(bell tones)
(gentle piano music)
- Hello, my name is
Doctor Bonny Whalen.
I am the medical director
of the Newborn Nursery
here at Dartmouth
Hitchcock Medical Center.
Welcome to the Birthing Pavilion
and congratulations
on your pregnancy.
And if you've
already given birth,
congratulations to
you and your new baby.
In this video we
would like to share
some important information
about the Birthing Pavilion
and the kinds of things
you and your new baby
will experience in his or
her first few days of life.
We'd also like to offer
you some tips and advice
on caring for your
new little one.
The Birthing Pavilion is
a comfortable, private
and calm place to give birth.
It has it's own operating rooms
and the intensive care
nursery is right next door
should you need any special
care right after delivery.
The Birthing Pavilion is
an especially safe place
for you and your baby.
(soft piano notes)
The first few minutes
and hours after birth
is an important
time for a mother
and her new baby to bond.
Spending time together
and skin to skin contact
for the first hour of
life is especially helpful
in making the transitions
after the birth's successful
for you and your baby.
Skin-to-skin contact
means the baby's naked skin
comes in direct contact
with the mother's bare skin.
The skin-to-skin
contact helps stabilize
the baby's blood sugars
and body temperature.
It helps the baby's
heart rate and breathing
become more stable and it's
very calming for the baby.
This quiet bonding
time is also helpful
with the baby's first feeding.
A mother's body benefits from
skin-to-skin contact too.
It helps the mother's
uterus contract
which helps decrease bleeding
and it also helps stimulate
a mother's milk hormones
if she is breast feeding.
- Does he look like
your other son?
- We encourage you to hold
your baby skin-to-skin
as much as possible
in the first few hours
and days of life.
Baby's who are held
against their mother's
or father bare skin are
often happier and healthier.
There may be times
when your baby
might not be able to
be placed skin-to-skin
right after birth, due
to a medical problem.
If this is the case, we will
do our best to let you know
ahead of time and explain why.
After the first hour of life,
we will apply an antibiotic
ointment called azithromycin
to your baby's eyes.
This helps prevent
eye infections
that can be caused by
bacteria in the birth canal.
This ointment should not cause
any problems for your baby.
We will also give your
baby a shot of vitamin K
soon after birth.
This is a special vitamin
that is made by the liver.
Vitamin K helps blood to clot
and helps prevent bleeding.
Baby's are born with
low levels of vitamin K
and it takes a few
weeks for their liver
to start making enough vitamin
K to help stop bleeding.
Without the vitamin K shot,
babies can develop serious
bleeding in their skin,
intestines and brain.
The shot will cause some
brief discomfort at first
but should not cause any
other problems for your baby.
(bouncy positive music)
After birth your
newborn is given
a foot band and an armband.
These are stamped with
your baby's name, date
and time of birth.
Mothers and their
significant others
receive a matching band.
Our healthcare staff
with check the bands
to identify both the
baby and the parents
before any test or
procedure is performed
and anytime your baby
is returned to you
after spending time
outside of your room.
An infant security tag will be
attached to your baby's ankle
as a special security measure.
If this tag gets close to
one of the Birthing
Pavilion's exits,
it will set off an
alarm and lock the door.
To keep from setting this
alarm off accidentally,
please try to stay
clear of the exits
when you wheel your
baby through the hallway
in his bassinet.
The alarm will also trigger
if the tag gets wet,
if it falls off or if
someone damages it.
Babies often lose
weight after birth
so tell your nurse if
the tag becomes so loose
that it might fall off.
For safety and security reasons,
when babies are
outside of the room,
they must be pushed
in their bassinet.
Staff members will
questions anyone
carrying a baby in their arms.
Even another staff member.
This is one of the best ways
we can make sure your
baby remains safe.
(soft piano notes)
A day or two after the birth,
we will perform several
important procedures
and tests for your newborn.
Sometimes these are done
in the Newborn Nursery
and sometimes they are
performed in your room.
If your baby needs
to go to the nursery,
you are welcome to come along
and help soothe him or her
with your voice and your touch.
To help keep your baby healthy
and to identify certain
medical conditions
before they become problems,
we will perform a
special blood test
called the Newborn
Metabolic Screen.
This is sometimes
called the PKU test.
We will take a few drops of
blood from your baby's foot
to perform this test.
This test can tell us if
the newborn has problems
in producing certain
types of hormones
such as in hypothyroidism.
It can also detect if a
baby will have problems
breaking down food or
in using his nutrition
such as with conditions
called PKU and Galactosemia.
Without screening,
these problems may not show up
until a baby becomes very sick
or has delays in
his development.
If the screening test shows
that there may be a problem,
your doctor will
do extra testing.
If this follow up testing shows
that there is truly a problem,
a special medicine or
diet can be prescribed
to help keep your baby
from getting sick.
You will receive results on
your baby's newborn screen
at the two week
well child visit.
If there is a problem
on the newborn screen,
you should hear from your
baby's doctor before this visit.
Your baby will also be
tested for Jaundice,
a common newborn condition
which makes a baby's skin
turn yellow.
Jaundice develops when a yellow
chemical called bilirubin
builds up in the body.
Bilirubin is formed
when a baby's red
blood cells break down
which is a normal
process after birth.
Babies get rid of
bilirubin through the liver
and then through
their stool or poop.
Since a newborn's liver is
not very mature at birth
and because babies
don't pass a lot of poop
in their first few days of life,
extra bilirubin can build
up in the baby's blood.
The bilirubin can
then get into the skin
and cause it to look yellow.
Most babies get
a little Jaundice
in the first few days of life
and normally this does
not cause problems.
But some babies
can get so yellow
that they need help getting
rid of their Jaundice.
To find out if Jaundice
is going to be a problem
for your baby, we will perform
a bilirubin blood test.
This will be done at the same
time as the newborn screen
to help limit an extra
poke for your baby.
Your baby may have a bilirubin
test performed earlier
if there are any concerns
about her looking too yellow
for her age.
While we perform these tests,
we will give your baby a very
small amount of sugar water
to suck on, this
helps lower pain.
Breast feeding your baby
and holding her
skin-to-skin a little,
just before these tests,
can also help to limit pain.
Most new babies hear well
at birth, but some do not.
About one to three
of every 1000 babies
will have a true hearing loss
We screen your newborn
for hearing loss
with a special machine.
The screening test is easy
and is done while your baby
is resting or sleeping.
Some babies may not
pass on the first try.
This can be due to
noise in the room
or because the baby
is moving around.
If your baby does not
pass on the first try,
we will repeat the hearing
screen one more time
before you go home.
If he does not pass
on the second try,
we will contact the
audiology department
and ask that they
call you at home
to schedule an appointment
for more testing.
We also recommend
that your baby receive
the Hepatitis B Vaccine before
going home from the hospital.
The Hepatitis B Vaccine is
an important first vaccine
for a baby.
It has been recommended
for all newborns
by the American
Academy of Pediatrics
and the Centers For Disease
Control for almost 20 years.
If a new baby is exposed
to the Hepatitis B virus,
a serious infection of
the liver can develop.
The vaccine helps
to prevent this.
This vaccination is recommended
even if the mother's
Hepatitis B test result
is negative during
her pregnancy,
because testing is
not always accurate
or sometimes the
mother can develop
the Hepatitis B infection
after her test is done.
The Hepatitis B vaccine is
a safe an effective vaccine.
The shot will cause
some brief discomfort
to your baby at first, but it
should not continue to hurt
and it is unlikely to
cause any other problems.
Some babies are born with
a dangerous heart condition
that can cause a low level
of oxygen in the blood.
For this reason, we will
perform a special oxygen test
on your baby before you go home.
This test is painless
and can be done right
in your own room.
If this test shows that your
baby has a low level of oxygen
in the blood, we will
perform extra oxygen testing
to make sure that you
baby's heart is healthy.
If the extra testing
shows that your baby
may have a heart condition,
we will perform an ultrasound
of your baby's heart
called an echocardiogram.
This will look at the
structure of your baby's heart
to see if there is a problem.
(pleasant bouncy music)
- [Nurse] Just above it.
- One of the best
things a newborn can do
to get the best start in life
is to be a healthy eater.
Babies need to eat often
because their stomachs
are very small.
At first they can only eat
about two to three
teaspoons at a time.
Sometimes their
stomachs are full
of amniotic fluid
right after birth.
For this reason some babies
are not very hungry at first.
As their stomachs grow
and they get rid of this fluid,
they are able to eat more.
Usually newborns eat about
every two to three hours or so
whether it is daytime
or night time.
Sometimes they need to eat
only one to one and a half
hours after their last feeding.
This pattern is called
cluster feeding.
In the first few days of life,
babies often are
hungriest at night
and do most of their
cluster feeding then.
This can be quite
tiring for new parents
so make sure you take every
chance to nap during the day
when your baby is sleeping.
Limit visitors during the day
for these first few
days to make sure you
and your baby get all
the sleep you need.
Babies will show you
when they are hungry
by licking their lips,
sucking on their hands
or opening their mouths wide
when you touch their
lips or cheeks.
Your baby should
show you these cues
at least every few hours.
If it has been about two
and a half to three hours
since the last feeding,
unwrap your baby
down to the diaper
and use skin-to-skin contact
to help or her wake up
and get interested in feeding.
Some parents worry that
allowing their baby to feed
very frequently will
spoil their baby.
You cannot spoil your newborn.
Try to feed your baby
whenever he or she shows you
hunger cues and before
he or she start to cry.
Crying causes air to
enter a babies stomach
leaving less room for milk.
Crying also causes babies
to be gassier and fussier.
You will find that
your baby is happiest
when you feed her just as she
is starting to get hungry.
Brest feeding is the
healthiest type of feeding
for new babies and
has many benefits
for their new mothers as well.
For newborns, breastfeeding
is especially important
in helping fight off infections
because the mother's early
milk called colostrum
has a lot of infection
fighting properties.
Breastfeeding also helps
to lower a baby's chance
of developing asthma, a
condition of the lungs
that causes problems
with breathing.
Eczema, an itchy skin condition.
Type one and type two diabetes,
childhood leukemia, obesity
and Sudden Infant
Death Syndrome.
Babies are born with
natural instincts
to help them breastfeed.
Just placing a baby
on a mother's chest
whilst she is laying
back a little bit
will bring out the baby's
natural feeding insticts.
Babies can often find
their way to the breast
and latch on without
any help at all.
Sometimes babies can have
difficulties breastfeeding
just as some babies
can have difficulties
with bottle feeding.
Our nurses will help you learn
how to breastfeed your baby.
We also have
lactation consultants
or breastfeeding specialists
who can help you if you
are having any problems.
Breastfeeding is the
healthiest choice
for both moms and their babies.
On rare occasions,
some mothers and babies
are not able to
directly breastfeed.
If you will be bottle
feeding your baby
breast milk or formula, we
will also help you learn
how to do this safely.
Whether breast feeding
or bottle feeding,
it is important to feed
your baby when hungry
and until she or he is content.
Babies show contentment
by falling asleep
after a good feeding
or by pushing the nipple
out of their mouth.
Babies often pause a
little during feeding
to take a rest to decide if
they are hungry for more milk.
After you baby has
taken this rest,
see if he or she is
interested in feeding more
by squeezing your breast
to give a little more milk
or by tickling your baby's
lip with your nipple.
If you baby doesn't seem
interested in feeding anymore,
see if he or she needs to burp.
Most babies will be
able to bring up a burp
within a few minutes,
while other babies may
not need to burp at all.
An excellent way to judge
how well your baby is eating
is by noting the number of wet
and dirty diapers each day.
Your baby should have
at least one dirty
and one wet diaper in
the first day of life.
Then one more of each
for each day older.
So on the second day there
should be at least two wet
and two dirty diapers
and on the third day
three of each and so on.
This starts leveling off
to about six to eight
of each wet and
dirty diaper per day
when your baby's
about one week old.
It is a good idea to
buy lots of diapers now.
In the first few days, a
baby's poops are very dark
and tarry looking
and are very sticky.
These poops are called meconium.
A baby usually passes
all of her meconium
in the first two days of life.
Then the stools start to get
less sticky and turn green.
Then brown, then yellow.
When you see these changes,
you can feel good
knowing that your baby
is feeding very well.
The most exciting
events after a birth
is finding out the
baby's birth weight.
Your baby will be
weighed right after birth
and then early each morning
during your hospital stay.
Most babies will lose about
8% of their birth weight
in the first few days of life.
This is because they are born
with extra fluid in their body
to help them stay hydrated
and when they pee
they lose this weight.
The first few stools
called meconium
also weigh a lot
and this causes babies
to lose weight too.
Some babies will lose more
than 8% of the birth weight
if their mothers had a
lot of fluid during labor
or if their labor was very long.
We will help watch
your baby's weight
and make sure he or she
is losing the right
amount and not too much.
By about day four,
your newborn will
stop losing weight
and then will start gaining
about a half an ounce a day.
Babies are usually back
to their birth weight
by the time they
are two weeks old
and some get there sooner.
Feeding your baby often at
his or her early feeding cues
and at least every three hours
helps keep your baby from
losing too much weight.
It also helps your baby
start gaining weight
and the right amount
at the right time.
Remember to feed your baby
at the first sign of hunger
and until she or he
is totally content.
(soft playful piano notes)
One of the biggest
transitions for a new baby
is learning to be away
from his or her mother.
While living in your belly,
you held your baby all the time
so it'll be natural for your
baby to want to be with you
all the time after birth.
A mother's touch
makes the baby feel
safe and secure.
We strongly recommend
against falling asleep
in bed with your baby.
Mothers are often very
sleepy after labor
and from their pain medicine
as well as from the baby's
frequent night time feedings.
Falling asleep in
bed with your baby
increases the risk
of suffocation
and of falling out of the bed.
Our hospital beds are narrow
so they are especially
unsafe for bed sharing.
If you are feeding
you baby in bed
and you feel sleepy,
please let your nurse
or support person know
so that they can help
you hold your baby.
When you are finished feeding,
place your baby
into the bassinet
so that you both can have
a restful safe sleep.
After the birth
it will be helpful
to find ways to make your
baby feel comfortable
lying alone in the bassinet,
whether awake or asleep.
While you're in the hospital,
we will teach you how to help
your baby feel comfortable
sleeping alone in the bassinet.
We'll also teach you how
to make her sleep time
the safest to help prevent
a condition called SIDS
or Sudden Infant Death Syndrome.
Having your baby sleep
on his or her back
is one of the best
ways to prevent SIDS.
It is also really
important to make sure
there are no loose blankets,
pillows or stuffed animals
in your baby's sleep space.
You and your partner
need to sleep whenever
your baby sleeps.
This is especially
important during the daytime
so you can be more
rested at night
for night time feedings.
(cheerful piano music)
(baby whimpers)
Remember to limit visitors
during the daytime
so you can get your sleep.
Please ask visitors not to
come in between two and four
in the afternoon so
that everyone can
have some quiet time
and a nap.
We have signs that you
can put up on your door
when you are taking a nap
so that no one
interrupts your sleep.
It's a good idea to ask visitors
to wash their hands before
they hold your baby.
Baby's immune systems are
not well developed yet
so they are at a high risk
for getting infections.
As we mentioned earlier,
breastfeeding helps babies
develop their immune system
and can help fight off infection
but they are still at
risk of getting sick.
We also recommend that you do
not allow anyone with a cough,
cold, fever or other
contagious illness to visit you
or your baby in the
first few months of life.
(gentle piano notes)
One other important thing
to know about babies
is that they can cry
a lot, this is normal.
Crying is a baby's
special way of saying
she or he is hungry,
uncomfortable,
or stressed about something.
Sometimes babies seem to
cry for no reason at all.
One of the best ways
to calm a fussy baby
is to put her skin-to-skin
with her mother
or another care giver.
Another way to help
calm a fussy baby
is with swaddling.
Swaddling means wrapping
a baby in a blanket.
Holding a baby close and gentle
swaying, rocking or jiggling
is also very calming.
Having a baby suck
on your own hand,
an adults finger or a pacifier
can help calm a crying baby too.
We do recommend waiting on
introducing a pacifier however
until you know
breastfeeding is going well.
And sometimes sucking on a
pacifier can cause problems
with how a baby breastfeeds.
It is also important to see
if you baby is hungry first,
anytime it looks like
she wants to suck.
Babies like a shushing
sound because it sounds like
the noises inside the womb.
You can make a sound like
(shushes)
in your baby's ear to
help calm her down.
If you have a very fussy baby
especially one who's
hard to calm down,
it is important to have
friends or relatives close by
who can help.
If you are feeling overwhelmed
with your baby's crying,
gentle place your
baby in the bassinet
and ask a friend or
family member to help
while you take a break.
If you are alone it is also okay
to put your baby in the bassinet
and walk away for a while to
give yourself a little break.
The bassinet is a safe place
and it will be okay for your
baby to be on his or her own
for a little while.
Remember that it is
normal for babies to cry.
Sometimes babies cry
for long periods of time
and sometimes for
no reason at all.
It is important to know
that you should never ever
shake your baby to
stop the crying.
Shaking can be very dangerous
and can cause serious brain
damage and other injuries.
(soft cheerful music)
Some parents choose to
have their son circumcised
for cultural, religious
or personal reasons.
If you would like
your son circumcised
you will be asked to
sign a consent for
and watch a video that
talks about circumcision
and reviews it's
risks and benefits.
Your baby's pediatric provider
will make sure your baby's
penis and foreskin look healthy
and that he is healthy enough
to have the
circumcision performed.
If your pediatric provider does
not think your baby is ready
to have a circumcision
performed before you go home
or a provider is not available
to perform the circumcision,
we will help coordinate this
procedure as an out-patient.
Because a circumcision is
not medically necessary,
some insurance companies
do not cover the cost
of the procedure.
Check your company's policy
before having your
baby circumcised
to find out whether or not
they will help pay for it.
(soft piano notes)
There are a few other
activities that will happen
in the Birthday Pavilion
before you go home.
Our secretary will
come to your room
to help you fill out
a birth certificate.
You will use your baby's name
if you have made a decision.
But a name is not required
to complete the form.
You will however need a
social security number
for both parents as well
as your places of birth.
When it's almost time
to bring your baby home,
we will help you set up your
first medical appointments
with your baby's
primary care provider.
- [Woman Red Top]
That's perfect.
- If you have not chosen
a primary care provider
for your baby yet,
we can help you pick
one soon after birth.
We will need to have a
specific provider's name
to set up your baby's
first appointments
and to include on the Newborn
Metabolic Screening Card,
so the results will go
to the right provider.
This is especially important
if there are any problems
on this early screening.
Before you go home,
a clinical resource coordinator
will meet with you
to help you identify
your discharge needs as
well as to talk to you
about any community resources
that may be of use to you.
She can help set up a home
visit with a visiting nurse
if there are concerns
with your baby's feeding,
weight or Jaundice.
Or if you need to
have a nurse visit you
for any complications
you may have had,
either with the
pregnancy or delivery.
The resource coordinator
can also help you obtain
a rental breast pump,
if that is needed
and a referral to a Good
Beginnings volunteer
if one is available
in your area.
By law and for safety's sake,
your baby must ride in an
approved car seat at all times.
A nurse will look
at your car seat
to make sure it is
an approved one.
We will help show
you how to make sure
your baby fits well
in his car seat.
We will also help you learn
how to use it properly.
The safest place in your
car for your baby's car seat
is in the back middle
seat facing to the rear
for his first year of life.
If your baby was born
before 37 weeks gestation
we will also perform
a special safety test
to make sure that his
breathing and heart rate
remain healthy while
in the car seat.
Your baby's nurse and
doctor will help teach you
how to best care for your baby
and discuss any medical problems
that your baby may have.
As you prepare to go home,
your nurse will also give you
some extra discharge teaching.
Much of this
information can be found
in our Going Home With
Your Newborn booklet,
that we developed
especially for new parents
to help them learn
how to provide
the very best care
for their new babies.
It is helpful to
read through this
during your stay here
in the Birthing Pavilion
when you have time.
Congratulations again on
your pregnancy or birth.
If you have any
questions of concerns
regarding any of the information
we have shared in this video,
please be sure to speak
with your baby's nurse,
the Birthing Pavilion's
resource coordinator
or your baby's
pediatric provider.
If at anytime you have
questions about your baby,
please ask your nurse
or your baby's doctor.
We are happy to answer any
questions that you might have.
Welcome to the Birthing
Pavilion and Newborn Nursery.
(soft piano notes)
