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Discussion Starter · #1 ·
We've been hoping for a homebirth but that might not be possible for us anymore.<br><br>
I'm nervous about giving birth at a hospital, what are some questions I should ask when selecting a hospital? Some I've thought of are:<br>
Do you require an IV or just a Heplock?<br>
Does the baby have to be continually monitored?<br>
Can I eat/drink?<br>
Am I free to move around/walk? If yes, at what point do you require me stay in bed?<br>
What vaccines are required? What if I decline?<br><br>
Thank you for your help. Suggestions are very much appreciated! I want to still keep this "<i>my birth experience"</i> as much as possible.
 

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ask if they have telematry units- these are fetal moinitors not connected to wires, so you could walk all over the hospital.<br>
ask if the baby will be/can be examined and bathed in the room with you<br>
ask how many hours after water breaking they require you to have delivered.<br>
ask about policies on cord clamping.<br>
ask who is allowed to be in LnD rooms.<br>
ask if they have squat bars and if they actually let people use them.<br>
ask if they have tubs or showers for use in labor.<br><br>
hope that helps!
 

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-group B strep policy (this might involve input from your hcp and pediatrician)<br>
-availability of lactation consultants/support<br>
-intact perineum rate (not sure if this is universally tracked, but it's a source of pride among nurses where I deliver)<br>
-nearest NICU<br>
-rooming-in/nursery options<br>
-techniques for induction (drug names, alternatives, etc)<br>
-atmosphere of room, is there a comfy spot for DH/DP/support person to sleep?<br>
-how long can you bond/bf baby before nurses weigh/examine/etc.<br>
-what is that goop that goes in baby's eyes? I'm blanking on the name, but can it be skipped or delayed until you've bonded for a while<br>
-who needs to ok baby for discharge? Ped affiliated with hospital, or anyone of your choosing<br><br>
I hope you find a nice spot to bring your baby into the world. I believe that hospital births can be beautiful, satisfying and as you said, your own. Best of luck!
 

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<div>Originally Posted by <strong>Salem Lily</strong> <a href="/community/forum/post/15428552"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">We've been hoping for a homebirth but that might not be possible for us anymore.<br><br>
I'm nervous about giving birth at a hospital, what are some questions I should ask when selecting a hospital? Some I've thought of are:<br>
Do you require an IV or just a Heplock?<br>
Does the baby have to be continually monitored?<br>
Can I eat/drink?<br>
Am I free to move around/walk? If yes, at what point do you require me stay in bed?<br>
What vaccines are required? What if I decline?<br><br>
Thank you for your help. Suggestions are very much appreciated! I want to still keep this "<i>my birth experience"</i> as much as possible.</div>
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these are all your choice<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"><br>
altho the hospital instead of saying"can we put this iv in you"<br>
they say "we're going to...."<br>
you have the right for each of these to say i do not want continuous fetal monitoring<br>
i would prefer a heplok instead of iv or you can have nothing<br>
they prefer women not to eat in case of emergency c-sec and going under<br>
women should drink while in labor it is a laborous task<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br>
like i said they will word things to make it sound like "you have to" but really they are questions and you have the final say<br>
had hospital birth w/ my 1st<br>
was offered over and over epideral (just ingnored and tuned them out)<br>
was sitting up through bad bad contractions<br>
was told i needed to lay back because the continous monitoring they had on me the whole time was slipping off in that position<br>
i ignored her<br>
was told if i didnt lay back she was going to put an internal monitor in me<br>
i was smart enough even w/ 1st baby and 21 to tell her "no your not" several times and once again ignore her<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry"><br>
hospitals births can go well just remeber you are in charge and pray you get nice nurses they are the ones w/ you the whole time <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin">
 

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also if you do not want vaccines(hep b birth) eye goop atbx, heel prick tests should be done after 48 hours or ped will have to do them again they are most accurate and yet hospitals continue to do them at 24 hours or earlier???<br><br>
if you do not want certain things be sure to tell nurses and have it in righting all over the place because they are very used to do it one way so may need lots of reminding<br>
hope you have a nice crunchy hospital <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love">
 

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I had a hospital birth with my first. It went fairly well. The hospital I was in didn't require continuous monitoring. Once I checked in I was given a hospital bracelet and allowed to roam and had to come back every hour for I think 5 minute of monitoring. That really wasn't bad. As far as the IV I wasn't required to have one but did end up with one towards the end. they can be put in quickly so asking if they can wait till they actually need it might be nice.<br>
Another thing is remember that they also put antibiotic eye drops in the babies eyes if that is something that bothers you. You can typically do a waiver for that and the vaccines.<br>
Another question I would ask is how quickly you can be discharged.<br>
Also I would find out each hospital's c-section rate. There are some hospitals I wouldn't dare set foot in. The one I delivered in was better then most.<br><br>
I would also recommend doing the hospital tour before hand. I found it helpful and informative. They answered alot of the questions I had and I had a good idea of what to expect from the hospital.
 

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<div>Originally Posted by <strong>Salem Lily</strong> <a href="/community/forum/post/15428552"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Do you require an IV or just a Heplock?</div>
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Is IV access even required for all patients? My local hospital does saline locks on an as-needed basis (they allow and encourage eating and drinking during labor, so hydration isn't an issue).<br><br>
In case anyone isn't clear - a heplock (almost always a saline lock these days - which is the same thing, except flushed with plain old saline solution instead of heparin) is simply the access point where the IV tubing is connected. So basically, you're getting the saline lock either way - what you're trying to ask is whether they require a continuously running IV or if it can be disconnected in between uses.<br><br>
Requiring a continuously running IV would be an indication that they don't allow any oral intake, since giving IV fluids to someone who is adequately self-hydrating would be unnecessary and potentially dangerous.<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">What vaccines are required? What if I decline?</td>
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I would word this as "What vaccines are routinely given?" and only ask about declining in order to gauge their reaction to the question (which will vary depending on the individual giving the tour, and may not actually reflect hospital policy).<br><br>
Other questions:<br>
Do they have experience supporting women self-positioning during labor and pushing? Do they have any equipment (stools, squat bars) to facilitate this?<br><br>
If tubs are available, can these be used for birth, or just for labor?<br><br>
What happens to the baby after the birth? Are babies routinely taken to the nursery after birth? How long after the birth are they taken, and how long do they typically stay there? What is normally done to the baby while in the nursery?<br><br>
Are postpartum rooms private? Who is allowed to stay overnight? Is rooming-in allowed? How is it supported by the nurses, especially in shared rooms where the partner is not allowed to stay overnight? (The hospital where I had my first "allowed" rooming in, but had shared postpartum rooms with no overnight visitors, and the only support they offered to mothers with crying babies was to offer to take the baby to the nursery.<br><br>
One thing to keep in mind about c-section rate - does the hospital have a NICU, especially a higher level one? They're likely to have a higher c-section rate, because known high-risk patients are going to deliver there. Likewise, smaller hospitals dealing with a lower-risk population should have a correspondingly lower c-section rate. A small hospital with a high c-section rate would concern me much more than a major hospital with a high rate (though obviously something like a 50% rate is going to be worrisome regardless).<br><br>
Remember that they cannot "require" anything. You are free to decline any procedure, either for yourself or your baby. The only things likely to cause serious problems are things they see as having potential impact on the baby's immediate health and welfare - I'd be more wary about things like refusing recommended supplementation (not that it's always necessary when they recommend it!) or taking the baby out of the hospital against medical advice than refusing vaccinations or the eye antibiotics.<br><br>
"I'd prefer to have it done in the pediatrician's office" is a non-confrontational way of declining many procedures.<br><br>
If you do eat or drink during labor against hospital policies (and I personally think those policies are stupid, and will probably do so myself if I end up in a hospital with one of those policies), be sure the support person tells someone this in the event of a c-section! You're not going to get in trouble for it, and it is important to know.
 

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<div>Originally Posted by <strong>mommyshanti</strong> <a href="/community/forum/post/15428968"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">heel prick tests should be done after 48 hours or ped will have to do them again they are most accurate and yet hospitals continue to do them at 24 hours or earlier???</div>
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Can you explain this more? We did have to go back to the hospital for a second heel prick because the first samples the blood separated or something. I was really annoyed that we had to do that to her again.<br><br><br>
I do think many of the question about vaccines, eating, eye goop, cord clamping, etc you should just say what you want versus asking.
 

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<div>Originally Posted by <strong>chambom</strong> <a href="/community/forum/post/15431092"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I do think many of the question about vaccines, eating, eye goop, cord clamping, etc you should just say what you want versus asking.</div>
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Not necessarily. This is the planning stage, and you want to elicit as much information as possible. You already know you have the option to refuse any procedure. It's more helpful to know standard hospital policy (as well as which things are hospital policy vs. OB policy vs. Pediatrician policy), both in terms of choosing which hospital to go to and which fights you want to pick.<br><br>
For example, with vaccinations - if you go in and say "I want to decline all vaccinations. Is that ok?" They'll say "Yes, but we don't recommend it and you'll need to sign a waiver" pretty much universally. That gives you no information whatsoever. Asking "What vaccinations are routinely given, and at what times?" lets you know that the HepB vaccination is routinely given within an hour of birth, and you can be prepared to deal with that.<br><br>
Or, you know you can refuse to be continuously monitored, but it's more helpful to know that hospital 1 has continuous monitoring as standard procedure, while hospital 2 encourages free movement and simply monitors by doppler once an hour after the initial strip.<br><br>
Also, this may sound bad, but you don't want to come off as a memorable extremist nutcase (especially at a smaller hospital). If you want to eat during labor regardless of hospital policy, don't say ahead of time that's what you're going to do! Just find out what the hospital policy on eating and drinking during labor is, so that you can figure out how discreet you need to be or better make a choice between two hospitals.<br><br>
If there is something specific you want, it does make sense to ask directly to see if it is something they can provide.
 

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Discussion Starter · #10 ·
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<div>Originally Posted by <strong>chambom</strong> <a href="/community/forum/post/15431092"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Can you explain this more? We did have to go back to the hospital for a second heel prick because the first samples the blood separated or something. I was really annoyed that we had to do that to her again.<br><br><br>
I do think many of the question about vaccines, eating, eye goop, cord clamping, etc you should just say what you want versus asking.</div>
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Thank you chambom for your reply, I'm curious about the heel prick tests as well. I'm due 11/12 and Audrey is on our short list for names!<br>
I do want to clarify that I absolutely plan on making my preferences clear instead of asking when I get to the hospital. There are a few options available to us and based on their reactions and responses to the questions (at the interview/tour) I'll have a better idea of which one I'm most comfortable with. Some hospitals are just more friendly and relaxed than others. I also plan on having a birth plan that my OB has signed off on and bringing along a doula.<br>
I'm a FTM so I have no idea what is typical and how the whole process works, I just want to know what to expect. These questions are really helping me think about what I feel strongly about and where I stand on certain procedures/policies. I know I can refuse and deny anything at anytime, but I'd like to avoid a confrontation/argument if I can help it. Discussing all this with my husband will also help him "enforce" my preferences in general and in the case I can't speak for myself for some reason.<br>
Best wishes to you and your family!
 

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Discussion Starter · #11 ·
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<div>Originally Posted by <strong>ocelotmom</strong> <a href="/community/forum/post/15431264"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Not necessarily. This is the planning stage, and you want to elicit as much information as possible. You already know you have the option to refuse any procedure. It's more helpful to know standard hospital policy (as well as which things are hospital policy vs. OB policy vs. Pediatrician policy), both in terms of choosing which hospital to go to and which fights you want to pick.<br><br>
For example, with vaccinations - if you go in and say "I want to decline all vaccinations. Is that ok?" They'll say "Yes, but we don't recommend it and you'll need to sign a waiver" pretty much universally. That gives you no information whatsoever. Asking "What vaccinations are routinely given, and at what times?" lets you know that the HepB vaccination is routinely given within an hour of birth, and you can be prepared to deal with that.<br><br>
Or, you know you can refuse to be continuously monitored, but it's more helpful to know that hospital 1 has continuous monitoring as standard procedure, while hospital 2 encourages free movement and simply monitors by doppler once an hour after the initial strip.<br><br>
Also, this may sound bad, but you don't want to come off as a memorable extremist nutcase (especially at a smaller hospital). If you want to eat during labor regardless of hospital policy, don't say ahead of time that's what you're going to do! Just find out what the hospital policy on eating and drinking during labor is, so that you can figure out how discreet you need to be or better make a choice between two hospitals.<br><br>
If there is something specific you want, it does make sense to ask directly to see if it is something they can provide.</div>
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EXACTLY! Thank you this!
 

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Here's some after birth info:<br><br>
The "eye goop" is erythromycin, an antibiotic to ward off potential eye infections. If you know you don't have an STD or anything, you probably don't need it. Usually they do the erythromycin and vitamin K shot immediately/very soon after birth. So if you don't want those, you should let the nurses know as you're laboring, just so they don't do it as part of the routine.<br><br>
Hepatitis B is usually the only vaccine given in the hospital. As with circumcision, the MD's usually need to talk to the patient to obtain consent before even ordering it, so if you tell the nurse on the postpartum floor or just don't give your consent to the MD, they shouldn't do anything like that without you knowing about it.<br><br>
The heel prick test is usually done after 24 hours, and is the newborn screen that tests for metabolic disorders such as PKU and lots of other stuff. You may not want to refuse that one.<br><br>
Any other stuff should be noninvasive, such as checking bilirubin levels for jaundice (probe on the skin). If the bilirubin levels are high or if your baby displays any worrisome behavior, they may draw labs, but they can usually do that with a heel stick, unless they're blood cultures to check for an infection, in which case they need to do a venipuncture.
 

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if you have a couple hossys to choose from<br>
another thing to look for<br>
some hospitals have different rooms for labor,pp care<br>
the hospital i was at 10 years ago was very nice and i stayed in 1 room the entire time all to myself<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br>
it had a sofa sleeper and dad was allowed to sleep over<br>
baby never left my sight the whole stay and even if they had asked that is not something i would allow<br>
so def. try to get your own room if you can<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"><br><br>
as for heel prick it is more accurate after 48 hours so that is why they do at 1st ped appt.<br>
hospital does it early to try to make sure everyone does it in case they dont go to ped.
 

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Dince you are due in the winter I would ask them what are there policies regarding visitors/support team members during the winter months. This past winter hospitals were very stringent with who they even let in the front door let alone allowed to stay. Just something to think over wht *might* be in place during the winter.
 

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Discussion Starter · #15 ·
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<div>Originally Posted by <strong>luv-my-boys</strong> <a href="/community/forum/post/15431799"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Dince you are due in the winter I would ask them what are there policies regarding visitors/support team members during the winter months. This past winter hospitals were very stringent with who they even let in the front door let alone allowed to stay. Just something to think over wht *might* be in place during the winter.</div>
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Thank you! This didn't even cross my mind!
 

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With DS2 they did a 'routine' blood sugar check and said he had 'low' blood sugar. They made me give him lots of formula, and poked his poor little heel every 2-3 hours around the clock. I know better now that a lot of that is crapola in an umsymptomatic baby, but you may want to check their blood sugar monitoring policy.
 

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I'd suggest asking what the epidural rate at their hospital is. Not because you'll "have" to get one (because you won't), but it gives you an idea of what the nurses are accustomed to and how natural birth-friendly they are. You can also ask what kinds of non-pharmaceutical methods of pain relief they have/use, though this may vary from one nurse to the next. But see if they suggest massage, walking around, laboring tub, shower, birth ball, etc.
 

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<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>ocelotmom</strong> <a href="/community/forum/post/15431264"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Not necessarily. This is the planning stage, and you want to elicit as much information as possible. You already know you have the option to refuse any procedure. It's more helpful to know standard hospital policy (as well as which things are hospital policy vs. OB policy vs. Pediatrician policy), both in terms of choosing which hospital to go to and which fights you want to pick.<br><br>
For example, with vaccinations - if you go in and say "I want to decline all vaccinations. Is that ok?" They'll say "Yes, but we don't recommend it and you'll need to sign a waiver" pretty much universally. That gives you no information whatsoever. Asking "What vaccinations are routinely given, and at what times?" lets you know that the HepB vaccination is routinely given within an hour of birth, and you can be prepared to deal with that.<br><br>
Or, you know you can refuse to be continuously monitored, but it's more helpful to know that hospital 1 has continuous monitoring as standard procedure, while hospital 2 encourages free movement and simply monitors by doppler once an hour after the initial strip.<br><br>
Also, this may sound bad, but you don't want to come off as a memorable extremist nutcase (especially at a smaller hospital). If you want to eat during labor regardless of hospital policy, don't say ahead of time that's what you're going to do! Just find out what the hospital policy on eating and drinking during labor is, so that you can figure out how discreet you need to be or better make a choice between two hospitals.<br><br>
If there is something specific you want, it does make sense to ask directly to see if it is something they can provide.</div>
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Yes, what you are saying does make sense. Especially for monitoring and things that really vary from hospital to hospital. The vaccines and eye goop and such are all standard. I have found that if I ask, then they assume I really don't know anything about it and will then refuse it out of fear or ignorance, not knowledge. It can be tough to balance.
 

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<div>Originally Posted by <strong>NortheastSuperstar</strong> <a href="/community/forum/post/15432276"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">With DS2 they did a 'routine' blood sugar check and said he had 'low' blood sugar. They made me give him lots of formula, and poked his poor little heel every 2-3 hours around the clock. I know better now that a lot of that is crapola in an umsymptomatic baby, but you may want to check their blood sugar monitoring policy.</div>
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Per policy, we must check a baby's blood sugar if their temp dips below normal, because they can get cold stress, which puts them into a cycle of burning their brown fat to keep their core temp up and their blood sugar dropping dangerously lower. A lot of times, moms and families are just stupid (pardon me) and leave baby way too exposed in the first 24 hrs after birth, so I know the baby's just cold because they let him get that way... <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"><br><br>
If a mom is breastfeeding and baby's just mucousy and not feeding well, we don't really get excited about it until after 24 hrs of life. After that, we get more concerned that baby needs to start eating and keep his blood sugar up.<br><br>
I know they've just changed the acceptable range, too. Baby's blood sugar can be a little lower now and still be considered "normal". We just really push kangaroo care, because it keeps baby warm and encourages him to nurse! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br><br>
I'm sorry. Sounds like that experience sucked for you and your baby! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad">
 

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<div>Originally Posted by <strong>mzminty</strong> <a href="/community/forum/post/15434345"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Per policy, we must check a baby's blood sugar if their temp dips below normal, because they can get cold stress, which puts them into a cycle of burning their brown fat to keep their core temp up and their blood sugar dropping dangerously lower. A lot of times, moms and families are just stupid (pardon me) and leave baby way too exposed in the first 24 hrs after birth, so I know the baby's just cold because they let him get that way... <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"><br><br>
If a mom is breastfeeding and baby's just mucousy and not feeding well, we don't really get excited about it until after 24 hrs of life. After that, we get more concerned that baby needs to start eating and keep his blood sugar up.<br><br>
I know they've just changed the acceptable range, too. Baby's blood sugar can be a little lower now and still be considered "normal". We just really push kangaroo care, because it keeps baby warm and encourages him to nurse! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br><br>
I'm sorry. Sounds like that experience sucked for you and your baby! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"></div>
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He wasn't cold, it was part of the 'routine' test they did within a couple hours of birth. Yes it sucked. And you might want to re-think your use of the word stupid here. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies//2cents.gif" style="border:0px solid;" title="2 cents">
 
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