Baby Care

Taking Care of Baby

Welcome to parenthood! This area of our site provides information of interest to parents of infants through toddlers. The initial months of the parent/child relationship are extremely important. The topics presented here should not only help you to be an effective parent but a happy one as well.

You and Your Newborn Baby: a guide to the first months after birth

Regardless of whether labor is long or short, whether it is hard or easy whether a baby is born vaginally or by cesarean, most parents recall the first hours and days after birth as crystal-clear images surrounded by haze. It is in this haze that you first take in your baby and make a giant leap from pregnancy to parenting.
Despite all the anticipatory parenting done before conception and during pregnancy, despite weeks of feeling movement within and fantasizing about your baby, despite months of having strange dreams, worrisome thoughts, and musings about what kind of parent you will be, the first time you hold your baby in your arms and call yourself mother or father, mama or papa, mommy or daddy, an awareness floods over you that life will never be the same again. Another human being is now dependent upon you for survival. More than anything else, you want to be the best parent possible.
Your awareness of your baby's dependency and your desire to be a good parent will together be a great source of energy and a great source of stress. Both are part of being a parent.

Becoming a good parent means much more than knowing a lot about babies. Ask pediatric doctors or nurses what it was like for them to be new parents. They will tell you that all their knowledge about babies was not enough to keep them from being over whelmed by their own babies. All new parents feel the same way. All new parents work at knowing, understanding, and loving their babies. Your baby will work just as hard at learning to know, understand, and love you. This is the process of attachment-the work that parents and babies do together to form a deep and lasting love. It is what becoming a family is all about.
This book is written to give you some help as you make the transition from pregnancy to parenting. It offers ideas on things you can do to make this time of change easier. It is written as much to encourage as to teach you. Besides providing the information you need about taking care of yourself and your baby, it can help build your confidence in your own wisdom about your family's needs. You will find the postpartum period easier if you know what to expect during this time, if you actively participate in health-care decisions, and if you build a network of support that nurtures your growing family.
New families in the United States face some challenges that families in most other countries do not. In the United States, where nearly 99 percent of women give birth in hospitals, the average hospital stay after childbirth is two days for a woman who has given birth vaginally, three to four days for a woman who has given birth by cesarean. In many communities, new families are discharged from the hospital within twenty-four hours of birth. Such early discharge will probably become the norm by the year 2000.
In most other countries, both industrialized and developing, the postpartum period is seen as being at least as important as the prenatal period. Because of this, women giving birth in hospitals have longer stays. More importantly, services are brought to the homes of new families. No matter how long the stay in a hospital or birth center, the family's transition to home-and to sole responsibility for the newborn-is overwhelming. in many countries all new families are visited at home by midwives, nurses, or other trained personnel who teach parenting skills, assess the mother's and baby's health, and provide moral support (and sometimes, as in the Netherlands, government-paid helpers do the housekeeping!). In the United States, such services are now provided to only a small minority of women.

Other Changes You May Notice.

The day after birth, you may ache all over from the work you did in labor. Your arms and legs may be sore from pulling back on your legs while pushing out the baby.
Although achy legs are normal, tenderness, pain, or warmth in your calves and swollen or reddened veins are warning signs that you should report to your doctor or midwife immediately. These signs could indicate thrombophlehitis, an inflammation of a vein that can result in formation of a blood clot. Postpartum women are at slightly increased risk of this because the vein walls normally relax somewhat in pregnancy. To reduce the risk of thrombophlebitis, increase circulation in your legs by doing foot rotations (see page 2 1) and by getting up and walking soon after birth. Thrombophlebitis is treated with bed rest, elevation of the affected leg, hot packs, and the use of elastic stockings. Medications may also be needed to prevent infection and clot formation. The affected leg should not be massaged.
Joints that relaxed in pregnancy to allow for the baby's growth and birth will return to their pre-pregnancy condition within several weeks of birth. Many women, however, feel that the rib cage and pelvis remain slightly expanded for the rest of their lives.
Abdominal muscles are relaxed after birth, so the abdomen is soft and still rounded. All women have some degree of separation of the abdominal muscles, which lessens with exercise.
Any stretch marks you have will seem more obvious after birth than before. Although stretch marks never completely disappear, they fade to silvery white lines in the months after childbirth. Darkened areas of the skin, such as the areola and the linea nigra, a dark line from the belly button to pubic bone, may tighten but may not completely fade.
Many women note changes in their hair after birth-most commonly, profuse hair loss. This is because pregnancy hormones stimulate hair growth. With the drop in these hormones, the extra hair that grew in pregnancy will fall out. This begins around three months after birth and usually ends within a couple of months.
Perhaps the most common feeling of new mothers after childbirth is that of being bone-tired. This seems especially true of women who have just had their first babies. Often, fatigue is combined with such excitement in the first days that sleep is difficult. The usual aches and pains of the early postpartum period can make it even harder to sleep. But beyond the first few days after birth, most women find daily naps are essential to their well-being.

Caring for Yourself after a Cesarean.

Each woman recovers in her own unique way after cesarean birth, just as after vaginal birth. Pain medications can help during the first few days (the medications given are considered safe during breastfeeding). The nurses will assist you in getting up the first time, learning to cough or huff to keep your chest clear, dealing with the gas that can follow surgery, and learning to hold your baby in ways that are comfortable for you. If assistance is not available when you need it, press your call button and ask for help.
All new parents can benefit from assistance at home after childbirth, but for a woman who has had a cesarean birth such help is essential for at least the first week. Not only are you undergoing a transformation to a nonpregnant state and learning to care for your new baby, you are recovering from major surgery. Adequate help, allowing you to rest often during the day, can make a great difference in how quickly you feel strong and well. Taking care of yourself and your baby should be your only duties until you feel ready to take on more.

25 Things Every Mother Should Know: How you mother your baby does make a difference

Twenty-eight years ago I (Martha) became a mother for the first time. Even though I had "R.N." after my name I was pretty frightened. All those babies I'd played "Mommy" with in the hospital were other people's babies, not my own. I had to learn how to be a mother to my little Jimmy from scratch. It was intense and personal learning, and I have been privileged to experience it intensely and personally seven more times.
My husband, Bill, learned along with me all the things we discuss in this book for brand-new mothers. My voice, speaking mother-to-mother, will dominate the book, with Bill's interjected here and there to give his perspective as a father and pediatrician.
This is not a traditional baby-care book. You won't find anything in it about diaper rash, cord care, or how to give a bath. You can get that information from a lot of other sources. Instead, this book is a guide to mothering your baby, and it is as much about the process of becoming a mother as it is about babies. It will help you to get to know your baby better, and we hope that it will also help you understand yourself as you take on this new, motherly role.

We believe that babies have a lot to teach mothers. Listening to your baby and responding to his or her cues will lead you into a parenting style that will help both of you thrive. Biology and infant behavior will help you get started and build your confidence as you and your baby develop a two-way trusting relationship. But this is not an ideal world we live in, and there are forces you'll meet along the way that can make you doubt your mothering intuition. We hope that this book will prepare you for some of those bumps in the road, and will help you meet the challenges and changes ahead.
Mothering and fathering eight children has taught us a lot. We are very different persons from the ones we were before we had children, and most, if not all, of these differences are for the better. Although personal growth is sometimes hard, we've had a lot of fun along the way. Fun in your life with your baby is what will convince you and the baby that life is good. Enjoy your baby!
How you mother your baby does make a difference.
Mothering in the twentieth century has become a tricky business. We can take our babies' survival pretty much for granted, and in this way we differ from all the mothers who have come before us. Instead we worry about whether our babies will grow up to be happy and productive, a more complicated issue.
Nobody yet has scientifically tested and perfected a parenting system that guarantees children will turn out okay. Much of the research focuses on what goes wrong, rather than what goes right, and psychologists from Freud onward have often laid the blame on mothers. This creates a lot of anxiety, as mothers struggle to raise psychologically healthy children. Mothers often feel that the stakes are high on everything they do, and the possibility of making serious mistakes makes the job of parenting seem frightening.
In reaction to Freud, there's another school of thought that suggests that mothers aren't all that critical to their children's psyches. Children need dependable caregivers, yes, but these are more or less interchangeable, and group care not only is satisfactory, it also makes children independent at an earlier age. Babies do prefer their parents, but they really don't need all that one-on-one attention that goes along with traditional mothering. It's interesting that these theories have evolved at a time when more and more mothers of young children are in the workforce.
So where do you fit in? How important are you, a responsive, nurturing, trustworthy mother, to your baby's development? How do you know if you're making a difference?
In the parenting business, science often fails us. It's hard to study behavior that is as complicated as mother-and-infant interactions, much less relate these interactions to how children behave and feel years later. "Experts" speculate, spinning advice out of tiny threads of evidence, but who really knows?
I believe that experienced parents--parents of children who are turning out well---have the answers. Bill and I have talked to thousands of wise and seasoned mothers over the years, and while we don't pretend that this is a scientific sample, we do feel confident about relaying what we've learned from all these families. We believe that how you mother your children makes a difference in the kind of people they become.
The mothering advice that we have given in this book reflects a style that we call attachment parenting. For babies, attachment parenting includes closeness right from birth, responding sensitively to cries, baby wearing, sharing sleep, and breastfeeding. The involvement of the father, both directly with the baby and in support of the mother, is also important. These practices together make up a very nurturing style of baby care, one that yields a wonderful sensitivity between mother and child. The mother understands what the baby is thinking, most of the time, and the baby responds well to the mother's care. Babies who experience attachment parenting rarely need to cry to get their needs met (though they may cry plenty when something hurts or bothers them), because they can communicate in other, more subtle ways. Mothers who nurture in this style feel confident that they are doing the right things for their children, because they feel they can perceive their babies' needs, and because their babies are happiest when they are most responsive. Even high-need babies can be mellowed by this style of parenting into children who are fun to be with.
There are long-range benefits to attachment parenting. As a baby cared for this way turns into a toddler, he is easy to manage. His mother has a pretty good idea of what he is trying to do or say, so the young explorer is less likely to get terribly frustrated. Since he trusts his mother and wants very much to stay in her good graces, a word of warning or some creative redirection from her is often all that's needed to head off problem behavior.
As children of attached parents grow older, the benefits continue. These kids internalize their parents' sensitivity toward them. They have an inner sense of what is right and are bothered when situations violate their values. They know themselves well and can remain true to their own character in the midst of a crowd going in another direction. They are compassionate and understanding with other people. Having learned intimacy from their early closeness with their parents, they go on to establish and maintain healthy relationships with other people. They bring their parents joy and pride.
So, are you important to your baby? Yes, you are. You as his mother know him best and are the person he trusts most and will look to for guidance in the months and years to come. You are his window to the world and his faithful interpreter of what is going on inside him. Your relationship is built on a long history of knowing each other, a history that begins even before birth. Because this relationship is grounded in love and trust and many small interactions, it can tolerate mistakes and misunderstandings. No single moment is critically important. What counts is the harmony that is developing between you.
So relax and enjoy your baby. This is a special time in your life, and while it's full of worries and adjustments, it is also full of wonder. You have much to look forward to. Being a mother can enrich every corner of your life. Get ready for a marvelous journey.
When you bring home a new baby, remember you are modeling parenting for your older children. Also, you are bringing up someone else's future husband or wife, father or mother. The parenting styles children learn are the ones they are most likely to follow when they become parents. Here is an example of how modeling affects children: A mother brought her newborn, Erin, and her two-and-a-half-year-old, Tiffany, into my office for checkups. During her examination, Erin began to cry. Tiffany rushed to her mother, pulled at her mother's skirt, and exclaimed, "Mommy, Erin cry; pick up, rock-rock, nurse!" This little child had just described responsive parenting according to her mother's model. When Tiffany becomes a mother and her baby cries, what do you imagine she will do? She won't consult a book or call her doctor. She will intuitively pick up, rock-rock, and nurse.