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What do you think about these routines ?

Posted by on Feb. 20, 2011 at 4:57 PM
  • 4 Replies

Routine Newborn Baby Care Procedures

Choices for newborn baby care procedures begin immediately at birth.  The best preparation is to have considered them and decided beforehand what procedures you desire (or don't want) for your newborn.  For a hospital birth, there are numerous routine procedures which can be administered, delayed or even refused.  Unfortunately, first time parents are often unaware that many of these routine procedures are not grounded in evidence-based practice, but are rather the product of ease and access for staff.

Many parents don't realize the impact that these procedures can have on their newborn child.  Once you have decided what procedures you prefer and whether you want them performed immediately or on a delayed schedule, the best way to communicate them to staff/caregivers is to include a Newborn Baby Care section in your birth plan.  This will ensure that your preferences are on paper before the birth and remove any doubt as to your wishes for your new child after birth.

Another critical point to remember is that you can and absolutely have the right to receive information about each and every procedure that will be performed, as well as the right to either request the procedure be performed in your room or that a parent/guardian accompany the newborn for each one.  This includes weighing, measuring and the pediatrician's evaluation of the baby - all can be performed right there in the mother's room.  Remember, your first responsibility is to the welfare of your child, not to the comfort of the hospital staff nor arbitrary hospital policies.

The most commonly performed routine newborn baby care procedures to consider are:



For most hospital births, it is routine procedure to suction the baby's mouth and nose as soon as the head emerges on the perineum.  Either a deep suction hose or a bulb syringe is often used to extract any mucus or meconium that may be present. 


There are several reasons why routine suctioning in this manner is unnecessary and often ill-advised.  Babies born vaginally gain the benefit of traversing the birth path, which aids in squeezing any mucus and amniotic fluid from their nose, mouth and lungs, reducing the amount of mucus present and lowering the risk of aspiration and respiratory distress at birth.  This effect is increased when the mother's perineum is free of tears or episiotomy.  In addition, the gag reflex is present in healthy babies and will, in the vast majority of cases, let babies clear their own mucus.  The research supports that at most, 10% of all births will require some form of active resuscitation, including suctioning.  


Furthermore, suctioning the baby while still on the perineum is typically not necessary as the baby is still receiving oxygen via the placenta so long as the cord is left intact.  This gives the infant time to clear its own mucus after birth without using suctioning as a first resort.  The need for suctioning can be determined after the baby is fully birthed and signs of distress have been noted.  In addition, the benefit of gravity is available at this point and can be utilized by supporting the baby in a prone position (belly parallel to the floor), reducing the need and amount of suctioning required.   

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Cord Clamping

The next and perhaps most critical newborn baby care decision to be made for your baby's welfare is cord clamping - immediate or delayed. The benefits of delayed cord clamping, which is defined as waiting until the cord has stopped pulsating until clamping or cutting it, are well-documented.  Once the baby is born, its entire circulatory system undergoes an amazing transformation to allow the baby to receive oxygen via its lungs rather than through the umbilical cord - a valve in the heart closes, the lungs perfuse with blood and eventually a first breath is taken.  When this delicate balance is interrupted by prematurely severing the child's lifeline, its umbilical cord, numerous undesirable side effects can occur.  

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Newborn Vitamin K Injection

All newborns are born with a low level of Vitamin K which is responsible for preventing hemorrhage by enhancing the blood's clotting ability.  In a small percentage of newborns, cerebral hemorrhage can occur which spurred the universal practice of newborn vitamin K injections in the United States.  There are, however, some points to ponder when considering this intervention, especially the alternative of an oral dose.

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PKU Screening

Certain metabolic disorders, including a  PKU test, are routinely part of a newborn baby care screening at birth through a heel stick blood sample.  These disorders have devastating effects that are best handled with early detection and treatment to ensure the best possible outcomes.  This is the least controversial newborn baby care procedure since the benefits do outweigh the risks.

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Hep B Vaccine

The Hep B Vaccine, a disease that is transmitted via infected blood and sexual intercourse, is given at birth in the hope of catching as many people as possible.  It is not required for administration at birth and may be given at any time in childhood or adulthood.  In low-risk families, it may be advisable to delay the administration to the weeks after birth, rather than injecting a minutes-old baby, causing pain as one of its first experiences outside the womb.

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Silver Nitrate or Antibiotic Eye Ointment

To prevent the chance of blindness due to gonorrhea from an infected mother, hospital-born babies may be given silver nitrate or other antibiotic drops in their eyes, even if the mother previously screened negative for this or other STDs in her pregnancy.  Silver nitrate causes pain, burning, swelling and blurred vision for the first days of life and in the vast majority of cases, is not needed when the mother is known to be free from infection.

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To Bathe or Not to Bathe

If there is one newborn baby care procedure that many families never consider, it's bathing  a newborn.  However, this may indeed be something a new family decides to decline.  The vernix which coats the baby's extremely sensitive skin is the best natural moisturizer available and will protect it from infection when massaged into the skin.  Additionally, a bath can cause a baby's body temperature to drop, thus necessitating further interventions to regulate it.


Male circumcision, and female circumcision, for that matter, are very controversial subjects.  Some religions require circumcision.  However, there are no proven medical benefits to the procedure and significant drawbacks.   It is now considered a cosmetic procedure and its routine performance is being phased out in many areas.  The American Academy of Pediatrics no longer supports it.  In Australia, public hospitals are no longer performing routine circumcisions.   


Please give due diligence to your decision in this matter.  There is no research to support its use.  If you are uncertain whether or not to circumcise your son, consider viewing a circumcision video.  If you can't handle watching it, why would you consider doing it to your son?

Carefully consider your newborn baby care options, especially if you are birthing in a hospital.  Over 1 million healthy infants each year spent up to 3 days in the NICU for "observation" in the United States, with many unneeded interventions simply because the technology exists.  If at any time you have questions about a newborn baby care procedure, don't hesitate to ask questions.  You are your child's first and foremost advocate - be the voice they lack as you choose what interventions are in their best interest.

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by on Feb. 20, 2011 at 4:57 PM
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by Emerald Member on Feb. 20, 2011 at 5:19 PM

  Some of them I am okay with and some of them I live without.

by on Feb. 20, 2011 at 5:23 PM

Which will you avoid Marlena?



by on Feb. 20, 2011 at 5:24 PM
I've had them all done to my kids with no problems. 8)
by on Feb. 20, 2011 at 5:26 PM

i have no idea what happened after brandon was born to be honest but he's perfectly healthy, assuming they did the normal routine listed above.

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