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Your New Baby: After the Birth - Choosing a Pediatrician, Postpartum Checkups

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Choosing a Pediatrician

If this is your first baby, you will need to find a pediatrician to care for her throughout her childhood. There are many fantastic, experienced doctors around, but you’ll need to do some homework to ensure that you find someone who shares your approach to health and well-being.

  • Ideally, you should begin the search in the final months of pregnancy; but even at the last minute, your caregivers at the hospital or your own doctor should be able to recommend a pediatric practice

  • Ask around—personal references from friends are a great way to start

  • Check with the Federation of State Medical Boards (FSMB) before you visit a doctor to check that his or her record is clear of disciplinary actions

  • He or she should be knowledgeable about child development and illness prevention, and able to answer your questions fully

  • Look for an open mind—you will have your own ideas about how to deal with minor health problems; it’s helpful for a pediatrician to share some of your views, and provide different perspectives on other issues

  • Warmth, compassion, and understanding are essential

  • Check that your insurance covers the pediatrician you want to use

  • Interview all the prospective candidates

  • If there is more than one office or your pediatrician has partners, will you always have access to him or her?

  • Check out the office—is it clean, friendly, and appropriate for babies (look for books and toys)? Are the staff helpful and friendly? Are there separate areas for well and sick kids?

  • Check the office hours—If the office closes early and on the weekends, it might be impossible to schedule appointments that work for you

  • Ask how middle-of-the-night illnesses and emergencies are handled

  • Above all, is this pediatrician someone you can trust to steer your baby through a healthy childhood, and make the right decisions for him? Go with your instincts on this one…


Postpartum Checkups

Your baby will be examined immediately after the birth, and again before you are discharged from the hospital. If you deliver at home, your baby will be checked by her pediatrician. Your health is equally important, and you can expect regular examinations as well as a postpartum checkup with your doctor.

Your baby

  • The Apgar test is performed at one and five minutes after the birth; this rates your baby’s skin color, breathing, heart rate/pulse, movement, and crying/response to stimuli, with a total possible score of 10

  • Your baby will be weighed and measured, and the circumference of her head will be noted

  • Your baby’s mouth will be checked for signs of thrush and her eyes will be checked for any infection

  • Your baby will be given a vitamin-K injection to help her blood clot

  • A nurse will put antibiotic ointment or drops in your baby’s eyes within an hour after birth—these are required by law to prevent eye infections

  • A heel-prick blood test within the first 48 hours will test for genetic conditions and an enzyme deficiency (phenylketonuria) that can cause mental retardation if left untreated; the number of screenings varies between states—some experts recommend screening for 30 major genetic disorders

  • Most babies are also screened for MCADD, a rare condition that affects the way the body converts fat into energy

  • Within 48 hours your baby will be given a head-to-toe assessment to check for problems or conditions in her: head, ears and eyes, mouth, skin, heart, lungs, genitals, hands and feet, spine, hips, and reflexes

  • Your baby will be given a hepatitis B shot within 48 hours of the birth

  • A nurse or doctor will regularly check your baby’s skin and color (for signs of jaundice) and ask about the regularity of her wet and dry diapers

  • Your baby’s cord will be checked to ensure it is drying adequately

  • If you and your baby leave the hospital within 24 hours of birth, you may be asked to return in a week or two to finish testing; in some states, all newborns must have the tests repeated at the hospital after two weeks

  • If your baby is born at home, your pediatrician will handle the tests—in your home following delivery, and some at a hospital or her office

  • After 2–3 days, your baby will be given a checkup by her pediatrician; her hearing may be screened—possibly twice, if she does not respond as expected (often due to tiredness or distress)

  • Her hearing may be checked again at later checkups

You

  • Your doctor will check your uterus to be sure it’s firm, and that there are no retained products of the birth

  • Bleeding and discharge will be assessed

  • Your blood pressure will be checked

  • A vaginal examination may be offered if there is abnormal bleeding, problems with vaginal tears, unusual pain, or if you had an episiotomy

  • Your blood will be checked if you were previously anemic

  • You’ll need to confirm that your bladder and bowels are functioning well

  • Your urine may be taken to test for kidney function and rule out infection

  • Your cesarean scar or perineum will be checked

  • Breastfeeding will be discussed

  • You’ll be asked about your emotional health and mood, to ensure that you are not at risk for, or suffering from, postpartum depression

  • At six weeks, you’ll be given a full checkup with all of the above being covered again; by this time, bleeding should have stopped, and your uterus should have returned to its normal size

  • If you are not immune to rubella (German measles) and were not given an immunization before you left the hospital, you will be offered one now

  • The postpartum or six-week check marks your official discharge from maternity care, unless you have complications, which need further visits

  • You may be offered a Pap test at this checkup, and discuss contraception; if you choose to use an IUD, it may be inserted now

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