Dr. Benjamin Ho on What All New Parents Should Know

Dr. Benjamin Ho, Medical Director of Texas Children’s Pediatrics Concierge Medicine program

Expert advice for new parents from Dr. Benjamin Ho, Medical Director of Texas Children’s Pediatrics Concierge Medicine program. Part 1 of 3-part article series.

·         Part 1: Planning Your Baby’s Arrival & Hospital Stay

The birth of your first baby is an amazing, unforgettable experience!  I vividly remember the tremendous avalanche of emotions as a brand-new parent.  As you are holding your newborn baby for the first time, a wide spectrum of emotions, from immense joy to profound fear, surge through your body like an electrical current.  Millions of questions run through your mind and it’s sometimes difficult to find answers.  As a pediatrician and father of 3 children, I would like to offer advice and guidance from my unique perspective.

Planning for Your Baby’s Arrival

Before the arrival of your new baby, there will be many things to do to prepare.  From fun things, like buying cute newborn clothes, to the banal, such as ensuring adequate medical insurance coverage, it can be overwhelming at times. 

However, one of the most important things you must do is pick your pediatrician.  Especially during the first few years of life, your baby will get sick often and you will also certainly have many new parent questions.  Your pediatrician is an invaluable resource of information, and it is imperative that you find a doctor whom you can relate well with and who shares similar viewpoints and values as yourself.  And certainly, from a pediatrician’s standpoint, I often feel remarkably close to my patients as if I am a part of their family as well.  For this reason, it is important to interview several different doctors and ask key questions that may include: their experience level, stance on topics like vaccines and breastfeeding, availability, general office policies and if they visit newborns in the hospital.  Your relationship with your pediatrician will be one of the most important relationships that you will have during this time, and it is crucial to invest your time to cultivate it. 

During the first year of life, there will be many standard doctor’s appointments.  After your initial pediatrician’s visit 1-2 days after discharge, you will also be seen at 1, 2, 4, 6, 9 and 12 months of age.  During these visits, you will have the chance to ask questions and review basic newborn topics.         

Hospital Stay

For some people, the hospital can sometimes be a scary place as we venture into the unknown.  However, it does not have to be.  Armed with knowledge and preparation, you can enter the hospital confidently knowing that this is the first step in meeting your beautiful, newborn baby.  Here is a list of some common tests and topics that you will encounter during your hospital stay.

Apgar score

In 1952, Dr. Virginia Apgar developed a scoring system to quickly assess a newborn’s health after birth.  The acronym, Apgar, stands for appearance, pulse, grimace, activity, and respiration.  The baby is evaluated at one minute after birth and at five minutes after birth.  Each attribute is scored from 0-2, with a maximum score of 10.  Please keep in mind that this score is just a general assessment and in no way predicts the future health of your baby

Vitamin K shot

Vitamin K is important for blood clotting and typically low in babies.  Therefore, babies receive this shot immediately after birth to prevent a rare but serious bleeding problem known as hemorrhagic disease of the newborn.  Delaying this shot could increase your baby’s risk for bleeding so do not hesitate to have it given in the nursery.

Eye ointment

Babies will receive an antibiotic eye ointment to prevent any bacterial infections associated with birth.

Newborn screen

All newborns are screened in the United States for certain conditions, such as phenylketonuria (PKU), hypothyroidism, sickle cell disease and cystic fibrosis, which may not be obvious at birth.  If detected early, these conditions may be prevented or treated with better outcomes.  This heel-prick test is done initially in the hospital and usually at 1-2 weeks of age.

Hearing screen

To detect early hearing loss, all newborns receive a hearing screen in the hospital.  A small earphone or microphone in the baby’s ear will test how their brain responds to sounds.  If your baby does not pass the first test, it does not necessarily mean they have hearing loss, and the test will be repeated

Hepatitis B vaccine

Hepatitis B is a serious virus that can be transmitted from mothers to newborns during childbirth and can cause liver damage.  This vaccine is usually given at birth in a series of three or four shots. 

Heart disease

Since 11 out of 10,000 babies are born with heart or circulatory problems at birth, this screening test for critical congenital heart disease is done in the hospital before discharge.  A pulse oximetry sensor is placed on the baby’s hands and feet to detect any possible heart conditions that may not be initially obvious.

Jaundice

When babies appear yellow, it is because of a condition called jaundice.  This appears when the level of bilirubin builds up in the baby.  Thankfully, at low levels it is harmless and can be treated with phototherapy if the level becomes too high.  It is now standard for all babies to have their bilirubin level checked while in the hospital.  Since bilirubin is excreted in stool and urine, it is essential that babies feed as well as possible. 

Feeding

Feeding your baby is obviously important but this can sometimes be difficult, especially with breastfeeding.  As pediatricians, we always recommend breastfeeding first and thankfully, there are usually lactation consultants in the hospital to assist you with this. If the baby is not breastfeeding well and losing too much weight, we also recommend supplementing with formula at times.  Please consult with your pediatrician about the type of formula that is best for your baby. 

Stooling

In the very beginning at birth, you may notice a black, tarry stool, known as meconium, which your baby may have in the first 24-48 hours.  This is normal and will gradually transition to a yellow, seedy stool afterwards.  Your baby will usually stool many times throughout the day.

Circumcision

Although this procedure is not mandatory, this practice, which is the removal of the foreskin of the baby’s penis, is generally done in the United States.  Many parents elect this for medical, religious, and cultural reasons.  Please consult with your pediatrician about the possible risks and benefits of this technique to see if this is right for your family.

General Advice

The birth of your first baby is undoubtedly a life-changing event.  Most parents stay 2 days after a vaginal delivery and 3 days after a cesarean delivery.  Although your baby will need many things and moms need time to recover, there will also be plenty of down time.  My advice is to take time to rest yourself.  When expecting parents ask me for first-time advice while in the hospital, I always advise them to take advantage of the newborn nursery.  Don’t be afraid or feel guilty about leaving your baby in the nursery for a period of time so that both parents can rest peacefully.  There will be plenty of things to do when you get home, so try your very best to get as much rest as you can to prepare for your amazing journey with your little one.

Learn more about Dr. Benjamin Ho and Concierge Medicine at Texas Children’s Pediatrics.

Check back in for the Part 2 of Dr. Ho’s series, where he discusses Basic Medical Expectations and Sleep.