Caring For Your Newborn

Transcript

00:01
[Music]
00:12
you
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[Music]
00:22
hello my name is dr. Bonnie Whelan I am
00:25
the medical director of the newborn
00:27
nursery here at dartmouth-hitchcock
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Medical Center welcome to the birthing
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Pavilion and congratulations on your
00:33
pregnancy and if you’ve already given
00:35
birth congratulations to you and your
00:38
new baby in this video we would like to
00:40
share some important information about
00:42
the birthing pavilion and the kinds of
00:44
things you and your new baby will
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experience and his or her first few days
00:48
of life we’d also like to offer you some
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tips and advice on caring for your new
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little one the birthing pavilion is a
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comfortable private and calm place to
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give birth it has its own operating
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rooms and the intensive care nursery is
01:03
right next door should your baby need
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any extra special care right after
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delivery the birthing pavilion is an
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especially safe place for you and your
01:12
baby the first few minutes and hours
01:22
after birth is an important time for a
01:24
mother and her new baby to bond spending
01:26
time together and skin-to-skin contact
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for the first hour of life is especially
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helpful in making the transitions after
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the births successful for you and your
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baby skin-to-skin contact means the
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baby’s naked skin comes in direct
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contact with the mothers bare skin the
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skin to skin contact helps stabilize the
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baby’s blood sugars and body temperature
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it helps the baby’s heart rate and
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breathing become more stable and it’s
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very calming for the baby this quiet
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bonding time is also helpful with the
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baby’s first feeding a mother’s body
02:00
benefits from skin-to-skin contact you
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it helps a mother’s uterus contract
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which helps decrease bleeding and it
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also helps stimulate a mother’s milk
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hormones if she is breastfeeding we
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encourage you to hold your baby’s skin
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to skin as much as possible in the first
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few hours and days of life babies who
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are held against their mother’s or
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Father’s bare skin are often happier and
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healthier there may be times when your
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baby might not be able to be placed
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skin-to-skin right after birth due to a
02:29
medical problem if the
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is the case we will do our best to let
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you know ahead of time and explain why
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after the first hour of life we will
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apply an antibiotic ointment called
02:40
erythromycin to your baby’s eyes
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this helps prevent eye infections that
02:45
can be caused by bacteria in the birth
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canal this ointment should not cause any
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problems for your baby we will also give
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your baby a shot of vitamin K soon after
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birth this is a special vitamin that is
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made by the liver vitamin K helps blood
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to clot and helps prevent bleeding
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babies are born with low levels of
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vitamin K and it takes a few weeks for
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their liver to start making enough
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vitamin K to help stop bleeding without
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the vitamin K shot babies can develop
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serious bleeding in their skin
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intestines and brain the shot will cause
03:17
some brief discomfort at first but
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should not cause any other problems for
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your baby
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[Music]
03:26
after birth your newborn is giving a
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foot band and an arm band these are
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stamped with your baby’s name date and
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time of birth mothers and their
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significant others receive a matching
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band our health care staff will check
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the band’s to identify both the baby and
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the parents before any test or procedure
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is performed and anytime your baby is
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returned to you after spending time
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outside of your room an infant security
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tag will be attached to your baby’s
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ankle as a special security measure
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if this tag gets close to one of the
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birthing pavilions exits it will set off
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an alarm and lock the door to keep from
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setting this alarm off accidentally
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please try to stay clear of the exits
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when you wheel your baby through the
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hallway in his bassinet the alarm will
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also trigger if the tag gets wet if it
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falls off or if someone damages it
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babies often lose weight after birth so
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tell your nurse if the tag becomes so
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loose that it might fall off for safety
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and security reasons when babies are
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outside of the room they must be pushed
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in their bassinet staff members will
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question anyone carrying a baby in their
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arms even another staff member this is
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one of the best ways we can make sure
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your baby remains safe
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a day or two after the birth we will
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perform several important procedures and
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tests for your newborn sometimes these
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are done in the newborn nursery and
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sometimes they are performed in your
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room if your baby needs to go to the
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nursery you are welcome to come along
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and help soothe him or her with your
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voice and your touch to help keep your
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baby healthy and to identify certain
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medical conditions before they become
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problems we will perform a special blood
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test called the newborn metabolic screen
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this is sometimes called the PKU test we
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will take a few drops of blood from your
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baby’s foot to perform this test this
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test can tell us that the newborn has
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problems in producing certain types of
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hormones such as in hypothyroidism it
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can also detect if a baby will have
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problems breaking down food or in using
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his nutrition such as with conditions
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called PKU and galactosemia without
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screening these problems may not show up
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until a baby becomes very sick or has
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delays in his development
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if the screening test shows that there
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may be a problem your doctor will do
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extra testing if this follow-up testing
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shows that there is truly a problem a
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special medicine or diet can be
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prescribed to help keep your baby from
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getting sick you will receive results on
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your baby’s newborn screen at the 2-week
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well-child visit if there is a problem
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on the newborn screen you should hear
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from your baby’s doctor before this
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visit your baby will also be tested for
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jaundice a common newborn condition
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which makes a baby’s skin turn yellow
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jaundice develops when a yellow chemical
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called bilirubin builds up in the body
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bilirubin is formed when a baby’s red
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blood cells break down which is a normal
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process after birth
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babies get rid of bilirubin through the
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liver and then through their stool or
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poop since the newborns liver is not
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very mature at birth and because babies
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don’t pass a lot of poop in their first
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few days of life extra bilirubin can
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build up in the baby’s blood the
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bilirubin can then get into the skin and
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cause it to look yellow most babies get
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a little jaundice in the first few days
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of life and normally this does not cause
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problems but some babies can get so
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yellow that they need help
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getting rid of their jaundice to find
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out if jaundice is going to be a problem
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for your baby we will perform a
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bilirubin blood test this will be done
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at the same time as the newborn screen
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to help limit an extra poke for your
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baby your baby may have a bilirubin test
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performed earlier if there are any
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concerns about her looking too yellow
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for her age while we perform these tests
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we will give your baby a very small
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amount of sugar water to suck on this
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helps lower pain breastfeeding your baby
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and holding her skin-to-skin a little
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just before these tests can also help to
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limit pain most new babies here well at
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birth but some do not about 1 to 3 of
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every 1,000 babies will have a true
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hearing loss we screen your newborn for
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hearing loss with a special machine the
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screening test is easy and is done while
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your baby is resting or sleeping some
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babies may not pass on the first try
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this can be due to noise in the room or
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because the baby is moving around if
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your baby does not pass in the first try
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we will repeat the hearing screen one
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more time before you go home if he does
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not pass in the second try we will
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contact the audiology department and ask
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that they call you at home to schedule
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an appointment for more testing we also
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recommend that your baby receive the
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hepatitis B vaccine before going home
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from the hospital the hepatitis B
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vaccine is an important first vaccine
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for a baby it has been recommended for
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all newborns by the American Academy of
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Pediatrics and the Centers for Disease
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Control for almost 20 years if a new
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baby is exposed to the hepatitis B virus
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a serious infection of the liver can
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develop the vaccine helps to prevent
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this this vaccination is recommended
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even if a mother’s hepatitis B test
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result is negative during her pregnancy
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because testing is not always accurate
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or sometimes a mother can develop the
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hepatitis B infection after her test is
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done the hepatitis B vaccine is a safe
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and effective vaccine the shot will
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cause some brief discomfort to your baby
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at first but it should not continue to
09:00
hurt and it is unlikely to cause any
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other problems some babies are born with
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a dangerous heart condition
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that can cause a low level of oxygen in
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the blood for this reason we will
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perform a special oxygen test on your
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baby before you go home this test is
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painless and can be done right in your
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own room if this test shows that your
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baby has a low level of oxygen in the
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blood we will perform extra oxygen
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testing to make sure that your baby’s
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heart is healthy if the extra testing
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shows that your baby may have a heart
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condition we will perform an ultrasound
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of your baby’s heart called an
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echocardiogram this will look at the
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structure of your baby’s heart to see if
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there is a problem one of the best
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things the newborn can do to get the
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best start in life is to be a healthy
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eater babies need to eat often because
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their stomachs are very small at first
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they can only eat about two to three
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teaspoons at a time sometimes their
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stomachs are full of amniotic fluid
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right after birth for this reason some
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babies are not very hungry at first as
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their stomachs grow and they get rid of
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this fluid they are able to eat more
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usually newborns eat about every two to
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three hours or so
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whether it is daytime or nighttime
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sometimes they need to eat only one to
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one and a half hours after their last
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feeding this pattern is called cluster
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feeding and the first few days of life
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babies often are hungry at night and do
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most of their cluster feeding then this
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can be quite tiring for new parents so
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make sure you take every chance to nap
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during the day when your baby is
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sleeping limit visitors during the day
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for these first few days to make sure
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you and your baby get all the sleep you
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need babies will show you when they are
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hungry by licking their lips sucking on
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their hands or opening their mouths wide
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when you touch their lips or cheeks your
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baby should show you these cues at least
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every few hours if it has been about two
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and a half to three hours since the last
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feeding and wrap your baby down to the
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diaper and use skin-to-skin contact
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to help him or her wake up and get
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interested in feeding some parents worry
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that allowing their baby to feed very
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frequently will spoil their baby
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you cannot spoil your newborn try to
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feed your baby whenever he or she shows
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you hunger cues and before he or she
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starts to cry
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crying causes air to enter a baby’s
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stomach leaving less room for milk
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crying also causes babies to be gassy ER
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and fussier you will find that your baby
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is happiest when you feed her just as
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she is starting to get hungry
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breastfeeding is the healthiest type of
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feeding for new babies and has many
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benefits for their new mothers as well
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for newborns breastfeeding is especially
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important in helping fight off
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infections because the mother’s early
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milk called colostrum has a lot of
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infection-fighting properties
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breastfeeding also helps to lower a
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baby’s chance of developing asthma a
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condition of the lungs that causes
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problems with breathing xima and itchy
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skin condition type 1 and type 2
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diabetes
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childhood leukemia obesity and sudden
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infant death syndrome babies are born
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with natural instincts to help them
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breastfeed just placing a baby on a
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mother’s chest while she is laying back
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a little bit will bring out the babies
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natural feeding instincts babies can
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often find their way to the breast and
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latch on without any help at all
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sometimes babies can have difficulties
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breastfeeding just as some babies can
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have difficulties with bottle feeding
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our nurses will help you learn how to
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breastfeed your baby we also have
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lactation consultants or breastfeeding
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specialists who can help you if you are
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having any problems
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breastfeeding is the healthiest choice
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for both moms and their babies on rare
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occasions some mothers and babies are
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not able to directly breastfeed if you
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will be bottle feeding your baby breast
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milk or formula we will also help you
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learn how to do this safely whether
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breastfeeding or bottle feeding it is
13:02
important to feed your baby when hungry
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and until she or he is content babies
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show contentment by falling asleep after
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a good feeding or by pushing the nipple
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out of their mouths babies often pause a
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little during feeding to take a rest to
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decide if they are hungry for more milk
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after your baby has taken this rest see
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if he or she is interested in feeding
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more by squeezing your breasts to give a
13:24
little more milk or by tickling your
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baby’s lip with your nipple if your baby
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doesn’t seem interested in feeding
13:30
anymore see if he or she needs to burp
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most babies will be able to bring up a
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burp within a few minutes while other
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babies may not need to burp at all an
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excellent way to judge how well your
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baby is eating is by noting the number
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of wet and dirty diapers each day your
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baby should have at least one dirty and
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one wet diaper and the first day of life
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then one more of each for each day older
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so on the second day there should be at
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least two wet and two dirty diapers and
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on the third day three of each and so on
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this starts leveling off to about six to
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eight of each wet and dirty diaper per
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day when your baby’s about one week old
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it is a good idea to buy lots of diapers
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now
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in the first few days a baby’s poops are
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very dark and tari looking and are very
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sticky
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these poops are called meconium a baby
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usually passes all of her meconium in
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the first two days of life then the
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stools start to get less sticky and turn
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green then brown then yellow when you
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see these changes you can feel good
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knowing that your baby is feeding very
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well the most exciting events after a
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birth is finding out the baby’s birth
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weight your baby will be weighed right
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after birth and then early each morning
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during your hospital stay most babies
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will lose about 8 percent of their birth
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weight and the first few days of life
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this is because they are born with extra
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fluid in their body to help them stay
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hydrated and when they pee they lose
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this weight the first few stools called
14:57
meconium also weigh a lot and this
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causes babies to lose weight too some
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babies will lose more than 8 percent of
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the birth weight if their mothers had a
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lot of fluid during labor or if their
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labor was very long
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we will help watch your baby’s weight
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and make sure that he or she is losing
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the right amount and not too much by
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about day for your newborn we’ll stop
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losing weight and then we’ll start
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gaining about a half an ounce a day
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babies are usually back to their birth
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weight by the time they are two weeks
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old and some get there sooner feeding
15:28
your baby often at his or her early
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feeding cues and at least every three
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hours helps keep your baby from losing
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too much weight it also helps your
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babies start gaining weight in the right
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amount at the right time remember to
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feed your baby at the first sign of
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hunger and until she or he is totally
15:45
content
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one of the biggest transitions for a new
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baby is learning to be away from his or
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her mother while living in your belly
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you held your baby all the time so it
16:00
will be natural for your baby to want to
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be with you all the time after birth a
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mother’s touch makes the baby feel safe
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and secure we strongly recommend against
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falling asleep in bed with your baby
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mothers are often very sleepy after
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labor and from their pain medicine as
16:17
well as from the babies frequent
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nighttime feedings falling asleep in bed
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with your baby increases the risk of
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suffocation and of falling out of the
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bed our hospital beds are narrow so they
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are especially unsafe for bed sharing if
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you are feeding your baby in bed and you
16:33
feel sleepy please let your nurse or
16:35
support person know so that they can
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help you hold your baby when you are
16:40
finished feeding place your baby into
16:42
the bassinet so that you both can have a
16:44
restful safe sleep after the birth it
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will be helpful to find ways to make
16:50
your baby feel comfortable lying alone
16:51
the best net weather awake or asleep
16:55
while you’re in the hospital we will
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teach you how to help your baby feel
16:59
comfortable sleeping alone in the
17:00
bassinet will also teach you how to make
17:03
her sleep time the safest to help
17:05
prevent a condition called SIDS or
17:07
sudden infant death syndrome having your
17:11
baby sleep on his or her back is one of
17:13
the best ways to prevent SIDS it is also
17:17
really important to make sure there are
17:19
no loose blankets pillows or stuffed
17:21
animals in your baby’s sleep space
17:23
you and your partner need to sleep
17:25
whenever your baby sleeps this is
17:27
especially important during the daytime
17:29
so you can be more rested at night for
17:32
nighttime feedings
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[Music]
17:39
remember to limit visitors during the
17:41
daytime so that you can get your sleep
17:43
police ask visitors not to come in
17:46
between 2:00 and 4:00 in the afternoon
17:47
so that everyone can have some quiet
17:50
time and a nap we have signs that you
17:53
can put up on your door when you are
17:54
taking a nap so that no one interrupts
17:56
your sleep it’s a good idea to ask
17:59
visitors to wash their hands before they
18:01
hold your baby baby’s immune systems are
18:04
not well developed yet so they are at a
18:06
high risk for getting infections as we
18:09
mentioned earlier breastfeeding helps
18:10
babies develop their immune system and
18:12
can help fight off infection but they
18:15
are still at risk of getting sick we
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also recommend that you do not allow
18:19
anyone with a cough cold fever or other
18:23
contagious illness to visit you or your
18:26
baby in the first few months of life one
18:34
other important thing to know about
18:36
babies is that they can cry a lot this
18:39
is normal crying is a babies special way
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of saying she or he is hungry
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uncomfortable or stressed about
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something sometimes babies seem to cry
18:48
for no reason at all one of the best
18:51
ways to calm a fussy baby is to put her
18:53
skin-to-skin with her mother or another
18:56
caregiver another way to help calm a
18:58
fussy baby is with swaddling swaddling
19:02
means wrapping the baby in a blanket
19:04
holding a baby close and gently swaying
19:06
rocking or jiggling is also very calming
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having a baby suck on her own hand an
19:12
adult’s finger or a pacifier can help
19:14
calm a crying baby too we do recommend
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waiting on introducing a pacifier
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however until you know that
19:21
breastfeeding is going well as sometimes
19:23
sucking on a pacifier can cause problems
19:26
with how a baby breast feeds it is also
19:29
important to see if your baby is hungry
19:30
first any time it looks like she wants
19:32
to suck babies like a shushing sound
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because it sounds like the noises inside
19:37
the womb you can make us sound like Shh
19:41
in your baby’s ear to help calm her down
19:43
if you have a very fussy baby especially
19:47
one who is hard to
19:48
down it is important to have friends or
19:50
relatives close by who can help if you
19:54
are feeling overwhelmed with your babies
19:56
crying gently place your baby in the
19:58
bassinet and ask a friend or family
20:00
member to help while you take a break if
20:02
you are alone it is also okay to put
20:05
your baby in the bassinet and walk away
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for a while to give yourself a little
20:09
break the bassinet is a safe place and
20:12
it will be okay for your baby to be on
20:14
his or her own for a little while
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remember that it is normal for babies to
20:20
cry sometimes babies cry for long
20:23
periods of time and sometimes for no
20:25
reason at all it is important to know
20:28
that you should never ever shake your
20:30
baby to stop the crying shaking can be
20:33
very dangerous and can cause serious
20:35
brain damage and other injuries some
20:43
parents choose to have their son certain
20:45
sites for cultural religious or personal
20:47
reasons if you would like your son
20:49
circumcised you will be asked to sign a
20:51
consent form and watch a video that
20:53
talks about circumcision and reviews its
20:55
risks and benefits your baby’s pediatric
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provider will make sure your baby’s
21:00
penis and forced skin look healthy and
21:02
that he is healthy enough to have the
21:04
circumcision performed if your baby’s
21:06
pediatric provider does not think your
21:08
baby is ready to have a circumcision
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performed before you go home or a
21:12
provider is not available to perform the
21:14
circumcision we will help coordinate
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this procedure as an outpatient because
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a circumcision is not medically
21:21
necessary some insurance companies do
21:23
not cover the cost of the procedure
21:25
check your company’s policy before
21:27
having your baby circumcised to find out
21:29
whether or not they will help pay for it
21:37
there are a few other activities that
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will happen in the birthing pavilion
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before you go home our secretary will
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come to your room to help you fill out a
21:45
birth certificate we will use your
21:47
baby’s name if you have made a decision
21:49
but a name is not required to complete
21:52
the form you will however need a Social
21:54
Security number for both parents as well
21:56
as your places of birth when it’s almost
21:59
time to bring your baby home we will
22:01
help you set up the first medical
22:03
appointments with your baby’s primary
22:04
care provider if you have not chosen a
22:08
primary care provider for your baby yet
22:10
we can help you pick one soon after
22:12
birth we will need to have a specific
22:14
providers name to set up your baby’s
22:17
first appointments and to include on the
22:19
newborn metabolic screening card so the
22:21
results will go to the right provider
22:23
this is especially important if there
22:26
are any problems on this early screening
22:28
before you go home a clinical resource
22:31
coordinator will meet with you to help
22:33
you identify your discharge needs as
22:35
well as to talk to you about any
22:37
community resources that may be of use
22:39
to you she can help set up a home visit
22:42
with a visiting nurse if there are
22:44
concerns with your baby’s feeding wheat
22:46
or jaundice or if you need to have a
22:48
nurse visit you for any complications
22:50
you may have had either with the
22:52
pregnancy or delivery the Resource
22:55
Coordinator can also help you obtain a
22:57
rental breast pump if that is needed and
23:00
a referral to a good beginnings
23:02
volunteer if one is available in your
23:04
area by law and for safety’s sake your
23:07
baby must ride in an approved car seat
23:10
at all times a nurse will look at your
23:13
car seat to make sure it is an approved
23:15
one we will help show you how to make
23:17
sure your baby fits well in this car
23:19
seat
23:19
we will also help you learn how to use
23:21
it properly the safest place in your car
23:24
for your baby’s car seat is in the back
23:26
middle seat facing to the rear for his
23:28
first year of life if your baby was born
23:31
before 37 weeks gestation we will also
23:34
perform a special safety test to make
23:37
sure that his breathing and heart rate
23:38
remain healthy while in the car seat
23:41
your baby’s nurse and doctor will help
23:44
teach you how to best care for your baby
23:45
and
23:46
discuss any medical problems that your
23:48
baby may have as you prepare to go home
23:51
your nurse will also give you some extra
23:53
discharge teaching much of this
23:55
information can be found in our going
23:57
home with your newborn booklet that we
23:59
developed especially for new parents to
24:01
help them learn how to provide the very
24:03
best care for the new babies it is
24:05
helpful to read through this during your
24:07
stay here in the birthing pavilion when
24:09
you have time congratulations again on
24:11
your pregnancy or birth if you have any
24:13
questions or concerns regarding any of
24:16
the information we have shared in this
24:17
video please be sure to speak with your
24:20
baby’s nurse the birthing pavilions
24:22
Resource Coordinator or your babies
24:24
pediatric provider if at any time you
24:27
have questions about your baby please
24:29
ask your nurse or your baby’s doctor we
24:32
are happy to answer any questions that
24:34
you might have
24:35
welcome to the birthing pavilion and
24:37
newborn nursery
24:39
[Music]
24:42
you
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