Ep 102: Newborn Terms to be Familiar With (Part 4/4)

What started as one episode about perinatal vocabulary, quickly escalated into a 4 part series, but we’re here for it!  In this episode, we discuss newborn terms that aren’t part of your everyday vernacular, but you will hear after your baby arrives.  And just like with the postpartum terms, it’s important to look over these terms during pregnancy (because some of these procedures could be included in your birth plan!).  And because the immediate postpartum can be overwhelming, it’s a good idea to have some knowledge of these terms before baby arrives.

We talk about:

• The golden hour
• Meconium 
• Jaundice
• Newborn metabolic tests 
• Placenta 
• Fundal massage 
• Hemorrhage
• APGAR
• Delayed Cord Clamping
• Newborn procedures
• Vernix
• and more!  

Resources mentioned in the episode:

• Episode 57: Cranial Adjustments with Dr. Martin Rosen 
• Episode 69: Benefits of Pediatric Chiropractic Care
• Dr. Green mom (just use the search tab to look for the newborn procedures we mention)

Transcript

Unknown Speaker  0:03  

Welcome to the alive birth podcast. Do you have both hosts here today? Do a Rachel Dr. Shannon here and today we are talking about postpartum terms for baby. This has turned into a four part series what was originally one episode. But every time we sat down to do this, it has taken too long for us to get through all of the terms and we really don't even have that many terms. It's just some of the terms require extra explanation. And again to I feel like I've said this on some of the other ones. But the point with this is to familiarize ourselves with these terms. Specifically these postpartum ones that we do so we just did postpartum terms for mom. That included a lot of like the definitions of postpartum and matresses and breastfeeding stuff and the mental health aspects. But now we're going into postpartum terms for baby. And both of these two episodes. It's really good to highlight the fact that it's nice to know these things prenatally so that you're not thrown into postpartum and then feel overwhelmed and then don't know what some of these words are. And especially once baby is born, it's like wait, what are we doing? What's the heel stick? What's this? What are we testing for hearing like some of that it's good to know beforehand. So to combat some of the overwhelm that can come from having baby. So today is part four. I think this is the last. The last one I don't know. It's only a page of notes I think will be good. But I'm joined here today with Rachel and we're going to talk about these postpartum terms for baby.

Unknown Speaker  1:48  

Oh, a friend, Dr. Shannon, so excited to continue this conversation with you. I just think it means we have a lot of really important helpful things to share and there's a lot to learn. So we didn't want to rush

Unknown Speaker  2:03  

through some of it like the last one that we were doing like we were really good. We went way more in depth with breastfeeding than thought we were going to but I was like, I'm kind of how do you describe

Unknown Speaker  2:11  

one thing without describing the other thing at all? Like you gotta come out, you just leave it you can't just like leave it as a Word and we really like to, you know, explain and describe and talk in depth and kind of go back and forth. So hey, I think that's worth it. I love that we're on Episode Four and that we still have all the patient notes. Come on.

Unknown Speaker  2:32  

Hello, and welcome to the aligned birth podcast. We are so glad you're here. I'm Dr. Shannon of prenatal chiropractic.

Unknown Speaker  2:39  

And I'm Rachel a birth doula and childbirth educator and we are the team behind the Alliance for podcast.

Unknown Speaker  2:45  

Between us we have experienced a cesarean birth a VBAC hospital births and home birth. Our personal experiences led us to where we are today we share a lot in common.

Unknown Speaker  2:55  

We are friends from high school who reconnected through our work we both changed career paths after the birth of our own children. We line up with talking about health and birth and we are both moms to two young boys.

Unknown Speaker  3:08  

This podcast was created to share conversations and interviews about topics from pregnancy and birth to motherhood and the importance of a healthy body and mind through it all. Our goal is to bring you fun, interesting and helpful conversations that excite you and make you want to learn more.

Unknown Speaker  3:23  

We believe that when you are aligned and body, mind and your intuition you can conquer anything. We hope you enjoy the episode.

Unknown Speaker  3:43  

Before we dive into today's topic, I did want to talk about new opportunity to participate in our show to contribute to our show through direct listener support and you know we've talked about this are beginning to talk about it more trying to get more comfortable with with being transparent in communicating about this and so, you know between the topic research the one on one guest interviews, the recording editing, the posting every week, every week mind you, you get a new episode full of information and resources every single week. You know, this podcast takes time it takes effort that takes resources for us to do this. We're very humbled and grateful for all of our listeners and the reviews and the feedback that we are receiving. It's letting us know that this podcast is making a difference and then it's inspiring people. You know, we want to keep doing this episode or keep doing our podcast and I'm gonna focus on content where we're informing or inspiring and we're entertaining. And then we're being mindful of your time hence why we've separated this topic into four episodes. So that you're not in a four hour TED Talk. One way for us to do this is with direct listener support. Your support would help the show grow and reach more listeners just like yourself and with intentionality inconsistency, which is really important to us we will slowly and surely create a ripple effect that will have a positive and long lasting impact for birthing people and new mamas, new families, you know, and we've tried to make this easy so we set up a link where you can quickly and easily support the show the whole thing takes less than 60 seconds. You can access it at aligned birth.buzzsprout.com it's also linked in our show notes. We're asking for $5 a month but you can contribute as much or as little as you like. Whatever is good for you. We are grateful. If a live birth podcast is a part of your day a part of your work and you love what we're doing. Please visit aligned for that les brown.com and use the link in our show notes as well. Any way you can do it, we appreciate it.

Unknown Speaker  5:48  

Yes, yes be part of our community and join the newsletter. And we appreciate all the support so hurray for today's episode of part four of our postpartum terms. And these are I guess we can even say these are like newborn terms.

Unknown Speaker  6:08  

Postpartum, postpartum, yeah, and baby and baby newborn terms. Yeah,

Unknown Speaker  6:15  

um, because sometimes too. It does it. Yes, it definitely looks different if it's, you know, hospital verse birth versus a home birth in how the care team that is there, the number of people and the equipment that is used and that sort of thing, but some of I mean midwives are also assessing newborns for a lot of the same things that we're doing in the hospital to because we're looking at you know, health and safety on the baby. So, um, and I don't know that our list is really in any sort of order, it kind of is and in my head it kind of flowed with like okay, these are the things I immediate,

Unknown Speaker  6:55  

immediate causes to norm.

Unknown Speaker  6:56  

Yeah, that's was the flow. Yeah. Okay. Yeah, I'm just

Unknown Speaker  7:01  

going on in with the first one. Yeah. So we're going to start

Unknown Speaker  7:04  

with the delayed cord clamping. And we went we had a very good talk about the placenta and defining those terms and how the baby is connected to the mom via percent of via umbilical cord and the whole gotta go listen to the whole episode on that because that was the second

Unknown Speaker  7:27  

one that was part two, we dive into earlier anatomy of the the birth of pregnancy and birth so yeah, if you're like why are we just picking up here explain more. Go bass bar was this part one of pecking listen, and we will be debating on where to put this one. If we should put it there. But this is where we're at. We're delayed cord clamping babies. Yes,

Unknown Speaker  7:52  

exactly. Like baby's already here. And so that's kind of part of it. And so yes, you did deliver the placenta but also that delayed cord clamping. I think this is become more talked about now and I think moms are putting it more on their their birth plan or their birth wishes as far as not that immediate babies here cut the cord like it if it's not so it doesn't have to be done so quickly. You know, it

Unknown Speaker  8:23  

doesn't matter. There's evidence and research that supports it, and then, you know, at a snail's pace, everyone has, you know, hospitals and stuff have caught up.

Unknown Speaker  8:33  

Exactly. So I feel because I know this did that. This did not happen in my world with my hospital births. I think it was very much like it was just the routine of babies born. This is what we do. Right? So I want to what does it mean to with delayed cord clamping? Can you talk about some of the benefits some of the research that's out there, but also what does it mean to wait for white

Unknown Speaker  8:59  

Yeah, so I think a lot of people focus on setting a time limit and that is, unfortunately, because of ACOG American College of Obstetrics and Gynecology, kind of gave it a timeframe as far as being evidence based and beneficial at 60 seconds. What I've learned through my research being childbirth educator and a doula is waiting for yt is optimal. Because if we set a timeframe so what what's happening after the baby is born is the between the placenta and the baby as the umbilical cord and the blood is flowing between the placenta and the baby. And it's regulating and after. After the baby is born. The placenta is also born and begins to stop working but it has served its role it is done. And then that process, baby is getting as much of the blood from the placenta as it needs, right? There's no set quantity. But if we cut the or clamp and cut the cord too soon, you run the risk of depriving baby of important blood volume. And if you clamp and cut the cord at a time where the baby has a excess amount of blood, the neck can contribute back and cause problems like jaundice. It's harder for the kidneys to filter out all the blood and so it can cause jaundice. So that's why waiting for YT says that the baby has regulated as much blood as they need between the placenta and the baby. And white means of the umbilical cord is like juicy supple purplish red. It is like alive at the time of birth. It is like it's pulsing you can touch it and feel. Right. And then when it's done, it's not pulsating anymore. It becomes white gray Placid, like it's Aveo longer there. It's no longer there and this can take anywhere from a minute to five minutes sometimes longer. I see it happening that three to five minute mark, you know, and so, cutting it 60 seconds is considered delayed cord clamping maybe by definition, but we like to use encourage our clients to talk with their either midwife or OB about waiting for white and not putting a timeframe on it and understand the benefits of that. So there's a whole like, I think there's a wait for white campaign like if you go online and look, you can learn more about that. And just having this conversation with your midwife or OB whether you're giving birth at home or hospital definitely see it more supported in the in the home setting and the birth center setting but it can't be accessible at a hospital too. It just takes a little bit more you got to really have those conversations about defining delayed and really just asking for permission before they cut it. So you can like if this means a lot to you, then you can say okay, do not cut the cord without my permission. And then when they say are you ready, you can say is a white. Let me feel it. Let me see it. So you're still staying in that driver's seat here and it's very beneficial for the baby.

Unknown Speaker  12:15  

Yeah, yeah, I think it's you don't have to, you know, but I think it's a good thing to know, understand and kind of go down that rabbit hole with information as well too. With the delayed cord clamping now we've already talked about placenta so placenta is on our list, but we love that we did. But we did a whole bunch of the births term. So but we didn't this was another one Placenta Encapsulation, where we were like, well, let's talk about this in the postpartum like terms for baby because once the babies deliver after deliver placenta exactly, so and this is something else too. It's not for everybody. So you don't have to do it. But it could be worth researching and looking into and I know some of the research out there is a little hit or miss as to how beneficial it is with placenta encapsulation. But what it is is using and nothing is really done with the placenta after the birth. I mean sometimes they'll do if you I guess you can probably donate it to science or you can do some stem cell aspects things with it, but typically it is just trashed and so you could take it, put it on ice in a cooler and then take it to someone who is well versed in how to kind of sterilize clean it, you know and make it consumable for Vermont for whoever just gave birth so I I've talked to some Placenta Encapsulation specialists like in my area, I think it's just like my mom's to know like, hey, it's an option. You can do it. You don't have to they can do a lot of different things with it. They can make tinctures out of it. So you could do something more liquid they can make smoothie cube so you can have it in a smoothie. You can just put into a capsule to where you actually just swallow it. You could I don't know you can make things where you actually like eat it. I don't know you could go it can go on all ends of the spectrum with with this if you want but when I talked to some of the specialists they were talking about how the moms that did consume it they noted that they just had a better healing process a better healing journey and especially related to their mood and their mental health. Now it's not going to be you know, an end all be your cure all for any sort of mental health issues. But um, and I just think it's an interesting thing for for moms to know about. And I've dealt with a lot of moms who have loved consuming and have felt really, really good with it that one place that I know they've been do artwork with it as well too. It's a very beautiful organ. I will say that, do your research with it because there are going to be it's not something that's like managed so there's not like there's certification programs with it. So you are going to want I would recommend finding someone that is certified or to a certain level and has like good manufacturing procedures and practices type of thing. And so as far as like the sterilization aspect and how it's done and handled, and to if there was any sort of infection I think not all placentas are going to be able to be used. So it's kind of being aware of that as well. It has to be healthy tissue for you to be able to consume it. So those are some of the red flag things but it's pretty interesting. Have you dealt with moms that have done this?

Unknown Speaker  15:55  

Oh, yeah, lots to have and lots who have chosen not to. I like to just highlight the placenta is an amazing organ. It has grown specifically to take care and how's your baby for the duration of your pregnancy and I think it's super cool it can, you know, it supports the baby. And when you look at the placenta on the on the fetal side and the baby side, this is the art side like It looks like a tree of life stemming out from where the umbilical cord inserts into the placenta and all the veins coming out of it. And then so like just honoring it, I think it's really about understanding that you ground this organ that you didn't have before of you've expelled it. You've given birth at a stage it's the third stage of labor, you give birth to your baby and then you give birth to your boss and that's that kind of just like the idea of honoring it, even if it's just for a second after the birth like don't be scared to look at it. If you ask your midwife or doctor, we'll give you a tour of it be like this is the maternal side. This is the part that was attached to your uterus. This is the part that where the baby lived and where the sack was attached, and then the umbilical cord and it's just like super interesting. Again, it may not be your thing at all, but just give it a moment. Honor it and know that you have a right to take it and keep it and do what you want with it. If not it can be disposed of fine. Your choice. We're all about understanding your options and that I just don't like hearing that after the fact that like oh, I didn't even know I could do something with it. I didn't even know I could take it or that I was mine. Some people just like to know that and knowing that making again having choice and autonomy over the process, you know, some people will take it home, I just had a client who was going to take it home and planted under a tree, or they're gonna you know, the tree was going to represent the brand new baby there listen to him was going to be in the soil. Oh. Your three year forever. So I thought that was beautiful. I've known people who just keep them in their freezer and that's just like, you know, but I couldn't get rid of it, but I also didn't want to consume it. Cool. Yeah, like, you know, I also spoke with an ibclc the other day and they said that, you know, the placenta, you know, consuming the placenta can be beneficial. It can also inhibit milk production, it can affect people negatively. So understanding like being aware, it's not like you need to set a beautifully like it's not a bad it's not a one doesn't fix everything necessarily. It's not a guarantee. So understand if you do decide to consume it if there's any sort of problems that you're facing or you're not feeling 100% That's one thing you would want to remove. And consulting with a specialist of course, about your options in the safety and, and you know, I did it I consume both of mine. So antidote, Anik, Dodik Lee, I had a positive experience I have most of our clients have, but again, it's not for everybody, but just knowing you can and that, you know, the placenta is pretty cool.

Unknown Speaker  18:47  

I know. I think knowing what I know now I probably would have like, I think I would have like ah, that's pretty me. So but i i Even when you said honor, and I was like Oh, I'm honoring my placenta like I'm gonna honor it now, even though it's been 30 years. Now, it's pretty freakin cool. Yeah. So that's, you know, I encourage people to do that, too. Yeah. Yeah. Yeah, never too late. Um, okay. What else do we have on our list? The

Unknown Speaker  19:15  

next thing kind of an order. I feel like because what would come up after you've delivered the baby in the placenta is the potential for hemorrhage. And so this word comes up a lot. Some people have strong fears around the idea of hemorrhaging and hemorrhaging is like losing a lot of blood at one time, to the point where it could be problematic, right and need further intervention. It is normal to have blood loss after you give birth, but there's degrees of what is considered safe or not safe. And so hemorrhage I would say is up there as far as like, top like things that happen after giving birth, that are problematic, that can you know, cause further intervention. So it is something to be aware of that word hemorrhage, understanding what it means. So when you give birth, baby comes out, when the placenta comes out and where the placenta was attach. There is like a plate size wound. And you bleed right? There's like you have blood loss. The uterus is job is to then contract and clamp down and be firm. To restrict the bleeding. So in a normal, healthy birth, all of that happens and then bleeding stops and slows or is very minimal, so aiming for under 500 milliliters for vaginal birth, and then versus Aryan birth, even if the baby didn't come out through your vagina you still are going to have bleeding and they're still going to monitor your bleeding. But the level of what is considered a hemorrhage is much higher. It's up to 1000 milliliters and midwives and doctors and nurses are trained to measure blood loss in the birth setting. Just by I usually eyeballing it or in a hospital, they'll weigh like certain way pads and waist swabs to kind of determine how much has been lost. And they a good trained professional can eyeball it a lot and tell when it's more than normal or it's trending. It's like going in the direction and they're gonna try and hit it off before it gets to that 500 milliliter part. Like if you're like, 250 300, like they're gonna, they're gonna bet, okay, we're trending that way. Let's be proactive. In the hospital setting, some places do what's called prophylactic Pitocin. That means they're going to give you Pitocin regardless of if you are hemorrhaging. And that's important to know because it's it does happen and then and when you consent to give birth in the hospital, like you're basically consenting to that. So if you care to only get it if you need it, you would want to speak up and say I don't want it prophylactically but because they, I mean, statistically if you get the Pitocin it's going to dramatically decrease hemorrhaging. And so it's like this, it's a insurance policy. But if you don't want that, then you can opt out and say if I need it, then of course I will take it but only if but the Pitocin is synthetic oxytocin, it helps the uterus to contract so if you've had a long labor long pushing stage, the uterus is a muscle, it can be tired, and it may not contract effectively to stop the bleeding. So that's where Pitocin can be really effective. homebirth midwives carry most of them again, you would ask I'm pretty sure they all do carry Pitocin and can give you like a shot of it in your thigh. If it feels like you're going that way. And then that typically does the job and it helps the uterus to contract and slow things down. There are some other homeopathy ways and more like herbal ways to stop and slow hemorrhaging, like in the home birth setting that I'm not so familiar with. But if you're giving birth and if you're planning a home birth, I just encourage you, you can have that conversation with your home birth midwife is like, Okay, I know this is the thing that might happen. How do you handle it? It's not a reason to not give birth at home because all the homebirth midwives I know are trained to handle this. Yeah, I just don't know all of the other ways. Outside of a shot of Pitocin. And I know there are ways and then so multiple conversation. Yes. So just exploring that conversation with your with your provider. Yeah.

Unknown Speaker  23:21  

I think it's important talking about because there's there's degrees of normal and that blood loss after birth is normal. It's just the aspect of how much you know we are bleeding knees. Now. This is interesting. That goes back to sneezing. I know like I'm going to use the next one is fungal massage. And on our notes here, I like how Rachel had written this one down because it's, it says not necessary, and I was like wait, why? Because I definitely remember having this and I did not like it. I just didn't get the feel. I just didn't like it. So what is it? What it is? Yeah, well, I just it was like a lot of heavy massage and pressure on my stomach and I'm like I just gave birth Would you please? Like really? And it was like deep pressing. It's not like a fun massage. Like I to me, this was an i Well, I had the C section so I don't obviously didn't have anything like this. So this was with my second just for being like, oh my god, I just want to like relax. Is that a baby? What's going on? Um, but I think it's interesting that you had here that you don't necessarily. You don't have to have it done. No. Tell me a little bit about why it's done. And when it's done, and what are some of the options or what how can we communicate?

Unknown Speaker  24:56  

Right so fondle massage. So it's where the there is either you or someone else. Usually in a hospital setting or at home. It's a midwife or nurse, massaging your uterus basically and then pressing on your stomach in an effort to cause your uterus to contract. Right? So that it stays firm. And what has happened in the hospital setting is that it's become standard of care to just come in and push really hard on this new Mama's very tender belly and uterus to make sure it's firm. And so what I understand to be better protocol is to you can gently feel and make sure it's firm. And if it's firm, then we leave it alone. Then we're not just like always getting in there and digging in causing unnecessary discomfort. Also, if you let your baby lay on your belly, and push down with their legs, that will massage your uterus and help it be firm too. So you could just be doing your baby and let them push and kick and it's kind of like part of the breast crawl that you let them lay there and kind of work their way up in that process that pressing on your belly to and in the Humber setting. They are going to make sure your firm but they're not massaging your fundus bear just as vigorous because so many people are like please stop that hurts. And I am so sorry, honey. I'm just That's how Yeah, and I get it. We need to but also I've seen where they'll like hey, can you press your belly and tell me or they'll show like after the birth they'll show them on? Press on your press here. Do you see how firm that feels? That's what we want it to be. And then you can check in and be like, Okay, I'm feeling it. It's firm. It's not firm. So you're Park you're part of that and you understand what's happening and what they're looking for. Right? And then they're also touching on your belly to measure so where your belly button is like the fundus the top of the uterus. That's what the fundus is, should stay below your belly button after you've given birth. And that's the other thing they're checking for is to make sure it hasn't come up too far. Again, if they show you what you're looking for, like when after I gave birth at home they showed me they're like this is what it should feel like if it comes up to this point in your abdomen that's not good. Let us know if it ever feels not firm, massage it breastfeed skin to skin and they told me all the things that could help encourage a firm because breastfeeding releases oxytocin skin to skin releases oxytocin being with your baby. All of that's going to

Unknown Speaker  27:41  

help breastfeed is what contracts uterus. Yes. Right.

Unknown Speaker  27:46  

So as long as you've got that stuff going back can also help. And so you know, it's just understanding that the aggressive fundal massage doesn't have to be Yeah, routine, aggressive. Yeah, right.

Unknown Speaker  27:56  

It's not a fan of that.

Unknown Speaker  27:57  

Well, there's so many people don't know what's coming. That's why I did to put it in the list. Because it's like, they come in there and they are they're doing their job. This is not a knock. They're doing what they're told they want to protect you. They really do want to make sure you're saying

Unknown Speaker  28:10  

but it's a it's like okay, I understand this but also it was really vigorous.

Unknown Speaker  28:16  

So it is always something to be aware of.

Unknown Speaker  28:19  

This is why it's on our terms. I know I'm glad you had it on there. Um, okay, so baby is here, and they come out of the birth canal and they got this like, waxy, cheesy look. And you're like, that is not cute. It's not cute. Very. Yeah, it can be it's very interesting. So it really is this waxy substance called vernix. That covers the baby but you have to think that they've been living in this fluid. They've been living in the amniotic fluid their whole life. And so, you know, if you go out into the ocean for 30 minutes, you turn into a prune or you go to the pool for 30 minutes you turn into a prune so we're trying to not be pruning for the fetus. That's the point of it, but I'm protected also, yeah, Texas skin but it also doesn't have to be like immediately cleaned off. You know,

Unknown Speaker  29:16  

it actually has many helpful properties. And

Unknown Speaker  29:20  

so I think in more of the hospital setting, it's more of like had the baby cut the cord take the baby clean. And then you get the baby. It's a little bit different typically in that home birth setting, but you can have you can, you can voice these things for a hospital birth as far as part of that birth plan, you know, delayed cord clamping we talked about but delayed cleaning baby as well and letting you do immediate, you know, skin to skin. So just voicing those things, but there's good reasons why and so yet you don't necessarily have to immediately clean off

Unknown Speaker  29:59  

now. Yeah, so when you say it, you have to be scared of it and it's kind of cheap.

Unknown Speaker  0:02  

babies who are born like after the due date tend to have less vernix. And as they get older as the placenta gets older and the baby gets older, like the vernix tends to absorb and dissolve, whereas an earlier baby might have a ton of it, you know, and it can be just like in clumps all over. Me, but we encourage take it. It's like nature's youth serum. You can rub it on you rub it into the baby, but knowing that it is a it's a temperature regulator is anti microbial life. So you just want that baby on us skin to skin and covered in a blanket and all of that vernix will either absorb into you or the baby. And then in time, you can either wipe it off or really just let it absorb or rub it in. It is a miracle thing. That should not be wasted. Yeah,

Unknown Speaker  0:55  

so that's another and a lot of these words on here are things like I didn't know this when I heard vernix Oh, yeah. Um, okay again. So now we have and I asked this in the office, you know, Apgar score and so a lot of times parents like I have no idea and I'm like, you usually don't know your Apgar score unless something was wrong typically, because it's kind of they're assessing and you're really if again, hospital setting, you may not know what's going on, but it's very quick way and it stands for something we'll go through it to just assess how is newborn functioning post birth immediately. So they do they take it twice is a range from one to 10 and they'll score it and you take it at a minute and then you do it again, five minutes, because sometimes when baby first comes out, it's not the best score, but when you get baby five minutes, it kind of regulates their so they're looking at appearance, just color of baby you know when when baby's born, pulse related to a heartbeat. remise as far as certain reflexes that they're supposed to have. activity you know, the muscle tone respiration, breathing, right, like all of those things. All of that is part of the word Apgar. And so it's just a score that they have and but it's good to know too. It doesn't mean that there isn't going to be anything wrong with them. If they had a lower Apgar score at birth. But it's just tools and assessments and a really quick way and it's really non invasive, you know, for them to they're

Unknown Speaker  2:32  

doing their eyes. So credible because you're like, wait a second, there's a test that's happening this soon, but it's not there. It's all with their eyes. And and the promotion was and doctors are trained and nurses are trained to be assessing all of those things, and it's just how are they doing right? And do we need you know, after I would say if they haven't if the Apgar score is low at one minute, that's not as concerning as a lower score. At five minutes. That's usually when like other intervention might need to be that a lot of babies come back out and they're not like announcing it. You might care but what I like is if you're hearing midwives or nurses talking, and they're saying things like Apgar score, you have an idea of what they're talking about. So many people like they talked about the Apgar. Score being a five, I didn't know what that meant, or whatever. Now you know. Some other things that might come up right after giving the light either right after you give birth or in the first 24 hours, depending on where you're giving birth. These are some newborn procedures. So in the hospital setting, standard procedure is to give a reefer myosin which is iLight meant an antibiotic ointment originated to help for like before we started testing for STDs and STIs of gonorrhea and chlamydia if a baby was born during an active outbreak, then they could get an eye infection that could cause blindness, and that's detrimental but now most birthing people have screening of STDs and STI is and no. So it's sort of like one of these things that based on your unique situation. Your health are you in a monogamous relationship? Do you have any known STDs or STI? Then getting the IOM it should be kind of an individual choice but they give it to everybody because then they also say that any sort of it's going to ward off any kind of eye infection again giving birth in a hospital setting. There are you have you have the potential being exposed to more viruses and things so sure it is a layer of potential. So that might be something else that they might mention as a general precautionary thing to avoid any sort of eye infection and a newborn. That could be detrimental. Of course if you're giving birth at home far less likely to be exposed did other things outside of what they picked up on their way out of the vagina. So again, choice you have choice, what is it? It gives them it kind of gives them a goopy eyed look, it causes blurry vision. Yeah and abiotic so you know,

Unknown Speaker  5:05  

I will say I and I put in here too. There's a lady that I follow on Instagram, Dr. Green mom, and it's so funny. She literally just did post about like birth plan newborn checklist and she has like some of the ones that are listed on here and it's really really good because she mentioned to even if you do want to go through and you do want to do it, maybe delay it a bit too because with that blurry vision, maybe you at least do some skin to skin maybe you at least kind of work on the latch a little bit to get that somewhat established before before doing it as well but again to get the choice there.

Unknown Speaker  5:42  

Yeah, I'm all about delaying and we talked about this a little bit through the golden hour, giving all time for all the things you just said before doing these things. So yeah, I can options. You can do them right away. You can do them delay. You can do them at your first pediatrician appointment within a few days or you can forego them altogether. It's all about options and knowing what could disrupt you know, that initial bonding period and knowing what might come up in a hospital setting versus a home birth setting and knowing that your options in both settings within for these things right. The other other thing that might come up is a vitamin K shot. This is not a vaccine. Vitamin K is naturally produced in the body. But in newborns, it's slow like you're born with low vitamin K levels, and it builds up over time. And so vitamin K helps with blood clotting. So if there's some sort of undetected or unknown brain bleed or surgery that's needed or if they're being circumcised, like vitamin K can help. And for a while, they're like when I was giving birth but vitamin K it felt like everyone was like, at least in the quote unquote crunchy community was like, hard No. Like then there was like, don't disrupt the initial period at all like no vitamin K hard No. And now I feel like the evidence is that there is some benefit to the vitamin K shot. There are some options you can do an oral you can ask for no preservatives. So you know but understand there are there are some benefits evidence base birth has a great article on all of these that we're talking about because she mentioned

Unknown Speaker  7:21  

because I would say to there's been a shift and even a lot of Yeah, crunchy community too. Because it's not like a like you said it's not a vaccine, but it's typically in the US a shot I know some you are gonna have to do some research and find for an oral aspect of it or to ask for it or to see if that's an option and that just changes again to some of the preservatives that are in it as well. I know mostly like the European countries will use and that's from evidence based birth, but they'll use like an oral one, which

Unknown Speaker  7:57  

and you can sell it in a hospital setting. If you want to do oral you would just forego the shot and then you would administer your own food bring in your own there. They're not at least they don't supply an oral option. So you because it's the thing with oral is you have to do a certain number of drops over a certain number of days because you're helping build up that vitamin K store. And so you know it's a hard regimen to ensure that you're gonna get it like the hospitals like we can give it a shot. Otherwise, like you've got to be diligent doing it over the course within seven to 10 days and you kind of increase either do one drop over seven and 10 days or you to kind of increase the amount we did it with Marshall my second he was born at home and then we opted for the the oral option and we went off of our midwives recommendation for the oral but we purchased it and then we administered it

Unknown Speaker  8:51  

and you did it yourself. So yeah.

Unknown Speaker  8:53  

So lots of options there. And evidence and research. We encourage exploration on all of this, just knowing what might come up. The next thing that comes up in the hospital setting is the hepatitis B vaccine. And they do offer this they would like to give it within the first 24 hours 24 to 48 hours. Some do it sooner just depends on when they like to do their newborn stuff. So Hepatitis B is like for its if you work or are exposed to like blood being if you're exposed. Yes blood pathogen. So like if you are a nurse or you work in a field where you're exposed to blood on a regular basis or you know, sex workers or if you have you know, not in a monogamous monogamous relationship you might be have a greater risk of being exposed to it. So, it's given in the hospital because they feel like because it can cause like liver disease and problems later in life, if you do get it when you're at this stage. And I feel like it's administered as like this broad swath of like if we get it early, while people are out here, we're saving people's lives like down the road right? And then reaching as many people as they can in the hospital because we will not a lot of people. There is a population that they give birth in the hospital and then they don't ever go to any sort of follow up, follow up with a pediatrician, right? So they're like, What can we give here? That is beneficial down the road? Possibly right? And so it doesn't, I don't think it's an apply all I don't think everyone needs to get it at all. You have to look at your individual circumstances and situation and say does this work for me right and it isn't vaccine. So it does come with side effects. So you can opt to do it in the hospital. You can opt to do it when at your first pediatrician appointment. You can delay it even further than that or forego it altogether. This is not a vaccine conversation. That's a complex conversation. But this one comes up because it isn't in the

Unknown Speaker  11:09  

immediate postpartum. Yeah. So and it's good to know and that's what you don't necessarily want to be blindsided when you get in because it's like I've had some moms too. And they're like, Well, I did this because I didn't know and I'm like, I didn't know Okay, yeah. And so, we don't want to happen to didn't know so you have options, you have choices again. too. And kind of exactly what you said. As far as maybe it's not that broad spectrum, you know, everybody needs it type of thing, because it is yeah, it's just everybody's needs are different. Everybody's body is different. And so you I would recommend looking over that, again to it's not the end all be all that you have to know right at birth with this one because it could be like you know what, I just want to get to that first pediatrician point maybe want to talk about to your pediatrician, maybe you need some more time or information but it's okay to be like you know what, we're gonna pause on this for now and revisit it you know, later or not at all.

Unknown Speaker  11:58  

So and all of this should be hard. But just like if you're into creating like a birth preferences sheet, or like your birth wishes, birth plan, whatever you want to call it, that newborn care plan, this would be on that so researching it before you go into labor can mitigate a lot of stress.

Unknown Speaker  12:19  

And like is the link to the Dr. Green mom because she has some she has a lot of good information on that as well too. Um, something else that comes up is the newborn screening test or PKU tests what a lot of people will call it or even like the heel prick, and even homebirth midwives come equipped and able to do this as well. So it's not something that only happens in hospital births and it is where they will take a blood sample from the heel of the newborn. And there's a whole process how they learned how to do it and then they'll put the blood spots on to a filter paper card, and then they will mail that card off to the public Department of Health for whatever state it is. And then they will test they will run a series of tests on those blood spots, using little hole punches of it and they will test for several different these are metabolic disorders. Sometimes, hormone disorders, blood disorders, that can easily be tested with the blood spot and can give sometimes vital information as far as how baby needs to be cared for or fed. This is actually what I used to do. Yeah, whatever. The CDC Yeah, it's funny I was I was in so I was in the newborn screening, quality assurance. program. So I would make the quality assurance blood spots to send to public health labs and they would run it alongside the actual test samples. So you knew that the test had been run well and correctly so you didn't have you know, false positives, false negatives, those type of things, but it's named PKU. PKU test phenyl ketone urea. That's the main one that's like the oldest one that we know of. It's just an inborn error of metabolism. These people can't process phenyl alanine, which is an amino acid and so if you can't process something and you're missing some of those metabolic enzymes to break it down, then you get a toxic overload in the system. And so then you don't have the detox means and so that's where you'll get it can affect the brain, it can affect other organs. It can affect. That's just, that's how it goes. It can be levels for everybody, but also it can be a very simple fix, and that you just really watch what's been allowed and you have you can't have sprite I can't like aspartame is something that is very random little things, but you have to watch how much protein or how much certain amino acids that you have. Now they've come out with pills. I have some friends that have PKU and so there's other you know, they're constantly doing research and stuff with it, but I do recommend I know too, sometimes in the crunchy world that can be a push, well, I don't want you to take my baby's blood and what are you going to do with it? And because I remember hearing that, even at the CDC before, I guess I was somewhat crunchy. I don't know, wherever I was in my health journey, but there are some that can definitely impact feeding so like we would test for galactosemia which that just means galactose, you know, it's in the its milk sugar, essentially. And so these babies will not be able to break down galactose which is would be found in breast milk. It would be found in formula so there's some that are very immediate that you need to know and it was it's nothing bad. It's just we've got to feed them a different way. So I do like to say and like sickle cell, that's another thing that they'll test for congenital hypothyroidism. I used to work. I mainly worked with digital hypothyroidism, but adrenal hyperplasia. I worked with sickle cell, all those sorts of things. So it's very fascinating, but I think it's an important test because there are yes, they are very rare and yes, they are. They're sometimes genetic. But

Unknown Speaker  16:02  

it can be such an easy test to do for me when I was learning about I felt like it was just more of an interruption and just disruption for the baby right? It's uncomfortable. It's a pretty good heel prick. But you know, I went for Marshall to the hospital lab, like I had given her the home and took him to the hospital app. I held him I breastfed him while they practice heal. Yeah.

Unknown Speaker  16:25  

Babies well,

Unknown Speaker  16:27  

he flinched for a moment. And then he was soothed by feeding. And you know, it's like, I think it's a pretty easy thing. But of course, it's all about options and knowing what it is and not just being like, Oh, they're gonna prick my kids heel and take their blood, but the way you just described it, it's just like, boom, it's just like, that's all really important stuff. And it's an easy test, like five little drops on a piece of paper are going to tell us a lot of information that can help preventatives. So, you know, when you can do that in the hospital before you leave, pediatricians don't normally do PKU, testing or that he'll break so you have to go to the lab of some sort if you decide not to do it in the hospital. So, yeah, and another test that they'll do in the hospital is the hearing test to and it's pretty simple. I didn't like my first work was at the hospital that took them out of the room for it, which I didn't love, you know, and they're just testing the hearing. It's not uncommon for babies to fail it. They have a lot of fluid still in there. So

Unknown Speaker  17:34  

what's the second baby? They may have a lot more fluid last. Yeah, because they didn't get that big squish. So yeah, yeah. So

Unknown Speaker  17:43  

pediatricians can retest. Your nose and throat doctors can test but it is it is something that would come up. I don't know what happens if you I don't know anyone that has declined it. I don't know how that works. But you know, it's something you want to know, I think. Yeah, definitely. Um, so something that I mentioned earlier is the golden hour. And that's a term to describe the first one to three hours after giving birth. And it's this time that you would want to protect you want to optimize bonding, skin to skin feeding, family unit comfort, hydration, eating, rest, before all of the other things that might come up in newborn tests, newborn screenings, procedures, the doings of the things the baby weighing does not need to happen right away, measuring unless there is a medical need, you would aim to delay it until after the golden hour. So that would be a minimum of one hour, but really like two three hours of just like uninterrupted notice.

Unknown Speaker  18:51  

Yeah, that sounds magical. You know, yeah, that's probably easier with that home birth setting, obviously, but in the hospital, I would say you got to request it. You know, you might have to be, you'd have to really advocate for yourself. With conium is another word that we have on here. That's baby's first bowel movement. It's pretty nasty. See that? It's like tar veered.

Unknown Speaker  19:19  

Off of skin

Unknown Speaker  19:20  

Oh, it's so hard to clean off of skin. Now. Sometimes babies will have that first bowel movement in mom and so a lot of times they can tell with the amniotic fluid, looking at the fluid, what the fluid should look like compared to what it does, if meconium has been passed, and where that sometimes that's not necessarily an issue. It's more of an issue as as baby aspirate has baby inhaled, ingested the amniotic fluid that now contains the conium. So that's and that just requires extra caution for baby afterwards and maybe some extra tests

Unknown Speaker  19:55  

not in terms of things. The monitor closely just to make sure it doesn't feel like maybe aspirated

Unknown Speaker  20:01  

Exactly. And but I think that's an important word to know. I will never forget.

Unknown Speaker  20:06  

Yeah, and if if your baby didn't have that first bowel movement, even if they did have it in utero, they're going to continue their next couple poops right the first day or so continue to be that the dark part like stuff. So something to help is putting coconut oil on their booty and then their diaper and if with the Macondo which is a lot easier to clean off otherwise, it just really sticks to the skin really is so sticky. Yeah, so once the baby's here

Unknown Speaker  20:34  

just ending when they pee the same time that you're trying to clean them. McCone was just so much fun.

Unknown Speaker  20:40  

You're now been fully indoctrinated, been christened.

Unknown Speaker  20:44  

Um, I want to mention fontanelles that's just a fun word on smells. So it's the little squishy spots on baby's head. You got one and kind of at the top there's one kind of towards the back. Little soft spots on top spots. Yeah, um, we don't need to go no need to be pressing on. But they are really really cool because that is how the bones of the skull the cranial bones, kind of like overlap each other and allow babies Boglehead to come out of birth canal so it's really really cool. It gives that space there and then what we have after baby is born, and it can take a little bit of time to have those cranial bones come apart and allow for those soft spots and then to come back into that cranial molding and that shaping in that forming that's where you get that normal head shape and what you're, you know, looking for the balance, the symmetry between the eyes and the ears and the frontal bones, everything there but they serve a purpose. So and it takes a while for them to actually fuse each one you have an anterior and a posterior one and they fuse at different times. So it's not uncommon because again to that brain is just growing so much in those first few years of life. And so that school just allows for that and we talked with an episode 57 did an interview with Dr. Martin Rosen who is a pediatric chiropractor, but he talked all about cranial adjusting and so that's a really good episode and I highly recommend listening to that because with infant chiropractic care, I am looking to make sure like the head shape has. We've got a good head shape with an owl the cranium has actually molded post birth. So,

Unknown Speaker  22:31  

so cool. It is pretty cool, fascinating little creatures as being nine now.

Unknown Speaker  22:35  

I'm John, this is something else that tends to be mentioned quite a bit and that can just be where you get like the yellowing of the skin. A lot of times you'll see it in the eyes. You'll see it sometimes. And it just it's that yellow look there and it has to do with the liver processing some of the excess red blood cells we talked about this with the delayed cord clamping and the maybe some of the reasoning of not wanting too much excess blood but really waiting for that core to kind of stop posting waiting for white knowing that baby has regulated that well. But it's not typically something that is very harmful. But sunlight can be really good to break down the excess bilirubin that we have. That's where you get the belly blankets. I like those where they just put in like a little light blanket to help break it down cocoon

Unknown Speaker  23:31  

but it doesn't need to be addressed like if it's not harmful if it's address is addressed. It would be harmful if it continued and nothing was noticed any yellowing of the skin yellowing of the eye so they have looked for it again after you give birth midwife OB home hospital they're going to be looking for this and monitoring and I think they even in the hospital setting will check the bilirubin levels with just a little eye it's almost like a one this thermometers on the forehead where it can give them a quick reading to give an idea. So they'll check that make sure they're good but again, you can observe it with your own eyes. And then it is determined that they have jaundice. If it's subtle, sitting in light, under direct sunlight through a filtered window or outside like undressed as possible as much skin exposed as possible. But if it if it's severe then getting some some lights go in assistance yeah

Unknown Speaker  24:26  

and help really blankets and

Unknown Speaker  24:28  

being proactive in that so if you suspected at all, you can ask your pediatrician to check if your pediatrician suspects it they'll check but with the like I said there's like an easy test and then there's like a more they'll drop blood to do more

Unknown Speaker  24:41  

to get actual levels. Yeah,

Unknown Speaker  24:43  

yeah. Yeah. So that's really all of our terms. I know the last two things we wanted to talk about was sort of our individual roles in all of this like, Mike for understanding how birth doula participates here. And I know how chiropractic care for infants, how that and for moms, and I know we have lots of episodes on that, but I just like to remind people that everything I've shared here and that you shared, having someone on your team alongside you through pregnancy and birth and postpartum someone who understands all of these terms and has the resources to figure things out or provide referrals or more information can just help reduce overall stress and make this whole time a little bit easier and less overwhelming. And birth. doulas are there to help provide information, emotional support, and of course physical support during the birth and just help you understand what's going on what's happening inside of your body. What's happening with your baby. You know, checking in with you regularly, just someone right there alongside you, helping you navigate the PAP does path that that society it's like some normal right so many I mean 100 70 million babies are born a year or something crazy like that, like so it's common, right? But if you only do it once or twice like so making the most of the experience means a lot and how you feel throughout this whole process will last a lifetime. And so staying in the driver's seat, you know, learning your options, learning your own needs, tapping into your own like preferences and needs, not about doing it a certain way. And having a birth doula on your team can help you achieve that,

Unknown Speaker  26:26  

yes can definitely help you navigate that and feel good about your birth, but then feel good about the postpartum time as well. And understanding and getting that knowledge beforehand. You know, we have an episode two, we do episode 69 benefits of pediatric chiropractic care so that's where we went through and we have quite a few you know, in there and spattering sometimes some of our nursing ones we talk about, you know, chiropractic care for infants, but yeah, really assessing how the nervous system is functioning. Post birth because birth can be that stressful, stressful process, not only for mom but for a baby as well. So yeah, really looking at how the nervous system is functioning and the little ones and making sure we're developing well, so yeah, laying that

Unknown Speaker  27:09  

foundation, setting them up for success. And I love there were so many things here that like you're like yeah, I talked about this with my clients. Like I'm asking them about this. I'm sharing this with my patients like you're all like so again about having these people on your birth support team, you're going to be like you're going to be getting this information from all different ways and I love that you take that approach with your patients and and introduce some of these concepts and ideas and words and tools. To help them have the best work possible and postpartum possible and life really.

Unknown Speaker  27:40  

Exactly, exactly. You know, because how we feel about that birth process matters. So I love I love when people have doulas and chiropractors on their birth record and then on their postpartum versus

Unknown Speaker  27:54  

their postpartum. Well, Shannon, I think we have officially Yes, simply done. This is not a four part series about various terms that you will most likely hear when you are pregnant giving birth and or postpartum and all along the way. So we hope you have found the series helpful. Definitely share it with anyone you know who is on this journey too. And we invite you again to become a direct listener supporter through our new or we've set up a new communities for us option where you can help us continue to do the work that we love. You can you know doing this podcast takes a lot of effort and time and energy and editing and researching and interviewing and posting and all the things and we love it and we want to keep doing it. But we need we need your help. And so if you you know were a part of your day or part of your week and you love what we're doing, please visit aligned birth.buzzsprout.com and use the link in our notes and support us at whatever level works for you. The way we set it up is it's it's not like it's $20 a month it can be $1 it can be $5 it can be $10. Whatever works for you, whatever you feel like you want to do. It means a lot to us. We're so so grateful for all of our listeners for the feedback we've been getting for, you know, the positive reviews. We just We can't thank you enough and it is it's a hard thing to ask for but we realized that in order to keep doing this we have to be offsetting our our time and our expenses. So here we are asking for help being vulnerable and inviting you into our community. Yeah, but you're part of the community. Yeah, if if if doing a monetary donation is not where you're at if you want to sign up for our emails, that's also a signal to us that hey, I'm here I care I want to be in the community. So you can also sign up for emails which is free, and you'll be the first to know about any new episodes we have any new happenings we have. Our goal is to only show up for you once a week give you direct access to the episode all the show notes all the resources in your inbox super easy to find. And another way that's free if you want to support us and show your love for us is to leave us a review. You can do five stars. Leave some words. Tell us what you think. Tell us your favorite episode. Tell us who you're sharing it with. If you're a birth worker, if you're pregnant if you've already given birth, we want to hear from you so you can leave all of that in a review if you would like. And yeah, we just appreciate you I want to give you all the ways you can be part of be part of this with us. We want you to be here. We want you part