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First Weeks at Home with a Newborn
PREVENTING FATIGUE AND EXHAUSTION
For most mothers the first weeks at home with a new baby are often the
hardest in their lives. You will probably feel overworked, even
overwhelmed.
Inadequate sleep will leave you fatigued. Caring for a baby can be a
lonely
and stressful responsibility. You may wonder if you will ever catch up
on
your rest or work. The solution is asking for help. No one should be
expected
to care for a young baby alone.
Every baby awakens one or more
times a
night. The way to avoid sleep deprivation is to know the total amount
of sleep you need per day and to get that sleep in bits and pieces. Go
to bed earlier in the evening. When your baby naps you must also nap.
Your baby doesn't need you hovering while he or she sleeps. If sick,
your baby will show symptoms. While you are napping take the telephone
off the hook and put up a sign on the door saying MOTHER AND BABY
SLEEPING. If your total sleep remains inadequate, hire a baby sitter or
bring in a relative. If you don't take care of yourself, you won't be
able
to take care of your baby.
THE POSTPARTUM BLUES
More than 50% of women experience postpartum blues on the third or
fourth day after delivery. The symptoms include tearfulness, tiredness,
sadness, and difficulty in thinking clearly. The main cause of this
temporary reaction is probably the sudden decrease of maternal
hormones. Since the symptoms
commonly begin on the day the mother comes home from the hospital, the
full
impact of being totally responsible for a dependent newborn may also be
a
contributing factor. Many mothers feel let down and guilty about these
symptoms
because they have been led to believe they should be overjoyed about
caring
for their newborn. In any event, these symptoms usually clear in 1 to 3
weeks
as the hormone levels return to normal and the mother develops routines
and
a sense of control over her life.
There are several ways to cope with the postpartum blues.
First, acknowledge your feelings. Discuss them with your husband or a
close friend as well as your sense of being trapped and that these new
responsibilities seem insurmountable. Don't feel you need to suppress
crying or put on a "supermom show" for everyone. Second, get adequate
rest. Third, get help with all
your work. Fourth, mix with other people; don't become isolated. Get
out
of the house at least once a week--go to the hairdresser, shop, visit a
friend, or see a movie. By the third week, setting aside an evening a
week for a "date"
with your husband is also helpful. If you don't feel better by the time
your
baby is 1 month old, see your physician about the possibility of
counseling
for depression.
HELPERS: RELATIVES, FRIENDS, SITTERS
As already emphasized, everyone needs extra help during the first few
weeks alone with a new baby. Ideally, you were able to make
arrangements for help before your baby was born. The best person to
help (if you get along with her) is usually your mother or
mother-in-law. If not, teenagers or adults can come in several times a
week to help with housework or look after your baby while you go out or
get a nap. If you have other young children, you will need daily help.
Clarify that your role is looking after your baby. Your
helper's role is to shop, cook, houseclean, and wash clothes and
dishes. If
your newborn has a medical problem that requires special care, ask for
home
visits by a public health nurse.
THE FATHER'S ROLE
The father needs to take time off from work to be with his wife during
labor and delivery, as well as on the day she and his child come home
from
the hospital. If the couple has a relative who will temporarily live in
and
help, the father can continue to work after the baby comes home.
However,
when the relative leaves, the father can take saved-up vacation time as
paternity leave. At a minimum he needs to work shorter hours until his
wife and baby have settled in.
The age of noninvolvement of the father is over. Not only does
the mother need the father to help her with household chores, but the
baby also needs to develop a close relationship with the father.
Today's father helps with feeding, changing diapers, bathing, putting
to bed, reading stories, dressing, disciplining, homework, playing
games, and calling the physician when the child is sick.
A father may avoid interacting with his baby during the first
year of life because he is afraid he will hurt his baby or that he
won't be able to calm the child when the baby cries. The longer a
father goes without
learning parenting skills, the harder it becomes to master them. At a
minimum,
a father should hold and comfort his baby at least once a day.
VISITORS
Only close friends and relatives should visit you during your first two
months at home. They should not visit if they are sick. Friends
without
children may not understand your needs. During visits the visitor
should
pay special attention to older siblings.
Our basic rule is that only the
newborns' parents, siblings and grandparents may hold or feed the baby.
For everyone else, the rule is that for the first two
months,
LOOK FROM AFAR AND DO NOT TOUCH!
FEEDING YOUR BABY: ACHIEVING WEIGHT
GAIN
Your main assignments during the early months of life are loving and
feeding your baby. All babies lose a few ounces during the first few
days after
birth. However, they should never lose more than 7% of the birth weight
(usually about 8 ounces). Most bottle-fed babies are back
to
birth weight by 10 days of
age, and breast-fed babies by 14 days of age. Then infants gain
approximately an
ounce per day during the early months. If milk is provided liberally,
the
normal newborn's hunger drive ensures appropriate weight gain.
If you need to take a
medication while you're nursing, you can perform a search through the
following two links to learn about its safety while nursing. Before
you make any changes based on this information, be sure to call the
physician who prescribed it!!
Keep this card handy . . .
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MARIA
L. COTTY, RNC
Preparation for Parenthood Programs
- Lamaze
- Lactation Consultations
- Breastpumps
- CPR, Safety, First Aid
- Infant Massage
(718) 767-7808 Fax 747-5422 mlcnyc@aol.com |
A breast-feeding mother often wonders if her baby is getting
enough calories, since she can't see how many ounces the baby takes.
Your baby
is doing fine if he or she demands to nurse every 1 1/2 to 2 1/2 hours,
appears satisfied after feedings, takes both breasts at each nursing,
wets 6 or more diapers each day, and passes 3 or more soft stools per
day. Whenever you are
worried about your baby's weight gain, bring your baby to your
physician's office for a weight check. Feeding problems detected early
are much easier to remedy than those of long standing. A special weight
check 1 week after birth is a good
idea for
infants of a first-time breast-feeding mother or a mother concerned
about her milk supply. Click
here for excellent information for nursing mothers by Dr. Jack
Newman.
DEALING WITH CRYING
Crying babies need to be held. They need someone with a soothing voice
and a soothing touch. You can't spoil your baby during the early months
of
life. Overly sensitive babies may need an even gentler touch.
Remember,
there will be the "period
of PURPLE crying."
SLEEP POSITION
Remember to place your baby in his
crib on
his back. This is the sleep position recommended by the
American Academy of Pediatrics for healthy babies. The back (supine)
position reduces the risk of SIDS.
TAKING YOUR BABY OUTDOORS
You can take your baby outdoors at any age. You already took your baby
outside when you left the hospital, and you will be going outside again
when
you take him or her for the two-day or two-week checkup.
Dress the baby with as many layers of clothing as an adult
would wear for the outdoor temperature. A common mistake is
overdressing a baby in summer. In winter, a baby needs a hat because he
or she often doesn't have
much hair to protect against heat loss. Cold air or winds do not cause
ear
infections or pneumonia.
The skin of babies is more sensitive to the sun than the skin
of older children. Keep sun exposure to small amounts (10 to 15 minutes
at a time). Protect your baby's skin from sunburn with longer clothing
and a bonnet.
Camping and crowds should probably be avoided during your
baby's first two months of life. Also, during your baby's first year of
life try to avoid close contact with people who have infectious
illnesses.
MEDICAL CHECKUP ON THE THIRD OR FOURTH DAY OF LIFE
Early discharge from the newborn nursery has become common- place for
full-term babies. Early discharge means going home within 24 to 48
hours after giving birth. In general this is a safe practice if the
baby's hospital stay has been uncomplicated.
These newborns need to be re-checked several days after
discharge to see how well they are feeding, urinating, producing
stools, and breathing. They will also be checked for jaundice and
overall health. Before your discharge home from the hospital, we will
let your know when to return to the office for this exam.
THE TWO-WEEK MEDICAL CHECKUP
This checkup is probably the most important medical visit for your baby
during the first year of life. By two weeks of age your baby will
usually
have developed symptoms of any physical condition that was not
detectable
during the hospital stay. Your child's physician will be able to judge
how
well your baby is growing from his or her height, weight, and head
circumference.
If you'd like your own copy of the growth chart for your records, click here.
This is also the time your family is under the most stress of
adapting to a new baby. Try to develop a habit of jotting down
questions about your child's health or behavior at home. Bring this
list with you to office visits to discuss with the physician. Most
physicians
welcome the opportunity to address your agenda, especially if your
questions
are not easily answered by reading or talking with other
mothers.
If at all possible, both the mother and father should go to
these visits. Most physicians prefer to get to know both parents during
a checkup rather than during the crisis of an acute illness.
If you think your newborn is sick between the routine visits,
be sure to call your child's physician for help.
New parents,
please review our vaccine information page
before your infant's two month checkup.
Copyright ©
Clinical Reference Systems 1999
Pediatric Advisor
MD Consult L.L.C.
http://www.mdconsult.com
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