In this lesson, we go over the first 24 hours at the hospital, including skin-to-skin contact, breastfeeding, and antibiotics. The choices you make there are up to you, but we want you armed with this information before you go into labor.
No matter how much preparing you do, and how much time you spend thinking about your baby’s birth (and there is a lot of time during pregnancy to think) you don’t have much control once you go into labor. But there are still a lot of decisions you’ll have to make, both during and after you give birth.
Here’s how to prepare for some of the most common decisions you’ll face once you get to the hospital.
- I Tested Positive for Group B Strep. Should I Get Antibiotics?
Near the end of your pregnancy, you’ll most likely be tested for Group B Strep (GBS). Nearly 25% of moms have this bacteria in their vagina or rectum, though most don’t have symptoms. If you have it, you will be given IV antibiotics during labor. You also will not be allowed to swab your baby with your vaginal fluids in the event of a C-section.
You’ve read how antibiotics can be really harmful to a person’s microbiome and should only be used as necessary. This is one time it’s necessary. Group B Strep can easily pass to your baby during a vaginal delivery. If it does, it can cause pneumonia or meningitis in your baby, and this used to be a leading cause of death among healthy newborns.
Research has shown that babies who received antibiotics during labor had very different microbiomes than babies who didn’t. However, those differences often disappear in about 12 weeks, with other microbiome-improving tactics like breastfeeding and skin-to-skin contact. It is far more important for your baby to be born without an infection.
- Should You Take Time for Skin-to-Skin?
Yes! Baby-friendly hospitals are moving to a model where skin-to-skin contact is encouraged right after your baby is born. This means the baby will be immediately dried off and laid directly on your bare chest after birth. You’ll be covered in a warm blanket for about an hour, or until after the first feed.
Skin-to-skin contact after the birth helps you and your baby calm down after an exhausting experience. It also has the benefits of:
- Transferring your friendly bacteria to your baby’s skin
- Stimulating your hormones to support breastfeeding
- Offering your baby a chance to feed for the first time, during which she will get even more nutrients and friendly bacteria from you.
- Is Breastfeeding Important?
Yes, but not more important than your own health and sanity. You should breastfeed if it’s possible for you, but don’t panic if it’s not.
While many of the benefits of breastfeeding vs. bottle feeding are oversold (babies bond with their mothers either way), nursing provides your baby with bacteria both from your nipples and your breastmilk that bottle feeding cannot replicate. Breastfeeding for the first couple months of your baby’s life has also been shown to reduce the chances of all allergic diseases. As one paper recently determined, breastfeeding both directly exposes your baby to the milk bacteria, but also provides the human milk oligosaccharides, which promote healthy gut bacteria growth.
Breastfeeding can be overwhelming for a lot of moms, and impossible for some. But for those who can breastfeed, or pump and bottle feed, it can be really beneficial in preventing future eczema, asthma, and food allergies. The American Academy of Pediatrics recommends breastfeeding for 6 months, but any amount of time you are able to do it is better than none.
- Should My Baby Get the Hepatitis B Vaccine?
Yes. The first dose of the Hepatitis B vaccine is usually given to your baby on their very first day. As discussed in previous posts, there is no evidence that vaccines negatively impact the gut microbiome or that they are linked to eczema, asthma, or allergic disease in any way.
While some will claim that vaccines do something to the immune system that causes food allergies, you should know that vaccines for viruses act on a different pathway (TH1) in the immune system than the pathway (TH2) in food allergies. There is no scientific connection between vaccines and the development of food allergies. Vaccines save lives.
- Does My Baby Need Eye Antibiotics?
Maybe, maybe not.
A lot of hospitals will apply erythromycin, an antibiotic, to your baby’s eyes within two hours of birth. The antibiotics usually come in the form of eye drops or an ointment. Hospitals started doing this to prevent blindness in babies from STDs like chlamydia and gonorrhea. If you have one of these, your baby should definitely get the antibiotics. Again, using antibiotics only when necessary means use them when necessary.
However, if you have tested negative for these germs, and have no reason to believe that you acquired them between the test and childbirth, there’s no real reason for the antibiotics. One of our favorite books, Expecting Better, has a great chapter on this point. Most hospitals (some state laws are different) will allow you to refuse the erythromycin.
If you go in prepared with answers to these questions, you can soak up every minute with your baby in the hospital until they boot you out and say “good luck!” But don’t worry — we’re not booting you out. We’ll stay in touch with more timely information on how you can reduce your baby’s risk of food allergies, eczema, and asthma as she grows.
Do you have a birth plan?