Do you need a pediatrician?

After discharge, the care team will discuss the plan of care with your baby’s pediatrician. If possible, please choose a pediatrician who takes your insurance before your baby is born. This can help ease the transition from hospital care to primary care when you and your baby are discharged (go home after a hospital stay).

The care team will also send the results from your baby’s Newborn State Screen to the pediatrician about 5 days after the test.

Pediatric Primary Care at MGHfC has providers in Boston and in many cities and towns throughout Massachusetts.

Newborn Care

A member of the Newborn Hospitalist team will see your baby daily and work with you to develop a plan of care. Members of our team are at the hospital during the day. At night, there is another team of pediatric doctors and nurses who care for you and your baby and answer questions or concerns. There is also an attending neonatologist (senior doctor who cares for newborns) available at all times for emergencies.

Medications

During your baby’s hospital stay, they will receive the following three medications. All babies routinely receive these medications during their stay:

  • Vitamin K injection: All babies are born with low levels of vitamin K. Vitamin K helps blood clot normally. Without enough vitamin K, babies have a higher risk of developing vitamin K deficient bleeding (VKDB). VKDB can cause bruising or bleeding in nearly every organ of the body.
  • Erythromycin is an antibiotic ointment that is applied to your baby’s eyes. Erythromycin helps prevent neonatal conjunctivitis (pink eye in newborns).
  • Hepatitis B vaccine: The hepatitis B vaccine is given in 3 doses over the course of 6 months. Your baby will receive their first dose in the hospital shortly after birth. This is often called the birth dose. If you have questions or concerns about vaccines, please talk with your baby’s pediatrician.

Rooming in

Rooming in (having your baby stay in your hospital room) can help create a stronger bond between you and your baby. At MGHfC, your baby will stay in your room at all times. If needed, your baby may leave the room if they are having any procedures or tests done that are not included in routine testing.

Feeding

The care team is here to support your baby’s feeding plan. The nursing staff and doctors are trained and have experience with teaching about formula feeding and/or provide breast feeding support. The care team also includes lactation specialists to assist with breast feeding.

If your baby has certain medical conditions, they may need formula in addition to breast milk. The care team will support your desire to breast feed. At MGHfC, you can supplement your baby’s feeding plan with traditional formula or pasteurized donor human milk (PDHM). The care team can also teach a number of methods to continue breast feeding.

Bath

Your baby will generally have their first bath between 12-24 after birth. The nurse will show you how to bathe your baby. You can ask the nurse any questions.

Testing

Your baby will have the following tests as part of their routine care:

  • Jaundice screen: Most babies develop some level of jaundice after birth. Jaundice is a condition in which high levels of bilirubin (a protein in the blood cells) and causes yellowing of the skin and eyes. The care team will check your baby for jaundice 24-36 hours after birth, depending on which risk factors your baby has for developing jaundice. The jaundice screen involves gently tapping your baby’s chest with a specialized reader (device that checks for jaundice). If the reader shows high numbers, your baby may need a blood test.
  • CCHD (Critical Congenital Heart Defect) screen: For this test, the care team will check your baby’s oxygen levels about 24-36 hours after birth. An oxygen monitor is attached to your baby’s right hand and one of their legs. The monitor looks like a white cord with a bandage on one end to hold it in place on the skin. Oxygen levels help the care team learn if your baby has any congenital heart defects (physical differences or medical conditions babies are born with that can affect the heart) that cannot be found through a physical exam.
  • Newborn State Screen: In Massachusetts, 30 disorders are included in the required newborn screening test. The Newborn State Screen is a blood test done about 24-36 hours after birth. You will also have the option to include tests in the current pilot program. The results are sent to your baby’s pediatrician in about 5 days.
  • Hearing Screen: This screen checks your baby’s hearing. Audiology technicians (hearing experts) from the Massachusetts Eye and Ear Infirmary will do the test in your room when they round (visit patients each morning). The test works best when your baby is quiet and relaxed.
  • Car seat test: The car seat test is used to identify babies who have a higher chance of developing breathing problems when in their car seats. If your baby needs a car seat test, please bring your baby’s car seat into the hospital, ideally by 24 hours of life.

    The test is done in the nursery and takes about 90 minutes (1 ½ hours). Your baby will be in the car seat with a respiratory (breathing) and heart monitor to be sure they are safe in this position. The car seat must be rear facing and not expired. The care team will give you more information in the hospital if your baby needs this test.

Circumcision (for babies assigned male at birth)

This service is offered in the hospital. It is done by one of the pediatricians on the Newborn Hospitalist team. Doctors use a local anesthetic (numbing medication injected under the skin with a needle) to numb your baby’s genitals. Once the genitals are numb, doctors do a circumcision using a special clamp. The care team will explain how to care for your baby after the circumcision.

Discharge

The timing of discharge will depend on many factors affecting both you and your baby. This can include your baby’s prematurity, feeding and jaundice. For you, it can also include blood pressure and pain control.

The earliest possible discharge is after 24 hours. This allows the care team to complete your baby’s Newborn State Screen. Going home after 24 hours in the hospital is common for mothers and babies who meet the following:

  • Have no medical concerns
  • Are feeling well
  • Have support at home
  • Can see their pediatrician in 24-48 hours

Most healthy newborns will also need to see their private pediatrician 1-3 days after they are discharged from the hospital.

If you or your baby need to stay longer than 24 hours, the care team will discuss the length of stay with you, based on your and your baby’s needs. Your nurse and the pediatrician will review discharge instructions with you and give you the opportunity to ask questions.

Rev. 5/2021. MassGeneral Hospital for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.