The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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The cord stump>> It’s normal for the umbilical cord stump to ooze and turn black before falling off a week or two after birth. Most pediatricians recommend cleaning it with rubbing alcohol after each diaper change. What to watch for: Redness, pus, tenderness or fever could indicate an infection; call your pediatrician. Note: Look out for the same symptoms at your baby’s circumcision site, if applicable.
The skin>> It’s not unusual for newborns to develop a touch of jaundice. This occurs when the blood contains too much bilirubin, a chemical formed when red blood cells break down. What to watch for: Call your pediatrician if you notice that your baby has yellowish skin (it usually appears first on the baby’s face).
The digestive system>> Spitting up a bit after feeding usually is normal. What to watch for: Forceful vomiting or spitting up most or all of a feeding.
>>Shortly after delivery, a nurse will take a small amount of blood from your baby’s heel for testing. “Thirty diseases can be ruled out with just a few drops of blood taken after birth,” says Jonathan Muraskas, M.D., a professor of neonatal-prenatal medicine at Loyola University Medical Center in Maywood, Ill. In some cases, such blood tests can catch conditions that, if corrected right away, can prevent serious problems in your baby’s future. For example, if tests show that a baby has congenital hypothyroidism, medication can prevent severe mental retardation.
Unfortunately, not all states require extensive newborn screening, according to the March of Dimes. All states screen newborns for phenylketonuria (PKU), a disorder that can cause brain damage and mental retardation if undetected. But only about 30 states currently screen for biotinidase deficiency, an enzyme deficiency that can lead to infections, hearing loss, mental retardation and death. For an updated list of what your state mandates, check out the National Newborn Screening & Genetics Resource Center at http://genes-r-us.uthscsa.edu/index.htm.
The March of Dimes urges all states to test for 10 treatable disorders. Check with your obstetrician or pediatrician to see what screening tests your baby will receive and whether additional ones would make sense. Private companies such as Pediatrix Screening (www.pediatrixscreening.com) screen for 45 to 61 disorders, at a cost of $25 to $70, depending on the number of tests requested. Check with your health insurance carrier to determine whether non-mandated tests are covered.