Mary Anne’s Guide to…

Mary Anne's Guide to Newborns

A couple of my friends have had babies recently, and as I listen to their struggles with their newborns, I'm reminded of all the things I wish I'd understood in advance. There's a *steep* learning curve to your first new baby, and so much gets hurled at you all at once. Here are some things that may help. Some of this is mommy-specific, but a lot of it applies to mommy's partner(s) too.

General

  • sleep -- expect to be woken every 2-3 hours for the first month, and have to be awake for at least 30-45 minutes each time. You will feel horrible; an occasional all-nighter in college is not enough to prepare you for this. It's because baby's stomach is too small to hold more than 2-3 ounces of milk. She's not doing it to torture you. When they say to sleep when the baby sleeps, they really mean it. Let other people do *everything* else except eat and shower and pee for you. Even if you can't lie down and properly go to sleep, dozing on the couch while holding the baby will help. Turn off the tv sometimes so it doesn't keep you awake when you should be dozing.
  • love -- don't be surprised if you don't love your baby right away. It is a sack of potatoes, a sleepy demanding creature that will not even smile at you for weeks. It may not show much personality at all. It is hard to love a lumpy sack. Don't worry, just keep taking care of it, and the love will come. This applies to both mommy and partner(s) -- really, to anyone who spends much time at all caring for the little bugger.
  • kangaroo care -- this may or may not help with breastfeeding, but regardless, spend as much time as you can snuggling with your naked (diapered is okay) baby against your skin (partners too!). It is just really lovely, and one of the few rewards you get in the first months. It'll help you love her more too.
  • stay inside -- for the first month, it's really best to avoid other people as much as possible. Why? The reason to avoid people is that what would be an ordinary cold with a light fever for a two-month old means, for an under-one-month old, a possible multi-day emergency stay in the hospital with a spinal tap. Terrifying. So there's a reason for the old tradition of the 'lying in' period, and you should follow it. If there are people you really want to see, have them come to you, and make them wash their hands before touching the baby. If they have a cold, don't let them come at all. And send someone else out to the store if you need things!
  • the first six weeks really are like running a gauntlet. It may well be the most physically demanding, emotionally draining thing you will ever do, and all the while, people around you will expect you to be joyous and ecstatic. Screw them. You just concentrate on getting through this, and trust that IT WILL GET BETTER. Because it will, I promise.

Breastfeeding

  • bring a boppy to the hospital; they'll keep trying to pile up pillows, but it'll be ineffective and make things harder
  • if you possibly can, even if you feel like utter crap, within the first hour after delivery, try putting the naked baby on your naked stomach and see if they crawl up and latch on their own; make your partner/doula/doctor aware that this is a priority for you, because it may make your life infinitely easier later on. Even though I was in shock after the c-section, I wish I'd asked for this.
  • understand that the hospital's supposed 'lactation consultants' are probably actually nurses who have taken a one-week course -- they usually know three things to try, and will try them forcefully and repeatedly -- but only in five minute chunks, before they rush off to another room. If they are upsetting you, send them away and snuggle your baby. Say, firmly, "I'd like to be alone with my baby right now, please." If you can't send them away, have someone else do it for you.
  • trust your instincts on what seems to be working for you -- Kavi and I did pretty well with side-lying nursing in the hospital, but the nurses were worried that I'd fall asleep and roll over on her, and kept trying to get me to sit up (v. difficult with c. section) and do football hold (which, as it turned out, probably exacerbated the overactive letdown reflex she had so much trouble with). I really wish I'd ignored them all and kept doing co-sleeping and side-lying feedings in the hospital.
  • try to understand how the breast works. I had no clue about engorgement, for example, so when my daughter started refusing my huge, rock-hard breast on day 2-3, I didn't know what was going on. I eventually figured out the pumping out some of the excess would make it much easier for her to latch onto, but we lost a good day or so to this, at a critical period. It also helps to understand how much you need to feed/pump to establish a good supply, what foods can help with supply, at which point the breasts switch from on-demand production to something else, etc.
  • the best book I've found on this is The Nursing Mother's Companion, lots of practical, non-judgemental advice, and if you keep nursing, will be useful throughout the months to come. I also learned a tremendous amount from Kelly mom and the Yahoo pump moms list. I wish I'd started reading them about a month before delivery, instead of waiting 'til after.
  • consider cup-feeding if you're having latching difficulties -- I wish I'd tried this, in retrospect, before we gave her a bottle to supplement. The SNS didn't work for me, because when we were already having trouble latching, adding a little plastic tube to the latching process was like adding insult to injury. (It might work well for someone who has no trouble with latch but who is having trouble with milk production, though.) Cup feeding might have kept her from getting used to the ease of the bottle; I don't know.
  • when you're trying to breastfeed, expect that it may take a long time to get in position, get comfortable, get a good latch, etc. Long time, as in 30-45 minutes. So try when you're rested and able to be relaxed and patient with the process, and when you have someone there to give you moral support

Useful Stuff to Buy

There are lots of things that are fairly obvious, but here's some that worked really well for us.
  • boppy! or boppy-like device. Something to nurse baby on, but also a safe place to put baby down on the couch initially, so she can't roll away. I loved my boppy. Super-useful for a good three months, at least.
  • if you have multiple floors, you need a changing station on each floor, with a safe place to change her, diapers in right size, sensitive wipes (although apparently a damp paper towel will do, it's easier to use wipes, especially early on when you're going through a lot of them), diaper genie. I also highly recommend a small laundry basket on each floor to toss soiled baby clothes into.
  • baby carriers: the Moby Wrap was great with a newborn; I could swaddle her in it and comfortably type, make breakfast, wander around the apartment for hours (without back pain). The Bjorn was excellent a little later -- easy for me or friends watching her to put on and take off, with such obviously great support for the baby that it reassured those unfamiliar with babies that they weren't going to drop or break her.
  • pump -- if you're going to be exclusively pumping, it's worth the rental cost of the Medela Symphony for efficiency (least time spent pumping, because it works fast) and gentleness on your poor nipples. If you're not exclusive, then Pump in Style works pretty well, and is portable. Have a hand pump for emergencies in your diaper bag, and be sure you have tubing and bottles for it in there too.
  • bottles: BPA-free bottles. I know the Medela ones are safe, as are the Born Free ones. I don't know about others, but while I'm not certain of how serious the risks are from using bottles with BPA, I know that I sleep better knowing that hers are BPA-free.
  • diaper bag: backpack style is ideal, as it will let you wear baby on your front, bag on your back, and still have two hands free for the rest of life. Be sure it has a side pocket you can easily reach where you can stow the current bottle of milk -- hugely helpful. I picked one that was big enough to hold my laptop as well, which has worked out really well for travelling; when I fly, I only need the one bag on the plane -- it holds diapers, computer, wallet and iPhone, book to read, toys for her, etc.
  • moses basket and rocking stand -- this was great to have on the first floor, as it provided a safe place to put her down, and the stand ($40) meant that if she started to wake up, and moved, it would often rock her right back to sleep, without any intervention from you. She's still sleeping in it at six months, and loves it. We love being able to carry it from room to room.
  • lots of onesies or little wrap tops (she'll go through 4-6 in a day), burp cloths (you can use receiving blankets, but they're a little big for it), and someone to do laundry for you. Do *not* try to carry a full laundry basket in the first weeks after a c-section -- you may feel like you can, but it is heavier than is good for your incision, and you really really don't want to rip it open again.
  • receiving blankets -- you need these to swaddle her initially. 4 or so will probably be enough, though we had 8, I think, and it made life easier. Practice a lot in the hospital, when the nurses are there to help you. Swaddling will save your life. (If your baby likes it -- apparently, some don't, and I weep for those poor parents.)
  • a swaddler -- we used a SwaddleMe, and it was a fast and easy way to swaddle her after about three months, when she was starting to outgrow the receiving blankets. It's not so useful before then, as it's too big for a little baby. Depends on the size of your baby, of course. Kavi was about seven and a half pounds.
  • a sleep sack -- essential item for keeping baby warm at night without increasing risk of SIDS through blankets that may smother. You want 2-3, for when one's in the laundry, as she *will* spit up on it occasionally.
Please feel free to add suggestions in the comments!

11 thoughts on “Mary Anne’s Guide to…”

  1. boppy this, boppy that. Hey, so my girlfriend just had twins… and it turns out the only way to get any sleep at all is to pre-emptive feed one when you get up to feed the other. And suddenly the boppy, which had been somewhat optional for her first daughter, turned out to be absolutely indispensable. Because she can just sort of stuff each kid under one arm and let them go to town. (but then she has a hard time putting them back where she got them from without dad)

    Anyway, I’ll be sending this link to my expecting-any-day-now sister-in-law, hope you don’t mind…

  2. Oh, good list! The one thing that really has hit me is, even though I was prepared for it being the hardest thing I’ve ever done in my life, how this is way way way WAY harder than I’d even imagined. Having the c-section and having to recover from that, too, makes it harder, I’m sure, but I still wasn’t imagining anything close to how difficult this is. But it’s so worth it.

    I have a couple of addendums to your list:

    Breastfeeding — I have a (unfortunately named) “My Brest Friend” instead of a Boppy, and I have to say I prefer it. It fastens around your body (it’s adjustable) so the baby can’t slide down between you and the pillow as you try to nurse. I’ve also mastered walking around with him cradled on it (supported by an arm, of course), which makes it easier to ease him into his crib when he falls asleep nursing in the other room.

    Also, I recommend a nipple shield to help get the baby used to the idea of latching on in the first few days. It gives the baby something longer to latch onto, and I managed to wean him off of it and onto the breast itself after just over a day of using it. Until we tried the nipple shield, I despaired that I’d ever get him to latch on and stay on (and I would try for an hour and a half at a time).

    We used an SNS (filled with pumped breast milk) taped to Daddy’s finger to feed the baby to let me get more sleep for the first couple of weeks. Really difficult to set up by himself, but it let me skip a feeding in the middle of the night without giving him “nipple confusion” by using a bottle.

    (Kaiser Oakland has really awesome lactation consultants, I must say. The nurses I had would give me conflicting/ bad nursing advice, but the actual lactation consultants were patient, knowledgable and very helpful and didn’t rush us. It was a little tricky the first few days getting them in there when the baby actually wanted to nurse, but thanks to the c-seciton I was in the hospital long enough that we got to see two different ones for several long sessions, and I got help with all sorts of different positions (including side-lying). And they have as many free follow-up lactation appts. as you want (we’ve had half a dozen at least since we left the hospital), which has helped us refine our latch (though it’s still not perfect).

    While I’m touting Kaiser Oakland, I have to say that I loved every single doctor I came in contact with during my labor/ delivery/ recovery. Smart, liberal thinking (they didn’t hold me to rigid rules about how long I could push, as long as both the baby and I were doing ok), kind, good bedside manner and also just generally cool women (as in, I wish we could all hang out sometime). I was really impressed with them all.)

    Stuff:
    We have one SwadddleMe that’s actually small enough for him now (newborn), so I know they come pretty small. We cry when it gets dirty, though. Our little houdini wiggles out of blanket swaddles, no matter how much we try; the velcro on the SwaddleMe keeps him imprisioned for longer.

    Gowns! It’s much easier to change him when I just have to pull an elastic hem over his diaper rather than snap/ unsnap a onesie while he kicks and wiggles. Though he often pees all over what he’s wearing anyway.

    I wish we’d gotten a moses basket/ rocker thing. Sounds wonderful! The mini co-sleeper helps us get a little more sleep in the bedroom, though. And how long was the Moby Wrap useful? He’s still too small for nearly every carrier we have, but I don’t want to go get one if he’s going to outgrow it in a month or so.

    I’ll add more things as I think of them. It’s amazing how fascinating this all is to me now!

  3. Huh — I hadn’t even heard of (or thought of) using the SNS with daddy’s finger — cool. That would have been a good thing to try.

    One nurse did vaguely suggest a nipple shield, but in a discouraging sort of way, and somehow we never got around to trying it until Kavi was five months. (The LC who suggested it at that point was great, actually — someone Thida recommended, and I only wish I’d talked to her sooner. She had a little plastic syringe so you could squirt some milk into the nipple shield after you got it positioned, to help convince baby that this was a milk-producing object.) I think it might have been really helpful if we’d tried it months earlier.

    According to their website, you can use the Moby wrap to 45 lbs., and most people are comfortable using it to 35 lbs. So years and years. 🙂 I was just at Dan and Nadya’s showing them how to wrap theirs, and I slung Kavi into it, no problem (although she’s too big for the newborn hug hold, which is the only position I know offhand — have to go look up the next one). It’s a bit warm for summer, but is great in winter, and offers better back support than the Bjorn.

  4. You did not talk about the post partum depression that every new mother experiences when she comes home with the baby.

  5. Hmm…Elise, I’d be happy to have someone else talk about post partum depression, which I do understand is really common, whether in a mild form or a severe one.

    But for myself, I don’t know that I did experience it — or if it did, it was entirely overshadowed by all the stress and trauma of the breastfeeding difficulties we had. In fact, aside from breastfeeding trouble and terrible exhaustion, I was actually happier and more energetic, creative, etc. than I had been before the baby. So I don’t think I’d say that *every* new mother experiences postpartum depression — though certainly, many, if not most, of them do.

  6. Hi — Jed linked to this, and it’s a great list. I’ll add a few things:

    1) we had a Maya wrap, and it was great. It’s a bit tricky to figure out, since it’s very simple — cloth, rings. Their online videos are a great help. We used it from birth through about age 2 (toward the end of that time with the baby on the hip and the sling under her butt).

    2) some advice for partners: the stuff about sleep and the mother doing nothing but sleep, nurse, eat, and pee (shower was often an unattainable luxury for Jill) is absolutely right. Partners: it can be tough, because while the mother needs you to do everything, she usually CANNOT POSSIBLY tell you what she needs you to do. You have to just try stuff. For example, don’t ask “what would you like for lunch?”. Offer two things you know she likes, and let her pick between them. This is the kind of thinking that is just too hard on extended lack of sleep.

  7. A few quick thoughts:

    Don’t get wrapped up in the “I wish I’d…” — no matter what path you have, you’ll naturally think another one might have been better. Steve got Wolf latched on right after my C-sec, when I was too out of it to do it myself, and the result was a big blister on the nipple from a poorly positioned latch. Ah, well, we all survived.

    Lactation consultants and nurses are as variable as any humans — from useless to great. Plus, they all have the unenviable job of educating patients in the early stages of lacto-dementia, who are still suffering from placenta-brain. Best to have ongoing support for when your brain comes back.

    All you need for a “changing station” is a laundry basket of supplies — a towel or mat to spread on the floor, wipes, diapers. (Things you learn when you have a bum leg the first two months post-partum.)

    Whatever sling or baby carrier you have, wonderful! I think the prevalence of schlepping babies around in their car-seats rivals the prevalence of formula-feeding for dysfunctional American infant care practices. Messes with their vestibular development, which is key in the first few months, as well as all the obvious issues of not being close to their care-givers (smell is up there among the baby’s primary senses, early on).

    Co-sleeping rocks. Get a secure and comfortable set up (for us, a futon on the floor, and some half-jacket to allow the blankets to be at the right height for baby without me freezing, and a plastic diaper that could go the distance), and a significant part of the sleep deprivation is alleviated. It’s amazing how much nursing you (plural) can do in your sleep. But you sure wake up the first time you roll away without popping the baby off first.

    Most of all, surround yourself with people who can offer advice, and banish those who only know how to Tell You The Right Way To Do Things. A new mom who does some things less than ideally is no big deal, but a new mom who comes to believe that she doesn’t know how to do anything right — that’s going to be an ongoing cause of stress and pain for the whole family.

  8. I also came to this from Jed. I have 2 babies, and my God, was Baby 2 easier. because I’d gone through my trial by fire a few years ago.

    Breast feeding is wonderful. It’s one of the best things that will ever happen between you and your baby. But if it just isn’t working, don’t beat yourself up. I had a crappy time with Baby #1–she ended up in the e.r. due to dehydration on Day 3 at home. And yes, this was after lactation consultatns, La Leche, etc.

    Baby #2 nursed longer, but then I got mastitis and she got a rash from the antibiotics.

    They are both happy healthy loving girls, sick very rarely, smart little stinkers.

  9. I came here from Jed as well.

    The one best bit of advice we got was to try simethicone (a liquid that helps pass stomach gas) for an exceptionally fussy baby. If you’ve got an infant that cries just about every time you put him/her down, sucks to soothe him/herself all the time, and sometimes will only settle with constant movement, you just may have a baby that desperately needs simethicone.

    For partners, one thing I’d mention is that, for a first c-section, you don’t know if you’ll faint or vomit. (Really. No matter how tough/macho/nurturing/special you are.) So listen to the nice nursing staff, and concentrate on a) soothing your partner and keeping her happy and focused, and b) paying attention to everything and making mental notes so that you’ll be much better for c-section #2. (It worked for me; I kept track of baby #2 much more closely and got him back to mom much faster, which made everyone happier.)

    Oh, and if you hope to exclusively breastfeed (or just primarily), tell the nurses ahead of time, and do your best to keep them from automatically feeding the baby a bottle. (They did this to baby #1, which didn’t end up being as helpful as they might have hoped.)

    And, as you say, you’ll need even more baby clothes than think you will, and, after roughly one day, “cute” will take a backseat, massively, to “goes on and off easily” (and, depending on location and time of year, “warm.”)

  10. Great list! I’m expecting #2 this month, and gearing myself up for the inevitable newborn months. (Oh, sleep. How I will miss you.)

    One thing I’d add is that if you’re breastfeeding, keep tabs on what YOU eat. My daughter had screaming-fit gas pains the first two nights at home, and we traced it to… the green pepper and onion in my dinners those nights. Once we cut out the gp&o, the screaming fits disappeared. (Mylicon helped, too; I already have a bottle on tap for #2, just in case.)

    I’d second your comment on not all mothers having postpartum depression. I didn’t have it. Granted, PPD is very serious; if a new mom is starting to feel hopeless and lost and finds herself not able to cope with the baby, she needs help pronto (and it may be that her partner is the one who needs to get that help for her).

    That said, another tip for new moms is: Don’t be surprised, at least for the first few weeks, by sudden mood shifts or bouts of crying. (Yours, not the baby’s.) These are normal. I once burst into tears while we were eating dinner. My husband asked what was the matter, and I honestly answered, “Nothing… actually, I’m really happy!” And it was the truth.

  11. That’s what happens when I write too late in the evening after an all-night shift — I aim for “a few quick thoughts” and wind up with longish comments which nonetheless leave out key details. Please let me amend my above comments:

    What I find dysfunctional in American infant rearing is the high percentage of new moms who never even consider breastfeeding, often persuaded by free samples and claims of formula being “more convenient” (never understood that, seeing the other mothers schlepping a small steamer trunk of bottles and other formula supplies). Of course formula has good uses — allowing mothers who can’t pump to return to work when necessary (I was able to take Wolf to school with me; if I’d had to return to a regular work schedule, we’d’ve had to turn to formula, since my milk soured very quickly), allowing fathers to be more active participants in feeding, and absolutely to compensate when a mother is unable to nurse sufficiently due to nipple damage, milk supply, or basic discomfort (any benefit of breastfeeding would be easily counterbalanced if the mother is, for whatever reason, repulsed by the process, I’d expect). Somehow in my tired brain last night, I stupidly thought the single word “prevalence” would magically convey all the rest of those details. I deeply, sincerely apologize to anyone who felt slighted or insulted — any decision about breastfeeding vs. formula reached after careful cosideration is, to me, absolutely valid — I only meant to bemoan those who don’t think about it at all. Similar arguments go for the decision regarding circumcision (well, except for the obvious differences).

    I was mosty thinking about how breastfeeding is such a hugely discussed issue, while thre’s a lot less attention on the way babies are ported around. But even here, I think I mangled the coherence — obviously, car seats are wonderfully and absolutely necessary when babies are in cars, and they can be very useful for moving a sleeping baby from the car to another place without waking, or as a handy portable mini-crib. But I’ve seen plenty of babies who pretty much spend the bulk of their waking day in them as well, with little physical contact other than what they get as they are lifted from crib to high seat to play pen to car seat to stroller. So that’s part of why I love the increase in the use of slings and other strap-on carriers.

    Sigh. I hate it when I mangle things like that. I’d make a rule that I should never write or post anything without careful, alert thought… but if I do that, I’ll never have such an ideal opportunity write anything. Again, my most sincere apologies to everyone.

    Bh

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