I love to read, and I absolutely love reading to little ones.  Reading to your baby is an opportunity to slow down, snuggle with your baby and create a routine that fosters connection.  Anyone can read to baby; Dad, siblings, aunts, uncles, grandparents, neighbors.... As a midwife, one of the sweetest things I have witnessed is Dad reading to his newborn daughter who was less than two hours old and her brothers while Mom was taking a shower. 

I read to both of my sons, starting while I was pregnant.  When my oldest child was born and I started reading to him from one of the books I had read often while pregnant, he got so excited, cooing and flapping his arms. He recognized the rhythm of the words I was reading, and now he could see the pictures that went with the words.  If he was fussy while we were driving somewhere, I could open a book and put it where he could see and he would stop fussing to look at the pictures.  Books were stuffed in the diaper bag and went with us everywhere. Reading kept my boys occupied when we were waiting, at the doctor's office or a restaurant, or whenever they were bored while we were out. Reading was also part of our bedtime routine.

My boys are adults now so my list is probably more of a "classic" children's book list, but the classics are tried and true. Here's my list:

Goodnight Moon by Margaret Wise Brown
Katie Caboose by Bill Peet
Wait Til the Moon is Full by Margarat Wise Brown
Sheep in a Jeep by Nancy Shaw
Sheep in a Shop by Nancy Shaw
Sheep Out to Eat by Nancy Shaw
Cat in The Hat by Dr Suess
Green Eggs and Ham by Dr. Suess
Peter Rabbit by Beatrix Potter
Winnie the Pooh by A. A. Milne
Mike Mulligan and His Steam Shovel By Virginia Lee Burton
The Little House by Virginia Lee Burton
If You Give a Moose A Muffin by Laura Joffe Numeroff
If You Take A Mouse to the Movies by Laura Joffie Numeroff
The Little Engine That Could by Watty Piper
​Tootle by Gertrude Crampton
The Velveteen Rabbit by Margery Williams
​​Guess How Much I Love You by Sam McBratney
The Kissing Hand by Audrey Penn
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These are what I consider my favorites to read to my sons when they were babies. I read them so often that I can still recite the texts of some of them. Today my sons like to read whether it's to expand knowledge or just for fun. I think reading to them starting before birth was a big part of the love of reading we all share now.
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​I serve many clients who have pets and I have attended births where pets are present and I have some observations and thoughts about pets, labor and birth.

Full disclosure here: Cats have been part of my life from day one. I've been told that when I was brought home from the hospital after birth, our cat decided to sleep with me in my crib that day. So I may be a little biased about pets and infants.

I think dogs and cats know when Mom is pregnant. Cats and dogs have very sensitive noses, and can detect changes in odors and pheromones. While there aren't studies on pheromone changes during pregnancy, we do have research that hormonal changes can change body odor. I strongly believe our pets pick up on these changes. I have been at labors where I could tell that Mom was getting closer to birth because her pets wanted to be closer to her the nearer she got to birth. Even if pets aren't in the room with Mom for labor and birth, they will hear a baby crying, and will know there has been a change and that they are hearing someone new.

I encourage families to introduce pets to their newborn in the first hours after birth. Just as you would introduce your pet to a guest who comes into your home, you should introduce your pet to the new family member. I do recommend a supervised introduction so parents can help pets to stay calm when they meet baby. I also recommend continued  supervision when your pet and baby are together in the future. 

After baby is born, expect a few changes in your pet. If you have dogs, they may become very protective and guarding of your baby and may not be as welcoming to visitors as they used to be. With a little time, they will figure out that visitors are okay when a parent is around. Cats may want to sniff baby and that might be all they are interested in doing. Some cats might want to sleep where baby sleeps in the hopes of getting more attention.

Pets are family members too. Letting pets be part of your baby's journey will make life all the richer for both your little one and your pet.

What is vitamin K?
Vitamin K is a group of fat-soluble compounds involved in blood clotting, bone metabolism and cardiovascular health.  Newborn babies have almost no vitamin K at birth since it does not cross the placenta efficiently and isn't produced until baby starts digesting food.
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What are the concerns about baby having low vitamin K?
Low vitamin K levels in babies can lead to vitamin K deficiency bleeding (VKDB). VKDB is a rare but serious bleeding disorder that can occur in infants within the first 6 months of life.  There are three types of VKDB.

• Early VKDB occurs within the first 24 hours of life and is usually caused by medications such as blood thinners the mother took during pregnancy. Early VKDB affects .025%  to 1.5%  of newborns.
• Classic VKDB occurs between days one to seven after birth and is typically characterized by bruising or bleeding from the umbilical site. Classic VKDB occurs in approximately 0.44% of newborns.
• Late VKDB is the most concerning type and occurs between two and 12 weeks of age. Late VKDB is often linked to high rates of infant deaths caused by internal bleeding. Late VKDB occurs in about 4 to 7 babies out of every 100,000 who do not receive any Vitamin K at birth.

Can I increase the amount of vitamin K my baby is born with by changing my diet or taking a vitamin K supplement?
In studies, researchers have found that the concentration of vitamin K in cord blood was significantly lower than the concentration in maternal blood, indicating that vitamin K does not cross the placenta efficiently. This result was the same whether Mom included vitamin K rich foods in her diet or took a vitamin K supplement. The evidence indicates maternal diet or supplementing with vitamin K in pregnancy doesn't increase vitamin K levels in newborns.
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Why are babies born with low vitamin K?
We don't know, but there is some indication that newborns may have a slightly different clotting mechanism than is found in adults. However, if a newborn does have bleeding or bruising, it is wise to be cautious and give them vitamin K.

What is the treatment for VKDB and how effective is it?
The recommended treatment for VKDB is to give the baby a vitamin K injection. When a a baby with VKDB receives a shot of vitamin K, this will usually slow or stop the bleeding within 20-30 minutes. However, if bleeding happens in the brain, the baby may already have brain damage by the time the shot is given.
The vitamin K injection is highly effective at preventing classical and late VKDB, and basically eliminates all cases of late VKDB. Most babies who have VKDB will recover, especially if they receive treatment quickly. 

What about giving baby oral vitamin K drops?
Oral vitamin K is effective in preventing VKDB, but it is not as effective as the injectable form. The 3-dose regimen of 2 mg oral vitamin K lowers the risk of classical and late VKDB to under 1 per 100,000, but is  still not as effective as the injection, which has incidence rates even closer to zero.

Do you require vitamin K for baby in your practice?
I trust my clients to make the best decision for their babies, and I will fully support whatever decision they make. If I see bruising or other issues that I think may merit getting a Vitamin K shot, I will share that with my clients.

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What is jaundice?  
Bilirubin is a yellowish substance that is a byproduct when red blood cells are broken down. Red blood cells are always being broken down and replaced by the body. Bilirubin is normally broken down by the liver.  Jaundice occurs when bilirubin builds up faster than the liver can break it down and eliminate it from the body. Newborns are transitioning from fetal red blood cells which have a slightly different form of hemoglobin to normal red blood cells. That process begins right after birth. Their liver is just beginning to function so that makes them more susceptible to jaundice.

How common is jaundice in a newborn?
It is pretty common, 60% to 84% of all newborns born at term will experience some level of jaundice in the first week of life. It even has a name, physiologic jaundice because it is considered normal.

How will I know if my baby has jaundice?
​The newborn will start to get a yellowish tinge to the skin. It starts at the top of baby’s head and travels down the body through the torso. The whites of baby’s eyes may start to take on a yellowish tinge.  Jaundice usually peaks between 2-5 days after birth, and  lasts 1-2 weeks.

What can I do to minimize jaundice?
Bilirubin is eliminated through the digestive system. The single most helpful thing you can do to minimize jaundice is to nurse baby frequently. (Supplementing with formula does not clear out bilirubin any better than breastmilk so formula supplementation is not beneficial.) Light therapy can also be helpful since sunlight breaks down bilirubin. Place baby where natural sunlight will shine with just a diaper on, or completely naked.  Do this for 20 minutes 3 times a day. You could also consider having baby under a SAD (seasonal affective disorder) light if there isn’t a lot of sunlight in your home.  

When should I be concerned about jaundice?
In between postpartum visits, these are things that would indicate baby may need some help:

• Baby has yellow skin within the first 24 hours after birth
• Baby becomes jaundiced around 3 weeks old
• Baby has yellow skin below the knees
• Baby is lethargic
• Baby is not having wet or soiled diapers.  Baby should have wet diapers equal to how many days old they are, and should have some soiled diapers as well.
• Baby has lost more than 10% of birth weight.

Can jaundice be a problem?
Yes, in rare cases, jaundice can be a problem. There is breast milk jaundice, and pathological jaundice, often caused by blood type issues. These types of jaundice are typically recognized by when they appear, or how long they last. Both types are easy to treat if they are recognized and treated early.

Summing up
Jaundice is pretty common in newborns. It is also pretty easy to address with frequent nursing, and some sunlight exposure or other light therapy. There are some recent studies that indicate jaundice may actually have some benefits as an antioxidant in the first few days after birth, as well as protecting baby from Group B Strep infection. As your midwife, I will help you monitor and address any jaundice your newborn may develop, and advise you when it might be necessary to seek medical help.

Other sources not linked in post:
Thureen, Patti. Deacon, Jane. O’Neill, Patricia. Hernandez, Jacinto. (1999) Assessment and Care of the Well Newborn. W.B. Saunders Company.

What is jaundice?  
Bilirubin is a yellowish substance that is a byproduct when red blood cells are broken down. Red blood cells are always being broken down and replaced by the body. Bilirubin is normally broken down by the liver.  Jaundice occurs when bilirubin builds up faster than the liver can break it down and eliminate it from the body. Newborns have more red blood cells than adults and they begin transitioning from fetal red blood cells which have a unique hemoblogin to regular red blood cells after birth.

How common is jaundice in a newborn?
It is pretty common, 60-84% of  newborns born at term will experience some level of jaundice in the first week of life. It even has a name, physiologic jaundice because it is considered normal.
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How will I know if my baby has jaundice?
The newborn will start to get a yellowish tinge to the skin. It starts at the top of baby’s head and travels down the body through the torso. The whites of baby’s eyes may also start to take on a yellowish tinge.  Jaundice usually peaks between 2-5 days after birth, and  lasts 1-2 weeks.

Can jaundice become a problem?
Yes, in a small amount of cases, jaundice can be a problem.  Jaundice can be a sign of blood type incompatibility, whether due to rH factors, or blood type. If bilirubin levels get high enough, brain damage can occur. Thankfully, jaundice induced brain damage is rare.

What can I do to minimize jaundice?
Bilirubin is eliminated through the digestive system. The single most helpful thing you can do to minimize jaundice is to nurse baby frequently. I prefer that baby is nursed every two hours. Light therapy can also be helpful since sunlight breaks down bilirubin. Place baby where natural sunlight will shine with just a diaper on, or completely naked. Do this for 45-60 minutes 3 times a day. You could also consider having baby under a SAD (seasonal affective disorder) light if there isn’t a lot of direct sunlight in your home. 

New perspectives and understanding of jaundice  
In the past, blood serum levels of bilirubin were used to determine whether treatments were necessary, regardless of the age of the newborn. As the understanding of the normal trajectory of newborn jaundice has expanded, blood serum levels of bilirubin based on how old the newborn is should be used to determine if treatment is needed. Results from recent studies show that jaundice may be beneficial to the newborn, acting as an antioxidant and preventing illness from Group B Strep. As a midwife, I find it reassuring that the research is showing increasing evidence that physiological processes after birth may not be harmful but actually serve a beneficial purpose.