Before your Baby is Born: Things to Consider
Please give good consideration to Breastfeeding, which is provides an essential part of the baby’s immune system and development. See the Breastfeeding page for more info.
Everyone who will be caring for your newborn should have a flu shot. I also recommend a TdaP (Tetanus with Pertussis) shot for the parents, as your child will be at risk for Pertussis/Whooping Cough, which can be severe in babies up to about 6 months. These are especially important if you are thinking about delaying vaccinations. The only way your breastfed baby can benefit from your vaccinations is if you are up-to-date!
Even before your baby is born (i.e., if you are not yet a patient), you can get vaccinations at our office without an appointment.
Circumcision is an important decision that is largely cultural and religious. Since it is a surgical procedure, you will want to understand the risks and benefits. It may be performed by the Obstetrician after birth in the hospital, or can be done by a Urologist later. The AAP (American Academy of Pediatrics) says that this surgery is not medically necessary and some insurance plans don’t cover it.
I highly recommend Birthing Classes which are offered all around town. Even the one-day Saturday course is helpful. Bring a significant other -- and remind them they must help!
Cord Blood Banking is a decision that must be made before birth. It is fairly simple, but somewhat expensive. The company provides a kit that the OB uses to collect the blood from the placenta, which is otherwise wasted. This blood is filtered to collect the “CD34” cells, which are blood stem cells. Placenta cord blood can provide millions of stem cells, which could be a match for any family member in the future. These may be needed in the case of a blood cell cancer (leukemias or lymphomas), sickle cell, or aplastic anemia. Banking cord blood is really banking on potential and the future of medical technology (which is unknown). There is only a small possibility that they would be needed or useful. At this time, blood stem cells cannot be “turned back” to re-grow brain cells, or nerve cells, or any other type of tissue. However, technology is always changing, and who knows what the future holds! If you are looking into the cost, Cryo-Cell is a reasonable company to consider: www.cryo-cell.com.
Choosing a Pediatrician
There are many factors to consider in this very important choice. Insurance coverage (see this list of insurers we accept), small verses large practice, accessibility, doctor’s style and demeanor (click here to learn more about Dr. Stiles), location, and the service you receive from the staff. I believe that as a Med Ped doctor I can offer a great deal more than many other doctors (see “What is Med Peds?” for more info). What a small practice may lack in office hours, we make up for in accessibility (although we have very good hours; see them here).
Choosing a small practice is a special decision. We hope that the following advantages will make us the right choice for you:
Calm, quiet atmosphere.
Being able to talk to someone you know when you call
A doctor who is easier to talk to..
Staff that know you.
Staff that care about you.
Continuity of care (in other words, you won’t see a different doctor each time you visit).
Having Your Baby
If you have your baby in a hospital, the staff there will ask you who you want for your Pediatrician, and they will call them. You do not need to call the Pediatrician yourself.
You are welcome to a free visit and consultation with Dr. Stiles before your baby is born, but it isn’t required. Dr. Stiles usually discusses the topics mentioned above at this meeting, and also the decisions you should make regarding breastfeeding, circumcision and cord blood banking.
If the Pediatrician goes to that hospital, he or she will come see the baby while you are there. Dr. Stiles goes to Methodist Germantown and Baptist Women’s and Children’s. If your Pediatrician doesn’t go to your hospital, the staff there will assign one for you during your stay.
You can always choose any Pediatrician after you leave the hospital. However, it is often difficult to get an appointment quickly if you do so.
After Birth: When to See your Pediatrician
A newborn needs to see the doctor within 3-5 days if he or she is breastfeeding, and within 2 weeks if not (this is from the “Guidelines on Prevention of Neonatal Jaundice”). When discharged from the hospital, the staff there will tell you when to see your Pediatrician. If you didn’t see Dr. Stiles in the hospital, just tell our front desk when you call that you need to be seen, and when, because you are just getting out of the hospital.
Babies delivered at home with a Nurse Midwife will be cared for by the Midwife through the first weeks of breastfeeding. These mothers and babies are always welcome to come and get further information as well as help with breastfeeding.
New Parents Information – When to Call
Click here for information on calling us after office hours.
The New Baby’s First Doctor Visits
The first visits are more frequent for Breastfed babies, and Dr. Stiles can assist with all aspects of care. We hope to help the baby regain birth weight by 2 weeks. For all babies, there are Well Child visits at: 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, and then annually. Sick visits can’t replace these Well Child Checks because there are so many things to discuss.
Vaccinations (more info here)
This is a huge and sometimes contentious topic. If you have concerns about Vaccinations, be sure to start discussing them before they start (which is at the 2 month visit).
Foods for Your Baby
See our handout on this topic. Babies can start with rice cereal (fed with a spoon) at around 4 months if they can hold their head and trunk. Starting baby food is a process that takes a while to become “nutritious” as the baby begins learning to eat from a spoon. There is no benefit to putting cereal in the milk bottle. The AAP recommends delaying to 6 months if there is a history of problems or a strong family history of allergies, asthma or eczema.
Babies and Sleep
Here is a handout that summarizes a very good book on babies and sleep. Developmentally, I think that between 6 months and a year of age is the best time to work on getting the baby to sleep through the night in his or her own bed. Around 9 months you are dealing with a phenomenon known as “Object Permanence,” which can make it more difficult. After a year you may be dealing with “Separation Anxiety” and weaning from the breast, which can disrupt sleep.
I was a co-sleeping Mom and loved it. It is a beautiful experience and most of the world co-sleeps or has a “family bed”. It definitely has a place and can be very helpful in the first 6 months of breastfeeding when the baby can’t sleep through the night, yet Mom has to go back to work. Please discuss with your doctor the rules of safe co-sleeping. However I believe that prolonged co-sleeping can cause sleep difficulties for kids that can last until adulthood. The problem is that a child that can only fall asleep with another person and may not be able to fall asleep on his or her own. This “sleep disorder” has even been given a name by sleep Neurologists.