Friday, February 12, 2010

Think ahead to the baby: A checklist for new parents-to-be

This post is part of the 2010 API Principles of Parenting blog carnival, a series of monthly parenting blog carnivals, hosted by API Speaks. Learn more about attachment parenting by visiting the API website.

newborn baby
Oh, boy — he's here.


The Attachment Parenting International carnival this month is on AP Principle #1: Prepare for Pregnancy, Birth, and Parenting. I've already written a couple times about this topic in my Attachment parenting primer and Move and groove during labor and birth, but I want to address something specific today: the new parents getting ready for the newborn.

I think in these days of online forums and Dr. Google, MD, PhD, it's more common for people to go into childbearing having given forethought to their parenting. But it still shocks me when I occasionally meet someone who has done no research beyond the pregnancy stage, or sometimes the birth. She might know (for it is often the mother-to-be I'm talking with, though I wouldn't be surprised to find this is just as common if not more so with the non-gestating partner) precisely how to time intercourse in her cycle for the best chance at conception; she might have a handy pocket chart of foods to avoid during pregnancy; she might have toured a half-dozen birth suites and booked the coziest; but when the conversation turns to what to do with the child who will soon come forth, there's a blank look.

I get it, I do. Pregnancy is fun (depending on circumstances). Getting pregnant can be (also depending on circumstances). Whereas raising a child?

Well, it's all a little murky when you're getting into it for the first time.

So I'm going to just put together a little checklist of suggestions for parents-to-be, a few things to think about and make decisions on as you sail into the uncharted waters of having your first baby. I'll leave registry recommendations and nursery d├ęcor to someone else; these are more the sort of thing you need to hash out in terms of how you'll care for your newborn.
  • First of all, you might or might not have chosen or been able to avoid interventions during birth. Either way, there are a bunch of interventions following birth that will be offered to you and your new little one. Some of them depend on whether you give birth in a hospital or alternative setting, but common ones given to your newborn include eye drops, Vitamin K supplementation, a vaccination for hepatitis B, and blood glucose monitoring if your child was over or under a certain weight or you had suspected or confirmed gestational diabetes. If you had a fever during birth, the mother or both the mother and child might also receive IV antibiotics. If you have postpartum hemorrhaging, the attendants will want to give you medicine (such as Pitocin) or perform steps (such as uterine "massage," which is not as comfy as it sounds) to stop the bleeding. Some of these interventions you might be fine with (halting a bad bleed, for instance, or suctioning and giving oxygen to a baby with respiratory distress), and others you might want to do without (how many babies are promiscuous drug dealers at high risk for Hep B, for instance?). Either way, it pays to do the research beforehand so you know what you're getting into. That way, when these items are offered to you in the euphoria or chaos following the birth of your baby, you will know your answers. It helps to tell a trusted someone (partner, other family member, doula, or midwife) your answer as well so they can advocate for your choices and ensure your wishes are followed if you and the baby are separated or you're distracted by afterbirth care.
  • Another big intervention that deserves its own bullet point is routine male circumcision. Please think about this topic beyond checking to see whether the other males in your life are intact. While you and your partner might feel more comfortable continuing whatever pattern was established in your families, matching the father is not a good enough reason to remove a functioning part of a baby's sexual organs. Read about what role the foreskin plays (here is a link that includes drawings of the male anatomy), and consider what your child's wishes will be once he's old enough to have a voice. Here is a good starting point for reconsidering routine circumcision.
  • Within a short time after birth, you'll want to start breastfeeding if you're going to. This is one of those old-timey things that should be completely natural but unfortunately has become less common, to the point that women have to research it ahead of time instead of having just seen it done everywhere and knowing about it as a matter of course. Don't let this intimidate you. Read up on the benefits of breastfeeding, and if you decide to give it a go (you might as well try, if you can, because the colostrum that comes in early on is chock-full of antibodies for your vulnerable new babe), have some support in place in advance. Line up a lactation consultant who can meet with you on the first day or two or in the first weeks thereafter, attend some La Leche League meetings, read some books (such as The Nursing Mother's Companion, by Kathleen Huggins; The Breastfeeding Book, by Martha & William Sears; The Ultimate Breastfeeding Book of Answers, by Dr. Jack Newman; and you can even win Andi Silverman's big-sisterly beginner's guide to breastfeeding Mama Knows Breast from me), check out helpful and supportive websites (KellymomDr. Jack NewmanAsk Dr. Sears), and view some of the videos online showing what breastfeeding babies look like. Depending on your comfort level and your relationship with them, you might also be able to ask other nursing mothers for permission to stare or for their tips. Once you've done all your prep work, trust yourself to provide your baby's nourishment, or to know to seek help if you need it.
  • Babies love being carried. We had one who wouldn't let us put him down for about four months. And we had to be standing up and bouncing the whole time. Invest now in one or more good baby slings or soft carriers to save your arms! It will calm your baby with that snuggled-back-in-the-womb feeling, it will keep your hands free to grab a bite to eat or read a book, it will help you establish your breastfeeding relationship by keeping your newborn and your breasts in proximity — and it just feels nice to have your baby so cuddly warm against you! The best baby carriers are soft and versatile. An easy and cheap option is to make your own no-sew fleece mei tai using this pattern adapted from WearYourBaby.com. Just get it cut out before the baby comes, because it's unlikely you'll have time after!
  • You'll want to map out your diapering situation, because you'll need to have a stash on-hand. If you've never considered cloth diapering or are imagining sharp pins and nylon covers, cloth diapers have come a long way and are decidedly easy to use, frugal, and cuuuute — not to mention eco-friendly. For true ease, see if your town has a cloth diaper service, at least in the first month or two when laundry is the furthest thing down your to-do list, and make sure you set it to drop off your first delivery a couple weeks before your due date. If you're buying and washing your own, a simple and cost-effective solution is prefolds with wool covers. If you want disposable-like, foolproof convenience, try all-in-ones or pocket diapers. This site describes how simple it is to do diaper laundry. If you're feeling even more adventurous, give elimination communication, or infant pottying, a gander.
  • The topic that inspires the most conversation where newborns are concerned is sleep. Sleep, blessed sleep. It helps to prepare for life with a newborn by learning, first of all, a little bit about why they sleep the way they do, and what you can do to make them feel more at ease in this strange new world. A book that works superbly well for zero- to three-month-olds is The Happiest Baby on the Block, by Harvey Karp. I say this because I finally got it into my hands when my baby was four months old. It still helped us out immensely, but I heartily recommend reading it before you have a baby so you can get your soothing tactics ready. Think also about where you want your baby to sleep. One of the things you'll learn about newborns is they eat multiple times a night. If you're breastfeeding, consider setting up a safe cosleeping environment before your baby arrives in your bed. You'll get more sleep, and your baby will receive the benefits of close contact with you.
  • Just as important as learning why infants sleep the way they do (or don't) is learning in general what to expect of a newborn. A book I found fascinating and perspective-altering was Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent, by Meredith Small. Small challenges the cultural assumptions that determine the way we parent and looks instead to our biological and anthropological roots. If you know what's developmentally appropriate, you won't get as frustrated when your baby's acting like a baby — and you'll realize it's all short-lived.
  • Another important task is to learn what to expect of yourself in the postpartum period. Don't expect too much, in other words. You'll still be bleeding, sometimes heavily; no matter what your childbirth experience, you'll need to recover physically. Try to give yourself a lying-in period to rest and bond with your newborn. Plan to have visitors only if they will help. If you have a co-parenting partner, be aware that this postpartum time is a sensitive one for both of you; try to hold off on any major decisions, and cut each other a lot of slack as you get used to the newest presence in your family. Don't worry (if you can swing it) about the emotional highs and lows of those first months (or beyond). By "don't worry," I mean don't worry that you have them, and don't feel guilty about the lows. But if the lows are really low, seek help, and don't feel guilty about that, either.
I hope this list might start you off on your parenting journey. There's a lot that comes up once you don't have a newborn any longer, of course, but there's no sense in researching all the way through to teenagerdom on as little sleep as you'll have late in your pregnancy and early in your parenthood. There'll be time to figure out most of it and wing the rest, but it pays do a little prep work on some of these important issues, before you're too bushed to reason them out.

How much preparation did you put into the task of caring for a newborn? If you're a been-there-done-that mama, what other aspects of new parenting would you add to the list of things to consider beforehand?

13 comments:

Olivia said...

We researched everything on your list except circumcision since we knew were having a girl. And I only did a little research on sleep. Once we decided to co-sleep I didn't worry much about it. It would have been good to know about The Happiest Baby on the Block soothing techniques, too. We only discovered them at around 4 months, but fortunately our baby was pretty easy-going.

Melodie said...

Fantastic idea! I was (gasp!) one of those moms who didn't really research parenting beyond womb-carrying. I knew I was going to breastfeed and cloth diaper, but that was about it. I learned all the rest along the way. This list would have been sooo handy back then.

leo said...

Wow! This is a whole lot of information! Thanks for posting this. I will recommend this post to my sister who is giving birth next week.
solid wood bedroom furniture

Rambling Rachel said...

Excellent post! I'm one of the women mentioned in the first paragraphs. Read every week about my baby's development, researched labor and then got home and realized I didn't know how to bathe and diaper my son.

Good treatment of the subject of circumcision.

macondo mama said...

This is a great idea for a post! So much information about 'thinking ahead to when the baby is born' is about buying a million things you really don't need and getting a nursery ready. It's great to have the time during pregnancy to think about many of the issues you raise and to agree (or not) with your partner about what your approaches will be.

Scoping out some mama- and baby-friendly places and activities could also be a fun thing to do while pregnant. It's great to connect with other mamas in those early months (and forever after, of course).

Taryn said...

GREAT POST. This is an amazing resource! You outlined many of the things that I wish I had known with my first child (a hospital birth with a nurse-midwife), and that I now make a point to bring to other first-timer's attention whenever I get the chance.

Another thing I might add, would be to write a birth plan outlining your preferences regarding many of the issues you brought up in this post and other previous posts (episiotomy, labor augmentation, internal examinations, fetal monitoring, Vitamin K, Hepatitis B shot, circumcision, breastfeeding preferences, pacifier use, formula/sugar water via bottle, the various infant blood tests offered following birth etc.).

Also consider what would make your birth a fulfilling, comfortable, memorable and beautiful process for yourself/birth-partner/infant (low lights during labor, soft music playing, video taping of the birth, use of birthing ball, other family/friends attending the birth, doula or birthing coach, different birthing positions, laboring or even birthing in water, eating/drinking, who you'd like to cut the cord, immediate skin-to-skin contact etc.). Included these personal comfort preferences in your plan alongside your medical care preferences.

Discuss your plan with your doctor/midwife prior to giving birth to make sure that your wishes are clear and that they are actually feasible--this will help to insure that things that really matter to you personally are taken into account during your labor and following delivery. Leave a copy of your plan with your midwife/doctor to keep on file and review.

Once you go into labor, take a copy of your plan with you to wherever you will be delivering your child (I feel like this is especially important for hospital births--I'd even take a few copies for the nurses,docs and anyone else who needs to know what your preferences are, so they will have your wishes clear in their minds. That way, you, and your birthing partner, can be free to focus on the birthing process rather than the details). Remember to keep some mental flexibility regarding your birth plan since sometimes labor/delivery/recovery present some unexpected surprises. Plan for the best, but be at peace with the possibility of having to make some last-minute adjustments to your plans.

If you are interested in getting some ideas for your birth plan, there are many sites online that offer free birth planners. Simply google "birth plan" and you will be well on your way to creating your own birth plan...

Taryn said...

So, I exceeded the word limit...this is a lot longer than I intended...sorry. Here's the rest of the comment...

In addition establishing a birth plan, I would also recommend that parents-to-be install baby's car seat a few weeks prior to when the baby is expected to arrive. The seats can be tricky and sometimes frustrating to install, and you want to make sure that they are installed correctly so your precious bundle will have a safe ride home. It's an astounding figure, but The National Highway Traffic Safety Administration says that 75% of car seats are not installed correctly. http://news14.com/charlotte-news-104-content/top_stories/?ArID=599669
Often you can go to your local fire station or highway patrol station and somebody who is specifically trained in safety seat installation can confirm if your seat is properly installed or help you install the seat altogether.

Finally, if you are planning on breastfeeding, I would buy some lanolin (Lansinoh brand is a good one) and plan on using it from the get-go to protect your nipples until they get used to nursing an infant. This will help to prevent cracking which can make nursing life miserable. Also, either purchase or at least stake- out a place where you can purchase nursing supplies (bras, pumps, pads etc.) prior to delivering. This will be a good resource to help you along your breastfeeding journey...and it can be kind of stressful trying to figure out this information out when you are busy trying to establish a breastfeeding relationship with your infant.

One final note on breastfeeding. I think that many women don't realize that breastfeeding is a learned skill and it doesn't just "happen" for many of us. There is a decent amount of trial-and-error, and often frustration that can accompany learning to breastfeed (both for mother and baby). When coupled with the common initial pain of breastfeeding, it is easy to become discouraged and loose faith in our abilities to breastfeed our babies even to the point of believing that we may not be able to breastfeed. Don't give up! It won't be like this forever! Like Hobo Mama said, there are people who would love to lend their help an support(lactation constants, Le Leche League, other breastfeeding mothers). Make sure to put a breastfeeding support system into place prior to giving birth just in case you need it. Hang in there and remember you are learning an priceless skill. All the hard work is well worth it!

Wow, that was an epoch comment...I appologize for the length!
Thanks again Hobo Mama for the great post!

Taryn said...

I forgot to mention that Dr. Karp also has made a one hour DVD outlining the main ideas contained in his book "The Happiest Baby On the Block" for those of you who are really pressed for time and don't have time to read the book through before delivering. This method for calming babies is really a sanity saver for parents with new babies.

Dagmar said...

Thank you for this extensive post! It covers so many things a lot of new parents don't really educate themselves on enough, and you made it very easy to find links to a lot of pertinent information.

Education is key, be it about labor, about breastfeeding, about unnecessary interventions, circumcision, and more.

So nice to find another mommy who writes about the same topics I do :)

Dagmar
Dagmar's momsense
http://DagmarBleasdale.com

Olivia said...

Off topic, but I keep wondering...am I the only mother who does NOT like Lansinoh nipple cream? It's too thick to spread around and pulled my delicate skin. I preferred olive oil. Just FYI if there is anyone reading who doesn't like the thick lanolin. ;)

Jessica said...

This is a really great checklist, Lauren! I have two friends expecting their first and I'm going to pass this on to them.

Hobo Mama said...

Olivia: Totally. I included sleep because it's ALL I hear most new parents talk about! I agree that cosleeping parents tend to obsess less about it, I think because maybe they have more realistic expectations, and maybe because the mother's nursing in bed during the night so it's not as big a deal. That's been true for us, at any rate. And as for lanolin, I mostly saved it for lanolizing my wool covers. ;) I find, though, that it's easier to spread on nipples if you warm it up a bit between your fingers first so that it's a little meltier and not so goopy. But I hate how the residue on my fingertips then won't come off. Olive oil's a great idea. Will have to try that.

Melodie & Rambling Rachel: You managed pretty well, then! I forgot to mention bathing, but that's probably because I didn't have any astonishing methods. All I did was tuck him in with me when I was taking postpartum baths for healing purposes. After that, we totally slacked about washing him and did it maybe once a week, until he started actually playing in the bath and looking forward to it. But still one of us always climbs in there with him and plays! Are we the only parents who do that?

Macondo Mama: Talking to your partner is a great one, and scoping out activities and new friends, too. I kind of just thought we'd continue our lives as usual, which kind of sort of worked for a short window, and then, um, not. So we've adapted, but I definitely could still use more parent friends!

Taryn: So glad to see I'm not the only one who breaks the Blogger character limit! That keeps happening to me. Halfway through writing my article, I totally decided to skip the whole idea of preparing for birth, just because it was so overwhelming a topic I figured it deserved its own post. Now I still think so, but think you should write it! Want to guest post? I really like the car seat angle, too, very important, and having breastfeeding supplies and support lined up. It's funny you mention the Harvey Karp DVD, because that's totally what Sam watched instead of reading the book! Ha ha! They had it at our library. I loved how it showed his techniques in action. It was really magical to watch.

Dagmar: Absolutely true about education! Thanks!

Jessica & Leo: Share away! :)

nerdmafia said...

what a great post! thanks so much for sharing. i must leave your comments section now so that i can go back to the post and click on some links! thanks again!

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