Ep 204: Preparing for Your Newborn with Pediatrician and CEO of Newborn Prep Academy Dr. Emeka Obidi

Dr. Nicole (00:00): This is a fantastic episode with pediatrician, Dr. Emeka Obidi, where you are going to learn all that you need to know to help you get off to a great start with your newborn. Welcome to the all about Pregnancy and birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OBGYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at https://birthwithpowermd.com/. Now, let's get to it.

(00:56): Hello there. Welcome to another episode of the podcast. This is episode number 204. Whether this is your first time tuning in or you are a returning listener, I am so, so glad that you are spending some of your time with me today. In today's episode, we have Dr. Emeka Obidi. He is a board certified pediatrician who practices in Maryland where he owns a multi provider family practice. He's also CEO of Newborn Prep Academy, where he runs an online newborn preparation course that helps both new expected moms as well as moms who have recently given birth understand how to care for their newborn baby and what to expect so that they can feel confident, empowered, and ultimately enjoy their babies. He obviously clearly loves his work. You will hear the joy for his work come through, and we take a deep dive into what happens with your newborn in the hospital and that first visit after you leave the hospital so you are going to feel really ready right after your baby is born.

(01:59): So you are learn, going to learn what is the vitamin K shot for what erythromycin eye ointment is for? What is the Hepatitis B vaccine and why is it given at birth? You'll learn the types of exams and tests that are done in the hospital for your baby and why they are done like the hearing test, testing for jaundice, chest testing for congenital heart disease. You'll learn what you can expect with weight loss after your baby is born. This is something that Dr. Obidi sees a lot of women get stressed about and probably unnecessarily so maybe folks are making too big of a deal of things. And then we also chat about how soon that first visit will be with the pediatrician after you leave the hospital as actually very soon. And then how you can make the most of that visit. I love some of the advice that he gives to make this visit really productive and make sure you get everything you need out of that visit to understand how to care for this newborn.

(02:56): We also chat about the role pediatricians play in screening for postpartum depression and moms, they actually check a lot longer than I thought, and then we end with the confident mom's mindset, which I really, really, really, really love and I think you are going to love it too. Now, before we get into the episode, I have to tell you about an upcoming live class that I have coming up. It is on Monday, April 24th, and this class is all about VBAC, VBAC is vaginal birth after success after cesarean. And if you want to get calm, confident in empowered for your VBAC, then come join me in this live class. The truth is that too many doctors are not telling the truth about VBAC. I don't think it's done with malicious intent. I think some of it comes from not being informed on up-to-date guidelines or having outdated practices, but some of it is straight lying y'all.

(03:55): And some of the things that I hear are overstating the risk of uterine rupture saying that you can't receive Pitocin or be induced if you're trying for a VBAC give VBAC again as vaginal birth after cesarean saying that you can't try for a VBAC after two cesarean or not telling you that the real reason you can't try for A VBAC is because they don't support it, not a medical reason. So you're going to learn all of the lingo in the class TOLAC versus VBAC, VBAC calculators are trash, in my opinion, the most important thing you need to do if you want to try for A VBAC, things that increase success, things that decrease success, evidence-based recommendations, what a low intervention VBAC looks like. Good, good, great stuff in this class. If you want to have a vaginal birth after having had a cesarean, you can register for the class@drnicolerankins.com/VBAC and it's going to be on Monday, April 24th at 7:00 PM Eastern standard time live. All right. I cannot wait to see you there. Okay. Let's get into the conversation with Dr.Obidi

Speaker 2 (05:00): Obie.

Dr. Nicole (05:07): So Dr. Obidi, thank you so much for coming on the podcast. I am so excited to talk about this topic today.

Dr. Emeka Obidi (05:14): Well, thank you so much for having me, Dr. Rankins. I've been looking forward to chatting with you.

Dr. Nicole (05:18): Yeah. Yes. Why don't you tell us about yourself, your work, and your family.

Dr. Emeka Obidi (05:22): Sure. So I am a husband and father of three. My wife and I have two daughters age 19 and 15. Time crazy how time flies and doesn't it though? I saw I was nine years old. Yes. So I'm a pediatrician. I practice out in Western Maryland. I run a family practice and also more recently have produced content online to help moms who are expecting or recently delivered understand what to expect from their newborns, how to care for them confidently so they can really truly enjoy their newborns, and that's lots of fun to do as well. And that's on the opposite of Newborn Prep Academy.

Dr. Nicole (06:01): Absolutely. And we will link all of your things in the show notes and whatnot, but you should follow him. He produces great videos. His energy is lovely. It's easy to understand, so you should definitely go check it out. So let's talk about what training you went through to become a pediatrician. I always like to have experts tell what kind of training Sure. You

Dr. Emeka Obidi (06:21): Went through. Sure. So the medical school journey studied in Nigeria, which is where I'm originally from, and it's a patent after a European system, a British system. So med school is six years. Oh. And yes it is. So you go right from high school right into med school, and it's a six year program. So that was interesting. It was fun. I actually wanted to be an ophthalmologist. Oh, all through med school? Yes. We had a family friend who was an ophthalmologist, and she let me come hang out with her during my vacation time, obviously surgeries I found eyes so fascinating. Beautiful. But then, so the buts system, when you're done with med school, you get a provisional license as to practice as a physician, but you have to do a one year internship where you do three months, you do OBGYN, three months in surgery, three months internal medicine and three months in pediatrics.

(07:13): And pediatrics was my last rotation. I just fell in love with pediatrics. I was just out the blues. I wasn't expecting it at all. Right. I had such a wonderful time. It was an under-resourced country, so there wasn't always a pretty site. Right, sure. There are lot of kids who could have had bad outcomes. I didn't have to, but it was just such a rewarding three months. I just said, okay. I say pediatrics. I came to the States and did other licensing exams to get into residency. I had a gap here. So I did a master's in public health at Columbia University of New York, concentrated in maternal and child health, and that was really fun. Yeah. I did my residency in Sun Downstate in Brooklyn, New York. Okay.

Dr. Nicole (07:55): Yeah. All righty. All righty. And you've been in practice how long?

Dr. Emeka Obidi (07:59): Oh, I've in practice for about 20 years now. 20. 21 years. Okay. I did a one year hospitalist work, pediatric hospitalist work in New York, and then I came out here to western Maryland to this practice where I've practiced for 18 years now. Wow.

Dr. Nicole (08:16): Okay. All right. I love it

Dr. Emeka Obidi (08:18): For the last nine years.

Dr. Nicole (08:20): Yes. So lots of experience.

Dr. Emeka Obidi (08:21): Lots of experience.

Dr. Nicole (08:22): Yes. Lots of experience. All right. So let's get into what happens in the hospital after your baby is born. I can tell you that obstetricians don't know anything about what happens if people ask us. I'm be like, we don't know. And people don't realize once mom and baby are separate, then the pediatrician takes over for the baby immediately and the OB doesn't do anything anymore. So let's talk about those things that are going to happen in the hospital after the baby's born. First up is the vitamin K shot. Yeah. So what is that for?

Dr. Emeka Obidi (08:58): Yeah. Well, I'm glad you mentioned this. I'm going to back up for a second because Please. You're right. Mom's, first of all, I mean, pregnancy in and of itself, I don't have to tell you, it's just a whole journey and in of itself all kinds of crazy things going on with your body, hormones, the pain, the whatever, the baby, all kinds of worries. And then what I've found is most times when mom's also thinking about the baby, they're thinking about the baby care and the nursery and all those different things, and no diapers, everything that's going to happen after the baby's born. So it's really great to talk about it because I think, and having been in the delivery room, several times's been a while now since that it's taken care of by theologist at a hospital where in my local hospital, but from prior experience, there's just so much going on during delivery.

(09:47): And I think the baby just plops out. And then there's all this stuff going on with the baby and have the time. Mom's not sure what's going on with the baby because we stuff some, some of the other place. But when the baby is born, so typically you're just going to make sure the baby's fine, and most babies are going to be born and be okay, but some may need some little stimulation or some help to recover and transition. I think we're all getting better with trying to recognize that golden hour where we try and make sure that mom gets some skin to skin time with baby, and we're trying to establish feeding as quickly as possible, especially if she's going to breastfeed and all of that. So all that's going on. And typically we will get all that happening for us, make sure baby is stable, but then they start.

(10:31): Then there's some treatments that baby gets, which yep. Are helpful and for a particular reason. So one is vitamin K you mentioned, and that's a vitamin K shot, an intramuscular shot that's given to the baby because babies, so vitamin K is important for blood clotting, the blood clotting process, and babies are born with very low levels of vitamin K and sometimes low enough to cause some significant serious bleeding conditions where you can have bleeding into the brain and cause permanent brain damage bleeding into the organs. And so to prevent that one simple shot, one shot of vitamin K will prevent that, and that bleeding can actually occur up to six months after baby is born. Okay. So it's been shown that just that one shot can prevent that from happening since you're not able to predict what baby might have low enough levels of vitamin K to cause serious significant bleeding. And since the effects of those bleeding can be quite damaging and long lasting, it's just safer to keep all babies vitamin K injection at birth.

Dr. Nicole (11:40): Gotcha. And why can't they get vitamin K in their diet?

Dr. Emeka Obidi (11:43): So a number of reasons. One is you don't get high enough levels with oral vitamin K, and especially for newborns because it's very variable how much vitamin K is actually absorbed in the intestinal tract. For a newborn, for an older kid, an adult who has some bleeding issue and a new vitamin K, they're able to take that orally. But for newborns, you don't trust the levels you get. It's usually very low levels. The vitamin K you get in breast milk is usually very low and not enough to actually prevent vitamin K deficiency. Gotcha. With

Dr. Nicole (12:15): Hemorrhages. Gotcha. So oral vitamin K doesn't do the same thing and breast milk isn't going to bring the levels up. Well, would will formula if people decide to formula feed, it still doesn't same. No, it's still the same. Okay. Yeah. It's one of those weird things to me, why are babies, why are we born with low levels of vitamin K? What's like, why? But I guess it is what it is.

Dr. Emeka Obidi (12:41): You're just thankful for advances in medical care, right? Yes. Yes. There's so many conditions that advances have helped us be able to better navigate

Dr. Nicole (12:49): Those. Absolutely. Absolutely. And are there any side effects from the vitamin K? Not

Dr. Emeka Obidi (12:53): Really. Not really. Yeah. Okay. Well tolerated those side effects universally given. And so millions of doses have been given at this point. I think we'll recognize any significant

Dr. Nicole (13:04): Issues. Sure. Okay. All right. Yeah, it's been given since for decades. Yes. Decades.

Dr. Emeka Obidi (13:09): It was like nine 60 something or so.

Dr. Nicole (13:11): Yeah, it's been a while. Yep. Yep, yep, yep. So let's talk about the erythromycin eye ointment

Dr. Emeka Obidi (13:17): Appointment. Yes. So the erythromycin eye ointment is given to prevent what's called Al Ophthalm auditorium, which is basically just a pink high in the newborn. So a conjunctivitis or eye infection in the newborn. And that again, when you have an infection in the newborn eye can also be significant also. And of course, threaten eyesight, it could be from any bacteria we're most concerned about bacteria, gonorrhea or chlamydia, obviously an S sexually transmitted infection. And so those are sometimes screen for during pregnancy, but not always caught. And so that's just a simple, again, treatment that can prevent your baby from getting an eye infection that can be damaged into their eyesight. It's a simple ointment that just applied once right after birth.

Dr. Nicole (14:10): So if this is one of the ones that I've like, I don't know. I've heard that it's not as effective as we think. How effective is it at preventing infection?

Dr. Emeka Obidi (14:19): Yeah. And the truth is it's effective, but nothing is a hundred percent. And yes, there are some bacteria that may not be covered. I think where mom has been properly screened for an sexually transmitted infection, maybe it's less of an issue than where maybe that screening wasn't done for whatever reason. Gotcha. Maybe there was spotty prenatal care. But again, it's a simple application. It's a simple antibiotic ointment. There's really very minimal side effect, if any, some eye irritation and millions of doses have been given at this point and really haven't resulted in any significant side effects. Sure. That one worries about. Sure, sure. But the point is taken as we did the number of things we do, none even a hundred percent.

Dr. Nicole (15:11): And then also sometimes I do think, I wish we could kind of individualize things more because if you are in a stable, I know we often in the medical profession tend to always think the worst in a way. But if you've been screened for sexually transmitted infections, especially in the third trimester, and it's negative, then if this is something that less an issue, you feel like, yeah, it's definitely going to be less of an issue for sure. Yeah, that's very true. And then what's the third thing that's going to happen? Yes.

Dr. Emeka Obidi (15:38): So the third treatment that newborns typically get is a hepatitis B vaccine. And again, that's just the process of getting newborn vaccinated against hepatitis B. Now, that's another one where one has to maybe call individualize. One of the reasons we do it in newborn period is quite a number of percent, quite a percentage of individuals that have hepatitis B are not, are unaware. They have hepatitis B is so they don't even know they have the impact. And so the baby copo potentially be exposed to people who have hepatitis B. Now, transmission of hepatitis B does involve blood and can also be sexually transmitted. So it's not necessarily something that your newborn is going to get just because they were carried by someone who has Hepatitis B. But again, you don't know what that exposure could look like. And so newborn, in a newborn period, you can start that process of getting them vaccinated or protected from hepatitis B infection. And again, it's one of the ones where I think that, and in my practice, I practice the same way. I have open conversations with parents and around vaccines as well. And where there is some concern, I'm open to listening and I'm seeing what we can do to get baby there. But again, none of this is life threatening per se. And so I think it's one of those things where you do provide some information and allow parents to make the best decision for their babies.

Dr. Nicole (17:08): My husband and I, neither one of our girls, we are very pro. Yeah. But neither one of them got Hep B vaccine in the hospital. And it was just because we were like, I don't know, we were just sort of felt like they're, honestly, the pediatricians also were like, we can just do it in the office. It's not a big deal. So yeah,

Dr. Emeka Obidi (17:29): The same thing. Also, don't sweat it if you're worried about it, but I think it's one of the reasons we also do it in the newborn period, why they're there. It is a captive audience. Right. Cause sometimes the gender, the majority of babies are going to make it into the office, but there're going to be some babies who sleep through the cracks, never make it for whatever socioeconomic issues going on in the family. And so they'll have at least gotten some protection right before they're out on the wall. Sure, sure. So again, this is where individualizing care can be really helpful because if you have a very stable household and parents are connected to a healthcare system or to someone who's going to provide care afterwards, it's less of an issue that that's not going to happen down the road should they choose to do so. Sure,

Dr. Nicole (18:10): Sure, sure. So if parents have some concerns about these or want to ask questions, then how should they approach this? Is this something they should ask even during pregnancy? Or how should they get all of their questions and concerns addressed?

Dr. Emeka Obidi (18:24): Yeah, I think so. I think so. And one of the great things I love, pediatricians will still do pre a prenatal visit where they can come in and talk about whatever concerns they have, get to visit the pediatrician and see if it might be a good fit. So I think that's someplace they can certainly get information. It's just the local pediatrician. And I know some information is provided at the hospital. Again, I think there's so much going on when a mom is in labor, right? I dunno how much she actually,

Dr. Nicole (18:53): Yes, really take this yes

Dr. Emeka Obidi (18:56): Sign. Just tell me where to sign, sign, whatever. Right? Let's get this party under the road because Yeah, I need to get his baby out.

Dr. Nicole (19:04): Yeah, exactly.

Dr. Emeka Obidi (19:05): So I think where they're able to get information ahead of time and really think through this carefully, I think it'll be great.

Dr. Nicole (19:13): Or this is something for instance that, and I'm not affiliated with his class or anything like that, but this is something that would be included in like a newborn Absolutely. Prep class or should be that you can absolutely.

Dr. Emeka Obidi (19:24): Should be. Absolutely should be. And we may talk about this later on, but I do have a newborn preparation course that lays all of this out. But again, it's getting that information ahead of time before so you can really think about it. And actually we talk about informed content, and it's informed you have to be informed and being the right mindset to actually yes. Digest information and consent to or not to partake in subject.

Dr. Nicole (19:49): Absolutely. Absolutely. Okay. So those are the ones that are done fairly soon after birth. What other exams and tests are done in the hospital for babies?

Dr. Emeka Obidi (19:59): Yeah. Yeah. I think this is where it's really great that we've advanced the place we have in medical care. There are a number of other screenings that are done while the baby's still in the hospital, typically. Sure. One of them is a hearing screen. So that's a universal program. All babies get screened, get the hearing screen, and it's great because you can pick up babies who have a hearing deficit very early on where you can actually intervene and make a significant difference in their outcome down the road. Okay. Hearing is very important to be able to develop speech, and so the baby's not hearing properly and that's not caught early. That can interfere with speech and also maybe limit the options that they have in terms of being able to provide some support in their hearing. Sure.

Dr. Nicole (20:45): How often do, baby, I'm, go ahead. It sounds like you were going to answer my question. I was going to ask how many babies have trouble with the hearing screen? I

Dr. Emeka Obidi (20:52): Was going to say most of the vast majority of babies actually will pass a hair and screen have no issues. And actually those, and a majority of babies who don't pass the hearing screen, I'm not quite sure what the exact numbers are now, but just from experience, majority of those babies who don't pass the initial screen, and they're usually screened twice at a hospital, they feel it, each ear is screened. If either of them fail, they screen again a second time. If they still feel that screen, then they're referred to get a proper hearing screen at an audiologist's office down the road a couple weeks down the road. But most of those babies end up passing that screen. Okay. It's usually due to just some fluid, amniotic fluid still in the canal, interrupting, interfering with the test. And sure. A few weeks down the road that's cleared and they pass that screen. But of course, the whole reason for a universal screen, such as a hearing test screen that is very in our cost to the baby, you're, what's the right word? Right now, it's not intrusive. Right. You're able to catch those babies that truly do need that help. And if it's not done universally, there's no way of knowing Sure. Catching those babies until those too late perhaps.

Dr. Nicole (22:03): Sure, sure, sure. Okay. So the hearing screen is one, what else happens?

Dr. Emeka Obidi (22:07): Yes. And then the other is the newborn, a newborn screen that's done, and that's a universal program. Every state, the state programs, every state is slightly different, but it contains a battery of tests that are done from just a few drops of blood that typically will be gotten just from pricking your babies hill. And that's sent to a state lab where it is screened for a battery of, or a list of disorders that typically are not easily recognizable at birth, but if you can recognize them or pick them up at birth, you can provide treatment or interventions that provided significant improvement in outcomes. So that may be picking up some metabolic disorders where you have to feed a certain kind of formula to prevent that from progressing. Or maybe where you can pick up a thyroid disorder, where you can provide thyroid hormone as its supplementation so it doesn't have that growth.

(23:03): So a number of those conditions, sickle cell disease, a number of, quite a long list of conditions that are screened for in the newborn screens. That's one. And usually that's done 24 hours after the first feed. Okay. Cause part of the test is trying to see how your body metabolizes proteins and carbohydrates and fat. Okay. So it's done 24 hours after that first feed. Gotcha. And typically a second one is done eight days to a month out to confirm the initial test to make sure nothing was missed. And that's usually done in the pediatrician's office. So that's one screen. And then more recently, which is also, again, I think becoming universal now is screening for congenital heart disease. It's a very simple screen. They typically will just hook up a pulse oximeter just to measure your oxygen levels, one upper extremity, like the hand, the hands, and one in the lower extremity on the same side like the foot, and see if there's a difference in the oxygen levels. They should be really close together. If they're past a certain cutoff point difference, then that cues you in that it may be a congenital issue, a heart disease where our blood is not circulating in the right way to provide oxygen equality around operating on lower extremities. So that's a very simple test that's also done a screen that's done at the hospital. And the last one is screening for jaundice,

(24:28): Which is the yellowing that you can see on the skin of the eye caused by bilar Ben. And that's also one of those things though also that mom's like, I don't know what's jaundice. I know ceiling of the eye and blah, blah, blah. But simply what jaundice is really simply is our old red blood cells get broken down by the body and gotten read off while new ones are produced. And those old red blood cells, when they break down, one of the things they break down into is bilirubin, which is this substance that can cause a yellow tinge to the skin or to the eyes. And the reason we worry about it is because at very high levels that can be damaging into the brain. And in newborns can't, all of us can get rid of bruine the way it's initially produced or initially produced.

(25:13): When the red blood cells are broken down, we have to convert it to a form we can get rid of in the poop. So your baby oftentimes doesn't have enough enzymes to convert all that bine that's floating around in the system. And over the next few hours and days produces more enzymes to get rid of that jaundice. And so depending on how high those levels are, and if there are other issues, complicated matters, maybe some bleeding that may produce more cells being broken down, producing more bine. Sure. Those can get to really high levels. And so all newborns are now screened for jaundice before they leave the hospital, usually in the first 24 hours as well, to see if those levels are are acceptable, or if they're levels we need to watch more carefully, or if they're really high levels where they need intervention right away.

Dr. Nicole (26:04): Got it. Got it. Those

Dr. Emeka Obidi (26:05): Are for screens that you usually have at most hospitals.

Dr. Nicole (26:09): And then what are the interventions for elevated bilirubin?

Dr. Emeka Obidi (26:12): So for the therapy is the main way that's taken care of, especially if it's not critically high, where you now have to do what's called an exchange blood transfusion where you're taking blood out of the baby and putting fresh blood in does happen when it's really critically high. But most of the jaundice is caught before it gets there. And for therapies, a way to take care of that. And so your babies put under some light for the therapy lights that have a patch wavelength that do the same thing the enzymes do. So they break down that bilirubin into a form that a baby cannot get rid of in the pee, in the poop. And so that usually is how you'll take care of that. And you know, we're also told, you know, could put a baby out in the sun, indirect sunlight. It's indirect sunlight on them covered. You don't want them to get a skin sunburn. But those usually, if the levels are really high, just indirect sunlight would not be concentrated enough light to take care of the jaundice.

Dr. Nicole (27:09): Gotcha. Gotcha, gotcha. Okay. Awesome. That was an excellent overview. Oh, thank you. So the next thing to talk about, and I know I am sure that this gets mom's parents really worried, what can they expect with their baby's weight after the baby is born?

Dr. Emeka Obidi (27:24): Oh, I'm so glad you asked that, because that's one of those things, I just feel like there's so much, I mean, caring for a newborn is just so exhausted. There's just so much going on. It's really tasking. And I feel that all these small things that kind of eat at a mom's like reserve, that if you can just clear them all, she can know this has had more bandwidth to deal with the real stress of caring for a newborn. And one of them is this, because a lot of moms are really unprepared for the fact that the newborn is going to lose weight. And so almost every newborn is going to lose weight the first few days. And most moms are going to go immediately to the place of, oh my God, I'm not providing enough food for my baby. My breast milk is not enough. Sure. They're not taking the formula, whatever. And which is usually not the case in most cases. So newborns loose weight. And the reason is it takes a few days for moms to ramp up breast milk production. You can imagine how uncomfortable it'll be for a mom who's already uncomfortable in being pregnant, having to carry around breasts that are full of milk, and gosh, the whole time she's pregnant. Just the nature understands that that's, that's not going to be good. We'll probably just stop having babies.

(28:37): And so babies actually come with some extra on board, some extra calories on board to help them through that transition period. And they're actually allowed to lose, for most healthy babies, allowed to lose up to 10% of their bed birth weight. And usually by seven to 10 days, they're back up to birth weight. Got it. And so they have a few extra calories to tie them through. It's beautiful how nature works, right. They're fat cells are a different kind of fat called brown fat that produces more energy. Okay. It's them, again, provides energy during those first several days. And beyond mommy's breast milk, the initial few teaspoons of breast milk you can get from the breast called colostrum, has lots of calories packed in it already. Again, to tie a baby through that period. So just to say that babies will all lose weight for moms not to worry when they're told the weight on day two and is less than what it was the day before. Sure. It's not because you're not feeding them well, it's not because of any of those things. Most times it's just a normal physiological process of adjusting to a new world and getting ready to feed baby.

Dr. Nicole (29:47): Gotcha. So you don't need to, if you're breastfeeding and you want to breastfeed exclusively, then you don't necessarily need to start formula just because

Dr. Emeka Obidi (29:55): Yes. You don't necessarily need to start formula, supple, lost weight, the few separate days. And that's where monitoring a baby closely can be helpful because we can tell, oh, this is acceptable weight loss, we don't have to worry about it. Sure. We have time. And even when they get to 10%, I'm still able to look at a mom and say, and see how breastfeeding is going. Maybe observe the latch and see, I think things are okay here. I think we just need a few more days because some babies would get back to their birth weight at two weeks past birth. Gotcha. And still be okay. Gotcha. So I think, yeah. Gotcha. No rush. No, no need necessarily to rush immediately to formula if you want an explicit breast.

Dr. Nicole (30:31): Okay. Okay. Okay. You seem to take a very, what's the, I don't want to say lay back cause you obviously take it seriously, but you also don't want to make people anxious about all worked up about the things.

Dr. Emeka Obidi (30:44): Yeah. I think, cause most times there is no reason to. Okay. I mean, in the walk you do, right. You'll see a mom who is in a critical condition and you can recognize her right away. And there's no time emergency. Our daughters where csec, were all accused by C-section, but the first one obviously was the first time. And I had newfound respect for you ob. Cause even as a pediatrician, as a physician, I was shocked at how quickly we got to that or Right,

Dr. Nicole (31:18): Right, right.

Dr. Emeka Obidi (31:19): How quickly that baby was out. Right. Cause my heart rate was just dropping. And so there's no wasting time when it's warranted, when it's needed. But a lot of times the things that issues with we face and we see there's leeway to really think about it and talk through it and see what can be done. And even where something needs to be done urgently, we don't need to get mom all flustered. Sure,

Dr. Nicole (31:44): Absolutely. Yeah. You can convey the seriousness without being dramatic about it. Exactly. Yeah. Exactly. Yeah. Okay. So once baby leaves the hospital, I think this is another thing that people aren't prepared for. How soon will that first pediatrician's visit be?

Dr. Emeka Obidi (32:01): It's true. So I would say generally speaking, it's going to be that first week. Most times the first two to three days, sometimes even the very next day. So it really depends on what's going on with the baby. If you have a baby who's lost quite some weight and you're worried and you want to kind of just watch them carefully, it may be the very next day or another case will be a baby who had jaundice and was significantly enough to either treat, or maybe it's sort of on the fence where you might or might not treat. You might want to see them the very next day to repeat those levels, make sure it's fine. So there's some instances where you want to see the baby right away the very next day. Most times it's going to be two, three days out to monitor weight, see how they're doing. But it does take a few. Usually within that first week, all babies should be seen.

Dr. Nicole (32:44): Okay. Yeah. And then is there anything that you recommend parents do in order to make the most of that first visit and feel good at that first

Dr. Emeka Obidi (32:52): Visit? Yeah. Yeah. A few simple things they could do. Yeah. One I would say is, and this will start right after the baby's born. As those questions start to come up, open up a notes note app on your phone or someplace and start to just put all those questions down. Sure. Because you cannot forget half of them when you come into the office.

Dr. Nicole (33:13): And then you remember them right after you left,

Dr. Emeka Obidi (33:15): Right after you leave. So you do want to sort of put all those questions down so you can ask them when you are with a pediatrician or whoever's seen the baby, you want to really, as much as I really want to encourage moms and dads to bring in that discharge paperwork that are given at the hospital, the time is for Got it. But has really important information for the pediatrician. It has a birth weight, which was moms and as I remember, but also has a discharge weight, which is really important because then we can tell, okay, they were discharged two days ago. This was that weight. This is what it is today. We're still fine. We're still within whatever. Got it. Right. Okay. Yeah. So that's really important. It might have their bilirubin levels. It does wear dawn. It might have other concerns that the pediatrician or whoever saw them at the hospital was worried about or just wanted to highlight. So all that is on there. So I really want to encourage them to bring that discharge paperwork in with them. Make sure where you're going to for the office visit visits and give yourself time. Just typically there's a lot of paperwork to do. Yes. And you want to give yourself time.

Dr. Nicole (34:28): Yes. You got to pack up all the

Dr. Emeka Obidi (34:29): Stuff. It's probably going to have a blowout as you're walking out the door. You have to go back in and change them all about drama. So give yourself enough time to get there and then just dress them in something simple, because they're going to be stripping them down to their diaper, so no fancy clothes because it's all going to come off. Sure. And they're not always the easiest of close to manipulation to a newborn, especially for first time parents, really free, they're going to break the baby. So

Dr. Nicole (34:59): Just keep it simple. Keep it

Dr. Emeka Obidi (35:00): Simple. Yeah.

Dr. Nicole (35:01): Keep

Dr. Emeka Obidi (35:02): It simple. Those are a few maybe helpful things that Ill sing. Yeah. Something else I found very helpful, and I always tell parents this all the time, is your phone is my best friend. Because you can take pictures of things, you can take video recordings of things, my baby's breathing funny. Just record it. It's much easier for me to be recording and see if it's an issue or not. Then you're trying to describe what it looked like or sounded like the baby's poop looks funny. Just take a picture of it and it just helps.

Dr. Nicole (35:32): See, I love it because some doctors are so like anti, I don't want to, don't need to see all that. That is great. Why would you not use, makes it easier that Yes. Yes. You can give people reassurance very quickly. Very quickly, or know that it's an issue very quickly. Yeah. So I love that. I love that. Okay. So one thing that I've seen more and more, and I think the American Academy of Pediatrics talks about this too. How do you play a role in screening for postpartum depression? Because you're almost always going to see moms sooner than we do.

Dr. Emeka Obidi (36:05): Yeah. So all the moms are screened at that first visit, and actually at every, well child checkup up to six months. So Really? Yes. Cause at the first visit, it's at the one month, two month, four month, six month visit. I

Dr. Nicole (36:21): Did not know that. Okay. Farm

Dr. Emeka Obidi (36:23): Is the Edinburg test that we use. And I will say this is one where I've started to pay more attention to, especially since I started to do some more work around educating moms around newborns and talking more clothes to moms, and realizing that a number of times postpartum depression goes unrecognized by providers. Moms put on their brave face when they come in and they kind of pretend like everything is okay.

Dr. Nicole (36:49): You're supposed to be happy because you have this new baby

Dr. Emeka Obidi (36:51): Supposed to be happy. You have a new newborn baby. I mean, what's not to be happy about. And so they can just feel they can be a lot of shame around for certain depression, which unfortunately ends up making it something that becomes difficult to provide help for

Dr. Nicole (37:08): Sure. Sure. Yeah,

Dr. Emeka Obidi (37:09): Sure. So I do really look carefully at those screens and also even when the screens don't seem to match what I'm seeing, go beyond understand. Yes, everything is okay. Yes. But yeah. Yes, it's

Dr. Nicole (37:20): Important. Gotcha. To get with the screen. And do you feel like you have resources that you know where to send people? Because that can be hard too.

Dr. Emeka Obidi (37:27): That can be hard. That can be hard. I think that the primary care provider is one resource in terms of, especially if it's significant because they can provide some support there. I try and talk to them about therapy, especially if there's also been a history of depression or anxiety already. Sometimes it's helpful because they already have a mental health provider they're connected to, and so encouraging them to really reach out if they need more help. Sure. But you're right. I think it's one of those things where maybe more help could be done. Yeah. I will tell you, I did an in a podcast interview months ago with a lady who lives in Sweden, and after the baby's born, every mom gets a community health nurse who visits her for the first year after the baby's born the first year. Dr. Francis, are

Dr. Nicole (38:18): You serious?

Dr. Emeka Obidi (38:19): I'm not kidding. I was like,

Dr. Nicole (38:21): What? The first year?

Dr. Emeka Obidi (38:23): And they have the ladies' te cell phone to text her. She's dropping in several times the first month and then monthly after that should talk, you know, really have someone that keeps an eye on you to see, make sure you're fine. Help to transition. Hopefully we'll get them some tired.

Dr. Nicole (38:41): Oh my God. That's because they actually value people and families, whereas in the US, we don't the way we should. Oh my God. Okay. Oh, you're right. Yeah, yeah, yeah. Okay. So the last thing I want to talk about is the confident mom's mindset. I love this how you frame this. I think this is really important, so please share that with us.

Dr. Emeka Obidi (39:02): Sure. I think we just walk in with moms, and in the last several years I just realized, although I love all the pediatrics and still do, I practically enjoy just taking care of newborn new moms and newborns. And I've noticed that from just carefully observing the patients I've taken care of and walked with, which has been thousands of moms at this point, that the moms that seem to thrive the most in that initial period, I think just have a different mindset coming into it. And I've tried to break this down into three kind of legs to are stool and one is festival. Just recognizing that you're the best mom for your baby. Yes. It's a simple statement, but I think one that a mom really needs to sit with, I love. Yes. Right. You're the best mom for your baby. It's not the mo mom next door.

(39:46): It's not your sister, it's not your mother, it's you. Right? Yes. Whether that baby came to you by natural birth or adoption, you are the best mom for your baby. Things have walked out where you get to care for this newborn and it shouldn't feel like you're not enough. I don't have enough to care for that baby, which is the second tenant, let say, is that you've got what it takes to care for your baby. You have absolutely everything. You have to take care of the baby. They might be information that you don't have, but then you have agency to go get that information, right? Yes. So no one's saying you have to know every single thing about a newborn, but where you need information, you can also get it. Also, you don't have to rely on somebody else to make all those decisions for you or to guide you, get what you need, but knowing that you are more than enough to provide what that baby needs. And the third will be that you are in charge of a baby's care. And I truly feel, and this may be controversial, but I truly feel that your baby gets to actually adapt to you another other way around.

Dr. Nicole (40:53): Listen. Yeah. Okay. And I

Dr. Emeka Obidi (40:55): Really truly believe that Some moms may throw things at me, but I say, what do we know? But I think that's way it works best, right? Because we're all different. And I think I find that lots of moms that are super stressed are trying to confirm to what they feel is the right way to care for this baby. The baby should be, but it should be the other way around. So if you have the mom who is really very regimented and likes everything on a schedule, your baby actually falls in line very quickly and they get into a schedule, we feed him, we feed out, because no mom is going to ignore that baby. Sure. Right. The majority, right? Sure. So your baby can really adapt to your way of showing up in the world. If your mom is just carefree and loves to do things as they pop up, your baby will fall in line with also, and you'll feel on demand and they'll be okay. And I think that that way you can really, parents from a very authentic place at a very comfortable place. It's already a very stressful period. And trying to change yourself into somebody else for this newborn, I think just sets you up for just a very horrible experience.

Dr. Nicole (42:05): I I'm going to have to agree with you. And it doesn't mean that you're not meeting the needs of your child Exactly. Or that you won't adjust if you need to sometimes. Yes. But you're starting from the place of you are coming into our family and this is how we as a family are going to make this work. Exactly.

Dr. Emeka Obidi (42:21): Exactly. Exactly. You're so right. You will adapt to the baby's needs. That's just modern instincts, right? Yes. But you're not bending yourself into a pretzel

Dr. Nicole (42:33): Or changing who you are, so all of a sudden, yeah, yeah, yeah. Exactly. Exactly. All right. So as we wrap up, what is one of the, these are questions I ask everyone. What is the most frustrating part of your work?

Dr. Emeka Obidi (42:43): Oh, I think I just want to say it's when I just feel moms in the context of newborn care. I just not getting information they need where they also feel, and I try to create that environment as much as possible where a mom feels like she cannot ask the questions she wants to ask, I'm just supposed to keep quiet and just listen to whatever you see and not challenge any of that or ask any questions. But I think it's just frustrating when there isn't that openness in that relationship between the parents and within a patient and physician.

Dr. Nicole (43:19): Sure, sure, sure. And then on the flip side, what's the most rewarding part of your work?

Dr. Emeka Obidi (43:23): Oh, it's pediatrics. What's not long? I get see cute babies all day long. Oh, kids all day long. I get to, which is really rewarding because especially when I've done it, as long as I have to see kids grow and remember when they're born now the teenagers now, their voice broke. The young ladies, I'm like, wait time. So patients now who are coming back with their own babies, I'm like, no, I'm not that old. It's rewarding. It's

Dr. Nicole (43:57): Beautiful. Isn't it just a great feeling when you love your work and you feel like you're in the place where you're exactly supposed to be. Absolutely. Yeah. Doing the work that you were put on this earth to do Very

Dr. Emeka Obidi (44:05): Much though.

Dr. Nicole (44:06): Yeah. So what is your favorite piece of advice that you would give to expected moms or expected parents?

Dr. Emeka Obidi (44:11): Yeah, I think it'll go back to mindset. Just saying it really affects a lot of things we do. And I didn't think we realize just in a lot of personal development, walk over the last several years realize how critical mindset is. And I think in midst of getting all the other things ready with the nursery and the baby gear and diapers and what going to use the cloth or not and all that, taking time to really prepare your mind and your emotions for what's about to happen. And because I think you just come at it, you just end up in a more centered person when you newborn arrives. Sure, sure. Just not eradicating it to something, some w woo thing, but really taking time to think through it. How am I going to show up? Okay, this is going to be difficult. What are my resources? How am I going to be able to navigate this barrier? Just thinking through some of the things that end up just hitting you, like you're blindsided by if you don't think about it beforehand.

Dr. Nicole (45:11): Yeah, I love that. I love that. And that's going to set you up for the journey of parenthood because the newborn period is just the start and it really sets you up in life to manage things that happen. For sure. Yeah, for sure. So where can people find you? What are all of the things you have to offer? Tell us all the things. Sure,

Dr. Emeka Obidi (45:30): Sure. One good place to just be newborn prep academy.com is newborn prep academy.com. I have some free resources on there, how to choose the right pediatrician for your baby. I have a confident new mom guide that kind of goes through some of what we talked about today. And for those who really need more support and I think really want to prepare themselves with a barn, I offered the newborn preparation course. It's a four module course that really just goes through all of this, the mindset, what your baby's poop is supposed to look like, what breastfeeding looks like, and formula feeding. And if you want to do both, how to do successfully and all the different things, how to take care of a circumcision and the umbilical cord and all of that. It's a really very helpful course, I think prepares you for your newborn and you Kim found on social media on Instagram at Dr. Obidi This is D R O B I D I, or on Facebook at Dr. Emeka Obidi. Awesome. The E M E K A, O B I D I. Okay.

Dr. Nicole (46:28): Thank you so much. This was incredibly useful. I appreciate you coming on. This was great information.

Dr. Emeka Obidi (46:33): Aw, thank you so much for having me. And Dr. Nicole, it was really wonderful chatting with you today.

Dr. Nicole (46:44): What's been a great conversation? Can you just hear the joy that he has in his work? I love it when I get to connect with people who are as excited about their work as I am. There's just such joy and pleasure in being able to do work that you so love, and he clearly loves this work and just gave some great information there. Now after every episode when I have a guest on, I do something called Dr. Nicole's notes where I talk about my top takeaways from the conversation. Here are my Doctor Nicole's notes from my conversation with Dr. Obidi. Number one is understanding what's going to happen in the newborn period really should be a part of preparing for the postpartum period, and it should start in the third trimester. We do not do a good enough job of helping people get prepared for having this new baby.

(47:33): And yes, people do registries and baby showers, and of course all of those things are fun and necessary and rituals surround having a baby. But you also need to understand a bit about how to take care of this new person that you're going to have. And it doesn't have to be complicated or involved, it's just helpful to sort of know what to expect, just like childbirth education. So definitely start thinking about doing a newborn prep class somewhere in your third trimester. Again, they don't have to be very extensive or long, but it just helps you to have a sense of what to expect when this new baby is coming. Okay, number two, as I said in the episode, my husband and I actually decline the Hepatitis B vaccine in the hospital for both of our children. Not that we're we're all vaccinated, our children are vaccinated against all the things, but for us, it just felt like we don't understand why our child needs this right now when they are not at risk of being around anybody who has Hepatitis B.

(48:32): And our girls are 13 and 15 now, and at the time our pediatricians were like, this is no big deal. You know, can just get it done in the office. I think some pediatrician's attitudes have shifted and they may not be as flexible about it. I'm sort of my gestalt just from hearing what people say online. I can't say that's necessarily true, but for us it just didn't feel, I don't know, it just didn't feel like it was something that needed to be done right away. It got done at their a later visit. And honestly, looking back, I would probably also decline the erythromycin eye ointment. It's really given to help reduce the risk of gonorrhea or chlamydia in the eye. And if you're confident that you don't have those things, then your baby's not going to get them. So I probably would've declined those as well.

(49:18): We had conversations with our pediatricians, and again, at the time, that was all fine. Now, I'm saying all this to say that I really wish in our system that we would take a more individualized approach in the context of population health. Like doing vaccines and doing things on a schedule is important in terms of population health. And when you look at things like syphilis for instance, there's been a big increase in neonatal syphilis recently. That's a big population health problem, and some of that can be reduced by testing or screening for syphilis more consistently in the third trimester. That's syphilis, by the way, would not be prevented by the eye ointment. The eye ointment is really for gonorrhea and chlamydia, and quite frankly, it doesn't work that well to be honest with you. So I'll say all that to say is that I wish we would take a more event, individualized approach to the way we care for people and have conversations and be more trusting, I guess, that people are going to make decisions that work best for them.

(50:21): So that's just my 2 cents about making those sort of choices and decisions. This also filtered into when we did vaccines as they got older, it didn't feel right for us to do five shots at once and that kind of thing. So we sort of spaced them out. So we kind of made our own schedule, which I know irritates the blank out of pediatricians, but we did, did what felt best for us, and you should do the same. Okay. Third thing is I just love that confidence mi mom's mindset. You really are the best mother for your child. I like to say that our children choose who their mothers are, and the combination of the sperm and egg that came together to make your child was right for you. You are the best mother for your child. So really believe that and internalize that. And I also really like the advice that yes, your children need to adapt to your life to some extent.

(51:20): You don't need to upend your whole existence because you suddenly have a child. All right? And that's not to say that things won't change or that you won't adjust things in your life in order to meet the needs of your child. Of course you will, but you should not upend your entire existence for your children. Your children need to fit to a large degree into your own life. I think that that is very important and helps create a healthy, balanced family and environment. And that can look like different ways. For example, if you traveled a lot before you had a baby, some people continue to travel after they have a baby. Just because they have a baby, that doesn't mean that they don't suddenly do the things that they used to enjoy. If you like to eat out, then people still continue to eat out after they have a baby.

(52:07): They just bring the baby with them or find a babysitter. So you certainly need to have children adapt to your life that that's really important in order to keep everybody happy. Okay, so there you have it. Do me a share this podcast with the friend. Sharing is caring, helps me reach and serve more pregnant folks, and I appreciate you doing that. Also, subscribe to the podcast wherever you're listening to me right now, helps the show to grow. Leave a review, an Apple podcast. I love to hear what you think. You can also let me know what you think by DMing me on Instagram. I just love it when I get those messages and I try to respond to as many as I can. When folks let me know what the podcast has done for them and how it has impacted them, it really just warms my heart and helps to keep me going on those days when things can get a little bit stressful. So that's DMing me. DM me on Instagram at Dr. Nicole Rankins. And don't forget about the VBAC class, that's dr nicole rankins.com/vbac. That class will be Monday, April 24, 7:00 PM Live Eastern Standard Time. So if you are wanting to have a VBAC, do join me there. So that is it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.