Home birth newborn care

Direct parents to contact Member Services at 1-888-901-4636 as soon as possible to enroll their newborn in their chosen health plan and to select a pediatric primary care provider. The pediatric provider may be a family physician or pediatrician. Refer all well-newborn and acute care to this pediatric physician.

Immediate post-partum care

Immediately after delivery, you will provide the following care:

  • Follow current routine Neonatal Resuscitation Protocol steps using warming, drying, stimulation, suction, and PPV per protocol to help the newborn breathe.
  • Arrange for transfer to the hospital if infant is experiencing complications. (See Home birth consultation.) Use a Kaiser Permanente owned or network facility except in emergent or life-threatening situations. Contact the 24-hour Emergency Notification Line at 1-888-457-9516 when transferring an infant to the hospital.
  • Evaluate the condition of the newborn by performing Apgar score at 1 minute and 5 minutes. Perform a 10-minute score if the 5-minute score is less than seven.
  • Allow time for the new family to become acquainted and for suckling to start.
  • Avoid heat loss in the newborn by drying the infant's skin, covering the infant with dry receiving blankets or towels, and keeping the infant in skin-to-skin contact with the mother.
  • Administer eye prophylaxis to all newborns, pursuant to Washington state law.
  • Administer vitamin K intramuscularly, after informing parents of the rationale for doing so and obtaining their consent.
  • For infants whose mothers are hepatitis B surface antigen-positive, or if surface antigen status is unknown, administer HBIG and the first dose of the hepatitis vaccine within 12 hours of delivery. Infants of hepatitis B surface antigen-negative mothers should receive the first dose of hepatitis B vaccine between birth and 14 days.
  • Review postpartum instructions pertaining to newborn care and signs of emergency.
  • Provide parents with educational materials regarding metabolic screening of newborns.
  • Plan a follow-up visit for newborn and mother within 72 hours (as per Home Birth Post-Partum instructions), or assist in scheduling the newborn for follow-up with a pediatric care provider within 72 hours.
  • Refer infant to the pediatric primary care provider for a visit between 7 to 10 days of life. The physician will perform a newborn screen, including PKU, at this visit.
  • Complete record of all examinations and newborn procedures.
  • Provide copies of medical records to the pediatric practitioner.
  • Review and complete relevant items listed on Home birth post-partum care.

Newborn evaluation

Additionally, be teaching parents through performing a thorough newborn exam, which shall include:

  • Weight, length, and head circumference measurement.
  • Determination of gestational age.
  • Complete physical exam.
  • Assessment of reflex response.
  • Recognition of gross anomalies.

Lactation consulting services

For information on lactation consulting services in your area, contact the Provider Assistance Unit at 1-888-767-4670 or a Kaiser Permanente owned or contracted obstetrics/gynecology clinic.

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