The Washington Hospital Birthing Experience WHAT TO EXPECT AND HOW TO MAKE IT MEMORABLE
Your Pregnancy Learn as much as you can about pregnancy, breastfeeding and caring for a newborn. The more you know about breastfeeding and about caring for yourself and for your baby, the easier it will become because you will have a better idea of what to expect. ■■
Read books and watch DVDs.
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Take prenatal and breastfeeding classes at the Washington Maternal Child Education Center (MCE) located at 3569 Beacon Ave. in Fremont
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Prenatal Care/ Smart Start
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Prepared Childbirth
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Refresher class for Prepared Childbirth
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Cesarean Section
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Becoming New Parents
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Big Brother/Big Sister
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CPR for infants and children
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Prenatal Breastfeeding
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Back to work Breastfeeding
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Mastering Multiples
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Prenatal Exercise
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Infant Massage
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Baby and Me
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Birthing Center Tours
Call (510) 818-5040 for
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Post Partum Exercise
class information and
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Sign, Say & Play
breastfeeding support.
Create a Support System for Breastfeeding YOUR FAMILY Share the books, brochures and DVDs you receive with the people who will be helping you when your baby is born. As your support person learns more about breastfeeding, he or she will be more supportive and more prepared to help you once your baby is here. COMMUNITY SUPPORT ■■
Maternal Child Education (MCE): 510-818-5040
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La Leche League (LLL): 510-496-6009
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Nursing Mothers Counsel: 650-327-MILK (6455)
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Women, Infant and Children Program (WIC): (510) 595-6400 YOUR HEALTHCARE PROVIDER IS YOUR CHOICE Find a pediatrician who is supportive of breastfeeding. Let your doctor know that you plan to breastfeed.
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Plan to Exclusively Breastfeed Exclusively breastfeeding means your baby is receiving your breast milk and nothing else. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months and continuing to breastfeed when other foods are slowly introduced until at least one year of age. Having your baby breastfeed frequently and whenever he/she wants is extremely important for establishing a good milk supply. The first several days of breastfeeding “sets ” your milk supply. It’s as if your baby is calling in her order for just the right amount of milk she needs to grow. Using formula in the early days may set your milk supply at a lower volume than your baby needs. If you set your milk supply at a higher volume, it will be easier to maintain your supply after you begin to pump if you are returning to work or school.
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Plan to Limit Your Visitors After the first day, babies usually breastfeed at least 8 to 12 times or more every 24 hours. Remember, there will be plenty of hospital staff coming in and out of your room: your nurse, your doctor, your baby’s doctor, the lactation consultant, the birth certificate authority, the photographer, food service workers, housekeeping and others. By limiting your personal visitors, you can cut down on distractions, leaving plenty of time for breastfeeding, bonding, and important skin to skin contact.
To avoid uncomfortable moments with visitors: • Ask them to knock and wait for a reply before entering your room • Ask some of them to call instead of visiting you at the hospital or wait to visit you once you and the baby are home. • Tell them you will be breastfeeding often and having skinto-skin care with your baby between feedings. • Tell them they may not be able to stay long if you need to feed the baby soon after they arrive
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Practice Skin-to-Skin Care Skin-to-skin care should be practiced immediately after birth for at least one hour and then as frequently as possible afterwards. Skin-to-skin care is when you keep your baby dressed in only a diaper and cap against your bare skin with a blanket covering your baby’s back. Your significant other should hold the baby skin to skin too! Newborn procedures will be done with your baby on your chest rather than taking your baby away. Babies kept in skin-to-skin care are more likely to breastfeed well and breastfeed often which is important for establishing your milk supply. Holding your baby skin-to-skin is the best thing you can do for breastfeeding success.
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What to Expect After Your Baby is Born ■■
The following immunization/medications: ●
Hepatitis B vaccine
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Vitamin K injection
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Erythromycin eye ointment
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Bath after at least one hour of skin-to-skin contact
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Exam by the pediatrician
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Hearing screen
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Pulse oximetry screen
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The following blood tests after 24 hours of age ●
Bilirubin level to test for jaundice
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California Newborn Screen to test for a variety of hematologic, metabolic, and endocrine disorders
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You and Baby Will Room Together at All Times
Rooming in provides you the opportunity to learn your baby’s early hunger cues so that you can feed him/her at his first signs of hunger. Early hunger cues include lip movement, finger or hand sucking, mouth opening, arm movement and stretching, and head turning towards you. Fussing and crying are later hunger cues. Don’t wait until your baby cries before offering your breast. A crying baby has a hard time latching. If your baby has to be taken out of your room for a procedure, send your support person with your baby to calm her. FEEDING YOUR BABY AS SOON AS POSSIBLE AFTER DELIVERY Your baby will be alert and interested in breastfeeding for the first hour or two after delivery. Tell the hospital staff that you wish to breastfeed your baby immediately if possible. If you have an emergency cesarean delivery and are unable to nurse your baby right after birth, tell the hospital staff you want to begin breastfeeding as soon as possible. If your baby has difficulty suckling or latching on at any time, ask for help right away. 8
Feeding Your Baby YOUR COLOSTRUM IS EXTREMELY IMPORTANT FOR YOUR BABY Colostrum is the milk you will make in the first few days after your baby is born. It is often thick and can be clear to yellowish in color. Colostrum coats your baby’s insides and helps prevent allergies, viruses, and infections in your baby. Your colostrum is so protective it’s similar to giving your baby his first immunization. A newborn baby has a very small stomach which can only take small amounts. The “early milk” is the right amount at the right time. Your breast milk volume will increase as the baby’s stomach gets larger. HOW MUCH DO NEWBORNS TYPICALLY EAT? At birth the baby’s stomach can comfortably digest what would fit in a hazelnut (about 1 teaspoon) In the first week, the baby’s stomach grows to hold about 2 ounces or what would fit in a walnut. NEWBORN (FULL-TERM) FEEDING AMOUNTS Day
Feeding Amount
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Few drops to 5 ml (about 1 teaspoon per feeding)
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15–30 ml (up to 1 tablespoon per feeding)
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About 2 ounces per feeding
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About 2–3 ounces per feeding 9
UTERINE CRAMPING IS NORMAL After having your baby, you may experience cramping during breastfeeding. It may feel like menstrual cramps or a milder version of the uterine cramping you experienced during labor. This is your uterus returning to its pre-pregnancy size. Cramping during breastfeeding will lessen as your body recovers. A LACTATION CONSULTANT WILL SEE YOU DURING YOUR STAY Even if you think breastfeeding is going well, it’s a good idea to allow someone to look at how your baby is positioned and latched. This will give them a chance to give you tips to avoid soreness and how to recognize when your baby is hungry or full. If your baby is having difficulty latching, ask for assistance in hand expressing your colostrum into a container or using a breast pump. Using an alternate feeding method (other than a bottle) to feed your baby promotes breastfeeding. If you plan to formula feed your baby, we highly recommend you still give your baby the colostrum or “early milk” to provide important protection that only your milk can give. If this is what you desire, please ask your nurse for help to express or pump.
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Breast Pumps IF YOUR BABY CAN’T BREASTFEED, ASK FOR A BREAST PUMP If your baby is unable to breastfeed for any reason, it is important to begin hand expressing or pumping within 6 hours of delivery. If you think you will need a pump longer than your hospital stay, please let the lactation consultant know. If you decide that you need one after discharge call MCE at 510- 818-5040.
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We Would Also Like You to Know… DEPO-PROVERA’S EFFECT ON MILK SUPPLY Health care professionals commonly give Depo-provera shots, which is a type of birth control. The Depo-provera shot may delay or prevent milk production if given before milk supply is well established. If you would like to use the Depo-provera for birth control, it is advised that you consult with your OB doctor. Many estrogen or progesterone containing birth control pills could affect your milk supply as well. BE AWARE OF FORMULA ADVERTISING Remember, any amount of formula can decrease your milk supply. It is important to exclusively feed your baby at your breast for at least the first 3–4 weeks to get your milk supply well established prior to bottle use. Please be aware that formula manufacturers distribute free formula samples and discount coupons to doctors and hospitals for the following reasons: ■■
Research indicates that mothers who take a formula gift bag are more likely to stop exclusively breastfeeding their babies by 10 weeks of age. Families are then forced to purchase their own formula for the rest of their baby’s first year.
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Often these bags are called “breastfeeding promotion” bags but they still contain formula samples and coupons. Some baby magazines even have tear out coupons reminding you to ask for your free bags at the hospital.
In the first month, just one bottle of formula:
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Can reduce your breast milk supply.
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Lessens the protective effect of your breast milk on your baby
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Can result in premature weaning from the breast
Breastfeeding Support Breastfeeding is the best gift for your baby! Before you reach for formula, reach for the phone and call 510-818-5041 for help. Your breast milk is a gift of health to your baby that lasts a lifetime and you only have one opportunity to give this gift to your baby. Breastfeeding benefits: ■■
Can stabilize your baby’s blood sugar
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Provides protection for your baby’s digestive system
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Develops your baby’s immune system
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Encourages your baby’s first bowel movement
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Helps your uterus decrease bleeding
ASK THE HOSPITAL WHAT KIND OF BREASTFEEDING SUPPORT THEY OFFER AFTER DISCHARGE Washington Hospital offers breastfeeding assistance after discharge through our Maternal Child Education Center (MCE). You can also call your local Women, Infants and Children (WIC) office and ask to speak with a breastfeeding counselor. Breastfeeding may take some practice for you and your infant. Do not be afraid to ask for help as soon as you think you need it. BREASTFEEDING QUESTIONS? Call Maternal Child Education (510) 818-5041 13
Visiting Policy
Dear Birthing Center Patient and Family, The Washington Hospital staff wants to welcome you to the Birthing Center, and let you know that our chief concern is the comfort and safety of you and your infant. Our philosophy is that the birth of your infant should be a family experience. We want you to know that the Birthing Center staff supports your right to have those important to you with you at this time. However, there are a few rules that are in place for your protection and safety. ■■
All visitors must wear a badge at the security station located across from the elevator
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All visitors must be at least 1 year of age (except for siblings of the newborn)
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All visitors must be free of infection
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A responsible adult must accompany all siblings under the age of 12.
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Children are never to be left in the care of the patient or left unattended in visitor areas and must go home by 10pm.
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Your significant other and the brothers and sisters (siblings) of your newborn are welcome at any time during labor and delivery. Other visitors must have the mother’s approval to be present. It is understood that they may be asked to leave, if activities in the labor room warrant this.
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Siblings’ attendance at deliveries is arranged on an individual basis. Both the mother and infant’s physician should agree to your child’s presence. It is strongly recommended that the siblings attend the “sibling preparation class,” so that this is a positive experience for mother and child. An adult, other than the mother’s primary support person, must be present with the children. At the time of delivery, there can be the significant other, the newborn’s brothers and/or sisters (siblings). Other support persons will need to check with the nurse caring for the patient. Those persons unable to attend the birth will be asked to wait in the Amanda room located on the same floor.
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After delivery, in the post-partum period, visitors will need to be limited by you. Remembering this is a time of rest, bonding and instruction for the mother. For the same reason we require that you limit your overnight visitation. UNDER NO CIRCUMSTANCES ARE CHILDREN ALLOWED TO STAY OVERNIGHT OR FAMILY ALLOWED TO SLEEP ON THE FLOOR.
The purpose of these regulations is to insure quality care, comfort and safety for all the patients. We are delighted to have the opportunity to be with you during this very special time. If there is anything that our staff can do to enhance this time, please don’t hesitate to let us know. Congratulations, The Birthing Center Staff
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2000 Mowry Avenue Fremont, CA 94538 (510) 797-1111 www.whhs.com
