Newborn Hospital Care

Vitamin K and Erythromycin Eye Ointment Administration

Vitamin K is essential for blood to clot. Vitamin K is naturally manufactured by special bacteria in the colon of an older infant, child, and adult. Newborns have not yet acquired these special bacteria. Consequently, they are born with inadequate stores of Vitamin K. There is relatively little Vitamin K in breast milk. Without adequate intake or body stores of Vitamin K, infants are at risk of hemorrhage (bleeding), particularly bleeding that may occur in the brain, which can cause serious damage or death.

To prevent hemorrhage in infants, Vitamin K is given by injection into the thigh in the first hours after birth. Vitamin K is given only once. Administration of Vitamin K soon after birth virtually eliminates serious hemorrhage in infants.

The dose of Vitamin K given to the newborn is in accordance with the recommendation of the American Academy of Pediatrics and has not been associated with any complications such as jaundice. The area around the injection site might appear red and raised for a day or two.

Erythromycin eye ointment is administered to your newborn after birth to prevent possible infection.

Newborn Screening Test

State law requires that all babies have a blood test called the “newborn screening test.” This test identifies disorders in the baby that, if not found and treated early, can cause intellectual disability or result in serious illness. The law gives parents the right to refuse the screening test for their baby if having the test conflicts with religious belief or practices. If this is true for you, be sure to tell the hospital staff or your health care provider.

Circumcision

Following a circumcision, a piece of Vaseline gauze may be wrapped around the end of your son’s penis for about 24 hours. When this falls off or is removed, you may apply Vaseline or A& D Ointment to the circumcision area to prevent the diaper from sticking to his penis. Do this for a few days. Otherwise, no treatment is necessary. If the gauze does not come off after 24 to 48 hours, wrap the gauze dressing in a wet, warm washcloth to soak the area. Or you can also soak the baby in a warm bath. Gently unwrap the gauze after soaking. You may wash the area with water. As the site heals, there may be a small amount of yellowish drainage but this should be gone within one week and you may see white or yellow patches with no drainage.

• Notify your baby’s doctor if: Bright red bleeding or oozing occurs. Call physician immediately! Apply gentle, firm pressure to the circumcision site to slow the bleeding. Your baby does not urinate within 24 hours following the circumcision. Any unusual swelling or redness is seen. There is an obvious foul-smelling and thick yellow or green drainage.

Uncircumcised Infant

No special care of the penis is necessary if your son is not circumcised. Do not attempt to forcibly retract the foreskin. As the penis grows, the foreskin loosens and is usually retractable by four to six years of age. There may be a whitish discharge, called smegma, around the tip of the penis. Gently clean and wash when bathing your baby.

Newborn Hearing Screening

It is estimated that three infants per 1,000 suffer from hearing loss. One in 1,000 newborns is born deaf. And, ninety percent of children with hearing loss are born to hearing parents. Without newborn hearing screening, most children with moderate to profound hearing loss are not diagnosed until they are two years old. Others with mild to moderate hearing loss may not be identified until they enter school.

The first two years of a child’s life are the most critical for learning speech and language. Undetected mild hearing loss can significantly affect a child’s ability to learn language, can interfere with parent-infant bonding, and delay social and emotional development. When detection of hearing loss is delayed, infants and children who are hard of hearing or deaf do not get early opportunities to learn language and have their hearing aided. As a result, they fall behind hearing children in communication and social-emotional development. This may eventually result in lower education and employment levels in adulthood.

Newton-Wellesley Hospital offers newborn hearing screening to all families with newborns. You will be given information about the program during your hospital stay. The newborn hearing screen is performed after birth while you and your baby are in the hospital. It takes only a few minutes and causes no discomfort to your baby.

When hearing loss is detected early, steps can be taken to aid hearing and improve language and communication skills. The American Academy of Pediatrics, the National Institute on Deafness and Other Communication Disorders, and the National Institutes of Health have all published position statements endorsing universal newborn hearing screening. In addition, they state that all infants with a confirmed hearing loss or deafness should receive appropriate intervention before six months of age from health care professionals with expertise in hearing loss and deafness in infants and young children. If hearing impaired, early educational opportunities for your child may also be available through the Americans with Disabilities Act. The State Department of Education can provide details about a child’s rights to educational assistance, the Act, and how to initiate an education plan for your child within your community’s school system.

Equipment to detect hearing loss at birth is effective and efficient. A specially trained technician administers the test. The test we use is called Automated Brainstem Auditory Evoked Response (ABAER). Special sensors are placed on your baby’s skin. A soft rubber earphone sends a series of quiet sounds into your baby’s ear. The sensors measure the responses of your baby’s hearing nerve. The data is computerized and stored.

Babies either pass the screening test or are referred for further testing. You will be informed of your baby’s results right after the test. If your baby needs further testing or intervention, your baby’s physician and the Newborn Screening Program staff will refer you to the appropriate resources for help. And, any future concerns you may have about your baby’s ability to hear should be shared with your baby’s physician.