immediately postpartum that she should be completely focused on her baby - with no hands touching her or the baby, no unnecessary words spoken to her, etc. I think keeping this birth bubble intact helps greatly reduce the amount of hemorrhage and other postpartum complications



I think it was a saying by one of my favorite midwife authors, Sara Wickham, that asks why is it that we have to prove something to be unnecessary or disruptive for us to stop doing it? Shouldn't the science or evidence be about WHY we SHOULD do it? So far, I have yet to see how placing a hat on the baby actually helps maintain their heat....and I'm not convinced that 98.6 is where a newborn SHOULD be right away.

Skin to skin with mom. Without a doubt. Even better than wrapping a baby up in a blanket and a hat.

[alegna]

Originally Posted by pamamidwife

I think it was a saying by one of my favorite midwife authors, Sara Wickham, that asks why is it that we have to prove something to be unnecessary or disruptive for us to stop doing it? Shouldn't the science or evidence be about WHY we SHOULD do it?

I really like that. That pretty well sums up my thoughts on pregnancy and birth...

-Angela

[fourgrtkidos]

Originally Posted by pamamidwife

4 - When babies heads are covered, mothers do not touch them or kiss them. Since I've stopped using hats at births, I see more and more mothers kiss their newborns heads/faces in the minutes after birth than ever before

5 - I think it's a routine intervention that allows a provider to step into a mother's birth bubble - a time immediately postpartum that she should be completely focused on her baby - with no hands touching her or the baby, no unnecessary words spoken to her, etc. I think keeping this birth bubble intact helps greatly reduce the amount of hemorrhage and other postpartum complications

This is also what I have noticed. After the bonding and a couple of hours of breastfeeding, skin to skin with mom bonding.... or when mom wants to get up and shower, etc and we do the newborn exam I put a loose cotton hat on the baby.

Not sure what Pam's opinion is on if the baby should wear a hat for a couple of days or not. I tend to give the direction of baby wears a cotton hat for a couple of weeks in cold weather or air conditioning.

[velveeta]

WOw, I had no idea. This makes great sense. No hat for us! Thanks!

[jraohc]

This isn't something that had ever crossed my mind. Interesting question and interesting answer. Thanks!

[alegna]

Also, interesting, dd hated hats from day one so we never used them

-Angela

[shellbell]

WOW!!! The stuff you never think of! I was just waiting to hear the reply on this one... couldn't figure out any reason why a hat would be bad for a baby. But, you know, now that you bring up all those awesome points, I can remember that it seemed like the perrrfect place for my neworn's head was nestled right up in the curve of my neck. I babysit for a living... and I still do that witht he babies I watch. I remember my mom telling me it is probably comfy for them because it is similiar to the womb... where there was always something warm for their head to press against. And, if you put a hat on... then the skin to skin flies out the window.

[chiro_kristin]

Not wearing a hat, as Pam mentioned, allows the mom to kiss and touch that baby's head, and her instinctive directional stroking really will help align those cranial bones.

[cjanelles]

Thank you for everyone's responses and well-thoughtout answers.

I understand the position now, and I guess I was having trouble "getting it" because of what I know about most body heat being lost through the head, etc...

My baby is due at the very end of May and we live in central Georgia, so I expect the temperatures to be in the high 90's, at least...I don't think we'll have to worry about a hat on our girl. LOL

[cottonwood]

When you think about how we evolved to survive in the wild, well, there were no hats in the wild, were there. Does that mean that for hundreds of thousands of years newborns have been at risk for losing too much body heat? Or is it possible that the process was made to be in total sync with the environment?

After the studies that have been done on cooling for disease or trauma, I'm more than ever questioning the assumption that babies are not supposed to cool down to a certain extent after emergence. There seems to me to be far more risk in overheating.

Also, in my experience, I felt a far more intense feeling of bonding when I was able to smell the baby's head immediately after birth. I was never really interested in the scent of my other children, but with these babies I couldn't get enough of smelling them, it was ambrosial. Definitely something chemical going on there, and possibly a window of opportunity for me to be wired to respond to that that was missed when my babies were covered immediately.

[pamamidwife]

isn't it also interesting that we towel off all the vernix on babies? talk about something that helps them retain heat!

still love you, Linda.

[Romana]

When dd was born, and the umbilical cord was still attached, right before they put her on my tummy they went to put the hat on. I immediately said, "Does she have to have the hat?" I think it was the first coherent thing I said since arriving at the hospital ready to push, and that says a lot to me. I wasn't able to argue about the pain during stitching much or get a clear thought through my head, but I knew I wanted to just hold my naked babe and smell and kiss her sweet head. I had a very strong instinct to kiss her head, even though it had blood and vernix on it, and rub my face on her face and head gently. And I wanted to smell her head, oh, so much! Just thinking about smelling her newborn head makes me smile. I still love smelling her head, lol.

Of course, the doctor and nurse both immediately said "YES!" and put the hat on her. Well, I don't want the hat next time. I was reading recently that in Europe (France maybe?) they don't put hats on newborns b/c they think it affects their ability to regulate their own heat (i.e. if you artificially regulate baby's heat right after birth, baby's body will not learn quickly to self-regulate). That makes a lot of sense to me.

I did refuse the newborn bath and dd was unbathed for about 3 days, during which time I kept taking off her hat to kiss and smell her head. It was practically intoxicating to me and I was just totally instinctively compelled to do it. I think it was a huge bonding thing for me/us. For all those reasons, next time I'm going to try and avoid the hat.

Julia
dd 10 mos

[mamabadger]

I think Pamamidwife's reasons are all excellent, but the one that really hits home with me is this:

Originally Posted by pamamidwife

I think it's a routine intervention that allows a provider to step into a mother's birth bubble - a time immediately postpartum that she should be completely focused on her baby - with no hands touching her or the baby, no unnecessary words spoken to her, etc.

Birth attendants tend to insert themselves into the mother/father/baby relationship far too much. Doctors and nurses are the worst, but even some midwives tend to do this.
I remember reading an article by one of the midwives who worked at Pithiviers in the 1970s. She said that even after the staff had given up most routine interventions and learned to leave a labouring woman alone, it took a long time to give up trying to join in the new parents' first contact with the baby. She said it was easy to want to be part of the parents' emotional high, and to make oneself important by being the one to announce the baby's sex, have the first contact with the baby, show the mother how to hold it, etc. etc. She felt that this was a breakthrough for the midwives, and they learned to step back and remove themselves from this experience, because it didn't belong to them. I thought that showed a lot of wisdom.
Even something as relatively small as insisting on dressing the baby a certain way, putting on the knitted cap, places the birth attendant between the mother and baby.

[pamamidwife]

Originally Posted by mamabadger

I remember reading an article by one of the midwives who worked at Pithiviers in the 1970s. She said that even after the staff had given up most routine interventions and learned to leave a labouring woman alone, it took a long time to give up trying to join in the new parents' first contact with the baby. She said it was easy to want to be part of the parents' emotional high, and to make oneself important by being the one to announce the baby's sex, have the first contact with the baby, show the mother how to hold it, etc. etc. She felt that this was a breakthrough for the midwives, and they learned to step back and remove themselves from this experience, because it didn't belong to them. I thought that showed a lot of wisdom.

what is sad is that Michel Odent and his midwives have been writing about this for over THIRTY YEARS. even amongst homebirth midwives, it seems that we cannot get over ourselves and how we "need" to do certain things.

why do these things get said over and over, yet midwives don't apply it? why do they agree at conferences, yet they can't put it in practice? I'm not perfect everytime, I will admit right up front. But my awareness is THERE and I'm trying hard.

when will we, as midwives, stop looking to our clients for validation of our worth? when we will stop using their birth experiences as boosts for our esteem?

oy, I'm so ranty. sorry.

[Daniel's Kitty]

They tried that stupid hat thing with ds. I felt bad for the poor nurses, his head was too big for the hat so it would just pop off as soon as it touched. He still won't wear hats unless it is about 5 degrees. They wanted him in that dumb little hat because his temp was about 96-97 degrees, which it still is 1 1/2 year later.

[TinkerBelle]

Have you all ever thought that sometimes, they are trying to cover themselves legally?

People are so sue-happy.

[georgia]

Hats interfere with that new baby scent. That alone is enough reason for me

[tinyshoes]

wow.

facintating.

I never thought about the hat.

I find it hilarious that the standard-issue hats at the hospital are ineffective:

Originally Posted by pamamidwife

most hats are polyester - these do not keep baby heads warm. they are thin and snug and could affect how the plates of the skull go back on their own

I clearly remember repeatedly sneaking my hosp-born baby's hat off, to sniff her head, worried that I'd get "in trouble" (ah, naive young tinyshoes....)

Originally Posted by mamabadger

Even something as relatively small as insisting on dressing the baby a certain way, putting on the knitted cap, places the birth attendant between the mother and baby.

Absolutely--wow....the hat (formerly appriciated as a helpful and cute newborn accessory) is now another element of Mainstream Birth for me to frown about.

[jessjgh1]

Hmm,
That is so interesting to consider... and totally makes a lot of sense. I doubt I would bother so much at home with hats, but the hospital was a little chilly at times. (In so many ways)


I mention this with hesitancy, because it was something I read and did not question at all... after all many of us all have it some what ingrained that newborns need hats etc, and so much heat is lost through the head...
I do recall a hat initiative to the 3rd world and there was some research that had shown that such a simple measure would save x# of newborn lives. Perhaps it was because they were low-birth weight?? Ok, heres the info:

http://ww2.kcd.org/staff/stringfellow/stitchforacause/
"...four million newborns worldwide die each year in their first month of life...
Many... infants could be saved with simple,inexpensive items,like sterile blades to
cut umbilical cords,antibiotics for pneumonia and knit caps to keep them warm,
[Save the Children] said in State of the World's Mothers 2006.... Ninety-nine
percent of newborn deaths are in developing countries,where such items are
often not widely available.
The New York Times, May 9, 2006

And noted that the statistic represents the combined package of sterile equipment, breastfeeding, hats, etc (well breastfeeding is mentioned more often in the full package of information). I do understand the reason they would focus on hats, since its kinda hard for the average person to put togehther sterile equipment or antibiotics to donate.

I had actually wanted to try to put together this project with the nursing home I work with, but it just wasn't going to happen before the end of the year.

And it saddens me that this initiative collected less than 200 hats )-: Of course I feel guilty cause I didn't contribute either, but I just had started to learn how to knit and couldn't possibly teach ti yet. I thought it was a really nice initiative and hoped that they would be flooded with hats.


Jessica