Category Archives: Maternal Child Health

New York Neonatologist Talks Pulse Oximetry and Newborn Screenings

Posted on: July 16, 2014

The Fourth Vital Sign

By Dr. Rick Stafford

SONY DSCCongrats. You’re having a baby! Whether this is your first, or your fifth, you’ve most likely read everything you need to know about what to expect, and you’ve no doubt gotten advice from well-meaning friends and relatives. But before you take your infant home, doctors will be looking for a few key signs that your child is healthy and ready to leave the hospital. All states require specific tests for newborns to assess for potentially fatal disorders that aren’t otherwise apparent at birth, among them the recently required pulse oximetry assessment. The information below explains its significance.

New to the newborn screening docket, as of 2013, is pulse oximetry screening for cyanotic congenital heart disease (CCHD). Pulse oximetry, which indirectly measures the oxygen level in the bloodstream, has become almost a fourth vital sign (temperature, pulse rate and respiratory rate are the traditional 3 vital signs). New York State health code now mandates pulse oximetry screening for CCHD in all newborns born in New York. Northern Westchester Hospital was proactive in this regard and has been administering the screening since April of 2013.

The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is then pumped to the rest of the body. There are some congenital cardiac defects that impair oxygen delivery to the blood.  This results in the delivery of de-oxygenated blood to the body, a condition (cyanosis) that is not compatible with life. Pulse oximetry screening can pick this up in a newborn before he or she becomes critically ill. In a fetus, the circulation is very different. Oxygenated blood comes from the placenta and two shunts; it then circulates around the lungs into the left side of the heart where it flows to the rest of the fetus.  Because of this, a fetus with a cyanotic congenital heart defect will not be sick while in the womb.

These shunts are supposed to close within a few hours after birth, and when they do, the babies may begin to get sick. The shunts don’t always close right away and a baby may get sick after being discharged home. This is why applying pulse oximetry screening to a newborn is so valuable. Doctors and nurses normally wait at least 24 hours before administering the screening. Do the test too early and it’s possible those shunts are still working, thus masking the condition. Too late and the baby could become very sick very rapidly.

The test is administered with a sensor that measures and compares the differences in the wavelengths of oxygenated and deoxygenated blood. The sensor is first placed on the baby’s hand and then on the foot, with the expectation that the numbers will be the almost the same. A cardiologist would be called in for a consult if there is a percentage difference of three points or higher, or if the baseline saturation is low. If a diagnosis of CCHD is made, the neonatology team would then work to stabilize the baby and prepare him or her for transport to a large regional center where corrective heart surgery could be performed.

It’s all about early detection, intervention and treatment.

Editor’s Note: Rick Stafford, MD, FAAP is the Director of Neonatology at Northern Westchester Hospital. Parents looking for more information on this subject should check out the web-site of the American Academy of Pediatrics: www.aap.org

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Northern Westchester Hospital Maternity Nurse Talks Birth Plans

Posted on: May 27, 2014

Making it Your Birth Experience

By RoseMary Stevens, RNC-OB, Northern Westchester Hospital

birth_planA Birth Plan is a document that tells your health care provider and the hospital staff what kind of childbirth experience you would like to have and how you would like your newborn cared for. Continue reading

Northern Westchester Hospital Maternity Nurse Shares Resources for New Parents

Posted on: March 25, 2014

New Parents have Q’s…
…Here’s Where to Find the A’s

By Maureen Varcasio, RN at Northern Westchester Hospital

iStock_000019586817Medium2Having a baby requires parents to learn new skills in order to care for their newborn and themselves. Much of what you need to know can be learned from the nurses while you are still in the hospital. However once parents are discharged home they may still have questions or new questions can arise. For example:  What should I do if my baby won’t nurse or won’t stop crying? Do I have Postpartum Depression? or Am I bleeding too much? Here’s where you can turn for answers… Continue reading

New York Nursery Nurse Discusses Newborn Screening and PKU

Posted on: February 20, 2014

Why Will My Newborn Get a PKU Screening?

By Martha Zavras, RN III, Northern Westchester Hospital

Northern Westchester Hospital maternityIf you, a family member, or close friend is pregnant, it is important to know that your newborn will be screened for several serious medical conditions, as mandated by New York State. Among the conditions screened is PKU. What is this blood test for, and what do the results mean for your new baby and your family?

As a Nursery nurse, I often administer the PKU test to newborns, also explaining to parents why it must be given so early in life. PKU is the abbreviation for phenylketonuria, a metabolic disorder. In New York State, the PKU screen, which is a simple blood test, also screens for many other disorders, including thyroid problems and some types of anemia.

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Westchester Lactation Consultant on the Benefits of Breastfeeding

Posted on: February 11, 2014

Breastfeeding: A Small Moment with Far-Reaching Benefits

By Kim McKechnie, RN, IBCLC, Lactation Coordinator at Northern Westchester Hospital

mother breastfeeding babyWe know that in most cases “natural” is better, and breastfeeding is no exception. Breastfeeding your baby is the most healthful way to feed and nurture most newborns, and the American Academy of Pediatrics (AAP) backs this contention. The AAP recommends exclusive breastfeeding for the first six months of a baby’s life, as well as continued breastfeeding for at least the first year as solid foods are introduced.

Breastfeeding your baby can also lead to broader benefits. Breastfed babies are sick less often than babies who are fed with formula because of the natural antibodies that are passed from a nursing mother to her baby. Breastfeeding protects babies from infections by contributing to their immune system resulting in lower occurrences of conditions such as ear infections, diarrhea, and respiratory infections. Continue reading