The first week with your newborn

The first week passes in a daze of information overload and sleep deprivation. Everything is new, emotional…..

Too much is happening. The body has gone through a tough time, a whole new person is attached to me like superglue for the foreseeable future, too many people coming over to meet, well meaning advice being shoved down your throat, well intentioned help invading my private space, information overload and not enough time to process it, no sleep, joy, anxieties, bringing the baby home……

For me, the first week was actually tougher than the birth.

Tips to increase intake and weight gain of breastfed baby

My son, as you all know is underweight and breastfed. Like any concerned mother, I want to see him put on weight consistently. This led me to really look for ways to up his intake and make the best of what he will eat. These insights were priceless and difficult to find on the net – took a lot of careful observation and experimenting.

The milk you feed him. Excess of foremilk and not enough hindmilk will cause gassiness. We know that – lactose overload or foremilk hindmilk imbalance. But why does getting enough hindmilk resolve this? Because hindmilk contains fats in addition to all that the regular stuff in the foremilk and the more the breast is empty, the more fats the milk will contain, making it travel slower through the intestines and get more time to be digested. So, if you have a good milk supply, pump off foremilk and then put the baby to breast. This way, what little quantity the baby drinks will have more calories in it, in addition to saving energy spent in gas pain, fussiness, etc.
Feed at first cues of hunger. Okay, so we can’t always recognize them… Really, when in doubt, offer. When your baby starts following you with his eyes, offer. When baby has been awake for a while since previous feed, offer. If its hot weather and he could be thirsty…. Whatever. Offer. I was really surprised to see how much more than “every two hours” my baby would want to eat. If you catch the hunger before it reaches desperation and fussiness levels, your baby will be that much calmer and eat more.
Don’t stop feeding when your baby takes a break. Often my son will stop drinking because he wants to burp or poop or pee. Getting that done will see him drinking again, if I offer, but he’s not hungry enough to fuss. (He will look at me constantly or stare at my breast though). After burping always offer to continue feeding if baby wants. If you miss this, he’ll just end up asking that much sooner, or god forbid, if you are a time table mom or don’t figure out he’s hungry, he’ll go partially hungry.
Sometimes the baby plays with the nipple, rubs head against breast, arches back alternating with mouthing the nipple, cries, etc. He is NOT refusing milk. He is hungry, but is uncomfortable and can’t focus on it. Most of the time, burping will do the trick, or try calming him, waiting for a poop, helping him release gas. Whether it works to resolve the discomfort or not, sometimes you manage to help enough that he can now drink comfortably.
Don’t soothe a hungry baby when you could feed him. Won’t work for long anyway, and aren’t you trying to increase his growth? Hunger is an opportunity. Even if it means he is eating all the time. If he is constantly asking to feed, obviously he is constantly feeling hungry. Don’t analyse it – “how could he be hungry again so fast?” etc – obviously he is. How doesn’t matter. Could be because he didn’t feed enough last time, or burped after that and now has more space or a growth spurt, or whim/weather…? Sometimes Nisarg will eat almost all the time, and when he settles again, his meals will have increased in size – a growth spurt in appetite?

These tips together probably doubled my son’s intake within a couple of weeks and kept the good doctor beaming in approval though his weight is still off the charts low.

Supporting an infant's neck

You look at that fragile little thing and your heart flutters with fear for its safety. You are so scared of jerking that flimsy neck supporting that big head, that you take a full minute before the baby transfers from the bed to your arms.

Well…. Life has a way of enforcing efficiency, as has confidence and observation. Trust me, I learned, and then had conversations with the doctor, other experienced people….

The first sign you get that you may be being too careful with the infant’s nect is when you want to snatch your baby back from the doctor when s/he handles him. Fact is, most infants are able to take movement of the neck comfortably. What you want is to avoid jerks, head dropping from gravity, and such horrible things.

Most of the time, if you are picking up your baby with a hand under its head, you are already doing things right. If you are supporting it in the crook of your arm, that works too, as do many other ways.

Most people will advise you to be super careful, under the belief that better safe than sorry. However, it doesn’t help if you fear damaging your child for life each time you pick him or her up. Babies will move their heads at will and often correct uncomfortable head positions themselves. Sometimes they will nod their heads to angles beyond what they are able to control, and the head will suddenly flop.

My technique is to keep my arm/hand or other body part or soft surface loosely and attentively ready to “catch” the head if it tries to go more than the baby’s usual range of movement. However, I don’t see the sense in immobilizing my son so much that he strengthens his neck through fighting restraints rather than attempting normal movement. This has gotten me grief from my mother-in-law who always holds him like he’s strapped to a splint. However, it hasn’t even earned me a whimper of discomfort from my son.

I don’t think nature ever intended us to keep our offspring unnaturally rigid till some predecided date when they miraculously started not needing support. Nisarg learns to hold his neck every day and keeps getting better at it. He can now raise his head easily when sleeping on his tummy, turns to look in every direction, and will often rub his forehead on my chest or bang his head on my breast himself. He doesn’t seem to have suffered from the wear and tear.

If you are still trying to figure out how and how much to support your infant’s neck:

provide support under neck and head for all horizontal positions, but it is not necessary to restrict any voluntary movement.
Provide support underneath for diagonal positions and be attentive for baby’s movements moving head to positions he can’t control or recover from and and situations where gravity could tax the neck muscles and cause the head to drop. This includes pulling into sitting positions for example
When holding baby upright, there is no real need to keep holding head, though positioning him so that he can rest on your chest or shoulder and keeping one hand on is a good idea. Don’t “hold”, just keep it there for comfort and readiness.

Milk coma in infants?

I learned a new term today – milk coma.

Apparently it is the state of the baby after it has fed well, and can barely keep his eyes open. Like this:

Talk about drunk

That’s it – not a drop more!

I used to call it Niarg getting tipsy on milk and then blackout, but “milk coma” describes it good too….

How to play with a newborn

I read a lot about the importance of play in the growth and development of a baby. However, there was little I found on when to begin and how to go about it with a newborn baby.

Of course, like any other parent, I was eager to “test drive” my brand new son. Unfortunately, said son had other ideas. He was hopelessly unable to smile, make interesting sounds or move in any way that could lead to playing. Now what. Here are some tips fom experience and what little information I could find.

Forget about “training” baby to do anything. Doesn’t work. The idea is to train yourself to do stuff he can relate with or find interesting.
Singing: This guy knows my voice and he loves to listen to it. Singing makes him look intently at me if I’m close, or in my direction if he can’t focus on me.
Chatter: Talk to him. Doesn’t matter what. Stocks will work, as will romance or fairy tales and chemistry equations. Just keep your tone relaxed and go on.
Cuddle: You will love this and so will your loved one.
Don’t expect enjoyment to mean smiles. If it ain’t crying or avoiding looking at you, its good with what you’re at.
Hand holding: Give him a finger to hold… or not. Whatever. Don’t expect too much every time your finger is offered.
Be brief: Conclude while its good. Everything is new to the baby, so your efforts could just end up tiring it out. begin when he seeks eye contact, and stop after a while (particularly with talking while looking at his eyes). No limits to cuddling though.

Baby's naming ceremony

We had a small naming ceremony for the baby yesterday. We have named our son Nisarg.

Since Nisarg is still quite young, we decided on an immediate family only event, which went exactly as we had hoped. With lots of love, cheer and caring.

Nisarg means nature in Marathi.

Sunlight for newborn jaundice

Blue light has long been accepted as a way of treating jaundice. This treatment came about through the observations of a very smart nurse who observed that babies near windows had less problems with jaundice, which led to research…..

Another separate study assessed the use of sunlight (which is abundant) as compared with the special blue lights (less available in resource poor regions in the middle east) and found that it works just fine and in fact better, though I guess medical facilities would prefer to avoid risks of sunburn or infection for severely jaundiced babies.

Here is what to do if your baby is mildly yellow.

Figure out a place where the baby can enjoy sunlight. This may be near a window, balcony, or, like in our case, the terrace of our building.
Morning or evening light is what you want. Day is too harsh for baby. Morning is better if you live in the city – less pollution.
If you are at home, lucky you. If like me, you head out, prepare well.
You will want to expose the most skin, but protect the eyes. If you have special dark glasses like in the hospital, great. If not, creating shade for the eyes works well, particularly if you are careful about timing. This can even be in the form of a cap or bonnet.
Stuff you want to take along, or keep handy. A mat to lie on, some means of protecting eyes and ideally, some way to create a darker area in the direction the baby is facing.
I take along a tent-like mosquito net, which I used to place over the baby and drape a dark cloth on the side opposite to where the sun rays hit. Then I used to place the baby inside with his head toward the sun, so that he had a nice dark area where he was looking.
Careful placing of the shade for the eyes, and this dark area worked well to protect his eyes so that he wasn’t squinting while still allowing him to sunbathe.
Duration is important. 5-10 minutes is good. You don’t want to cook the baby. 5 minutes or less on his back and similar on his tummy should do the trick.
Watch baby carefully. My baby loves this time. He used to “unfurl” from his preferred curled up posture and really stretch out when the sun rays hit him. Watering eyes, squinting, fussiness should prompt you to immediately pay attention to protecting his eyes.
Do this for a couple of days till the yellowness goes away.

Please note that I’m not a doctor, and this is not medical advice. I am simply sharing suggestions based on what I did. Might be a good idea to bounce this off your doctor first before trying it out.

Newborn jaundice

Today, baby looked slightly yellow to my inexperienced eye. Various visitors, depending on whether they were trying to reassure me or talk straight disagreed or agreed, but the bottom line was that the guy looked rather yellow.

The nurses assured me that mild jaundice was normal and not an issue. The pediatrician agreed with that statement, and was fine with us taking the baby in its yellow colour home on the next day.

Needless to say, I hunted on the net, and this is what I discovered.

Jaundice is common in newborn infants and resolves in a week to ten days
If it lasts longer, talk with doctor
Jaundice is more common with breastfed babies
And for once…. jaundice is less prevalent in newborns of mothers who smoke. Though I guess this is not any benefit considering how easily jaundice can be sorted out and the other messes smoke creates on the health front.
Exposing baby to mild sunlight will help with jaundice. Precautions for it and stuff is material for another post.

Newborn's first poop

Okay, so I asked around to find out when a newborn begins pooping. Peeing happens almost immediately. Pooping is basically that sticky tar like meconium stuff. My son hadn’t pooped for a full 24 hours after his birth, and that is considered fine. Most babies I asked about pooped some time during the second day for the first time. One had pooped almost immediately after birth, but apparently, he had also pooped inside mom before birth, so…..

The nurses in the maternity home said that the newborn should have pooped at least once before he will be cleared for discharge. Apparently this is to ensure that all the machinery inside is working how it should.

I waited impatiently for that first poop for a day and a half, and spent the next couple of days wishing I hadn’t. you see, that black-green poop is rather strange. its sticky, stains stuff, and doesn’t smell like poop at all. For my son, once he began passing meconium on the second day (third if we go by date, since he was born at 11pm), he kept passing it if he so much as looked at my breast. Cleaning it was rather yucky. Luckily we were done with the yucky stuff and on mostly normal poop by the time we headed off home, so it was good.

Unfortunately, he passed the yucky stuff easily, but started straining in a manner that looked rather painful once we began with the yellow stuff.

11 First breastfeeding tips

The first breastfeeding can be a stressful time for the new mother, particularly if its your first baby (as mine was). There is so much happening. You have barely registered that the painful labour is now over, you are excited about the baby, family is usually clustered close to see the baby and wish you well…. Well meaning relatives want to “help” you….

I was lucky to give birth at night so that I had time to rest before the visitors started flooding in. A friend delivered in the late afternoon, and the visitors were in her room before she returned from delivering.

All things considered, it is a rude shock to discover that babies don’t instantly feed absolutely “correctly” and the maternal instinct (if present after the ordeal – sets in later for some) doesn’t extend to knowledge about breastfeeding.

Here are some things you can do to make life easier for yourself and the newborn. Please note that these are based on personal experience and yours may vary:

Kick everyone who doesn’t belong in the feeding plan out of the room. This is one lucky time in your life when no one will think you are anti-social for doing that. It could even extend to the husband if he is the type to hover over your shoulder anxiously. The only two people required are you and the baby – everyone else can go.
Ensure that the room is warm enough for you and the baby or keep a blanket handy. The one on your bed will do fine.
Strip from the waist up. I can’t stress this enough. Its “logical” that nothing except the breast needs bared, but my experience was that I didn’t need the fidgeting and fumbling with clothes in addition to the fidgeting and fumbling with baby that was inevitable.
Take a moment to calm down. There is no wrong way to do this at this stage as long as milk enters mouth. Blessedly, the newborn doesn’t depend much on milk at this stage as it has glucose and fat reserves that get him well through the first day. Also blessedly, you will likely have a few drops of colostrum that can be expressed from your breast, so its not like you’ll be managing a fire hose. You can get those few drops into baby anyhow. So chill and enjoy!
Calm baby, change diapers, etc. Get a warm, dry cuddly baby ready for a meal. Most people recommend that you strip the baby to diaper as well to ensure he stays awake. Others would recommend swaddling since that takes care of unpredictable limbs that could challenge your unproven “fielding” skills. My experience was that the baby was wide awake with no intentions of sleep at this feed. However, skin to skin feels good for both of you. Still, there is so much going on, and figuring out baby to nipple is going to be a big challenge, so fair enough if you want to take the limbs out of the dexterity equation. Whatever appeals to you.
Bring baby to breast and get nipple into mouth. Do it however it works as long as baby’s neck is supported and you move entire baby (not just head) to fit mouth to nipple. Worry about posture later. This is about the time when a spare pair of hands would come handy. So if your husband (or boyfriend, friend, sister, relative…. if there is someone you’ve kept in the room to assist you) is the useful type, he could help get the nipple into the baby’s mouth when in range. Believe me, as excessively personal as it sounds, all the other stuff is best done by your hands.
Baby will open immediately and suckle. That’s one thing that works as advertised. Correct latch and positioning and all is described all over the net, so I don’t repeat it here. Anyway, my experience was that it can’t be learnt from reading. What works is whatever gets milk into mouth, manages safety and doesn’t hurt me. The pillows for the baby to breast campout mission are unnecessary at this stage (for me). There isn’t enough milk for baby to be doing this enough for me to tire of holding this miracle to my breast. More so, it takes a whole load of fidgeting to get to a place where things work, which is impossible to predict and prepare pillows in place for and once you manage it, the last thing you want is to move to adjust pillows and risk having to start over. Don’t even think of pillows until your milk comes in. Something to lean against is plenty.
Don’t worry if it doesn’t all go how its supposed to. I kept pressing on the nipple and when the milk beaded out, brought baby to it to lick it off. Baby used to latch on briefly. Lather, rinse, repeat. Slowly, you will automatically figure out how you can hold the baby so he stays on longer.
Remember, you have stripped, so don’t worry about any drips of the sticky stuff. Just wipe off with wet towel when done.
Express all the colostrum you can into baby’s mouth. For these first few days, the “feeding” of breastfeeding is more active than the “suckling”, since it takes some getting used to for both of you. This means that you are doing it all correctly even if you are expressing every drop the baby gets into his mouth. Eventuall practice and laziness will collaborate to get you there, as your milk increases and you try to get the baby to suckle more effectively, since you can already see that expressing will only go so far.
Done. Cuddle baby and celebrate these first quiet hours before the poo and pee parade runs you over.

Nisarga

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