(Note to HIPPA police: this were random images found on google search - none were pictures taken by me, nor were they at my hospital).
What is the common denominator with these photos? These babies are crying/unhappy!! Why are they crying and unhappy? Because (obviously) they are cold, away from their mothers, and are lying in supine positions, which stimulates the moro and startle reflexes, which then make them = CRY!
How can we do this more humanely?
(Once again: pictures borrowed from the web, from WebMD - first picture, and from Amaze Studios - second picture.)
What an amazing difference! These babies are lying prone (on their bellies), with something very soft underneath them. They are not crying and they are instinctively lying in a fetal position, which is very comforting for them.
Personal nursing goal: start weighing newborns on multiple layers of soft blankets, with them lying prone.
Proposed outcome: newborns in the prone position while being weighed, lying on soft blankets, will be more content, with decreased startle reflex, as evidenced by reduced or absent crying.
23 comments:
I wonder how the staff would react if I put this in my birth plan for my upcoming baby???
I think you are going into the wrong field. Not that I don’t think midwives are great, but I think you would go from hospital to hospital showing the staff there is more than one way to do things.
Do you share your ideas with your coworkers? And if so how do they react?
I've been reading your blog since I decided to have a natural childbirth (I will be a FTM in early oct). I love all of your posts and am so impressed by how caring and thoughtful you are to mothers and babies. I would LOVE for my baby to be weighed like this instead of the usual way...I am going to put this on my birthplan and see what happens :)
Thanks for the ideas and I look forward to reading more as my pregnancy progresses and beyond from you!
~Heather
I've also been reading your blog since I decided on a natural childbirth (I am due with my 3rd on 7/16) and I love this! The bottom pictures are just beautiful. I wonder, if I were to bring my own blanket, if the staff would be willing to weigh my baby girl on it, as was done in the bottom pictures...? However, those don't look like right-after-birth pictures, they look like studio newborn pictures...big difference. But...I wonder. Thanks!
That's how they weigh babies in my hospital's breastfeeding clinic. They lay soft cloth diapers down too. :)
I just graduated from nursing school and did my internship in L&D. The weighing process always looked a touch cruel. Any ideas on how to get hospitals to implement this since I think they'll often get the length/height at the same time? I've never seen this done with the baby prone?
THANK YOU. Why is it so difficult to get people to do this? It is as if they like to see the newborn cry and the startle reflex???
I sense a study in the making! Get a checklist and a control group and we'll be reading about it in Pubmed.
Cassidy
Hmm, I also sense a study in the making!
As for measuring the length of the baby - I would imagine a more gentle way of measuring would be to lay the baby on his/her side, and use a flexible tape measure (found in every birthing room!). Length measurements would be a challenge as to how to go about it in a much more gentler way than the "standard" stretching of a leg with the baby supine on the scale. Good question!
PS - I'm also contemplating doing a variety of presentations on how nurses can help influence more positive outcomes (ex: rotating a posterior baby, skin to skin contact, breastfeeding support, etc)
FYI: to see some pictures of babies being weighed prone (on their belly), go to http://charlestonbirthplace.com/VirtualNursery.aspx
Take a look at 12/9/09, 12/30/09, 1/15/10, 1/17/10. I'm sure there are more babies pictured.
Why do they have to weigh the baby right away anyway? I get its convenience but if a mom has an epidural the baby has a little "water weight" (I dont remember where I read that) so wouldnt it be best to wait an hour or two? Whats the rush to get the baby over to the scale/warmer?
Good question Carol! Probably because it's one of the "tasks" that nurses have to do after a birth.
BTW - I usually don't weigh the baby until after the first hour or so of bonding/breastfeeding/getting to know you time.
Just so you don't forget to recalibrate the scale each time --even if it becomes a general policy, each nurse will use a different towel or blanket, each of which has its own weight.But I must say that I weighed the baby so rapidly that he was back with the mother before he began to cry, usually.
The pictures of the prone babies on towels are not pictures of newborns, btw.
Waiting to weigh the baby has its pros and cons. Most parents want to know the weight right away [and grandparents definitely do]
As a NICU nurse who works nights (weighing babies is a nightly activitY) I find that many babies are still just as distressed being laid prone on the scale on a blanket. They often still cry and kick their legs out and push themselves around on the scale. Sometimes it looks even more distressing and painful to them. I think they just hate being cold and not contained!
Also, weighing usually happens so soon after birth due to parental/family request. I can't tell you how many times a parent or family member comes over to the warmer while we are resuscitating a baby and asks us how much they weigh! The baby isn't even 5 minutes old. Oh how I wish I could say "how about we wait for him to start breathing on his own before we get his weight!" People are obsessed with those "first numbers" even though they are usually wildly inaccurate due to so many factors!
Out of hospital midwives often use a hanging scale with the baby in a sling/hammock. Those babies are snuggled up in a soft blanket, dangling in a fetal position and usually very peaceful. They seem to feel quite comfortable in that snug little bundle and the digital read out over their heads still gives the same numbers. Maybe you could include those in your study too. :)
Antigonos - the newborn scale is zeroed before we place the baby upon it to weigh him/her. This is done after the paper sheet/blankets are put on the scale first. So yes, the scale is always recalibrated/zeroed before each baby is weighed.
As far as I know it actually makes sense to check for the Moro reflex among other things (appendices behind the ears, Babinski, open palate, tongue band, wrinkle state of palms/foot soles etc.) when the baby is born. Usually the first check (U1 here) is done by the midwife, and the pediatric doc does the second set of checks (U2) on the third day. Especially the first checks are often done very professionally and calm while doing "regular" things like the weighing, so it often doesn't register as check to an unknowing onlooker. The weight etc. of course doesn't need to be taken immediately when the baby is clinically fine, but it makes sense to do them in the first hour after birth so the baby and mother can settle down undisturbed afterwards.
@arzt4empfaenger --
Why is it so important to do these things in the first hour (which is when mothers and babies most want to be together), when it could be delayed by an hour after mother-baby bonding? Also, if it is that important to do these things immediately, could they not be done with baby in the mother's arms, with minimal fuss and interruption?
-Kathy
@arzt4empfaenger --
Why is it so important to do these things in the first hour (which is when mothers and babies most want to be together), when it could be delayed by an hour after mother-baby bonding? Also, if it is that important to do these things immediately, could they not be done with baby in the mother's arms, with minimal fuss and interruption?
-Kathy
I would say that weighing isn't so important in the first hour, but same as NICU nurse anon above....it is usually parental request that has us scrambling for the scale.
It is almost the first thing asked, almost every single time.
If you would rather wait, just let the healthcare workers know....and more than likely they would accommodate you. Weighing can't be done in mom's arms btw.
In my hospital we always use blankets, never paper. They cry just as much. It's all to do with the difference between being inside mom's uterus and in the outside world. :) Babies differ too - in their reaction, after all, babies are people too!
artztefor: you don't need to do the exam right away. In several hospitals i have worked at, the MD or peds doesn't get there right away and they will do it all several hours later...even the next am if it is during the nite.
Yeah! You are so freaking smart! I have wondered this exact same thing. My babies were both weighed in slings because they were born in out-of-hospital settings and I HATE placing babies on the cold hard scale to weigh them! I am going to try this too, I'll get back to you. :)
I wish there were copies of you everywhere because when I suggested this to a midwife I was working with once, she just brushed me off...
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