Newbie questions - cord clamping, Hep vaccine and baths...

ally2011 · January 2013

Hi Ladies,

I am working on my birth goals with my doula and need to make decisions on the following things....I am wondering if any of you have any experience one way or the other that you might share or why you chose one way or another. Thank you in advance.

1. Hepatitis vaccine? Vitamin K? Eye stuff? Pros/cons? When can they do if not at birth?

2. Delayed bathing? How long? What are the benefits/downsides?

3. Delayed cord clamping? How long? Doula thinks best to wait until placenta is delivered if possible.

I am delivering at a hospital if that changes anything.

Thank you so much for your advice ladies. Also, if there are any great websites for researching these things please share.

I hope everyone has a great night.

KateLouise · January 2013

1. I'm in NZ hep B and eye ointment are not routine here, so I never considered it. We chose to do Vit K as we felt the benefits outweighed the risk plus DD2 was pretty badly bruised after her birth.

2. Here it is standard to delay bathing, and with DD1 we had to beg staff to show us how to bathe her before we left the birth centre 2 days after she was born.

DD2 we didn't bathe for at least a week, except to keep sponge her face/eyes.

They really just don't need it. Although if they do a poo explosion, it can be easier to just dip them in a bath or shower.

3. DD1 it was a few minutes. DD2 was at least 10minutes.

There's a bit of back and forth with delayed clamping that it provides extra nourishment to baby. But some feel it increases the chance of janudice.

Both my babies had jaundice, but I will never know if when the cord was clamped played any part in that. They didn't require treatment, I was just encouraged to BF often and get them in the sunshine.

sthomas1222 · January 2013

1. Hep can be done at the first pediatrician appointment as far as I know. The eye antibiotics and Vit K are not essential but highly recommended. Plenty of articles out there about both pros and cons. I'm all for them personally b/c the side effects are minimal. But we will be delaying them until at least 2+ hours after birth so we can bond. Hep shot can also be delayed until that time or later.

2. Not sure about this one. When I did my L&D rotation in school the first real bath was not til hours later. Again, not something that has to be done ASAP. The only "pro" I can think of in delaying it is allowing baby to be able to stabilize their temp post birth. I personally want to give the first bath so I'll do it when I get around to it.

3. We're delaying til the cord stops pulsating. Sometimes that's when the placenta is delivered, sometimes sooner. What matters is that it's stopped pulsating, b/c that signifies all the blood has gotten to where it's supposed to.

tokenhoser · January 2013

1. Hepatitis vaccine?Easy to defer to the first office visit. Little to no benefit to giving at birth (in fact, in my province, they do it in Grade 6).

Vitamin K? I did this and will do it again; it prevents uncontrolled bleeding and you don't always know a baby needs it until it's too late. Some people will find you some longshot drawbacks, but I've never seen anything more than a conspiracy theory.

Eye stuff? Did this, but delayed it for about an hour to cuddle and breastfeed.

2. Delayed bathing? How long? What are the benefits/downsides?

We delayed until mid-morning (he was born at 1 am). Bathing is likely to make baby cold (which leads to over zealous nurses wanting to put him in a incubator). Plus stuff about how the vernix is good for them, and baby and mother both have some primal scent recognition going on. Some people delay longer, but about 8 hours was fine for us. Mostly, I made them wait until DH came back and he learned the bath stuff. I wanted him to be the "expert" in something. Some hospitals require nursing staff to wear gloves with your baby until they are bathed.

3. Delayed cord clamping? How long? Doula thinks best to wait until placenta is delivered if possible.

I just delayed about 2 minutes. From what I read, that provided most of the blood volume. I also delivered on my hands and knees and the cord was too short to move around much, so I couldn't hold him until after we cut the cord. Not cutting until the placenta is delivered is the most extreme delay - ask your doctor, but perhaps be willing to bend a bit.

pdilly2b · January 2013

I had DS in a hospital with a midwife. My main stance on everything was "choosing my battles".

1) We delayed the Hep B vaccine until DS's 2 month appt. I didn't want him getting any shots at birth that weren't really necessary since I think birth was probably stressful enough for him. We could have delayed longer without any downside, other than I wanted him to be roughly on the "normal" schedule so not have to worry about making things up later. We did to the Vitamin K shot, which I felt was very necessary since we had him circumsized. I think even if he was a girl, we would have just because I would never be able to forgive myself if something bad happened that was preventable like that, even if the chance of something bad is really small. We did do the eye stuff - my thinking is that I wouldn't want to stick my finger in my vagina and then wipe my eyes. Not the most scientific or data-driven, but that's my emotional feeling on it. I think the Hep B is the only one of these that can really be delayed - the other 2 are either yes or no, because if you wait, that ship has sailed.

2) We contemplated delaying his bath, but I had been in labor for 36 hours and didn't want something else to deal with being off schedule on or needing to do myself so I let them do it. It was probably 60-90 min after his birth, so I felt like he'd had the vernix on him for some time to get some benefits.

3) We delayed cord clamping until it stopped pulsing. I think it was about 10 min. i can't remember if the placenta was delivered before or after. It all seemed to be happening about the same time. I would honestly make sure your care provider and doula know you want to delay it until at least it stops pulsing and then let them worry about the exact timing. You'll be busy holding your new baby, delivering the placenta, being stitched up, etc.

angelacez · January 2013

I'm not doing eye drops, there is no real reason to. We"ll be doing oral vit-k after breastfeeding and we'll cut the cord when it's done pulsing. There's no real reason before hand to do it. We'll see later on the bath. We're having a homebirth, so all the decisions are ours, thankfully.

bornmommy · January 2013

1. Hepatitis vaccine? Vitamin K? Eye stuff? Pros/cons? When can they do if not at birth? We delayed DSs first hepB until his 2 month well check. We allowed Vit K since newborn are born without it and we have a history of blood clotting problems in my family. We didn't deny the erythromycin (eye goop.) Its a VA state law newborns get it and we felt like it could only help protect against infection.

You can deny ANYTHING, any if its state law. Just do your research and make your decision.

2. Delayed bathing? How long? What are the benefits/downsides? I've never heard of "delayed" bathing but DS wasn't bathed until day 2 because we wanted in room bathing and they kept forgetting. No big deal, we were all gross together.

3. Delayed cord clamping? How long? Doula thinks best to wait until placenta is delivered if possible. We delayed until it stopped pulsing which was only about 30 seconds after birth for us.

I am delivering at a hospital if that changes anything. Shouldn't change anything but make sure you speak with your provider! I birthed naturally in a hospital and it was a great experience.

Thank you so much for your advice ladies. You're welcome Smile

aylafsu88 · January 2013

1. Hepatitis vaccine? Vitamin K? Eye stuff? Pros/cons? Hep vaccine- I did it in the hospital when she was 1 day old. Vitamin K- I did this as it prevents uncontrolled bleeding. I think the benefits outweigh the risks. Eye stuff- I Did this, but delayed it for about two hours so we could cuddle and breastfeed.

2. Delayed bathing? How long? What are the benefits/downsides? We delayed the bath for a few hours. I wanted to cuddle with baby and bond with her. I would have waited a few days but H thought LO needed it since she had a lot of blood and juices on her when she came out. It was great becuase they taught H to give LO a bath and swaddle her. To avoid her getting cold they double swaddled her after the bath.

3. Delayed cord clamping? How long? Doula thinks best to wait until placenta is delivered if possible. I just delayed for about 5 minutes. My OB was OK with that and the chord was long enough that I could cuddle LO on my chest while I was waiting to deliver the placenta.

shortstuff15 · January 2013

KateLouise:
1. I'm in NZ hep B and eye ointment are not routine here, so I never considered it. We chose to do Vit K as we felt the benefits outweighed the risk plus DD2 was pretty badly bruised after her birth.
2. Here it is standard to delay bathing, and with DD1 we had to beg staff to show us how to bathe her before we left the birth centre 2 days after she was born.
DD2 we didn't bathe for at least a week, except to keep sponge her face/eyes.
They really just don't need it. Although if they do a poo explosion, it can be easier to just dip them in a bath or shower.
3. DD1 it was a few minutes. DD2 was at least 10minutes.
There's a bit of back and forth with delayed clamping that it provides extra nourishment to baby. But some feel it increases the chance of janudice.
Both my babies had jaundice, but I will never know if when the cord was clamped played any part in that. They didn't require treatment, I was just encouraged to BF often and get them in the sunshine.

I'll add my anecdotal (sp?) evidence to this on number 3 and then answer the rest. For my first we did cord clamping right away and had bad jaundice. We were 5 points away from being under the bililights. With number 2 we delayed cord clamping for a few minutes (maybe 10?) and had very little jaundice. That doesn't really prove anything and there is no way of knowing what caused the jaundice or not, but it's my little story!

#1 - For baby 1 we did vita K & eye goop because she was a vacuum delivery and the risks far outweighed anything. Baby #2 we did only eye goop and didn't delay it at all. Hep B is not given here until at least grade 5.

#2 - Here it is routine for the first bath to be about 12ish hours after birth so we don't see any point in delaying longer. It is around that time because then baby has a few hours to regulate their temperature. They actually don't bath here until baby has been able to hold a steady temp anyway.

#3 - well I've already answered this one.

kxp004 · January 2013

1) we declined vit k shot, eye goop and hep b shot.... the eye goop just didn't seem necessary since its really to prevent infection due to STDs the mother might have... DS was not circumcised since that was also an unnecessary procedure in our opinion, so no vit k although I believe you can request a half dose... so you might check on that... hep b we won't be getting until much much later, like 12 years old...

2) we did a birth center water birth so I guess DS got a birth as he was born lol... we went home that same night and he took a bath with me almost everyday after... he seemed to actually enjoy it though he was submerged with just his face above water... he got very calm and smiley; however you are in a hospital so I'm not sure how you could swing that one... I would definitely want to be the one doing it so maybe you could delay until you're up and moving...

3) DS probably had his clamped when it stopped pulsing around 5 minutes later...

Haley.Beth · January 2013

1. Hepatitis vaccine? Vitamin K? Eye stuff? Pros/cons? When can they do if not at birth?
I declined the Hep B until her 2 month appointment and her full set of vaccines. I didn't feel the odds of my newborn contracting it were high enough to justify sticking her with another needle. I did get the vitamin k because I had a long, pitocin-augmented labor. With #2, I'm planning a home birth and unless something goes wrong, I probably won't get it this time. The eye goop I declined because I know for a fact I have no diseases or infections in my vaginal canal (though the hospital went against my wishes and still put it on her for us to wipe off, but that's another story).

2. Delayed bathing? How long? What are the benefits/downsides?
We didn't actually bathe dd until her cord fell off (around 5 days old). She didn't need a bath. The vernix covering newborns protects and moisturizes their skin. Before her cord fell off, we gently wiped her with a wet cloth when it was needed.

3. Delayed cord clamping? How long? Doula thinks its best to wait until placenta is delivered if possible.
When I had dd, the hospital wasn't very natural-friendly, so this didn't make it close enough to the top of the list for us to fight for. With #2, I will delay the cord clamping until it stops pulsing, whenever that happens. At that point, the baby has received any benefits it can get from cord clamping.

MamaMcCleary · January 2013

All of this, we will be delivering at a birth center. We are not doing the Hep Vaccine until later (2mos check up) possibly opting out of it all together it possible.

I want to be the one giving the baby its first bath, so basically whenever i feel up to it.

The cord will be cut after done pulsating. Some areas need forms filled and signed stating your refusal of vaccines but your midwife/doula should be able to tell you what you need to do.

GOOD LUCK

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