Silent Knowledge

Things to know about: Circumcisions 

• Most parents think that when their baby gets a circumcision/circ, it will be easier for you to do the photo session the next day. It's actually the opposite- when a baby gets a circ, they are going to be really sleepy afterward and it's actually the perfect time to do a session. The baby is often given a local anesthetic when a circumcision is performed and will most likely sleep for quite some time afterwards. Since an anesthetic was given, you can handle the baby without worrying about causing pain.

• If the parents ask you to come back the next day because the baby is getting a circ/just got one, explain that it is actually better that you do the session today since the baby will be sleepy for a while and will more than likely be fussy the next day.

• Be mindful that if the baby just had a circ the nurses will be doing 15min checks on the circ site. You must be respectful and let this happen, regardless of what your doing. If you time your session right you can get the whole session done before the next check.

• You can do all the poses with a circ baby, but it is best to have an extra dip to place the baby in so that their feet are extra tucked on a belly down pose. If the baby seems extra stressed while you're handling and you can't get them to settle down, casually ask about the last diaper change because even a slightly wet diaper irritates them.

Things to know about: Cesarean Sections

• A C/S is a very common surgical procedure during labor where an incision is made in the abdominal wall and uterus to remove the baby.

• There are many different reasons for a c/s- elective, medically indicated, and emergency.

• Typical hospital stay is 3-4 days for a woman who as a C/S

• Recovery time is a minimum of 6 weeks.

Posing with C-Section Patients

• • There are certain poses that we should be mindful of when we have a c/s moms.

  • Try to bring the baby to her in bed- most of the time, it is still incredibly painful to ask mom to walk to you and/or sit on the couch/chair.

  • Some patients wear an abdominal binder after surgery and it makes it hard to breathe and/or move.

  • It's always good to give mom a rundown of how the session will go (we typically always do anyway) With a c/s mom I like to save family photos and singles for mom at the very end so that she can enjoy watching me with the posed and fresh 48's before preparing her at the end.

Things to know about: Magnesium

• What is magnesium (mag)? Mag is given to moms who are at risk for seizures due to preeclampsia.

• How does Mag affect the mom and make her feel? Most of the time, magnesium will make the mom feel really out of it. It can cause flu-like symptoms and mom may not feel up for a session.

• Can we do a session when Mom is on mag? This is when solid communication from your nursing staff is helpful. Communicate with your nurses and see how mom is feeling- if she seems to be taking the mag okay, you can check in with her. If she is not, check in the next day.

Things to know about: Blood Sugars

• When a baby has low blood sugar, the baby will need to stay warm (i.e skin to skin or swaddled) and eat a lot more than a typical newborn. Low blood sugars can be caused by many things and typically resolves itself within a few hours or days. For babies that have low blood sugar, we want to postpone our session until the baby's sugar is testing within normal limits. Since the baby needs to stay bundled up and eating, we do not want to impede that process with a photo session where we will be unwrapping and moving baby quite a bit.

• This is a situation where you need to keep in communication with your nurses as to when you may be able to do a session.

Things to know about: Bilirubin Lights

• When a baby has high levels of bilirubin, they will need to undergo phototherapy. The bilirubin lights work at a specific wavelength that helps to break down the bilirubin in the body. Baby will need to stay under these lights until directed otherwise by their care team.

• Under no circumstance do we photograph a baby when the baby is doing phototherapy. When the baby has completed treatment, you can perform a session. Do not ask the parents to remove the baby from phototherapy for you to complete a session.

• You may also hear bili lights referred to as glow lights, glow worm, lights, or light therapy.

Things to know about: Premies

• Find a nurse to ask about how to best handle the baby during session (are there wires, monitors, feeding tubes) we can photograph all attached but most of the time parents won't want to

• Inquire how long baby is in the nicu, will they qualify for a nicu chronicle

• Best cart set up: You can layer extra blankets, or baby blankets around feet to hide wires. Really try to focus more on lifestyle and fresh48. Premies really love to curl up, so belly posing is the way to go when doing posed- just remember to keep hand under head and have enough support for their size.

• Premie babies tend to be around 4-5lbs, they have a tough time controlling their temperature so keeping them swaddled/wrapped with a lot of fresh 48's will help.

Things to know about: Breech Babies

• Ideally, when babies are born, they come out head first. When a baby is breech, it means that they are coming out either feet or bottom first.

• After breech babies are born, their legs will either stay up (ankles by their ears) or in a 'frog leg' position. Sometimes it resolves within a few weeks and sometimes a cast system is used.

How do you photograph babies who were born breech?

• Depending on the severity, you may need to focus more on fresh48 images in the bassinet or lifestyle images with the family holding the baby. Properly executing posed photos may be more of a safety concern.

• Leaving baby wrapped/swaddled will help with the legs

• Belly down posing is perfect for breech babies

Things to know about: Substance-exposed newborns/newborns with opioid withdrawal

• Always check with the nurse and mom before handling the baby. These babies stress easily and it can take a while to calm them back down. You can ask the nurse/mom about feeding schedules as it may be easier to do the session after a recent feed.

• Substance-exposed newborns may have tremors, cry excessively, or be easily startled. This is common and temporary with substance-exposed newborns. It is tough and emotional for parents to witness their infant's withdrawal and to care for these infants.

• These babies will stay in the hospital for 5 days. It may be easier to schedule a session on day 1 of life (before symptoms typically increase) or day 4 (when most symptoms will have resolved).

• Best poses: swaddled, Fresh 48's, Skin to skin with mom

Things to know about: Broken Bones

• The most common orthopedic injury sustained during labor is a clavicle fracture (broken collar bone). Treatment for this injury requires the baby's arm to be strapped down to their chest for a few weeks. Photographing babies with orthopedic injuries can be very limiting and difficult- but not impossible.

• Try not to move the baby too much as they are in a lot of pain- if the baby is in the bassinet, stay there and capture what you can. If parents are holding a baby, focus on that. Work around the baby and capture what you can instead of overdirecting the parents with specific poses. This is still a special time that the parents should be able to capture, but work with the unique situation instead of making it more stressful for the parents.

Things to know about: Medical Lines

• IV's are typically hidden in a little cast, you can handle this baby as you would one with broken bones. Stick to parents holding them, fresh 48's, and carefully placed in basket on the floor

Things to know about: Trauma Survivors

What is Trauma?

• Sexual molestation and assault; childhood, adolescence, or adulthood

• Domestic or street violence

• Human trafficking

• Child maltreatment

• Emotional, verbal or physical abuse

For patients that have gone through trauma, we strive to be as respectful and understanding as possible. When it comes to healthcare, patients may experience: social stigma, fear of loss of children, fear of judgement, mistrust of healthcare providers​, denial or anger. While we wont always be aware if the patient has experienced trauma since we are not their medical providers, it is still our duty to be mindful of every room we walk into.

Words of Mothers:

"Always be encouraging/positive"​

"Don't judge me- we can tell what you think"​

"Inform me, but don't lecture me- most of what your telling me I already know"​

"Make me a part of the process"​

Never underestimate the value of small things, as they can weigh heavily on the success of the photographer-patient relationship.​

Understand that depending on the type of trauma sustained, the patient may present with certain behaviors during a photo session:

• Triggers from childbirth leading to PTSD symptoms (legs positioned, invasive vaginal checks, people in authoritative positions having control over them and their body {presumed}).

• Breastfeeding- exposing breasts, sensations, feelings of being at the baby's will may impact bonding​

• May have a hard time connecting with baby and may not want to be involved in photos. Or the opposite- may be very overprotective of baby and won't be comfortable putting baby down or letting someone else handle baby

Opportunities for empowerment:

• Remember that mom needs to be empowered- help her have the control.

• Ask about baby- 'who is this? Did you know you were having a boy/girl? Tell me about him- does he like to be swaddled? I see he loves his hands, huh?" Make that connection with her.

• Keep the conversation open and light: "Did you get to sleep a bit or did little one keep you up all night? Tell me about how you picked their name, etc"

Things to know about: LGBTQ+ Community

• This is something we should be very respectful about- not just as photographers, but as humans. When a patient has a pronoun they prefer to use- it is not optional to use it- be respectful, please.

• Avoid assuming- when you walk into a room, as innocent as it may be- try to avoid saying, 'hi mama'/'hi dad'

• When you are unsure please say something like, "Who do you have with you today?"

Things to know about: Extra Digits

• It is not uncommon that a baby is born with an extra finger or toe.

• They will vary in size, but rarely will they be fully developed and most of the time they will be surgically removed before discharge.

• Parents will express whether it bothers them or not. If it does not, proceed as normal with detail shots. If it is something that they don't want visible in photos, respect that and hide the digit the best you can.

Things to know about: Cleft Lip

• This is usually an incredibly emotional time for parents, if this information is on the census check with the nurse before coming in as a precaution.

• Take all the photos, don't shy away. A lot of times moms want these photos as a keepsake before their corrective surgery.

• Calming cleft baby: Often their palette is too high for a pacifier to so it is best to utilize mom and dad to help soothe. You can see if the parents are ok with wearing a glove to use their finger for babies to suck on.

Things to know about: Symbrachydactyly/ Missing Limbs

• Symbrachydactyly is a rare congenital hand condition in which a child is born with abnormally short fingers that may be webbed, misshaped or missing.

• If a baby has missing limbs, it is okay if the parents prefer to keep mittens/socks on or keep baby swaddled. Work with the parents comfortability.

• Parents may have known, or it may have come as a surprise. Be mindful either way. Parents may still be processing the new discovery.