Babies Benefit from Birth in Hospitals (Pedcast)

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Musical Introduction

Introduction

Welcome to another edition of DocSmo.com…the pediatric blog that brings you portable, practical pediatric information. From diapers to the diploma, if its kid related, we take it on. I’m your host and founder of DocSmo.com…. Dr. Paul Smolen. Parents often ask me why their baby needs to be born in a hospital and why they need to stay for a while after birth?
We can all think of plenty of reasons to stay away from hospitals:
-cost…high
-risk of infections…real and quantifiable
-lack of privacy…for sure
-separation from your family
-And as one of my Nurse Practitioner colleagues pointed out to me, if a mother uses a large OB group rather than a midwife at home, she never really knows which doctor will be there at the time of the delivery to help her?? It really could be a stranger… a doctor who she has never met.

How Hospitals Help Babies

So why go there? Why have babies in hospitals and if you do, why stay for the recommended 2-3 days? This topic came up the other day when I was making rounds at the hospital. A family with a newborn asked the question, why did they need to be in the hospital to have a baby and why are they staying after the delivery?
So I thought today, we would examine why having a baby in a hospital IS a good idea… not a perfect idea but on balance, in my opinion, the right decision. What is the value that a hospital adds for both a new mother and a newborn baby?

A Very Short History of Hospitals

Lets start with some history. Hospitals are a modern invention… a 20th century invention. For the first part of the 20th century, hospitals served largely one purpose…a place to go die. I have read that the healthcare expenses in 1900 America averaged $5/year/person. Medicine had very little to offer people to improve their lives.
Average life expectancy was 46 years in 1900. Middle age on today’s standards. Remember, there were no penicillin, no vaccines, and no pharma grade medicines in those days. Surgeons and obstetricians were just learning about washing their hands! As medical knowledge increased through the 20th century, people became convinced that we could improve people’s lives with medical care. Everything improved. Surgical sterility, antibiotics were invented, vaccines were developed, X-ray was discovered and provided diagnosis previously unimaginable. Next came biochemistry and an understanding of how cells work. A revolution was being born. Recently has come an understanding of how our genes run everything and the era of molecular biology has been born.

Hospitals Today Do Amazing Things

Which brings us to today. The range of things that a doctor and hospital can offer is absolutely mind-boggling… right in your local community hospital; rapid diagnosis and treatment of infections, incredible imaging capability, powerful antibiotics, metabolic and genetic testing, and minimally invasive surgery just to name a few.

So let’s get back to my rounds the other day. This family asked me if it would be OK to leave when their baby was approaching 24 hours of age? They just didn’t see the value in staying. Here is what I told them:
I explained to them that the birth process was not the only time Mom and baby got value from the hospital…their baby was still benefiting from being in the hospital in the following ways:
-Screenings were still going on with their baby-
-Blood was about to be collected that is incredibly powerful in detecting metabolic abnormalities in newborns. Babies needed to be at least 24 hours old to have this done.
-Ongoing testing for jaundice was going on.
-NB hearing screening to detect deafness still needed to be performed.
-Cardiac screening looking for silent heart defects was also still to be done.
-Teaching was going on.
-Breastfeeding advocates and experts to help Mom be successful at breastfeeding were at their disposal. Their support is important.
-Pediatric nurses were also coming helping to teach Mom everything from swaddling techniques to cord and skin care.

And finally, their baby was being observed by very experience doctors and nurses who know how to sense trouble.

A Hospital Staff Knows Quickly Recognizes an Abnormal Baby

So here is a Doc Smo opinion: THE most important thing that a baby gets during their hospital stay is the observation by experienced pediatric nurses and doctors with excellent judgment…You need to understand that everything is subtle with babies… Is that baby jittery, or this one have floppy muscle tone, or does that baby have an unusual cry? Could this baby’s color not be right? Those doctors and nurses who stay up all night watching for these things… well THEY JUST KNOW BABY BEHAVIOR and usually can recognize when something is not right.

A Newborn Hospital Stay is Valuable

I guess you now know my opinion. Babies need to stay in the hospital long enough to get all the valuable things hospitals have to offer and to ensure that they are healthy… usually about 48 hours for vaginal births: and that is not just my opinion. Check out the AAP’s recommendation on the subject. In the past 100 years or so, medicine has created incredible value for babies and their families. It would be a shame not to take advantage of these advancements if you can. Well, that’s this weeks post. I hope you know a little more now than you did 15 minutes ago. Your comments are welcome at my blog, www.docsmo.com. If you find value in this podcast, please take a moment to write a review on iTunes. That really helps us.

This is DocSmo broadcasting in the recently upgraded studio 1E, hoping you won’t say nay, to your next hospital birthing stay.

Until next time.

Outro

Smo Notes:

  1. Cost of hospital healthcare

http://www.theatlantic.com/business/archive/2012/04/how-america-spends-money-100-years-in-the-life-of-the-family-budget/255475/

2. Recommendations for hospital care of newborns-Academy of Pediatrics

http://pediatrics.aappublications.org/content/113/5/1434.full

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