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Infants rapidly dissipate heat at birth from large surface and evaporation from wet skin. They need to be dried and wrapped in a blanket immediately. I want them evaluated with-in 15-20 minutes in the nursery by trained staff with proper lighting and equipment and then returned to the mother.
I strongly encourage breastfeeding as early as possible, but want a small amount of sugar water fed initially to assure there are no anatomical problems that would lead to aspiration directly into the lungs.
Although there is a lot of advice about breastfeeding, I like my infants to eat as early as possible and encourage a good schedule of feeding at least 3 hours apart and no more than 10-15 minutes on each breast. The initial milk is colostrum that is high in nutrition and antibodies but low in volume, with good milk supply appearing in 2-4 days.
If you choose not to breast feed, all is well. I still encourage a good schedule. The goal is to be alert and active during the day and sleep well at night, so I do not like my infants awakened to feed.
I watch the infants weight, diapers for voiding pattern, tone, etc. to assure enough nutrition is given. No infant should be allowed to dehydrate.
IMPORTANT: The test and treatments in the nursery are to assure greatest chance of long-term health for your infant. One, we bathe and maintain temperature until weaned to open bed. Two, Erythromycin ointment is placed in the eyes to prevent the infections that in the past caused blindness. Three, the Vit K shot is given and that has totally prevented the Hemorrhagic Syndrome of Infancy and death. And four, a spot of blood is sent to the State Newborn Lab to give early warning of many preventable illnesses. I am NOT flexible about the above mentioned newborn care.
I am flexible about the hearing screen, pulse ox reading, and feeding protocol (within reason). The Hep B Vaccine can be postponed but I do prefer it prior to discharge.
I encourage rooming in as much as you like, except for the few moments I need to do exams.
If any expecting parents would like to meet and discuss any of the above information in more detail before delivery, please call my office to set up an appointment.
Dr. Stephen A. Corontzes