Friday, July 29, 2016

Thoughts on L&D and first few months with new baby

I'm heading into the third trimester of pregnancy number three!  This blog post is the best pieces of advice I've learned about labor and delivery, first few months with baby, and feeding the baby.  And a couple memes about what it feels like to be in your third trimester of pregnancy.

Labor and delivery 

  • Birth classes - they are worth taking if you're trying to learn a particular skill (such as techniques to get through natural labor, how to breastfeed).  It is NOT worth taking a hospital based birthing class otherwise - just spend 10 minutes reading an article about the stages of labor and delivery and you'll be equally prepared.  
  • Come in informed and have someone to help you advocate  - they will be throwing lots of information at you when you come in with contractions (dilated, effaced, fun words like that), and it's a lot easier to handle if you have some idea of how this all relates to you being done with the whole thing.  Whether to have a written birth plan or not is really up to your personal preference (i never did), and don't expect the hospital to honor it like a contract - it just helps keep you on track with asking for the things that are important to you.  If someone else can be with you to help advocate for you (this could be a spouse / relative / friend or a doula), that's really helpful, as you will be at capacity making it through contractions and managing pain.  
  • But also, be flexible - labor and delivery is a crazy process, and sometimes, despite the best efforts of both mama and the medical team, things are going to need to happen that weren't in your plans.  You might need to get induced, or get a c-section, or other types of interventions, and this might be the thing that saves the health of you or your baby.  It's good to keep the end goal in sight:  baby comes out, and both baby and mama stay as healthy as possible through the process, however that happens.  
  • Happened the first two pregnancies.  Has not happened yet with #3, but i'm calling it now.
  • Get the epidural!  I have tons of respect for mamas who have done their research and decided that natural birth is definitely for them, so this is not intended to dissuade that group.  But if you are like me and think, "I'll just go as long as i can and then get the epidural if i can't stand the pain"; or if you are part of a group where many people prefer natural births, but you're not feelin the Bern; or if you feel guilted into trying natural, but don't actually have positive, concrete reasons why you want that to be your birth experience -- then get the epidural.  It makes a world of difference in pain management.  And get it sooner rather than later - there are no medals given out for making it more hours into the ordeal without help.  


First few months with new baby


  • Details of caring for baby -  Before Josh was born, I was worried about mastering the details of diapering and swaddling and sleep schedules - you figure that stuff out as you go - don't worry about it too much ahead of time.  Most stuff comes pretty easily (there is more to be said about feeding, so i put that in a separate section, below).  
  • The thing that's hard is endurance - for a few months, you will be running on little sleep, constantly meeting physical needs, and possibly dealing with lots of crying even after meeting all of baby's needs.  This too shall pass!  It can feel really long when you're in the middle of it, but most babies get a lot easier in every way by the time they hit 3 or 4 months.  Until then, be extra kind to yourself - accept offers of help, be okay with toddler siblings watching extra TV and eating frozen pizza for dinner, let the house be messy, and know that it's a stage that will pass.  
  • Baby gear - when baby first comes home, all they need is a car seat, a place to sleep, a few outfits, and a plan for diapering and feeding.  There are a million extra things you can get, but what's helpful and necessary will depend a lot on your baby's personality and your life circumstances.  With Josh, we used all the little baby containers (rock and play, swing, bumbo, pack and play) heavily - he was cool with being set down, he was delayed at sitting, and it was a great set up for his tube feeding.  With Zoey, we had all that gear and didn't use it at all - the thing she really needed was a good baby carrier because she wanted to be held 24/7 and we were out and about a lot more with an older sibling.  So with this third baby, I plan to wait and see what the baby is like before ordering any extra gear that isn't bequeathed to us via hand-me-down.  (Thank you, Amazon Prime, for making wait-and-see a much more viable option.)
  • Baby clothes - Newborns are messy.  Get a couple cute outfits for things like pictures and special outings (which will very likely come in as gifts), but mostly stick to sleepers and onesies, because babies like to be comfortable, and babies get outfits dirty really fast - which is a lot easier to handle when they're wearing the $1 onesie that you can throw in the washer than if they're wearing the $40 beautiful handmade dry clean only ruffled Etsy romper.  (The window for dressing up kids is long - you've got years to put them in cute outfits, and it's so much easier once they get past the spit up / diaper blow out phase.)  
  • Make friends with other moms - I never thought this would happen to me, but it happens to all of us - you will want to have people you can talk to, at length, about teething and first foods and all the other baby stuff.  It's great when you have more in common than just parenthood, and it will probably make the friendship much more sustainable in the long term, but in that first year it's helpful to have other people who are willing to have the long conversations about baby stuff that people who not in baby-land are not willing or able to do.  
  • Keep friendships with others, too - In the first few months, it's all about survival, but eventually (and that's sooner rather than later) you will want to have conversations about the other things in life that matter to you - faith, politics, hobbies, etc. - and you will want your life to be about more than just baby again.  It's harder to fit in time for friends once kids are part of your life, but it's really good for everyone.  (I am LOUSY at this one, so need to take my own advice here.)  
  • Mommy wars stuff - This seems to hit especially hard in the first year of baby's life.  Moms can be very judgmental towards each other (especially on the Internet / Facebook, much less so in real life).  It's puzzling because a lot of it is about stuff that doesn't matter that much (how baby is diapered, when and where baby sleeps, do you use a cover when breastfeeding in public, etc.), or is determined completely by the baby and family's circumstances (how baby is fed, whether both parents work full time, etc.).  I don't know why we feel the need to be so harsh towards each other, but it seems to come out the worst regarding parenting choices in baby's first year.  It might just be that sleep deprived, post-partum mamas feel extra sensitive and therefore are 1) more easily offended about their own choices, and 2) sometimes the response to that is to attack other ways of doing things.  As much as you can, stay away from Internet articles and Internet commenters during those first few months.  Parenting controversies continue as they get older (at preschool age, it looks like:  how much and what kind of screen time?  what are they eating?  School - how much, what kind, at what age?  And the ever present - working or stay at home parent?), but as kids get older, I feel like it's much easier to ignore advice that doesn't pertain to you, or not get offended whenever someone disagrees with you, or just understand that there are many different ways to be a good and loving parent.  So in summary, mommy wars type stuff becomes a lot more bearable after the first year - in the meantime, do everything you can to just stay away.  

Feeding
This blog post is turning into a novel, so if you're still reading, thank you for sticking with me!  The two things I would say about breastfeeding are:

1)  Of all the things about caring for a newborn baby, breastfeeding is definitely the thing with the biggest learning curve.  So if this is your feeding method of choice, I would read up or take a class or talk to other moms about the things involved.  Suggested topics to learn about ahead of time:  how to use a breast pump, gear you will need (nursing pads, lanolin, a cover, a breastfeeding pillow, etc.), where to get more support if you're having trouble in the first few days and weeks, what it feels like when you're first getting started (so you know what's normal and what's not), and what the schedule is like at first.
2)  For many, it's not going to work out to breastfeed exclusively for 12 months - between work demands, individual issues going on with baby or mom, or what's best for the family overall, you might have to use a different feeding method.  After you've carefully made this decision, let go of the guilt!  Your baby is getting fed and that is BY FAR what's most important.

My experience feeding my first two kids was extremely different.  I've written about Josh's tube feeding at length, but have never said much about exclusively pumping while caring for a medically complex infant.  That ish was HARD, and I was only able to keep it up for about 4 months.  I felt so sad and guilty when my milk supply ran out, but also extremely relieved that it was one thing off my (at the time) overly full plate.  We switched Josh to formula and fortunately he responded well, and suddenly I didn't have to find the time to be pumping and cleaning and re-assembling pump parts 8 times per day (and then doing NG tube bolus feeds 8 times per day on top of it).  Josh and I have a very close bond, and he rarely gets sick these days (even with the chromosome deletion), so many of the fears associated with switching to formula early on did not come to pass.

Zoey, on the other hand, was easy to establish with breastfeeding.  She latched well right away, she was a hearty eater and grew well, and she slept well at night, waking only a few times to eat and then going quickly back to sleep.  I didn't have to restrict my own diet to accommodate her needs, I didn't have a work schedule where I had to figure out pumping times and places, and I didn't have problems with supply.  So with Zoey, breastfeeding was everything it can be at its best and easiest:  it was a beautiful bonding time with baby, it was easier and cheaper than formula would have been, and we were able to keep it up with no trouble for 16 months.  (It's also worth noting that, while Zoey is now a very healthy almost-4 year old, she had her share of ear infections and a few respiratory sicknesses when she was a baby, so breastfeeding did not completely protect her from the germs of the world.)  Zoey's breastfeeding was a very healing experience for me (after the pain of not being able to do the one thing i was sure i was going to do as a new mom with Josh), but the two experiences combined made me realize that the way you feed your baby can go a lot of different ways, and things will probably turn out okay even if the feeding experience is not everything you had hoped and dreamed.

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