If you're going to do long term window time, I'd recommend doing it yourself, too. If you lay out on your belly or back and place the baby on top of your naked skin, you are a great radiant heater and you will know if the temperature is too warm or cold.
Speaking personally, not professionaly...obviously you can and will make your own decisions
- I'm not sure I'd be comfortable without the information provided by a cord blood analysis and regular bilirubin checks in this situation. I am scared of the damage that is known to be caused by high bilirubin levels. I'd like to think that I'm not a scare monger like one local pediatrician (maybe I am 
), but I wouldn't like to see a baby with levels above 20, for sure. So, I might figure out how I was going to get that checked - could the midwife do it? Would I be taking the baby into the ped's office every day? Would the home phototherapy service do it for me? Once I had the answer, that would tell me who could order the blanket, if needed.
As you probably know, getting rid of bilirubin requires two things - one, the baby has to have good liver function to conjugate the bilirubin, ie, make it soluble in water and blood. Second, the baby needs to be eliminating waste as most bilirubin is excreted in the stool. Anything that supports the baby's overall heath is good for the liver - ie, born at term, a natural birth, no narcotics for the liver to deal with, no hepB vaccine at birth, enough blood from the cord to allow good oxygenation, keeping the baby from experiencing cold stress, or low blood sugar (only a problem for diabetic moms, really), etc. The baby needs to eat regularly to be able to poop. Usually that's not a problem for mothers who have breastfed before - as their milk comes in quickly and well. The usual hospital solution is formula to increase excretion, but I don't feel comfortable with that usual solution. But I might consider my own stored breastmilk, or colostrum stored pre-natally, or a gift of milk from a friend.
Speaking personally, not professionaly...obviously you can and will make your own decisions
- I'm not sure I'd be comfortable without the information provided by a cord blood analysis and regular bilirubin checks in this situation. I am scared of the damage that is known to be caused by high bilirubin levels. I'd like to think that I'm not a scare monger like one local pediatrician (maybe I am ), but I wouldn't like to see a baby with levels above 20, for sure. So, I might figure out how I was going to get that checked - could the midwife do it? Would I be taking the baby into the ped's office every day? Would the home phototherapy service do it for me? Once I had the answer, that would tell me who could order the blanket, if needed.As you probably know, getting rid of bilirubin requires two things - one, the baby has to have good liver function to conjugate the bilirubin, ie, make it soluble in water and blood. Second, the baby needs to be eliminating waste as most bilirubin is excreted in the stool. Anything that supports the baby's overall heath is good for the liver - ie, born at term, a natural birth, no narcotics for the liver to deal with, no hepB vaccine at birth, enough blood from the cord to allow good oxygenation, keeping the baby from experiencing cold stress, or low blood sugar (only a problem for diabetic moms, really), etc. The baby needs to eat regularly to be able to poop. Usually that's not a problem for mothers who have breastfed before - as their milk comes in quickly and well. The usual hospital solution is formula to increase excretion, but I don't feel comfortable with that usual solution. But I might consider my own stored breastmilk, or colostrum stored pre-natally, or a gift of milk from a friend.
