Pets and Newborns: Myths and Realities

The late Christopher Hitchens, on pets:

Owners of dogs will have noticed that, if you provide them with food and water and shelter and affection, they will think you are god. Whereas owners of cats are compelled to realize that, if you provide them with food and water and shelter and affection, they draw the conclusion that they are god.

 

I own both a cat and a dog. This places me in a rather uncomfortable position, theologically.

I cannot speak with any authority on the divinity of my cat, or my own divinity with respect to my dog. But I can make a comment or two about their relationship with babies, particularly as it concerns sleeping.

Pets and Sleeping: the Myths

Cats and humans have had a tumultuous relationship, at least since the late middle ages. About this time, our feline friends became objects of distrust or worse, as they became associated with witches. If a cat came to your window after you brought a baby home, legend said, it meant a witch had sent her “familiar spirit” to case the joint, as it were. Such visits usually did not end well for the cat.

Because historical memory is long and legends die hard, we all still feel a little uncomfortable with the idea of a cat and a sleeping baby. Today, it is generally believed that a cat is likely to jump into the bassinet or the crib and smother the baby.

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I know of no case reports of cats smothering babies. Sadly and tragically, infants do die of suffocation in their cribs, but the cause of death is due to bedding or other (inanimate) objects in the crib. Despite the Myth of the Smothering Cat, the official recommendation, even from the ASPCA, is that cats and other pets be kept out of the nursery. pets 3

Another myth is that your cat will mistake the crying baby for a rival cat and will attack the baby as a result. Again, there is no evidence of this whatsoever. A cat may investigate the source of crying, but only because of innate curiosity. The baby would always be fine. We know where how well the proverbial curiosity served the cat!

Dogs and Sleeping Babies

Dog owners may be concerned that the dog may try to harm the baby, particularly while she sleeps. This may be more of a concern when the dog in question is herself a puppy and/or has not yet been trained.

I tell clients that their dogs are extremely unlikely to hurt their babies on purpose; they could, however, hurt the baby by accident. Puppies are enthusiastic and don’t know yet how to modulate their enthusiasm around humans, who, they learn, don’t play as rough as other dogs. For this reason, it’s best to keep the dog and the baby separated, particularly if the former is young and rambunctious.

Recommendationspets 2

  • I don’t recommend leaving a cat or or a dog alone with a baby. This isn’t because I believe that pets will harm your baby if given a chance. Pets can be thought of the same way we think of some baby toys. We should keep at least one eye on the baby while she’s playing with it, just in case.
  • Pets should be kept out of the nursery or the parents’ bedroom, as the case may be. You already have your hands full attending to the needs of the baby. Attention to a needy animal only adds to your stress.
  • In light of the above, if you are expecting a baby and the animal already has the habit of sleeping with you, this would a good time to re-train the animal to sleep elsewhere!
  • If the baby is born in a hospital, it’s a good idea to bring home a receiving blanket that smells like baby so that the animal will be already familiar with the new baby when she comes home.
  • Always introduce the baby to the pets. Do not force either party to “say hello”, but spend a lot of calm, peaceful time allowing them to become acquainted with each other. Of course, these meetings are always “chaperoned”.

Your pets may become the best friends, and protectors, your baby will have for a long time. Observe a few simple safety rules and you will be glad you did.

 

 

 

 

 

 

 

 

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Sleep Deprivation With a Baby

Sleep deprivation after the baby comes home is no joke. You may think the all-nighters you pulled in college were a piece of cake. Maybe you thought the “tiny bladder syndrome” you had when you were pregnant would prepare you for loss of sleep after the baby came home. I’m here to tell you that nothing can prepare you for this kind of sleep deprivation. Real postpartum sleep deprivation can harm your health and your relationships, not just with your significant other, but also with your baby.

The Toll Sleep Deprivation Takes

Just because you’ve brought a baby home doesn’t mean you need less sleep! To the contrary, you need all the sleep you can get. Yet one study showed that mothers get an average of 1.5 fewer hours of sleep per day in the first week after giving birth. And the quality of that sleep wasn’t very good, meaning it was fragmented into smaller parts. This happens with newborns, who sleep short intervals.

Most of the research we have was done on generally young, healthy volunteers who knew that they could drop out of the study if the stress became too much for them. So research probably does not tell us the full story of what happens to parents when they come home from the hospital. Real mothers and fathers do not have that luxury. In addition to being sleep-deprived, they know that they cannot drop out of the study at any time.

sleep deprivation 4
Weight of the World?

The good news is that we do not see any increase in child abuse that occurs because of sleep deprivation. Although we have read warnings about it on the internet. However, it does appear that new moms with sleep problems may be more susceptible to postpartum depression.

Postpartum Brain

It’s clear that lack of sleep makes it harder to think. Working memory, flexibility, even reaction time are diminished when you haven’t slept. The risks can be substantial if you get in a car and try to drive, with or without the baby! Between 15-33% of fatal car accidents are caused by driver drowsiness.

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And many studies have shown that your satisfaction with your partner can be damaged in the first year of a baby’s life, possibly related to other stresses in addition to lack of sleep. But lack of sleep certainly does not help. It’s clear that sleep-deprived people are grumpier, less patient and more argumentative.

So What’s a Sleep-Deprived Parent to Do?

 

twins sleep deprivation 2
Don’t be that guy

There are many things you can do. Here’s a list of some of the better ideas I’ve come across.

  • Sleep When You Can: This means sleep when the baby is sleeping. Sure there are other things to do: bathe and wash clothes, etc. But some of these things you can do while baby is awake. Baby sleep time is the best time for you to sleep as well. This goes for night-time bedtime as well!
  • Exercise: This is one of the three legs on which all of health stands. It’s best to get some vigorous exercise in the morning or the afternoon. Night time would not be ideal, as it may wire you up too much and make it difficult for you to sleep.
  • Eat Well: Meat and vegetables, nuts and seeds, some fruit, rare grains, no sugar. Diet matters. You’ll feel better and you’ll sleep better.
  • Avoid caffeine, alcohol and nicotine: Especially after lunch time. These substances are not the friend of sleep.
  • Avoid screen time at night: The blue light from screens inhibits melatonin, the “sleepy hormone”. We tell teenagers this all the time. It goes double for sleep-deprived parents!
  • Get help: Yes, you can do this alone. But if you can get someone to help you do things around the house, including taking care of the baby, by all means do it. And take a nap when you are being helped, for the love of Pete!
  • Remember perfection is unattainable: Stop trying to do it all and cut yourself some slack. Learn to prioritize. Sometimes you have to wear the same pair of panties two days in a row and eat leftovers.  The world will keep turning.

 

 

Back to Sleep Saves Lives

What position is the best for putting my baby to sleep? We know now that putting the baby on her back, on a firm surface, is the safest? But how do we know this? The famous “Back to Sleep” campaign did not appear out of thin air. It was the result of many years of careful study in the field of epidemiology. One tiny little change in our behavior, putting the baby down on her back instead of her belly, has saved millions of lives in the 20th century.

SIDS

“Back to Sleep” campaigns came about as the result of the search for the causes of Sudden Infant Death Syndrome (SIDS). SIDS has also been called “cot death” or “crib death”.

In the US, unexplained sudden infant death is the #3 cause of infant mortality, after congenital malformations and extreme prematurity. But between the ages of 1 month and 1 year, SIDS is the #1 cause of death. The most common age for SIDS deaths is between 2-4 months of age.

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By definition, SIDS has no cause. For example, if an infant suffocates on a blanket in her crib, the cause is suffocation, not SIDS.  We cannot make a diagnosis of SIDS unless a thorough forensic investigation and an autopsy has been completed. Only then, when no other medical or criminal cause has been found, can SIDS be given as the reason for death.

Because the causes of SIDS remain mysterious, researchers had to find other ways to figure out how to prevent it. The search began with a number of observations starting in the middle of the 20th century.

The Origins of Back to Sleep

In 1944, in an article entitled “Accidental mechanical suffocation in infants”, Dr. Harold Abramson suggested that someone ought to do a study to ask whether sleeping position had anything to do with infant deaths. It was not until the mid 1960’s and early 1970’s that these studies were actually done. Both showed that sleeping on the belly was associated with infants dying of SIDS. But it was not until 1986 that any researcher even suggested that infants sleep on their backs to reduce the incidence of SIDS. This study was done in Australia. The suggestion was taken up and SIDS rates began to go down. The United Kingdom and Denmark soon followed with their own campaigns, with positive results.

back to sleep
She’s on her back

Several other interesting observations were made. The rate of SIDS is extremely low in Hong Kong, compared to the US. A well-done study of the the territory in 1985 showed that the most Hong Kong babies go to sleep on their backs.

Another carefully-performed study in Sweden showed that rates of SIDS went up and down as recommendations about infant sleeping position changed over time.

The US climbs on board

Finally, public health officials in the US began to pay attention to the mounting evidence. As you can see from the graph, the American Academy of Pediatrics started its back to sleep campaign in 1992. From that point on, an interesting thing began to happen: Rates of back sleeping began to increase (green dotted line), and rates of SIDS began to fall (red bars). This was a similar result to what had happened in other countries.

Causation is not correlation, but…

You always have to be careful when you look at studies like the ones mentioned here. It is always possible that the cause (putting baby on her back) and the effect (lowered SIDS rate) are not related to each other. This could be a coincidence. This is especially so because we still don’t know what causes SIDS. There’s a lot of speculation, but we just don’t know. What we can say is that all over the world, the same result has happened. Back to sleep campaigns get started and SIDS rates go down. If this is the case, we should be less concerned about what the true causes of SIDS are, because we appear to have found a way to prevent many cases of SIDS.back to sleep

Keeping in mind that we don’t know what actually causes SIDS, there are a number of other risk factors that have emerged from these studies:

  • Tobacco smoke: SIDS rates are higher for mothers who smoke during pregnancy
  • Sleeping with a pacifier: This appears to lower the risk of SIDS
  • Breastfeeding: Infants who breastfeed are at slightly lower risk of SIDS
  • Genetics: Boys are more likely than girls to die of SIDS
  • Vaccinations: These appear to be protective. Again, no one knows why

What to do about “flat head”?

There’s no question that it’s a very good thing that SIDS is so rare now, thanks to what we’ve learned. But there is one unintended consequence of all the back to sleep campaigns: flat head. Called “positional plagiocephaly“, it’s the result of, well, laying on the back while your baby head is growing rapidly. It’s occurring now in about 10-50% of all babies that sleep on their backs. Most babies who have a mild case of flat head will grow up to have a normally-shaped skull. The best way to reduce the amount of head flattening your baby has is to do observed “tummy time” about 20 minutes per day. It’s also recommended that you position the baby’s head alternatively to the right and to the left when she sleeps. This will help keep her most symmetrical. Do not use positioners. These are not recommended.

If you’re concerned about any of this, SIDS and/or flat head, please consult your pediatrician!

Baby Box: Good Idea, But Not That Good

The Finnish “Baby Box” is enjoying something of a moment. Since the appearance of an article on the subject in BBC Magazine, the concept has “gone viral”. Entrepreneurs and public health experts on every continent have jumped on that crazy Finnish baby box bandwagon. It’s a neat idea, and it’s nice for parents. But claims are being made for the “box” that are not supported by the evidence.

What’s a “Baby Box”?

In 1938, the government of Finland began mailing packages to low-income pregnant women. The packages contained diapers, bedding, gauze towels and other child-care products. But the most notable feature of the package was the box itself: there was a mattress at the bottom, that the baby was meant to sleep in. The precise reason for the baby box is unclear, but one suggestion is that many poor Finnish women could not offer a clean place for their babies to sleep.

Beginning in 1949, the program was expanded to include all mothers, which is to say, the “means testing” mechanism was removed. But there was a catch: in order to get the box, mothers had to begin attending a prenatal clinic before the fourth month of pregnancy. This was done to ensure that mother enjoyed a healthy pregnancy, giving her baby the best chance at being born healthy.

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The contents of the box has changed with time, depending on contemporary trends or the privations of war time. Seventy-eight years later, Finnish moms continue to look forward to receiving their baby box no matter how many children they have.

The Box Goes Viral

After the appearance of the original article in BBC magazine, the Finnish government sent a baby box to the Duke and Duchess of Cambridge when they were expecting their first baby. Expectant parents all over the world wrote to the Kela, the Finnish social security agency, to request their own baby boxes. Entrepreneurs jumped on board and began selling baby boxes world-wide, from Finland and the United Kingdom.baby box

The concept also captured the attention of public health experts throughout the world. The reason for the attention is very likely the inclusion of a single graph in the original BBC article, showing the decline of infant mortality in Finland throughout the 20th century.

The implication was that the box itself contributed to the decline in the Finnish infant mortality rate.

How likely is this to be true?

In the early part of that century, throughout the world, infant mortality was high by modern standards. But infant mortality rates were doing something very significant since the late 19th century: they have been falling rapidly.

The Defeat of Infant Mortality

We would like to say we know the reasons why infant mortality has been plummeting throughout the developed world. The truth is that we don’t really know why. There are many factors involved. It’s almost certainly the case that several factors were important. According to experts, in the early 20th century the most important factor was the decline in deaths from infectious disease. This was due mostly to improvements in nutrition and public health. By mid-century, the development of antibiotics contributed to further improvement in life expectancy. Today, the largest contributors to infant mortality are congenital abnormalities and the consequences of extreme premature birth.

Further down the list of causes are SIDS and injuries. The latter group includes death by suffocation, usually in the crib. These are the causes of death most likely directly related to the place where the baby sleeps, as in, say, a baby box. The claim, hinted at in several articles, is that the box has been responsible directly for a reduction in SIDS and suffocation deaths.

baby box
Big Drop, No Box

Not so fast.

It’s important to note that infant mortality has been plummeting in every other developed country that did not distribute baby boxes. There’s no evidence to suggest that Finland’s very low rate (around 3 per 1000 live births) has anything to do with the box. It’s more likely that other improvements in public health and medical innovations had more to do with it.

But wait. Could the box have nothing to do at all with the low Finnish infant mortality rate?

It’s probably the case that the box was part of a multi-level public health effort, the cumulative effects of which was better overall health of new mothers and their babies. Other features of the effort included better prenatal care and education for mothers and fathers.

Similar efforts in India include mosquito netting over the box, to help stem the spread of malaria.

So what about cities in the US with relatively high infant mortality rates?

An initiative in Fort Worth, TX, hopes that a baby box distribution program will help lower the rate of 7.9/1000 closer to the national average of 6.1/1000. It’s unclear how much of the excess infant mortality is due to sleep-related deaths. If the program is to succeed, and I wish them well, it will likely succeed because of the increased attention that pregnant woman pay to their own health. The effect on rates of premature birth may be substantial.

So the baby box itself may not be the answer to the infant mortality problem. But if the box helps persuade mothers to get prenatal care, the program may be worth the investment. Also there are all those cool boxes.

Private Umbilical Cord Banking is a Bad Idea

Wanna bet your baby gets cancer?

If you were expecting a baby, and some guy got in your face and said that to you, what would you do?

Most people would probably want to take a swing at him. Now what if that same guy came up to you and handed you a brochure for a private Umbilical Cord Blood Bank?  The front fold has a color photo of a nice couple and a young child walking together on a beach, or in a field. Everybody is smiling.

What’s an umbilical cord blood bank?

Maybe you don’t know yet what an umbilical cord blood bank is.  It’s fine, the brochure will explain.  Did you know that when your baby is born, her umbilical cord holds the key to life? It’s full of special cells that doctors are using to treat serious diseases, helping families all over the world.  It can help your family too!

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Now perhaps you’re interested, but the brochure goes on for several pages telling stories of miracle cures from cord blood transplants.  You start thinking that if your new baby were ever to get cancer, she could…

Wait.  Keep reading.  It turns out that if the baby ever has a brother who gets cancer or some other horrible disease, they can use her cord blood to cure him!  Now you’re really interested, so they might as well tell you what it costs.

Mucho Dinero

Ok, it’s expensive.  It’s REALLY expensive. $1000, $2000. And there’s a monthly fee to keep it frozen.  But it could save her life?

No.  It’s not going to save her life.  And there’s very little chance that it’s going to save a sibling’s life some day. Basically what this brochure says is no different from a guy getting in your face and asking you to bet that your baby is going to get cancer.

The chances that this cord blood will be transplanted back into your child is vanishingly small. If she needs such a transplant, likely it will be for a disease that she is born with, making her own cord blood useless to her.

The truth about cord banking is available, and yet there are still private umbilical cord blood banks.  Why do people spend this kind of money for something that you can be metaphysically certain will never be used? Why bet on such lousy odds that your baby, or any future children, will get cancer?

Your Child is Essentially Healthy

We do this because we have forgotten how healthy our babies really are.  Your baby, about to be born, is among the healthiest human beings that has ever walked the earth. That’s not just pie-in-the-sky optimism. That’s fact.  By any metric, children born today are healthier and have a longer life expectancy than we have ever in our history.

And yet we tend to consider our children as essentially un-healthy humans, one sniffle away from certain doom.

Now sure, kids are not unbreakable.  They get sick. They fall down and hurt themselves. But children’s essential healthiness doesn’t change.  They get better.  Broken bones heal.  Common sense, right? So why don’t we believe this?  Why do we take bets that they’ll get cancer?

There are probably several answers, but one stands out: we’re victims of our own success.

Technology evolves quickly. Humans evolve slowly. Several generations ago, living into your 30’s was a rarity. If disease or starvation didn’t kill you, the Saber Tooth Tiger lurking outside your cave would.  We survived these many millennia because we learned to be vigilant in case the Saber Tooth Tiger was nearby. And it worked.  For a long time.  We survived because of our vigilance.

Tiger, Tiger

wanna bet your baby gets cancer?
See? He’s extinct

Fast forward to the present and there are no more Saber Tooth Tigers.  But we haven’t evolved out of the tendency to be always vigilant for danger.  We stand watch for tigers that are not there. We guard our babies against threats that are long extinct. We’re basically cave dwellers with cell phones.

That’s why you listen to the guy with the brochure from the private umbilical cord bank. He’s offering you a high-tech club to fight off a 21st century Saber Tooth Tiger.

Folks, there’s no tiger outside your cave.  If you must bank your baby’s cord blood, choose a public bank. The donation will cost you nothing and you might just save someone’s life some day. But it will be someone you don’t know.  Not someone from your cave.

How to Sleep During Pregnancy

So you’re pregnant and you can’t sleep. You toss and turn, you switch positions, you get up to pee what seems like every five minutes. Then there’s the heartburn and the trouble breathing… you wish they taught you how to sleep during pregnancy!

Wait, have any of your friends told you that the lack of sleep is supposed to prepare you for your newborn, when sleep supposedly goes away for ever?

It’s a bunch of crap: You’re supposed to sleep well during pregnancy! Healthy sleep is important to growing a healthy baby. It’s as important as healthy diet and healthy exercise during pregnancy – maybe more important.

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Here’s what you need to do to get the best sleep possible during pregnancy.

How to sleep during pregnancy

Many moms-to-be report sleep troubles starting during the first trimester, even before they start showing. There are a number of reasons for this, most of them hormonal. And sometimes pregnant moms just stay up at night and stress about having a newborn.  This is understandable, but there are ways to get into good sleep habits early.  You’ll be grateful these habits during the third trimester!

  • Stop napping during the day. I put the toughest one first. I know you’re worn out.  Progesterone does that to you. But you’ll screw up your night time sleep if you nap!
  • Eat well and exercise regularly. There’s a tight relationship between diet, exercise and sleep. It turns out that people who eat well tend to have better energy for exercise and they sleep better. People who exercise regularly tend to eat better and sleep better… and so on, each good habit supports the other!
  • De-stress. Easier said than done, right? Along with diet and exercise, stress reduction is one of the foundations of staying healthy during pregnancy. It almost doesn’t matter what you do to help reduce your stress: do yoga, quit your job, stop watching the news, anything. Motherhood is stressful enough: better to discard useless sources of stress before baby arrives [hint: all sources of stress are useless]
  • Quit caffeine and late night television. Both will keep you up at night. Full-disclosure: I’m addicted to caffeine. I really and truly feel for all my fellow caffeine addicts who must cut back during pregnancy. It’s so worth it. TV (and internet) at night are just too stimulating. Good advice to remember for raising your baby!
  • Lay off the cell phone. This is a #21stcenturymom problem. It’s as stimulating as coffee with dinner or Saturday Night Live. Best to leave the phone somewhere outside the bedroom. Any kind of light stimulation, including the bathroom light, will make it tougher for you to fall back asleep.
  • Keep a routine and go to bed at a decent hour. This is a great habit to get into, not only for pregnancy but also for helping baby sleep well.  You’d be surprised how helpful it is to stick to a routine. Having a reasonably consistent pattern to your day will absolutely help you sleep better at night. The regular schedule and the early sleep hour are two of the best kept secrets in the world of sleep. And I just revealed them to you. You’re welcome.

When sleep starts to get uncomfortable

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not sleeping

As you progress into the later trimesters, many moms start noticing that they just can’t get comfortable when they lay down to sleep.  There are several reasons for this, and all of them are fixable.

  • Restless legs. It’s a real thing, folks. Restless leg syndrome feels like pins and needles, or a crawling sensation on your legs. Some mothers report that it’s actually painful. In some cases, the pain could be from swelling at your ankles.  If you’re getting this, please tell your OB! No one knows what causes restless leg, and if we knew how to prevent it, that would be great. The best remedies I know of are the old stand-by’s: eat healthy, exercise regularly, and reduce stress.
  • GER. Also known as “reflux”. Even moms who never had it before often get it during pregnancy. This is probably due to the added pressure in your belly causing stomach acid to head in the wrong direction: up toward your throat. The burning sensation makes lots of mom’s feel nauseous and actually throw up (quite apart from morning sickness).
    • The best first step to helping heartburn is to avoid caffeine (see a pattern developing here?), spicy foods, and cruciferous vegetables, like kale. My apologies to you lovers of kale out there: if you have heartburn, you might consider cutting back.
    • Try to increase the amount of time between dinner and bed time, to give food time to digest. And avoid snacking before bed. That goes for fluids as well!
    • Try sleeping on 2-3 extra pillows.
  • Tiny bladder syndrome. That’s not really what it’s called. I made it up. Your bladder will not get tiny unless it was tiny to begin with. What happens is that your uterus, which happens to be right next to your bladder, is getting larger and full of baby. And it’s leaving less room for your bladder to get full. So you will feel like you have to pee way more often. The remedy is to reduce your fluids at dinner and take nothing to drink after that, unless it’s a sip to get a pill to swallow a prescribed medicine. You’ll have plenty of opportunity to drink during the day and you should. Just not so much at night.

    how to sleep during pregnancy
    dreaming of sleep
  • Trouble breathing. Your bladder isn’t the only organ getting crowded out. There’s also your lungs. There’s only so much space in your body. You’ve got your lungs in your chest and you’ve got a growing baby in your belly. When you lay down, the contents of your belly tend to press up against your chest cavity and make that space smaller. Something’s gotta give, and for many moms, that’s total lung capacity. The way to manage this is similar to the way you manage heartburn: let gravity be your friend. Prop up your upper body with 2-3 extra pillows.  Let gravity pull your belly down and away from your lungs.
  • Back pain. Lots of moms complain of sore backs, especially lower backs. At some point, if you’re a back sleeper, you may have to give up on this position and go to sleeping on your side, with a pillow between your legs. The larger, cylindrical pillows are great too.
  • Speaking of sleeping on your side. It turns out that sleeping on your left side is better than your right. Why? Because when you’re on your left side the baby inside you won’t press as hard on some important blood vessels. Your circulation will be better and so will baby’s.

How much sleep should you get during pregnancy?

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well slept

The answer is: the same amount you should be getting when you’re not pregnant! Seven hours, at least, is optimal for health. Even in the latter stages of pregnancy, when you may be waking up more often, it’s best if you limit light stimulation, avoid drinking fluids, and try to go back to sleep.

So if your friends tell you that “pregnancy sleep” is supposed to get you ready for “newborn sleep”, they’re actually right, but not for the reasons that they think.  Healthy sleep habits will make your pregnancy better, and they’ll make life with your new baby happier and healthier.

 

 

 

 

 

7 Things Your Baby Will Need to Come Home With

We’ve talked about things you’ll need to bring to the hospital with you when you have a baby. Here we discuss things your baby will need when she comes home.  I’m sticking to what I consider the bare essentials, because the truth is the baby doesn’t need very much besides you!

A car seat

Most “things your baby will need” lists leave the car seat off altogether. That’s a mistake.  If you’re having the baby in a hospital, you have to bring in an approved, rear-facing car seat or they won’t let you take the baby home!  I recommend the kind that has a base that remains attached to the back seat of the car.  Trust me, you’ll use many fewer swear words installing it if you do!

Diapers

Lots of them. But don’t go crazy.  She won’t be in newborn size for very long: A couple weeks at the most. You could go through about 50 of these per week, especially in the first week, especially while you’re trying to figure out how to put them on (though they’re “self-contained and fairly explanatory“)

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Baby clothes

things your baby will needDon’t go crazy on these either. She’ll need about 8 shirts and bottoms to go with it. It’s just that, well you know, newborns get their clothes dirty a lot, so these are more things your baby will need!  I say “bottoms” instead of “pants”, because though your baby probably has legs, she won’t be using them to get around with for a while. So it doesn’t make a lot of sense for you to stress about getting a newborn’s leg into a pant.  First time you try it you’ll see what I mean. You’ll want to wash her clothes in something gentle.  I like Dreft.

Avoid things with snaps. Why do so many baby outfits have so many snaps? There is no possible way to snap them up correctly when there are as few as three snaps: why do outfits have to have 15 snaps?

Avoid sleep wear that has textured bottoms on the feet. They’re just silly. YOUR BABY CAN’T FREAKING WALK YET!!!

A bassinet or “Moses Basket”

Since this blog is focused on baby sleep, you’d think I’d put this first. But the truth is your baby will fall asleep in the car seat before she ever sees her bassinet.things your baby will need

I prefer bassinets to co-sleepers. They’re much less hassle and just as easy to transfer the baby to. I definitely prefer the bassinet to her sleeping in bed with you (a topic for another post)!

Things your baby will need: a sleep sack!

For sleep these are the best.  The kinds with velcro, as shown here, double as swaddlers as well as sleep wear!  Remember the baby has legs and feet but she really just does not have to use them for a couple months. Rather than repeat my pet peeve about snaps, here’s a good word for the zipper: Zippers are great. Zippers are awesome. Zippers are way better than buttons, which are almost as bad as snaps.things your baby will need

Avoid sleep wear that has textured bottoms on the feet. They’re just silly. YOUR BABY CAN’T FREAKING WALK YET!!!

Sleep sacks are warm, they’re comfortable, and they’re effortless to put on. When you’re exhausted you’ll appreciate them so much more.

A baby bath

Pro Tip: when you bathe a boy, you’ll need to place a wash cloth over his “nether regions”. Think about it…

Now, truthfully this isn’t something your baby will need, necessarily.  It’s perfectly okay to bathe the baby in the sink. It’s just sloppy.  There’s all that splashing. And some sinks just can’t accommodate a baby and water and your hands.things your baby will need

To go along with the bath she’ll need her own wash cloths. Pro Tip: when you bathe a boy, you’ll need to place a wash cloth over his “nether regions”. Think about it for about 10 seconds and you’ll figure it out if you haven’t already. To bathe, you’ll need only Johnson’s Baby Shampoo.  This stuff is the best.  You can wash baby’s hair and body, and if you get it her eyes it doesn’t sting! It’s like a miracle substance! I bathed both my boys exclusively in Johnson’s Baby Shampoo for the first two years of their respective lives.

A breast pump

things your baby will need
this is not a breast pump

This one is obviously for your breast feeding moms. If you plan to breastfeed exclusively, this isn’t necessarily one of the things your baby will need when she comes home from the hospital. But it’s a good thing to have for a couple reasons: If, like a lot of new moms, you get breast engorgement in the first few days after birth, this device can be a life-saver. Sure, you can manually express breast milk, but I find that the devices do a better job.  You don’t have to spend a lot of money on the electric types with all the fancy bells and whistles. A simple, mechanical pump will do nicely. Also, if you will be storing milk for whatever reason, you’ll need 4-ounce bottles and nipples to go with the pump. Breast milk freezes great. You can store frozen breast milk for up to 9 months.

 

9 Things You Absolutely Have to Bring to the Hospital

What do you absolutely have to bring to the hospital with you when you have a baby? Wait! Before you ask what you should get ready to bring, think about when you should get it ready: you already know that things usually don’t go as planned, and babies sometimes come early. Don’t get caught with your (maternity) pants down! Pack early! I recommend having a bag ready to go at 34 weeks.  And what should be in that bag?

Warm clothes, especially socks

Hospital floors can be very cold, even when you’ve got that crazy progesterone thing going on and you’re hot when everybody else is cold. There are all kinds of hormonal shifts that go on when you give birth, so prepare for getting the chills.  You’ll feel more comfortable as well as warm, and comfort is extremely important here, especially if you’re going to breast feed.

Don’t get caught with your (maternity) pants down! Pack early!

Something for your Boobs: maternity bras and nursing pads

Even if you’re not going to breast feed, you’re probably going to leak colostrum. Be ready for it!

Toiletries, especially your own toothbrush and hairbrush

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Have you ever seen a hospital toothbrush, let alone try to brush your teeth with it? You’ll feel so much more comfortable with your own bathroom stuff.

A phone charger

absolutely have to bring to the hospital
If you’re having the baby in Europe

This is a very 21st century thing, I admit. Nothing’s worse than your phone going dead when you’re trying to tell the good news to friends and family. Or when you’re trying to share pictures of your new baby to Facebook. Since you’re going to need your charger after 34 weeks, it makes sense to pack a spare.  Oh, and don’t forget to bring the phone!!!

Absolutely have to bring to the hospital: Lip balm!

Hospitals may be hot or they may be cold, but all of them are dry. Your lips are going to really need it!

Eyeglasses

absolutely have to bring to the hospital
It’s the balm!

This one is for you contact lens wearers. It helps to be able to see.  Please pack a spare pair of spectacles!

Something to help you relax

This can be a book, something that will play music (remember charger!), or any focus object that will help distract, calm, and relax you.

Something to put up your hair

Ladies with long hair! Scrunchies are good, clips not so much because they’ll pinch you in hospital beds!

White noise machine

Hospitals are noisy places in general.  All those pumps, alarms, and other laboring women can make for an… interesting sound garden. You’re probably better off drowning out the noise!

Of course, if you forget anything, these would be things that your partner will absolutely have to bring to the hospital!

Birth Plans: Why They Aren’t a Good Idea

Here’s a dirty little secret about birth plans: having a baby almost never goes the way you plan it.

There’s an old saying that goes “Man plans, God laughs”. It’s sounds cruel, but it says something true about life: we can plan all we want, but life is unpredictable.  And what is true of life goes double for childbirth!

New parents are justifiably nervous when they’re going to have a baby, especially their first baby. What writing a birth plan does do is give anxious parents a sense of control, and that’s very valuable.

I can appreciate wanting to be in control of a new scary situation.  That’s understandable. The thing is, childbirth is quite possibly the most un-controlled event of your entire life!

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There are several harsh truths about birth plans that you ought to know if you’re thinking about writing one:

The Problem with Birth Plans

Nurses hate them.  Your labor and delivery nurse is a compassionate, caring human being, and in your darkest hour of need she will be the best friend you ever had – way more help to you than your partner! But she has a job to do and she knows how to do it better than any mom who ever gave birth. Birth plans tend to drive a wedge between you and a woman who really and truly wants to help you.

Birth Plan
Oops. I meant to do that

Unless you’re a nurse (or you live with one, as I do) you may not know that nursing is a highly protocol-driven profession. They have tons of paperwork and documentation to do.  Birth plans only tend to pile more storm and stress on top of an extremely stressed person.  And nevertheless, she’s the best advocate you’ll have throughout the entire experience!

OB-Gyn’s tend to ignore birth plans. This is a sad but natural fact.  OB’s tend to be the most risk-averse human beings on the planet, with good reason.  They want to do the best they can for you because they want you and the baby to get through childbirth happy and healthy. Hopefully you chose your OB wisely, and he/she is a person you can communicate with.  That includes communicating what you want prior to birth. But you have to understand that plans change in real time.

Mike Tyson once said “Everybody has a plan until they get punched in the face.” As wonderful as having a baby can be, it’s a lot like being punched in the face. Whatever happens, it happens fast, you weren’t ready for it, and you never saw it coming!

Everybody has a plan until they get punched in the face

birth plans
Be open to the Unbidden

Such is parenthood.  We’d like to believe that we can know what our baby will be like, how she’ll grow, what kind of person she’ll be.  Every parent thinks this way, even if only fleetingly. But as anyone who has had a child will tell you, they never turn out the way you thought they would.  And it’s wonderful nevertheless.

The first day of that child’s life is a good place to start appreciating that her life will be awesome and amazing.

In The Case Against Perfection, Michael Sandel writes that it’s human nature to want to control uncontrollable events. At the end of the day, Sandel concludes, life is happier and more fulfilling if we allow ourselves to be “open to the unbidden.” That means letting life hatch, unfold, and be amazing.

Why Babies Cry; Why They Make US Cry

Figuring out why babies cry means figuring out what they want. Fortunately, what they want is pretty straightforward.

I want, therefore I Cry: Deciphering the Real “Baby Talk”

The auditory cue that may be the most difficult to interpret is the cry. Why babies cry? Three reasons really: because they’re hungry, because they’re uncomfortable, or because they just want to be held. The trick is to figure out what it is the baby wants. We’ll deal with each cry separately.

The “I’m hungry!” cry

If the baby eats every two to three hours and it’s time to eat, her crying could mean she’s hungry.   You’ll want to avoid delaying feeding to the point that the baby starts to cry.

The “I’m hungry!” cry is fairly loud and insistent, often accompanied by rooting behavior. Rooting is the name for the baby’s natural reflex to look around for a nipple somewhere near her face. The rooting expression appears as almost a half-smile. What’s actually happening is the baby is opening her mouth in part to signal to you that she’s hungry and in part hoping to hook a nipple in the vicinity.

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why babies cry
Grumpy Kitty is Hungry

After about a minute, the “I’m hungry!” cry can get louder, more insistent, and more piercing until it seems as though the baby is in pain. She’s not in pain; she’s just really upset because she’s so hungry. And this creates a problem for her. When a baby is wailing because she’s so upset about her hunger, she may be too upset to calm down, slow her breathing, put a nipple in her mouth, and start to feed, so it will be difficult to get her to stop crying.

The “Why babies cry” cry

When a baby is lost in the fog of her own hysterical crying, it’s difficult but not impossible to find your way through to her. The first trick is to try to remain calm yourself. If the baby senses that you, too, are on the edge of tears (or perhaps crying yourself), she’ll probably feel even more upset. Try to muster all your best acting ability and pretend you are calm, cool, and collected.

One method to get your baby to stop crying and to start feeding is to gently rock her while waiting for her to come down a bit from her hysterical peak or to wait for a pause in her wailing while she takes a breath. When this happens, try to introduce the nipple and see if she begins to suck and calm down. Another method is to lay the baby on her back and place a thumb in each of the baby’s palms. Then raise her hands up to her mouth, placing one of her hands against her lips. As she’s rooting, she may start sucking her fingers and stop crying for a moment. Meanwhile, you’ll want to bend over and bring your head close to hers. You can say “Shhhhhhhhh” really calmly and serenely or you can just talk to your baby in a calm voice. You might notice her body begin to relax and her breathing begin to slow down. This is the time to put her to the breast or get that bottle in her mouth.

If none of these techniques work, it could be that your baby isn’t hungry as much as she’s uncomfortable.

Why Babies Cry: The “Something’s bothering me!” cry

why babies cry
It gives me gas

This cry sounds a little harsher and more insistent than the “I’m hungry!” cry. It’s worth mentioning here that even if your baby is uncomfortable for some reason, she might be comforted by feeding. But after a quick feed, you’ll notice that your baby is still uncomfortable because she’ll start crying again. Sometimes after a normal feeding, your baby will start crying because she has a gas bubble or because her wet or dirty diaper is bothering her. The solution in this case is not to try feeding her again; the solution is to try to find out what the problem is. If your baby has just fed, or has fed recently, and you’ve determined that hunger is not the problem, there are a couple of places to look right away. First, has your baby pooped or peed recently?  Many babies don’t care at all if their diaper is wet or dirty, but some babies care a great deal. It’s fairly easy and straightforward to undress your baby’s bottom half and check the diaper. If it’s dirty or wet, you can change it and see if this makes a difference to your baby.

why babies cry
Hold me

Another likely source of discomfort for your baby is her stomach. Actually, the problem is rarely the stomach itself. It’s either her intestines (large and small) or her esophagus (the tube between the mouth and the stomach). When a baby’s intestines get full of gas or poop, it can be painful, and she’ll probably cry. There are many techniques available to you to try and relieve the baby’s gas or other intestinal distress. Sometimes just being with your baby and holding her while she deals with a gas bubble can help her feel better. Many babies cry because they have reflux. The technical name for this kind of reflux is gastroesophageal reflux. Simply put, this is milk that starts in the stomach and moves backward, up into the esophagus instead of down into the intestines.  Finally, some babies who cry have good, old-fashioned colic.

Why Babies Cry: The “Hold me!” cry

After hunger and discomfort, the most common reason why babies cry is that they just want to be held. This cry is more of a whimpering, miserable cry. Babies seem to have an instinctive need to be held and comforted, especially by their mothers and fathers. Sometimes the need is greater than at other times. I suppose parents have the same needs with respect to holding their babies. Unfortunately, the deal seems to work out to the baby’s advantage. The reason why babies cry isn’t only because they want you to hold them — they also probably want you to stand up. Hundreds of parents have told me how their babies seem to know that mom or dad sat down, because they start crying again. And it gets worse: They don’t want you merely to stand with them, they want you to walk with them. This can seem very labor-intensive at 4: 00 in the morning.

Why Babies Cry: Can You Hold a Baby Too Much?

There’s an old cultural myth that says if you hold an infant too much she’ll become spoiled. All theories of parental-infant bonding reject this myth. In fact, most experts agree that for most of the first six months, the word “spoiled” doesn’t even exist in the baby’s “vocabulary.” That is to say, it is impossible to spoil an infant by holding her too much. To the contrary: Prior to around four to six months of age, infants lack the internal means to soothe themselves. They require something (usually someone) outside themselves to feel calm and secure. This is a period of life when parents really have to respond when the baby cries. Parents often ask me whether they can just let a one-month old cry. I usually respond, “Sure, you can… it won’t work, though.”

Bottom line: Hold your baby as long as you want. You couldn’t spoil her if you tried.