The Baby - First Things First

What happens when the baby is born varies in cach country (and each state in the U.S.).  You may want to check with the hospital whether they routinely do the following, and if not, decide whether you want it done.

Antibiotics during labor:
Group B Strep (GBS) is a common bacteria that lives in mucous membranes including the bowel, bladder and vagina.  Estimates indicate that between 10 and 30 percent of western pregnant women carry GBS bacteria, and Indian doctors suggest the figures are likely higher for Indian surrogates.  Without treatment, 1% of babies born to GBS positive mothers can become infected and develop early-onset GBS disease which can cause sepsis (a blood infection), pneumonia or meningitis.  The two main preventative measures are to (a) have the surrogate screened between 35 and 37 weeks of pregnancy (much earlier if  you have multiples as they often deliver closer to 34 weeks), and, if the surrogate tests positive, provide antibiotic treatment during labor or (b) to have/schedule a caesarean delivery which then avoids exposure to bacteria in the vagina.  Because of the higher prevalence of GBS among Indian women, some Indian doctors give the antibiotics routinely.

Eye Drops
Babies are typically given medicated drops or antibiotic ointment in their eyes when they are born.  This protects their eyes from bacterial infections that can be contracted during delivery.

Vitamin K Shot
Immediately after birth, babies cannot produce their own vitamin K, which assists in blood clotting.  A Vitamin K shot will help prevent bleeding problems that can sometimes occur. 

Hepatitis B vaccine
In the U.S., this is often given before discharge.  It is a series of three shots, with the first given in the hospital.

Screening Tests
A newborn often receives a blood test to screen for disorders.  A few drops of blood are obtained by pricking the baby's heal.  In the U.S. most states screen for 21 life-threatening disorders, although some screen for more.  These include phenylketonuria (PKU) and hypothyroidism, both which are treatable but can cause mental retardation if left untreated. 

Hiranandani Hospital, where most babies from Rotunda are delivered, does offer optional newborn screening tests.  These are currently done through Preventine Life Care in Mumbai.  Comments from Dr. Shetty (suvin.shetty (at) hiranandanihospital.org) about these screening tests indicated:

  • Being a screening program, any test, which is positive, would need to be confirmed by further testing (charge would be additional as these tests are different) while treatment is being instilled.
  • In a newborn we prefer to collect sample in the 1st week (Day 3 – Day 5 preferably) as this period will give results for a number of disorders and help the pediatrician to take appropriate action wherever necessary.
  • The results are available in 3 working days (blood sample) and 8 – 10 working days (urine sample).
  • The newborn screening has been optional and hence not included in the package. Hence, there will a charge of Rs 6500/- (approx US$150) for the screening on OPD basis.

Hearing Test
This is typically done in U.S. hospitals as well.  The test measures how the baby responds to sounds by putting a small earphone/microphone in the baby's ear.  Without testing, hearing loss may not be diagnosed until the baby is 3 years old.  Diagnosing hearing loss earlier can help prevent speech development problems. 

Circumcision
If you have a boy, you'll have to decide whether you want him circumcised.  If so, check to confirm the hospital has facilities to support this.  

Cord blood banking
Cord blood can help treat a number of diseases, including leukemia and lymphoma.  Studies seem to show that the odds of requiring a stem cell transplant to treat such a disease during ones lifetime is 1 in 217.  India has private cord banking services available including from private companies like Cord Life India

 

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