mrg-post natal folder insides

mrg-post natal folder insides
Congratulations on the birth of your new baby. Once again, thank you
for choosing TriHealth as your health care provider for maternity services.
It is our hope that your care has been outstanding, your stay has been
comfortable, and your experience has been exceptional. May your life
as a mother be one filled with joyous memories.
TriHealth Mother/Baby Nurses and Staff
Table of Contents
I. Self-Care for New Mothers . . . . . . . . . .
Uterine Contractions . . . . . . . . . . . . . . . . . . . . . .
Lochia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Perineal Care . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cesarean Birth and Incision Care . . . . . . . . . . . . .
Hemorrhoids . . . . . . . . . . . . . . . . . . . . . . . . . . .
Elimination (ridding the body of waste products) . .
Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breast Care . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Activity and Rest . . . . . . . . . . . . . . . . . . . . . . . . .
The Kegel Exercise . . . . . . . . . . . . . . . . . . . . . . .
Adjusting to Family Life . . . . . . . . . . . . . . . . . . . .
Baby Blues and Postpartum Depression/Anxiety . .
Postpartum Complications . . . . . . . . . . . . . . . . . .
Resuming Sexual Relations . . . . . . . . . . . . . . . . . .
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II. Caring for Your Newborn . . . . . . . . . . . . . . . . . . .5
Your Baby from Head to Toe . . . . . . . . . . . . . . . . . . . . . . . . .5
Parent Information about Universal Newborn Hearing
Screening (UNHS) in Ohio . . . . . . . . . . . . . . . . . . . . . . . .5
Speech and Language Milestones . . . . . . . . . . . . . . . . . . . . .6
Jaundice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Infant Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Feeding Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Caring for Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
III. Paternity . . . . . . . . . . . . . . . . . . . . . . .
Paternity Facts for Married/Unmarried Mothers . . .
Paternity Testing and Child Support . . . . . . . . . . .
The Importance of Establishing Paternity . . . . . . . .
Common Misconceptions about Maternity Affidavits
Common Mistakes on Paternity Affidavits . . . . . . .
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IV. Safety Check . . . . . . . . . . . . . . . . . . . .
Cribs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Car Seats . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Suffocation . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Supervision . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Choking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Shaking Hazards . . . . . . . . . . . . . . . . . . . . . . . .
Shots for Your Child’s Health . . . . . . . . . . . . . . . .
SIDS (Sudden Infant Death Syndrome) . . . . . . . . .
Helping Your Baby Sleep and Nap Safely . . . . . . .
Frequently Asked Questions about Safe Sleep . . . .
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Table of Contents
V. Helpful Services and Information . . . . . . . . . . . .19
United Way Help Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Helpful Numbers in Greater Cincinnati . . . . . . . . . . . . . . . . .19
Ohio Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Kentucky Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Indiana Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Providing Healthy Food for Your Children is Very
Important — Maybe WIC Can Help . . . . . . . . . . . . . . . . .22
Hamilton County WIC Program Locations . . . . . . . . . . . . . . .23
Your Child’s Social Security Number . . . . . . . . . . . . . . . . . . .23
Your Child’s Birth Certificate . . . . . . . . . . . . . . . . . . . . . . . .23
Helpful Tips for Applying for Your Child’s Birth Certificate
and Social Security Number . . . . . . . . . . . . . . . . . . . . . .24
Your body went through tremendous changes during pregnancy and birth. In upcoming weeks, you will continue to undergo physical
changes as well as experience emotional changes as you return to your normal, pre-pregnancy state. During this adjustment period, it will
be very important to take care of yourself. To help make the adjustment easier, please review the information provided in this section.
I. Self-Care for New Mothers
Uterine Contractions
Call your physician/midwife if:
After delivery, your uterus will begin shrinking. By the eighth
week after delivery, uterine contractions will cause it to return to
its normal size. You may feel cramping as your uterus contracts.
Contractions may feel stronger to women who have had prior
children because the uterus has been stretched more, and it must
contract harder to get back into shape. These contractions can
be uncomfortable, but keep in mind that they are temporary and
important for getting the uterus back into shape. An added benefit
is that the more quickly your uterus shrinks, the more quickly
your bleeding will subside. To get your uterus back in shape:
• Empty your bladder frequently (every three to four hours).
• Lie on your stomach.
• Massage your uterus (ask your nurse how to do this).
• Walk.
• Your vaginal bleeding returns to a bright red color after
beginning to lighten or returns to a heavy flow after beginning
to slow. Occasional clots may be passed but should not be larger
than a golf ball. In general, the more babies you have delivered,
the heavier and longer you will experience bleeding.
• Your discharge has a foul smell, unlike your menstrual flow.
The first one or two menstrual periods after delivery are seldom
the same as the periods you had before. They usually are somewhat
heavier in flow and longer in duration, but may be lighter in flow
or shorter in duration. Do not let this alarm you. The first period
usually will begin anywhere from four to six weeks after delivery.
However, some women may go longer before resuming their
periods.
If you are very uncomfortable with the contractions, you can try
relaxation and breathing techniques. If these suggestions do not
help, you may try pain medication as prescribed by your physician.
The pain should subside naturally in four to seven days.
Perineal Care
Lochia (bleeding after delivery)
Lochia is the term used to describe the shedding of the uterine
lining after delivery. This vaginal discharge of blood, mucus and
tissue occurs in three stages with both vaginal and Cesarean births.
It begins as a red, bloody color that lasts three to four days.
During the first couple of days after delivery, you may notice small
clots on your sanitary pad or in the toilet. This is normal. In the
second stage, your blood flow will be pinkish and mixed with
mucus. Lochia eventually will turn a brownish color and last until
the ninth or 10th day. The final stage lasts two to three weeks and
is a yellowish-white color. The process generally lasts four to six
weeks. (Time frames are approximate and vary from person to
person.)
You may notice an increase in bleeding during the first days at
home due to an increase in activity. If your bleeding increases,
your body may be telling you that you need more rest.
Do not use tampons, douche or have intercourse until you have
the approval of your physician/midwife.
The area between the vagina and the rectum is called the
perineum. Even if you do not have an episiotomy or tear during
delivery, it will be important to keep this area clean and dry to
prevent infection and promote healing. Your perineal muscles
will be stretched and weakened during the delivery and may
be swollen, bruised and painful. The discomfort generally will
decrease each day. Kegel exercises will provide comfort and aid
in the healing process. Details on performing Kegel exercises are
given later in this section.
At delivery, you may have had an episiotomy or a tear that
required stitches. You can expect stitches to dissolve in as soon
as seven to 10 days or as long as four weeks, depending on the
type of suture used. Depending on the type of suture your
physician/midwife used, you may notice tiny black “strings”
(stitches) on your sanitary pad.
Caring for the perineum at the hospital and at home
• Always wash your hands with soap and water before and after
you care for your perineum.
• Change your sanitary pad every time you go to the bathroom
or at least every three to four hours.
• With each pad change, use the squirt bottle provided by the
hospital to rinse the perineum from front to back with warm
water.
• You may pat, blot or wipe gently from front to back.
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Self-Care for New Mothers
• Use ice packs to help reduce swelling and increase comfort. Ice
packs will be provided during your hospitalization immediately
after delivery and for the next six to 12 hours depending on your
physician/midwife recommendation.
• Medications applied directly to your stitches, such as foams or
creams, sometimes are ordered by your physician/midwife. These
medications are designed to increase comfort and should be
discontinued if irritation occurs. Use only one medication at a
time and apply directly to affected area.
• Per physician order, you may be given a portable sitz bath to take
home. Your physician may prescribe that you start using sitz
baths after you are finished using ice packs. Sitz baths should be
taken at least three times a day, and more if you prefer.
Instructions for sitz bath use
• Fill the sitz bath pan and bag with water as warm as you can
tolerate. Be sure to have the tubing clamp shut.
• Raise the toilet seat and place the sitz bath pan on the commode,
suspending the bag.
• Sit in the water and open the clamp.
• When the bag is drained, the sitz bath is complete.
• Pat the perineum dry and replace your sanitary pad with
a clean one.
Medications that may be prescribed for perineal
care include:
• Epifoam - Apply quarter size amount in the middle of your
sanitary pad directly to affected area. Use no more than three
to four times a day. Epifoam contains hydrocortisone and a
local anesthetic.
• Hydrocortisone cream - Apply quarter size amount directly
to affected area with your fingertip.
• If your physician/midwife prescribed both Epifoam and
hydrocortisone cream, do not use both medications at the same
time to the same area. Use the Epifoam first before you switch
to the hydrocortisone cream.
Cesarean Birth and Incision Care
If you had a Cesarean delivery, your incision may be closed with
internal stitches that will dissolve by themselves, or with metal
staples that may be removed in the hospital before you go home,
or in your physician’s office at a later date. A special tape called
Steri-strips may be placed over your incision upon removal of
the staples. Your physician will give you instructions on when to
remove the Steri-strips. It is important to keep the incision clean
and dry. Air drying will help promote healing. Cotton underwear
is preferred to nylon or other material. Most physicians will permit
showering the day after surgery. Along with information regarding
your care, your physician will give instructions for showering.
Call your physician if you experience:
• Increased redness at the incision site.
• Increased swelling or tenderness at the incision site.
• A fever greater than 100.4 degrees Fahrenheit.
• Separation of the incision.
• Continued bleeding or drainage from the incision site.
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Hemorrhoids
Hemorrhoids are varicose veins of the rectum. You may develop
them during your pregnancy or during delivery. Hemorrhoids
often cause a persistent dull pain and a feeling of pressure in the
rectal area. Hemorrhoids usually shrink on their own with time.
To ease discomfort:
• Apply ice packs or take sitz baths.
• Use Tucks or other medications prescribed by your physician.
• Rest on your side and avoid prolonged sitting.
• Drink six to eight glasses of water per day.
• Eat plenty of fresh fruits, vegetables and whole grains.
• Perform Kegel exercises frequently.
Elimination (ridding the body of waste products)
After vaginal and Cesarean deliveries, the body will begin to
produce more urine due to IV fluids given during the birth process
and as the body begins to rid itself of extra fluids retained during
pregnancy. With this in mind, it will become important to keep
track of how frequently you empty your bladder. If your bladder
becomes too full, it can inhibit the uterus from contracting, thus
increasing your bleeding. A full bladder also can cause you not to
be able to urinate and can add discomfort by putting more
pressure on your uterus and surrounding tender tissues. Your nurse
will assist you to the bathroom the first time. The first attempt to
urinate may be difficult. To help ease this process:
• Drink plenty of water.
• Use the squirt bottle to spray water over the perineum.
• Turn the faucet on and listen to the water run.
• Use the sitz bath or shower (your physician will give you
instructions for showering) to allow warm water to help
you relax.
• Perform Kegel exercises.
Constipation is a common problem after giving birth. It occurs for
a variety of reasons, including inactivity, relaxed abdominal
muscles and narcotics contained in some pain medications. Some
women become concerned about episiotomy stitches and worry
that a bowel movement will pull the stitches loose. This should not
be a concern, because the stitches generally are stronger than that.
It is important not to delay bowel movements. Bowel movements
will relieve the feeling of abdominal and perineal pressure. To assist
this process:
• Get up and begin walking as soon as your physician/midwife
allows.
• Drink plenty of fluids and eat plenty of fresh fruits, vegetables
and whole grains.
• Drink warm fluids to help soothe and promote intestinal activity.
• Avoid gas-forming foods such as cauliflower, broccoli and
cabbage, and carbonated and ice cold beverages.
Self-Care for New Mothers
Nutrition
You can expect a weight loss of about 12 to 15 pounds during the
first week after giving birth. You should continue gradually to lose
the weight you gained to support your pregnancy. It is important
not to diet until after the follow-up visit with your physician/
midwife. Healthy eating habits include a wide variety of foods
to obtain essential nutrients, vitamins and minerals.
Breast Care
Many women are eager to regain their figure and will want to
begin exercising. An exercise program should begin only after your
physician/midwife has approved the types of exercises you can
perform. When you begin, start slowly and gradually increase as
your strength improves.
If you had a Cesarean delivery, your recovery process will take a
week or two longer. Your physician/midwife will advise you of
limitations on other activities such as driving and exercising.
Almost immediately after delivery, a hormone is secreted that
stimulates milk production in the breast. There will be some milk
present in your breasts. You may experience milk leakage for
several weeks. If your breasts are not stimulated or emptied,
no additional milk will be produced. Engorgement occurs when
breasts fill and are not emptied. Your breasts will become firm,
tender, swollen and sometimes painful 48 to 72 hours after
delivery and symptoms may last for about 24 to 48 hours. To
relieve discomfort during engorgement:
• Begin wearing a well-fitting, supportive bra within six hours
after giving birth and wear it continuously until milk production
is inhibited.
• Apply ice packs to the top of the breasts (above the nipple area,
toward the armpit) as needed for comfort for 20 minute
intervals.
• Turn your back toward the water when showering to avoid direct
stimulation of the breast.
• If discomfort continues, you may try medication as directed
by your physician/midwife.
The Kegel Exercise
Activity and Rest
Resource: Nichols, F., and Humenick, S. Childbirth Education:
Practice, Research, and Theory. Philadelphia: W.B. Saunders Co.,
1988.
It usually takes about six to eight weeks after you have your
baby for your body to return to its normal state. Recovery is
a progressive process. You will feel stronger each day. You must
remember you have just been through the equivalent of a major
operation and you should give your body time to recover.
It is very important to rest after giving birth. It will be easier to
cope with the physical and emotional demands of parenting if you
are well rested. Allow family members and friends to take care of
household chores such as cooking, cleaning and laundry. (Family
members feel useful when they know they are helping you
recover.)
If stair climbing is necessary, limit frequency by planning trips.
Do not lift more than 10 pounds. If you have other small children,
you will need to sit down and encourage them to climb next to
you to snuggle rather than lifting them.
The pelvic floor muscles form a hammock that extends from the
pubic bone to the tailbone. These muscles support the uterus and
other organs in the pelvic cavity. The pelvic floor muscles surround
the three openings in the perineum — the urethra (where urine is
passed), the vagina and the rectum (where stool is passed). To
locate the muscle group, pull in as if you are stopping a stream of
urine. Then pull in as if you are stopping a bowel movement. This
action of tightening the muscles is called the Kegel exercise.
• To perform the Kegel exercise: (1) tighten your pelvic floor
muscles (see guidelines above) and hold to a count of five (this
can be increased to a count of 10); (2) relax and (3) repeat in a
series of five at a time.
• During postpartum, to strengthen muscles and increase urinary
control: (1) tighten muscles; (2) hold to a count of 10, relax and
(3) repeat 100 times.
• Women should do Kegel exercises 100 times a day for life.
Adjusting to Family Life
During the first few weeks after giving birth, life will be extremely
hectic. Even if you have had children before, caring for an infant
will still be challenging. This little being you have brought into the
world depends on you 24 hours a day. With this dependency there
will be a change in daily and nightly schedules, loss of sleep,
frustration, irritability and loss of your former lifestyle. All of this
may seem overwhelming at times. Remember that good
communication is the cornerstone for your new family. Share your
concerns, doubts, joys and insights and make decisions together.
Trust your instincts. Many new parents are unsure of their
parenting skills. As you experiment and learn new skills and
attitudes toward parenting, you will become more confident,
and life will settle into place.
Entertaining is tiring. Ask your partner to help you limit the
number of visitors and time that they stay.
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Self-Care for New Mothers
Baby Blues and Postpartum
Depression/Anxiety
Postpartum depression is the number one complication of
pregnancy, affecting nearly 700,000 women in the United States
each year. It is a physical disorder that can occur any time from
pregnancy to a year postpartum.
The “baby blues”
The “baby blues” start within the first three days of giving birth
and fade away within two weeks. Most new mothers may feel
weepy, drained, anxious, irritable and sad. A call to your physician
or nurse midwife may be necessary if baby blues go beyond two
weeks.
Postpartum depression
Up to 30 percent of new mothers may have feelings of
hopelessness, irritability, sadness, loneliness and isolation that last
longer than two weeks. They also may cry a lot, have frightening
or repetitive thoughts, and have trouble eating or sleeping.
Postpartum anxiety
Some mothers may experience postpartum anxiety on its own or
together with symptoms of depression. Others may feel worried
or panicky, fear losing control or going crazy, or have chest pains
or a racing heart. Postpartum anxiety also may make women feel
shaky, dizzy or short of breath.
Postpartum psychosis
This rare condition can be a horrible experience for the whole
family. The mother may have severe mood swings, hallucinations,
and irrational or violent thoughts. Postpartum psychosis is a
serious condition that requires immediate medical attention.
Bethesda North and Good Samaritan hospitals offer a
Postpartum Support Group. Please call 513-569-HOPE
for information.
Postpartum Complications
Call your physician/midwife if you experience:
• Symptoms resembling the flu - chills or fever of 101 degrees
Fahrenheit or greater.
• Vaginal discharge that has a foul odor.
• Frequent urination, burning during urination or the inability
to urinate.
• Bleeding that saturates more than one sanitary pad per hour
during a few hours or clots larger than a golf ball.
• A return to bright red bleeding after bleeding has decreased
and/or has lightened in color.
• Severe pain in the lower abdomen.
• Reddened, swollen or painful areas in your legs.
• Reddened, swollen or painful areas in the breast.
• Worsening pain in the episiotomy or hemorrhoid areas.
• Severe or prolonged depression (see previous section).
• Any pus-like drainage from episiotomy or incision.
• “Baby blues” lasting longer than two weeks.
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Always know your temperature and any other symptoms when
calling your physician/midwife. You also should have your
pharmacy phone number ready. The follow-up visit with your
physician/midwife is important to ensure that you have healed
from delivery. Keep a notepad handy to write down any questions
you may have. Take your questions with you when you visit your
physician/midwife or your baby’s physician for follow-up care.
If you have additional questions, please consult your
physician/midwife.
Resuming Sexual Relations
Your physician/midwife will advise you on resuming sexual
intercourse. Family planning can be achieved in a variety of ways
and should be discussed with your partner and physician/midwife.
Remember that breastfeeding is not a form of birth control.
After the birth of your baby, your sex drive may decrease
temporarily due to hormonal changes, fatigue and adjusting to the
demands of parenting. Many men and women fear that
intercourse will be painful to the woman. Not all women have
pain. For women who do experience pain, the intensity varies from
woman to woman.
During this time, kissing, cuddling and massage can be acceptable
alternatives to intercourse. Most importantly, talk to each other
about your feelings and concerns.
When you decide to resume intercourse, the following suggestions
may be helpful to you and your partner:
• The natural lubrication of your vagina following childbirth may
take longer than before you had your baby, particularly if you are
breastfeeding. Use a lubricant such as KY® jelly or Astroglide® to
assist in this process.
• Breastfeeding before intercourse will help keep your baby content
and decrease the chance of leaking breast milk.
• Varying positions may help, as some may be more comfortable
than others.
• Maintaining your sense of humor will be helpful.
• Contact your physician/midwife for additional suggestions.
II. Caring for Your Newborn
Your Baby From Head to Toe
Your child is the greatest gift you will receive. Gathering
information and educating yourself will calm your fears and
answer questions as you prepare to care for your infant.
You probably know much more about being a parent than you
think. From childhood, you have learned parenting skills by
watching your own parents and other families. Perhaps you have
experience in caring for other children. Also, you have instinctive
responses that will help you develop your own skills and parenting
style. This section will serve as a guide to the first days and weeks
of life of your newborn.
Soft spots
There are two fontanels, or soft spots, on your baby’s head. These
are normal and allow for rapid growth of the brain. Fontanels
can vary greatly in size from one baby to another. The larger one,
located on top toward the front of the head, has a diamond shape.
The other one is located toward the back of the head and is
somewhat triangular. Do not be afraid to gently touch these areas.
There is a tough membrane under the skin that protects the skull’s
contents. You can expect the soft spot at the back of the head to
close by 4 months. The soft spot at the top will close between
10 and 20 months.
Vision
Although your newborn’s eyes may be closed most of the time,
when he is awake, he can see. The best distance for him to focus is
eight to 15 inches from his face. Babies can distinguish light from
dark, prefer patterns to solid colors and are fascinated by the
human face. As you look at your baby’s eyes, you may notice small
red areas in the whites of the eyes, making them appear blood
shot. This is caused by blood vessels breaking during the birth
process. These areas will disappear on their own. You also may
notice his eyes appear crossed or like they are drifting. This occurs
because his eye muscles are immature and are still developing.
Eye color may change until he is 6 months.
Hearing
Your newborn can hear at birth. Very early, your baby will
recognize familiar voices and can be comforted by them. In
addition to providing comfort, speaking to your baby can aid in
language development. If you watch carefully, you may even see
him make slight movements with his arms and legs in response
to your speech.
Sometimes your baby’s ears may appear flattened or even folded
against his head. This soon will correct itself.
Smelling, tasting and touching
In addition to preferring certain patterns and sounds, your baby
will prefer certain smells and tastes. A nursing baby quickly learns
to recognize the smell and taste of his mother’s milk and will
ignore another nursing mother’s milk. He also is sensitive to touch
and the way you handle him. Gentle stroking will comfort him,
while picking him up roughly is likely to cause him to cry.
Skin
At birth you may notice a creamy, white substance covering your
baby’s skin or in the folds of skin. This substance is called vernix
and acts as a protective coating. It is easily absorbed or wiped off
and usually disappears after the first bath. Your baby’s skin also
may peel as it adjusts to the air outside the womb. This process
is normal and requires no treatment. Small white dots on the face,
called milia, also may appear. They may look like pimples, but
don’t squeeze or wash them vigorously. They will clear on their
own. General skin rashes and birthmarks are common. Most fade
in the first weeks without treatment. The breast area on both boys
and girls may be slightly swollen and even have a small discharge.
This is normal and will correct itself. A bluish appearance of your
baby’s feet and hands during the first few hours after birth is due
to immature circulation and will correct itself.
Male and female sex organs (genitalia)
The genitals of newborns are often reddish and seem quite large
for bodies so small. Your baby girl may have a clear white or
slightly bloody vaginal discharge caused by exposure to her
mother’s hormones during pregnancy. This is normal and requires
no special treatment.
Parent Information about Universal
Newborn Hearing Screening (UNHS)
in Ohio
In Ohio, hospitals perform a hearing screening, called Universal
Newborn Hearing Screening, on every baby before they go home
so that hearing loss can be identified at the earliest possible point.
What is Universal Newborn Hearing Screening?
Universal Newborn Hearing Screening is a statewide program that
requires all babies to receive a hearing screening before they go
home from the hospital. In Ohio, there are approximately 450
babies born with hearing loss each year.
Why is my baby’s hearing being screened?
A law in Ohio requires that all babies have their hearing screened.
Hearing is an important part of the communication process.
Hearing plays a very important part in speech and language
development.
When is the hearing screening performed?
The hearing screening is usually done a few hours before the baby
is due to go home.
How is the screening performed?
Each method is a quick, simple and safe way to screen your baby’s
hearing. It is okay for your baby to be asleep while the screening
is being done.
• ABR (Auditory Brainstem Response): Three patches are placed
on the baby’s face, cheek and neck. Small headphones are placed
over the baby’s ears, and the baby hears soft sounds.
• OAE (Otoacoustic Emissions): Soft foam or rubber tips are
placed inside the baby’s ears, and the baby hears soft sounds.
5
Caring for Your Newborn
What do the results mean?
3 to 6 months
• Pass: This means hearing loss was not found at birth.
• Non-pass/refer: This result means that your baby will need
to have his hearing checked again.
• Turns head to search for sounds
• Uses eyes to look for sounds
• May squeal, whimper or gurgle
• Imitates own voice - “ooh” and “ba-ba”
• Enjoys rattles and other toys that make sounds
What does a “refer” result mean?
A “refer” result means that your baby needs to have his hearing
checked again. Sometimes babies are fussy during testing or may
have fluid in their ears from the birthing process. If your baby
receives a non-pass or refer result, please do not be alarmed.
This means he will need a more detailed hearing test to confirm
his hearing ability.
6 to 8 months
• Turns head toward interesting sounds
• Babbles (“ma-ma,” “ba-ba,” “da-da”)
• Understands “no,” “bye-bye” and other common words
10 to 15 months
What happens next?
If your baby needs another test, you will be given a list of
audiologists who can test your baby’s hearing. An audiologist
is a person who has expertise in hearing testing.
• Points to or looks at familiar objects or people when
asked to do so
• Imitates simple words and sounds
• Bounces or makes sounds when music is playing
• Enjoys games like “peek-a-boo” and “pat-a-cake”
What if my baby has a hearing loss?
If a hearing loss is found after more testing, there are programs
that are available to help you and your baby. These programs are
designed to help promote and support your child’s development.
Early identification is important
Universal Newborn Hearing Screening is important because babies
use their hearing to develop speech and language skills that are
necessary for communication. Therefore early identification of
hearing loss is critical. If at any time during your child’s growth
you are concerned about his speech, hearing or language, please
call your physician and request a full hearing test by an
audiologist. Your baby’s hearing can be tested at any age.
For more information about the Universal Newborn Hearing
Screening program in Ohio, or for information on early
childhood programs, such as Help Me Grow, please call
1-800-755-GROW (4769).
Resource: Information on UNHS provided by:
Bureau of Early Intervention Services - Infant Hearing Program
246 N. High Street, P. O. Box 118
Columbus, OH 43266-0118
Phone: 614-644-8389
Fax: 614-728-9163
E-mail: [email protected]
www.ohiohelpmegrow.org
Speech and Language Milestones
Most babies who pass the hearing screening at birth have good
hearing ability. Some babies who pass the hearing screening at
birth may be faced with hearing loss later in life. Therefore,
parents are encouraged to monitor their baby’s speech and
language development. It is important to have your baby tested
again if you have concerns about his hearing. Use the following list
to help you keep track of your baby’s hearing, speech and language
development.
Birth to 3 months
• Startles to loud sounds
• Calmed by familiar voice
6
15 to 18 months
• Follows simple directions, such as “give me the ball”
• Answers when name is called from another room
• Responds to singing or music
• Understands simple yes/no questions
• Uses 10 to 20 words
• By 18 months, should use many more words
Jaundice
Jaundice is a yellow or suntanned tint to your baby’s skin. Many
newborn babies get some jaundice. It is caused by an increase of
bilirubin, which comes from blood breakdown. You can lessen the
amount of bilirubin by breastfeeding soon and often after the birth
of your baby and for a long period of time. Your milk has a
laxative effect that helps your baby move his bowels more.
Bilirubin passes out of his system with bowel movements.
However, your pediatrician may suggest supplementing with
formula to increase the fluid intake. If you are not breastfeeding,
your pediatrician may increase the amount of times you offer your
baby formula.
An infant at home with significant jaundice that is not
appropriately treated can develop severe and permanent brain
damage. If your baby shows signs of significant jaundice (spreading
to include the chest and stomach), blood tests must be performed,
and occasionally treatment will be required.
Keep in mind:
• Jaundice is rarely present at birth and may not become evident
until a baby is several days old. It typically peaks at day three
or four.
• Jaundice is first noticed on the baby’s face. As it increases in
severity, it spreads to the chest, the stomach and then the legs.
• Test for jaundice by pressing gently on your baby’s stomach with
your thumbs and pulling your thumbs apart to stretch the skin
slightly. If the resulting imprint is yellow (not flesh), contact
your pediatrician. Always check for jaundice in natural light —
not by lamp or fluorescent lights.
Caring for Your Newborn
Call your baby’s physician if:
• The yellow or suntanned tint spreads to your baby’s eyes,
stomach or legs, or if your baby is drowsy and feeding poorly.
• Your baby has fewer wet diapers and bowel movements
(recording them daily will provide good information for your
baby’s physician).
Infant Behavior
Sleep
Infants generally are alert and active for the first one to two hours
after birth. Some may be interested in breastfeeding right away,
while others are content to be held and observe their new
surroundings. After this initial period, most babies tend to become
less active and may be less eager to eat. Your newborn probably
will sleep up to 16 hours a day divided into two- to four-hour
naps. Your baby’s sleep needs will be unpredictable at first, and
some babies will sleep more or less than others. During this time,
it is important for you to get enough rest by sleeping when your
baby sleeps.
Crying
Crying is your baby’s primary method of communicating. He will
cry for many reasons. He may be hungry, tired, uncomfortable,
overstimulated, bored, lonely or sick. As you get to know him,
you’ll learn how to interpret each cry. Respond quickly to your
baby’s cries in the first few months. You cannot spoil a baby by
giving him attention. The more relaxed you remain, the easier
it will be to console your newborn.
If your baby is crying a lot, try some of these consoling techniques:
• Burp him frequently during feedings to relieve trapped gas.
• Rock him in a chair or stand swaying back and forth.
• Gently stroke or pat his head, back or chest.
• Wrap him snugly in a receiving blanket.
• Reduce the amount of noise and bright light.
• Introduce rhythmic noise and vibration, such as riding in the car
or walking him in a stroller.
• Put him in a warm bath if his umbilical cord has come off and
healed (most babies like this but not all).
• Sing, talk or play soft music.
Crying is difficult to listen to and can be frustrating. If you’re
feeling overwhelmed and are unable to console your baby, it is best
to put him in a crib and leave the room until you can regain your
composure. If you need help dealing with frustrations, call a friend
or family member to help so that you can have a break. It is very
important to never shake a baby no matter how impatient you
feel. Shaking can cause brain damage, mental retardation or death.
For additional information or help, call the 24-hour Parent
Helpline at 513-961-8004.
Common traits
Additional behaviors you can expect from your newborn:
• He’ll sneeze to clear his nose and throat.
• He’ll keep his arms and legs bent up close to his body
and his fingers tightly clenched.
• He may startle easily or have tremors of the legs, arms
or chin. This is due to his immature nervous system that
is still developing.
• He will hiccup. Hiccups are little muscle spasms. You may
offer a feeding, but hiccups usually go away on their own.
• He probably won’t have tears when he cries for a few weeks
or months.
• When placed on his stomach, he may try to lift and turn
his head.
Feeding Your Baby
Breastfeeding
Developing an “I can do it” attitude is the most important step
you can take toward successful breastfeeding. Breast milk is the
perfect food for your baby, supplying nutrients, vitamins and
germ fighters for healthy development. Nursing your baby also
is a wonderful time for closeness as your body continues to
nourish him just as it did in the womb. For more information
on breastfeeding, refer to the breastfeeding guide given to you at
the hospital. If you have questions about breastfeeding, contact
one of our lactation consultants at 513-862-PUMP (7867).
Bottle feeding
You may choose to bottle feed your baby. There are several infant
formulas on the market. Contact your pediatrician for a
recommendation of a formula brand and type. Infant formula is
available in different forms: ready-to-use, liquid concentrate and
powder. Follow the manufacturer’s directions for mixing, using
and storing formula. Never give your baby regular milk —
always use formula recommended by your baby’s physician.
If your tap water is chlorinated, you can clean bottles, nipples,
caps, etc. in your dishwasher or wash them in hot water with dish
soap. If you hand wash them, be sure to rinse them thoroughly in
hot water. If you have well or non-chlorinated water, boil bottles,
nipples, caps, etc. for five to 10 minutes. It is best to feed your
infant formula every three to four hours. At first, some babies may
take only one ounce of formula. The amount he takes will increase
over the first week. Most babies take one to three ounces over a
10- to 20-minute period. Call your baby’s physician if the baby
takes less than one ounce at each feeding for two to three feedings
in a row.
Tips for bottle feeding
• Powdered formulas will mix more easily and the lumps will
dissolve faster if you use slightly warm water.
• Refrigerated formula doesn’t necessarily have to be warmed for
your baby, but most infants prefer it warmed at least to room
temperature.
7
Caring for Your Newborn
• Be extra careful when heating a bottle containing formula to
make sure it isn’t too hot. A few drops on your wrist should not
feel too hot. Never heat a bottle with formula in a microwave
or in a pan of water directly on the stove! It can heat unevenly,
feeling cool to warm on the outside and yet be very hot in the
center. Instead, heat the bottle in a bowl of very warm water
until it reaches a comfortable temperature.
• There are several nipple styles available. Consult your
pediatrician for a recommendation. Periodically check nipples
for signs of damage or wear and check the size of the nipple hole.
A nipple hole that is too small may cause the baby to suck harder
and take in more air. A nipple hole that is too large may allow
the formula to flow too quickly, causing the baby to choke.
- To test whether the nipple hole is the right size, hold the bottle
upside down. When you first turn it upside down one drop
should escape every second. After a few seconds, the dripping
should stop. You can also tell if the nipple hole is the right size
by how your baby feeds. If he sucks hard for a while and then
pulls away frustrated and cries, the hole is too small. If he gulps
and milk keeps leaking out of the corners of his mouth, the
hole is too large.
- You can shrink a large nipple hole by boiling the nipple for five
minutes. If that doesn’t work, save the nipple until your baby is
bigger and can swallow more fluids. You can widen a small
nipple hole with a red-hot needle. After you widen the nipple
hole, sterilize the nipple by boiling it.
• When feeding your baby, cradle him so that he is sitting almost
upright and support his head. Never feed him when he’s lying
flat and never prop the bottle. This could increase the risk of
choking or developing ear infections.
• To minimize the intake of air while feeding, make sure you hold
the bottle so that formula fills the neck of the bottle and covers
the nipple. Bottle systems that use pre-sterilized plastic inner
liners prevent air from entering as the baby sucks. Burp baby
halfway through each feeding and at the end. If your baby is
a fast eater, you may need to burp him more often.
• You may need to increase the quantity and frequency of your
baby’s feedings. Your pediatrician can best advise you regarding
when to do this.
Burping
There are a few tried and true burping techniques. After a little
experimentation, you’ll find the one(s) that work best for your
baby. You also may develop new methods of your own.
• Head on your shoulder - Hold your baby upright with his head
on your shoulder, supporting his head and back while patting
gently. Put a soft towel or cloth diaper on your shoulder in case
of spit-up.
• Sitting up - With your baby seated on your lap, lean him
forward and support his chest and head by allowing his jaw
to rest in your hand. Pat him gently on the back with your
other hand.
• Tummy down across lap - Lay your baby on your lap with his
stomach over one leg and his head resting on the other. With his
head turned toward one side, hold him securely with one hand
and pat him gently on the back with the other.
8
Spitting
Spitting up is another common concern during infancy. Spitting
up the first day or two after birth is most often due to fluid
swallowed at delivery. Sometimes spit-up is caused by the baby
eating more than his stomach can hold, or sometimes spit-up will
occur when the baby is burping or drooling. This is no cause for
concern. Some babies spit up more than others, but most are out
of this phase by the time they are sitting. Spit-up never should be
brown, red or green in color. If it is, consult with your
pediatrician; this could be stool, blood or bile.
Vomit differs from spit-up in that it is forceful and produces a
greater volume (about a tablespoon of fluid). To decide whether
your baby is vomiting, splash a tablespoon of water on a cloth and
compare it to the fluid your baby spit up. If your baby vomits on a
regular basis (one or more times a day), consult your pediatrician.
Using the bulb syringe
A bulb syringe will be sent home with you when you leave the
hospital. This can be used to clear formula from your baby’s
mouth and clear mucus from his nose. To use it, completely
depress the bulb before inserting the tip into the side of the baby’s
mouth; suction is achieved by releasing the bulb. Empty the bulb
completely and then depress it before suctioning another time.
After suctioning the mouth, you may suction each nostril using
the same technique. Remember to suction the mouth first, nostrils
second. Afterward, wash the bulb inside and out by depressing it
in warm, soapy water and rinse well. Prop the bulb so all the water
drains.
Caring for Your Baby
Bathing
Your infant doesn’t need a lot of bathing as long as you clean the
diaper area well when you change his diaper. A sponge bath two
or three times a week until his umbilical cord has fallen off and the
area is healed is all he requires. Tub baths can begin after the cord
area is healed.
• Gather supplies to be used for the bath before getting the baby.
You’ll need a basin of warm water, two washcloths, a towel, mild
soap, baby shampoo, Vaseline for circumcision care (if your child
is a boy), a clean diaper and clean clothing.
• In a warm room, lay the baby anywhere that’s flat and
comfortable for you. If the baby is on a surface above the floor,
use a safety strap or keep one hand on him at all times to ensure
he doesn’t fall.
• Keep baby in a towel and expose only the parts of his body you
are washing.
• Test the temperature of the water with your wrist or elbow.
• Start by washing the face with clear water — don’t use soap.
Use a corner of a washcloth to clean the area around each eye,
wiping from the inner to the outer corner. Use a different corner
of the washcloth for each eye.
• For the ears and nose, use a washcloth, wiping only what can be
seen. Never use cotton swabs in the ears or nose due to the risk
of damaging delicate tissue from cleaning too deeply.
Caring for Your Newborn
• To shampoo hair and scalp, cradle the baby’s head or use a
football hold, wet the head and apply a tear-free baby shampoo.
Massage the scalp using your fingers, a washcloth or a soft brush.
This will help prevent baby dandruff called cradle cap. Rinse
thoroughly with clear water and gently dry.
• Wash the rest of baby’s body with warm, soapy water, paying
close attention to creases around the neck and under the arms,
and around the legs and diaper area.
• When cleaning the diaper area, clean girls from front to back
so that you don’t spread bacteria from their bowel movement.
When cleaning boys, be sure to wipe beneath the scrotum.
See “Circumcised/uncircumcised penis care” in this section.
• Dry your baby thoroughly and dress him appropriately for
the weather.
• Cautions regarding the use of oil, powder and lotion: Oils
generally are not recommended for use on newborns because
they are not easily absorbed into the skin. Powder creates a risk
for suffocation if the baby breathes the powder. If you are going
to use powder, shake it out away from your baby and then pat
the powder on his skin. Be sure to keep the powder out of baby’s
reach. You should use only lotions and other skin care products
specifically made for babies.
pediatrician will tell you when the foreskin has separated and can
be pulled back safely.
Cord care
After birth, the umbilical cord will be clamped and cut. This
clamp will remain in place for 24 to 48 hours or until the cord
is dry. The remaining cord will turn black and fall off when your
baby is between 1 and 4 weeks old.
Do not give baths until the cord falls off. Simply wipe the area
with a wet washcloth or sponge, avoiding the umbilical cord. If the
cord becomes soiled, appears moist or there is a small amount of
discharge at the bottom near the skin, use rubbing alcohol on a
cotton ball to wipe it down. Since the cord will dry and heal faster
if exposed to air, turn the diaper down below it and fold clothing
above it, leaving the cord exposed. Do not place your infant in any
tight-fitting sleepers or onesies until the cord falls off. It is normal
for there to be a slight amount of bleeding as the cord falls off.
Call your pediatrician if the skin around the cord becomes
excessively red, if there is a foul odor or if there is a lot of
drainage.
Diapers
Circumcised/uncircumcised penis care
Whether or not to have your son circumcised is a decision that
ideally should be made before coming to the hospital. Your
pediatrician can advise you on the risks and benefits of either
choice. Your obstetrician can perform the procedure. Your baby
may need to stay in the hospital as long as two hours after the
procedure so the site can be observed for bleeding.
Circumcised penis care - For five days following the circumcision,
squeeze a pea-sized amount of Vaseline onto the site during each
diaper change until the tube of ointment is used. It is important
to keep the area as clean as possible. If particles of stool get on the
penis, cleanse the area by squeezing warm, soapy water over the
site and wiping gently with a soft cloth.
The tip of the penis may look quite red and have a yellow
secretion for the first few days. This indicates that the area is
healing normally. If there is bleeding at the circumcision site, apply
pressure with a clean cloth or gauze pad. Contact your pediatrician
if this does not stop the bleeding. Within a week, the redness and
secretion should gradually disappear. One week after the
circumcision, you will need to pull back the skin from the cut
surface to keep it from sticking. You can do this by giving the base
of the penis a tug about two times a day. If, after a week, redness
persists or there is swelling or crusted yellow sores that contain
cloudy fluid, the penis may be infected. If so, consult your
pediatrician.
Uncircumcised penis care - During the first few months, clean the
penis with warm, soapy water as you would the rest of the diaper
area. Do not try to pull back the foreskin. It is not necessary to
cleanse the penis with swabs or antiseptics. On occasion, you
should watch your baby urinate to make sure the opening in the
foreskin is large enough to permit a normal stream. The
Choose between cloth and disposable diapers before your baby
is born so you can have diapers on hand when your baby comes
home from the hospital. Plan on using about 70 diapers per week.
Change your baby’s diaper as soon as possible after bowel
movements or wetting. Gather the supplies ahead of time and
choose a safe, flat surface with enough room to work. Never leave
your baby unattended. When changing a wet diaper, cleanse from
front to back. When changing a diaper after a bowel movement,
use a soft cloth and warm, soapy water, cleansing from front to
back. Be sure to rinse with clear water and pat dry. Pay close
attention to removing the stool from creases around the legs
and the diaper area.
Urination
Your baby may wet his diaper every one to three hours or as
infrequently as four to six times a day. If you notice signs of pain
while your baby is urinating, call your pediatrician. Pain while
urinating may be a sign of a urinary tract infection. Urine should
be clear or light yellow in color. Blood in the urine or a bloody
spot on your baby’s diaper also should be reported to your
pediatrician.
Bowel movements
For the first few days, your baby’s bowel movements will be thick
and dark green or black. This is called meconium. Once the
meconium is passed, the stools will turn yellow-green. If your baby
is breastfed, the stool then takes on a yellow, seedy appearance.
The consistency of the stool will be soft or slightly runny. If your
baby is bottle fed, the stool will usually turn a tan or yellow color
and will be firmer in consistency than the stool of a breastfed baby.
The frequency of bowel movements varies from one baby to
another. Many babies have a stool soon after each feeding. By age
3 to 6 weeks, it is typical for some breastfed babies to have only
9
Caring for Your Newborn
one bowel movement a week. This happens because breast milk
leaves very little solid waste. Infrequent stools are not considered
a problem as long as they are not hard and dry and your infant is
otherwise normal, gaining weight steadily and nursing regularly.
If your baby is formula fed, he should have at least one bowel
movement a day. Whether you are breastfeeding or bottle feeding
your baby, hard or dry stools may be a sign that your baby is not
drinking enough fluids or that he is losing too much fluid due to
illness or heat. Contact your pediatrician for advice to manage this
condition.
Call your pediatrician if your baby has a sudden increase in
frequency of bowel movements (more than one per feeding) and
the stool is more watery. This may be a sign of diarrhea. Large
amounts of blood, mucus or water in your baby’s stool also could
be a sign of severe diarrhea or an intestinal problem. The main
concern with diarrhea is the chance for dehydration. If your child
is less than 2 months and has diarrhea combined with a fever, call
your pediatrician immediately.
Diaper rash
Frequent diaper changes and thorough cleansing and airing
of the diaper area usually will prevent diaper rash (redness or small
bumps on your baby’s skin in the diaper area). If diaper rash
develops, call your pediatrician for recommendation of a diaper
cream or ointment and any further treatment.
Handling and positioning
Newborns have very little head control and need to have their
head and neck supported to keep their head from flopping side
to side or front to back.
When positioning your baby for sleep, it is important to place
your baby on his back to help reduce the risk of Sudden Infant
Death Syndrome (SIDS) (see section 4). Do this whether your
baby is being put down for a nap or to bed for the night.
Although this recommendation is different from the way many
people were taught in the past, physicians and nurses now believe
that fewer babies will die of SIDS if infants sleep on their backs.
Be patient as your baby adjusts to this safer sleep position.
Your baby should be placed on his tummy when awake to help
promote muscle development and prevent flattening of the back
of the head. Be sure someone is in the same room watching
your baby anytime he is on his tummy. Head flattening can also
be avoided by changing head position while sleeping on the back.
Taking your baby’s temperature
We no longer use or encourage use of a mercury thermometer.
Please follow the instructions on the package insert for the proper
use of any purchased digital thermometer.
10
When to call your baby’s physician
From age 1 to 3 months, a fever is considered to be greater than
99.5 degrees Fahrenheit rectally or 99 degrees Fahrenheit axillary
(under the arm). Notify your pediatrician if your baby has a fever
and specify the method you used to take it — axillary or rectal.
Also, contact your pediatrician if your child has the following
symptoms:
• Poor feeding, continued spitting up of formula or forceful
vomiting
• Excessive drowsiness, sleeping through feeding times, or unusual
inactivity or quietness
• Persistent crying or irritability
• Less than two wet diapers a day during the first 48 hours of life
and less than three wet diapers a day after 48 hours
• Constipation or dry stools
• Loose, watery bowel movements
• Difficulty breathing or a persistent cough
• Grayish-blue coloring around the mouth, lips and tongue when
feeding or crying
• Yellowing of the skin or whites of the eyes (jaundice)
• Redness or discharge from the eyes
• Generalized rash, especially if accompanied by fever
• Redness or foul odor in cord area
• Bleeding or drainage from the circumcision that continues and
increases after discharge from the hospital
• Reddened, enlarged breasts (both girls and boys)
• White patches in the mouth (thrush) that cannot be wiped away
with a soft cloth (unlike formula or breast milk, which is easily
wiped off )
When calling your baby’s pediatrician, have the following
information available:
• Your baby’s temperature and the method used to measure it —
rectal or under the arm
• Other symptoms that are causing you concern
• The phone number of your pharmacy
Having all this information ready will help your physician make
a fast, informed decision.
III. Paternity
Paternity Facts for Married/Unmarried
Mothers
Provided by The Paternity Enhancement Program, based on the Ohio
Revised Code Section 3705.09
For married mothers
If you are married when your child is born or conceived, or married
any time during the 300 days before the baby’s birth, Ohio law states
that your husband is the legal father of your child, and his name
must go on the child’s birth certificate.
For unmarried mothers
• If you finalized your divorce during the 300 days before your child’s
birth, your ex-husband is presumed to be the legal father. His name
must go on your child’s birth certificate, unless you have a divorce
decree that specifically states that the husband is not the biological
father of the child or the child is not a “product of this marriage.”
This wording may be in the form of an order or a statement from
the court that is plain enough that the birthing facility understands
that the husband should not be on the birth certificate (e.g.
“NAME OF HOSPITAL is hereby ordered not to place NAME
OF EX-HUSBAND on the birth certificate,” or “NAME OF EXHUSBAND is not the father of the above named child”).
• If you are not officially divorced, you must provide legal
documentation in the form of a judicial statement or separation
agreement. Both are court orders that must include the judge’s
signature, seal and court number. Please bring all documents to
the hospital at the time of delivery. Documents will be given to
our Birth Records department, who must submit these to the Ohio
Department of Health for approval. A decision about maternity is
not made by the hospital.
Paternity Testing and Child Support
If you are unsure about the identity of the baby’s father, you must
wait until after the delivery of your baby to do paternity testing. For
paternity testing, call:
Central Paternity Testing 1-888-810-6446
DNA Diagnostics Center 1-800-DNA-CENTER (362-2368)
For questions about child support, call:
Child Support Enforcement Agency (CSEA)
513-946-7387
The Importance of Establishing Paternity
Establishing paternity (the identity of a child’s biological father)
provides a wide range of benefits for children and families:
Relationship
It is important for a child to know his or her mother and father and
to benefit from a relationship with both parents. Once a legal
relationship is established with the father, he is more likely to
maintain his own relationship with the child.
Identity
Only if unmarried parents acknowledge paternity will the child have
access to information about medical histories on both sides of his or
her family. This is especially important in situations in which the
child inherits a medical problem. After completing a Paternity
Affidavit, a legal document verifying the biological father's identity, a
father may also be able to add the child to his health insurance policy.
Custody and visitation
If parents are unmarried at the time of a child’s birth, the mother is
presumed to have custody. However, once paternity is established, the
father can ask the court for visitation rights and/or for a share in
custody arrangements.
What are your options?
If your husband’s or ex-husband’s name is placed on your child’s birth
certificate and he is not the birth father of your child, there are ways
to have his name removed from the birth certificate and the birth
father’s name added. You should contact a private attorney to pursue
the matter through court.
Adoption
A legal father gains the right to have a voice in any plans to have the
child adopted by someone else. This provides an important safeguard
for the father, the child and prospective adoptive parents.
Financial benefits
If you refuse to put your husband’s or ex-husband’s name on your
child’s birth certificate, the birth certificate is considered incomplete.
This means your child will not receive a birth certificate, because
it cannot be processed without the husband’s information. As a
result, the state will not apply for a Social Security card for your
child, the child may not be eligible for state/federal assistance
programs and you may have difficulty enrolling your child in school.
To avoid these potential problems, you can put your husband’s or exhusband’s name on the birth certificate at the hospital and then take
steps to amend the birth certificate with the actual birth father’s
information.
Paternity establishment allows the child to qualify for important
financial benefits from the father. Possibilities include Social Security,
life insurance, veteran’s benefits and inheritance rights in the event
that something happens to the father.
11
Paternity
Child support
Both parents have responsibility to support their child, emotionally
and financially. If the parents choose to separate and paternity has
already been established, it will be easier for the parent who has
custody to obtain child support to aid in providing for the child.
Common Misconceptions about Paternity
Affidavits
A Paternity Affidavit is a legal document that recognizes the identity
of a child's biological father. The affidavit gives the father certain
rights and responsibilities toward his child. Some beliefs about this
legal document are not true, however:
BELIEF: Only unmarried parents who want their baby to have the
father’s last name need to sign a Paternity Affidavit.
NOT TRUE! The baby’s name has nothing to do with paternity. In
the State of Ohio, a mother can name her baby anything she wants.
The Paternity Affidavit is a legal document that allows the father to
become the legal father of the baby. The father is then allowed to be
on the birth certificate and gains the rights and responsibilities of a
legal father. All unmarried parents should be offered the Paternity
Affidavit.
BELIEF: If a man voluntarily acknowledges a parent and child
relationship by signing an Acknowledgment of Paternity Affidavit, he
assumes the parental duty of support, which may be enforced
through a child support order.
Again, this is NOT TRUE! If parents have worked out financial
support for the child between themselves and have no need of public
assistance, then no one will be “coming after them” for support. The
Child Support Enforcement Agency becomes involved when one
parent goes to court to obtain child support from the other, or when
the mother applies for public assistance.
BELIEF: Once the father signs the Paternity Affidavit, he
automatically becomes the legal father and cannot change his mind.
NOT TRUE! The Paternity Affidavit does not become legally
binding until 60 days after the last notarized signature. At the end of
60 days, and within one year, either parent can change his or her
mind. The couple must go to the Child Support Enforcement
Agency in the county where the mother resides and request a
rescission. This is simply a piece of paper saying that the couple is not
sure the father is the real biological father and they are requesting
genetic testing.
12
Common Mistakes on Paternity Affidavits
You will save time and effort by avoiding these common mistakes on
Paternity Affidavits.
• Cross-outs or write-outs in child’s name section
• Illegible (unable to be read) handwriting
• Incorrect date of birth for parents (e.g. mistakenly writing in the
baby’s date of birth)
IV. Safety Check
Cribs
Bringing your new baby home
Cribs should meet the Consumer Product Safety Commission
standards.
• Crib sides should always be up when baby is unattended.
• Crib slats should be no more than 2 3/8 inches apart.
• The mattress should fit snugly inside the crib, and linens should
be well fitted — not loose. There should be no missing, loose,
or broken crib or mattress-support hardware.
• There should be no soft materials or objects such as pillows,
comforters or loose bedding under a sleeping baby or in the crib.
If blankets are to be used, they should be tucked in around the
crib mattress so the infant’s face is less likely to be covered by
the bedding.
• Avoid toys with long strings and small objects. Mobiles and
cradle gyms must be tightly secured. Big floppy toys should
not be in the crib.
• Dress your baby in clothes with legs so the crotch strap can
go between his legs.
• Adjust the harness to fit snugly. Avoid using thick blankets, a
heavy snowsuit or a bunting under the straps. These make it
impossible to get the harness tight enough to hold the baby in
a crash. To keep your baby warm, buckle the harness first, then
tuck a blanket over it.
• Put the harness straps in the lowest slots. Straps should be in
slots closest to or just below your baby’s shoulders in the rearfacing position.
• Pad the sides of the car seat so your new baby sits comfortably.
• Tuck rolled blankets or towels alongside your baby. If he slumps,
add a rolled washcloth between his crotch and the crotch strap.
There is no need to buy a separate head pad, which could make
the straps too loose. A pad that comes with the seat is okay.
Car Seats
Note: Hospital staff are not allowed to help you place your baby
in a car seat or secure the seat in the car.
Ohio state law requires that your infant ride in a properly
installed, federally approved and crash-tested car seat every time
he rides in any vehicle, beginning with the trip home from the
hospital, until he both turns 4 and weighs 40 pounds. Newborns
always should ride in an appropriate car seat facing rearward in the
back seat of the vehicle. Never place an infant in the front seat of
a vehicle equipped with an air bag.
If your baby does not have a safe car seat, an infant car seat can be
purchased through TriHealth’s Car Seat Program by calling one of
the numbers below. Parents must have a car seat before bringing
their baby home from the hospital.
Bethesda North Hospital 513-865-1526
Good Samaritan Hospital 513-862-4388
Basic car seat safety
• Your baby should ride in a rear-facing car seat up to at least
age 1. This is the safest position. It protects babies from spinal
cord injury.
• Transport your baby in the back seat. The back seat usually is
safer than the front seat.
• If your car has a passenger air bag, never put your baby in the
front seat, unless the air bag has been turned off (see right).
• Make the seat belt tight around the car seat. Fasten the harness
snugly over your baby’s shoulders.
• Follow car seat instructions and the vehicle manual to use and
install the car seat correctly.
• Beware of used car seats. They may have hidden safety problems,
compromising safety effectiveness if you’re in an accident and
putting your baby at risk.
• Never leave your baby or child alone in the car. There are a
number of hazards including the danger of overheating.
Air bag danger — put baby in back!
An air bag can kill a baby riding in the front passenger seat, even
in a minor crash. Some small trucks and sport cars have air bag
on/off switches. If you must put your baby in front, make sure the
air bag has been shut off. Older children also are safer in the back.
Buckle them up!
Installing a car seat securely
• Place the car seat in the back seat, facing the rear. The back seat
is usually safer than the front, especially in a vehicle with a
passenger air bag.
• Fasten the seat belt tightly. Different types of belts are tightened
in different ways. Check the vehicle owner’s manual and labels
on seat belts. Make sure the car seat stays in place when you
push down on the top or sideways at the base. It is okay for a
rear-facing car seat to tip toward the back of the car. Some new
car seats have LATCH straps to anchor them to the vehicle. Use
the straps if you have a new vehicle with special LATCH anchors
(check car owner’s manual and seat instructions).
• Make sure your baby reclines far enough so his head doesn’t flop
forward. If the vehicle seat slopes, put a tightly rolled towel or
“noodle” under the base of the car seat. Do not tilt it more than
halfway back.
As your baby grows
• Keep harness straps in the lowest slots until your baby’s shoulders
reach the higher slots.
• If your baby uses an infant-only seat, move him into a
convertible car seat (one that can be used rear-facing or forwardfacing) when his head is one inch from the top of the back of the
car seat.
• Use a convertible seat facing the rear until he reaches at least
one year of age. Even after age 1, ride facing the rear to protect
baby’s spine.
13
Safety Check
Child car seat fitting locations
To verify that your car seat is installed properly in your car, you can call AAA, Children’s Hospital Medical Center or your local
fire or police station (see chart below).
Car seat fittings are by appointment ONLY. Please be sure to call ahead and bring your car seat and manufacturer’s installation
instructions. If you cannot get an appointment within seven to 10 days, you might want to call another fitting station location.
Location
Children’s Hospital Medical Center
Amberley Village Police and Fire Dept.
Anderson Township Fire and Rescue
Blue Ash Fire Dept. (residents and employees
of Blue Ash businesses only)
Central Joint Fire-EMS District
Cheviot Fire and Police Dept.
Colerain Township Dept. of Fire and OEMS
Deerfield Township Fire and Rescue
Delhi Township Fire Dept.
Fairfield Fire Dept.
Florence Fire Dept.
Forest Park Fire
Ft. Mitchell Fire Dept.
Ft. Thomas Fire Dept.
Green Township Fire Dept.
Hamilton Township Fire
Hillsboro Fire and Rescue
Liberty Township Fire Dept.
Liberty Township Fire Dept.
Little Miami Joint Fire and Rescue (residents only
from Fairfax, Madison Pl., Newtown)
Madeira/Indian Hill Joint Fire Dept.
City of Mason Fire Dept.
Miami Township Fire Dept. (Clermont)
Miami Township Fire Dept. (Hamilton)
Milford Fire Dept.
Monroe Township Fire Dept.
Montgomery Fire Dept.
Newport Fire Dept.
Norwood Health Dept.
Oxford Police
Pierce Township Fire Dept.
Reading Fire Dept.
Sharonville Fire Dept.
Springdale Fire Dept.
Union Township Fire Dept. (Clermont)
West Chester Fire Dept.
Western Joint Ambulance District
Whitewater Township Fire Dept.
Phone
ZIP Code
513-636-7865
513-531-2040
513-956-7229
513-745-8533
45229
45236
45215
45236
513-797-4520
513-661-2700
513-385-1713
513-459-0875
513-922-2011
513-867-5379
859-647-5660
513-595-5243
859-331-1267
859-441-8393
513-574-0474
513-683-1622
937-393-2902
513-777-8388
513-777-8388
513-271-3636
45102
45211
45251
45040
45233
45014
41042
45240
41017
41075
45248
45039
45133
45011
45044
45227
513-271-2669
513-229-8540
513-248-3709
513-353-4026
513-831-7777
513-734-0847
513-985-1633
859-292-3616, ext. 234
513-458-4600
513-524-5240
513-752-6273
513-733-5537
513-563-0252
513-346-5580
513-528-4446
513-777-1133
513-353-4079
513-353-1518
45243
45040
45140
45002
45140
45106
45242
41011
45212
45056
45245
45215
45241
45246
45245
45069
45030
45033
Source: www.cincinnatichildrens.org/health/info/safety/vehicle/car-seat-list.htm
14
Safety Check
To learn more about car safety for babies
• Contact the National Auto Safety Hotline at
888-327-4236 or www.nhtsa.dot.gov.
• Contact the SafetyBeltSafe U.S.A. Helpline at
800-745-SAFE (7233) or www.carseat.org.
• Visit these Web sites: www.aap.org, www.saferidenews.com.
Bathing
• DO NOT begin baths until the umbilical cord falls off
(1 to 4 weeks). You may wipe the baby down with a sponge
or wet cloth.
• To prevent your baby from slipping while bathing him in the
sink, set him on a washcloth and hold him under the arms.
• To prevent your baby from being scalded, adjust the temperature
of your water heater to less than 120 degrees Fahrenheit. Never
run water while your baby is in the sink or bath or run it directly
on your baby.
• Never leave your baby unattended while you are bathing him.
Drowning can occur very quickly in small amounts of water.
Falls
To prevent falls, never leave your baby unattended above the floor
(e.g. on a changing table, etc.).
Suffocation
• Small objects such as safety pins, small parts of toys, etc. should
be kept out of reach of your baby. This includes the toys of older
brothers and sisters.
• Keep plastic bags or wrappings out of your baby’s reach.
• Sleeping with your baby in your bed, or on a sofa or couch,
may be dangerous. (See Helping Your Baby Sleep and Nap Safely.)
Fire
• Your baby should be dressed only in clothing treated with
flame-retardant chemicals.
• Install smoke detectors in appropriate locations throughout your
home and maintain them according to the manufacturer’s
instructions.
Supervision
• Never leave your baby alone in the house, yard or car.
• Never leave your baby alone with pets or other small children.
Choking
• Do not attach pacifiers, medallions or other objects to the crib
or to your baby with a cord.
• Do not place a string or necklace around your baby’s neck.
Shots for Your Child’s Health
Your child’s health is at risk unless he is properly immunized.
Shots (immunizations) prevent serious illnesses that can cause:
• Pain
• Hearing loss
• Fever
• Blindness
• Rashes
• Crippling
• Coughs
• Brain damage
• Sore throat
• Death
All babies need shots
A baby may get one shot right after birth. More shots should be
given later, starting at 1 or 2 months of age.* If a child did not
receive shots as a baby, he should still get them. Your child may
need shots to go to day care, camp or school. Don’t wait until
then. Protect your child by immunizing him now.
* A combination shot may be given for hepatitis B, diphtheria,
tetanus, pertussis and polio in place of individual shots at 2,
4 and 6 months. Ask about this shot.
Shots may hurt a little but are worth it
Ask your child’s health care provider what to expect after a shot.
Some side effects include:
• Crankiness
• Slight fever (see note below)
• Soreness or swelling where shot was given
Other problems are very rare. Call your child’s health care
provider right away if your child:
• Has a high fever (see note below)
• Has seizures
• Cries for more than three hours
• Is hard to wake up
• Goes limp/pale
• Has other unusual symptoms
NOTE: Call your health care provider if your child is:
• Under 3 months and has a temperature of 100.2 degrees
Fahrenheit or higher
• Three to 6 months and has a fever of 101 degrees Fahrenheit
or higher
• Older than 6 months and has a fever of 102 degrees Fahrenheit
or higher
Shaking Hazards
Never shake your baby. Shaking can cause brain damage, mental
retardation or death.
24-hour Parent Helpline: 513-961-8004.
15
Safety Check
Read the Vaccine Information Statement (VIS) for each shot your
child receives. Your child’s health care provider is required to give
you this statement.
Your child can’t afford to be without shots!
Need help paying for shots?
NOTE: Certain children may also need
• Hepatitis A shots
• A yearly influenza (flu) shot
• Additional or catch-up pneumococcal disease shots
For more information, call your local health department/clinic or
your Social Security or Medicaid office. You also may wish to
contact the Centers for Disease Control’s National Immunization
Hotline:
• 1-800-232-2522 (English)
• 1-800-232-0233 (Spanish)
• 1-800-243-7889 (TTY)
• www.cdc.gov/nip
Be sure to ask your child’s health care provider if your child needs
these and other shots (such as for foreign travel).
Based on information provided by The Ohio Department of Health Immunization
Program, P. O. Box 118, Columbus, OH 43216-0118.
CHILD’S AGE
SHOT
Birth to 2 months
1 to 4 months
2 months
Hep B (hepatitis B)
Hep B
DtaP (diphtheria, tetanus and pertussis), IPV (polio),
Hib (Haemophilus influenzae type b), PCV (pneumococcal
disease)
DtaP, IPV, Hib, PCV
DtaP, Hib, PCV
Hep B, IPV
Hib, MMR (measles, mumps and rubella), PCV
VAR (chickenpox)
DtaP
MMR, DtaP, IPV
Td (tetanus, diphtheria), then Td booster every 10 years
4 months
6 months
6 to 18 months
12 to 15 months
12 to 18 months
15 to 18 months
4 to 6 years (before starting school)
11 to 18 years
Catch-up shot(s)
24 months to 18 years
11 to 18 years
16
This chart shows acceptable age ranges for shots. Consult your
child’s health care provider on when your child should get shots.
VAR (if your child has not had the chickenpox shot and has
never had chickenpox), Hep B (if your child has not had the
hepatitis B shots)
MMR (if your child has not had the MMR shots)
Safety Check
SIDS (Sudden Infant Death Syndrome)
What is SIDS?
SIDS is the sudden and unexplained death of a baby under 1 year
of age. Because many SIDS babies are found in their cribs, some
people call SIDS “crib death.” But cribs do not cause SIDS.
Facts about SIDS
Physicians and nurses do not know what causes SIDS, but they
do know:
• SIDS is the leading cause of death in babies between 1 month
and 1 year of age.
• Most SIDS deaths happen in babies younger than 6 months old.
• Babies placed to sleep on their stomachs are much more likely
to die of SIDS than babies placed on their backs to sleep.
• Babies are more likely to die of SIDS if they are placed to sleep
on top of soft bedding or if they are covered by soft bedding.
• African American babies are two times more likely to die of
SIDS than Caucasian babies.
• American Indian babies are almost three times more likely
to die of SIDS than Caucasian babies.
What can I do to help lower the risk of SIDS?
Even though there is no way to know which babies might die
of SIDS, there are ways to make your baby safer.
• Always place your baby on his back to sleep, even for naps.
This is the safest sleep position for a healthy baby to reduce the
risk of SIDS. Research now shows that fewer babies die of SIDS
when they sleep on their backs.
• Place your baby on a firm mattress, such as in a safetyapproved crib.* Research has shown that placing a baby to sleep
on soft mattresses, sofas, sofa cushions, waterbeds, sheepskins or
other soft surfaces greatly increases the risk of SIDS.
• Remove soft, fluffy, loose bedding and stuffed toys from your
baby’s sleep area. Make sure you keep all pillows, quilts, stuffed
toys and other soft items away from your baby’s sleep area.
• Make sure everyone who cares for your baby knows about the
dangers of soft bedding and to place your baby on his back
to sleep. Talk to child care providers, grandparents, baby sitters
and all caregivers about SIDS risk. Remember, every sleep time
counts, day or night. So, for the least risk, remind every caregiver
to place your baby on firm bedding and on his back to sleep.
• Make sure your baby’s face and head stay uncovered during
sleep. Keep blankets and other coverings away from your baby’s
mouth and nose. The best way to do this is to dress your baby in
sleep clothing so you will not have to use any other covering over
him. If you do use a blanket or another covering, make sure your
baby’s feet are at the bottom of the crib, the blanket is no higher
than his chest and the blanket is tucked in around the bottom of
the crib mattress.
• Do not allow smoking around your baby. Don’t smoke before
or after the birth of your baby and make sure no one smokes
around your baby.
• Don’t let your baby get too warm during sleep. Keep your
baby warm during sleep, but not too warm. Your baby’s room
should be at a temperature that is comfortable for an adult. Too
many layers of clothing or blankets can overheat your baby.
*For more information on crib safety guidelines, call the
Consumer Product Safety Commission at 1-800-638-2772
or visit www.cpsc.gov.
Helping Your Baby Sleep and
Nap Safely
Keep the following suggestions in mind when you put your baby
down to sleep or nap.
How should I position my baby for sleep?
Babies should always be placed on their backs (face up) when they
are resting, sleeping or left alone. If you have concerns regarding
this recommendation, consult your pediatrician. Additionally:
• Babies should be placed on their tummies (tummy time) only
when they are awake and supervised by someone responsible.
Supervised tummy time is encouraged to help make your baby’s
neck and back muscles strong.
• The use of special devices such as wedges and cushions when
positioning your baby for sleep are not recommended.
Where should my baby sleep?
When babies are napping or sleeping they should be placed only in
cribs approved by the Consumer Product Safety Commission
(CPSC).
• Mattresses always should fit snugly into the crib’s frame.
• Cribs made after 1982 and sold in the United States by
a retailer should, by law, meet the CPSC safety standards
for cribs.
• If you do not have a crib, your baby can be placed to sleep on
another safe, firm sleep surface such as a bassinet, cradle or cosleeper that does not have any soft or fluffy items on its sleep
surface.
• Babies always should be placed on a firm surface or mattress,
never on a waterbed, recliner, futon or sofa — with or without
you.
Also, keep in mind:
• Dress your baby in a sleeper or warm pajamas instead of covering
him with a blanket.
• If you choose to cover your baby, always make sure the blanket
stays at or lower than his waist.
• Always dress your baby the way that you would want to be
dressed for the temperature around you. If it’s cold, layer the
baby’s clothing (for example, add a T-shirt and socks under the
sleeper) and use only a light receiving blanket, if necessary.
• Never place your baby to sleep or nap with any pillows, stuffed
toys, bumper pads, comforters, quilts or sheepskin.
17
Safety Check
Can I sleep with my baby?
Parents and babies should be close, but adult beds were not made
with infant safety in mind. Parents who want to be close to their
infant while they are sleeping can move the crib, bassinet or cosleeper next to their bed.
Though sharing a bed with your baby can be unsafe, if you
consider it, please remember:
• No one other than the baby’s parents or caregivers should sleep
with the infant.
• Parents or caregivers who choose to share a bed with their baby
never should smoke or be under the influence of alcohol or drugs
while sleeping with the baby.
Source: http://www.cdc.gov/SIDS/sleepenvironment.htm
Frequently Asked Questions About
Safe Sleep
Q. Is there a risk of choking when my baby sleeps on
his or her back?
A. No. Babies automatically swallow or cough up fluids. Physicians
have found no increase in choking or other problems in babies
sleeping on their backs.
Q. What about side sleeping?
A. To keep your baby safest when he or she is sleeping, always use
the back sleep position. Babies who sleep on their sides can roll
onto their stomachs. A baby sleeping on his or her stomach is at
greater risk for SIDS.*
Q. Are there times when my baby can be on his or her
stomach?
A. Yes. Place your baby on his or her stomach for “tummy time”
when he or she is awake and someone is watching. When your
baby is awake, tummy time is good because it helps your baby’s
neck and shoulder muscles get stronger.
Q. Can I bring my baby in bed with me to breastfeed?
A. Bringing your baby into bed could be risky for your baby. An
adult bed usually has a soft mattress and bedding, such as
comforters, quilts and pillows. If you choose to bring your baby
in bed with you to breastfeed, it is safest to return your baby to
his or her crib when done feeding.** One way to keep your
baby close to you is by having the baby’s crib in the room with
you.
Q. Can my baby share a bed with her brother or sister?
A. Bed sharing with other children, including brothers and sisters,
is unsafe for your baby. It increases the risk for SIDS
as well as suffocation. There have been reports of infants being
suffocated from overlying by an adult, brother, sister or other
family member who was sharing a bed with an infant.
18
Q. Will my baby get “flat” spots on his or her head from back
sleeping?
A. For the most part, “flat” spots on the back of a baby’s head go
away a few months after the baby learns to sit up. Tummy time
when your baby is awake is one way to reduce the flat spots.
Another way is to change the direction you place your baby
down to sleep. Doing this means the baby is not always sleeping
on the same side of his or her head. If you think your baby has
a more serious problem, talk to your physician or nurse.
*Some infants may have health conditions that require them to
sleep on their stomachs. If you are unsure about the best sleep
position for your baby, be sure to talk to your physician or nurse.
**If you do not have a crib, check with your state health
department about a crib donation program.
Reference:
“Changing Concepts of Sudden Infant Death Syndrome. Implications for Infant
Sleeping Environment and Sleep Position.” American Academy of Pediatrics. Task
Force on Infant Sleep Position and Sudden Infant Death Syndrome, Pediatrics Vol.
105 pg 650-656, 2000.
Information in this section provided by National Institute of Child Health and
Human Development, NIH Pub. No. 02-7040, August 2003.
V. Helpful Services and Information
United Way Help Line
The United Way Help Line is a 24-hour information, referral and
crisis line that links people who need information or help with
agencies that can assist them. Call 1-800-233-HELP (4357) or
513-721-7900 for help with:
• Emergency assistance – food, shelter and clothing
• Money management
• Legal assistance
• Child care
• Personal, family or relationship problems
• Chemical dependency – alcohol or drugs
• Family violence – spouse abuse and child abuse
• Health concerns
• Support groups
• Educational and vocational opportunities
• Parenting classes
• Loneliness and depression
• Special transportation and any other questions
Helpful Numbers in Greater Cincinnati
Lactation consultants
TriHealth Warm Line and
Outpatient Services
513-865-1525
TriHealth information
TriHealth Women’s HealthLine
513-475-4500
physician referrals, information on TriHealth
maternity education classes and other TriHealth services
513-862-3343
TriHealth Postpartum Support Group
Child abuse prevention
24-hour reports of child abuse
513-241-KIDS (5437)
513-961-8004
Parents Anonymous 24-Hour Hotline
Poison prevention
Poison Information Hotline
513-558-5111
Day care information
4 C’s — Comprehensive Community
Child Care
513-221-0033
Social Security information
1-800-772-1213
Ohio Resources
Butler County
Butler County Help Line
513-785-3095
Butler County Alcohol/Chemical
Abuse Council
513-868-2100
Butler Co. Job and Family Services
513-887-4000
Butler County Protective Shelter/
Domestic Violence Crisis Line
513-863-7099
Child Abuse Hotline
513-868-0888
Child Support
513-887-3362
Health Department
513-863-1770
Help Me Grow Program
513-785-6850 or
Early intervention and child
1-800-341-3025
development services for families with
children from birth to 3 years
Hope House
513-424-4673
Shelter for men, women and children
Immunizations/Well Child Clinic
513-695-1468
Legal Assistance (Domestic Relations Court) 513-887-3100
Mental Health Board
513-860-9240
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
Middletown
513-705-9040
Hamilton
513-896-7022
Clermont County
Battered Women’s Helpline and Referral
513-753-7281
Child Focus
513-752-1555
Child Support Enforcement Agency
513-732-7248
Children Protective Services
513-732-7173
Clermont Recovery Center
513-735-8100
Substance abuse recovery
Clermont Counseling Center
513-947-7000
513-753-7281
Clermont County Help Line
Clermont County Help Me Grow Program 513-732-5030
Early intervention and child development
services for families with children from birth to 3 years
513-732-7433
Clermont Transportation Connection
Department of Job and Family Services
513-732-7111
Family and Children First
513-732-5400
Healthy Start
513-732-7111
Legal Aid
513-241-9400
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
513-732-7329
19
Helpful Services and Information
Hamilton County
Chemical dependency
Substance Abuse
Alcoholism Council of Cincinnati Area
Child protection
Child Abuse/Neglect/Dependency
Parent Helpline
Child abuse prevention
513-281-7880
513-241-KIDS (5437)
513-961-8004
Day care
Child Day Care Services (HCJFS)
4 C’s (Comprehensive Community
Child Care)
513-221-0033
Domestic violence
YWCA Domestic Violence Hotline
Women Helping Women
513-872-9259
513-381-5610
Emergency food, clothing, shelter
Bethany House
Shelter for women and children
Free Store/Food Bank
Salvation Army
St. Vincent DePaul
513-946-1800
513-381-7233
513-241-1064
513-762-5660
513-421-0602
Information and referral lines
United Way Helpline
1-800-233-HELP (4357) or
513-721-7900
Hamilton County Job and Family
Services Link Line
513-946-LINK (5465)
Mental health
Mental Health Services
(Mental Health Access Point – MHAP)
513-558-8888
Psychiatric Emergency
513-584-8577
Recovery Resources Center
513-761-7353
Self-help method of recovery; support groups
to help cope with fear, depression and anxiety
Suicide Prevention Hotline
513-281-2273
Nutrition
Women, Infants and Children (WIC) Nutrition Education
513-821-6813
and Supplemental Food Program
LaLeche League
513-357-MILK (6455)
Support for breastfeeding mothers
Pregnancy/parenting support programs
Babies Milk Fund Children’s and
Prenatal Clinic
513-861-7313
also offers clinics for pregnant women and their children
Help Me Grow
513-281-GROW (4769)
Parenting support and child development/
early intervention services
20
Every Child Succeeds
513-636-2830
Support program for first-time mothers
Healthy Moms and Babes
513-591-5600
Support services for moms-to-be and existing parents
513-241-7445
Catholic Social Services
Counseling, adoption, parenting programs
Hamilton County Job and Family Services –
Pregnancy Services
513-946-7335
Services United for Mothers
and Adolescents (SUMA)
513-487-7862
Teen parent center, prevention program, fatherhood project
Birthright
513-241-5433
Childbirth classes
Public assistance
Hamilton County Job and Family
Services Information (HCJFS)
Appointments for cash, food, Medicaid
assistance at HCJFS
Healthy Start/Children’s Health
Insurance Program (CHIP)
Child Support Enforcement Agency
Transportation to medical visits for
Medicaid recipients
Social Security information
513-946-1000
513-946-2480
513-531-9999
513-946-7387
513-946-7335
1-800-772-1213
Warren County
Abuse Crisis Line
888-860-4084; 513-509-8402 (cell)
Bureau of Child Support
513-695-1580
Drug and Alcohol Center of
Warren County (Lebanon)
513-695-1131
4 C’s (Comprehensive Community
Child Care)
513-695-2276
Health Department
513-695-1228
Help Me Grow Program
513-695-4769
Early intervention services and child development
for families with children from birth to 3 years.
Human Services Department
513-695-1420
513-424-4673
Hope House
Immunization/Well Child Clinic
513-695-1468
Life Span
513-934-1330
Mental Health and Drug/Alcohol
513-695-1354
Warren County Transit Services
513-695-1323
Public transportation
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
513-695-1217
Helpful Services and Information
Kentucky Resources
Indiana Resources
Battered Women’s Hotline
859-292-6340
Brighton Center
859-431-5649 or 859-491-8303
Emergency food, clothing and financial assistance;
credit and budget counseling
Catholic Charities
859-581-8974
Community education, individual, marital
and family counseling
NorthKey Community Care 859-331-3292 or 859-578-3252
Mental health education and crisis intervention
Family Service of Northern Kentucky (United Way)
859-291-1121
Covington
Florence (United Way)
859-525-2602
Budget, consumer credit, substance and
sexual abuse counseling and family life education
First Steps
859-815-1095
Early intervention services
Mental Health Association of
859-431-1077
Northern Kentucky
Women’s Crisis Center
859-491-3335 or 1-800-928-3335
24-hour hotline for phone counseling; shelter
for battered and abused women and their children
Southeastern Indiana Economic Opportunities (SIEOC)
Serving Dearborn, Franklin, Ohio, Ripley
and Switzerland counties
765-647-5967
Provides commodities, energy assistance, Head Start,
information and referral, emergency assistance services,
Section 8, weatherization, child care assistance and
child care resource and referral
First Steps
866-644-2454
Early intervention services
Boone County
Assisted Housing (Section 8 Program)
Cabinet for Families and Children
(Applications for public assistance)
CASA:
Child Advocate
Child Support
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
859-334-2105
859-371-6900
859-586-1222
859-586-9100
859-525-1770
859-292-6700
859-431-0552
859-261-5200
859-431-1704
Kenton County
Cabinet for Families and Children
Child Support
Section 8 Housing
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
Alliance for Mentally Ill
812-537-0946
Division of Family and Children
812-537-5131
Public assistance programs and child protective services
Community Mental Health Center
812-537-1302
812-537-4357
Crisis Pregnancy Center
Domestic Violence Services
1-800-221-6311
Family Connections
812-689-6363
Home visits for prenatal support, education;
substance abuse recovery program
812-532-3081
Healthy Mothers/Healthy Babies
Education/support for young mothers
Rape Crisis Services
812-537-7375
Women, Infants and Children (WIC)
Nutrition Education and Supplemental Food Program
Lawrenceburg
812-537-4089
Dearborn, Ripley, Switzerland and
Ohio counties
800-456-0492 or 812-537-4777
Franklin County
Campbell County
Cabinet for Families and Children
Child Support
Section 8 Housing
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
Dearborn County
859-292-6340
859-491-4114
859-292-2188
Community Mental Health Center
765-647-4173
Crisis Pregnancy Hotline
812-934-5116
Division of Family and Children
765-647-4081
Public assistance programs and child protective services
Mental Health Association in
765-778-0186
Franklin County
Pregnancy Help Center
765-647-2029
Rape/Crisis Services
812-537-1302
Salvation Army
765-825-2011
Emergency services
Women, Infants and Children (WIC)
Nutrition Education and Supplemental
Food Program
765-825-5210 or 765-647-3663
859-431-3345
21
Helpful Services and Information
A MESSAGE FROM WIC
Providing Healthy Food for Your Children is Very Important —
Maybe We Can Help
If you are pregnant, breastfeeding or have children under age 5, you may be eligible for WIC’s specialized nutrition services.
Income guidelines effective April 2009 to April 2010
Economic*
Unit Size
Annual
Monthly
Weekly
1
$ 20,036
$ 1,670
$
386
2
26,955
2,247
519
3
33,874
2,823
652
4
40,793
3,400
785
5
47,712
3,976
918
6
54,631
4,553
1,051
7
61,550
5,130
1,184
8
68,469
5,706
1,317
*Pregnant women count as two.
For family size larger than nine people, please call for income guidelines.
WIC stands for Women, Infants and Children and is funded by the Department of Agriculture. WIC provides nutrition
counseling, breastfeeding support and nutritious foods such as milk, fruit juices, cheese, eggs, cereals, and peanut butter or
beans. Infant formula can also be provided if needed as a supplement to breastfeeding or if breastfeeding is not an option.
Many working families can participate in the WIC program. Eligibility is based on medical/nutritional needs, income and
family size.
Contact us today. We can let you know if you qualify financially by telephone in just a couple of minutes. Appointments
are available at locations throughout Hamilton County (listing on page 23). Evening appointments are available at many
locations; please call a WIC site for additional information.
WIC WORKS!
For general information, call:
513-821-6946 or
513-821-7012
USDA prohibits discrimination in the administration of its programs.
22
Helpful Services and Information
Hamilton County WIC Program Locations
Your Child’s Social Security Number
Call an individual location to schedule an appointment
and to check hours.
Cann Health Center
513-263-8777
5818 Madison Road (45227)
Children’s Hospital B-1
513-636-5818
3333 Burnet Avenue (45229)
East End Health Center
513-321-1395
4027 Eastern Avenue (45226)
Elm Street Health Center
513-352-3816
1525 Elm Street (45202)
Forest Park
513-742-3555
924 Waycross Rd. (45240)
Harrison BMF Clinic
513-367-5383
10400 New Haven Rd. (45030)
Lincoln Heights Health Center
513-769-5290
1401 Steffen (45215)
Millvale Health Center
513-352-3199
3301 Beekman Street (45225)
Mt. Healthy
513-522-4300
1310 Adams Road (45231)
Northside Health Center
513-564-2180
3917 Spring Grove Avenue (45223)
Norwood BMF Clinic
513-458-5678
4623 Wesley Avenue (45212)
Price Hill Health Center
513-357-2727
2136 West 8th Street (45204)
Roselawn
513-821-6813
7710 Reading Rd., #001 Lower Level (45237)
Walnut Hills/Evanston Office (WIC) 513-281-4116, ext. 6
2805 Gilbert Ave. (45206)
West End Health Center
513-352-3566
1413 Linn Street (45214)
Western Hills
513-251-4700
4966 Glenway Ave. #301 (45238)
Winton Hills Health Center
513-242-1720
5275 Winneste Avenue (45232)
University Hospital OB/GYN Clinic
513-584-8220
For patients who are attending this clinic only
Social Security numbers are free and required when filing a tax
return. You have two options for applying for one.
• Check the box at the bottom of the Birth Certificate Information
Worksheet to receive a Social Security number for your newborn.
It will take about four to six weeks to receive your baby’s Social
Security number.
• If you need more information about obtaining a Social Security
number for your child, call the Birth Records office at the
hospital where you delivered or the Social Security office at
1-800-772-1213.
For general information regarding the Hamilton County WIC Program,
please call 513-821-6946 or 513-821-7012.
For information regarding the locations of WIC programs in other
counties, refer to county listings.
USDA prohibits discrimination in the administration of its programs.
Your Child’s Birth Certificate
The hospital cannot provide patients with birth certificates. There are
two things you must do to apply for a birth certificate.
• Complete the Birth Certificate Information Worksheet.
This form must be turned in to your nurse or the nurses’ station
before you leave the hospital. A few things to note:
- Do not use your initials. Use your entire name as it appears on
your own birth certificate.
- Fill in your baby’s name exactly as you want it to be spelled on
the birth certificate.
NOTE: You will receive the Application for Certified Copy of Birth
Certificate in your discharge packet.
• Send the following information to the locations specified below:
- A self-addressed, stamped envelope
- The baby’s name and date of birth
- Name of the hospital where the baby was born
- Mother’s maiden name and father’s name
Bethesda North Hospital patients
• Mail a money order or personal check made out to the Hamilton
County Health District, along with the previous information to:
Hamilton County General Health District
250 William Howard Taft, 2nd Floor
Cincinnati, OH 45219
513-946-7815
Good Samaritan Hospital patients
• Mail a money order or certified check made out to the Treasurer of
the City of Cincinnati along with the previous information to:
Cincinnati Board of Health
Office of Vital Records
1525 Elm St.
Cincinnati, OH 45210
513-352-3120
Please call ahead to request the specific dollar amount for the
birth certificate.
23
Helpful Services and Information
Helpful Tips for Applying for Your Child’s
Birth Certificate and Social Security
Number
• If you have not named your baby before leaving the hospital, or
have questions regarding your baby’s birth certificate, call the Birth
Records office:
Bethesda North Hospital, 513-865-1737
Good Samaritan Hospital, 513-862-7776
• If you are a single parent, you have five days from your child’s birth
date to meet with the Birth Records clerk to complete necessary
information. If you are planning to include the father’s name on the
birth certificate, he must be present to sign an affidavit and have a
picture ID (i.e. driver’s license) or a Social Security card and a birth
certificate (must have both). Call Birth Records to schedule an
appointment; walk-ins also are welcome. Hours are Monday
through Friday from 9 a.m. to 4:30 p.m.
Bethesda North Hospital, 513-865-1737
Good Samaritan Hospital, 513-862-7776
• If you receive public assistance or if your insurance provider
requires, you can obtain a letter of verification stating that our
hospital has applied for your child’s Social Security number. Letters
are not issued automatically. You must request a letter. Letters of
verification or proof of birth are available 10 days after the birth of
your baby, but no later than 90 days. Only the mother of the baby
may pick up the letters from the Birth Records office. A valid ID
must be presented. Letters of verification will not be faxed or
mailed. Call the Birth Records office for more information:
Bethesda North Hospital, 513-865-1737
Good Samaritan Hospital, 513-862-7776
• Birth certificates are not free and are not automatically received.
Once all forms are correct and turned in, it takes six to eight
weeks to process. Questions about the birth certificate should
be directed to the appropriate hospital.
For births at Bethesda North Hospital:
Hamilton County Health District, 513-946-7815
For births at Good Samaritan Hospital:
Cincinnati Board of Health, 513-352-3120
24
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