Back from break

So it is easy to have long hiatuses when it comes to typing. Today I’m at a bit of a block. I love having Mondays off but it is so hard to be efficient when it comes to organizing the day. Much of the day is spent at the computer with random browsing, and I putter around the office trying to get rid of extra papers. The plan for today:

1) Schedule a carseat fitting at the DMV
Yesterday our Graco Snugride 35 arrived in the mail and it remains unopened. Now that I am on the verge of 32 weeks gestation I know that it is best to have the carseat opened, ready, and installed for whenever baby decides to arrive. The nurse at the hospital informed me that what parents usually regret not preparing for is having the carseat properly installed. And remember how eminently important this is. First of all – it is preferable to have a new car seat, and certainly one that has not been in an accident before. Infant carseats are typically rear-facing until the infant reaches 20 pounds AND is at least a year of age.  BabyBargains has several recommendations but the favorite I see around seems to be the Graco Snugride 35 – meaning for children up to 35 pounds (it is also available in smaller sizes for smaller babies, but the 35 should be usable for the longest amount of time).  Officially, if you take the carseat to a fitting station – which is usually free of charge – they can ensure that the carseat is fit properly.

I would highly recommend other new moms to do this as well – carseat safety cannot be underestimated.  Two weeks ago in my outpatient clinic there was an accident that occurred when a baby was being moved into the car and he fell forward on his face and had a bleed in his brain. Unfortunately, I am not certain of the exact details of how the fall occurred, but this accident magnifies to me the importance of carseat safety and in transporting infants. If a child is in a carseat make sure to always ensure that the carseat is buckled securely. Consumer Reports also gives great information on carseats.

The other part of carseat safety that I would recommend is only purchasing a carseat of a particular size when you are ready for it.  Carseat recalls occur frequently; visit the CPSC for up to date recall information on carseats and other consumer products.

2) Scheduling Doctor consultations
Any doctor-patient relationship requires that you be able to trust your doctor. A doctor should be able to treat your child and answer questions in a way that is compatible with your values.  Thus, it’s important to meet a pediatrician prior to your baby being born. That being said, most of us are pretty nice people and if we are board certified, went to good residency programs, and are keeping up with our CME, you should be able to be assured that we are trained well.

Thankfully, I already have a good idea of where I want to take my newborn baby. When I began interviewing for positions at local pediatric practices, I met the fine doctors at Brandywine Pediatrics. Because you don’t know when you are going to deliver your baby, it is a good idea to have a pediatric practice in mind. The best time to see a doctor with your newborn baby is within 1-2 days post-discharge from the hospital.

Does it seem strange that a baby needs to go to the doctor right away when they probably already saw a doctor at the hospital? Well, I have had children come to me for a first doctor’s visit at 2 months of age. But I would NEVER recommend waiting that long. The best continuity of care comes from moms who bring their children in right away – that way, we can get an accurate sense of the child’s weight – which will be different on my scale compared to the hospital’s scale, and we can intervene early when medical problems arise. I have had many instances with newborn visits where I found the babies to be jaundiced and was able to intervene and send them immediately to the hospital for evaluation. Also, various complications can occur after delivery including infections, poor weight gain, and feeding problems. If a mom is having problems with breast feeding, for example, the best time to intervene is right away – when moms still have opportunities for milk supply.

Remember that when you get to the hospital and the baby is born the first question they will ask is where you plan to take the baby for pediatric care. You’ll want to know your doctor’s phone numbers and have that information on hand, and be ready to schedule that first appointment.

3) Meet the Midwife
Okay, perhaps this should have been priority #1 but it was already on the schedule, so  I already knew this was going to happen today. In an ideal world, I would have done this weeks ago.  But here I am, switching from an obstetrician/gynecologist to midwife care. A crazy change in pregnancy, but one that I am looking forward to.  Now it’s time to come up with the questions I didn’t know I wanted to ask, to think about all the things I am worried about in pregnancy, to ask when/if I’m going to meet the backup obstetrician who the midwives associate with. What will the day bring?

3 thoughts on “Back from break”

  1. I hope the midwife visit went well!

    Car seats are one of the few things I’m really really really paranoid about. (I actually need to write a post about our car seat adventures when we flew to Boston earlier in the month.) Talk to the tech when you go about the recommendations for rear-facing; though the AAP hasn’t (I believe) officially changed their stance, it’s now recommending rear-facing until 2 or as long as possible, due to spinal cord injuries in kids whose spines haven’t solidified yet. I try to be a “free-range” (to put a term on it) parent and am generally very easy going, but car seats are my one big thing, especially given that cars are about the least safe place for any of us to be.

    Also important to get a new carseat because folks tend not to know that they do have expiration dates (usually 5 or 6 years after date of manufacture; you can find either the expiration date or the manufacture date on the seat itself) because the plastic starts to break down and it won’t be as safe after that point. It’s the same reason I will only use a used carseat from somebody I know and trust with my life, I don’t trust somebody to sell me one that hasn’t been in an accident, kwim? (FWIW, we did use a borrowed bucket, as we had a convertible seat that worked with small babies, and I knew already that I didn’t like buckets, so a)it was borrowed from friends that yes, I trust with my life and b)we only used it for two months before switching seats. We did have to have a bucket for the hospital, though.)


    1. Well I definitely know the AAP hasn’t yet changed their recommendations of 20 pounds AND 1 year though there was talk of changes to the recommendations. I guess the major point is that rear-facing is always safer than forward facing. You make excellent points, especially about the problems with used carseats. My parents were showing me a toddler carseat that they had purchased from a garage sale AND that was about 15 years old. I took one look at the seat and it made me nervous; I warned them not to use it for anyone, but because a nephew a few years ago “had used the carseat” my father was adamant that it must be safe. I take his cavalier nature to be pure stubbornness – an argument that ” I know better than you kids do” – but I would never consider putting my child in that carseat!

      1. Oh, I know they haven’t changed their official recommendation, I suppose I chose my words poorly. I do wish they would, though, as saying ’20 lbs and 1yr but as long as possible is safer’ just means people stop listening after the 20lbs and 1yr part. There are absolutely reasons to turn earlier, but for the most part people I know turn at one year just because it’s one year, like a right of passage, and never think about the safety aspect.

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