Choosing a pediatrician
When registering for pre-admission or when checking in for delivery, the hospital staff will ask if you have chosen a pediatrician for your baby. This can be a difficult decision because unless you have other children, you probably have never needed a pediatrician before. How is a pediatrician different than your doctor? Pediatricians focus only on infants, children, and adolescents. Since children have different health needs than adults, a pediatrician has extensive training on all aspects of child healthcare from mild illnesses to serious diseases.
We offer free prenatal visits for expecting parents. We encourage you to schedule a visit to meet our doctors and staff and to see the office. We can also discuss any issues specific to your child that may have come up during your pregnancy.
How soon after birth will the pediatrician see your baby?
The hospital will notify the pediatrician you have chosen as soon as your baby is born. If there are any complications with delivery or pregnancy, we will see your baby at birth or soon after. Otherwise, a newborn has their first examination within the first twenty-four hours of life.
What other care does the baby receive after delivery?
A nursery nurse will be present at delivery to provide care to your baby. Your nurse will start by drying off your new baby to keep her from getting too cold. Then, your nurse will do a quick exam to make sure your child is doing well transitioning from mom’s womb to this big new world. This will include taking her measurements, including weight and length. After measurements are taken, your baby will be handed back to you. It is really important to use this time for skin-to-skin contact.
In the nursery, several things are considered routine care.
- Babies have low levels of Vitamin K. This vitamin is needed for normal blood clotting. Babies will receive a dose of vitamin K to protect them from bleeding.
- Bacteria from delivery can cause an eye infection, so an antibiotic ointment will be placed on baby’s eyes to prevent infection.
- American Academy of Pediatrics recommends that all babies receive their first vaccination against Hepatitis B in the nursery. Soon after delivery is the best and proven time to protect your baby from Hepatitis B.
- The State of Tennessee requires a newborn screening test on all newborn infants. Prior to discharge home, a small amount of blood is taken in the nursery and sent for testing. This test detects any potential problems early in order to treat them properly, prevent disabilities, and save lives. In Tennessee, the newborn screening tests for 50 rare but treatable diseases. This includes hypothyroidism, sickle cell disease, and many metabolic disorders. These results are then sent to your baby’s pediatrician.
- The baby will also have their first hearing screen before discharge home. You will receive a certificate of baby’s results before you go home.
I am having a baby boy. Should he be circumcised?
The American Academy of Pediatrics has studied both the medical benefits and risks of a circumcision. At this time, there are no medical benefits to recommend routine circumcision. Because the procedure is not essential, the decision to circumcise in one best made by parents after discussion with the pediatrician. In our region, it is still the cultural norm to have male infants circumcised. This procedure is usually performed in the hospital prior to discharge, but can also be done in the office in the first few weeks of life. We will discuss all risks of the procedure prior to it taking place in the hospital.
How often does the baby see the pediatrician after discharge home?
The American Academy of Pediatrics recommends a checkup within 48-72 hours after discharge home. This is to evaluate feeding, weight gain, and any potential discoloration of skin (jaundice). After that routine visits during the first year are at 2 weeks, and 2, 4, 6, 9, and 12 months of age. Immunizations start in the clinic at 2 months of age. Other visits may be scheduled as necessary and when you have a concern or if your child is ill. We will also talk with you at the end of each visit about when the next scheduled visit will be and what to expect.
Common questions at time discharge from hospital:
- What do I do with this cord? After the baby’s umbilical cord is clamped, the clamp remains in place until it has dried. The clamp will be removed before you go home. After that, you should just keep the area dry. Fold the diaper down away from the cord so that it doesn’t rub and irritate the cord. Sponge bath the baby, no submersion in water, until the cord has fallen off. The recommendation in the past has been to clean the area with alcohol. This is no longer a recommendation of the American Academy of Pediatrics. The evidence now says this may make the cord stay attached longer. So just keep it dry and the cord should fall off around 10-14 days after birth. It is normal for there to be a small amount of bleeding when the cord does fall off. Please call your pediatrician if you notice any foul-smelling discharge from the cord, redness around the base of the cord, or crying when you touch the cord or the skin around it.
- How do I care for the circumcised penis? If your son was circumcised in the hospital, a small gauze and some petroleum jelly was placed on the head of the penis after the procedure. When the baby urinates, this is likely to come off. It is important to keep petroleum jelly over the penis while it is healing. It is normal for the tip of the penis to look very red during the first few days after birth. It often looks “ugly” as it is healing, just like a sore in your mouth would look while it is healing. If you notice crusted yellow sores or any drainage it should be looked at by the pediatrician. Once the circumcision has healed, no additional care is needed.
- How do I get the baby in the car? Car seats are tricky. Especially if you have never installed a car seat before. We recommend that you install the car seat way before you are expecting the arrival of your baby. If you have questions about the car seat installation, drop by the local fire department or police station. They can inspect and make sure your car seat is installed safely in your vehicle so that you have peace that your new baby is safe on their way home. The American Academy of Pediatrics recommends that all babies less than two years old remain rear-facing in the back of the vehicle. A rear-facing car seat should never be placed in the front seat of a car. The American Academy of Pediatrics publishes a new a list each year of car safety seats available “Car Safety Seats: A guide for families” at aap.org.