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Old 02-02-2012, 07:17 PM   #11
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Re: What (natural) choices/options do I have with a hospital birth?

Just be very very verbal! Let them know what's going on. Hopefully your staff will be supportive.
They can't force anything on you!

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Old 02-03-2012, 05:44 AM   #12
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Re: What (natural) choices/options do I have with a hospital birth?

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You can decline the PKU. It's actually not accurate if done on breastfed babies before the mom's milk comes in and since that can take up to 5 days, doing a PKU before they leave the hospital is not an accurate measure of if they present with some of the symptoms. The best thing to do is get it done at the ped or come to the hospital lab about 24 hrs after your milk comes in. They do it before discharge to cover their butts, but if you read the literature they hand out, it even says it's not accurate to do it before the mom's milk comes in.
And even though it is a "law" in my state, you still don't have to do it.
I would do the PKU before you go, some things can be caught before milk comes in, and if your baby has one of those (rare) disorders, they should not breastfeed (depending on the disorder, the PKU tests for a gazillion things). If you decide not to do it until your milk comes in, and then things get busy, and you don't do it right away your baby could have permanent neurological damage. I would not advocate that women don't get the PKU in the hospital. If you want to get it in the hospital, and then for a more accurate result redo it after your milk comes in, I think that is a viable option. But just because it is not as accurate before the milk comes in, does not mean that the entire test is invalid.

http://www.nlm.nih.gov/medlineplus/e...cle/007257.htm

Also, I was looking for some info about inaccurate results before milk comes in and I'm not finding reputable information. Just stuff from biased places like gentle birth and so on. I'd like some info and stats on that.

Do they do the newborn screen twice now? Dh's working so much I never see him anymore, so I can't ask him.
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Old 02-03-2012, 06:52 AM   #13
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Re: What (natural) choices/options do I have with a hospital birth?

I think having a doula is a great idea- sometimes you can even get a student doula for free or at a lower cost- you just have to look around and find one you like and that works well with you. That way you have an advocate for your wishes there in the hospital.

Also, it is important to remember that if you don't like a nurse ( one that is taking care of you or your baby) you can have them replaced. My doctor was awesome when it came to me having a natural peaceful birth in the hospital- the only problems I had were with the nurses. Just remember that they can be replaced. You are paying them and if they aren't delivering the type of service you want then you can find a nurse who will be more supportive of you.

All hospitals have rules that they say you must follow but in the end it is 100% up to you as to what interventions you are willing to allow.
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Old 02-03-2012, 10:56 AM   #14
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Re: What (natural) choices/options do I have with a hospital birth?

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I would do the PKU before you go, some things can be caught before milk comes in, and if your baby has one of those (rare) disorders, they should not breastfeed (depending on the disorder, the PKU tests for a gazillion things). If you decide not to do it until your milk comes in, and then things get busy, and you don't do it right away your baby could have permanent neurological damage. I would not advocate that women don't get the PKU in the hospital. If you want to get it in the hospital, and then for a more accurate result redo it after your milk comes in, I think that is a viable option. But just because it is not as accurate before the milk comes in, does not mean that the entire test is invalid.

http://www.nlm.nih.gov/medlineplus/e...cle/007257.htm

Also, I was looking for some info about inaccurate results before milk comes in and I'm not finding reputable information. Just stuff from biased places like gentle birth and so on. I'd like some info and stats on that.

Do they do the newborn screen twice now? Dh's working so much I never see him anymore, so I can't ask him.
I don't know. This was my 1st hospital birth in 12 yrs (previous 2 were at home) and I refused it in the hospital, which I will this time as well and have it done at 1-2 wk appt.
The March of Dimes website states that some experts recommend that if the PKU is done within 24 hrs of birth that they be re-tested at 1-2 wks of age.
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Old 02-03-2012, 12:28 PM   #15
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Re: What (natural) choices/options do I have with a hospital birth?

The March of Dimes does in fact recommend that the PKU be repeated if done as <24 hours because there is a slight chance (mostly depending on which test is used) that a baby might be missed who does in fact have an error of metabolism.

However, they absolutely do not recommend waiting to be screened until 1-2 weeks of age. It is imperative that as many children as possible are screened and the missing enzyme be recognized as early as possible. Babies with PKU can live healthy lives, but the longer PKU goes unrecognized, the longer permanent brain damage continues. The March of Dimes also stongly recommends that a diet low in phenylalanine start by 7-10 days after birth.

PKU has nothing to do with breastmilk. PKU is caused by a missing enzyme that prevents the body from breaking down the specific protein phenylalanine.

In most states the newborn heel prick tests for a wide variety of errors in metabolism. Perhaps there is another screening that is part of these tests that is changed by consumption of breastmilk. However, this does not make logical sense to me. If your body is missing the genetic material to produce an enzyme, no amount of breastmilk will change that. And, all babies are tested - regardless of whether they are breast of formula fed. I would be very interested in seeing the research.

I honestly, cannot think of any reason to avoid the newborn screenings in a healthy newborn. So much permanent damage can be done to baby if these errors are not discovered early.
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Old 02-03-2012, 12:38 PM   #16
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Re: What (natural) choices/options do I have with a hospital birth?

To the OP, I agree with the pp who said that they recommend talking directly with the people invovled, rather than writing up a big plan and passing it out to everyone. I would also recommend taking a birthing class at the hospital so that you can get a feel for what their norms are.

I live in central Ohio and would not normally think of this area as natural medicine friendly. However, most of the things you want were simply the standard of care. Certainly, it depends on the health of mom and baby, but I would expect most of those things to be non-issues.
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Old 02-03-2012, 02:45 PM   #17
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Re: What (natural) choices/options do I have with a hospital birth?

We called the midwife that did my last home birth, and I'm waiting to hear back from her. She sounds like she would be happy to do another home birth with me, even though I've had an OB for my care thus far. I just had a home birth with her last April (delivering my 2nd surro-daughter), and it was wonderful and super, super easy. She basically was just there to observe, and then cut cord and help with baby after. I just LOVED her, and it was an amazing experience.

We took the hospital tour, and it was the same-o, same-o. She told me after birth they would cut the cord, take baby away to be looked at measured and warmed. She said sometimes they allow baths in the room if you refuse to have your baby leave for it's bath, and that they prefer to do all the testing stuff in the nursery. I told her we wouldn't need a bath at all, and that I would prefer to have the cord clamping/cutting delayed for a while. She went on about how that is 'questionable' as a good thing. She mentioned they use to squeeze blood down the tube and "rush" it to the baby, and then it would create too many blood cells. Well.. I said "wait" to clamp the cord, not "rush the blood in", and DH pointed that out to her. The lady giving us our tour was the Lactation Consultant, but she must be very involved based on all she knew and 'did' besides just LC advice.

She said she has been there for a LONG time, and there was ONE time a lady gave birth standing up next to the bed, because the OB "let" her. They have a tub, but you can't deliver in it, so you get out way before pushing, and have to be on the bed for pushing. They did have birthing balls, and stuff. It 'seemed' more natural, but yet... not. So I get a birthing ball, but I still have to deliver on the bed with my feet in stirrups.. yay.

SO... we are going to see how much the midwife would charge, and most likely do a home birth. I still want DD to have all the testing done she needs, so we will schedule an appointment with the pediatrician now so we have that set up. Do you just call a peds office and ask for an appointment? How would this work? I have never done this before, because with DS we just kept whatever pediatrician came in at the hospital to see us when I delivered.
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Old 02-03-2012, 03:11 PM   #18
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Re: What (natural) choices/options do I have with a hospital birth?

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Do you just call a peds office and ask for an appointment? How would this work? I have never done this before, because with DS we just kept whatever pediatrician came in at the hospital to see us when I delivered.
Do you have a pediatrician? If so, I would just call the office and talk with the doctor or nurse (I would avoid the MA if possible) and explain that you are having a baby and would like to have them perform all of the newborn exams/screenings. Ask them their procedure for scheduling this type of appointment.

If you don't have a pediatrician, I would ask friends for recommendations and see if you can find a couple who are on your insurance, have openings for new patients and are recommended by people you know and trust. Then, I would call the offices and set up a meet and greet and see if you can find one who you believe would fit your needs.
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Old 02-03-2012, 03:36 PM   #19
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Re: What (natural) choices/options do I have with a hospital birth?

Jennifer, there are disorders the newborn screen tests for that would require the use of special formula. I would have to do some research to find out which one(s), but I remember dh took care of one baby once whose newborn screen came back positive for something or other, and they had to use a rare prescription formula. The insurance covered it, but he had to find it, and I remember he was frustrated about that, but he really needed to find it to get the insurance stuff in line so Tricare would pay for it. It was super expensive. It's rare, but happens, and thankfully there is a screening test for it.
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Old 02-03-2012, 03:52 PM   #20
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Re: What (natural) choices/options do I have with a hospital birth?

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Jennifer, there are disorders the newborn screen tests for that would require the use of special formula. I would have to do some research to find out which one(s), but I remember dh took care of one baby once whose newborn screen came back positive for something or other, and they had to use a rare prescription formula. The insurance covered it, but he had to find it, and I remember he was frustrated about that, but he really needed to find it to get the insurance stuff in line so Tricare would pay for it. It was super expensive. It's rare, but happens, and thankfully there is a screening test for it.
I'm sorry if I wasn't clear. My comment was related to the pp who said that it's better to wait 1-2 weeks to do the PKU test. Whether a mom's breastmilk is in has nothing to do with the PKU test. If baby doesn't have the necessary enzyme, they don't have it. Colostrum, breastmilk or formula won't change that inborn deficiency. If baby has PKU it is imperative to find out asap so that they can receive a diet that won't cause them to have brain damage. There are definitely special formulas that baby could take that would prevent permanent mental retardation and waiting a couple of weeks to get tested means a few weeks without the proper diet while permanent damage is taking place.

Unfortunately, there are websites out there spouting misinformation and leaving the impression that the heel stick used in the NBS test is the equivalent of torture. I know not everyone feels the same way I do, but I would much prefer my 24 hour old baby have a couple of minutes of discomfort to make sure that he doesn't wind up with brain damage or dead due to a treatable inborn error in metabolism.
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