In one of the videos on skin to skin that I observed recently (sorry, old, have the crs syndrome), the baby was given vitamin K while on mom's belly before he started the "awakening" phase of the breast crawl. The narrator pointed out that the baby showed no reaction to the injection, stating that baby was in a "numb" state physiologically immediately after the birth, a condition nature-planned for coping with the pressures of passing through the birth canal. I have never heard that before, but it seemed logical. And the baby did not flinch or cry when the injection was given. Just some food for thought in the discussion. Why do mothers and babies have to be separated to give the vitamin K?
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Rachel Myr
Sent: Thursday, July 22, 2010 5:41 PM
Subject: Vit K policy and education CD
I'm behind, catching up slowly. Jane Crotteau asked for research on delaying Vit K administration to newborns to give mother and baby more time together, which makes me wonder. It's been years since WHO first said there is no reason to separate mothers and babies in connection with routine observation and care after birth, and since then we have learned many things about the damage that such separation does. Good for you, Jane, for making an effort to have Vit K given with baby on mother's body. As a midwife in a gov't hospital in Norway I can't picture where else we would put the baby for this procedure, or for most other procedures carried out in the first hours after birth. We don't give babies eyedrops either, haven't done so in decades. I've never seen a case of gonococcal conjunctivitis in my 21 years of practice.
While I am on the subject of cultural differences in care, I can tell you that the only procedures people sign anything about beforehand in this country are sterilization and induced abortion. Surgery is done without signed consent forms and indeed without formal consent at all and I think a Norwegian GP would think you were an alien from another planet if you started talking about consent forms for care. It's possible that cosmetic surgery requires consent forms, but it is not considered therapy for medical condition so it is regarded quite differently. The forms for sterilization and abortion are not exactly consent forms either, they are 'orders' from the patient to the professional in which the patient states in writing that they demand to be sterilzed or have a pregnancy terminated. I don't think there are other procedures for which forms are used.
If someone wants to leave the hospital and a doctor advises against it, they will be asked to sign a disclaimer before going home, releasing the hospital from responsibility should anything untoward happen that would have been avoided in hospital. But to accept care all one does is lie there and take it.
I don't think this system is necessarily better, I just want you to be aware that there are other approaches to the issue of 'consent'. No idea what other countries do.
Rachel Myr
Kristiansand, Norway
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