From the Publisher

An authoritative resource that parents can refer to about their baby's health, from newborn through the first year, this book features scores of references to reliable Web sites and other sources of the most up-to-date pediatric information for parents.

Publishers Weekly

L.A.-based pediatrician Natterson wisely taps into parents' need for practical medical information during the first year of their child's life, providing a comprehensive, straightforward guide. The first section deals with the hospital experience, including everything parents should know about delivery, Apgar scores (which determine a newborn's health) and problems that may arise. Natterson goes on to address caring for a baby literally from head to toe, discussing each aspect of an infant's anatomy. For each topic, she includes a section on what parents can do, when a doctor needs to be involved, tests that are required, what the results mean, treatments and possible complications. Finally, Natterson covers tests and vaccines, giving basic information on when and why they're necessary. Natterson's style is parent-friendly yet professional, and she's terrific at tackling universal parenting questions that may be especially compelling during the first days and weeks of a child's life. Both veteran and parenting newcomers will find this a worthy resource, with solid advice and information (including up-to-date Web sites). (Feb. 11) Forecast: Natterson's book joins a crowded market (at least three books on infant health were published this fall). But a national print, radio and television publicity campaign, coupled with ads in BabyTalk magazine, could attract readers. Copyright 2003 Reed Business Information.

Product Details

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Table of Contents

Read a Sample Chapter

YOUR NEWBORN

Back Bay Books

Chapter One

Babies are delivered one of two ways: vaginally or by cesarean section. In vaginal deliveries, most babies are pushed through the birth canal. But sometimes, despite vigorous pushing by the mother, the baby just can't get out on his own. In these cases, aids such as forceps or vacuums can be used.

In a cesarean section (also called a C-section), the uterus is cut open so the doctor can pull the baby out of the womb. Some C-sections are planned in advance, but other times they happen emergently.

Depending on the type of delivery, a baby may be faced with a variety of challenges. This chapter covers the delivery experience from the baby's point of view, explaining how your baby may be affected by different delivery techniques.

VAGINAL DELIVERY

Vaginal deliveries aren't always just about pushing the baby out. If the baby is stuck in the birth canal, then obstetricians have a variety of tools to help deliver the baby without requiring a cesarean section. The two most common are the vacuum and the forceps.

Vacuum. A vacuum is a plastic cup about the size of an apple. It is dome shaped, with a balloon-inflated rim. If the baby's head is visible in the vaginal canal but the baby is not coming out, then your obstetrician may choose to place the vacuum on the baby's head. A pump connected to the vacuum cup generates suction so that the cup attaches firmly. Once the vacuum is in place, the obstetrician waits for a contraction. When this happens, the mother pushes and the obstetrician pulls at the same time. The vacuum often helps to ease the baby out of the birth canal.

Because the vacuum generates so much suction, it can cause swelling on the baby's head. This swelling is usually only superficial-involving the scalp or skull but not the brain below. This can cause a prominent, boggy bump on the head for a day or two. Rarely a vein in the scalp will break, causing a large bruise in the area where the vacuum was placed. While the swelling and bruising can appear dramatic, they almost always go away by the time the baby leaves the hospital.

In rare cases, the vacuum can cause a tear in specific veins, resulting in a subgaleal hematoma. This injury can be dangerous because the broken vessels can bleed into a large space around the skull. Over several days (or sometimes hours), the blood loss can be significant, stealing blood supply away from the rest of the baby's body. While this is exceedingly rare, a baby with a large subgaleal bleed can develop jaundice or even shock. In most cases, however, the prognosis is good.

Forceps. Forceps are metal tongs used by the obstetrician to grip the sides of a baby's head and help pull the baby out of the vaginal canal. Like vacuums, forceps are used when the head is visible but the baby does not continue to descend through the birth canal. The obstetrician uses the forceps to grab the head gently and then pull when there is a contraction. The combination of the mother pushing and the doctor pulling helps guide the baby out of the vaginal canal.

The forceps can scrape or bruise the sides of the head where they grip the baby. Usually this is along the temples. The bruises and scrapes almost always heal in the first few days of life. If the forceps hit a particular spot on the side of the face, they can irritate a nerve that travels to the eye and the mouth. If the nerve is stunned, the eyelid on that side of the face may be unable to close and the mouth may droop. This is called a Bell's palsy. In almost all cases, the nerve returns to normal within a few days and the Bell's palsy goes away.

Additional Resources

http://www.medem.com (Go to "search medical library" in upper right-hand corner and type in "forceps" or "vacuum.")

CESAREAN SECTION

A cesarean section is the surgical way of delivering a baby. A C-section will be performed for a number of reasons-sometimes the baby is in the wrong position for vaginal delivery (a baby whose feet are pointed toward the vaginal canal is called breech), sometimes the baby is too big to get out through the vaginal canal, and sometimes the mother has a medical condition that makes a C-section necessary. Sometimes the C-section must be performed emergently because the delivery is not progressing or because the health of either the mother or the baby is in danger. Regardless of the cause for the C-section, life for the first few hours or days is generally not much different for a baby born by C-section than for one delivered vaginally, with only a couple of exceptions.

First, a baby born by C-section is slightly more likely than a baby born vaginally to have fluid in her lungs. When water is present in the lungs, the baby must work harder to breathe air, so she may make grunting sounds or breathe very fast. When a baby is living in the womb, the lungs are filled with amniotic fluid. Because a developing baby doesn't breathe air, the water doesn't cause a problem. But once the baby is born, the water needs to leave the lungs quickly so that the lungs can work effectively. Doctors once thought that when babies traveled through the small vaginal canal, the extra water was literally squeezed out of their lungs. Now we know that probably isn't true. Instead, the act of labor stimulates endorphins-chemicals that make labor pains feel a little less intense-in both mom and baby. Endorphins help mop up water from the lungs. So, when a baby is delivered by C-section without much (or any) active labor beforehand-as in the case of a scheduled C-section-the baby is more likely to be born with some extra fluid in her lungs. A baby who is forced to work hard to breathe because of extra fluid has transient tachypnea of the newborn (TTN).

Second, a baby born by C-section is more likely to be sleepy during the first hours (or even days) of life. This is a direct result of the anesthesia that the mom received during the delivery. This is described in more detail in chapter 8.

Additional Resources

http://www.medem.com (Go to "search medical library" in upper right-hand corner and type in "cesarean section.")

http://www.nlm.nih.gov/medlineplus/encyclopedia.html (Click on "C-Cg," then scroll down to "C-section.")

(Continues...)

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Excerpted from YOUR NEWBORN by Cara Familian Natterson Copyright © 2004 by Cara Familian Natterson, M.D.. Excerpted by permission.
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