WELCOME TO DR.OZA’S HOSPITAL WISH YOU A HAPPY AND PLEASANT STAY

1) ACCOMPANYING PERSON  -It is necessary to have one close relative present with you throughout your stay. If you have undergone an operation, one male and one female relative should stay with you for first 24 hours; thereafter, only one relative may stay with you. The accompanying person should look after your money, mobile, jewellery, other valuables and your Newborn. It is advisable not to keep jewellery and valuables in your room.

2) VISITORS —Visitors may be harbouring some infection or germs, which may be easily passed on to you or your Newborn. So, restrict the number of visitors to minimum.

VISITING HOURS for our hospital are 4 pm to 7 pm only. Visitors should remove their footwear on Ground Floor on shoe rack, outside the waiting area.

THE LIFT (ELEVATOR) is for use of Doctor and the admitted patient. Visitors should not use the Lift. Doctor or Hospital shall not be responsible for any injury sustained by Visitors including their Children from improper use of the Lift.

HANDLING THE NEWBORN-The Newborn should be handled by its mother, that is, you, and our Hospital Staff. Visitors should avoid touching/handling the Newborn. If you wish to allow Visitors to touch your Newborn, the Visitors should wash their hands with soap and water three times and also apply “Hand Sanitizer” to their hands, before touching your baby.

BEHAVIOUR-Visitors should be properly dressed up and should not misbehave with, or use bad language towards the Doctor or Hospital Staff Members. During Doctor’s Round/ visit to you,visitors should have courtesy to wait outside your room Smoking or Consumption of Tobacco, Gutka, Maya, Alcohol is strictly prohibited in your room and in entire hospital. Visitors should not make noise in lobby or on staircase.lt can disturb other patients.

DAMAGES: If your relative or visitors cause any damage to fixtures or furniture in the Hospital or in the Room allotted to you, you will have to pay the damages for the same.

3) BREAST FEEDING THE NEWBORN — The Newborn is the most active in first 60 minutes after birth and you should try and breastfeed the Newborn within 60 minutes after birth or as early as possible. Even after Caesarean Operation, breast feeding should start within 4 hours. It also encourages successful lactation and emotional bonding between you and your baby. Colostrum (initial thick yellowish secretion from breast) provides antibodies ie (Immunity = protection) against diseases, to your Newborn. For Fullterm Newborn, Demand Feeding suffices, that is, when Newborn cries for feeding, that is usually after every 2 to 3 hours. For Preterm Newborns, 2 hourly feeding may be required. You get enough flow of breast milk secretion in first time delivered mother by 96 hours (4 days) and in second time delivered mother by 72 hours (3 days). Till then, if required, our nurse will give formula feeds after you have given your breast milk to your Newborn.

4) 10 STEPS TO SUCCESSFULL BREAST FEEDING (WHO AND UNICEF)

  1. a) PRE-DELIVERY PREPARATION-You should be psychologically prepared for breast feeding, after Understanding advantages of breast feeding, disadvantages of formula feeding, top milk and dangers of bottle feeding.
  2. b) THE FIRST CONTACT AND FEED-Soon after Normal Delivery, after the baby has cried, started breathing well and thoroughly dried, the Baby should be put between your two breasts and allowed “Breast Crawl”. Babies are very alert in first hour and have a very active suckling reflex.ln Caesarean Delivery also, breast feeding can be initiated in Operation Theatre (baby can be put to your breast over your shoulders) or soon after you are shifted to your Room, certainly WITHIN 4 HOURS.
  3. c) AVOID TRADITIONAL PRELACTEAL FEEDS like Glucose/ Jaggery / Sugar / Plain water or Honey ,as these can cause infection of baby’s digestive system and baby with full stomach will not be inclined to suckle at breast , preventing successful establishment of breast feeding.
  4. d) COLOSTRUM IN THE FIRST 3 DAYS Thick yellowish early discharge from the breast, though scanty in quantity, is highly protective against infection, is nutritious and sufficient for the baby.
  5. e) KEEP THE BABY WITH YOU in the same bed (BEDDING IN), allowing good bonding, warmth and care to the Newborn. Avoid Keeping the baby in a ci doie/ jhooia / hammock.
  6. f) DURATION AND FREQUENCY OF FEEDING Demand Feeding, that is, whenever your baby is hungry and without restriction of time. Feed at ONE BREAST for as long as possible because the initial milk (Foremilk) is watery (contains sugar and proteins) and satisfies the baby’s thirst , while the milk that is secreted later (Hindmilk) is rich in fats and satisfies baby’s hunger. Newborn needs to be fed every 2 to 3 hourly ( i.e. 8-12 times in 24 hours).
  7. g) LEARN TO HOLD IN PROPER POSITION (OF MOTHER AND BABY ) FOR BREAST FEEDING BEFORE DISCHARGE FROM HOSPITAL.
  8. h) EXCLUSIVE BREAST FEEDING Give only breast milk till the baby has completed six months. Avoid giving water, honey, fruit juices , gripe water, i Balkadu , etc. Mother’s milk contains enough water, hence, even in Summer , a healthy baby does not require to be given water.
  9. i) BREASTFEEDING DURING ILLNESS Mother suffering from common illness , can continue to breast feed the baby .Similarly, since sick children lose appetite for food and become entirely dependent on breast milk, they should continue to breastfeed.
  10. j) COMPLEMENTARY FOODS After completion of 6 months, gradually introduce soft homemade food in small quantities (Refer to chart given to you). However continue to breastfeed also, until the second birthday that is till the child completes 2 years. INADEQUATE BREAST MILK after 72-96 hours: you may be advised certain medicines, by Doctor. Reassurance and persistence with breast feeding are quite helpful. EXCESS BREAST MILK-Express the extra milk out of your breast. Do not allow engorgement of breast with milk, which may progress to infection (Mastitis) or pus formation (Breast Abscess). If there is tightness of breast (Engorgement) or redness (Mastitis) or fever with chills (Abscess), Consult Dr. Oza IMMEDIATELY and express the excess milk out of the breast and get medical guidance from Dr.Oza. If you delay getting timely treatment from Dr. Oza and waste time at home and if Abscess forms, it may require SURGERY-Incision and Drainage of Abscess , which will add to your hospital stay, expenses and later dressing of wound for 3 to 4 weeks.

SORE NIPPLE, CRACK NIPPLE are due to incorrect positioning for breast feeding. Once the position is corrected, they heal quickly.Learn from Doctor or Nurse, how to cope up with retracted nipple. DO NOT USE BOTTLE, PACIFIERS, NIPPLE SHIELD, AND TINNED BABY FOODS.

5) CARE OF PARTURIENT MOTHER Proper Personal Hygiene is very essential. Normal Delivery Mother should bathe daily. Caesarean Delivery patient can have sponging done. Frequent hand washing with soap and water. Proper use of hand sanitizers. Trim your nails short. Comb and tie your hair properly. You may use Maternity (big size) Sanitary Napkins (Pads) initially till you are having more blood loss (usually for first 2 to 3 days) , followed by your preferred Sanitary Napkins (Pads).For Normal Delivery women , Episiotomy Wound (stitches) will be cleaned with dilute Dettol Swabs twice a day, by nurse, which you should continue to do at your home. These stitches are self dissolving (10-14 days). For Caesarean Mother , abdominal dressing will be changed once after 48 hours. Do not wet your dressing with water etc. Caesarean stitches will be remuved o.-! around 8th to 10th day after operation.

6 )YOUR DIET-Normal Delivery Mother can have tea biscuits soon after you are shifted to your room. You may have vomiting initially. Later you can have your home food hygienically prepared AT HOME. For Caesarean or other Operation Patients: You should not take anything by mouth for first 12 hours after operation. After 12 hours, with your Doctor’s advice, start having plain water (Aquaguard Water) and coconut water. After 24 hours , add home made fresh fruit juices. Only after you pass flatus (gas) from your anus, you can start with tea biscuits, followed by Kheer, Kanji, Kaneri, followed by Upma, Pohe, Idli followed by Full Diet as per Doctor’s advice. Both, Normal Delivery and Caesarean Delivery patients can increase their breast milk supply by consuming cow’s milk and fresh fruits. Both of them SHOULD NOT consume oil, ghee, dry fruits,laddoos (made of any material) in your diet . It causes permanent weight gain without any scientific benefit. 1 laddoo = 400 calories which require 2 hours of exercise to burn calories obtained from one laddoo.

7) CARE OF YOUR NEWBORN-Ideally, only the mother of the Newborn and our hospital nurse should handle the Newborn. Sponging and Bathing and Cleaning of Newborn will be done by our nurse. Visitors should not handle or touch your Newborn. Newborn can acquire infection very quickly from visitors, e.g. Cough, Cold, Skin infection, Loose Motions, Fever etc. If you want Visitor to touch the Newborn, ask the Visitor to wash hands with soap water 3 times and apply hand sanitizer before touching your Newborn.

8) BIRTH REGISTRATION-It is mandatory to register birth details with local authority, i.e. Panvel Municipal Parishad. So please, give in writing , the details required, in English and Marathi to our hospital staff nurse. Also give 2 copies of Adhar Card and Ration Card along with birth registration form. If there is ANY mistake in birth registration (even spelling mistake ), Panvel Municipal Parishad may not correct it later or it may require a lot of paper work (Affidavit, Notorization etc), hardship and expenditure to be incurred by you . Your birth registration data will be forwarded by us to PMP on first Monday after your delivery.You have to fill up Marathi form given by us and submit to Panvel Municipal Parishad WITHIN THREE MONTHS form date of birth and collect the Birth Certificate Copies from PMP after checking the correctness of details in it. DO NOT DELAY IT TILL. SCHOOL ADMISSION.

9) COMMON PROBLEMS IN NEWBORN-

  1. a) Passing first Urine and Stool: Generally Newborn passes first urine and stool (Macorium -black coloured) within first 24 hours after birth. If it does not, it may need evaluation.
  2. b) Vomiting-Can occur in first 24 hours. If necessary, Doctor will give Stomach Wash, especially if Newborn had passed meconium in uterus. Nurse might give some drops for the same. Newborn may bring out small amount of feed which is called Regurgitation ( and not vomiting) and ‘Burping’ by holding Newborn upright for 20 minutes after feeding, generally helps.
  3. c) Jaundice- It is common between Day 3 and Day 10, called Physiological Jaundice, as the liver of the Newborn starts functioning properly only by day 10 after birth, so Yellow pigmentation (Bilirubin) derived from destruction of 90 days old (senescent) Red Blood Cells is not cleared rapidly and shows as jaundice; first in eyes, then face, then chest, then over abdomen and then over extremities and finally on palms and soles. It may just require observation and holding the Newborn in Sunlight for 2 hours in Morning. However, sometimes certain blood tests (Bilirubin, CBC) and Phototherapy may be required.

Pathological Jaundice occurs when a) Mother is Rh Negative and Newborn is Rh Positive or b) Mother is 0 Rh Positive and Newborn is A or B or AB Rh Positive or c) Jaundice appears early, say, on Day 1 or Day 2 or increases (progresses) rapidly. In such cases, blood tests (S.Bilirubin, CBC, DCT) are required and Newborn requires Phototheraphy and rarely Exchange Blood Transfusion. d) Loose Motions-After taking Breast Milk , Newborn may pass stool , which is small in amount and medium in consistency , called as Gastro-Enteric Reflux. If stools are Watery (loose) and more in quantity, it may be required to get Stool tested in laboratory and treated as well. Commonly it is due to Lactose Intolerance when the Newborn is not able to digest Sugar (Lactose) in Mother’s milk or formula feed for initial few days. Generally it is self-limiting problem , rarely requires lactose free formula feeding. Loose motions may be related to Mother consuming Antibiotic , which in small quantity may pass through Breast Milk to Newborn.

10) DISCHARGE FORMALITIES AND CLEARING BILLS-Depending upon type of Delivery (Normal/ Induced Labour/ Forceps/ Vacuum/ Caesarean) and the type of Accommodation (General/Special/AC Room), your bill may vary. It may increase if hospital stay is prolonged or if New-born requires additional treatment ( e.g. Phototherapy) or if additional tests (New-born Screening Tests) are opted for, by you. It is advisable to stay for 3 days (72 hours) for Multipara and 4days (96 hours) for Primipara after Normal Delivery and 5 to 8 days after Caesarean Operation Delivery. Before Discharge ,obtain Estimate from Doctor and settle the Bill. Also ,inform Doctor if you are going to claim Bill before your Office or Health Insurance Company. Check All Relevant Documents in your file before taking discharge and preserve the File with all records for future reference.

11) FOLLOW UP VISITS AND CARE-

For Normal Delivery patient, follow up after 3-4 days after discharge. For

Caesarean Operation patients, follow up for Stitch Removed on Day 10 or as

advised.

For Neonate’s Immunization (Vaccination), refer to the” Immunization

Schedule Card” given to you.

DANGER SIGNALS FOR FOLLOW UP

FOR MOTHER- Fever, Chills, Excessive Bleeding per Vagina, Pain and Swelling

Of Episiotomy Wound, Discharge from Caesarean Wound.

FOR NEWBORN-Lethargy, Refusal of feeds, Fever ie Temp, more than 1000F

(Dangerous sign for first 3 Months), Redness and Stickiness of Eyes

(COnjunctivitis ) , Redness of navel (Umbilicus) and foul smelling discharge from

Umbilicus, Vomiting, Loose Motions, Excessive Weight Loss, Difficulty in

Breathing.