If anyone has been in a delivery room while a woman was giving birth, or noticed how many professionals were in the delivery room in the span of a few hours, then it would be obvious that a pediatrician plays a vital role in a woman's birth and delivery story.
Pediatricians carry out a series of extremely important tests on babies once they are born. The main reason for the series of tests is to check for proper growth and development of the baby’s body parts and internal organs. These pediatricians use these tests to check the overall health of the new baby and to consider the next reasonable course of action. Most newborn babies are not able to carry out some of their body functions as would be expected, so sometimes doctors have to intervene.
Most of the activities during a baby’s first physical exam are part of hospital standard procedures, and they are the main reasons why pediatricians should always be present during all hospital deliveries. These are for the benefit of the baby so the pediatrician does not need the consent of the parents to check on the baby, carry out a test, or administer meds as he or she sees fit.
However, there are a few times when pediatricians need to get permission from parents to conduct particular checks on a baby. Here are 20 things pediatricians can do to a newborn without needing consent from parents.
20 Hearing And Pulse Oximetry Screening
The moment a newborn baby is at least 24 hours old, a pediatrician can conduct some screen tests during the baby’s first check-ups. The screening normally includes a hearing test and a pulse oximetry test, which the doctor can do without parental consent.
Hearing tests consist of two different procedures used to screen for loss of hearing in babies. One will determine if certain parts of the baby’s ears are responding to sound while the other will evaluate auditory brain stem as stated by Babys First Test. Both tests happen in less than 10 minutes. The pulse oximetry test, on the other hand, determines how much oxygen is in a baby. These tests are completely safe and comfortable for the newborn.
19 Ordering A Baby’s Bath
When babies are born, a white substance called vernix—and other types of bodily fluids— usually cover them. Some pediatrician will choose to have the baby immediately bathed while others will wait a few hours so that the baby can benefit from the vernix, as stated by Children's MD.
Despite the choice, pediatricians or nurses can wash the baby without parental consent. They do so because they are aware that mom is still nursing her childbirth wounds and barely has enough energy to hold the baby let alone give him a bath. It is even more sanitary for moms to hold and bond with their little one after they have had their first bath.
18 Give Antibiotic Eye Ointment
Newborns are born with very sensitive eyes and if the doctor does not take good care of them, they can contract infections. When pediatricians are conducting the baby’s first checkup, they can apply an antibiotic eye ointment into the baby’s eyes. Most states mandate this treatment and pediatricians do not need parental consent to do it. However, there are parents who refuse the treatment, as claimed by What to Expect.
It is important to apply antibiotic ointment in the baby’s eyes routinely to prevent pink eye, which can cause blindness, and get rid of any other bacteria present. These bacteria usually get to babies born through natural births, though babies born via C-section can also get the pink eye.
17 Give The Hep B Vaccine
According to the new Pediatrics Policy, newborns should get their hep B vaccine within their first 24 hours of life. Previously, pediatricians could delay the vaccine until the two-week checkup. Most pediatricians can give a baby the vaccine without consent from the parents because it is now a standard procedure. Nevertheless, they should inform the parents of their intentions to administer it.
Parents who do not have information about the risks of contracting the virus may not understand why the baby is going through vaccination at such an early age and can end up refusing the vaccine. However, they should sign a parent refusal form as claimed by Today's Parents.
16 Take The Baby To The Nursery
Pediatricians do not need any parental consent to take a newborn baby to the nursery. After giving birth, mom gets a few hours with the baby and then the doctor takes the baby to the nursery. Babies stay in the nursery while mom recovers especially if she has had a C-section.
According to Cafe Moms, the purpose of placing babies in nurseries is to monitor and give them preventative care if need be. Nurseries also have a standard temperature, which helps the newborn with raising their own body temperature so that they can survive in the outside world. It is also the safest place to be while mom is resting. Nurses usually take the babies back to their mothers when they need to feed.
15 Swaddle The Baby
After a baby is born, it is a common practice for most hospitals to clean, dry, and swaddle them in a receiving blanket. Doctors then hand over the baby to mom, who then clothe the baby in what she has packed. Pediatricians or nurses can swaddle the little one without anyone’s consent.
Swaddling has many benefits; it mimics the small space that the baby was in while in the womb. It also prevents unnecessary wake-ups due to startle reflexes and therefore helps the baby to sleep for longer, as claimed by Baby Sleep Site. However, the swaddling cloth should not cover the baby's head or be too tight.
14 Administer Vitamin K Injection
Babies are usually born with very little vitamin K which can cause them to bleed profusely when they get small bruises or wounds, as stated by Better Health. This is why for many years; pediatricians have been administering the vitamin K injection immediately after birth without parental consent. The injection helps in the clotting process.
These days, parents know a lot about the safety of the injection and they can make an informed decision on whether their baby should go through it or not. However, pediatricians strongly recommended having the injection because it is the best preventative measure for excess bleeding in babies.
13 Insert An IV Line
When newborns are at their very first check-up, pediatricians can put IV lines on them without asking the parents. Babies can be born looking healthy but sometimes certain situations may warrant the pediatrician to give them meds.
Because they are small and barely know how to function on their own, they receive most of their meds through IV lines. IV lines are also useful in the sense that they help a baby transition to life outside the womb when he or she is low on food, water, or any other fluid which can pass through an IV, as Stanford Children's points out.
12 Take A Fluid Sample
When babies arrive for their first check-ups, pediatricians can sometimes get a sample of their plasma without any consent from the parents. Most of the time, parents are welcomed to be part of the process by holding the baby while the pediatrician pricks them to get the sample.
This sample enables the doctor to know the baby's classification in case he or she will ever need a transfusion. It can also tell whether the baby has any existing abnormalities. The doctor places some of it on a paper card to create dried spots, which stay in the hospital, ready for use when the newborn needs quick retesting or diagnosis, as claimed by Baby First Test.
11 Give An Oxygen Mask
According to About Kids Health, some newborns may experience breathing difficulties immediately after birth or in their first hours of life. When a pediatrician notices that a baby needs help breathing, they can give them an oxygen mask without the parents’ permission.
If a baby urgently requires oxygen, no pediatrician is going to wait for parental consent. Pediatricians also know and want what is best for the baby so at the end of the day, most parents will be grateful that they chose to save their babies lives. Notably, doctors must make ensure that the oxygen they are administering is not cold to avoid a drop in the baby’s temperature.
10 Perform A PKU Test
Unless the pediatrician has informed consent from the parents not to do a PKU test, the test is usually done as part of hospital procedures. According to Health Link BC, “The phenylketonuria test (PKU) is usually done to check whether a newborn baby can make enzymes needed to break phenylalanine in his or her body.”
Phenylalanine is an amino acid needed for normal growth and development. It regulates almost all the metabolic processes in the body. Every newborn undergoes the PKU test in the US unless their parent refuses. The test involves getting samples from the baby by pricking their heel and sending it to the lab for analysis.
9 Carry Out The First Diaper Change
Have you ever seen or heard of a new mom who would be against the nurse or pediatrician changing her baby’s first diaper? In fact, most parents welcome it because they know they will have a million other diapers to change. More often than not, no consent is required to change a baby’s diaper.
After birth, mom’s energy levels are usually low; therefore, nurses have to assist them with taking care of the baby, which includes changing the baby’s diaper. The nurses also carry out the first diaper changes to monitor whether the baby is passing meconium, a dark green substance found in the baby’s first bowel movement, as stated by About Kids Health. Babies should have their first bowel movement within the first 24 hours.
8 Administer Antibiotics
When babies are born, they move from a safe and sterile environment to a world full of germs and bacteria and to make it worse, they are born with low immunity. Therefore, pediatricians have the permission to prescribe antibiotics to fight potential infections that the baby might catch without the parents’ consent according to Children's MD.
When a mother breaks her water early and ends up having prolonged labor, her baby is left without any protection against infections for hours and in order to be safe than sorry doctors can put the baby on antibiotics. The same case applies if mom has an infection that can get to the little one during birth, as explained in brochures.mater.
7 Give Sugar Water During The Snip
Sometimes during a baby’s first check-up, parents may request the pediatrician to circumcise their little one and, of course, this is a personal decision that requires consent from the parents before commencement. The consent is not just verbal, it appears in writing so that parents can read and understand the procedure and risks involved before the doctor does anything.
However, pediatricians can give sugar water to the baby when doing the procedure without any parental consent. Sugar water helps to relieve pain in young infants during painful procedures, according to HealthLine. The doctor will use a syringe to administer this sugar water, and not through any other means.
6 Use A Pacifier To Soothe The Little One
During check-ups, pediatricians normally spend a good number of minutes with the baby while examining them in the nursery. There is a great chance that the baby will cry during the process and sometimes pediatricians can opt to give them pacifiers to soothe them while they finish. This does not normally need any parental consent.
While some mothers will not mind the pacifier, others will mind, because pacifiers have a reputation of interfering with breastfeeding and it is best to introduce them after the baby is used to breastfeeding. According to What to Expect, such moms need to note this in their birth plans or inform the nurses.
5 Perform Suction For Meconium Aspiration Syndrome (MAS)
Sometimes newborns may pass meconium while still in the womb and end up inhaling it. When they do this, they usually have meconium aspiration syndrome (MAS). As stated by Kids Health, if a baby inhales meconium and is active with a strong heartbeat, the pediatrician will just monitor him or her in the NICU for MAS symptoms.
However, if after inhaling the meconium, he or she is not active, has a low heart rate and has poor muscle tone, the pediatrician can suction the meconium out using a plastic tube to clear the airways. This does not require parental consent because it is an urgent procedure.
4 Carry Out A Jaundice Test
A pediatrician should examine a baby for jaundice during the baby’s first checkup and this does not require parental consent. However, the hospital should explain or provide a write up to the parents explaining what jaundice is and how to monitor it as stated by BabyCenter.
Because babies are born with livers that have not fully developed, their livers are unable to get rid of bilirubin, a yellow pigment formed when RBC breaks down. Doctors test to confirm, but symptoms like yellowness in eyes and skin can tell the doctor that a baby has jaundice or excess of bilirubin. If tests show that a baby has a lot of bilirubin, the pediatrician can recommend light treatment to reduce it. Jaundice usually clears within the first 14 days.
3 Reflex Checks
Babies are born with reflexes that help them function in their first few months of life. Usually, the reflexes will disappear as the baby grows. During their first few check-ups, pediatricians can check for rooting, sucking, startling, and grasping reflexes without parental consent.
The doctors do this by safely encouraging the baby to show his or her reflex according to Baby Centre. For example, the pediatrician can check for the startle reflex by quickly changing the baby’s position. Startling the baby is usually through any sudden movement. Other things pediatricians check for include; blinking and whether the baby is closing and opening its eyes especially in response to light.
2 Taking The Baby’s Measurements
After birth, pediatricians can take the babies measurements without getting any consent from the parents. This is part of standard hospital procedure. The pediatrician will have to undress the baby if they are clothed and gently place them on a scale to determine how heavy the baby is at birth.
After that, doctors use a unique tape to get the measurements of their heads circumference and height. While some pediatricians may choose to wait until the baby is clean, some will take the measurements right after birth and announce the same to the parents. Later on, the doctors plot the measurements on a graph chart to determine the baby’s growth curve, according to Mayo Clinic. Other measurements done on the baby include temperature, heart rate, and respiratory rate.
1 Physical Exam
During the baby’s first checkup, pediatricians conduct a general physical exam without requesting permission from the parents. This first exam is important because owing to it, the pediatrician is able to check the baby’s overall physique. The check is thorough as the doctor normally checks every part of the baby’s body.
According to Mayo Clinic, pediatricians will check the baby’s soft spots on their head, eyes, ears, tongue movement, lungs, limbs, abdomen, hips, heart, skin, and number of toes and fingers to see if everything is normal. This physical exam usually takes less than five minutes and then the doctors hand the baby over to the mother for soothing and bonding.
Sources: mayoclinic.org, babysfirsttest.org, babycentre.co.uk, childrensmd.org, whattoexpect.com, healthcare.utah.edu, babysleepsite.com,stanfordchildrens.org, healthlinkbc.ca, cafemom.com, brochures.mater.org.au, healthline.com, aboutkidshealth.ca,babysleepsite.com, todaysparent.com, kidshealth.org, betterhealth.vic.gov.au