Category: Hospital 101
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Q&A: Premature Babies
<p>If your baby arrived a little earlier than expected, we've got answers on caring for your premature baby, from feeding to short-term and long-term health care.</p>
<p><b>Can I hold preemies in the NICU?</b></p>
<p><em>Can parents hold and touch preemies in the NICU?</em></p>

<p>Sick and premature babies have a lot of trouble regulating their body temperature, so they need to be kept warm in an incubator, but that doesn't mean parents can't touch them. They can reach in and touch their baby with special gloves that are threaded through the incubator. Depending upon the baby's health, they may also be able to take her out for periods of time to feed her and care for her. Many experts recommend that premature babies get daily kangaroo care -- time spent pressed against their mother's bare skin -- because it promotes the parent-child bond and, in some cases, helps babies gain weight and thrive.</p>

<p><em>Used with permission. © Meredith Corporation., All rights reserved. </em></p>
HUGGIES® Hospital Prep 101 Checklists
You're about to meet the most awesomest little person ever. What are the quintessential essentials? Explore and print out checklists for a baby first aid kit, the changing table, what to pack for dad, baby naming tips, third trimester to-dos, the ultimate library and the mom-approved hospital bag.
Bringing Home Baby: 4 Tips for Your Hospital Homecoming
I’ll never forget the day we brought our newborn son home from the hospital. He looked impossibly small in his brand-new car seat and his feet stuck out from under his tiny cotton gown. I sat in the backseat with him on the ride, and when we pulled into the driveway of our little while house the whole family greeted us on the porch.
Tips for Moms on Bed Rest
When I was 30 weeks pregnant with baby #3, I went into pre-term labor and was told I’d need to be on bed rest for the remainder of my pregnancy. It turns out the baby (and my body) didn’t seem to care that it was my oldest’s 5th birthday (with all kinds of fun stuff planned) the following week. Or that my (then) 2-year-old son was about to start Mommy and Me soccer. Or that my husband’s job tends to take place in about 30 of the 50 United States.
Choosing a Pediatrician: Solo Practitioner or Group Practice?
Advice on the type of pediatrician that's best for baby.
Do You Have the Right OB?
Every woman wants an obstetrician who is just right for her. After all, obstetrics is pretty personal stuff! Take our quiz to find out if your obstetrician is a good fit or if it's time to move on.
When to Call the Doctor if Baby Has a Fever
In most cases, a mild fever doesn't warrant a call to the pediatrician, but you should ring the doctor if your baby has any of the following symptoms.
Which Birth Professional Is Right for You?
Giving birth is a group effort. Although you'll be the star of the labor and delivery show, it's essential to chose the right supporting cast. This includes your primary caregiver, labor coach or coaches, and any specialists you might need.
Doctor Right: How to Choose an Ob-Gyn or Midwife

<p>Experts reveal how to choose the ideal ob-gyn or midwife for your delivery day.</p>
<p>By Judy Koutsky </p>

<p>Now that you're expecting a baby, you're going to be visiting the doctor -- a lot. But perhaps the doctor you're seeing isn't the right fit. She's a wonderful gynecologist, but she doesn't practice obstetrics. Or she's pro-natural birth and you want an epidural. You'd like to give birth at a birthing center but she only delivers at hospitals. Regardless of why you're looking for a new practitioner, we have expert advice that will help make your search less overwhelming.</p>
<p><b>Decide on a Type of Provider</b>
"Most women deliver with either a physician trained in the care and delivery of pregnant women, or a midwife," says Michele Hakakha, M.D., an ob-gyn in Beverly Hills and coauthor of Expecting 411: Clear Answers & Smart Advice for Your Pregnancy. Trying to decide between the two? Consider which qualities are most important to you in a practitioner, whether it's her credentials, the hospital or birthing center she attends, her point of view on pain relief, or her rate of cesarean deliveries. Then think about the type of delivery you want, as well as special circumstances that apply to your pregnancy. "If you have a condition that would make your pregnancy high-risk, such as diabetes, or you're delivering twins, you should see an ob-gyn and deliver in a hospital," Dr. Hakakha says. If you're healthy and wish to deliver in a birthing center, consider using a midwife.</p>
<p><b>Get Recommendations</b>
Talk to others who have given birth recently, and ask about the practitioner's bedside manner, delivery philosophy -- whatever it is that's most important to you in a doctor. Once you have a list of names, do background research on the doctors to be certain they're board-certified ob-gyns. You'll want to note if they've ever been disciplined or lost their license, as well as how often they've been sued, suggests John Connolly, Ed.D., CEO and president of Castle Connolly Medical, which publishes America's Top Doctors. "One or two lawsuits is typical, but more frequent suits might suggest a problem," he says. Visit for an online directory of links to disciplinary records for doctors in each state.</p>
<p>Labor and Delivery unit, ask to speak to one of the labor nurses, and get her recommendation for a good obstetrician, suggests William M. Gilbert, M.D., a high-risk ob-gyn in Sacramento, California. "Then call back during a different shift and ask someone else for a recommendation. Once you get the same name from two or three nurses, then you've hit the jackpot. These nurses see all the doctors in action."</p>
<p><b>Schedule Consultations</b>
Pay attention to the demeanor of the doctors when you meet them, says Robert Atlas, M.D., who is a maternal-fetal medicine specialist and chair of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore. "If you feel rushed during the consult visit, it's probably indicative of how you'll be treated going forward," he says. Have a list of questions ready: Is the doctor available by e-mail or only by phone during office hours? Who will deliver you? When your ob is in a large practice, you often end up with whoever is on call. Your own doctor is more likely to deliver you in a small practice. What is your C-section rate? (Dr. Atlas says 15 percent is ideal, unless you're dealing with a high-risk ob who typically performs more.) Mention any preexisting medical conditions you may have, such as high blood pressure or diabetes; if you've had a C-section, ask about vaginal births after cesarean (known as VBACs), since some hospitals don't allow them for insurance reasons.</p>
<p><b>Follow Your Gut</b>
Choose the doctor you felt most in sync with during your consultation appointment. If you're only a few weeks pregnant -- say, you've just gotten a positive sign on a home pregnancy test -- then you won't have to deal with the awkwardness of switching doctors mid-pregnancy. Moving to a new practice later on? Keep in mind that some doctors will take pregnant patients up to their last month, while others won't take patients after their first trimester, Dr. Atlas says. It's best to talk to your current doctor about why you're unhappy, but if you're still feeling dissatisfied, move on. You should be confident that your doctor will take excellent care of you and your baby, Dr. Hakakha says. "After all, her hands will hold your baby first."</p>

<p><em>Used with permission. © Meredith Corporation. All rights reserved. </em></p>
What to Expect: Hospital Birth Costs
<p>Giving birth doesn't come cheap. From prenatal care and epidurals to pre-term deliveries and hospital stays, here's the bottom line on hospital births.</p>

<p>By K. Aleisha Fetters </p>

<p>News flash: Having a baby is expensive. It's the most costly health event families are likely to experience during their childbearing years. On average, U.S. hospital deliveries cost $3,500 per stay, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Add in prenatal, delivery-related and post-partum healthcare, and you're looking at an $8,802 tab, according to a Thomson Healthcare study for March of Dimes.
But a lot of factors can move your bottom line, says Aleksandr M. Fuks, M.D., Director of the Department of Obstetrics and Gynecology at Queens Hospital Center. Here, we break down what to expect from hospital bills -- and how to safely lower them -- when you're expecting.</p>

<p><b>Type of Birth</b></p>
<p>Vaginal delivery or cesarean section -- that is the question. The answer could mean an average difference of $1,900 to $2,600 in your hospital bill. Vaginal births, on average, cost $2,600 without complications, and C-sections cost $4,500, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Vaginal deliveries account for about 7 in 10 childbirths, and C-sections for about 3 in 10, according to the Project.</p>
<p>A C-section is a major operation that involves anesthesia, longer hospital stays, and higher instances of morbidity and mortality, says Toni Stern, M.D., Chair of Obstetrics and Gynecology at Coney Island Hospital. All of these mean more resources used -- and more dollars spent.</p>
<p>However, vaginal delivery with complications requiring an operating room procedure has the highest average price tag of any type of birth, costing parents (and their insurance companies) an average of $6,900, nearly double the average cost per stay for all types of delivery, according to the Project.</p>

<p><b>Mom's and Baby's Health</b></p>
<p>Happy and healthy -- that's all that matters, right? Although that wish has nothing to do with hospital costs, complications can really increase them.</p>
<p>Some common (and costly, but not-so-common) delivery complications include premature rupture of the amniotic sac, abnormal presentation, dangerous umbilical cord positioning, difficulty breathing, amniotic fluid embolisms, irregular blood pressure, postpartum hemorrhage, bleeding in the brain, fluid accumulation in the brain, neurological problems, intestinal problems, jaundice and anemia, according to the Mayo Foundation for Medical Education and Research.</p>
<p>Many of these complications are out of your hands, but you can help to make sure they are treated as quickly and easily by getting good old-fashioned prenatal care, Dr. Stern says. You want your healthcare team to know your and your baby's chart backward and forward, including all of your medications, allergies, health conditions and any problems experienced during pregnancy, as all of these can affect how your doc should treat you on the big day. Talk, talk, talk with your ob-gyn during your prenatal checkups and on the day. She can read your tests, but not your mind.</p>
<p>Be aware that any health condition can increase complications and delivery costs. For example, a delivery stay costs an average of 55 percent more ($5,900) for a woman with diabetes, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.</p>
<p>Premature birth is one of the largest game-changers in terms of medical costs, occurring in about 1 of 8 pregnancies. Average healthcare for premature/low birth weight infants is nearly 11 times more costly than that for newborns without complications, according to a Thomson Reuters study for March of Dimes.</p>
<p>However, knowing the symptoms and avoiding particular risk factors can lower your chance of going into premature labor. If you are pregnant or trying to become pregnant, talk to your ob-gyn about what you can do to help prevent premature delivery. If you do go into premature labor, your doctor may use medications to halt uterine contractions, according to Mayo Clinic-- but those meds are going to cost you. And if they cause additional maternal complications, they are going to cost you even more.</p>

<p><b>Health Insurance Coverage</b></p>
<p>You've probably given a lot of thought to your health insurance coverage and costs. But if you don't know your maternity coverage, it's time to take another look. Health insurance is vital to obtaining maternity care services -- and being able to afford them, according to the March of Dimes.</p>
<p>Make sure your insurance covers childbirth costs, including baby's nursery care. Depending on your birth plan, you may also want birth setting and labor support options included in your provider's plan. Pay attention to your co-pay, deductible and what percentage is covered after your deductible is met.</p>
<p>If you decide to change health insurance plans, you may wish to do so before becoming pregnant. The federal government prohibits group health insurance plans from treating pregnancy as a pre-existing condition, but individual health insurance plans can legally treat pregnancy as a pre-existing condition, effectively denying you maternity coverage, according to the U.S. Department of Labor.</p>
<p>Some companies also require you to "pre-authorize" coverage for your baby, and some require that you call them when you arrive at the hospital to deliver-- if you forget, you could be refused coverage.</p>

<p><em>Used with permission. © Meredith Corporation. All rights reserved. </em></p>
Your First OB Exam
<p>Congratulations on your pregnancy! Here's what you can expect from your very first visit to the doctor's office.</p> 
<p>By Dr. Laura Riley  </p> 
<p>Will your baby be a Taurus or a Gemini? You'll find out at your first prenatal exam, when your obstetrician will calculate your official due date. The exam, which is typically scheduled around week 9 or 10, will likely include the following:</p> 
<p>•	Complete medical history. Your doctor will ask about your health, details of any past pregnancies, your partner's health, and the health of your family and your partner's family.</p> 
<p>•	Physical exam. Your height, weight, and blood pressure will be measured and recorded. Your doctor will discuss any chronic health problems you may have and how they will affect or be affected by your pregnancy. She will perform a complete physical exam that includes checking your thyroid and breasts and listening to your heart and lungs. She will also perform an internal exam, checking your cervix, ovaries, vagina, and uterus.</p> 
<p>•	Calculation of your due date. Your due date is based on the date of the start of your last period. An average pregnancy is 40 weeks (280 days) from the first day of your last normal menstrual period (LNMP). (Keep in mind that 40 weeks is average. A normal pregnancy can last anywhere from 37 weeks to 42 weeks.) If your periods are irregular or you don't know your LNMP, then your due date will be based on your earliest ultrasound.</p> 
<p>•	Laboratory tests. See "Common Prenatal Lab Tests" (above) for the kinds of tests your doctor may perform. Most are performed by analyzing blood or urine samples.</p> 
<p>•	A discussion about genetic testing. Depending on your medical history and ethnic background, your doctor may talk with you about doing tests for cystic fibrosis; Tay-Sachs and Canavan disease (if you're an Ashkenazi Jew); and sickle-cell anemia if you're black.</p> 
<p>•	A schedule for future appointments. Ask your provider about upcoming tests and when you should schedule your regular appointments.</p> 
<p>•	Prenatal vitamins. Ask your provider for a prescription, if you aren't already taking them. Or head to a local drugstore to buy prenatal vitamins over the counter. Ask the pharmacist if you aren't sure which kind to buy.</p> 
<p>•	Healthy-pregnancy information. Your doctor may give you advice or a handout sheet about diet, exercise, weight, and over-the-counter medications that are safe during pregnancy. You may also get contact information for when your doctor's office is closed.</p> 

<p><em>Used with permission. © Meredith Corporation. All rights reserved.</em></p>
What to Expect at Baby's First Doctor Appointment
<p>Are you a little nervous to take your newborn to her first doctor appointment? Don't fret. We'll help you with what questions to ask, what paperwork to remember, who to bring along, and what Baby needs.</p>

<p>By Caitlin Beren</p>

<p><b>Scheduling Must-Knows </b></p>
<p>Baby's first 2-week well-visit appointment will come up quicker than you think. Most parents schedule this visit with a pediatrician either while in the hospital postdelivery or shortly after coming home. When scheduling, ask for an appointment during the least busy part of the office day or if the doctor has a certain part of the day or week dedicated to seeing newborns. Expect the visit to take about 25 minutes, but this can vary. Prepare for the possibility of a wait or setback and be sure to plan time to fill out paperwork.</p>
<p><b>Who to Bring</b> </p>
<p>At Baby's first doctor appointment, it's helpful to bring yourself, your baby, and another primary caregiver, such as Dad. With two people in the office, it will be easier to take care of your little one, remember all of the information from the doctor, and recall what questions to ask. More than two people can become a distraction and make the doctor's office into a free-for-all for questions. The focus needs to be on Baby. It's normal to be nervous, but remember that this visit is meant to be both empowering and informative for parents.</p>
<p><b>Preparing Baby </b></p>
<p>Since the doctor will want to examine all of your baby, it's best to dress her in simple clothing or a comfortable blanket. That way there's less time wasted undressing and more time to focus on the exam. Also bring a change of clothes, extra diapers, and anything needed for feeding. In the diaper bag bring along everything you would for a normal trip with Baby: bottle, pacifier, wipes, etc. According to Brian MacGillivray, M.D., who practices in San Antonio, "at a 2-week exam, warmth, cuddling, loving, and reassuring voices are more helpful than a stuffed animal."</p>
<p><b>Paperwork </b></p>
<p>Be prepared to fill out paperwork. Remember to bring your insurance card. Have knowledge and records of anything that concerns you and Baby. Bring any hospital paperwork, including information about Baby's discharge weight or complications during pregnancy or birth. Also bring your medical paperwork, including medical history, medicine taken during pregnancy, and any medical issues.</p>
<p><b>Waiting Time</b> </p>
<p>If you're able to attend the appointment with Dad or another primary caregiver, send him in first to prepare for the appointment and complete paperwork. Waiting in the vehicle will limit Baby's exposure to sick people in the waiting room. If you do go into the waiting room, be aware of children and adults wanting to look at and hold Baby. Any well-meaning person can carry germs, especially at a doctor's office. Most office staff are good at placing newborns in a room quickly, but if you must wait, have Baby face the corner. This way your body will become a safe barrier. According to Mary Ellen Renna, M.D., a pediatrician from Woodbury, New York, if you maintain a 3-foot radius from others, the chances of catching sickness are very low.</p>
<p><b>Meeting the Nurse </b></p>
<p>A nurse will often handle the first part of your baby's exam: She'll take Baby (who should now be undressed) to weigh and measure him. It's normal for the nurse to put your little one on a scale to check his weight, extend his limbs for measuring height and width, and use a tape measure to determine head circumference. According to pediatricians, it's normal for a baby to lose weight after delivery (up to 10 percent of his body weight), but by the 2-week visit, generally most or all of this weight will be gained back.</p>
<p><b>Meeting the Doctor</b> </p>
<p>There are a few main things that the doctor will accomplish during this initial visit: Examine Baby, educate parents, and ask and answer questions. Every pediatrician's approach differs. Some will examine and provide information at the same time. Others will finish the examination, and then begin to ask questions. During the physical examination the doctor will need to see your baby naked to examine her entire body. The doctor will look at her eyes, ears, nose, skin, and limbs, and also test that she is responsive and has proper reflective actions (such as becoming a little fussy when introduced to a cold stethoscope). The doctor will also look for signs of jaundice or hernias. The doctor will examine the umbilical cord and a circumcised penis for signs of infection and proper healing. A lot will be covered, but don't be afraid to ask the doctor to slow down, repeat, or clarify information.</p>
<p><b>What to Know: Feeding </b></p>
<p>The doctor will want information about Baby's feeding patterns. You don't have to record every time you feed your little one or exactly how much, but you should have a general idea of how often Baby is eating, how long (if breastfeeding), or how much (if formula/bottle-feeding). If he's on formula, the doctor will want to know how much, how often, and what formula he is eating. If he's being breastfed, the doctor will want to know how frequently, how long, and if he's having any latching-on issues. Don't be afraid to ask the doctor questions about formulas or tips for breastfeeding.</p>
<p><b>What to Know: Digestive System </b></p>
<p>Although you don't have to write down every time you change your baby's diaper, you should have a general idea of how many times you change her each day. It's important to note that formula-fed and breastfed babies produce different stool consistencies. By letting the doctor know about the consistency and color of Baby's waste, he can better assess how well Baby's digestive system is working and if she's absorbing nutrients well. Questions about diarrhea are common at this point. White stools or blood in your baby's stools are definite issues to bring up with your doctor.</p>
<p><b>What to Know: Sleeping Patterns</b> </p>
<p>It's normal for the pediatrician to inquire about sleeping and safety. Although most newborns spend the majority of the day sleeping, the doctor will want to ensure that your baby is sleeping in a safe location and in a safe crib. Most strongly encourage having Baby sleep on her back. Moms, you matter a lot, too, so don't be surprised if the doctor checks to see how your sleeping patterns are doing as well, and if you're getting enough rest.</p>
<p><b>What to Know: Shots & Vaccines</b> </p>
<p>Although opinion varies, most doctors won't start giving Baby shots, vaccines, or immunizations until he is 2 months old (at the next appointment). Some hospitals will give babies a hepatitis B shot shortly after birth. It's important to know if your baby received this shot in the hospital and to note any medical issues. Opinion on vaccinations can vary from doctor to doctor, and circumstances can change depending on Baby's exposure to health issues. Some parents are against vaccinations and others postpone them, so be sure to talk with your pediatrician about all of your options and concerns. You shouldn't need to worry about needles or shots at this appointment, however.</p>
<p><b>Questions </b></p>
<p>A lot of ground will be covered during your Baby's first doctor appointment, so it's wise to bring supplies to take notes. Also, with everything going on, it might be harder to remember all of the questions you want to ask. So write them down ahead of time and bring them along. Don't feel silly doing this -- by being prepared you'll be able to ask more questions and get more answers.</p>
<p><b>What to Ask</b> </p>
<p>•	Is ______ normal?</p>
<p>•	Is she eating enough?</p>
<p>•	Am I feeding enough?</p>
<p>•	How often should I feed her?</p>
<p>•	Should her stool look like that?</p>
<p>•	How many diapers should I be changing?</p>
<p>•	Is my baby pooping/peeing enough?</p>
<p>•	What should I expect from Baby in the next few days/weeks/months?</p>
<p>•	When/how often will I be seeing you?</p>
<p>•	What should I expect at this age?</p>
<p>•	How often should I bathe Baby?</p>
<p>•	What's an emergency for my Baby?</p>
<p>•	What would you consider spitting up?</p>
<p>•	Is __________ an unusual behavior?</p>
<p>•	Is it OK to give Baby Tylenol (acetaminophen)? [The answer is typically no, so consult your physician first.]</p>
<p>Don't be shy or intimidated about anything else that comes to mind; there is no such thing as a silly question.</p>
<p><b>When You Leave </b></p>
<p>Schedule your next appointment and walk away educated and assured that Baby is doing well. Keep the doctor's phone number handy, and also be informed of what to do and who to contact in case of an emergency or question. It's important to be comfortable with your doctor and to know her philosophy on medical issues, such as vaccinations. Be sure you understand how the clinic operates in regard to hours of operation, billing policies, and so on.</p>
<p><b>Be Educated</b> </p>
<p>It's important to ask questions and learn helpful information from your pediatrician. But it's also important to educate yourself. Read books, magazines, and legitimate websites on parenting and babies. Tips from friends and family members can be helpful, but be as safe as possible by verifying the information or finding better information via professional sources.</p>

<p><em>Used with permission. © Meredith Corporation. All rights reserved. </em></p>
What to Ask at the First Newborn Visit
<p>10 questions for your child's pediatrician from Child's columnist Michel Cohen, M.D.</p>

<p>•	How will I know if my baby is getting enough breast milk/formula?</p>
<p>•	How often should I feed my baby?</p>
<p>•	How should I respond when my baby cries?</p>
<p>•	When should my baby be sleeping through the night? What can I do to help him/her?</p>
<p>•	What is the best way to bathe my baby and how often?</p>
<p>•	How should I trim my baby's nails?</p>
<p>•	When is it okay for me to take my baby's temperature, and how should I take it?</p>
<p>•	How will I know if my baby is getting sick?</p>
<p>•	Is there anything I need to do to care for my baby's umbilical cord?</p>
<p>•	How many layers are necessary to keep my baby warm?</p>

<p><em>Used with permission. © Meredith Corporation. All rights reserved. </em></p>
10 Best Children's Hospitals for Emergency Care 2013
<p>Short wait times, highly trained staff, and a family-friendly atmosphere earned E.R.s at these children's hospitals the top of Parents' ranking.

<p>By Karen Cicero 

<p><b>1. The Children's Hospital of Philadelphia</b></p>

<p>Families feel comfortable here. The hospital employs eight Child Life therapists exclusively for the emergency department. Their job: to soothe, comfort, and distract young patients during scary procedures. The hospital has also implemented new protocols -- including a "Fast Track" section for patients who aren't as seriously ill -- to help reduce wait time.
<p>Hospital Website: Children's Hospital of Philadelphia >> [<a href=""></a>]

<p><b>2. Cincinnati Children's Hospital Medical Center</b></p>
<p>Despite being one of the busiest hospital emergency departments in the country (with 92,000 visits in 2012), wait times are relatively short -- averaging around half an hour. The hospital is also a leader in pediatric emergency research and is currently working on a study to reduce the need for a CT scan for kids with mild head injuries.
<p>Hospital Website: Cincinnati Children's Hospital Medical Center >> [<a href=""></a>]

<p><b>3. Children's Hospital of Wisconsin, Milwaukee</b></p>
<p>More than 4,000 children with violence-related injuries have been treated in the Emergency Department/Trauma Center at Children's Hospital of Wisconsin. That's why the hospital established Project Ujima, a network of services to assist with physical, social, and emotional recovery. The hospital also partners with other agencies to offer a day camp focused on youth development, leadership, and self-esteem.
<p>Hospital Website: Children's Hospital of Wisconsin, Milwaukee >> [<a href=""></a>]

<p><b>4. Boston Children's Hospital</b></p>
<p>To reduce wait time for families, the hospital's emergency department is piloting a new communications system called BEAPPER, which sends staff Twitter-like alerts when beds become available, when orders have been placed, and when lab results are back. The staff also works on emergency-related research that has immediate, practical applications for families, including a recent study on the hazards of glass tables and ornaments.
<p>Hospital Website: Boston Children's Hospital >> [a href=""></a>"]

<p><b>5. Nationwide Children's Hospital, Columbus, Ohio</b></p>
<p>The first thing children spot when entering the hospital's new emergency department: a 1,400-gallon aquarium with more than 100 colorful fish. Then parents can take kids to the section that is best suited to their mood -- an active zone or a quiet area. The hospital is also a leader in promoting the rights of families to be allowed to stay with their child during invasive procedures and resuscitative situations.
<p>Hospital Website: Nationwide Children's Hospital, Columbus, Ohio >> [<a href=""></a>]

<p><b>6. Children's Hospital of Michigan, Detroit</b></p>
<p>Despite seeing a large number of patients (more than 90,000 in 2011), average wait times in the emergency department are under 25 minutes -- and are far less for the most serious cases. About one in five patients take advantage of the hospital's "fast-track" area.

<p>Hospital Website: Children's Hospital of Michigan, Detroit >> [<a href=""/></a>]
<p><b>6. Children's Hospital of Pittsburgh of UPMC</b></p>
<p>The hospital is conducting more than 50 studies in the emergency department, including the safety and effectiveness of procedural sedation and the management of brain injury.

<p>Hospital Website: Children's Hospital of Pittsburgh of UPMC >> []
<p><b>8. Texas Children's Houston Hospital</b></p>
<p>Over the past two years, the hospital's emergency care team has created a new protocol that includes guidelines to improve earlier recognition and more effective treatment of sepsis, a life-threatening condition that occurs when the body reacts to a severe infection due to harmful bacteria or other germs. It has also offered families a chance to take a survey at the hospital to provide more feedback on their E.R. experience, including the doctors' communication skills.
<p>Hospital Website: Texas Children's Houston Hospital >> [<a href=""></a>]

<p><b>9. Children's Hospital Colorado, Aurora</b></p>
<p>The Emergency Department staff is forward-thinking in pain management, trying to create a more "ouchless" environment for kids. The hospital also pioneered parameters for the home treatment of bronchiolitis (a common illness of the respiratory tract), rather than the typical hospital stay.
<p>Hospital Website: Children's Hospital of Colorado, Aurora >> [<a href=""></a>]
<p><b>10. Children's National Medical Center, Washington, D.C.</b></p>
<p>Optimizing CT scans for patients with a head injury is among the hospital's 60-plus studies related to emergency care. Coming soon: Through an app, families will be able to access current emergency-department waiting times.
<p>Hospital Website: Children's National Medical Center, Washington, D.C. >> [<a href=""></a>]
<p><em>Used with permission. © Meredith Corporation. All rights reserved. 
The 24 Hours After Giving Birth
<p>Read about the first day in the life of a new mom.</p>

<p>It's All a Blur </p>
<p>Looking back, I know I was in labor for 14 hours and dilated to about 5 centimeters -- pretty good numbers, actually -- when my doctor convinced me to get the epidural that speeded me into the pushing stage. Grace Isaacs was born vaginally (if not drug-free) less than 15 hours after my first contraction. But if you'd asked me how long I'd been in labor, I wouldn't have been able to do the math.</p>
<p>That blur continues after the birth, let me tell you. When I was pregnant and imagining what meeting my child would be like, my visions were straight from Hollywood: Final push. A cry. "It's a girl!" A perfect 6-month-old Gerber baby in a tidy blanket is thrust into the mother's arms. The music swells. Cut to commercial. So what's it really like? I was still hooked up to the blood pressure monitor and oxygen mask when the doctor put squirming, wet Grace on my naked belly. I felt as if I were supposed to scoop her up in my arms, but I was so weighed down by equipment and so freaked out that a person had just come out of me that I just stared at her.</p>
<p>A nurse whisked Grace away for her Apgar scores, cleanup, and eyedrops while I was delivering the placenta. It's worth noting that contractions continue while you pass this "afterbirth." I was surprised by the size of the organ the doctor laid on a tray. It looked like a big liver.</p>
<p>Fifteen minutes later we got our family-bonding moment. Grace was returned to us bundled in a blanket, and I hugged her tight. She was so alert! She stared at Byron and me with those old-soul eyes that so many babies have, and we cried for joy.</p>
<p>The Gritty Details </p>
<p>While I was kissing Grace's bald little head for the first time, the doctor was repairing a small tear I'd suffered. During the pushing stage my doctor had given me a perineal massage, rubbing the muscles between the vagina and anus, which helped me avoid an episiotomy. But I tore a bit anyway, which is common. Because I'd had an epidural I didn't feel the stitches. It was strange to look down and see her sewing away. If you're not on painkillers -- and sometimes even if you are -- the doctor delivers a local anesthetic before stitching.</p>
<p>Finally I was all sewn up, and my mom, aunt, brother, brother-in-law, and cousin all crowded into the room to pass Grace around and take pictures. In the pictures, I'm sweaty, exhausted, and half-naked in the hospital gown, but grinning like an idiot. It's something to put in the baby book, but I don't show to anyone outside the family!</p>
<p>A nurse helped me hold Grace to my breast for her first nursing. It was more awkward than I had imagined. But there was no pressure -- it was just a test run! (It takes a few days for milk to come in; meanwhile, you're giving your baby colostrum, an antibody-rich liquid that's sometimes called "early milk."). Just as the experts promised, Grace had an instinctive latch-on while she was still so fresh from the womb. We joked about what a natural she was while I fumbled to hold her.</p>
<p>Two Great Gifts </p>
<p>The doctor and my family left, except for Byron. Two hours had gone by it was time for the rite of passage: a trip to the bathroom. So much had come out of me already that the idea of passing anything else seemed ridiculous. While I used the toilet, two nurses huddled nearby, warning me that "there'll be a lot of blood -- it's normal." I decided not to look, because I could feel the flow and that was enough. Then they handed me two great gifts: a peri bottle and a self-cooling sanitary napkin.</p>
<p>"Peri bottle" is short for perineum bottle. It looks like a ketchup or mustard squirter. You fill it with warm water and you spray a stream of water onto your perineum while you use the toilet. The water washes away lochia -- the medical name for blood and tissue left over from the pregnancy -- and keeps your stitches clean if you have any. I used the peri bottle every time I visited the bathroom, not just in the hospital but during my first week at home.</p>
<p>The sanitary pads were fabulous: I'd twist one, and within a minute it would feel cool. The soothing temperature lasted three to six hours, and the pads were long and absorbent. This didn't keep me from trashing several pairs of panties and a nightgown, though. (Bring clothes that you don't care about!)</p>
<p>It's currently in vogue to keep moms in just one room for the duration of their stay. My hospital, however, had laboring women in a different wing from recovering moms and babies, so the next step was moving me. A nurse pushed me in a wheelchair while Byron pushed Grace in her bassinet-on-wheels. Newborns couldn't be carried in someone's arms outside of their room -- in the hallway, they had to be in a bassinet.</p>
<p>The Adrenaline High </p>
<p>I gave birth at night, so our next order of business was to sleep, with me in the hospital bed, Grace in the bassinet, and Byron on a couch. I slept for a couple hours, then woke on the biggest adrenaline high of my life. I began calling friends with the news.</p>
<p>My energy high lasted most of the first day. An aide brought breakfast, and I ate everything on the tray. A nurse came by and asked, "What level of discomfort are you feeling, on a scale of 1 to 10?" I told her I was a zero, which was the truth. Had I needed it, though, she had acetaminophen for aches and pains. Eight hours after giving birth I got up and took a shower. I had brought bath wash, shampoo, and thick towels from home, and was grateful for all of it. I came out feeling refreshed and ecstatic. I was a mom!</p>
An<p>other nurse came to help me breastfeed. I made all the typical mistakes -- leaning over to the baby instead of lifting her to me, for instance. Grace's stellar latch-on was gone; she seemed skeptical of the whole thing now. When I tried to nurse her, she'd often just cry harder, which left me feeling defeated. Nevertheless, every few hours I'd ring the nurse-call button and insist that someone help me. Each nurse had her own tip or two, and when I combined all of their advice, I began to get the hang of it.</p>
<p>Aches and Pains </p>
<p>A resident came by to prick Grace's heel to check for jaundice and so they could determine her blood type. Grace cried bloody murder, and I winced. Then a nurse came in to give us a lesson on sponge bathing and diapering our baby. Most baby care is common sense, but it's natural to be nervous when you're handling a newborn, and we appreciated her guidance, especially on cleaning the umbilical cord stump (a nasty-looking thing). Grace, meanwhile, napped a lot that first day.</p>
<p>By the afternoon I began to feel muscle aches. All I can compare it to is the way I feel after a day of skiing -- because I tensed my muscles throughout so much of the previous day, I was paying for it. I kept switching positions in bed to get comfortable. A nurse offered acetaminophen again, but I didn't take any. I was paranoid about using medicine while nursing, even though I knew that what they were giving was safe.</p>
<p>Byron ran out to get film developed and to buy me bottled water and Gatorade. Recovery and the beginning of milk production made me tremendously thirsty. Guests brought me chocolate, my favorite treat. Lunch and dinner at the hospital tasted good but it was still fun to get outside food. It was a very happy time as we excitedly showed off our perfect, sleepy little baby.</p>
<p>Sleepless Nights, Already? </p>
<p>By evening I was still feeling pretty good -- tired, but happy. We settled down to sleep again, Byron on the couch again, and Grace swaddled in her bassinet. But I was in for a shock: Grace, having napped all day, was in no mood to sleep at night. She also entered the normal nursing-every-two-hours newborn groove. I had expected to muddle through sleepless nights, but this felt more like a struggle for survival. Grace cried, and I drank Gatorade after Gatorade and ate chocolate bars to keep awake -- not something I'd recommend, and not something I continued at home!</p>
<p>I have pictures of that night, with Byron sleeping while Grace, propped up in a nursing pillow, exercised her lungs. I nursed her, changed her, carried her around the room, and cursed myself for not having napped earlier. I tried to wake Byron, but he was dead asleep. And to make things worse, my bottom was starting to feel sore where the stitches were, making both walking and sitting uncomfortable.</p>
<p>The night nurses came by to offer encouraging words. Before breakfast, a woman from the nursery took Grace for a routine checkup, and I slept the hour that she was gone. By the time she returned I was awake, though in a sleep-deprived stupor. That stupor lasted the next several weeks.</p>
<p><em>By Jessica Hartshorn </em></p>

<p><em>Used with permission. © Meredith Corporation. All rights reserved. </em></p>
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