Congratulations on your pregnancy and
thank you for choosing to deliver your
special miracle at Cullman Regional Medical Center. Our goal is to exceed your expectations by providing high quality, compassionate care throughout your stay with
us.
The staff here not only wants you to have a safe and special delivery but also wants you
to feel like you are the only person that matters during your stay. Every patient has one
nurse to care for them throughout labor and delivery so it’s easy to focus on you and
your family. After you deliver, you remain in the same room and have some of the same
experienced staff care for you until you are discharged. With years of medical and nursing expertise and a warm, nurturing atmosphere in our newly refurbished rooms, we
expect your stay to be a safe and comfortable experience for you and your baby.
CRMC Maternity Center Room Amenities Include:
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New delivery beds
New infant warmer systems enclosed in custom
cabinetry
New fetal monitors
Double-recliner sofa and table that also converts into
a twin-bed for dad or guest to comfortably room in
32” Flat screen televisions and DVD players
Hairdryers for patients and caregivers
Custom cabinetry
High-end custom tile showers
New bathroom mirrors and solid-surface, Corian countertops
Schedule a tour by calling (256) 737-2200.
The content provided is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. Always seek the advice of your
physician or other qualified health provider with any questions you may
have regarding a medical condition. Reference herein to any specific commercial products, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by Cullman Regional Medical Center.
The views and opinions of authors expressed herein do not necessarily state
or reflect those of Cullman Regional Medical Center, and shall not be used
for advertising or product endorsement purposes. Cullman Regional Medical Center is not responsible for the contents of any off-site pages or links
referenced.
New Mom To Do List
4-5
Pregnancy Resources
6-7
Quit Now—Resources to Help You Quit Smoking
8
Minor Problems During Pregnancy
9
Medication List
10
When to Call the Doctor
11
Choosing a Doctor:
Pediatricians
Family Practitioners
12
13
Where to Go at CRMC to Have Your Baby
14
CRMC Maternity Center Visitation Policy
15
What To Bring to the Hospital
16
Go the Full 40 Weeks—Why it’s important
17
Labor Induction—Reasons & Process
18
Risks of Labor Induction & C-Sections
19
Your Baby’s Birth Certificate
20
Newborn Screenings
Hearing Screenings
Developmental Hearing Milestones
21
22
23
Breastfeeding Basics
24-27
Discharge from the Hospital
28
Safe Sleep For Your Baby
29
Twinkle, Twinkle Little Star
30
To help you prepare for your time with us, we have created an overview of what to
expect and what you should plan for over the next few months.
By 12th week of pregnancy, check with your insurance provider about any educational offerings they may have for you to learn about your growing baby, nutrition and feeding your baby.
For example, Blue Cross Blue Shield of Alabama has a Baby Yourself Maternity Program that
helps ensure expectant mothers and their babies receive the best possible healthcare during
pregnancy. This program is available to expectant mothers, regardless of whether or not their
pregnancy is normal or high risk.
What Services Are Provided?
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Support and educational material from a Blue Cross registered nurse, experienced in prenatal care, labor and delivery, and newborn care
A personal nurse that you can call with any questions or concerns throughout your pregnancy
Care coordination, including the arrangement of home health services when indicated, for
high-risk pregnancies
Useful gifts that support healthy habits, highlight the importance of prenatal care, and address the changes and challenges that accompany pregnancy
How Much Does it Cost?
The program may be available to you as part of your health plan at no cost.
How Can I Learn More?
Watch Baby Yourself, A Maternity Program on BrightCove Network, to learn more. You will
hear from mothers who have participated in the program, and other nurses who assist and
support participants throughout their pregnancies.
How Can I Enroll?
If you are pregnant and would like to participate in Baby Yourself Maternity Program, there
are two options.
 Enroll online
 Call toll free at 1-800-222-4379 (Monday - Friday: 7 a.m. - 6 p.m. Central)
By the 16th week of pregnancy you should have registered for CRMC’s Online Prenatal Education Class. Can’t come to class? We can come to you!
Our online childbirth class is the perfect alternative for busy parents needing a flexible class
schedule or for moms on bed rest. Have you given birth before? This online class is a great
refresher course! While an on-site childbirth class provides you with a connection to the
staff, you’ll learn the same essential information, including what’s happening to your changing body, how you’ll know when you are really in labor, helpful comfort techniques, advice
for partners, an overview of medical procedures, and much more.
Our online childbirth class will help you:
 Understand pregnancy – what’s happening to your body, discomforts, warning signs, nutrition, exercise, and more
 Learn about labor – preparing for birth, pre-labor signs, onset of labor, 3D animation of
labor process, and more
 See how the stages of labor unfold – watch amazing real-life birth stories
 Discover helpful comfort techniques – breathing, relaxation, massage, visualization, focal points, hydrotherapy, labor and pushing positions, advice for partners and more
Class Fee: $35 per registrant, $30 for WomenFirst Members, FREE for Medicaid MOMS
Your eClass registration includes:
 Online access for 90 days
 A tour of our birth center—CALL TO SCHEDULE YOUR TOUR (256) 737-2200
Call (256) 737-2200 for more information or Click here to register online
By the 20th week of pregnancy you should pre-register for your hospital stay. In order to
complete this process, you need to go Pre-Admission Testing Reception Desk, located in the
main lobby of Professional Office Building 1. You may also register online at
www.crmchospital.com/reg. The items needed to complete pre-registration include your picture ID and insurance cards; Medicaid patients also need the unborn Medicaid letter. Even if
you register online, you will need to come by Pre-Admission Testing to sign forms and bring
your ID and insurance cards, prior to giving birth. If you are under the age of 19 and not married, you must have someone with you that is 19 or older to sign as guarantor. Pre-Register
online —www.crmchospital.com/reg
Between weeks 28-36 of pregnancy you should:
 Select a doctor (Pediatrician or Family Practitioner for your baby) - click here for a list
 Buy a crib for your baby—click here for crib safety information & sleep tips
 Buy an approved infant car seat and familiarized yourself with it- click here for resources
 Packed your bag for the hospital—click here for a list of what to pack for mom & baby
If you do not have health insurance coverage, please contact the care coordinator at the
Cullman County Health Department for assistance in applying for Medicaid at
256-775-8574.
The Alabama Medicaid Maternity Care Program is designed to ensure that every pregnant
woman has access to medical care, with the goal of lowering Alabama's infant mortality rate
and improving maternal and infant health.
Prenatal Resources
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ACOG Patient Page - Resources from the American Congress of Obstetricians and Gynecologists
Birth - Resources from American Pregnancy Association
Dental Care
Diabetes and Pregnancy
Domestic Violence
Drugs and Alcohol & Preventing Birth Defects
Exercise During Pregnancy
Gestational Development
Grief Counseling
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SIDS
Miscarriages - Resources from American Pregnancy Association
HIV/AIDS
Nutrition
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Eating Right for You and Your Baby
Get a Healthy Life
Holiday Food Safety
Public Assistance
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W.I.C.
Transportation
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Medicaid Non-Emergency Transportation Program
Other Resources
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Medicaid Applications / Qualifications
Mental Health - Causes of Depression in Women
Multiples - Resources from American Pregnancy Association
Smoking Cessation - Connect to Alabama's free Tobacco Quitline!
Skin Care
Viral Hepatitis
Other Resources (continued)
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Sexual Health
Sexually Transmitted Diseases
Why at least 39 weeks is best for your baby: - From the March of Dimes
Working Mother/Workplace Issues
Delivery/Postpartum Resources
Breastfeeding
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Breastfeeding - Resources from U.S. Department of Health and Human Services Office
on Women's Health
Benefits to Breastfeeding
Breastfeeding Support Groups
Defects/Disorders
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Blood Disorders
Infant Safety
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ABCs of Sleeping Babies
Back to Sleep
Car Seat
Crib Safety
Recalls
Mental Health (PAL Line, e.g.)
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Alabama DMH/MR
Parenting Assistance Line (PAL) Line or call toll-free (866) 962-3030.
Parenting Tips
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Parenting Tips - Baby and Beyond
Infant Development
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Developmental Milestones
Text4Baby - Free text messages for new mothers
Family Planning
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Plan First Program
Family Planning Brochures and Fact Sheets
Maternity-Related Medicaid Forms
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Form 284 — To enroll children of Medicaid-eligible mothers (including SSI mothers) from birth to
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first birthday, with instructions
Form 354—Newborn Assignment Form - Mail or Fax
Form 470— Smoking Cessation for Pregnant Women and Plan First Recipients—effective 10/1/12
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Now is the time to quit smoking to help your baby get a healthy start in life. The
Alabama Medicaid Agency is here to lend a helping hand in your efforts.
Every year hundreds of babies in Alabama are born too early and too small, often
resulting in serious health problems or in some cases death. Smoking during pregnancy is a major reason babies have problems when they are born. We realize it is
hard to quit smoking, but there is help and it's free.
Helpful Resources
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Quitline - Free telephone-based counseling services
to assist you
Tabaco de Alabama Quitline en Español
AlabamaQuitNow.com - Free Internet-based counseling service
Local Smoking Cessation Programs - Support groups
of women trying to quit together
March of Dimes - Alabama Chapter
GAL - Get a Healthy Lifestyle from ADPH
Smoking Cessation Medication - List of smoking cessation medications offered
by the Medicaid Agency with dosing guidelines
If you have any other questions or concerns regarding your pregnancy, please visit
Alabama Medicaid Maternity Resources for assistance online.
NAUSEA & VOMITING / MORNING SICKNESS
Nausea and vomiting, sometimes called morning sickness, usually occur in the first 3 months
of pregnancy but can occur at any time during the day. These problems may cause low blood
sugar reactions if you cannot follow your meal plan. Call your doctor immediately if the vomiting becomes frequent. Frequent vomiting is when you get sick more than three times daily
and you are unable to keep food and liquids down for 24 hours.
 Morning sickness usually begins about the sixth week of pregnancy and gets better by the
thirteenth week.
 Morning sickness probably happens because hormone levels in your body change rapidly
during early pregnancy.
 Stress, not eating for several hours, or certain odors may trigger morning sickness.
The following suggestions will help you control nausea:
 Rest – Take more frequent rest periods or naps. Keep a slice of toast, saltine crackers,
pretzels or dry cereal at your bedside. It may help to eat something before you go to bed.
 Diet – Eat smaller, more frequent meals to avoid having an empty stomach. Avoid highly
seasoned, greasy, and fried foods. If food odors bother you select foods that are eaten
cold or at room temperature.
 Liquids – When bouts of vomiting occur, take sips of clear liquids only. As the nausea passes, increase the amount of liquids to ½ cup every hour. Some examples of clear liquid are
Jell-O, clear soft drinks (7-UP), apple juice, and broth.
You may worry about the health of your baby if morning sickness is a problem. If you are in
good health before pregnancy, your growing baby will have enough nutrients for the first
months of pregnancy.
CONSTIPATION
Constipation is common during pregnancy. If you have problems, try the following:
 Drink plenty of liquids.
 Eat high fiber foods, including whole grain breads, bran cereal, raw fruits and vegetables.
 Get plenty of exercise.
If the problem continues, talk with your doctor.
HEARTBURN
Heartburn feels like a burning sensation in the stomach or throat, an upset stomach, or a
stomach ache.
The following may help:
 Eat frequent, small meals, staying within your meal plan.
 Avoid greasy or spicy foods.
 Eat slowly, being sure to chew food well.
If heartburn persists, check with your doctor for help.
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MEDICINES
Medicines can be harmful to your baby. Do not take any medications, including those that are
nonprescription, unless your doctor approves it.
There are a number of medications that can be used safely during pregnancy and while
breastfeeding. Many of these medications you can buy over-the-counter. Please look at this
list, if you have a problem, try the listed medication first. If you do not get relief with what is
listed, please call your doctor’s office.
PROBLEM
MEDICATIONS
ACHES & PAINS
TYLENOL OR ANY BRAND OF ACETAMINOPHEN
COLDS/FLU
COUGH – ROBITUSSIN (ANY TYPE)
FEVER – TYLENOL (ACETAMINOPHEN)
CONGESTION – MUCINEX, TYLENOL COLD PRODUCTS, ZYRTEC,
CLARITIN, SUDAFED, CHLORTRIMETON, BENADRYL, ACTIFED
CONSTIPATION
STOOL SOFTENERS – MIRALAX, METAMUCIL, COLACE, CITRUCEL
LAXATIVES – MILK OF MAGNESIUM, DULCOLAX, SUPPOSITORIES
DIARRHEA
KAOPECTATE, IMODIUM-AD
HEMORRHOIDS
ANUSOL, PREPARATION-H, TUCK PADS
HEARTBURN/INDIGESTION
TUMS, ZANTAC, PRILOSEC OTC, MAALOX PLUS, MYLANTA II,
ROLAIDS, PEPCID AC, TAGAMET-HB
NAUSEA
DRAMAMINE
SLEEP
BENADRYL, DRAMAMINE, TYLENOL PM
DO NOT TAKE THE FOLLOWING MEDICATIONS
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ACCUTANE
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ADVIL OR ANY PRODUCTS WITH IBUPROFEN
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ALCOHOL
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ANTI-HYPERTENSIVES OF THE ACE INHIBITOR TYPE
ASPIRIN OR PRODUCTS WITH ASPIRIN IN IT
PEPTO-BISMOL (CONTAINS SALICYLATES)
ILLEGAL OR RECREATIONAL DRUGS
NERVE MEDICINE OR SLEEPING PILLS
TETRACYCLINE (TYPE OF ANTIBIOTIC)
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Call the doctor if:
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Rupture of membranes (water breaks) even if you
do not have contractions.
Bleeding from the vagina (like a period)
Contractions 5 minutes a part. They will not go
away when you move around. Time them for 1
hour. They should last 30-70 seconds.
When you call, the doctor on call will direct you to the appropriate place, ER or
the Maternity Center.
Numbers to call:
 If you go into labor during the day, call your doctor’s
office.
CPC OB/GYN Office: 256-736-6224 Doctors: Richard,
Sheffield, Wideman & Yarbrough
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If you go into labor at night, call the main hospital line
at 256-737-2000 to page the doctor on call.
Here is a list of Pediatricians that have medical privileges at Cullman Regional
Medical Center. The next page includes a list of Family Practitioners that also have
privileges.
PEDIATRICIANS
Mark Addison, MD, MPH
Click Here to Learn More
Brian Corliss, MD
Click Here to Learn More
Michael Lunsford, MD
Click Here to Learn More
Lisa Joines, MD
Click Here to Learn More
James Thomason, MD
Click Here to Learn More
Family Practitioners
Greg Bostick, MD
Click Here to Learn More
Walter Brumleve, MD
Click Here to Learn More
Christopher Coccia, DO
Click Here to Learn More
Angelia Elliott, MD
Click Here to Learn More
J. Rick Gober, MD
Click Here to Learn More
Joseph Johnson, MD
Click Here to Learn More
Joseph Jowers, MD
Click Here to Learn More
Mike Machen, MD
Click Here to Learn More
Tom Montgomery, MD
Click Here to Learn More
Randall Quinn, MD
Click Here to Learn More
Mike Schendel, MD
Click Here to Learn More
H. Jamie Sharpton, DO
Click Here to Learn More
Mark Tafazoli, MD
Click Here to Learn More
MATERNITY CENTER
The CRMC Maternity Center is located on the 2nd
Floor of the hospital. Elevators are located in the
Main Lobby of the hospital main floor, near the ER
Entrance. Take the elevators to the 2nd floor, go
to your right. The entrance and waiting area for
the Maternity Center is on your left.
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Click here for a printable version of the Campus
Map (pictured right)
Click here for a complete Campus Directory list
by building and floor
SCHEDULED C-SECTIONS OR INDUCTIONS
Patients scheduled for C-sections (Cesarean Sections) or Inductions, or if the doctor on call
sends you to the Maternity Center between the hours of 8 pm and 6 am, you must enter the
facility through the ER Entrance. You do not have to register in the ER, unless the doctor has
told you to be seen in the ER. Go through the ER Lobby to the Main Hospital Elevators and
take them up to the Maternity Floor as described above.
Important Reminders:
 For C-Sections: arrive 2 hours before your scheduled C-Section to allow for adequate preparation.
 For Inductions: Arrive 1 hour early
 You should have nothing to eat or drink after midnight, the night before your scheduled
delivery—C-section/Induction
Cullman Regional Medical Center is a Tobacco-Free/Smoke-Free Facility & Campus
The front doors to the hospital MAIN ENTRANCE are locked from 8 PM each evening until
6 AM each morning. The only way to enter the hospital during these hours,
is through the CRMC Emergency Room.
At CRMC, we strive to provide family-centered care; however, we must also maintain the safety of all patients in our care. Therefore, we have established the following visitation guidelines for the CRMC Maternity Services Center. This is to allow time for both mom and baby to rest and recuperate while in our care.
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Routine visiting hours for the Maternity Center are 8 am until 8 pm.
Visitors are restricted to three at a time during labor. Visitors will be permitted
to change out with one another at the discretion of the patient. No one under
12 years of age will be allowed in the delivery room until after delivery.
Two visitors are allowed during delivery.
Visitation for patients not in labor is based upon the
condition of that patient.
Visitors are not permitted to linger outside the patient
rooms or in the hallways. There is a Waiting Room located outside of the Maternity Center.
Visitors may be asked to leave the room at the nurses’
discretion depending on the patients’ condition.
Visitors with known or suspected infectious conditions
will not be admitted.
The front doors to the main entrance of the hospital are closed from 8 pm until
6 am, only admittance during these times is through the CRMC Emergency
Room Entrance.
The doors to the maternity center are locked at all times to protect the privacy
and safety of our patients. Enter the maternity center through the waiting area
near the patient elevators.
Phone calls will not be transferred to patient rooms after 9 pm unless it is
deemed an emergency.
The front doors to the hospital MAIN ENTRANCE are locked from 8 PM each evening until
6 AM each morning. The only way to enter the hospital during these hours,
is through the CRMC Emergency Room.
FOR MOM
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Chapstick
Socks
Cameras, film/memory stick, chargers, batteries, video cameras
Change for Vending Machines or Snacks for Partner
Phone numbers of people you wish to call immediately
Mouthwash, toothbrush, toothpaste
List of comfort measures you want to use (Music, iPod, rice pack, tennis ball, lotion, etc.)
Baby Book
Toiletries (shampoo, conditioner, make-up, deodorant)
Slippers and robe
2-3 nightgowns or Pajamas (button-down front or nursing gowns, if nursing). However, you
may use our hospital gowns, if you prefer.
2-3 bras (nursing bras or snug-fitting for nonnursing moms)
Panties (suitable for holding pads)
Something comfy to wear home (what you
wore at 26 weeks)
Laptop, wired for wireless (Ext. 2649 will assist
you, if needed).
FOR BABY
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Socks
Hats
Mittens
Picture Outfit & Blanket for background
Going Home Outfit & Receiving Blanket
Blankets—we provide some to use while you are here
Sleepers/Gown—wait to use these until the triple dye on the cord is dry to prevent staining
Pacifiers
Car Seat—already installed, we are not permitted to install them for you.
Boppy or other nursing pillow for breastfeeding moms
Bow or wreath for your door
Your baby needs at least a full 40 weeks of pregnancy to grow and develop. Inducing labor is
associated with increased risks, including prematurity, cesarean surgery and infection. Labor
should only be induced for medical reasons — not for convenience or scheduling concerns.
Reasons it’s important for your baby*:
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Birth a brainier baby – at 35 weeks your baby’s brain is only two-thirds the size it will be at
term
Skip an induction, which could lead to cesarean, by waiting for labor to start on its own
Recover faster from a natural birth than cesarean, which is major abdominal surgery that
causes more pain, requires a longer hospital stay and a longer recovery
Eat healthfully “for two” while indulging occasional cravings without remorse
Maximize those little lungs – babies born just 2 or more weeks early can have twice the
number of complications with breathing
Boost breastfeeding – term babies more effectively suck and swallow than babies born
earlier
Ignore people who say an induction is more convenient. Nothing is convenient about a
longer labor and increasing your risk of cesarean
Delight in those kicks and flips – marvel at the miracle of the life inside
Let your baby pick his/her birthday – if he/she decides to emerge after 37 weeks there’s no
need to try to stop your spontaneous labor
Give baby’s development the benefit of time since you may not know exactly when you
got pregnant
Relax! Babies are so much easier to care for in the womb.
* Recommendations made by the
Association of Women’s Health,
Obstetric & Neonatal Nurses
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Labor is a process that leads to the birth of a baby and usually starts on its own. Labor induction is the use of
medications or other methods to make labor begin.
Reasons for Labor Induction
Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth. Some reasons
your physician may recommend an induction of labor include:
 Your health problems—such as diabetes, high blood pressure, or heart, kidney or lung conditions
 Placental abruption (where the placenta begins to separate from the wall of the uterus before the baby is
born)
 Problems with your baby’s growth or not enough fluid around your baby inside the uterus
 Pregnancy that lasts more than 41-42 weeks
 Uterine infection
 Preeclampsia and eclampsia (high blood pressure, swelling, abnormal lab work)
 Premature rupture of membranes
 Death of the baby
 In special situations, labor is induced for non-medical reasons. This is called elective induction. If elective
induction is being considered, you should be aware that there are possible risks. Some have to do with
the baby being born too early. Elective induction should not occur before 39 weeks of pregnancy.
How is Labor Induced?
There are several ways to start labor if it has not started naturally. Factors to consider in the
choice used depend on your condition and the methods your doctor prefers. Sometimes
more than one method may be used together.
Ripening the Cervix
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor. Medications or devices may be used to soften the cervix so it will stretch (dilate) for labor. Whether the medication
is taken by mouth or inserted into the vagina, the desired response is for the cervix to soften and dilate for
labor to progress.
“Stripping the Membranes”
“Stripping the membranes” is another method used to start labor. Your doctor sweeps a gloved finger over
the thin membranes that connect the amniotic sac to the wall of your uterus. This action may cause your
body to release prostaglandins, which soften the cervix and may cause contractions.
Rupturing the Amniotic Sac
“Bag of waters” is another term used for the amniotic sac. If the sac is not already broken, your labor has not
started on its own, so rupturing the amniotic sac can start contractions. It also can make them stronger if
they have already begun. Your doctor makes a small hole in the amniotic sac with a special tool. This procedure, called an amniotomy, may cause some discomfort. Amniotomy is done to start labor when the cervix is
dilated and thinned and the baby’s head has moved down into the pelvis. Most women go into labor within
hours after their water breaks.
Oxytocin
Oxytocin is a hormone that causes contractions of the uterus. It can be used to start labor or to speed up labor that began on its own. Oxytocin is given through an IV in the arm. A pump hooked up to the IV controls
the amount given. Contractions usually start in about 30 minutes. Your condition, your contractions, and the
baby’s heart rate will be monitored when you are given this medication.
Problems can occur with both cervical ripening and labor induction. With some methods, the
uterus can be over stimulated, causing it to contract too frequently. Too many contractions
may lead to changes in the fetal heart rate, umbilical cord problems, and placental abruption.
Other risks of cervical ripening and labor induction include the following:
 Infection in the mother or baby
 Uterine rupture
 Increased risk of cesarean birth
 Fetal death
Medical problems that were present before pregnancy or occurred during pregnancy may contribute
to these complications.
What if it doesn’t work?
A failed attempt at induction may mean that you will have a cesarean delivery. The chance of
having a cesarean delivery is greatly increased for first-time mothers who have induction, especially if the cervix is not ready for labor.
Risks of Cesarean Deliveries (C-Sections)
Cesarean deliveries pose additional risks for the mother and baby including breathing problems for your baby or you could develop infection or bleeding from your surgery. There could
also be complications for future pregnancies, such as problems with the placenta. The recovery time for a cesarean delivery usually is longer than that for a vaginal delivery.
The key point to remember is that labor induction is sometimes necessary to protect the
health of both mom and baby. You and your doctor should weigh the risks and benefits of
labor induction compared with the risks and benefits of continuing the pregnancy.
Understanding the risks and benefits allows you and your doctor
to make the best choice for you and your baby.
Information and recommendations provided by the American College of Obstetricians & Gynecologists.
A member of the CRMC nursery staff will visit you after your baby is born to ask specific questions pertaining to the birth certificate and the option of filing for a social security number for
your child.
By stating on the birth certificate that you want a social security number issued for the child,
the Social Security Administration will issue a Social Security Card for your child within a few
weeks. It will be sent to the mailing address you provide on the birth certificate. After the
birth certificate worksheet is completed, you will be given the appropriate papers to obtain a
copy of your child’s birth certificate. You may purchase a copy through any County Health Department in Alabama or you may obtain a certified copy of the birth certificate by writing to
the Center for Health Statistics, at P.O. Box 5625, Montgomery, AL, 36103-5625. A copy may
also be ordered online through the Alabama Department of Public Health website at
www.adph.org.
Paternity Acknowledgement
Paternity Acknowledgement means the father acknowledges he
is the father of the child. It also initiates a parent-child relationship with legal responsibilities. If the parents are not married,
paternity papers may be filled out. Both parents must be present and provide photo identification in order to have the father’s name put on the birth certificate, as well as the father’s
employment information and any health insurance he may carry. If both the mother and father do not sign the Paternity
Acknowledgement Form, the baby will have the mother’s legal
last name and the father’s name and information will not be included on the child’s birth certificate.
Naming Your Child
Naming your child is an important decision for both you and your child. You may give your
child any name you wish. Be sure the child’s name is entered on the birth certificate exactly
as you want it. Since the birth certificate is a legal document, a court action may be required
to change the child’s name. Once the record has been filed, any corrections, such as misspellings or omission, must be made through the Center for Health Statistics, P.O. Box 5625, Montgomery, AL 36103-5625.
Information for Parents — What You Should Know About Newborn Screening
The newborn screen is a blood test for more than forty disorders including some secondary
conditions and requires only five drops of blood from a baby's heel. In Alabama, it also includes screenings for hearing loss and critical congenital heart disease. These tests are required by the State of Alabama, and all babies should have a newborn screening before leaving the hospital.
Newborns can still have a disorder even though they may look healthy. A baby has a greater
chance for healthy growth and development if a disorder is found early. Early diagnosis may
reduce morbidity, premature death, mental retardation and other developmental disabilities. Parents are notified, usually by their baby's doctor, if a screen is positive for a particular
disorder. A positive screen does not necessarily mean that a baby is sick. Additional testing
may need to be completed to confirm a disorder.
Please give the hospital your correct address, phone number, and name of the doctor who
will take care of your baby to make sure you are notified of any abnormal results. Ask about
your baby's newborn screening results at the first doctor visit. If your baby's doctor asks you
to return for a repeat test please do so as soon as possible so your baby can get appropriate
treatment and follow-up care if needed.
Additional Screening Resources
The information provided by the following resources is provided as an educational resource for parents and
should not be considered medical advice. Please contact a medical provider for further guidance.
Alabama Newborn Screening Timeline
Baby's First Test: Newborn Screening
Baby's First Test: Critical Congenital Heart Disease
Delivering You The Facts: Four Things You Should Know About Newborn Screening
March of Dimes Newborn Screening Information
March of Dimes - A Parent's Guide to Newborn Screening Video
Newborn Screening Frequently Asked Questions
Save Babies Through Screening Foundation: One Foot at a Time
Texas Pulse Oximetry Project: Importance of CCHD Newborn Screening
Video
Resources for Parents if a Disorder is Detected through Screening
Children's Rehabilitation Service
Cystic Fibrosis Foundation
FODSupport.org
National PKU News
National Urea Cycle Disorders Foundation
Organic Acidemia Association
Sickle Cell Disease Association of America, Inc.
The infant hearing screening is a simple, painless test that will be performed prior to discharge to determine if your baby has any hearing issues. Please inform your nurse if you wish to decline this test.
Alabama's Listening! Universal Newborn Hearing Screening
Alabama's Listening! Is the Early Hearing Detection and Intervention
Program (EHDI) for the Alabama Department of Public Health.
Every Baby Should Have a Hearing Screening
Statistics show that between four to six newborns per 1,000 have some degree of hearing loss. Although these statistics indicate that it is unlikely that your baby will have a hearing loss, if there is one, it is important
that you know about it as soon as possible.
The first two years of your baby's life are critical for learning speech and language. Because a hearing loss
could affect your baby's speech and language development, it is important to diagnose hearing problems early.
Hearing Screening Methods
There are two types of hearing tests that may be used with your baby. Both tests are very safe, take only
minutes to perform, and are non-invasive. Most babies sleep though the hearing screening procedure.
 Auditory Brainstem Response (ABR): Tests the infant's ability to hear soft sounds through miniature earphones. Electrodes measure your baby's brain-wave to determine if the sounds are heard normally.
 Otoacoustic Emissions (OAE): Measures inner ear function by inserting a miniature microphone in the ear
canal via a soft probe tip and measuring tones from the ear by sending responses to a special computer.
Hearing Screening Results
If your baby does not pass the first screen an attempt may be made to repeat the screening before your baby
goes home, or it may be scheduled after going home. Although a small percentage of babies who do not pass
the first screening actually do not have a hearing loss, it is important to find out for sure. If your baby does
not pass the second screening, different types of hearing tests administered by an audiologist will be recommended.
Because early intervention is so important to the development of infants with hearing loss, it is important
that the testing not be delayed. It is recommended that all testing be completed by three months of age and
that infants with hearing loss be involved in an intervention program as early as possible, but no later than six
months of age. Your audiologist and/or physician can provide you with information on early intervention programs in your area, or you may call 1-800-543-3098.
Hearing Loss: New Online Directory for Parents
Early Hearing Detection & Intervention Pediatric Audiology Links to Services (EHDI-PALS) is a new easy-to-use online directory that helps families
find the nearest clinic providing the type of hearing service their child needs. Visit EHDI-PALS for more information.
Retesting May Be Needed
The results of the screening show how your baby is hearing at the time of the test. Some children with recurrent ear infections and other serious infections, chronic illness or family history of hearing loss may develop
hearing loss later in life. If you have concerns about your child's hearing ability or speech and language development, you may have your child's hearing tested at any age.
Use this as a guide to see how your child is growing and learning. Information provided by
the Alabama Department of Public Health.
Birth to three months:
 Jumps or blinks to loud sounds
 Wakes up to loud sounds
 Quiets when he or she hears mom's voice
Three months to six months:
 Turns eyes or head to search for the sound source
 Responds to your voice even when you cannot be seen
 Enjoys toys that make sounds
 Starts babbling
At six months:
 Responds to his or her name
 Turns head to the direction of the sound source
 Begins to imitate speech sounds
At 10 to 12 months:
 Understands and follows simple directions
 Gives a block or toy to you when asked for it without
pointing
 Imitates speech sounds of others
At 13 to 18 months:
 Follows simple one step directions
 Uses 3-20 single words
 Points to 1-3 body parts when asked
At 19 to 24 months:
 Understands approximately 300 words
 Puts two words together ("eat cookie") by 24 months of age
 Points to five body parts
 Responds to "yes" or "no" questions
The Developmental Milestones in Hearing above describes normal development for speech
and hearing. If you have concerns about your baby's hearing, speech or language development, you should contact your baby's doctor or an audiologist.
Breastfeeding is the healthiest, most natural way to feed your baby. Each mother's breast milk is uniquely
formulated for her own baby and is full of infection-fighting cells and protein that will help keep a baby both
happy and healthy. Breastfeeding can be enjoyable for both of you. It can take some practice at first, but
there are many, many reasons to give breastfeeding your best effort.
Why Breast Is Best: The Benefits for Baby
The American Academy of Pediatrics recommends that mothers breastfeed
their babies for at least the first year of life, and exclusively for the first six
months. There are good reasons for such a strong policy statement. Breastfed
children are less likely to have ear infections, allergies, vomiting, diarrhea,
pneumonia, juvenile diabetes, and meningitis. New data also suggest that
breast milk enhances your baby's brain growth. Breast milk is easier for babies to digest than formula, cow's
milk, or goat's milk. It contains all the right minerals and the right balance of nutrients. And breast milk is
convenient: It's free, and it's always ready when your baby is hungry, with no preparation involved. The
health benefits continue for as long as a mother and her baby want to keep breastfeeding.
The Benefits for Mom
Breastfeeding provides definite health benefits for you as well as your baby. Besides being an ideal way to
closely bond with your new child, nursing helps stimulate hormones that shrink your uterus back to its prepregnancy size. According to some studies, women who breastfeed are 50 percent less likely to get premenopausal breast cancer, and are at lowered risk for ovarian cancer and osteoporosis as well.
Breastfeeding also helps you lose weight after pregnancy because it uses up the special kind of fat you put on
with pregnancy before it becomes an established part of your body shape. Nursing helps you lose that weight
at exactly the right pace. You don't want to lose too much weight right after giving birth, though. Nursing
women need an extra 5 to 10 pounds over their pre-pregnancy weight to keep their body healthy while they
nourish their child. If you lose weight too rapidly, it could hurt your milk supply when your baby has a growth
spurt and needs to eat more. Those extra pounds will slip away naturally over the first six months.
What to Expect at First
Your breast milk will come in a few days after your baby is born. Until then, your breasts will be busy producing colostrum for your baby to drink instead. This thick, yellowish substance is full of protein and antibodies
that will help your baby fight off diseases. Colostrum is intended to be your baby's very first food and his first
"immunization" against diseases. He has lots of stored water and fat to use while he takes in this precious
material. His tummy can only hold a teaspoon of liquid at this age, so he doesn't need a lot to fill it.
Your body was made for breastfeeding, and your baby was made to nurse, but that doesn't mean you won't
need a little help to get started. While you're still in the hospital, someone should help you put your baby to
your breast as soon as possible, help your baby latch onto your nipple, and show you how to tell when he's
nursing correctly. Ideally, breastfeeding right after delivery helps get things started. If you still need help after
you go home, ask the staff at the hospital whether they can recommend any resources. Lactation services,
the hospital itself, and health care offices are good sources of help. Everyone needs some help, and even very
experienced moms will encounter special issues.
Before your milk comes in fully, your newborn may start nursing every hour for the first day or two of life.
This helps your body create a good milk supply, one perfectly tailored to your baby's needs. In just two to
four days, your body will adjust itself to this "information," and your baby will need to nurse less often, about
every two to three hours, or 8 to 12 times in a 24-hour period.
Establishing a Good Milk Supply
When you are nursing, your good nutrition, plenty of fluids, and rest are all essential. Sleep when the baby sleeps, and drink plenty of healthy liquids. Milk, water,
and juice are all good options. Relax. Get rid of unessential tasks, disruptive people, and pressure and focus on you and your baby.
You will need to maintain a basic healthy diet to keep up your breast milk production, but you don't need anything fancy. Some breastfeeding babies are quite sensitive to certain things in their mother's diet, but most do well no matter what
Mom eats. If your baby seems fussy after you've had a spicy meal, that may be the
problem. But in general, nursing mothers can eat whatever they wish, as long as
it's healthy.
Vegetarian mothers who breastfeed need to make extra sure they're getting
enough vitamins and minerals in their diet. Your health care provider will be able
to refer you to a nutritionist or dietician who can help you plan a menu if you feel uncertain. Three healthy
meals and two snacks will help you feel better and maintain a good milk supply.
Sucking is very soothing to babies. But keep in mind that if you give your baby a pacifier in the early weeks,
she may eat less at your breast, which will in turn affect your milk supply. Several recent studies have shown
that early pacifier use can interfere with the success of breastfeeding. So it's a good idea to hold off on a pacifier until your milk supply is well established, which generally happens by the end of the first month. Try
swaddling your baby so her hands are close to her mouth instead. That way she can soothe herself by sucking
on her hands, as she did in the womb.
Bottle Strategies
If you want your baby to try a bottle, start at 2 to 4 weeks at the earliest. But
don't be surprised if at first your baby refuses to take a bottle of expressed
breast milk. A breastfed baby simply knows better than to take breast milk
from a bottle when Mom is right there. He can smell his mother and knows the
routine. You will probably have better luck if you have Dad or the babysitter
offer a bottle of expressed breast milk without you there.
If you start to add formula to a breastfeeding baby's diet, your milk supply will
diminish by the amount of formula you give your baby. It's certainly up to you, but think twice about introducing formula once your milk supply is established. Whatever you decide, be confident that any amount of
breast milk is better than none as far as protecting your baby's health goes.
When to Feed Your Baby
Feed your hungry newborn on demand; that is, whenever she wants to eat. She won't eat much at any one
feeding in the first days since her stomach is so small, but she'll want to nurse often. Most newborns will
need about 10 to 12 feedings in a 24-hour period, or one feeding every one to three hours.
When establishing your milk supply, wake your baby up to feed if she sleeps more than three hours during
the day or four hours during the night. Otherwise she'll wake up too hungry to feed well. When things get up
and running, she'll wake you up as she needs to.
How do you know your newborn is hungry?
Look for signs such as:
 Rooting reflex (opens her mouth and turns her head to where she
thinks your breast might be)
 Nuzzling at your breast
 Making sucking motions or putting her hands in her mouth
 Crying (a late sign of hunger—you don't need to wait for howling)
Breast milk is all a baby needs by way of nutrition until she's about 4 to
6 months. That's when the AAP recommends introducing a baby to solid foods to supplement her diet. She'll
continue to get most of her nutrition from breast milk (or formula), however, until she's 1 year old.
How Much Is Enough?
Like lots of breastfeeding mothers, you might not be sure when your baby has had enough to eat. You will
know he is getting something if you can hear him swallowing as he nurses. Another clue is how well
your baby sleeps after a meal. If his tummy is full and his diaper is clean, he will probably fall right back
asleep after feeding.
Other signs your newborn is getting enough to eat:
 He produces about six wet diapers every day after your milk comes in and between two and five loose,
yellowish stools each day until he's 6 weeks old. Some babies are such efficient breast milk processors
that they pass stools very infrequently.
 His urine is a pale yellow, not deep yellow or orange.
 Your breasts feel soft and "empty" after each feeding.
During the first week of life, it's expected that a baby will lose several ounces, up to 10 percent of
his birth weight. After the first week, however, your baby should be steadily gaining, and should at least be
back at his birth weight by the end of the second week. By the third week his face should be rounding out as
well. Your health care provider will weigh your baby at each visit.
If your baby doesn't seem to be thriving or gaining weight, or you're worried about any signs that he's not
getting enough, contact your health care provider.
How Much Is Not Enough?
Occasionally you may feel that your baby isn't getting enough milk. Your baby may seem hungry after a prolonged feeding, and yet you feel "empty." This is nature's way of making your milk supply keep up with your
baby's growth spurts. This is the way the system works.
To help you increase your milk production when this happens, nurse frequently as your baby demands. You
also need to drink more fluids and get enough rest. This may mean that for a day or two, you have to divert
more time to nursing and resting yourself than to your other activities. Be assured that your baby is fine as
long as she feeds vigorously and continues to urinate and stool normally as suggested above. Your increased
milk supply will meet her adjusted need.
It takes about 36 to 48 hours for your body to adjust to your baby's increased needs. It's your baby's job to
nurse frequently enough to give your body the right signals. So let her do her job. If you give her a bottle,
she'll get lazy on the job, and your body won't get the "increase" order.
All nursing mothers go through brief periods where supply doesn't meet demand. Nature's way of meeting
this increased demand is for the baby to nurse. Relax and enjoy these natural rhythms.
Milk on the Go
If you're going back to work, you can still breastfeed your baby by pumping
milk at work once or twice each day and bringing the milk home for the
next day's lunch. And we recommend that you do. It's one way to feel very
close even when you have to be away. Nursing frequently in the evening
and at night will keep up your milk supply and can give you the special
closeness to your baby that you may have missed while at work. Nighttime
nursing is even more effective than nursing during the day, so you may
want to nurse more at night, even longer than your baby needs it, in order
to maintain a strong milk supply.
There are several ways to express your breast milk: by hand, with a hand
pump, or with a motorized electric pump. Renting an electric pump for a
few months may produce the best results.
You can leave expressed breast milk at room temperature for about six to
eight hours, or in the refrigerator or a cooler for 3 to 5 days, if you need to,
since it contains natural preservatives. You can also freeze breast milk for
future use. It wilt lose some of its disease-fighting properties, but even after freezing, it still contains the best
balance of nutrients for your baby. Thaw frozen milk by setting it out at room temperature or running it under warm water. Once unfrozen, do not refreeze.
Stored milk should be gently shaken, as the fat will have separated and risen to the top. Mix it up for an even
meal and an easy flow through the nipple.
Be sure your workplace has a clean, private, relaxing place for you to express your milk. It will make a lot of
difference in your attitude and your success. If such a place isn't made available, speak up. Many employers
are willing to help out if you let them know what's needed for you and the other nursing women at your
workplace. There is a real financial payoff for employers who help out: less absenteeism for parents who are
at work (because of fewer days spent at home with sick kids), higher employee satisfaction, and better retention, too. There've been a lot of studies to show these benefits to businesses.
CRMC Breastfeeding Helpline: (256) 737-2217
Call and leave a message. One of our nurses will get back with you as quickly as possible.
Additional Baby Resources
Pampers.com—Provides helpful tips from Pregnancy through Preschool including potty training, taming fits,
coping with crying, feeling depressed, and so much more.
BabyCenter.com— another general, all around resource for moms and moms-to-be
Time to Go Home
On the day you are to go home, your physician will discharge you and your baby’s physician
will discharge your baby. Lab work may be ordered and drawn prior to discharge. If you have
not talked with a representative from the CRMC Business Office prior to your day of discharge,
you should notify your nurse so that arrangements can be made regarding any paperwork
that needs to be completed or co-payments needed before you go home.
What Time Will I Be Discharged?
Discharge time will vary according to the time you delivered your baby, completion of tests
ordered by your physician or depending on the timing of the rounding of your or your baby’s
physician. Generally your baby will stay in the hospital for a minimum of 48 hours prior to discharge.
Discharge Prescriptions for Mom
CRMC is happy to have two pharmacies located conveniently on the CRMC Campus . These
pharmacies are happy to fill your prescriptions prior to your discharge, if you desire.
 Professional Office Building 2: Cullman Internal Medicine Pharmacy, 3rd Floor
Hours of Operation: Monday - Friday, 8 am - 5 pm
Phone number: (256) 737-8021

Professional Office Building 3: Express Meds Pharmacy, Ground Floor
Hours of Operation: Monday—Friday, 8:30 am—5:30 pm (closed for lunch 12:45 -1:15 pm daily)
Phone Number: (256) 255-1142
Going Home
After both you and your baby have been discharged, the nursery nurse
and the maternity nurse will give you final instruction regarding your
care and the care of your baby. You must have the baby’s car seat
brought to your room prior to discharge. A cart and wheelchair will be
brought to your room to help you get your belongings to your vehicle.
After everything is packed, you and your baby will be discharged by
wheelchair to your car. Please be sure to read the instructions and understand how to use your baby’s car seat prior to your hospital stay.
Alabama State Law requires that you provide an approved infant car
seat for your baby.
Resources for Breastfeeding Moms


CRMC Breastfeeding Helpline: (256) 737-2217
Our Certified Lactation Counselor is here to help new breastfeeding moms with any
questions or problems they have along the way.
Breast Pump Rental: Borden Family Pharmacy (3190 AL Highway 157, Cullman, AL 35058)
(256) 734-7535
ABC's of Sleeping Babies
What is the safest way for your baby to sleep? Babies sleep safest when... they sleep alone on
their back in an uncluttered crib or other safe sleep surface. Follow these simple "ABC's of
Sleeping Babies" for guidance:
Alone
The Alabama Department of Public Health (ADPH), along with the
American Academy of Pediatrics (AAP), recommend that your baby
sleep in the same room where you sleep but not in the same bed
(room-sharing without bed-sharing).
Back
 Unless otherwise instructed by a pediatrician, an infant should always sleep on its back.
 An infant sleeping on its side or stomach faces increased risk of Sudden Unexplained Infant
Death (SIDS/SUID).
 Infants should sleep without the aid of wedges and cushions.
Crib
 Railings should be no more than 2 3/8 inches apart - tight enough that a soda can will not
fit through them.
 The mattress should be firm and covered with a tight, fitted sheet.
 Keep your baby's crib clutter-free - no quilts, duvets, bumper pads, stuffed animals, etc.
Waterbeds, futons, recliners and sofas are not acceptable substitutes for a crib.
Other tips:
 Breastfeed your baby if possible – studies show that breastfeeding your baby can help reduce the risk of SIDS.
 Schedule and go to all well-child visits – your baby will receive important immunizations.
Recent evidence suggests that immunizations may have a protective effect against SIDS.
 Keep your baby away from smokers and places where people smoke.
 Do not let your baby get too hot. Room temperature is recommended to be between 6772 degrees F.
 Offer a pacifier at nap times and bedtime – This helps to reduce the risk of SIDS. If you are
breastfeeding, wait until breastfeeding is going well before offering a pacifier. This usually
takes 3 to 4 weeks. It’s OK if your baby doesn’t want to use a pacifier. You can try offering
a pacifier again, but some babies don’t like to use pacifiers.
For more information on preventing infant sleep-related deaths, please view the following
sites: CDC-Sudden Infant Death (SIDS), AAP Guidelines, and First Candle.