Home Birth VS Birth Center - Which is Right for You?

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You’ve decided you want a natural birth experience with minimal interventions and a midwife as your caregiver. But what are your options for where to give birth?

Most natural births will either take place in your own home or at a birthing center, and the Cincinnati Birth Center is thrilled to be able to offer BOTH choices to expecting mothers! But how do you decide which location is right for you? Ultimately, the answer is wherever you feel the most comfortable giving birth. 

To help you make your choice, let’s take a quick dive into what makes home birth and birthing centers unique.

Benefits of a Home Birth

A home birth is exactly what it sounds like – giving birth in the comfort of your own home, often attended by a certified midwife and a trained doula. Here are some of the benefits to consider when contemplating a home birth:

  1. Comfort and Familiarity: Giving birth at home allows you to be in a familiar environment, which can help you relax and have a sense of security. You have control over your surroundings -  from the lighting to the music - creating a personalized and comfortable atmosphere. It’s also a more inclusive way to have older children, other family members, and anyone else present at the birth without getting outside permission.

  2. Use Your Own Supplies: While your midwife will bring needed supplies and possibly a birthing pool, you have the freedom to purchase/use your own supplies, use your own shower, and have access to anything else of yours as desired. 

  3. Personalized Care: Your midwife and/or doula will provide continuous one-on-one care, offering support and guidance throughout your labor and delivery. This personalized attention can be reassuring for many.

  4. No Unnecessary Interventions: If you wish for minimal interventions during your labor, have a low-risk pregnancy, and feel confident in your body’s innate ability, a home birth can be one of the most empowering events you will ever experience. 

Benefits of a Birth Center

A birthing center is a midwife-led, home-like facility designed for childbirth. It's distinct from a hospital environment and offers a balance between a home birth and a traditional hospital birth. Here's what you can expect with a birthing center:

  1. Home-Like Environment: Birthing centers are designed to create a comfortable, homey atmosphere while ensuring you have access to professional medical care should complications arise. They often feature spacious rooms, birthing pools, and cozy furnishings.

  2. Certified Midwives: The care you receive in a birthing center is led by certified midwives who emphasize a more natural approach to childbirth. If you opt for a birth center, you won’t have to wait for a midwife to arrive at your home, but you can still enjoy being at home for early labor before going to the center.

  3. Lower Intervention Rates: Birthing centers have much lower intervention rates compared to hospitals, making them a suitable choice for parents who want a more natural experience but prefer to give birth at a medical facility.

  4. Emergency Care Close By: Although birthing centers aim to provide a home-like setting and have a low transfer rate, they are equipped to handle emergencies and have a plan for transferring you to a nearby hospital should the need arise.

Which is Right For You?

If you’re still going back and forth on which birthing location is the best fit for you, consider the following:

  • Medical Risk Factors: Before anything else, evaluate your pregnancy's risk factors with your healthcare provider. If you have a low-risk pregnancy, both home births and birthing centers may then be considered.

  • Comfort Level: Consider where you feel most comfortable. Do you prefer the relaxation and familiarity of home or a medical facility with home-like comforts?

  • Support System: Discuss your preferences with your partner, family, or support system. Their input and comfort level may play a big part in your decision.

  • Distance to Hospital: If you choose a home birth, make sure you live within a reasonable distance to a hospital in case of emergencies. If you live far away from the nearest hospital, both you and your midwives may feel more comfortable with using a birth center instead.

  • Cost and Insurance: Investigate the costs and insurance coverage for both options, as they can vary significantly.

  • Legal Considerations: Research any legal requirements and regulations for home births and birthing centers in your area.

Ultimately, the decision between a home birth and a birthing center depends on your personal preferences, risk factors, and the kind of birthing experience you desire. Have open, honest conversations with your midwife and support system to make an informed choice that aligns with your values and needs. Whichever path you choose, the goal is a safe and positive birthing experience for both you and your baby!

10 Ideas to Create a Calm and Relaxing Birth Environment

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Home birth is an empowering experience that is starting to appeal to more and more women. For those with low-risk pregnancies, home birth is a beautiful choice for those who desire a more intimate and familiar setting.

What are some ways you can create a calm and relaxing birth environment right inside the comfort of your home?

1. Choose the Right Space

What place in your house makes you feel most at peace? You should choose a birthing room that is spacious, well-ventilated, and private. Many people opt for their bedroom for the convenience of their bed, but if you plan a water birth or other way of giving birth, you might prefer a different room. A space with soothing colors and natural lighting can contribute to a calming atmosphere - make sure the room can be dimmed to create a cozy and serene setting.

2. Declutter and Simplify

Get that nesting mode working for you the last few weeks of pregnancy! A clutter-free environment can reduce stress and create a sense of calm. Declutter the chosen birthing room by removing unnecessary furniture and personal items. This will not only make the space more comfortable but also make it easier for your birthing team to move around.

3. Set the Mood with Lighting

Calming mood lighting - what does that look like for you? Candles, soft string lights, a disco ball… okay maybe not that last one (unless you love it, you do you!), but the right lighting can make or break your calm environment. Natural light is ideal during the daytime, but you should also be able to dim the lights when needed. 

4. Include the People YOU Want

Make sure you decide ahead of time who you want included in your birth, and whether they will be there the whole time, just during labor, or just during the actual birth. Whether you want just your partner and midwife in the room or whether you want your whole family there plus the next door neighbor - make your desires known ahead of time so that there are no hurt feelings in the moment.

5. Use Aromatherapy

Aromatherapy is a powerful tool for relaxation. Try using essential oils like lavender, chamomile, or peppermint to create a calming atmosphere. Diffusers or scented candles can disperse these soothing scents throughout the room and help you relax. Be sure to choose scents that you find personally calming and pleasant.

6. Play Calming Music

Music can have a profound impact on your mood and relaxation. Create a playlist ahead of time of your favorite calming and soothing tunes. Consider sounds of nature, classical music, or meditation tracks. Music can provide a comforting backdrop to your birthing experience and even distract you during contractions.

7. Consider the Senses

Don’t forget about your other senses!Think about textures, tastes, and sounds that make you feel the most relaxed. Provide soft blankets or fabric for touch, have light and nourishing snacks available that you love, and use calming sounds or white noise machines to block out any distractions from the outside world.

8. Use Birthing Affirmation Cards

Affirmation cards contain phrases that help you keep a positive mindset all through labor and remind you that you do have the strength to birth your baby. Look up phrases online or write your own to keep where you can see them or available for someone read to you periodically.

9. Personalize Your Space

Add personal touches to your birthing environment. These could be items that hold sentimental value, such as family photos, artwork, or mementos. Having familiar and cherished items around can make you feel comfortable and secure.

10. Prepare a Birth Plan

First, a disclaimer you are probably well-aware of - births almost never go exactly to plan! However, if writing out a birth plan helps you feel calm going into labor, by all means, have one ready. Plus, they can be helpful in letting others know your desires and vision.

Coping with Sciatica During Pregnancy

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If you’ve felt it, you know it - that sharp, shooting pain radiating down your lower back and into your legs. Most expecting mothers experience regular aches and back pain at some point - one study showed 76% of mothers in the trial experienced back pain [1] - but what if you are among those who experience the debilitating pain known as sciatica?

Sciatica is a condition characterized by pain radiating along the path of the sciatic nerve, which runs from the lower back down through the buttocks and into the leg. It’s often caused by the compression or irritation of the sciatic nerve, leading to symptoms such as sharp pain, tingling, numbness, and muscle weakness in the lower back, buttocks, and legs.

Why Does Sciatica Happen During Pregnancy?

It seems like there are enough side-effects of pregnancy without adding one more, especially if it hinders your mobility. So why does sciatica often happen during pregnancy? A handful of factors may contribute to you developing sciatica during pregnancy [2]:

Lumbar Spine Problems - A bulging or herniated disc caused by the growing pressure of the uterus may be the cause behind your sciatica pain. If you already had spinal problems to start with, pregnancy may be exacerbating the issue.

Hormonal Changes - Hormones like relaxin, which help prepare the body for childbirth by relaxing ligaments and muscles, can also affect the stability of the spine and contribute to sciatic pain.

Postural Changes - Pregnancy alters your posture, as your center of gravity shifts forward. This can lead to changes in the curvature of the spine and increased pressure on the sciatic nerve.

Baby's Position - The position of the baby in the uterus can put pressure on the sciatic nerve, especially during the later stages of pregnancy. Sometimes the baby’s head may rest directly on the nerve itself.

How to Handle Sciatica While Pregnant

  1. Consult Your Midwife:

    • The first step in managing sciatica during pregnancy is to consult your midwife. She can help assess your condition, offer guidance, and create a tailored plan to address your specific needs.

  2. Prenatal Exercises:

    • Engage in prenatal exercises that strengthen the muscles supporting your lower back and pelvis. Your midwife can recommend safe exercises and stretches to alleviate sciatic pain.

  3. Pelvic Tilt Exercises:

    • Pelvic tilts can help relieve sciatica by stabilizing your pelvis. Lie on your back with your knees bent and gently rock your pelvis back and forth.

  4. Heat and Cold Therapy:

    • Applying a warm compress or ice pack to the affected area can help reduce inflammation and alleviate pain. Always use a cloth to protect your skin from extreme temperatures.

  5. Supportive Footwear:

    • Wearing comfortable, supportive shoes can help maintain proper posture and reduce the strain on your lower back and pelvis. 

  6. Prenatal Massage:

    • Consider getting regular prenatal massages from a qualified therapist who understands the needs of pregnant women. This can help relax tense muscles and reduce pain.

  7. Proper Body Mechanics:

    • Watch your posture when sitting, standing, and lifting objects. Avoid activities that exacerbate your symptoms.

  8. Sleeping Position:

    • Use a body pillow or pregnancy pillow to support your body while sleeping. Sleeping on your side with a pillow between your knees can relieve pressure on the sciatic nerve.

  9. Alternative Therapies:

    • Some pregnant women find relief from sciatica through complementary therapies like acupuncture or chiropractic care. Find a medical professional who is experienced in helping expectant mothers and who can tailor therapies to your needs.

Sciatica during pregnancy is a challenge, but it is a manageable challenge with the right care and support. By staying proactive, following a plan, and seeking professional guidance, you can reduce the pain of sciatica instead and look forward to the joy of welcoming your new baby into the world.

Natural Pain Management During Home Birth

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Pain - one of the first things women tend to worry about when thinking about labor, especially unmedicated birth. Pain levels can vary greatly from person to person and even from one labor to another - there is no guarantee you will have more or less pain than someone else. However, emotions, fear and anxiety can intensify the perception of pain. With this in mind, there are many mental and physical techniques to manage your pain naturally so you can enjoy your home birth the way you’ve always pictured!

Natural Pain Management Techniques

Breathing Techniques

  • Slow, Deep Breaths: Practicing slow, deep breaths can help relax your body and reduce pain. Deep breaths send oxygen to your blood which reduces stress hormones and slows down your heart rate. Inhale deeply through your nose and exhale slowly through your mouth every time you feel a contraction peak.

  • Patterned Breathing: Creating rhythmic breathing patterns can divert your attention from pain. Try techniques like "4-7-8" (inhale for 4 counts, hold for 7 counts, and exhale for 8 counts) or "circular breathing" (continuous inhales and exhales without pausing).

Movement and Position Changes

  • Walking: Taking short walks can promote better circulation, help the baby descend, and relieve pain.

  • Rocking: Gentle rocking motions can ease discomfort and provide comfort.

  • Changing Positions: Try experimenting with different positions, such as squatting, kneeling, or leaning over a birth ball to relieve pressure and pain. Remember to keep your options open, as what works for one person may not for someone else, or something that worked for you in a previous labor may not feel right this time.

Hydrotherapy

  • Warm Bath or Shower: Soaking in a warm bath or standing in a warm shower can relax tense muscles and reduce pain. Many women prefer to labor in a tub for pain relief.

  • Waterbirth: A step beyond laboring in a tub, waterbirth involves staying in the water during the actual birth of the baby. Those who experience waterbirth tend to report lower pain levels than those who push and deliver “on land” (i.e. out of the water) [1].

Massage and Counterpressure

  • Back Massage: Applying gentle pressure to the lower back can alleviate back pain, which is common during labor.

  • Counterpressure: Use a rolled-up towel or a partner's hands to apply pressure on the lower back and hips for the duration of each contraction.

Hypnotherapy and Visualization

  • Guided Imagery: Imagine serene and calming scenes to help you relax and cope with pain.

  • Hypnobirthing: Learning self-hypnosis techniques can enable you to enter a deep state of relaxation and reduce pain perception. Mothers who learn this technique tend to describe feeling pressure rather than pain with each contraction.

Environment

  • Essential Oils: Aromatherapy using essential oils like lavender, chamomile, or peppermint can create a soothing environment and reduce stress [2]. Keeping your mind stress-free is one of the best things you can do for pain relief.

  • Music and Sound: Soothing music or nature sounds are therapeutic if you are interested in what you’re listening to. A person’s favorite music triggers the release of natural pain relieving chemicals in the brain, creating an environment suited to your labor needs.

Finding the Right Techniques for You

How do you know which pain management techniques are right for you? Consider attending childbirth classes to learn about these techniques in-depth and practice them during pregnancy. The more familiar you are with these techniques, the more effective they will be during labor. Keep in mind, however, that labor is unpredictable. Be open to trying different techniques if your initial choices aren’t providing the relief you hoped for.

Remember, the goal is not just to manage pain but to welcome your new baby into the world with love, support, and a sense of empowerment!

Iodine's Impact on Pregnancy

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In the midst of all the advice and information you receive during pregnancy, there’s an essential nutrient that shouldn’t be overlooked - iodine, a micronutrient that holds the key to cognitive development and well-being for both you and your little one. 

Why Iodine Matters

Iodine is a trace mineral found in food that supports the production of thyroid hormones and normal function of the thyroid gland. These hormones play a critical role in regulating metabolism, energy production, and the development of the baby's brain and nervous system. Iodine deficiency during pregnancy can lead to complications such as poor thyroid function, intellectual disabilities, and developmental delays in the baby [1].

Benefits of Iodine for You and Your Baby

Healthy Brain Development:

Balanced iodine levels are vital for the development of the baby's brain and nervous system [2]. An underdeveloped brain can lead to developmental delays, impaired growth, deafness, and other issues.

Thyroid Function: 

Iodine supports both yours and your baby’s thyroid gland, helping maintain a healthy metabolism and higher energy levels for both of you.

Hormonal Balance: 

Keeping enough iodine in your diet helps balance your hormones throughout pregnancy, supporting various physiological processes.

Top Food Sources of Iodine

Pregnant women should try to get around 220 micrograms of iodine each day for a healthy pregnancy [3]. And don’t forget to keep up your iodine intake while breastfeeding! Iodine passes through breast milk to baby, which means you continue to support your child’s development during your breastfeeding journey.

Remember to look at the label on your prenatal vitamin to see how much iodine you’re getting from that source. Many prenatal vitamins actually don’t provide iodine, so it’s important to make sure you are taking a vitamin that provides this important mineral.

Also, chlorinated water and fluoridated water are known to block iodine absorption, contributing to iodine deficiency and poor thyroid health. Use caution in your exposure to these chemicals.

Some food sources high in iodine to keep in your diet include:

  1. Seaweed

  2. Seafood

  3. Greek Yogurt

  4. Full-Fat Milk

  5. Eggs

  6. Lima Beans

  7. Iodized Salt

Remember: Regular table salt that's been iodized is an easy way to ensure you're getting iodine in your diet. Many people use sea salt instead of iodized salt, which isn’t iodized, and a lot of processed foods do not use iodized salt. Don’t rely solely on iodized salt for your nutritional needs, but it is a great source of the mineral to add to your diet.

Nurturing Healthy Beginnings

During pregnancy, every nutrient counts, and iodine is no exception. Keeping up a steady intake of iodine-rich foods can significantly benefit your baby's brain development and overall health. By incorporating seafood, dairy products, iodized salt, and other iodine-rich foods into your diet, you're giving your little one the best chance for a bright and healthy start. 

Visit our wholesale account at Wellevate to look for prenatal vitamins, iodine supplements such as Liquid Light minerals, and other products that match your needs.

Thyroid Guide for Moms-to-Be

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You’ve probably gotten your thyroid checked before, but do you know why it’s so important to keep tabs on this particular gland?

What is the Thyroid?

Your thyroid, a small butterfly-shaped organ located in the neck, plays a crucial role in your health, especially during pregnancy. This gland is responsible for producing two main hormones: thyroxine (T4) and triiodothyronine (T3). These hormones are key to maintaining metabolism, energy production, and other essential functions such as brain development, heart rate regulation, and temperature control.

Thyroid Diseases While Pregnant

Thyroid disorders are fairly common during pregnancy, ranking as the second most common endocrine condition after diabetes [1]. During pregnancy, your body undergoes hormonal changes to support fetal growth and development, which can also affect thyroid hormone levels. It’s important to monitor your thyroid to promptly detect any abnormal fluctuations.

A family history of thyroid disease can increase the risk of a pregnant woman developing thyroid issues, and may be a sign for extra vigilance during thyroid monitoring. 

There are two main dysfunctions of the thyroid, known as hyperthyroidism and hypothyroidism:

A hyperthyroid occurs when the thyroid gland produces an excess of hormones [2]. About 1 in 100 people in the U.S. will develop hyperthyroidism, especially among women. Common symptoms to watch out for include:

  • Unexplained weight loss

  • Rapid or irregular heartbeat

  • Nervousness or anxiety

  • Increased sensitivity to heat

  • Fatigue and muscle weakness

  • Tremors

  • Changes in menstrual patterns

A hypothyroid, on the other hand, happens when the thyroid gland does not produce enough hormones [3]. Around 1 in 20 people in the U.S. are diagnosed with a hyperthyroid. Symptoms of hypothyroidism include:

  • Fatigue and weakness

  • Weight gain

  • Cold intolerance

  • Dry skin and hair

  • Constipation

  • Depression and mood swings

  • Irregular menstrual cycles

What are the Risks of Thyroid Disease While Pregnant?

Untreated thyroid disease during pregnancy can lead to unwanted complications such as:

  • Gestational Hypertension: Thyroid dysfunction may contribute to high blood pressure during pregnancy, increasing the risk of preeclampsia.

  • Preterm Birth: Pregnant women with untreated thyroid conditions may be more prone to preterm labor and delivery.

  • Miscarriage: Thyroid disorders can elevate the risk of miscarriage, particularly during the first trimester.

  • Fetal Development Issues: Thyroid hormones play a crucial role in fetal brain development. Untreated thyroid disease has been shown to sometimes impact the baby’s neurological development [4].

Managing Thyroid Health Medically and Naturally

  1. Get your thyroid tested regularly, especially if you have a personal or family history of thyroid conditions.

  2. Check with your healthcare professional if medical intervention (such as synthetic thyroid hormones) is necessary to treat your thyroid dysfunction.

  3. Maintain a balanced diet with plenty of iodine, selenium, and other essential nutrients for optimal thyroid function. 

    Selenium helps reduce thyroid antibodies and inflammation. Eating a brazil nut every day is a great way to incorporate this mineral into your diet. 

    Iodine is needed to make thyroid hormones, and a deficiency in this mineral is linked to thyroid diseases [5]. A great way to keep up a regular intake of iodine is through raw dairy, seaweed, and seafood.

  4. If you have any food intolerances, removing triggering foods such as gluten, eggs, or dairy is very important to your thyroid health.

  5. Lower your stress levels to keep your thyroid hormone levels in balance. Try relaxation techniques such as meditation or yoga to help manage stress.

  6. Try home remedies to support your thyroid health if you have the green light from your practitioner. Some common home remedies include: Evening primrose oil for anti-inflammatory properties, coconut oil for medium-chain fatty acids, or vitamin A for thyroid hormone synthesis.

Long story short, thyroid health is extremely important for pregnant women as it directly impacts both maternal and fetal well-being. By managing thyroid health with the help of healthcare professionals and adopting a balanced lifestyle, women can ensure a healthier pregnancy and a better start for their little ones!

You Need To Know About Prebiotics; Here’s Why

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Much research has been coming out over the past few years about gut health and the human microbiome. Supplement companies have taken this opportunity to create a 61 billion dollar industry producing probiotics, but are they truly helpful? Recently researchers have discovered a person’s gut flora or microbiome, the mixture of bacteria that are in their gut, is set by the time a person is two or three years old. In other words, probiotics don’t actually replace the bacteria in your gut. What they can do is communicate positive messages with your gut which can result in healthy genetic changes. So how do you improve your gut health if you can’t replace the bacteria that’s already established? The answer is to incorporate prebiotic foods into your diet on a daily basis. Prebiotics are foods which your body cannot break down without the assistance of beneficial bacteria. Breastmilk is full of prebiotics to set up a child with a healthy gut.

What are examples of prebiotic foods?

The most healing prebiotic foods are garlic, onions, asparagus, artichokes, dandelion, leeks, seaweed, almonds, chicory, Jerusalem artichokes, jicama and mushrooms. In addition, oats, carrots, dark leafy greens, non-starchy squash (such as zucchini, summer, and spaghetti), plantains, green bananas, avocado, mango, pistachios, hazelnuts, sweet potatoes, and kiwi. Cooked and then cooled rice or potatoes include resistant starch which is a prebiotic food. Fiber rich foods boost gut health. These include both soluble fiber and insoluble fiber. Soluble fiber is found in foods such as nuts, oat bran, chia seeds, barley, seeds, beans, lentils, Brussel sprouts, collards, kale, parsnip, parsley, psyllium husk, beets, sweet potato, and broccoli . Insoluble fiber, which doesn’t dissolve in water, is found in foods such as wheat bran, peppers, apples with skin, pumpkin, blueberries, celery, cucumber, eggplant, radish, raspberry, spinach, strawberry, brown rice, flax, quinoa, and buckwheat groats. Incorporate some of these foods into at least two of your three meals per day.

What are examples of probiotic foods?

Probiotic foods contain live and active bacteria. It’s beneficial to include small amounts of prebiotic foods in your diet such as kefir, yogurt (check the label to ensure it includes live cultures), cheese, especially hard cheeses like cheddar and parmesan, pickles if they’re lacto-fermented and require refrigeration (Clausen’s is a good brand), kimchi, and lacto-fermented sauerkraut (check the ingredients, it should require refrigeration and not be made with vinegar). Probiotic drinks include kombucha, beet kvass, and water kefir. Read the labels because sometimes those drinks have high amounts of sugar. Another way to incorporate probiotic foods is to make salad dressings with raw vinegars or mocktails with a teaspoon of vinegar. Any type of raw vinegar works. Keep in mind that balsamic vinegar can be very high in sugar.

What about herbs and supplements?

If you’ve completed a course of antibiotics in the past few years or are struggling with chronic illness, insulin resistance, chronic yeast infections, diabetes, or autoimmune disease, you may need to incorporate additional herbs and supplements for gut healing. These may include minerals such as selenium (found in Brazil nuts), zinc carnosine, chromium, and iodine. Herbal teas such as ginger, spearmint, lemon balm, lavender, cinnamon, turmeric, fennel, licorice and thyme help to heal the gut. Green tea can help with blood sugar regulation. Gruels can be made with deglycinated licorice root powder and slippery elm bark powder which soothe the mucous membranes in the gut.

Should I still take a probiotic?

If you’re incorporating the prebiotic foods in your diet and using the herbal teas and still struggling with health issues, you can try a probiotic supplement. The most evidence-based effective probiotics I’ve seen on the market recently are Microbiome labs, especially their megaspore probiotic complete, or Orthomolecular products.

You can order minerals, herbs, and Microbiome labs or Orthomolecular products from our wholesale account through Wellevate here:

https://wellevate.me/cincinnatibirthcenter

Meet India Stringer

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How long have you worked for the Cincinnati Birth Center?

The first birth I did for the Cincinnati Birth Center was in September of 2020.

What is your role within the center?

I’m the main birth assistant and a student midwife.

What brought you to the Cincinnati Birth Center?

Another midwife connected me to the Cincinnati Birth Center and I saw the opportunity to help moms.

What do you do outside of the Cincinnati Birth Center?

I'm a mom to a cool ten year old boy and I study midwifery. I like trying new restaurants.

Who is a strong woman in your life whom you look up to? Why?

My mom, Leslie Stringer. My mom is strong because I've seen her in many different roles and she always takes them on headstrong. She's super positive and optimistic and it inspires me. She's really caring. She could literally be in the worst mood ever and take care of any and everybody.

What motivates or inspires you?

I'm motivated by effort..the observation of effort in others. Even if you're showing just a little bit of effort it makes me see you are trying and realize maybe I can give a little effort too.

What inspires me is passion. Hearing other people passionate about birth made me find my own passion for it. Seeing others' passion inspires me to become passionate about something.

Share something not a lot of people know about you:

I binge watch documentaries all the time. I've slowed down recently but I'm a documentary junkie. I love serial killer documentaries, murder documentaries, animal documentaries, Ancient Aliens.

Words you live by?

“Honesty and loyalty.”

How to Choose a Pediatrician

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A Pediatric provider can be a pediatrician, family practice doctor or nurse practitioner.

A good pediatric provider will do these three things:

1) Be a sounding board.

Your pediatric provider needs to be able to listen to you and provide feedback and education as you navigate the many challenging decisions you make as a parent. Many different vaccinations are recommended and you should be able to discuss each of them with your provider. They should be educated about which ones are most important and the recommended schedules.

2) Growth and weight.

Your pediatrician needs to evaluate your child’s growth and weight according to evidence-based growth charts based on your infant’s feeding method. Formula fed babies follow a different growth pattern than breastfed babies, although the head measurements should be the same. How many wet and dirty diapers your baby has is also critical information to know your baby’s getting enough. A breastfed newborn baby should have 3-5 bowel movements each day and lots of wet diapers after the milk comes in on day three.

3) Detect rare conditions and be aggressive in pursuing diagnosis and treatment.

Although thanks to modern medicine, it is rare, some newborns will die shortly after birth. The three primary causes of death in newborns are infection, heart problems, and inborn errors of metabolism.

Infections typically start in the amniotic fluid during pregnancy or lungs before infecting the whole body, which is known as sepsis. A pediatrician needs to respond appropriately and differently between a two year old with a fever (probably okay to stay home) and a newborn with a fever (needs to go to the hospital immediately). They must understand newborn skin rashes and be able to detect whether they’re from allergens or infections. A good pediatrician understands newborn feeding habits. A newborn who has been nursing well but then refuses the breast could be very ill and should be evaluated immediately. Other newborns may have had a difficult time latching from birth because of a structural issues such as a tongue-tie and may need care from a bodyworker and pediatric dentist to release the tie. Newborn infections can progress in a matter of hours but are not as sudden and severe as heart problems.

Heart problems often have a very sudden onset. Sometimes heart problems go undetected despite the mother having anatomy scans during pregnancy and the newborn having the cardiac pulse oxygen screen performed 24 hours after birth. When the baby has a heart defect, often it will manifest at day 2-3 when the heart duct, which received oxygen from the umbilical cord in utero, closes after birth. A baby that has a heart condition may become blue or grey in color. This baby needs to be taken to the hospital immediately for urgent critical care.


Inborn errors of metabolism are rare genetic conditions which can manifest in different ways. These disorders often involve the baby’s ability to process sugars and proteins. Screening is performed by pricking the infant’s heel and taking a sample of blood on a spot card. This test should be performed after 24 hours to ensure the baby has consumed some protein but within the first 72 hours of life as it takes 5-7 days to obtain the results of this test. Individuals with these genetic conditions lack the ability to break down proteins or sugars, and if these products build up in their brain and tissues it will cause irreversible and sometimes fatal damage. Thankfully many of these serious side effects are preventable with prompt diagnosis and aggressive treatment. You should choose a pediatrician you think is knowledgeable in these conditions and who will respond aggressively when warranted.