3.29.2007

Silas Adrian Bloch hit the nail on the head...


Silas was born exactly on his due date Tuesday the 27th. He was even kind enough to give us time to get to the hospital and to be born during the day-- a rarity indeed. Although i had about 10 days of pre-labor contractions, including a full-day Monday of what we thought was the early part of the real thing-- once my labor started for real around 10:30 am Tuesday-- things moved fairly quickly.


I had sent JT to work on Tuesday morning after nothing came of being home with me Monday. I kept him updated on my status and after finding an acupuncturist to squeeze me in later that day to try to induce labor, i called our doula Pam and JT around noon and told them to head over. It was an ideal Henry-care situation because he was already at Brenda's and Tiffany was primed and ready to pick him up that evening. JT, Pam and i all went to the hospital where OB triage was absolutely crazy. They bumped another woman so that i could get a labor and delivery room. I wasn't able to use the birthing center because it was soo nutty but the midwife i had seen the most was on-call and with me for most of the labor and birth.


It was so strange to be at the hospital when things weren't crucial and i kept fully expecting to be sent home until just about the time i was ready to push. The whole thing was a little longer and probably a bit harder than last time just because Silas was quite a bit bigger. Needless to say we were very happy when he was born and now we can get on with recovery and re-entering the tired world of newborn care.


We were able to come home last night around 7-- we left after 24 hours. Silas definitely sleeps more in the day than at night which we'll have to work on, but at least no one is mopping my floors when he IS asleep.


My parents come in tonight so we'll have lots of extra hands and love for Henry. So far he's seemed bemused by the baby and interested in a sweet way but not overly concerned. JT took him to daycare today, but he'll be home with us and Gran and Nonna for the next week.

3.27.2007

Handling Uncertainty

My mom said yesterday that they always tell you not to compare you're children and this was Silas' way of letting us know not to compare him to Henry from the get-go. I seemed to be in "early labor" all day yesterday. I had contractions basically until about 10 or 11 pm and at times they got steadily more intense and regular (every 2-3 minutes apart when we were walking). Then phhtt. Nothing. The upside is i went to sleep around 11:30 and slept pretty much all night.

The plan is for me to call the midwife today and see if i can go into the birthing center and have them try their "natural inducers." If anything seems to take, i'll have JT come up and join me. I really thought we were going to have a baby (or at least be in the hospital by now) so this is just a little bit frustrating.

I had a dream that after Henry's labor they installed a "time-release valve" and once the Doctors remembered that they told me it could be adjusted and i'd have the baby in no time. Boy was i sad when i woke up and that was just a dream!

3.26.2007

Quick Update

It seems pretty clear that Silas is taking a very different approach to being born than Henry did. Henry's labor started and moved like a lightening bolt straight to birth in 4 hours. This one has been teasing me with regular but not-strong contractions all week. This morning i had a non-stress test and was having strong contractions every 4-5 minutes. They sent me to OB triage where they determined that i had dilated more (thank heavens) but by the time i got there my contractions had all but stopped. They sent me home.

We got Henry off to daycare and JT didn't go to work so now we're off to do a lot of walking and see if we can get this labor moving. Hopefully we'll have a little one that decides to make his entrance today-- perhaps even during daytime hours-- but that may be too much to ask for.

We'll keep you updated!

3.22.2007

23 Months, 5 Days


Although i just posted the 21 and 22 month pictures-- i might have to break down and feature some of them in my posts. I'm doing my best to leave the photocard in the camera so we don't wind up heading off to the hospital with the camera and no card! Speaking of which, i'm about ready for all this "false labor" to be done with. Each night since Sunday i've had at least a couple hours of contractions and other labor signs that get regular and have even been getting slightly stronger and then they just fizzle out. After nothing all day yesterday, i had 2 hours of pretty regular 7 minute-apart contractions. I had just told my mom that last night would probably be the most inconvenient time to actually have Silas, so i figured this meant we had a pretty good chance of actually having a baby. No such luck, or unluck. I'm still here plugging along and planning on wrapping up my official work schedule tomorrow.

I had a midwife appointment and NST today and everything seems well with the baby. Plenty of fluid and he's very active. Supposedly he's a bit lower and i'm a tiny bit more dilated so maybe i'll actually have this baby by his due date next week.

We are having beautiful weather today and it's supposed to stay warm but be very rainy for the next week or so. Last night we had thunderstorms move in and Henry was NOT happy about it. We were playing in his playroom and i kept talking about the thunderstorm and what it was and telling him how cool it was to watch the rain. He was skeptical but kind of okay until the thunder arrived and then he lept into my arms and didn't want to leave my lap. I just kept talking to him about the thunder and it was so cute because he would kind of look at me like "okay i'm trying to be brave" and would say "hiiii" and wave. This is what he does with the dogs when he knows he's scared of them but trying to get a grip. It was cute and sad all at once. After a few more minutes we went to the living room and snuggled on the couch while we watched his signing video.


3.20.2007

23 Months, 3 Days

Henry has been exploring more and more lately. He's definitely getting more interested in playing and running around on his own terms and less interested in sitting still to say eat dinner. We're not having major battles about this (yet) but you can definitely see his general activity level increasing.

One thing he's been really interested in lately is light and shadows. We recently stashed flashlights in a few places around the house in case of emergencies and Henry loves to tote them around and turn them on. The only problem is that once he starts flailing the light beam around the cats go nuts and start jumping up the walls after the light. We've tried to explain that they're excited and want to play but it scares the bejesus out of him and then he can't figure out how to turn the flashlight off.

A similar thing happened this morning in our kitchen. Sunlight comes streaming into the kitchen from the sunroom in the morning. Henry had his back to the sunlight and was waving two books around. This deflected the light onto the cabinets. The first thing was his face in a perfect "OH" expression while he watched the shadows dancing on the cabinets and then a freak-out when the cat came bounding in to catch the light.
I've put up new pictures on yahoo from Henry's 21 and 22nd months.

3.19.2007

23 Months, 2 Days


Henry is wending his way closer to his 2 year birthday, and i'm just about to the birth of his baby brother Silas. Tomorrow i'm 39 weeks which means that next Tuesday is my estimated due date. I was hopeful that perhaps we were going to have a baby early this morning. I had contractions every 10 minutes for 2 hours last night but they weren't particularly strong and they died out.

This morning i had one of my twice-weekly NSTs and although Silas was doing great it recorded tons of contractions on my part. So who knows-- maybe this baby will come a little early. I feel ready enough, although i think i'm resigned to finishing out my week of work.

Henry has been obsessed with blueberries for a long time. Actually he's just obsessed with "blue" one of the two colors he names and his favorite ingredient of all food. We've played it up by working BLUEberry into the title of most things he eats, "BLUEberry yogurt"-- no matter what flavor, BLUEberry sandwich of PB&J and of course BLUEberries which he will gobble up but leave quite a mess!

3.15.2007

One day shy of 23 months

Henry has taken quite a shine to his piggy bank lately. We've been trying to rustle up change for him when we can and he knows exactly where it goes and will tell you not to eat it (while pointing at his mouth he'll say "no no" with his pointer finger extended). He insists the bank be put on the floor while he puts the change in the slot. I think it's probably a bit early to start introducing lots of money management concepts, but i do try to talk up "saving" every time he puts change in his bank.

Our good friend Corey appears to be in labor. She's 3 days overdue and we were hoping she'd have the baby soon for her sake, but also for ours-- we have the same doula! I had Dr. appointments today and everything looks good-- i'm making some progress and the midwife thought that it was likely i would have this baby by the due date. It's a bit like a crystal ball though-- of course no one really knows. In the past week we've decided that we're ready to have this baby now so the thought of even having to wait another week and a half to my due date feels like forever.

I ordered two big brother shirts for Henry and he was excited to go ahead and wear his today. It's a little early but we're trying to talk up the baby a lot now that the time is getting closer. I'm pretty sure he still has no idea, but hopefully once we bring home this baby Silas that we've been talking and talking about he'll put 2 and 2 together.

3.13.2007

22 Months, 3 Weeks, 2 Days


We're enjoying another day of warm weather but i think it's about to end. JT took Henry to Brenda's this morning so i could get on an early-morning conference call, but we're hoping that we can all meet up at the park again this afternoon.

I took Henry to the park yesterday afternoon and he had a ball. I think especially since he was just there the day before he was more adventurous and by the end of our stay he was climbing up to the playground equipment-- crossing the shaky bridge, going up two steps to the slide and then sitting down, scooting forward and going down the slide himself. This is pretty amazing to watch especially considering how cautious he was on all the equipment in the fall when we were frequenting the park.

JT and i enjoyed getting out last night for our last planned babysitter outing before Silas arrives. Unfortunately our babysitter had a work complication so we didn't make our movie but we did have a nice dinner out and enjoyed some adult time. Amazingly i don't have any Doctor appointments today or tomorrow.

3.12.2007

22 Months, 3 Weeks, 1 Day

Henry is most definitely in the "mine" phase. It's interesting to observe though, because he's only about 50% of the time using mine as a declaration. The other half the time he says it in a questioning way and you really get that he's honestly trying to sort out what belongs to him and what doesn't. We went to the bookstore yesterday afternoon and while JT was browsing Henry and i headed to the train table they have set-up in the kids section. Henry played with the trains some and enjoyed watching the older little boy play with them as well. Then he noticed the boxes of train stuff for sale. He picked up a couple and asked "mine" repeatedly. I just told him no, those trains belonged to the bookstore. After a few times, it sunk in and he said "yeah" like this made sense to him. He does it with all kinds of other stuff, some of which is funny trying to explain that no the church bells aren't Henry's and the birds and squirrels don't belong to him either. I love watching his little brain sort all of the details of living out.

I'm so sorry that i forgot my camera, but we made it to the park yesterday for the first time in ages! We're enjoying a bit of a warm-up and we tried to take advantage of it. It was fun to watch what Henry could do, or do more confidently since we were there last in the fall. He loved the slide and just walking back and forth over the arched bridge and up and down the ramp. He thought he wanted to swing but was immediately interested in being back on the ground once he tried it out.

Saturday i hosted a baby shower for a friend of mine due at the end of April. Henry woke up from his nap to find the dining room peopled with ladies having tea. He was actually less shy than normal and was actually a little flirtatious. I even found him sitting on one guests' lap at one point. He and JT enjoyed a leisurely walk around the block while the party was winding down.

In news about me, i got my braces off on Friday which feels amazing, and i've some mild contractions off and on since Friday night. Nothing particularly strong and nothing that has turned into anything. It would be nice if this didn't last for two more weeks, but at this point i'm not due until two weeks from tomorrow.

3.08.2007

New Stroller



We received a new stroller yesterday that will accommodate both Henry and Silas. Henry helped me get it all set-up last night and was super-excited to try it out. First we tried him in the front seat (which he won't use much because it holds the infant carrier at first and then Silas once he's bigger) and then the back (where he'll sit at first and then stand once he gets a little older.) He was so excited to sit in the front with the tray on and eat his snack and to hang out on the back like a big boy. In fact he spent the rest of the evening climbing in and out of the stroller on his own and trying to figure out the clasps. I'd say he approves!


It's nice to see him becoming a little more adventurous physically because right now we are on a physical therapy hiatus. The insurance company has said that his therapy is not "medically necessary" and we're embroiled in the process of appealing that decision. In the meantime, we've been trying to replicate the exercises he works on in therapy and hopefully he won't be too far behind when/if we start up again.


The weather has finally taken a turn for the warmer here so we're hoping to head to the park this weekend and see how he does there.

3.06.2007

37 Weeks


That's right-- 3 weeks from today (more or less) we'll have a new baby to show off at Good Intent. I've had some drama related to my pregnancy lately that i'll try to encapsulate here quickly (short version is everything is fine). I met with a midwife that i had not previously seen on Friday and she turned out to be a little high-strung.


You could also describe her as gruff, aggressive and having ruffled my feathers. She wanted me to see "Maternal Fetal Medicine" ASAP to have them review the thyroid care I've received from my regular Dr. during the pregnancy. She freaked me out because the consequences of an unmanaged thyroid are dire-- severe physical deformities and mental retardation. She just sprung this on me and then got defensive when I tried to ask why she wanted me to see these people now (let alone who they were or what they did). The vibe I got was that it was almost more of a liability thing-- she wanted their experts to review what my Dr (who's through another hospital system) had done.

I had the appointment with MFM today and everything went fine. They did an ultrasound and again showed the baby was formed correctly-- still no indication of pyloric stenosis and growth looks right on-- they estimated his current weight as 6 lbs. 10 oz. The Dr. then reviewed my thyroid labs and care and said it all looked appropriate and they didn't have any qualms with it.


The Dr. does want me to start getting non-stress tests twice a week, instead of just once, to make sure the baby is doing okay. He also told me that with a thyroid condition you have an increased risk of developing pre-eclampsia so he went over the warning signs to watch for. The other thing you have to be careful of is placental failure at the end of the pregnancy. This is why i'm getting the NSTs twice a week now and am supposed to do "kick-counts" every day to make sure the baby is still active and responsive and getting the nutrients he needs. They won't let me go more than a few days past my due date, so we'll just hope for another timely baby.


Henry is doing great. I installed the infant seat in the back seat of the car and we've been talking about how Silas will be riding back there and all the things Henry will get to teach Silas. He seems most interested in that line of discussion but i'm just so curious to see how he responds to his new little brother once the time comes.


I'm hosting a shower for a friend of mine that is due at the end of April this week. It's a small "afternoon tea" shower we're having at our house and i think it will be really nice. After that i'm pretty much in the clear for being done with major commitments and work.

3.04.2007

22 Months, 2 Weeks


Although it seems a little too soon to be heading back to work tomorrow, we had a nice weekend. We tested out a new babysitter and although Henry was hysterical when we left, we really liked her and she said that after Henry wanted to get in his crib for awhile to calm himself down, he was actually fine the rest of the evening. She's coming again next week and then after the dust settles after Silas' birth, we're planning to have a regular weeknight out every other week or so. Hopefully all of those things will make it easier on Henry when we leave.


We left him for about an hour today at our friends house as kind of a mini test-run of when they'll possibly watch him while i'm in labor. He did absolutely great and didn't seem to miss us one bit. They have two girls-- one who's 3 and another one that is just about Henry's age and he loves to play with them and all their fun toys.


On Saturday we went out to a sushi restaurant that we love but hadn't been to since the night i went into labor with Henry. We were hoping it wasn't going to have the same effect this time, and luckily it didn't, but we did enjoy a great dinner.


Henry was very animated in his play this weekend. At times he was getting more interactive with our cat mason-- going right up to him and petting him or looking him straight in the face while down on all fours. He also was just playing with forgotten toys in new ways. This morning he climbed up on one of our kitchen chairs on his own and promptly stood up. We're not encouraging that but from a physical point of view, it was a great accomplishment.


Tomorrow begins the week of medical appointments for me. I have something almost every day, capped off with having my braces removed on Friday (!) So no getting to the gym this week i'm afraid but i'm very excited to be done with my braces before Silas arrives (hopefully.)

3.03.2007

Roundtable- Labor and Delivery

We’re focusing on labor and delivery this week and I’ll go ahead and let you know that we’re going to have a “Too Much Information” (TMI) edition of this message that will only go out to the women on this thread. There are just some things that are important to cover and you’re obviously welcome to share with your male partners, but I’ll be more comfortable writing them for a “women-only” audience.

I know most if not all of you have taken a birth class or heard from your Doctor when to call the hospital and how to know you’re in real labor. I’ve recently been re-visiting this information because with the second pregnancy, I find myself having a lot of Braxton-hicks contractions and other symptoms that had me wondering if I was going into early labor.

When contractions first start they can feel like a tightening across your whole abdomen (that may or may not hurt). They can also feel like menstrual cramping. Both types can mean the beginning of true labor or false labor. So, how do you tell which is which? The main thing is that over time false labor doesn’t get any stronger—become more regular, or increase in intensity. You’re advised to drink a lot of water and lay down or take a shower and see if the contractions lessen or stop. If they do, it’s most likely false labor. If despite your efforts at eating or drinking, changing your activity level or position, or showering you find that your contractions are becoming more regular and/or increasing in intensity, you may be in real labor.

The way to determine how regular your contractions are is to time them. This involves noting the time that a contraction first starts (i.e. 11:09 pm) and then noting how long it lasts—30 or 45 seconds. Then you would write down when the next one started (11:19 pm) and how long it lasted etc. If you find that your contractions are occurring at regular intervals for an hour or so (and you did the other things to rule out false labor) this may certainly be the real thing. Each Doctor or midwife is different so follow the guidelines you’ve been given about when to call, but I think the “general” rule is when your contractions have been 5 minutes apart for an hour.

Birth Stories
Of course you’ve heard about long labors and probably even some short ones. I’d love to hear the birth stories of the people on this list, but I’ll start with mine. Everyone in my family had very long labors and ultimately had to be induced. I was planning on natural childbirth, so I had mentally prepped myself for a 24 hour labor. My contractions started around 11 pm and I was able to just lie in bed and feel them—noting the time for about 45 minutes (they started out 7 minutes apart). I told my husband to get to bed and get some sleep because we probably had a long road ahead. I went to the guest room and could no longer lie down during contractions. I was leaning over a desk and swaying and breathing into the contractions.
I called my doula who listened to me making me way through a contraction or two and she said I sounded great and like I was in early labor (at this point they were about 5 minutes apart). About half an hour later (12:15 pm) I got JT up and got in the bathtub. At this point I lost all track of time—the contractions became very painful (intense if it makes you feel better) and it took absolutely all of my focus and energy to keep myself relaxed while my uterus was contracting like a vise. At some point I told JT to call the doula back because I needed her there (working backwards this was about 2:30/3:00 am.) By then the contractions were coming every 30-45 seconds and some after only 15 seconds. There was very little rest in between the contractions. The doula arrived about 30 minutes later—watched me during one contraction and told us that we needed to get to the hospital right then.

JT rushed around trying to get a few last minute things together and we headed over to the hospital. I think we got there around 3:45-3:50 am and Henry was born at 4:17 after I believe about 2 pushes.

So, even with a history of long labors mine went really fast. The thing about fast is that it’s over in a short amount of time, but at least for me it was really intense almost the whole time. Based on talking to other people, if you have a longer labor, it’s common for the less intense part of it to last awhile—i.e. you might actually lie down and rest during it or clean the house or something.

Even if you plan on getting an epidural as soon as possible in the hospital, you may feel contractions before they’ll admit you that you need help getting through. The best advice is to be as focused as possible on relaxing. You have to make the rest of your body as limp and relaxed as possible while your uterus gets all tight and does its own workout. If you stay relaxed, things are much more doable than if you tense up right as the contraction starts. If that happens, just get through the contraction and try to stay more relaxed with the next one. Your partner can do things like massage your back or hands or help point out that you’re grimacing or holding tension in your face or hands or shoulders.

Bouncing on one of the exercise balls can feel good as can being on all fours, laying in the bath, swaying your hips back and forth, etc. It’s not a bad idea to do a little reading on birthing positions just so you have some at your fingertips—especially if you’re going for a natural childbirth.

I'll dig in with my own stories. With Carys, my water broke at approx. 5 AM. Because I wanted the epidural, I did not want to wait to get to the hospital. Plus when I called my doc, she said to go the hospital. After dropping Carys off and going to the McD's drive through for a sausage biscuit (pregnant ladies have to eat), we made it to the hospital. I'll note at this point I was not feeling painful contractions so there was no feeling we needed to rush. At the hospital, I was still not having regular contractions and they tested the fluid to see if it was true that my water broke. The first nurse said the test was negative and they almost sent me home but b/c I was on bed-rest and my cervix was already thinned they decided to let me walk the halls until my doc arrived (around 11AM). While walking the halls I experienced more intense contractions which were like very bad menstrual cramps. I was thinking they were not bad at all. Once my doc checked me, she confirmed my water broke and I got hooked up for my saline. Note to ladies who are planning or not decided to get the epidural, you have to have 1 liter of saline one hour before to get the epidural. I'm not sure if this is just my hospital policy but if you are thinking you may get it, you should find out b/c once things get going, they do get intense. I never went to a birthing class but I watched so many birth stories on cable during my bed-rest, I felt like I had a pretty good idea of the things that could happen. So I learned to breath on the fly during the contractions that were more challenging before they administered my epidural. I think around 2pm, I was drugged and relaxed. And I don't remember the exact time but around 4pm, I had Carys.

With Helen, things were faster. I was on bed-rest and finishing up a project on my laptop. I remember I had timed the contractions from about 9:30 AM to 11:30 and I was telling Cullen how they were getting closer and stronger. Initially I thought it was false labor b/c there was no pain, it felt like a tightening of my belly. But after they were becoming regular (still without pain), I realized I did not want to wait. I finished off my project and told Cullen to come get me. We coordinated Tiffany to come and stay with Carys until my Mom flew in town. We got to the hospital and my doctor was on vacation so I met her stand in briefly and once he read my chart, he decided to break my water. I immediately let him know I wanted the epidural and once again, I had to wait for the saline. This time was much more intense, I think b/c it was faster. But again, by about 2pm, I had my epidural and was relaxed. I think I had Helen around 6pm, just in time to order a dinner for me from hospital cafe:). I actually got to pull Helen out this time which was surreal and cool at the same time.

I had great experiences both times, of course, the first was more anxious but beautiful too. Once Tamra shares the TMI posting, we'll get to the nitty gritty after effects of birthing and how to care for yourself.

I would just say try as best you can to be mentally prepared and be flexible for anything to happen. Hopefully your birth will be everything you imagine but sometimes you may need to change plans and go a different direction. Be focused but flexible and remember this is just one small step to your new life with baby.

Too Much Information Section
The intent of this message is not to gross you out or scare you, but to provide you with at least a basic understanding of the aftermath of birth. Of course not all of this will apply to you and if you have a c-section none of it may (I don’t have any experience with recovery from a c-section to share.)

Transition/Pushing
We’ve talked some already about laboring and different ways to deal with that experience. One thing I will say is that it’s absolutely true that if you’re making your way through natural childbirth, just when you think you can’t handle it anymore, that means that it’s time to start having the baby. Things get very, very intense during this “transition” phase but for a lot of women, pushing feels a lot better because now instead of trying to stay relaxed while your uterus contracts the hell out of itself, you’re able to push with the contractions—you’re able to be active.

When you’re pushing you want to try to focus all of your energy into the push—this means trying to keep your face and other body parts somewhat relaxed and putting all the force of your efforts into your butt—it’s just like you’re trying to have a bowel movement. The doctor/nurse/midwife will tell you when you’re having a productive push and when they do you want to focus on what it felt like and repeat it. Depending on your doctor/nurse/midwife, you’ll probably be on your back with your legs up pushing. If you have an epidural this is pretty much your only option. If you don’t you might want to consider other positions like laying on your side, squatting, sitting on a birthing chair, etc because they are actually more conducive positions to getting the baby through and out of the birth canal. Lying on your back actually narrows the pelvis which makes it harder.

Pushing is really hard work and if you have any experience with exercise I think it’s helpful to think of it like an endurance workout. The contractions are still painful too and the experience is intense so lots of women feel like screaming. Making noise isn’t bad—but I think it’s more helpful to make low moaning/grunting sounds rather than high-pitched screams because the low sounds tend to help you focus while the screams coincide with just releasing and “giving up” on that contraction.

Birthing/Afterbirth
So, you’re pushing and pushing and finally you’re bringing the baby down and their head has come out (if they were head-down to begin with). Frequently your Dr. will tell you to wait while they suction the baby out or unwrap the cord from their neck. Then they’ll give you the all-clear and you’ll be able to push the baby the rest of the way out.

What happens next depends on your hospital, your Dr. and your preferences. The baby can be immediately placed on your stomach and will probably be crying while the nurses are rubbing the baby all over—stimulating their lungs and getting them cleaned up. Someone (and it might be your partner) will cut the umbilical cord. Generally after all this happens in the first few minutes, the baby will be taken by a nurse to be weighed, measured, footprinted, and possibly bathed and dressed. The other thing that generally happens is they put eye drops on the baby’s eyes (I can’t remember for sure what this is and what it’s for, anyone?). You can request they delay doing some of this stuff so that you have more time to bond with your baby right away if you like. I let them move along with their schedule and had a few minutes to be totally overwhelmed and close with JT. Then Henry was brought to me and started to nurse.

During this time you’ll be working on delivering the placenta. I believe mine came out quickly after Henry was born and I don’t remember much about it—clearly the birth of the baby kind of overshadows this.

What I do remember is that I tore while Henry was being born and my Dr. spent quite awhile stitching me up. Actually the stitching was most unpleasant and seemed to take forever! It helped to have Henry there and focusing on him but i’m not going to say that I didn’t even notice because I was holding my new sweet baby.

Recovery
In many hospitals now, you labor and deliver in one room and are then transferred to another room for your recovery, i.e. your hospital stay. Old school was to labor in one room, deliver in another, and recover in a third which I guess could still apply, so you might want to ask about that during your hospital tour.

One thing I was surprised at was when it came time to move to our recovery room (3 hours after Henry was born) I had to get off the bed/table and get into a wheelchair. I’m sure that’s standard practice, but I was shocked that they expected me to STAND UP after I had just given birth. The nurse and my doula were really helpful but it hurt and I just kept thinking--can’t they just wheel this bed into my new room?

When you get to your room that’s when you’ll hopefully have a chance to get some rest. It’s also when you need to make sure to get all the supplies you need from the nurses. Here’s a rundown of the basics.

They will supply you with pads to use while you’re at the hospital. At first they gave me combo pads/ice packs which were amazing. They seemed to be in short supply though and after the first 4 or so I wasn’t able to get anymore. Next time I’ll be more aggressive about asking for these (and to be honest I ordered a case of them for my use at home from a medical supply business!)

The hospital also provides this mesh super stretch “underwear” to use. I’ve heard some people say that they didn’t like it but it was honestly all I wore for probably a week. It was WAY more stretchy and accommodating than any underwear I had (even old stretched out stuff). You need to wear something so that you have something to attach the pad to, but especially with a tear, you want it to be as loose as possible. I just got one pair but this time I’m definitely asking for a few more to take home.

They also give you this stuff called epi foam which has a numbing agent in it and can be sprayed on the pad. If you had a tear at all, it’s a lifesaver. It’s a really small bottle and again it’s something you should tell the nurses up front you’ll need another one for while you’re in the hospital and one to take home as well.

They also supply you with something called “chux” or “chucks” pads. These are basically plastic/paper sheets about the size of a small baby blanket that you can put under you to catch any overflow while you’re laying down. They’re helpful in the hospital and you can take quite a few with you when you leave at home to protect your sheets.

At some point after you get to recovery you’ll either have to go to the bathroom or the nurse will make you. At least for me they helped me to the bathroom the first time and explained how to use the little squirt bottle they give you. Basically you fill this plastic bottle with a squirt top with warm (not hot) water and spray that on yourself while you pee. It helps allay any stinging from the urine on you delicate parts and it can help relax you enough to let you go.

Make sure you drink as much water as humanly possible after delivery so that when it comes time for a bowel-movement things are regular.

At many hospitals the baby will be “rooming in” with you meaning that they will stay in your room while you’re in the hospital. If your baby had any complications after birth they might need to be in the NICU. Some hospitals give you the option of keeping the baby in the nursery while you get some sleep.

Ahh sleep—you’re exhausted, your partner is worn-out and (hopefully) the baby is sleeping already. Do your best to get some rest, but know that hospitals are about the least conducive places to sleep possible. The nurses will come in every 30 minutes and then every 45-1 hour to check your pulse, your uterus (to make sure it’s shrinking), take your temp, etc. They’ll also ask you about the baby and if s/he’s nursing, how often, and how many dirty/wet diapers you’ve changed. I found it really helpful to have a journal or at least a piece of paper to jot this stuff down on so that when they came in to check on me at least I could just read them what happened.

In addition to all the checks by the nurses, you have people delivering your food, picking up your garbage, picking up your soiled linens, giving you information about the hospital photos you can have taken, helping you fill out the forms you need to get the baby a SS card, etc. Also, your Dr. and a Pediatrician will have to come by at some point before you can leave the hospital to check both you and the baby out.

Bring ear plugs! Also, if you have a twin air mattress you might want to bring that for our partner. Hospitals generally have one of those fold-out chair beds and they’re not particularly comfortable. I’m a light sleeper so I wanted to get home as soon as we could so that I could be in my own home and get some rest there. If you are hoping to leave sooner rather than later, make sure to let the nurses know so that they can start lining things up for your discharge, it takes awhile.

Questions to ask your Doctor or Midwife
This last message touches on those things that are a good idea to discuss with your Doctor or midwife before the birth—even if you’re not planning on having this stuff happen to *you*, it’s still a good idea to know the Doctor of midwife’s policy.

Induction
What is their policy on induction. If you go later than your due-date, will they automatically induce you, refuse to induce you, etc. Some people are very ready to not be pregnant anymore, and demand to be induced if they go late. Others want to avoid induction—often if they’re hoping for a natural labor. Find out what their policy is, and also how inductions are generally handled. For instance, do you have to come in the night before and get the gel applied to your cervix and spend the night in the hospital or do you get to go home and come back in the morning to start the pitocin? If you don’t want to be induced can they recommend natural labor inducers that you could try first? How long will they let you try to “get your labor started” before they move on to something else, i.e. a c-section?
C-sections
What generally causes your practitioner to either schedule or recommend an emergency c-section? What is their c-section rate, i.e. how many of their patients wind up getting c-sections? How would a c-section work, both scheduled and emergency? Even if you don’t plan on having one, it’s not a bad idea to understand how a c-section would happen, what to expect, who can be with you, etc. in case you wind up needing one.

Fetal Monitoring
What is your practitioner or the hospital’s policy on fetal monitoring? Do you have to be monitored continuously (i.e. you have to stay in bed) or can you be monitored intermittently so you can get up and walk around? Or do they have portable monitors so that you can walk and be monitored continuously. How do they use the fetal monitors to make decisions? What could happen that would make them intervene in your labor, i.e. baby’s heart-rate speeding up or slowing down, etc.

Eating and Drinking
What is the policy on eating and drinking during labor? Most hospitals only allow you ice chips, is that the case, if you want to be able to eat can your practitioner make an exception for you, etc.

Episiotomy
What is your practitioner’s policy/approach to episiotomy? I don’t think many Doctor’s do them routinely anymore, but there are probably specific cases under which they would recommend them. What are those situations? If it’s important to you to avoid one, how much control will you have over the decision?

Family and Visitors
Depending on your wishes, you may want to find out who is allowed in the labor room with you. Also, what is the policy on photos and videos? If you have family or friends that will want to see you in the hospital, are there specific visiting hours, limits on the numbers of visitors, etc. Can you use cell phones in the facility? If not where can you go to make calls?

Nursery
Does your facility have a well-baby nursery? If so what are the policies around where the baby stays while they’re in the hospital. One extreme would be the baby being in the nursery most of the time and only being brought to you periodically and the other is not having a well-baby nursery at all—the baby is in your room at all times. Many women, especially if you’re planning to breastfeed, like to have the baby “room-in” with them so that you can feed when the baby is hungry. Others (breastfeeding or not) want to take advantage of the nursing staff and get some sleep while they’re baby is taken care of.

Discharge
What tests, evaluations, and hoops do you have to go through before you’re allowed to leave the hospital? How long do you have to stay, how long CAN you stay? Are there certain tests or exams the baby has to have before being allowed to leave? What about for you—what are the types of things that could prolong either you or the baby’s stay in the hospital?

Roundtable- Partner Relationships

This is such a big topic, it’s hard to know where to start. I think it’s pretty obvious that becoming parents is quite likely to change your relationship with your partner. It doesn’t necessarily change it for the worse, but bringing a new baby into your family changes each of you individually, so it makes sense that it would also change your relationship.

I have to recommend a book that I read a few years ago called:
The Transition to Parenthood: How a First Child Changes a Marriage: Why Some Couples Grow Closer and Others Apart by John Kelly (Contributor), Jay, Ph.D. Belsky.

It’s a book of case studies culled from the largest research project into how couples are affected by their first child that has ever been done. It appealed to me because of its basis in statistics/science and also because it basically lays out the factors that change and are affected by a couple having a baby.

Of course I read the book and wrote the synopsis about 4 years ago so off the top of my head I can’t remember what the factors are that contribute to the type of change couples experienced. I can think back on my own experience though and run-through what happened for us.

Changes to Expect
On a practical note the biggest surprise to me was how we suddenly had NO time together as a couple. Henry was very high-needs as an infant and it didn’t allow for any time in the evenings to sit on the couch and catch up or linger over dinner and talk—things that I was used to before Henry was born. After a few months this improved because Henry started to go to bed earlier and gradually you gain back some time when you’re not actively caring for the baby.

One change that can affect couples is an immediacy of having to come to agreement. Tabitha actually pointed this out to me before I had Henry. Pre-kids you might not see eye to eye with your spouse on certain issues- potentially even important ones, but with a lot of things you can find ways to cope and just “work-around” the differences you have. It’s much harder to do this once you have a child. If you differ on how often the baby should eat or what you should do when he cries, you’re going to find yourself arguing frequently and with the added tension of an upset baby making keeping cool more difficult.

I think the single most important thing for new parents is to let each of you adjust to becoming a mother or a father. That process doesn’t happen overnight. Maybe you were a goal-oriented working woman and you’re having a hard-time seeing your newly developed mothering role as on-par with your work challenges, or maybe you’re a new Dad that really wants to connect with your newborn but your spouse just seems so high-strung and ready to pounce on you for doing it wrong. There are loads of scenarios, but the bottom-line is it takes awhile for both of you to come into your role as new parents. Standing back and realizing that your spouse is finding his way while you find yours is pretty powerful (and difficult) and can give you the time to become parents and then re-connect with each other when the dust has settled.

I’m not saying postpone connectedness for the first several months—in fact at the beginning it’s really great if you can both approach it like you’re a couple on the Amazing Race. It’s just that some of the kinks that will get worked out in your relationship can be better dealt with once you feel a little more settled in your new parenting role.

I think this topic ties in with taking care of yourself as you discussed earlier as much as taking care of other people. Lack of sleep, and new experiences can make your judgement and patience cloudy. I think one of the biggest things is to realize that if you experience an upheaval in your relationship, that's normal, do not freak out. There are some things you can do to help.

Partner Discussions
Most of us have certain ideals we wish to impart to our children and it helps to identify them early with your partner. How do you imagine you taking care of your little one, what are the things you want to teach them? From eating to sleeping to discipline to TV watching. Even though you are just now having a baby, you will be raising a child and these things will come up sooner than you imagine. It's best to have had a preliminary discussion about expectations and wants. If you find you are in opposition to you partner on some things. Try to determine if this is something you can give on. Maybe their issue is not your hot issue and you can compromise. Maybe you agree but you differ on how to handle things. Early discussion about issues important to you is imperative.

I will say, even with these early discussions, a lot happens so quickly and sometimes without much thought, that you may stray from your original plan. Just get back on track and don't sweat it. One of the wonderful things about children is they are resilient.

Even if you have a "good" baby, you may find yourself devoting more time to your baby than to your partner. A baby takes so much energy and patience that you may give it all to baby and have none left for your partner. I don't have a good solution for this but just to be aware of the issue. Whatever is testing your patience, lack of sleep, non-stop feedings, etc. will pass. Try to identify ways you and your partner can share responsibility by alternating feedings or having your partner help with wakings etc. If possible try to work this out before baby and be flexible when baby comes.

Different Parenting Styles
Another thing Tamra touched on is allowing your partner to be different. It's Ok if they change a diaper different than or give a bath different than you etc., as long as the final goal is attained. This is harder than you think to let go of. But it's very important to try to recognize that issue when it arises and make allowances for differences.

It's easy to become sucked into baby life and not the worst thing that can happen to a person. But babies are really portable (especially if you have just one). Take time to go to dinner, spend time with friends as you are able. One of the things that really helped us through was the ability to get out with friends and have dinner or visiting. It gave us an outlet to be ourselves together and something else to focus on even if for a couple of hours. Or if you have family close by, take advantage of it. Looking back, I think that's one of the things we miss the most is being able to rely on grandma or grandpa who would ALWAYS be ready to take on baby and give us some time to ourselves to reconnect.

Roundtable- Taking Care of Yourself

So I was thinking this week would be devoted to the idea of how you take care of yourself after the baby is born. A big part of this has to deal with how you get enough sleep, which we can touch on again, but there are other issues, like how you maintain adult interactions, get some time out of the house, etc.

Sleep Plan
First the basics—you have to have a plan for getting enough sleep. If you are comfortable co-sleeping, advocates say that sleep deprivation really isn’t an issue, because you and the baby are only half awake as you’re feeding through the night. Another tactic would be to make sure you go to bed as early as possible (after the 8 or 9 feeding) so that you start your cycle of 3 hour chunks early. If you have a baby that will go back to sleep after the 6 am (or so) feeding, enjoy it and sleep until 8 or 9 when your baby wakes up. You’ll learn your baby’s rhythms. Just learn to work with them. For instance if sleeping in is crucial, you’ll want to do everything to avoid scheduling things in the morning that you have to get up and about for. If you have a baby that naps in decent chunks during the day, definitely try to rest or sleep while you’re baby is sleeping.

If you’re the least bit type A, you’ll have to give yourself permission to set aside the thank-you notes, phone and email messages to return, laundry, etc, and know that by taking care of yourself and getting enough sleep you’re doing something just as important on your “to-do” list.

Outings/Scheduled Interactions
If you’re someone that thrives on adult interaction or a scheduled day, you might give some thought to either the types of outings you could do once the baby is born or the broad outlines of a schedule. Just like a birth plan, what you put together might go right out the window, but I don’t think it hurts to give some thought to how you like to spend your days now and how you’d be most happy spending your days with a new baby. For instance, if you would like nothing more than to hang out at home lazing around watching tv and reading the paper, you might be perfectly happy stocking up on some movies and magazines and just hunkering down with your new little one. However, if you typically like to be “busy” with lots of scheduled outings, I would make a list of all the indoor projects, small-scale outings (i.e. a walk around the block or to your local coffee shop) and large-scale outings (the museums a baseball game) that you think might be the least bit workable with a newborn. Then once you have the baby and you start settling into a routine, you can see if you feel up to tackling one of each a week, a day, or never. If you’re using to outings and interactions, it’s easy to slip into a funk if you’re suddenly home alone all day taking care of your baby’s endless needs.

I don’t want to make it sound like you should be planning every second of your day and the most important thing to realize is that your baby is really going to dictate how much can take on. But even if you have a baby that cries all the time you need to feel like you have some ideas for getting some relief and getting out—even if it’s just a change of scenery.

If you have friends that want to watch the baby—take them up on it. They can easily pop your baby in a sling or stroller and take him for a walk while you unwind or take a bath or take a nap. You can also hire a postpartum doula for day or night to offer relief on a predictable schedule. A lot of this stuff you won’t have to decide on until your baby has arrived and you learn your baby’s personality and how you’re coping with the sudden change. Just know options for relief and help are out there and they don’t make you a bad parent for seeking them out.

Post-Partum Depression
I think I covered a lot of what I set out to in this weeks topic, but I did want to say a few words about post-partum depression. I had it pretty bad with Henry and it was really pretty terrible. It’s a bit difficult to figure out though because I think most moms go through what is annoyingly called the “baby blues.” The main thing to know is that most likely you’re going to be emotional in those first few weeks/months after having a baby. Your whole life just changed and even if you have the easiest baby on the block, you’re going to have some rough patches and some emotional feelings about relating to the whole thing. There’s not really a whole lot you can do to prepare because a) you don’t really know how you’ll react and b) really, what are you going to do about it now anyways?

I do think you can be educated about things that can/will help if you find yourself bogged down after the baby is born. First of all if you just have some fleeting “overwhelmed” moments or you feel like you have to get a break from the baby or you’re going to go crazy, that’s really completely and totally normal. Normal of course doesn’t make it easier, but with some strategies in place to get yourself some help of or a break, you’ll most likely be adjusting to your new life in no time.

If you find yourself increasingly unhappy, feeling like you just can’t cope or can’t take on the day’s tasks, or really anxious, panicked or overwhelmed all the time—definitely call your Doctor. If you have a good relationship with your regular Dr. you could call him/her, otherwise your OB or midwife is a good place to start because they’re familiar with post-partum depression, know what the signs are and how to get you help right away.

I started seeing a therapist twice a week, got a post-partum doula to come over 2 afternoons a week for a few hours, and even still wound up going on anti-depressants. Once they really took effect I started to feel like myself again. I’ve said before, Henry was a hard infant so it’s not like the medicine suddenly stopped him from crying 6 hours a day, but it did make me feel like with some real support I could do this, instead of feeling like taking care of him was absolutely and completely out of my realm of possibility.

The most important thing is to get help soon rather than letting it drag on forever. So even if you’re feeling kinda down but not sure that you really have, PPD, call your Dr. and mention it. You certainly want to take care of yourself and your little one by keeping you in good health.

Roundtable- Sleeping

This week we’re set to talk about sleeping which is a topic I definitely have first-hand experience with, because it is something we really, really struggled with when Henry arrived. I’m not entirely sure how to structure this week so I’m going to start tonight with the things that I wish I had known about sleeping BEFORE Henry arrived. Let me know if there are questions you have or ideas for sleep sub-topics and I’ll address those as the week progresses!

In the beginning…
For the first few days and sometimes up to 2-3 weeks, many babies will seem to literally sleep all day. They’ll wake to eat and maybe open their eyes a few minutes and then it’s back to sleep. I remember the day we got home from the hospital Henry slept for 6 hours straight which turned out to be his longest stretch of sleep until about 3-4 months! Of course we didn’t enjoy it because after 3-4 hours we kept trying to wake him up every 30 minutes to get him to eat. You’ll hear differing advice on this but unless your baby had a low birth weight or s/he’s routinely sleeping through feedings—I say just let them sleep and don’t worry about trying to wake them to eat.

In these first days, your baby may seem to sleep all day and then be awake much longer chunks of the night. I believe I remember reading that babies don’t manufacture melatonin which helps us regulate day from night until later so there’s no physiological reason to sleep at night at the beginning. This is why you’re encouraged to keep everything quiet and boring at night so there’s no social reason for them to be awake at night and asleep during the day.

Learning to Sleep
Somewhere along the first few days to weeks, your baby may “forget” how to sleep. I’m sure that not all babies are like this but I’ve heard and read lots of accounts of babies that were total sleepy-heads until 2-3 weeks and then suddenly seemed to stop sleeping altogether. This is definitely something that we went through with Henry. A BIG part of the problem was that I didn’t realize that some babies need help to get into a sleep rhythm. I was under the impression that if a baby was sleepy s/he would fall asleep. Unfortunately it isn’t this simple for all babies. Some babies aren’t very good at drifting off to sleep on their own and as they start to give us cues that they’re now over-tired and cranky, we respond by going through the checklist of things that might help—change the diaper, change of scenery, playtime, etc. If the baby is really tired everything we try just makes it worse.

The trick is in realizing that your baby is starting to get tired so you can help soothe them and let them fall asleep on their own. Ideally you do this from the start and then they “learn” how to fall asleep on their own without any complicated interventions that get tried later on. The sleep cues babies give can include:
· Decreased activity
· Slower motions
· Less vocal
· Sucking is weaker or slower
· Quieter
· Calmer
· Appears disinterested in surroundings
· Eyes are less focused
· Eyelids are drooping
· Yawning

Signs such as fussing, rubbing eyes, and being irritable and cranky are actually signs that your baby is overtired. The best thing to try at the beginning is to recognize the signs of sleepiness. If you catch them you’ll want to put your baby in her crib or wherever s/he sleeps. She might fuss a minute or two and then fall asleep. Or, your baby might need to be actively soothed in which case you might try a pacifier, swaddling, rocking, shushing, etc.

The other important thing to know is that for the first few months, babies need to sleep after being awake for 1-2 hours. While getting them on a nap schedule at this point isn’t really workable, it does help to know that your baby woke up at 9 am and therefore most definitely needs to be back asleep by 11, and you might start seeing signs around 10 that s/he’s ready for sleep. Keep that 2-hour wakefulness period in mind and it will really help when you’re still trying to learn your baby’s sleep cues.

Sleep Duration
As babies get older it’s more important for them to sleep for longer periods of time and most of them will achieve this on their own. I think that if you’re tuned into a baby’s sleep needs—i.e. watching for sleep cues and helping soothe them to sleep no more than 2 hours after they last woke, you’ll find your baby sleeps longer at a time anyway. But, you should know that not all babies sleep for even a magical 3-4 hour period at first. It can literally be the case that your baby gets enough sleep overall—but gets that sleep in 20-30 minute increments. This is why it’s really important to give some thought to how you’re going to get some rest once the baby arrives.

Back-up
I’m not sure you can prepare a “plan” before your baby arrives, because you just don’t know what sleep challenges you’re going to face (maybe none!). I do think however, that you can brainstorm some possible ideas to put into place once you know what issues you’re dealing with. For example, because I was breastfeeding exclusively, I needed to be available (and awake) for all the feedings. I would feed Henry around 9 pm and then go straight to sleep while JT stayed up with Henry or Henry slept with JT on the couch. Then JT would change Henry and bring him to me for the midnight feeding. I wasn’t getting 8 hours of un-interrupted sleep, but I was getting a head-start on my sleep for the night. Also, before I went back to work, Henry would usually wake around 5 or 6 am for a feeding. At that point I would bring him into bed with me and after eating we’d both fall back asleep until 8:30 or 9. I made sure to never schedule anything before 9:30/10 and that also helped me get some extra sleep.

Other things to consider are having a post-partum doula or babysitter come over an afternoon or two a week (or family member) to watch the baby while you take a nap. A lot of women that co-sleep say that they completely avoided the sleep deprivation of a newborn, because when you’re nursing in bed you’re able to basically start nursing and then just fall back to sleep (assuming you’re nursing lying down). Other people may have lots of other ideas, but here are a few to get you thinking about how you’ll deal with the sleep deprivation.

I also want to emphasize that I say this not because you’re being “hazed” into a new parents club, but because having a newborn can be exhausting and if you don’t make efforts to get the rest you need you’re at risk for getting sick, overwhelmed, depressed or all of the above.

Q&A
Q: For everyone with babies, when did they start to have a "normal" sleep schedule? Was there anything that you did in particular that helped them fall asleep or sleep through the night? At what point did you see if the baby can soothe his/herself and stopped going into the baby's room every time the baby woke up?

A: I have to say that even though I kept meticulous records I don’t remember very clearly what Henry’s sleep schedule was really like. What I did do was go back to the sleep book that really helped us called “Health Sleep Habits, Happy Child.” Sleep is a hot topic with parents-- not only because new parents are so sleep deprived but because how we treat our children's sleep has become a marker of the type of parent we want to be perceived as. There are "attachment parents" who would never dream of letting their children cry themselves to sleep and "cry it out" parents who wouldn't want their children's sleep to be dependent on them for very long. This book, HSHHC is perceived by some people as firmly advocating a “cry it out” strategy and is therefore dismissed by people that disagree with the practice. I do want to say that the book is written by a Doctor/Sleep Researcher and it definitely has a “scientific/researchy” bent to it. He provides suggestions for how to avoid sleep problems, but also gives solutions for how to deal with them if they develop. He definitely does include “cry it out” techniques and says quite plainly that based on his research these methods are more liable to “work” and to work faster. He does provide “softer” methods as well though.

So, disclaimer over, I found this book immensely helpful and I’ve gone back to it to jog my memory about how things were working for us between 0-3 months. I’ve also looked back at my blog posts during this time for some hard data to back up my recollections.

0-2 Weeks
Things are fairly all over the map. Generally at night Henry was sleeping in 2-4 hour chunks with mostly brief awakenings for feeding. During the day naps were anywhere from 30 minutes to 3 hours. At this point you’re just reacting—trying to learn the cues your baby is giving you and feeding him when he’s hungry and helping him get to sleep when he’s tired. I have a picture of Henry’s sleep and awake periods from when he was 5-13 days old that I’ve inserted below. It’s small and fuzzy but it should give you a brief snapshot of how their sleep isn’t very organized.

2-4 Weeks
Many babies start to get fussier during this time and may have a harder time sleeping in such extended chunks as they did before. This was definitely the case with Henry. During this time you really want to make sure you’re employing your techniques for getting rest for yourself, and you want to help your baby sleep when s/he’s tired by watching for the sleep cues and soothing him back to sleep within 1-2 hours from his last wake-up time.

Also, during this time the startle reflex really hits its stride in babies. Just as your baby is about to fall asleep or sometimes wake up you’ll see them jerk their entire body and flail their arms out. This often fully wakes the baby, “startles” him, and makes him cry—meaning no one gets any sleep until you can calm him back down. Swaddling restrains their ability to flail their arms and legs and therefore helps them sleep more soundly and longer. You can swaddle with regular receiving blankets or special swaddling blankets. My personal recommendation is for the Miracle Blanket which truly does help work miracles and doesn’t take an advanced swaddling degree to operate.

5-6 Weeks
Generally the fussiness that you started noticing in your baby around week 2 peaks at week 6 (unless your baby has colic in which case you should just call me when you reach this stage). Many babies have a particularly fussy time in the evenings and will need to get out for a walk, a drive, to be held in the sling, put in the swing—keep trying things until a) you find something your baby responds to or b) you know you’re tried every idea in the book.

Around 6 weeks is when some babies start to “sleep through the night” which at this age often means going to bed somewhere from 9-11 pm and waking up at 6 am or so. This is also around the time when your baby might start having a harder time sleeping anywhere. Previously you might have been able to cart your baby around with you to restaurants, shopping, on walks, etc. and not had to think about when he would get tired because he would just fall asleep wherever he was. For some babies this continues for awhile but for others—especially very social or sensitive babies, they will start to notice their environment more around 6 weeks of age, and at this time will have a harder time shutting down and going to sleep. Just be aware this might happen—you’ll just have to start taking your baby’s sleep habits into account when trying to plan outings.

7-8 Weeks
The main thing that happens during this period is that babies may start to go to bed earlier. Rather than a bedtime between 9-11 they may be ready for bed by 7-8. They also may start to sleep longer at night—in fact I’m told that some babies actually sleep all night at this point—meaning from an earlier bedtime to 6-8 in the morning.

8-12 Weeks
Somewhere during this time your baby’s nap schedule will also start to solidify. Most likely your baby will take 3 naps at this point—one around 9 am, one around noon or one and one later in the day somewhere around 3 pm. I think it’s common for the schedule not to be set in stone, i.e. if they woke up a little earlier or later it throws their actual nap times off a little bit—but you have some kind of routine to expect during the day.

I think the keys to helping babies fall asleep and sleep through the night are:
· Swaddling
· Getting them back to sleep no longer than 2 hours after they last woke up
· Being totally boring at night (i.e. no talking, singing, playing, etc. during their night feeds)
· Paying attention to their sleep cues so you put them down when they’re tired, not overtired

From the beginning it’s a good idea to give your baby a few minutes to see if they can settle themselves, or if they’re really waking up and need you. Something I didn’t realize was that lot’s of babies make lots of crazy noises while they’re sleeping. Henry actually grumbled like an old man in his sleep all night long. There’s no reason to go in to “soothe” them when they’re making every little peep—even if they just barely start to cry or cry out. Babies make noises and I think it’s better to give them some latitude on this. Of course when they’re under 3 months old, once they do start crying you’ll definitely want to respond to them to figure out what they need.

I think the earliest you’ll really find people telling you to start introducing “sleep training” techniques is around 3-4 months. This is where either you gradually decrease your direct soothing techniques (i.e. just patting your baby on the back rather than picking her up when she cries, then singing or talking to her but not touching her, etc.) or you let them cry checking on them periodically. Of course you can help your baby try to find their hands or be soothed by a pacifier earlier than that.

Roundtable- Feeding

Now that we’ve got the nuts and bolts of what you’ll need for the baby out of the way, we can start the more in-depth topics. This week will be devoted to feeding. I breast-fed solely for the first 9 months or so. Therefore I’m going to focus on breast-feeding and hope that some other pros can chime in with information about bottle-feeding a newborn. We did give Henry formula from the time he was about 10-12 months though so feel free to ask any questions you might have and if I don’t know the answer hopefully somebody else will.

Also, since we have a whole week on this topic I thought I might do this in a bit more stream of conscious fashion. My primary goal is to help you understand the basics and to at least cover enough to prompt questions you might have. I really recommend at least skimming the Breastfeeding Mothers Companion if you are planning to breastfeed. It covers just about everything you need to know and also helps you know what kind of problems might crop up and how to handle them.

Feeding Basics
At first…
As soon as your baby is born, you’ll want to try to breastfeed. Lots of babies take right to the breast and others might struggle around with “latching” on, i.e. getting the right suction with their mouth to activate the milk ducks. Either way, trying breastfeeding out at this point is a great thing for you and your baby. If s/he’s not that interested in feeding it’s not a big deal and you can simply try again a bit later. If you’re planning to breastfeed, you’ll want your baby to room in with you (i.e. stay in the hospital room with you instead of the nursery) so that you can “feed on demand.” This means when the baby cries you consider feeding as one of the key things they might need—in addition to being held or being changed.

For the first several days you don’t actually produce the normal milk you’re baby will eat once you’re “milk comes in.” At first he brings down colostrom which is a thick yellowish milk that is very rich in fats, proteins and antibodies. Supposedly it also helps to clear the meconium out of the baby. At this point your breasts probably won’t be that different from how they were at the end of your pregnancy.

Engorgement
Somewhere around 3-4 days postpartum though, your milk will come in and your breasts will get really absolutely gigantic and very hard. This is engorgement. Your body has been told to start producing milk, but it doesn’t really know how much your baby needs or when s/he needs it so you’ve got an oversupply. You’re encouraged to feed whenever the baby is hungry and over a few days your breasts should calm down a bit. Your body will figure out approximately when your baby tends to eat and your milk will “let down” once your baby starts to suck. In the meantime people swear by cold cabbage leaves around their breasts (I never tried that one), massaging your breast before nursing (from top of breast towards nipple) and cool compresses up to 20 minutes before feeding. Generally engorgement passes within 24 hours—mine lasted more like 36-48 but eventually went away on it’s own as well.

Timing/Frequency
Most things you read will tell you that your newborn will need to eat every 2-3 hours. I think this is generally true although sometimes they certainly want to eat more frequently and sometimes they will go longer periods between feedings—especially at night. What’s really grueling about this, and that I didn’t realize until Henry was born is that it’s 2-3 hours from start of feeding to start of feeding. It’s really normal for babies to take 30 minutes to eat when they’re this little and sometimes up to an hour. So, if they started to eat at 9:00 am and took 30 minutes to finish up, it’s really only 1.5-2.5 hours until they’re ready to eat again.

Although there are different strategies, I think consensus is to breast feed first on one side and then the other. Generally 10-15 minutes per side allows the baby to drain the breast and get all both the thinner foremilk and the more-filling hindmilk. One of the difficult things about feeding a newborn is that milk makes them really relaxed and sleepy, you’re constantly trying to keep them awake by tickling their feet or rubbing their hands, etc so that they can get a full feeding in. It’s preferable for them to eat a meal rather than a snack so that they start to move towards a more regular feeding routine—and you have longer in between feedings to sleep, eat and take care of yourself.
Set-Up
I mentioned last night that newborns tend to eat every 2-3 hours and it takes them at least 30 minutes to finish eating which means you’re spending a good deal of your day feeding your little one. It can really help to have a comfortable feeding set-up. During the day I think a comfortable chair with good back support and padded arm rests are nice. If you have something to put your feet up on (especially if you’re short) that’s even better. You’ll want to have the phone within reach as well as some water and potentially some snacks. Breastfeeding can make you ravenous. Magazines are also good to have on hand as is the remote if you like to watch TV or videos. Basically you want a “control center” in which you’ll be able to reach everything and partake in activities that only take one hand.

At night you’ve got a few options—if you’re co-sleeping or your baby is sleeping next to your bed, you can either just sit-up in bed and nurse or feed your baby lying down. Other people like to have a comfortable chair near the bed and actually get out of the bed to feed as well. In general I think it’s recommended that the night feeds be as boring and business-like as possible, so doing them in a darkened room without any other stimulation is good. This helps you fall back to sleep faster (without being jarred awake by the light of the TV) and helps your baby to realize eventually that it’s more fun to sleep during the night and actually interact with you during the day.

At first you’ll have to change your baby’s diaper when you feed them at night. In the early weeks they basically poop every time they eat, thus you’re constantly changing diapers. At some point (anyone remember when?) their digestive cycles get more normal and you won’t have to change as many or any overnight diapers because they’ll just be wet. I mention this though, because at least at the beginning you need a changing set-up near where the baby sleeps.
Latching
I encourage you to read the Nursing Mothers Companion that I read last night and other breastfeeding material you find to get a good description and pictures of what a good latch looks like. I’m going to focus on what it is, why it’s important, and what you can do to help achieve it. The latch is basically the code word for “breast lock.” It’s a particular way that the baby will connect with your breast and nipple so that the milk glands are activated and their sucking will bring down the milk. It’s important that the latch happen so that a) the milk starts flowing when the baby “requests” it and they don’t get frustrated and b) breastfeeding is comfortable for you and not super painful.

The tips I’ve read mention holding the baby out in front of you on their side with their mouth aimed at your breast. You stimulate them to open their mouth by stroking their cheek or rubbing your nipple on their bottom lip. When they open up you quickly bring their mouth to your breast. The key is that you want them to have their whole mouth around your breast—not just sucking on your nipple like a bottle nipple.

Even with the correct latch breastfeeding may feel uncomfortable at first. Especially during engorgement your breasts are full and hard and they can hurt. Even with a great latch your baby can make your nipples feel sore, and if you have a feeding session where they aren’t latched on correctly you can find yourself with really hurting or cracked nipples that take awhile to heal since they don’t get put on the DL.

Lanolin can be used to help soothe your nipples if you have severe pain and can also just keep things moisturized if you’re having normal adjustment aches. You don’t have to wipe it off or anything as it’s safe for the baby. They also make these soothing gel packs called “soothies” which you can get at the drugstore. I never tried them but I’ve heard they are very helpful.
Positions
Again, I would encourage you to consult a book to see pictures of the various nursing positions. I just want to draw your attention to some of the most popular, and let you know that there’s more than one way to breast-feed. The most popular position is called the cradle-hold. This is probably the one you picture when you think of breast-feeding. You are supporting the baby on your left arm laying across your body and the baby is nursing on your right breast (and vice versa). This tends to be an old standby and an easy position to get the hang of. It really helps to have a pillow underneath the baby (especially when they’re tiny) so that you aren’t slumped over trying to bring your breast down to the baby. You always want to elevate the baby to your breast so that a) you don’t put strain on your back and shoulders and b) the baby isn’t actually pulling on your nipple (ow!)

Another position that I actually had better luck with at the very beginning is the side-lying position. Basically you are laying on your side in the bed and the baby is lying next to you nursing on the breast nearest the mattress. To me this just came naturally and was great in those early days after delivery when sitting up didn’t always feel comfortable. I’ve heard some moms say this position was confusing though, so like everything you’ll just have to try different things out to see what works for you.

The last “basic” position is the football hold. In this position you cradle the baby on your right arm held at your side and they’re nursing on your right breast (and vice versa). This is just another one to hold and one that I hear can be great when your c-section scars are still healing.
Feeding on the Go
Regardless of your feeding method—at some point if you’d like to get out of the house at all, you’re going to need to feed on the go. Bottle-feeding and breast-feeding both have their own considerations.
Bottle-feeding
If you are feeding your baby with a bottle (either formula or expressed milk) you’re obviously going to have to bring the expressed milk or formula with you. If you have a bottle of expressed milk you can just ready the bottle(s) before leaving and store them with a cold pak. Some diaper bags actually have insulated bottle pockets which work great if you’re just going to be out for a little while. There are also these ice pak things that are circular and go around bottles of all types. These work well to go around baby bottles—wrap them in a towel and/or put them in a Ziploc bag and you’ve got your own little cooler.

If you’re using formula you’ll need to bring the formula with you. They sell little containers that hold a pre-measured amount of powdered formula so that you can bring say 3 bottles worth of formula. You would fill 3 bottles with the right amount of water and then just open the lid on one of the containers and pour it into the bottle (the hole in the container is the right size to match up to the bottle opening.) Alternatively, I’ve seen Moms just pre-measure the formula into a dry baby bottle and then add water whenever they get where they’re going (this presumes you have access to clean water of course). If you’re just going to be out for a little while you can go ahead and make-up the formula bottle and follow the same instructions as above for keeping it cool. I know the formula is supposed to be consumed X hours after you make it up, but I don’t remember how long that window is.

With bottle-feeding, you have to think more about the stuff you’re bringing but less about where you feed the baby. While it’s nice to find some place to sit, I don’t think I’ve heard of anyone getting upset or uncomfortable seeing a baby bottle-fed.
Breast-feeding
With breast-feeding you really don’t need to bring much with you when you’re going to feed. Many moms like to bring some kind of blanket along with them (which likely you’ll have packed in your diaper bag anyway) to throw over their shoulder and the baby while they’re nursing. Other than that, you don’t need any other stuff.

You do however tend to care more about location. Even if you are the most comfortable breastfeeder in the world and you consider it a very political issue to breastfeed anytime anywhere, your baby may actually turn out to be more sensitive. Some babies (especially as they get older and more aware of their surroundings) will have trouble concentrating on eating if they’re outside, in noisy surroundings, etc. For this reason, it can be nice to find a quieter place to breastfeed—at least in my experience.

The only thing really required is a place to sit. You can breast-feed in the car, on a bench, in the “living room” portion of the ladies room at a department store, anywhere really you can find a place to sit-down and have a few minutes of quiet. You’ll find your own comfort-level for what you find doable in terms of public breastfeeding. Most times you have the car as a back-up which is always preferable to a regular bathroom.

If you are actually traveling—as in long car-trips, it can be really nice to have expressed some milk. One thing that is very difficult (although I won’t say impossible) is to breast-feed your child while they are safely strapped in the car seat. If on a long car-trip your child is hungry it’s nice to have some bottles available rather than having to pull-over or stop all the time.
Pumping
If you are planning to breastfeed exclusively they generally tell you to wait 6-8 weeks before trying to give your baby a bottle. The reason given most often is that the baby might have “nipple confusion.” The rationale goes that a baby has to open their mouth wide and latch on to your breast to feed “correctly.” With a bottle nipple you just suck the very tip and you don’t have to work too hard to get the milk out. If you introduced bottles too early the baby might not be able to make the transition back and forth. To be honest I’ve never actually heard a mom with this problem so I’m tempted to dismiss it.

However, there are other reasons for waiting to give a bottle. The primary one is that it takes awhile for your body to get into a rhythm in terms of milk production (how much and when it’s needed) and for your baby to get into any kind of routine about when they want to eat. If you are replacing one of your normal feedings with a bottle of formula (supplementing) and you do it regularly, your body will stop producing milk at that time or your supply will decrease. If you know that your husband is going to cover the 9 pm feeding every night, this might not be an issue. But if by and large you will be doing the feeding and you plan to breastfeed for the first many months, you’re better off getting into a good pattern breast-feeding for the first 6-8 weeks and then transitioning into bottles.

Also, you may have plans to pump as much as possible to have a gigantic supply of breastmilk stored when you go back to work (if that’s part of your plan). You can slowly start pumping in addition to your normal feedings of your baby by either pumping for a few minutes on each side after your baby has finished eating, or by fitting in a short pumping session (10 minutes per side) halfway between two of your babies’ normal feedings. When you first start pumping you should try these techniques in the morning because that’s when your milk supply is at its peak.

It’s totally normal to get almost nothing when you first try pumping. Some women don’t have this problem but it takes others awhile to really “produce” anything. Down the road if you are pumping 2-3 times a day (mostly likely while you’re at work) you’re much more likely to get several ounces on each side—equivalent to what the baby would be eating if s/he was breastfeeding directly.

Breastfeeding Difficulties
These are the types of things that can happen that can make breastfeeding challenging. I think it’s helpful to know that these things CAN happen so that you can focus on fixing them rather than worrying about whether or not anyone else has ever had the same problem.

Sore breasts and nipples—this is probably the most common and easiest problem to deal with. When you first start breastfeeding, as you and your baby are adjusting to the process it’s likely that everything will be a little sore and hurt a bit.

Cracked/Bleeding nipples—if your baby is sucking just on your nipple and not latching on to your entire breast, you’re likely to wind up with cracked and or bleeding nipples. Obviously this is painful and it takes awhile to really clear up because your breasts are being used pretty frequently. Lanolin cream can really help as well as something called Soothies at the drugstore.

Difficulty latching—Some babies literally just “get it” right away. You put them to the breast and they basically do the work. Others act like they can’t be expected to have this all figured out. If you are having trouble getting your baby to latch on it can be extremely stressful—your baby probably isn’t just laying there cooing at you (which by the way happens much later) while you work with her to latch on. She’s more likely screaming and getting more and more agitated the more things you try. There’s no “winning” in this situation you just keep trying different things—different positions, trying to stimulate her to open wide and then pull her quickly to your breast, meeting with the lactation consultant at your hospital (or an independent one if you’ve already come home), and if need-be giving her formula while you pump and continuing to try the breast until she gets it.

Falling Asleep—this is something we really struggled with. I wanted to make sure that Henry was getting full feedings, so I would make sure that he was actually eating 10-15 on each side. Problem is, he’d fall asleep about 2 minutes into the feeding session and I’d spend the rest of the time doing a version of a) tickle his palm until he wakes up, b) nurse him 2-3 more minutes, c) falls back asleep, d) tickle his feet until he wakes up e) nurse him 2-3 more minutes, repeat. This clearly makes 20-30 minutes of actual eating take an hour which is totally exhausting.

Wanting to nurse constantly—Ideally your baby will eat between every 2-3 hours (closer to 3 you hope). However, there are times when it seems like your baby wants to nurse literally all day. A few things—if your baby is crying try the other obvious things to soothe her first such as changing her, helping soothe her to sleep if she’s tired, walking her around for awhile if she needs a change of scenery. If none of these things help and she just ate you could also try letting her suck on your pinkie finger or a pacifier to see if it’s just the sucking motion she needs. Finally I would offer to breastfeed her and see if she really eats. If she eats a little and falls asleep, it will help you know for next time that you probably need to help her get to sleep earlier—before she gets cranky. Babies go through little growth spurts and sometimes nursing is all that they want or that will make them happy. I think it’s nice to try out your other options first, but sometimes if they really want to eat—just feed them. You won’t ruin their “schedule” in one day and they won’t be nursing all day forever.
Q & A
Q: I was told by a midwife that is essential to take a breastfeeding class. Did anyone take a class and, if so, did you find it helpful at all?

A: I did not take a class, but I should have. I think the more you know about it beforehand, the better transition it will be. Some babies are naturals but if Mom is nervous, anxious it can turn the babies off. If you have the time you should do it.

A: I didn’t take a class so was a bit unclear what was covered and how they worked—i.e. are you just seeing pictures of people breastfeeding, are you trying out the positions with dolls, etc. Based on the responses I got on the board, it seems like the classes can really vary, so of course what you get out of them can vary as well.

My short answer would be that if you have done some reading or looked at some pictures of the latch or feeding positions and it just seems like hopeless mumbo jumbo, a class might be a really helpful tool in your preparation. If you’ve looked some stuff over or been around friends or siblings that have breastfed and it generally seems to make sense to you, I’m not sure it would make that much of a difference. If you’re the kind of person that feels like the more prep the better, by all means sign up for the class.

The only thing I would say is that while some prep is good I think people can get too stressed out about how complicated the latch is. I know this really differs from baby to baby—some “get it” right away and some you really, really have to work with, but I don’t find it particularly helpful to think that if you don’t take a class there’s no way you’ll figure it out.

The other thing I would mention is that I don’t think classes, and some of what you read, prepare you for the difficulties of breast-feeding. A lot of stuff you’ll read will tell you that it shouldn’t hurt but I think honestly that depends a bit on your body and your baby. It’s true that if your nipples are cracked and bloody and you feel like you’re giving birth all over again most certainly something is wrong. If it’s uncomfortable or hurts a little at first it’s highly likely that you’re just getting acclimated to the process. Still, it’s not like getting a back massage or anything.

Q: A couple of quick follow ups on feeding. In our labor class, the nurse said that you can go ahead and have alcohol and still breast feed. I was told in the past that if you are going to have alcohol you need to get rid of the "batch" that would contain the alcohol. Also, did your doctors tell you about any diet restrictions while breast feeding? A friend of mine was told to stick to a pre pregnancy diet of no sushi, no lunch meat etc while the labor class said that you can basically eat whatever, but stay away from tuna.

A: This is kind of a grey area and you'll probably hear more opinions on this but I thought I would jump in on what I think. If you have one drink, you're probably OK with feeding the baby but if you have two or more, I'd say just skip the next feeding and pump (discarding that milk) and use your stored milk as backup.

I ate whatever I wanted during nursing but it's said some babies can be more gassy with certain foods. So just be sensitive to it, if you are noticing something a little off in the baby. You probably do want to watch certain fish due to the mercury concerns. Big ocean fish, tuna, swordfish and others. Just don't have them more than once or twice a week.

Bottom line though, do what you are most comfortable doing. If you don't want to fee the baby after one drink, then just plan ahead an pump a little extra for the fridge the day before or day of your outing.

A: I agree with Tab that this is one area you’re likely to hear a lot of conflicting advice. I believe this is because the standard guidance that used to be provided regarding drinking and pumping has changed in just the last year or so. They used to tell you that if you were going to drink you needed to pump after the feeding and dump that milk. I believe now they tell you what you heard at your class—that it’s okay to either pump normally or feed normally after drinking.

I believe they also tell you that your best off feeding or pumping right after (or during!) having a drink because it takes 2-3 hours for the alcohol to make it to your milk supply. I also think that this advice pertains to having one drink slowly—not binge drinking or taking shots—anything where you’re rushing alcohol to your blood/milk supply.

3.02.2007

Thank You

Some really considerate offerings of support were made to me after my post last night and i just wanted to say thank you and let you know that i didn't mean to sound so desperate. As a good friend said, i was "desperate for a good night's sleep" and thankfully i got a great one last night. Henry is tucked away quietly in bed and i'm hoping to turn in shortly. I started taking the antibiotics the Dr. gave me after my sinus congestion took a turn for the worse and i think they are starting to work as well.

I hope everyone has a great weekend and i hope to have more pictures and things to post on Monday.