hello and happy Sunday we are here this week for our sit down q a where we answer questions
that you our fabulous viewers had this week yep and this week we're going to talk about if your
baby has an umbilical hernia and when you need to be worried about that little protruding belly
button yes and also how can you communicate birth plans or birth wishes when you are in
a group with multiple providers yeah just in case you haven't met us before I'm Kurt I'm a
board certified pediatrician I'm Sarah I'm a board certified OB GYN and we are the doctors bjorkman
foreign
with it our first question this week comes from zandile sabala and they say should I be worried
about an umbilical hernia my baby is two months old and it seems to not be going down it's a
great question incredibly common umbilical hernias or just having really pointed out belly buttons
sometimes bigger than the area of the belly button itself is very common sometimes one in ten one in
20 babies even depending on the population you are in this is all because the wall of the abdominal
muscles does have a little Gap that allows the vessels of blood coming in from the placenta while
babies growing inside a mom isn't complete there to allow those vessels in and so sometimes there
can be a little bit of weakness in that abdominal muscle that then grows and fills in as your child
grows and develop as well it is incredibly common as I've already mentioned in normal and they do
get better with time almost always the question you're probably wondering is when do I need to
be worried it's two months why isn't this better yet so as it turns out recommendations from the
AAP in 2019 are that they should not be repaired until closer to four or five years of age and
that's just because they so often improve with time usually most of them are gone by two years
of age but they say that even if it's still there at two years of age there's still a good chance
it's going to go away by the time your child is three or four or five even having said that times
that can wouldn't be concerning would be if it ever protrudes out so much that it gets really
dark red or discolored and it looks like it's not getting blood flow what that is there's a
little bit of intestines that can sometimes push out through the wall of the abdomen and if it gets
strangulated is the word where that there's so much out there that it gets stuck would
be a concern so it should be soft you should be able to push it in anytime you want but please
just let it be try not to bother it let it you don't feel like you're pushing it all in on its
own frequently just because to test it because you don't want to just weaken the muscles around your
at all so and your pediatrician is looking for it I know it cease's last well child check she
was like oh she has a little hernia and we said yes isn't it cute you should see it after a big
meal it's just this little so your pediatrician is looking for it if you notice it ask him at
your next well child check hey what do you think about this just so it's on everybody's radar
um they are looking forward to yeah so the fact that your baby has a hernia at two months very
normal and it should get better with time we know our little girls has gotten better yep and still
got a little ways to go and always talk to your pediatrician yeah yeah all right next question
comes from Amanda the redhead and they said if we don't know what doctor will be delivering our
child out of the hospital group we've chosen how do we make sure our wishes are known to the doctor
in regards to when to avoid a C-section immediate skin descent skin Etc Great question and I think
this is something that is happening for patients more and more often as OB GYN groups are kind of
joining others becoming bigger becoming Hospital employed so there may be multiple OB gyns in your
group or groups may cross cover for each other and you're not exactly sure who's going to deliver you
so on the front end during prenatal care often what practices sometimes do and this is an option
is you can opt to see the different providers for your appointments so that by the time you're done
with all of your prenatal care you've probably maybe said hi to all the docs in the group once
that's an option Some people prefer to say hey I'd rather see the same doc every single time
during my visit and then you know roll the dice with who's going to deliver me so talk to your
practice that you're going to see about those kind of options on the front end there's also a
possibility you know to say if you get to the end and you have a scheduled induction and it's not
with your doctor you're going to have a scheduled C-section it's going to be with someone else just
say hey is there a way I can do a little meet and greet I'd love to say hi to this doctor and
you can see if that's something that they can accommodate can't always do it and so if you
find yourself in labor or having a c-section or something with a duck you've never met
um the one of the ways to make sure you know your birth wishes are talked about are first
and foremost your nursing team so nurses can't say it enough are just amazing and really really are
so critical in important during patient's birth and your birth experience and the whole thing
doctors often have many many patients who are doing surgery or are seeing patients in clinic
or whatever and may be juggling multiple things generally when patients are in labor a nurse
is assigned to just that patient with one or two patients and so they are your go-to person during
your labor and they are in communication with the doc so you are going to have a lot more one-on-one
time with your nurse in labor and that is a great time to say hey here's the things we're thinking
about this is what our wishes are in terms of skin to skin or getting some of those vaccines
or eye drops afterwards or hey we'd like to try to be in the tub or I want to be up and about
as much as possible your nurse is your teammate and she is working with you to try to get you
that birth you want okay and so kind of having a powwow with the nurse is a great way to make sure
that someone is on your team in terms of what your wishes are and can be an advocate for you and help
you try to accomplish those goals because they also are you know communicating with the doctor
throughout your whole labor and then when you meet your doctors be like hi this is Who We Are
here's our goals what are your thoughts and just have a conversation with them they want
you to have a good experience they want again they want you to be safe your baby to be safe
and they want you to have a good experience and so which means you guys have the same birth plan
even before you start right safe Mom safe baby everyone has a good experience yeah like shared
goals it really just helps make us think better and if there's little details you've thought
about yeah it's just great that as Sarah said your nurse is your best Advocate that's awesome
yeah cheers to all the l d nurses out there you guys are the best so so anyway that's going
to be it for us this week please be tuned And subscribe for our regular content on Wednesdays
and we'll see you back next weekend for another sit down Sunday q a have a great week bye guys
we're doctors but not your doctors anything we've said in this video
is for education or entertainment purposes only it is not medical
advice any specific medical questions you have should be directed to your provider