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Becoming a Family

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Becoming a Family

This book has been written to help you understand what to expect at the hospital, and to give you some basic information about breastfeeding and caring for your newborn. While we feel all of the information in this book is important and will help you take care of yourself and your baby, please be sure to review these sections carefully before your baby is born: Skin-to-skin care...page 2-5 The physical effects of labor and delivery...page 3-1 Rooming-in...page 3-2 Routine care...page 3-3 First 24 hours of breastfeeding...page 4-6 Vaccines...page 5-17 Your labor and delivery experience will be unique to you and your baby but reading these sections will help you understand what to expect during your hospital stay. We are proud to offer two hospitals that give obstetrical and neonatal care and provide family-centered care. You can choose to have your baby at Poudre Valley Hospital located on Lemay Avenue in Fort Collins, or Medical Center of the Rockies, located at I-25 and Highway 34 in Loveland. Please talk to your healthcare provider about which hospital is right for you and your family. BECOMING A FAMILY

Welcome to Poudre Valley Hospital and Medical Center of the Rockies We would like to welcome you and your family, and acquaint you with our philosophy of patientand family-centered care. Patient- and family-centered care creates a partnership with families and builds a foundation of: Support for family decision-making and caregiving. Recognition of the vital role that families play in the health and well-being of family members. Respect for patient and family choices. Patient- and family-centered care nurtures those strong bonds between babies and their families that begin before birth. We encourage families to keep their baby with them at all times during their hospital stay. This allows families to learn more about their baby before going home. This is the philosophy of care that our department follows and supports: Family health care needs are unique and change over time. Each family is individual in its needs and background. Families can include members who are not related by blood or marriage. Care is a partnership between families and healthcare providers. Birth is one of life s special events. Birth and parenting can occur with greater ease, comfort, and joy when families have the information they need. Newborn care addresses the specific needs of each child and his/her family. Thank you for choosing Poudre Valley Hospital or Medical Center of the Rockies. We look forward to caring for you and your baby. BECOMING A FAMILY

Table of contents Preparing for baby...1-1 Labor and delivery...2-1 Caring for new moms and babies...3-1 Feeding your baby...4-1 Caring for your baby...5-1 Something s not right (postpartum mood disorders)...6-1 Caring for mom...7-1 Resources...8-1 Index...9-1 BECOMING A FAMILY

Preparing for baby

Preparing for baby Congratulations on the upcoming birth of your baby! Although you re probably busy and excited getting ready for your baby, you may find that life will be busy those first few weeks after your baby s arrival. Take time now to put your feet up, relax, and read as much as possible about life with your new baby. PREPARING FOR BABY 1-1

Prenatal care While pregnant, it is very important to take good care of yourself. Please see your healthcare provider or midwife as often as they recommend. Follow your healthcare provider s advice on nutrition, rest, exercise and any medications you should or should not be taking. Selecting a hospital We are proud to have two Baby-Friendly hospitals to care for you and your baby during labor, delivery and recovery. In addition to our team of healthcare providers and nurses, and state-of-the-art technology, we offer: Centralized fetal monitoring so your nurse is able to see your baby s heart rate. Anesthesiologists available around the clock to meet any medical pain management needs you may have. A high level neonatal intensive care unit at PVH. Our NICU routinely cares for premature and sick babies and is the highest level NICU between Denver and Billings, Montana. The special care nursery at MCR cares for babies born as early as 34 weeks and those who are sick or need a little extra help after birth. Expert neonatal nurse practitioners who specialize in taking care of your baby s needs and are available around the clock at both hospitals. Our neonatalogists, pediatricians with three additional years of training focused on the care of critically ill newborns, supervise the medical team that provides the daily medical care for babies in the NICU and SCN. The neonatologists based at our hospitals are members of the faculty of the University of Colorado at Denver and Health Sciences Center. They are members of the nationally renowned physicians group that cares for newborns at Colorado Children s Hospital in Denver. Our mission is to bring technology and expertise to Poudre Valley Hospital to provide comprehensive, state-of-the-art care for your baby in northern Colorado. We encourage you to tour both hospitals to see which hospital is the best fit for you and your family. 1-2 PREPARING FOR BABY

Financial arrangements We ask that you pay any amount on your account not covered by insurance, such as copayments, deductibles and coinsurance, when you leave the hospital. Payment plans are available. You may also make arrangements prior to delivery. To make financial arrangements, ask about current maternity estimates, discuss payment plans available once you are pre-registered, or review financial assistance options, please contact a financial representative at 970.495.7218. If you have insurance, we suggest you discuss with your company early in pregnancy what is and what is not covered by your policy. To avoid delays, please remember to notify your insurance plan within 30 days of your baby s birth if you want coverage for your baby. Preparing for childbirth We encourage you to attend childbirth classes to help prepare for labor and delivery. The classes give you information about your birth options and ways to make your labor and delivery more comfortable. You can take classes through our Family Education Program. Some healthcare providers also offer classes. Our classes and tours fill quickly. Please register early in your pregnancy and complete classes one month before your due date. Package deals are available. For a complete listing of classes, visit pvhs.org/classes. For more information, call 970.495.7500. SUPPORT GROUPS ARE AVAILABLE AFTER THE BIRTH OF YOUR BABY: Breastfeeding Support Groups PVH: 970.495.8283 MCR: 970.624.5100 Welcome to Motherhood Group Call 970.495.7500 for information. For more information on other support groups, look at the resource section of this book. PREPARING FOR BABY 1-3

Preparing for childbirth (Continued) HEALTHY KIDS There are many free or low cost programs available for families through the Community Health department. To learn more, go to pvhs.org/community. Preparing your family Having a baby is a time for adjustment - for you, the baby s father, other siblings, friends and other relatives. Start now by making realistic expectations about life after baby. Those first few months can be physically, emotionally and mentally exhausting, but also very rewarding, too. Use these tips to help make those first few months go smoothly: Set limits on visitors so you and baby get needed rest. The first hour after birth is a special time for mom and baby to bond through skin-to-skin care. Encourage visitors to wait to meet your baby until you ve had this special time together. Ask friends to prepare meals. Get help with household chores. Sleep is important to your health and recovery. Take naps when the baby naps. Re-evaluate your priorities, remembering that your baby is only going to be little once and doesn t care if the house is dirty. Simplify tasks. Get out of the house. Keep your sense of humor. Be flexible - babies don t know schedules or clocks. Have someone watch the baby so you can have a little break. Eat healthy meals to help keep up your energy. If your baby cries a lot, don t take it as a sign that you re a bad parent. Some babies are just fussier than others. 1-4 PREPARING FOR BABY

Preparing your family (Continued) Ask for help if you feel like you re losing control because of your baby s constant crying. Call family, friends or one of these resources: Your healthcare provider. Connections 970.221.5551. Women s Center 970.484.1902. Preparing brothers and sisters If you have other children, now is the time to start preparing them for the new baby. It is common for children to be jealous, feel left out, become quiet, ignore you or demand extra attention. These tips can help: Encourage older children to talk about their feelings. Let them know it is all right to have bad feelings toward the baby, but it is not OK to hurt the baby. Have visitors pay attention to your other children as well as the new baby. Show by actions and words that the other children are still loved the same as before. Have the other children help with baby tasks that are appropriate for their age. Try to maintain routines so the children feel secure. Use the same discipline methods. Spend special time alone with each child when you can. Don t count the minutes you spend with each child; rather meet the needs of the children as they arise. Car seat safety Motor vehicle crashes are a leading cause of hospitalizations and death to children in Larimer County, Colorado and the U.S. Protect your littlest passenger by restraining him in the appropriate car seat or booster seat. Safe Kids Larimer County can answer questions about or provide assistance with installing your seat: 970.495.7504. For a complete listing of car seat resources in Larimer County, recall information and details about our free car seat fit station services, visit safekidslcc.org. PREPARING FOR BABY 1-5

Car seat safety (Continued) REMEMBER the back seat is best for ALL children under age 13! BEST PRACTICE GUIDELINES FOR BUCKLING UP YOUR CHILD: Babies under 2 years old should: Use rear facing car seats. Sit facing the back of the car in her car seat. Always ride in a back seat and never in front of an air bag. Always ride in a car seat made for baby s size and age. Have straps that are snug on baby (no more than a finger s width of space between baby s collar bone/shoulder and the harness strap). Have a car seat that is buckled tightly in the car and doesn t move more than one inch when an adult pulls it. Use a bigger seat rear-facing until she outgrows the harness. Many harnesses go to 35, 40 or 45 pounds. HOW DO I INSTALL MY CAR SEAT INTO THE VEHICLE? Remember these two main points when installing your car seat: 1. Your child must be buckled snugly into the seat. 2. The car seat must be buckled tightly into your vehicle. HOW DO YOU KNOW IF YOUR SEAT IS INSTALLED CORRECTLY? To install your car seat prior to your baby s delivery, contact one of the agencies below to MAKE AN APPOINTMENT. Each agency has certified child passenger safety technicians to help you. These locations do not see drop-in clients so scheduling an appointment is the only way to get your car seat installed. Please keep in mind that the firefighters and EMS personal are on duty and may be called out to respond to a fire or other emergency. Your patience and understanding are greatly appreciated. Berthoud: Berthoud Fire Protection 970.532.2264 Estes Park: Estes Park Fire Department 970.577.0900 1-6 PREPARING FOR BABY

Car seat safety (Continued) Evans: Evans Fire Department 970.475.1108 Fort Collins: Poudre Fire Authority 970.221.6574 Nice Car Incorporated 970.490.2406 Greeley: Greeley Fire Department 970.330.6670 Johnstown: Johnstown Police Department 970.587.5555 Loveland: Fire and Rescue 970.962.2536 Windsor: Windsor Severance Fire Protection District 970.686.2626 Larimer County: Colorado State Patrol 970.224.3027 PVHS Emergency Medical Services 970.689.2462 Weld County: Auto Collision Specialists 970.622.8646 Colorado State Patrol 970.506.4999 Platte Valley Fire Protection District 970.353.3890 PVHS Emergency Medical Services 970.689.2462 For the most current list of community fit stations, go to safekidslcc.org If your baby is born at PVH, you can schedule an appointment before you leave the hospital to help with car seat installation. This is free, grant-funded education program. MCR does not currently offer this service. Only use a secondhand seat if: 1. You know the full history of the seat and it has never been in a crash. 2. It has not been recalled by the manufacturer (check latest recall list at www.nhtsa.gov). 3. You have the manufacturer s instruction manual for the seat. 4. The seat has all its parts, including all labels. 5. The seat is less than 6 years old. 6. Your child/infant is within the weight and height requirements specified for that seat. PREPARING FOR BABY 1-7

Car seat safety (Continued) USING YOUR CAR SEAT Follow manufacturer s instructions for using and installing the seat. Read your vehicle owner s manual to learn how your safety belts work. You may need to use a locking clip to secure the seat tightly in the vehicle. Baby supplies Now is the time to make sure you have a few basic supplies on hand so you can clothe and take care of your baby properly. And remember, babies grow fast and clothing sizes generally run small, so you might want to avoid buying too many tiny outfits. The most important thing you can provide your baby is lots of love. TWIG Twig, part of Twenty Three Trees, is a great, low-cost resource for high-quality, reliable products and supplies for you and your baby. We carry breast pumps and supplies. The certified lactation counselors at WeeSteps can help with questions about lactation supplies. Located in Westbridge Medical Suites across the bridge from PVH: 1107 S. Lemay Avenue, Suite 160 Fort Collins, Colorado We will deliver to MCR 970.495.8400 Drug and alcohol use during pregnancy It is a fact that half of all pregnancies are unplanned. This doesn t mean that these babies are not wanted, but because they are unplanned, many babies are exposed to drugs or alcohol unintentionally prior to a woman even knowing she is pregnant. It is estimated that one out of 10 babies may be affected. Substances that may harm a developing infant are called teratogens. These could include: Alcohol. Cocaine. Heroin. Marijuana. Methamphetamine (meth). Prescription painkillers. Tobacco. 1-8 PREPARING FOR BABY

Drug and alcohol use during pregnancy (Continued) Alcohol has been identified as the leading preventable cause of birth defects. According to the US Department of Health and Human Services, one million babies a year are exposed to alcohol and drugs during the pregnancy. We also know that most drugs are not used independently. For example, alcohol, tobacco and meth may be used together, or alcohol, marijuana and prescription painkillers together. A combination of substances can make the effects more harmful to the baby. WHAT KINDS OF THINGS MIGHT HAPPEN TO MY BABY? Anything you eat, drink or take affects all body systems. During the first 3 months an infant is developing his or her internal organs, so problems may occur if you have used drugs and alcohol during your pregnancy. Problems may include: Premature tearing away of the placenta. Low birth weight. Premature birth. Small brain. Seizures. Poor coordination in movements. Irritability. Sucking problems. Feeding problems. PREPARING FOR BABY 1-9

Drug and alcohol use during pregnancy (Continued) THINGS THAT MAY HAPPEN TO YOU ARE: Hemorrhage. High blood pressure. Stroke. Infection. Dental problems. MY FRIEND USED DRUGS AND HER INFANT IS FINE. We don t know that for sure. The infant s brain grows the most during the last half of the pregnancy and continues until the baby is 2 years old. Many effects to the brain are invisible so we call these soft signs. These include: Sleep problems. Developmental delays. Problems in school. Too much or too little muscle tone. Hypersensitivity to stimulation in the environment. Lower I.Q. Memory problems. Attention Deficit Disorders. Poor coordination. Poor problem solving ability. Impulsiveness. Hearing and speech problems. Poor social skills. Because the brain continues to grow rapidly until the second year, any tobacco or drug use in the home can continue to affect the infant s development. Second-hand smoke from tobacco, marijuana or meth can negatively affect growth, and can cause asthma or other lung problems as well. I AM ALREADY PREGNANT AND WAS USING SUBSTANCES. WHAT CAN I DO NOW? The most important thing to do is get consistent prenatal care. Women who get prenatal care even with drug use have better outcomes for their babies. 1-10 PREPARING FOR BABY

Drug and alcohol use during pregnancy (Continued) Stop using substances! If you can t stop, cut down on your use. Any reduction in use will have a positive effect on your baby. Be honest with your healthcare provider or midwife. If you weren t totally honest in the beginning, share with them now about your use. They will be able to more closely monitor your baby and also can help you get help for your addiction through a drug and alcohol counselor. WHAT WILL HAPPEN WHEN I GO INTO LABOR AT THE HOSPITAL? You will have your temperature, heart rate and blood pressure checked, and your baby s vital signs will also be checked by a fetal monitor. You will have an exam to see how far your labor has progressed and a health and social history will also be done. Colorado Vital Statistics gathers a great deal of information from your baby s birth certificate about prenatal care, tobacco, alcohol and substance use. The information is used to monitor the State s progress in improving outcomes for infants. If your health history indicates that your baby may be at risk from substance use, you may be asked to have your urine checked for the presence of drugs. This test is not done to judge you; it is to help us know how best to care for you and your infant. Babies may be tested by collecting their first bowel movements, which is called meconium. Meconium starts developing in their intestine about halfway through the pregnancy. It will contain drugs that have been used at a level high enough to be called abuse. It will not pick up occasional use of alcohol, even though we know that small amounts can also cause effects to the baby. Sometimes parents are not able to control their use of substances and a baby may not be in an environment that is safe. Healthcare professionals, social workers and teachers must report concerns to the Division of Child and Family Services. This is never to judge parents but to help speak for the infant who may need more help. Our goal is to keep parents and children together in a safe and thriving environment. WE KNOW THAT: Your intention is never to harm your baby. Addictions are hard to overcome by yourself. Relapse is often a part of recovery. PREPARING FOR BABY 1-11

Drug and alcohol use during pregnancy (Continued) Pregnancy is the most successful time for recovery from substances. Your healthcare provider and midwife care about you and will help you seek treatment. A consistent and stable environment for the baby is crucial. The first three years of a child s life are the best time to start treatments if delays or problems exist. RESOURCES Your healthcare provider Connections Mental health and substance abuse referrals Fort Collins: 970.221.5551 Loveland: 970.461.8944 United Way 211 970.407.7066 Community resources, including Alcoholics Anonymous, Narcotics Anonymous and other treatment centers. Antepartum care We provide a wide variety of services if you should need to be hospitalized for an extended amount of time prior to the delivery of your baby. The Birthing Center at PVH and the Mother and Family Center at MCR are equipped to provide you with a private room with 24 hour monitoring of your baby as ordered by your healthcare provider. If it is in your and your baby s best interest to remain hospitalized, you can expect: Intermittent fetal monitoring as ordered by your healthcare provider. A private room with refrigerator. Primary nursing (a core group of nurses will be assigned to your care to provide you with continuity). A visit from physical therapy to help with body positioning and exercises that can be done in bed to help alleviate pain and improve relaxation. Counseling referral for support as needed. For long-term stays, a care conference may be set up with you, your family, your healthcare providers and the nursing staff to develop a plan of care for your stay. 1-12 PREPARING FOR BABY

Antepartum care (Continued) If you are anticipating a possible preterm birth, you will be visited by a neonatal intensive care unit/special care nursery staff member to explain what to expect in the NICU/SCN. Having your baby Your healthcare provider gives you guidelines on when to arrive at the hospital after your labor begins. Be sure to fill out the admission form online (visit pvhs.org/babies) or mail it to the hospital at least four weeks before your due date so you can be quickly admitted. WHAT TO BRING TO THE HOSPITAL Robe. Slippers. Supportive bra. Toothbrush, toothpaste and shampoo. Loose, comfortable clothing to wear home. Clothes for your baby to wear home. Blanket for your baby. Names for your baby. The name of your baby s healthcare provider. A car seat. Labor tools. WHAT ISN T ALLOWED Alcohol, candles, incense and anything that burns are not allowed in the hospital. Where to go MEDICAL CENTER OF THE ROCKIES Anytime day or night Use the Emergency Department entrance. You may park in Stork Parking spots and come into the ED and go directly to the concierge desk for assistance. The ED is accessed by driving to the northeast corner of the building. PREPARING FOR BABY 1-13

Where to go (Continued) POUDRE VALLEY HOSPITAL 8 a.m. to 5 p.m. weekdays Use ER-Surgery entrance on the south side of the hospital. Park in the reserved Stork Parking spots near the Surgery entrance. Any other time Use ER Entrance (south side of building). Park in the reserved Stork Parking spots near ER door. GETTING TO LABOR AND DELIVERY At MCR, you ll take the elevator to the fifth floor and go to the Mother and Family Center. At PVH, you ll take the elevator to the third floor and follow the signs to the Birthing Center. At MCR, you will labor, deliver and recover in a room on one side of the unit, then you ll change rooms to the west side of the unit. You ll stay in your postpartum recovery room until you are ready to go home. At PVH, you will go through labor, delivery and recovery in the Birthing Center. You will move to your postpartum room on the Women s Care Unit a few hours after your baby s birth. You ll stay there until you are ready to go home. Both units have two operating rooms for C-sections. 1-14 PREPARING FOR BABY

Friends and family Visitors of your choice are welcome while you are in labor. A waiting room is also available nearby. All children must be accompanied by an adult. Children may attend the birth but please make sure you carefully prepare them for the experience. Room features Each birthing center room features: GetWell Network. (An educational tool available through your in-room TV. It provides useful information about taking care of yourself and your baby.) Free movies. Free internet access. Free wifi. A refrigerator. A kitchen with a microwave and refrigerator is available for your support person. Laboring mothers, however, should check with a nurse before eating or drinking anything. PREPARING FOR BABY 1-15

Labor and delivery

Labor and delivery The birth of your baby is a special time in your life. We are honored to share this experience with you. We would like to help you create a unique birth experience, and encourage you to share your feelings, questions and requests with all of your care providers. Before labor, we encourage you to talk with your healthcare provider about: the benefits of breastfeeding, pain relief choices and choosing a healthcare provider for your baby. The Parents Preview Tour offers an opportunity to see a birthing room and ask questions about what to expect at the hospital. We hope the information in this section is helpful in understanding what to expect at PVH and MCR. LABOR AND DELIVERY 2-1

Labor and delivery routines INDUCTION OF LABOR If you are scheduled for an induction procedure, your healthcare provider will give you a handout when your induction is scheduled. We do not schedule inductions or C-sections prior to 39 weeks gestation unless medically necessary. ADMISSION When you are admitted to the hospital, a fetal monitor will be placed on your belly for about 20 minutes to assess the baby s well-being and your contraction pattern. Your nurse will ask you questions which will help us care for you and your baby. Your nurse will draw blood for tests according to your healthcare provider s orders. We will continue to assess your labor and the baby s heart rate according to how your labor is progressing. Many care providers order a buff cap. This is a plastic catheter placed into your vein, and it allows access for IV fluids or medicine if needed. You will be encouraged to drink fluids. UMBILICAL CORD BLOOD BANKING If you re interested in donating your baby s cord blood, visit clinimmune.com/cordbloodbank. You may also wish to instead privately bank your baby s umbilical cord so that it is reserved for your family s own use. There are a number of private banks that will store your baby s cord blood and charge you a fee. You can discuss this option with your healthcare provider. ACTIVITY DURING LABOR We encourage you to walk, change positions, and use the reclining chair in your room during your labor. Occasionally, walking may be limited due to certain medical conditions or procedures. You may wear your own bathrobe and slippers. Some mothers like to change the temperature in the room. Support persons are encouraged to bring light and heavier clothing to wear because they may become hot or cold in the room. COMFORT MEASURES AND PAIN RELIEF IN LABOR We try to keep mothers and their support person(s) well informed of pain relief options, and we encourage flexibility to make changes in the birth plan if circumstances change. 2-2 LABOR AND DELIVERY

Labor and delivery routines (Continued) Many comfort measures are available that do not involve medicine. Examples are: coaching in breathing techniques, visualization, aromatherapy (nothing that burns), music, jacuzzi, shower, back pressure, warm packs, fit balls, and TENS units. Your care provider and your nurse will offer information about medicine and pain relief during labor. RECOVERY AFTER DELIVERY You and your baby will recover in the labor and delivery unit for a few hours after birth. We recognize the importance of mother, baby and family being together during those special early moments of life. We make every effort to keep your baby with you. The first hour after birth is a very special time for bonding with your baby. We encourage you to limit visitors during this time and hold your baby skin-to-skin (baby is naked or wearing only a diaper and is placed on your chest). We also encourage all moms to breast-feed and can assist with nursing. If your baby has physical needs that cannot be met safely in your delivery room, it may be necessary for your baby to go to the nursery. Your support person is encouraged to accompany the baby to the Neonatal Intensive Care Unit (NICU) at PVH or the Special Care Nursery (SCN) at MCR to be involved with your baby s care. We make every effort to reunite mother and baby as soon as possible. Following a vaginal birth, the hospital stay is usually one to two days. LABOR AND DELIVERY 2-3

Labor and delivery routines (Continued) CESAREAN BIRTH A Cesarean section is a method of delivery and is done to protect your health and/or your baby s health, or when a vaginal birth is not optimal. The operation is done in a special operating room on the labor and delivery unit. If a cesarean birth is necessary, your healthcare provider will talk with you and ask you to sign a consent form. Your support person can be with you in the operating room. Go to pvhs.org/c-section for more information about C-sections. You may bring your own music for use during labor and delivery if you would like to have background music. After the birth, you and your baby will recover in the recovery room for about one hour. During that time your nurse will monitor vital signs and provide pain management. You will be able to hold and breast-feed your baby. You may choose to have visitors in the Recovery Room. The hospital stay is usually three to four days following a Cesarean. Transition newborn care If your baby s health status is normal, routine care for your newborn is done in your birthing room. A nurse from the Neonatal Intensive Care Unit at PVH or the Special Care Nursery at MCR attends the birth of every baby. If your baby s health is normal, routine care for your baby is done in your birthing room. This includes: Weight and length measurements. Skin-to-skin time, especially in the first hour immediately following your baby s birth, are strongly encouraged. Baby s first foot prints. Baby s first bath. Eye antibiotic ointment and vitamin K injection within the first hour of life. Identification bracelets placed on the baby, mother and the person of mother s choice. THESE SHOULD NOT BE REMOVED UNTIL THE BABY IS DISCHARGED FROM THE HOSPITAL. 2-4 LABOR AND DELIVERY

Skin-toskin care We encourage skin-to-skin care is for all babies. Skin-to-skin care is a way of holding your baby to allow him or her to be closer to you. Your baby is naked (possibly with a diaper on) and is held between the mother s breasts or next to the father s chest. We understand how valuable this precious first hour after birth is and we know this opportunity is one to be cherished. Because this Golden Hour is so special, we encourage you to limit visitors during this time so your baby has one on one time with you and your support person. This special time will help your baby initiate breastfeeding and helps you and your baby develop a strong bond. Our goal is to allow you at least 60 minutes of this important time between you and your baby immediately after birth. We will do our best to support this model of care as long as mother and baby are physically stable and able to participate in this time together. If you or your baby aren t able to participate immediately in this time together, we will do our very best to give you that opportunity as soon as we can. This is one of the first things you as parents can do for your baby and it is a crucial first step in really getting to know your baby. LABOR AND DELIVERY 2-5

Skin-toskin care (Continued) THE BENEFITS OF SKIN-TO-SKIN CARE Skin-to-skin care during the first hour of life and the days after your baby s birth has multiple benefits for you as parents and your baby. The first and most important is that overall skin-to-skin care promotes infant-parent bonding and attachment. BENEFITS FOR YOUR BABY: A more stable heart rate and more regular breathing. Stimulation to breast-feed and all gain the benefits of breast milk. Improved circulation and better use of oxygen throughout the body. Longer periods of alertness and longer periods of sleep. More rapid weight gain. Increased likelihood of going home from the hospital earlier. Being soothed by listening to the sound of the parent s heartbeat. Being calmed by the gentle rocking of a parent s breathing. BENEFITS FOR YOU: Feeling of special closeness with your baby. Mother feels more confident/controlled in her ability to care for her baby. Stimulates production of breast milk. You feel more comfortable taking your baby home. 2-6 LABOR AND DELIVERY

Caring for new moms and babies

Caring for new moms and babies The birth of your baby is a time filled with excitement, fatigue, anticipation, discomfort and many changes unique to each individual. It is our goal to support and care for you as you enter this new phase in your life. Labor and delivery can be physically draining. During your hospital stay, you will be tired and feeling the physical affects of labor. We encourage you to limit visitors so you can rest when your baby rests. Babies are awake a lot at night. The ideal time for mom to rest is whenever baby is asleep throughout the day. The following section highlights what to expect during your stay at PVH or MCR after the birth of your baby. Please talk to your nurse about your needs, questions and concerns. CARING FOR NEW MOMS AND BABIES 3-1

Room assignment Patient rooms are filled on a first-come basis. All rooms either have a built-in bed or recliner for your support person. Nursing care for mom We are honored to care for you and your baby. We will work with you and teach you how to care for yourself and your baby. Please keep these things in mind during your hospital stay: We want to provide the best care possible during your stay. To help us accomplish this goal, please communicate with your nurse about your needs. Your nurse is routinely assigned to care for multiple patients. Clearly communicating your needs helps your nurse provide the best care possible. Please ask for pain medicine if needed, help with feeding your baby, or any questions you have. We are here to help you get ready to care for yourself and your baby at home. While in the hospital, we encourage you to care for yourself and your baby as much as possible, and use the nurses as resources. This will help build your confidence in caring for your baby. Rooming-in (having the baby in your room at all times), is routine so you and your baby can get to know each other. Many comfort measures are available. They may include but are not limited to: personal sitz baths, pain medicine, ice, Tucks pads, Dermoplast spray and breast shells for sore nipples. Please talk with your nurse about your needs so we can help you be as comfortable as possible. If you have chosen to breast-feed your baby, all of our nurses are trained to help you. Please call your nurse to assist you with feedings. Proper latch and positioning are important for preventing sore nipples. If you and your baby need additional help, we have certified lactation counselors to help you. The benefits of rooming-in Rooming-in, keeping your baby in your room at all times during your hospital stay, benefits both you and your baby in many ways. You and your baby will sleep better. (You should sleep when your baby sleeps, even during the day. Babies are up a lot at night.). Your baby will cry less. 3-2 CARING FOR NEW MOMS AND BABIES

The benefits of rooming-in (Continued) Better breastfeeding. Your milk will come in sooner, you ll learn your baby s feeding cues better, your baby will be fed more often and you will likely have a higher rate of exclusive breastfeeding. Your baby will gain weight better. Babies who room-in have decreased jaundice. You ll be better prepared to take care of your baby at home because you get to know your baby right away. Rooming-in promotes bonding with your baby. Routine care Our goal is to create an environment of care that is quiet and restful, with minimal disruptions. However, the following activities are considered essential to provide the best and safest care for you and your baby. Your nurse can help you plan these activities to best meet your needs. If you want to designate rest times, special signs are available to post outside your room. You can expect these hospital visitors during your stay: Healthcare providers for both you and your baby. This includes nurses, nurse aides, physicians, certified nurse midwives and possibly residents and student nurses. Nurses who give a bedside report. At the change of shift, your nurses will discuss the plan of care for you and your baby at your bedside. Your input is valuable. Nurses/nursing assistants who check on you each hour (hourly rounding). Your needs, including personal needs, pain management and overall comfort and safety, will be assessed each hour. Nursing leadership will briefly visit with you and your family. Leadership rounding helps us ensure your needs are being met or make any changes that will enhance your stay. Laboratory technicians will perform routine lab draws early in the morning so healthcare providers have results when they make rounds. Nutrition assistants will deliver your meals. Housekeepers. Birth certificate clerk. CARING FOR NEW MOMS AND BABIES 3-3

Routine care (Continued) PVHS volunteers to provide newborn hearing screen. Certified lactation counselors. Larimer County nurse. Volunteers. Visiting the hospital Your baby s father and brothers/sisters may visit anytime. Your other children must have adult supervision other than you. We encourage you to limit visitors during your hospital stay and sleep/rest when your baby sleeps. We also encourage family nap time each afternoon. Babies are usually awake a lot at night and you ll feel better and heal faster if you are well rested. If there is a time when you would rather not have visitors, let your nurse know. Please limit the number of visitors you have at one time. For the health of our moms and babies, anyone who has symptoms of an illness, such as runny nose, cough or fever, should not visit the hospital. We appreciate your help in keeping our moms and babies healthy. Meals HOSPITALITY SERVICES IS PROUD TO OFFER ROOM SERVICE Hospitality Services at Poudre Valley Hospital is proud to offer At Your Service Dining. Your meal will be prepared and delivered directly to your room when you are ready. A menu will be provided for you; simply call our customer services representative at 47559 at MCR or 53663 at PVH to place your order from. 3-4 CARING FOR NEW MOMS AND BABIES

Meals (Continued) COMPLIMENTARY ROOM SERVICE IS OFFERED FOR YOUR CONVENIENCE: Your meal can be delivered any time between 7 a.m. and 7 p.m. at MCR and 7 a.m. and 9 p.m. at PVH. Your meal is made fresh before delivery. Please allow 30-45 minutes for delivery. Your diet was ordered by your healthcare provider. If you have food allergies or special dietary needs, please inform your nurse. There is a pantry stocked with ice, juices, crackers, and other snacks for our patients. We invite you and the guest of your choice to enjoy a complimentary gourmet meal served in your room. Ask your nurse for the Baby Bistro menu. Baby Bistro lunch orders must be placed by 9:30 a.m. and dinner orders must be placed by 2:30 p.m. Other guest meals are available for $6 per tray and include a dinner salad, entrée, side dish, dessert and drink. You will need to pay for the meal at the time of delivery with cash or check. The cafeteria is located on the lower level. Family members are welcome to purchase food in the cafeteria and bring it to your room. Nursing care for baby If your baby is in the NICU or SCN, the nurses and healthcare providers will talk with you about your baby s daily routine. If you and your baby are on the postpartum recovery unit, you ll have a nurse that is specially trained to care for both you and your baby. We encourage you to ask any questions you have about caring for yourself or your baby. Please keep track of baby s feedings and any diaper changes on the diaper diary given to you by your nurse. Your baby will be examined each shift. The nurse will listen to your baby s heart, lungs and abdomen. She will watch for any signs of illness. Supplies for your baby, such as diapers, wipes and blankets, are stored in the cabinets under your baby s crib. CARING FOR NEW MOMS AND BABIES 3-5

Birth certificate information You may choose any name for your baby. Your baby s last name does not have to match the mother s or father s, and hyphenated names may be used (example: Henry Jones-Smith). While you are in the hospital, your baby will be given the same last name as you. This is for security reasons and does not necessarily reflect what the baby s legal last name will be. The time of birth will be recorded in military time on the hospital paperwork (example: 2130= 9:30 p.m.), but not on the official state birth certificate. Last names of all mothers are recorded on the birth certificate using the mother s maiden name. If you use your maiden name as your middle name, leave the middle name space blank on the worksheet. If your baby is born on the weekend, the birth certificate paperwork will be prepared on the following Monday. Before discharge, write baby s full name and your phone number on a special weekend/holiday form and give to your nurse. Information packets will be mailed to you. If you have not named your baby before you go home, the Birth Certificate Clerk will call you. If a name is not selected within eight business days of birth, the birth certificate is filed without first and middle names. They will then need to be added by making a written request to the state. Information about social security numbers is included in the birth certificate packet you will receive from the hospital. The baby must have at least a first name before a social security number can be requested. Information about the father will not be included on the birth certificate if the mother is unmarried at the time of baby s birth, or was not married at the time of conception or anytime during the pregnancy. A Statement of Paternity can be filed with the birth certificate. The father s name can then be added to the birth certificate. There is no fee for filing a Statement of Paternity if it is done at the same time as the birth certificate. Information can be added later, but there will be a fee. Ask the Birth Certificate Clerk if you have any questions about your baby s birth certificate. -- MCR: 970.624.4131 -- PVH: 970.495.8284 3-6 CARING FOR NEW MOMS AND BABIES

Hearing screen All babies will have their hearing tested. The test is done to check for hearing loss, which can lead to learning delays and problems learning speech and language. The test is easy, painless, reliable, and must be done while the baby is resting or sleeping. This test can be done in your room. Small patches are placed on the baby s cheek, forehead and the back of the neck. Small earphones are placed over baby s ears. The hearing is tested by measuring brain waves in response to clicks made by a machine. If the baby passes the test, you can be assured he or she can hear sounds needed for speech and language development. A letter will be placed in baby s crib to give you the results. A refer means only that the baby needs to be tested again in one month. Please talk to your baby s healthcare provider. Many babies that refer are not asleep at the time of the test, or have some fluid in their ears from delivery that makes it hard to hear the clicks. You will receive information about scheduling that second test. If your baby is discharged before being tested, you will receive a letter with instructions for scheduling the test as an outpatient. It is important to have the test done within the first month of baby s life. Newborn screen When your baby is about 30 hours old, a small blood sample will be taken from baby s heel for the Colorado State Newborn Screen. This test is required for all babies. Your baby will need a second test done at 8-14 days of life. You will be given instructions and information when your baby is discharged. In addition to the Newborn Screen, a lab test will also be done for a total bilirubin to check for jaundice. CARING FOR NEW MOMS AND BABIES 3-7

Newborn screen (Continued) The test screens for 30+ medical conditions. Newborn babies who have these disorders look healthy, but babies with some of these disorders will get very sick or die just a few days or weeks after they are born if they are not tested and treated. Other disorders can cause mental retardation. The newborn screening test helps find these disorders early, so babies can get medical treatment before they get sick. Some of the conditions are listed below with the problems that can develop if not treated. These conditions are not common but there are no cures. If these disorders are found early and your baby gets treatment, serious problems can be prevented or reduced. With early and continuous treatment, most babies can grow and develop normally and live healthy lives. CONDITION Phenylketonuria (PKU) Galactosemia Hypothyroidism Sickle Cell Anemia Cystic Fibrosis Biotinidase Deficiency Congenital Adrenal Hyperplasia PROBLEMS IT CAUSES Mental retardation Become very sick, liver and eye damage, mental retardation Do not grow and develop normally, mental retardation Infections, growth, anemia, and pain Growth problems and lung infections Seizures, mental retardation, hair loss, skin rashes and sudden death Death in infancy, do not grow and develop normally, early onset of puberty Infant security We care about your safety and that of your baby. You should become familiar with the following security information: KEEPING YOUR BABY SAFE IN THE HOSPITAL Everyone at the hospital is working to keep your baby as safe as possible. Staff in the maternal and child care area has been trained to spot a potential abductor. There are also strict rules on who can handle your baby, and how your baby is moved for examinations and tests. 3-8 CARING FOR NEW MOMS AND BABIES

Infant security (Continued) Security systems have been installed to help stop an abductor, including door locks, cameras, and an electronic infant protection system. The small tag applied to your baby s ankle means that your baby is being monitored at all times. If anyone tries to remove the tag or take your baby through a protected exit, an alarm will sound at the nurse station. Try to keep away from protected exits with your baby. You might set off an alarm by accident. Your nurse can give you more information on the infant security system in this hospital. YOUR ROLE You have an important part to play in your baby s safety, too. During your hospital stay, here are things you should do. KNOW YOUR NURSES At the beginning of each shift, the nurse who will be taking care of you and your baby should come to your room to introduce him/herself to you. It s a good idea to become familiar with the staff in the maternal and child care area. NEVER LEAVE YOUR BABY UNATTENDED While in your room, keep your baby in sight at all times. Whether you re taking a nap or just going to the bathroom, ask a family member to watch the baby for you, or take the baby in the bassinet into the bathroom with you. Keep the bassinet beside your bed, on the side away from the door. At night it is also a good idea to keep at least one light on so the nursing staff can help you keep an eye on your baby. CHECK FOR AN OFFICIAL HOSPITAL ID BADGE Be cautious of any person you do not know who enters your room. Before you let anyone touch your baby, check that person s photo (ID) badge. It must be facing forward so you can see the employee s name, picture, and the hospital s official logo. In addition, staff members who are authorized to move your baby wear special identification. Ask your nurse about this special identification. CARING FOR NEW MOMS AND BABIES 3-9

Infant security (Continued) If you re not sure about someone who has come into your room, press your nurse call button for immediate help. MAKE SURE YOUR BABY TRAVELS IN THE BASSINET Any time a nurse takes your baby from your hospital room, your baby must be in the bassinet. Only authorized staff members are allowed to move or care for your child during your hospital stay. If you are walking in the hall with the baby, always use the crib. DO NOT take the baby anywhere else in the hospital. MATCHING YOU AND YOUR BABY For most of your stay in hospital, your baby will remain right beside you in your room. There may be times, however, when your baby has to be away from you. When your baby is brought back to you, your nurse will check in to make sure you and your baby are correctly matched. Here s what to expect: CHECKING ID BANDS Matching identification bracelets are placed on the baby, mother and support person of mother s choice immediately after the birth of the baby. These bracelets need to remain in place until the nurse removes them upon discharge from the hospital. Every time your baby is returned to you after being away, your nurse will check that your ID bands match. 3-10 CARING FOR NEW MOMS AND BABIES

Infant security (Continued) AFTER GOING HOME For additional information about keeping your baby safe once you ve left the hospital and infant abduction, visit pvhs.org/baby-security. WeeSteps breastfeeding support program WeeSteps offers a wonderful opportunity to get help with breastfeeding from a certified lactation counselor one-on-one after you go home. You are invited to make an appointment to come to our office with your baby and anyone else you would like to bring. A full examination of your baby, including weight, and a check for any problems, such as jaundice, are part of the visit. The certified lactation counselor will observe a feeding and help with any difficulties. If you need additional assistance with breastfeeding, follow up appointments can be scheduled. After you get home you may have many questions and maybe some concerns about taking care of yourself or your baby. Your WeeSteps appointment is a great chance to ask those questions, and discuss any feeding issues for your baby. WeeSteps can help with a variety of topics including: -- Back to work support. -- Breast pump set up. -- Clogged ducts. -- Feeding support. -- Free weight checks. -- Milk supply questions. -- Opportunity to participate in milk donation. -- Positioning and proper latch. -- Transitioning to solid foods. -- Weaning support. -- Weekly support groups. CARING FOR NEW MOMS AND BABIES 3-11