Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
The Gentle Birth Archives are a great source of information about newborn procedures, and about pregnancy, childbirth, newborn care, midwifery etc. in general.
Most newborns in the US get an injection their thigh shortly after birth. Whether the injection is painful or not is difficult to say. Certainly babies protest being stretched out for the injection, but they are stretched out in order to be measured typically anyway. The goal is to prevent a rare bleeding disease that can occur within a week of birth. The disease can occur within a few hours, or after a week, but the injection is not known to help particularly in these cases.
Here is a summary of the rationale for the injections, the history of them, and what contributes to hemoragic disease of the newborn, which is what Vitamin K shots are designed to prevent/cure/fix.
Gentle Birth summarizes the debate associated with the extra dose of Vitamin K.
Some parents (that would include us) are skeptical of the usefulness of this shot, since the problem is very rare. And all procedures at birth are traumatic to some degree for a newborn. We really wanted our baby as happy and alert as possible, to make sure breastfeeding and attachment got the best start possible. Our midwives said that some parents were giving Vitamin K to their newborns orally instead. We did this. Our hospital (we had to transfer from the birth center) was not happy about this idea. As long as we signed appropriate paperwork they were okay with not giving our baby the shot; they did not want to know anything about any oral vitamin K we delivered (although to be fair, this varied amongst the nursing staff.
Once upon a time (early 20th century) women who had gonorrhea and who had babies saw those babies develop really awful eye infections from the gonorrhea and go blind. This was so awful, and so scary, that when silver nitrate drops helped prevent it, public health departments coerced everyone into using them. Eventually, when antibiotics could cure gonorrhea, in the mother, the baby, or both, antibiotic eye ointment became available as an alternative treatment. However anything in the eye interferes with the baby's ability to gaze at mama and attach, latch and generally get on with the business of being alive in the world: eating, sleeping and loving mama (and other people as well). For this reason, it is becoming easier to convince health care professionals to at least delay the eye drops, and to insist on antibiotics, rather than silver nitrate. However, that scary time in the past left a deep impression of amorphous badness; a lot of current health care professionals do not realize that that old risk is completely solved now through other means. Do what you can to at least delay, if not avoid, the eye drops.
For a few decades now, medical professionals have been required by law to prick newborn's heels and milk blood from the heel, enough to fill several dots on a piece of cardboard. Tests are then run on this dried blood for a variety of extremely rare, but really pretty scare disorders that might be otherwise hard to diagnose. This testing technique is old, and I'm here to tell you that babies really hate it. It took all of our considerable skill to keep Teddy calm through this process (which was repeated on a home visit a few days later, because some of tests were not able to be run because there had not been enough blood drawn). I hope they fix it. It would be really hard to refuse these tests, and I'm not sure I'd feel great about doing so. However, it's ridiculous they do not have a better way of running these tests. I'd happily fork out a substantial amount of additional money for a more humane test.
A lot of people know of a baby which has been treated with some form of the bili lights for newborn jaundice. This is often presented as a near disaster barely averted by high technology. In fact, most jaundice requires no treatment, and the bili lights are an overdone (literally, overcooking some babies) version of what nurses noticed some decades ago: that babies near the window in the nursery recovered faster from jaundice than those who were not near the window. That story alone tells you that no technology is needed even if the jaundice might need treatment. Unfortunately, fear runs amok. Learn the numbers and fight back if they try to put your baby under the lights, and your baby is otherwise obviously quite healthy, alert, and eating well. Treatment is not just the lights. They'll heel stick your baby repeatedly, and you will never want to see this done a second time after you've seen it once.
This used to be a hard one to fight. But between the thimerosal controversy (this vaccine alone in an premature or low birth weight baby constituted a massively over the top mercury exposure, back before trace-only thimerosal vaccines were available) and the general ridiculousness of administering this vaccine to everyone when it's so easy to test mothers who are receiving prenatal care for Hepatitis B, the schedule allows for delaying this vaccine to 2-6 months. Exploit that delay for all it is worth, and then slip it further. Unless you give it to your baby, your baby won't be getting Hep B.
Unfortunately, some of the discussion on the gentlebirth site suggests Hep B can be spread via saliva. It is only likely to do so if a bite is involved, and the saliva gets directly into the blood. Hep B is hard to get, other than through sex and drugs which, hopefully, your baby will not be involved in for at least a decade or so.
Epidurals during labor commonly cause the mother to develop a fever. There is some debate why this happens (and many health care providers do not realize how common this side effect is). Epidurals "turn off" the nerves on a large portion of a woman's body while she is engaged in quite strenuous activity. It's possible that the sweating that is turned off with those nerves causes her body to, over time, be unable to self-regulate temperature adequately.
In any event, where there is fever there might be infection; where there might be infection, health care providers think you should treat with antibiotics prophylactically -- better safe than sorry, as if antibiotics are always very safe. Because the newborn might also have the same infection (or develop it), they may also give the baby antibiotics, and want to observe the baby in a NICU for a while, do extra heel stick tests and so forth. If you do develop a fever post-epidural and it goes down as the epidural wears off, resist these antibiotics for you and your newborn; really resist a baby being stuck in the NICU if this is the only concern. You might consider doing enough research to support this stance, including it in your birth plan, and including photocopies of supporting documentation with your birth plan. Separation from your baby can make it really hard to establish breastfeeding, exposes the baby to everything else going on in the NICU, and antibiotics can set you or the baby up for yeast overgrowth (which can further compromise breastfeeding). Better safe than sorry; resist unnecessary antibiotics for the baby, and for you.
Not so long ago, babies routinely received nothing at all for the first twenty-four hours (which, surprisingly enough, is fairly common across cultures). In the wake of research on attachment, there has been a strong emphasis on getting the baby to the breast immediately (within an hour or two) after birth. If things have not gone well for mama, she may or may not be able to do this (particularly if, for example, her health status is still being stabilized). Often people feed babies, in this situation or in all situations, bottles of formula, sugar water, and so forth, even when the mother intends to breastfeed and has informed those around her of this intention.
Do not contribute to this nonsense. That baby is not going to starve in twenty-four hours (again, see above; this used to be normal procedure in hospitals). The full-term newborn stomach is tiny (think walnut) and does not stretch. Very little will fit. Colostrum is perfect, but it isn't much as a food; it's mostly antibodies and more medicine than anything else.
Feeding a baby anything other than what comes from mama's breast (colostrum, at this stage) is dangerous. It can disrupt the development of a latch. One or a very few bottles early on may mean mama never gets to breastfeed at the breast, but must instead pump her milk for her baby, which is considerably less convenient, less sustainable (leading to earlier weaning) and less fun. Formula at this age is particularly hazardous, as the newborn gut is "leaky" and cow's milk or soy proteins can get into the bloodstream directly and wreak all kinds of havoc on almost any baby this age, never mind a baby whose genetic background predispose her to trouble with cow's milk or soy proteins.
While many people believe that bottle feeding is easier than breastfeeding, this is not only not true in general, it's dangerously false with newborns. They have to protect their airway from the bottle's flow. This impacts their ability to get enough oxygen and stresses their heart and lungs.
Do not give a newborn anything in a bottle. Try hard to keep anyone else from doing so. Note this in your birth plan.
Do not do this to your son. Here are some people to convince you not to do this to your son. There are a lot of Jews who do not do this to their sons. Miriam Pollack has some fascinating and powerful information and analysis arguing against circumcision as a central part of Jewish identity.
When I started writing this, I intended to say the following: I am completely opposed to circumcision except for those who consider it a central part of their religious, ethnic or cultural heritage. But then a wonderful young man who provides child care for our son set me straight on this one, and I learned from Mothering magazine that even some orthodox jews are opposed to circumcision. And having gone looking for links, I now say the following: even if you are Jewish, think long and hard before deciding to circumcise your son.
That said, a lot of people circumcise their sons without adequate information, and deeply regret doing so. I grieve with these people, that they were pressured or misled, or simply uninformed.
Some people believe there is a health argument in favor of circumcision. The AAP used to push this argument; they no longer hold that position. You may have heard about research in South Africa suggesting that circumcision in adult males was somewhat protective against AIDS. Disregarding, for the moment, the consent issue (adult males are not vulnerable newborns), it is worth noting that those researchers also argued in favor of female "circumcision". Additionally, numerous scholars and scientists have pointed out huge flaws in that research.
If by some chance you belong to a group which engages in some form of female genital mutilation or "female circumcision", I can only say, double extra strongly, do not do this to your daughter, either. Parallel arguments apply; clerics are coming out against the procedure and it is not regarded by good, well-informed people as part of religious, cultural or ethnic identity.
And if you are a health care provider, refuse to perform this procedure. If you are at all a decent human being, you've got serious reservations about it. If you refuse, the younger crew is unlikely to step up to do it, and we can put a stop to this barbaric practice in a few years.
Copyright 2006 by Rebecca Allen
Created January 17, 2006 Updated April 10, 2006