Baby and You - Bronson Health · 8 Baby and You, Getting Ready for Motherhood & Baby – 2nd...

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Baby and You Getting Ready for Motherhood & Baby Battle Creek

Transcript of Baby and You - Bronson Health · 8 Baby and You, Getting Ready for Motherhood & Baby – 2nd...

Page 1: Baby and You - Bronson Health · 8 Baby and You, Getting Ready for Motherhood & Baby – 2nd Trimester Baby and You, Getting Ready for Motherhood & Baby – 2nd Trimester 9 Checklist

Baby and YouGetting Ready for Motherhood & Baby

Battle Creek

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Baby and You, Getting Ready for Motherhood & Baby – 1st Trimester 32 Baby and You, Getting Ready for Motherhood & Baby – 1st Trimester

Table of Contents – 1st Trimester

Adjusting to Pregnancy ........................ 3

Nutrition ................................................ 4

Preparation for Childbirth .................... 5

Notes

Adjusting to Pregnancy

ChangesPregnancy is a major life change. Your entire life will have new direction and focus after the birth of your baby. For most of us, the joys of pregnancy and parenthood make for many ups and downs.

Things affected by pregnancy and birth include:

• Your body

• Your relationship with others

• Your work, school, and daily schedules

• Your nutritional needs

• Your moods - up one minute, down the next

Things to DoThings that you can do to help you enjoy being pregnant are:

• Read the handouts given to you by your nurse, midwife or doctor

• Ask your nurse how you can sign up for classes

• Write down your questions and bring them with you to your appointments

• Get plenty of sleep

• Eat a healthy diet

• See your doctor, nurse or midwife regularly

Talking to your friends and family is important. Share your feelings and listen to each other. Talk to your nurse, midwife or doctor if you are having a hard time coping with your pregnancy due to the following problems.

• Emotional

• Physical

• Money

When to Call Your Nurse, Midwife or DoctorWhile most women have a healthy pregnancy, things can occur that need the attention of your medical professional. We want you to tell us if you notice any of the following:

• Vaginal bleeding

• Abdomen tightening or cramping

• Backache that comes and goes

• Severe abdominal pain

• Any fluid coming from the vagina (birth canal)

• Severe headache that won’t go away

• Changes in your vision

• Swelling of your face or fingers

• Burning or pain on urination

• Fever or chills

• Nausea or vomiting for more than 24 hours

• Your baby isn’t moving normally (after 5 months)

For More InformationAs a part of the Baby & You program, you received a coupon for a free copy of the book What to Expect When You’re Expecting. The Baby & You program often refers to sections of that book. If you have not done so, please return the coupon to Bronson Battle Creek for your free copy. If you have the book, please refer to pages 100-118 for this topic, Adjusting to Pregnancy. Of course, feel free to read the entire book, but for now, we think that these pages will be most helpful.

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Baby and You, Getting Ready for Motherhood & Baby – 1st Trimester 54 Baby and You, Getting Ready for Motherhood & Baby – 1st Trimester

ExerciseWomen who exercise regularly during pregnancy:

• Have easier labors

• Usually have more energy

• Cope better with the minor discomforts of pregnancy

• Control their weight easier

Check with your doctor, but usually you may continue with exercise that you were doing before you were pregnant. Later in your pregnancy, your growing baby and the changes in your body make exercise harder. Skating or biking, which require more balance, are generally okay early in pregnancy. However, these activities will have to stop as your balance changes. Do not exercise to the point of not being able to talk while exercising.

It’s time to get moving. If you have not been exercising, go for a walk and do it regularly. Many community centers have specific exercise programs for expectant moms. If you need the support of group activity, check your local center. Be sure to read pages 189-198 in What to Expect When You’re Expecting. For more information about your activities please ask your nurse, midwife or doctor.

Hot TubsHot tubs and hot baths can raise your body temperature. This could be a danger to a developing fetus if your body temperature gets above 102 degrees.

Suggested ReadingsExercise

1. Moving Through Pregnancy, Elizabeth Bing

2. The Pregnancy Exercise Book, Barbara Dale; Johanna Roeber

Mother Wisdom

1. 25 Things Every New Mother Should Know, Martha Sears; William Sears

2. The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby, Martha Sears, William Sears

Preparation for Childbirth

1. The Birth Partner, Penny Simkin

2. Pregnancy, Childbirth and the Newborn, Penny Simkin; Ann Keppler; Janet Whalley

3. What to Expect When You’re Expecting, Heidi Murkoff; Sharon Mazel

4. Your Pregnancy Week by Week, Glade B. Curtis; Judith Schuler

Breastfeeding

1. The Ultimate Breastfeeding Book of Answers, Jack Newman; Teresa Pitman

2. Breastfeeding Pure and Simple, Gwen Gotsch, La Leche League International

3. Breastfeeding: A Parent’s Guide, Amy Spangler

4. The Womanly Art of Breastfeeding, La Leche League International

5. Nursing Mother, Working Mother, Gale Pryor

6. The Breastfeeding Book: Everything You Need to Know about Your Child from Birth through Weaning, William Sears

Nutrition

Your growing baby depends on you and the things you eat to build a healthy body and mind.

Many women have nausea and vomiting (“morning sickness”) during pregnancy, which makes it hard to eathealthy. This usually goes away after the third month. You can do things now to help yourself feel better.

• Keep some healthy snacks like whole-wheat crackers and dried fruit at your bedside.

• Eat small frequent meals (6 per day.)

• Don’t drink liquids and eat solids at the same meal when you experience severe nausea.

• Sip liquids between meals throughout the day.

2 Please read pages 104-107 in What to Expect When You’re Expecting.

Food Groups and Daily Amounts You Should Eat Everyday

Meat or Poultry 2 to 4 servings

Fish Serving size is 3 ounces

Eggs No more than one egg per day

Milk/dairy products 4 servings

Breads/cereals 5 or more servings

Citrus fruit (oranges, grapefruit) 2 servings

½ grapefruit = 1 serving

Yellow or dark green vegetables 1 to 2 servings

Other fruits or vegetables 1 to 2 servings

Fat (margarine, salad oil) 8 tablespoons

Liquids (8 ounces = 1 serving) 8 servings

Everything that you consume goes to your baby. Therefore, you need to avoid:• Smoking, including being close to people who are smoking. Smoking lowers blood flow and oxygen to the

baby and may affect brain development.• Alcohol, which can cause birth defects in babies.• Drugs, which can permanently damage your baby. Do not take any drugs unless ordered by your doctor

or midwife.

2 �In the book What to Expect When You’re Expecting, you can find more information about your diet during pregnancy along with some recipes on page 80-98.

For more information about diet, talk to your nurse or midwife about nutrition classes.

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Baby and You, Getting Ready for Motherhood & Baby – 2nd Trimester 76 Baby and You, Getting Ready for Motherhood & Baby – 1st Trimester

Table of Contents – 2nd Trimester

Preterm Labor.......................................... 8

Checklist for Packaging for the Hospital ....................................... 9

Feeding Your Baby .................................. 9

Baby Names ........................................... 13

Notes

Child Care and Development1. Taking Care of Your Child, Robert H. Pantell; James F. Fries; Donald M. Vickery2. The Irreducible Needs of Children, T. Berry Brazelton; Stanley I. Greenspan3. The Baby Book: Everything You Need to Know about Your Baby from Birth to Age Two, William Sears;

Martha Sears; Robert Sears; James Sears4. The Mother of All Baby Books: The Ultimate Guide to Your Baby’s First Year, Ann Douglas5. Your Baby’s First Year Week by Week, Glade B. Curtis; Judith Schuler

Perinatal Loss1. Empty Arms: Coping After Miscarriage, Stillbirth and Infant Death, Sherokee Isle2. Timothy Duck, Lynn B. Blackburn3. Forever Silent, Forever Changed: The Loss of a Baby in Miscarriage, Stillbirth, or Early Infancy - A Mother’s

Experience, Kellie Davis

Post Partum Depression1. Down Came the Rain: My Journey Through Postpartum Depression, Brook Shields2. Women’s Moods, Women’s Minds: What Every Woman Must Know about Hormones, the Brain,

and Emotional Health, Deborah Sichel; Jeanne W. Driscoll3. Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety,

Shoshana Bennett; Pec Indman

Preparation For Childbirth

None of us would jump into the deep end of a swimming pool without knowing how to swim. In the same manner, no one should approach labor and birth without knowing what to expect and some idea how to respond to it. There are many ways to get ready for childbirth.

2 You might want to start by reading pages 206-213, 236-248, and 260-308 in What to Expect When You’re Expecting.

There is no best way for everyone to get ready for labor and birth. However, we suggest you enroll in childbirth preparation classes. These are taught by nurses who are specially trained to help women get ready for the birth of their babies. Classes will teach you what to expect during labor, birth and time after you deliver. You will learn:

• Breathing patterns that help you relax during labor

• Exercises that will get you ready for delivery

• Different ways to control pain during labor (you will see videos of vaginal and cesarean births)

• Roles of the doctor, midwife, nurse, patient and support person

• How to tell when you are in labor

• When to go to the hospital and what to take with you

The classes will also help your support person. He or she will also learn how to be more comfortable during labor and ways to help you. You and your support person will be able to ask any questions.

Be certain to sign up for the childbirth preparation classes as soon as possible. You will go to one class a weekfor five weeks. You may also sign up for the class on breastfeeding.

If you cannot go to classes, you can still help yourself by watching videos and reading about childbirth preparation. For more information about getting ready to have your baby, be sure to talk to your doctor, midwife or nurse.

For information on Bronson Battle Creek childbirth education classes call (877) 462-2247.

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Checklist When Packing for the Hospital

Instruction sheets from your childbirth class

A comfortable nightgown or nursing (front button) gown

Bath robe and slippers, nursing bra and nursing pads, lotion for back massage

Shampoo, soap, deodorant, toothpaste, toothbrush, and necessary cosmetics

Barrettes, ponytail bands or a headband for hair if necessary

Loose-fitting, comfortable ‘coming home’ clothes for mom

List of relatives and friends with phone numbers to be called when the baby arrives

‘Coming home’ clothes for the baby and a blanket

Snacks

Camera and film (be sure to check the batteries before you pack)

Gifts for siblings

Car-seat for going home

Feeding Your BabyWhen thinking about a way to feed your baby, you may find the following ideas helpful. There are two ways to feed your newborn baby. One is breastfeeding (also called nursing.) The second is bottle-feeding.

Today more and more women are choosing to breastfeed. Human milk is the perfect food for babies. Breastfeeding can please the sucking needs of the baby and help him or her develop a sense of trust or security. It allows the mother to get to know the needs of her baby. The entire family will find that breastfeeding the baby saves time, money and energy.

Benefits of Breastfeeding• Breast milk is the best food for your baby.

Breastfeeding is said to be the healthiest feeding choice for babies by the American Academy of Pediatrics, The World Health Organization and UNICEF.

• A mother’s resistance to disease is passed on to her baby through her milk and helps the baby’s own immune system.

• Breast milk can help to prevent or delay allergies.

• Breast milk is used better by the baby and is easier to digest.

• Breast milk is a living, changing food that cannot be factory-made.

• These unique properties of breast milk protect against upper respiratory, digestive and ear infections; there is less vomiting and diarrhea. Elements of breast milk either destroy bacteria or retard its growth.

• Breast milk has living cells that fight infection, help digestion and aid with stomach development.

• Breastfed babies have higher IQs.

• Breastfeeding makes a bond through skin-to-skin contact between mother and child.

• There is less of chance of Sudden Infant Death Syndrome (SIDS) in breastfed babies.

• Breastfeeding promotes healthy oral development.

• Mothers who breastfeed have less risk of premenopausal breast cancer.

• Mothers who breastfeed have less risk of ovarian cancer.

• Breastfeeding saves money because breast milk is free and there are fewer visits to the doctor.

• Breastfeeding lessens bleeding after delivery and helps to shrink the uterus back to its normal size faster.

• Breastfeeding increases your calorie needs and helps you lose weight.

• Breastfeeding is safe for the environment.

• Breast milk can be pumped and saved to feed the baby when mother is not around.

Pre-term Labor

Signs of Pre-term LaborPre-term labor is labor that begins after 20 weeks and before 37 weeks of pregnancy. Most women go into labor between 37 and 42 weeks of pregnancy. Pre-term labor can be dangerous to both mother and baby. It is important to know the signs of pre-term labor. They are:

• Increase in mucousy vaginal discharge

• Tightening or cramping in the stomach

• Low back pain or pressure – especially if it comes and goes several times an hour and doesn’t improve with rest

• cramps with or without diarrhea

• Aches, pains, pressure or feeling of fullness in the pelvis, thighs or groin

• Any fluid coming from the vagina

• Regular cramps – or cramps that are coming faster and lasting longer

Labor contractions usually start in the back and move around to the front. However, women experience labor in different ways. If you are unsure whether you may be experiencing preterm labor, try the following1. Empty your bladder.2. Try lying on your left side.3. Drink 2-3 large glasses of water.

If symptoms do not stop within 1-2 hours, call your nurse, midwife or doctor.It is possible to have all of these signs and not be in labor. But, we don’t want to take chances with you and your baby. If your nurse, midwife or doctor thinks you are in labor, you may be sent to the hospital. There are many things that can be tried to stop labor so your pregnancy can continue.

Causes of Pre-term LaborThe possible causes of pre-term labor are:

• Poor eating habits – Women do not eat enough or enough of the proper foods before and/ or during pregnancy.

• Smoking – The more you smoke the greater the risk.

• Too much physical activity during pregnancy

• Alcohol or drug use

• Age – Women under 18 or over 35 are at greater risk than women between 19 and 34

• Being exposed to certain drugs before you were born, such as DES, a drug which may have been given to your mother to prevent miscarriage

• Infection in the uterus

• Bladder infection in the last three months of pregnancy

• Prior pre-term delivery, low birth-weight baby or abortion late in pregnancy

• Pregnancies less than two years apart• More than one baby (for example, twins)• Congenital birth defect• Previous surgery on the cervix• Vaginal bleeding or spotting after the 12th week of

pregnancy• Dehydration• Dental or teeth infection

If you have any of these risk factors you should tell your nurse, midwife or doctor.

2 �For more information about pre-term labor, read page 219-221 and 361-362 in What to Expect When You’re Expecting. Also, your nurse, midwife or doctor is ready to answer your questions.

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What Grandparents Can Do

Q. What is the grandparents’ role in breastfeeding?

A. Grandparents can support the mother’s decision. Remember that mom will be giving baby the best possible food. It doesn’t leave grandparents out. Grandparents can at first offer help with:

• Meals

• Laundry

• Cleaning

• Grocery shopping

• Caring for older children

Grandparents can also:

– Support the new father. Show him how to get to know his baby by rocking, talking and singing to baby, bathing and changing baby.

– Allow the mother privacy if she wants. If you are uncomfortable having her breastfeed in your presence, and have a hard time getting used to it, let her know. You may be surprised how discreetly it can be done. Your approval and excitement for her decision makes breastfeeding more positive.

– Don’t blame every baby “problem” on breastfeeding. Remember, babies cry for many reasons which may not be related to breastfeeding.

What Not to Say

– Are you sure you have enough milk?

– Your milk looks thin. Do you think its rich enough?

– Are you feeding that baby again?

– A bottle won’t hurt.

– Cereal will help him sleep through the night.

Comments like those can make mothers doubt their ability. In time, this can cause the experience to fail.

Q. Are breastfeeding parents more likely to stay at home?

A. No. During the first months when babies need to be nursed often, usual activities can be done with the baby. Breastfed babies are easy to take along almost anywhere. When baby is hungry, mother can nurse and then carry on what she’s doing.

Q. Can breastfeeding continue if the mother returns to work or school?

A. Yes. More and more women continue to breastfeed and return to work or school. Breastfeeding is a skill and becomes easy. It does have to be learned. Common problems usually happen during the early weeks of breastfeeding. Most are brief and can be avoided or solved. Frequent feedings are perfect for baby’s digestion and help to build a good milk supply. Spending time with your baby will provide him or her with the security he or she needs to grow self-confidence. You will be closer to your baby and him or her to you. Many mothers find this a joy.

While breastfeeding, you will not to be able to use all types of birth control. Ask your medical professional if you need more information.

Preparation

• The more a woman learns about breastfeeding, the more likely she is to be successful. Know what to expect during the first few weeks after baby’s birth.

• Ask your doctor’s office to help you sign up for a breastfeeding class at Bronson Battle Creek. This class will give you helpful tips to start breastfeeding.

• Call (877) 462-2247 to register for breastfeeding classes or call (269) 245-8586 to talk to a certified lactation consultant (a nurse who has special training in helping mothers to breastfeed).

Breast Changes

Early pregnancy• Breast tenderness• Increase in breast fullness• Veins more noticeable on chest/breasts

Mid–Late Pregnancy• Increase in breast fullness.• May or may not leak colostrum.

Delivery• Colostrum is the first milk ready for the baby at birth.

It is has many proteins, calories and antibodies. Small amounts are perfect for the baby’s first feedings.

• The first 24 hours of feeding may be quite irregular. This depends on the effects of delivery on the baby.

• Put your baby to breast whenever the baby shows signs of wanting to suck. Remember, practice helps the baby and you to get better at each feeding. Many feedings and holding the baby increases the hormones that make milk.

3-4 Days after Delivery• There will be more milk. Your breasts may feel very

full for about 48 hours. Nursing often will keep you more comfortable.

• Breasts will soften again and not be overly full

Answers to Common QuestionsQ. Do breastfeeding mothers have to show their breasts in public?

A. No. Breastfeeding can be done around other people. A mother can turn her back to begin nursing. Use a blanket or shawl over the chest and shoulder to hide the breast. Many people think that the mother is cuddling her baby.

Q. Can breasts be too small or too large to breastfeed?

A. No. Enough milk is made whether the mother has large or small breasts. The more often the mother nurses, the more milk is made. Milk comes from the glands in the back of the breast and then is carried to the nipple by the milk ducts. This breast-feeding tissue develops early during pregnancy in every woman.

Q. Does breastfeeding cause mothers to lose their figures?

A. Breast size increases during pregnancy and while nursing. Breasts return to their normal size after weaning. Breasts may become less firm after pregnancy. However, this is from pregnancy, not breastfeeding.

Q. Do breastfeeding mothers have to follow a special diet?

A. The only diet needed during breastfeeding is a well-balanced one. You do not need to avoid certain foods. If there is a family history of food allergy, you may want to not eat that food.

The Father’s RoleQ. What role can the father play in breastfeeding?

A. Fathers can have a special bond with their breastfed baby. Fathers can show love without connecting it to food. They can get involved by changing diapers, bathing and dressing. When mother goes shopping, exercising, or to an appointment, father can feed the baby pumped milk if needed. A father can help breastfeeding by giving support to the mother at times when she is tired or discouraged. A father can also help with housework or cooking so the mother gets enough rest and a balanced diet. Anything special the father can do for the mother helps the ongoing success of breastfeeding.

• If you become full enough that your breasts are painful, keep nursing your baby. It may also help to remove milk from your breasts by:- Pumping- Hand expression- Leaking during a shower

- Applying ice packs- Taking pain medicine

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Preparation

• It’s helpful to go to a baby care class. You will learn how to prepare formula and safety tips.

• Have bottles and formula ready when you come home from the hospital. Read the directions on the formula container and check the expiration date.

• Babies usually drink 1-2 ounces every 3-4 hours by the time you go home. At first put only 1 to 2 ounces of formula in the bottle so that you don’t waste formula. Any formula left in the bottle after feeding your baby must be thrown out. You must not save it for the next feeding. Do not keep open already made formula for more than 48 hours. All open prepared formula must be kept in the refrigerator.

• A discussion of bottle-feeding is included in our Prepared Childbirth class. Call (877) 462-2247 to register.

Formula Feeding BooksCheck your local library or bookstore for What to Expect the First Year, by Heidi Murkoff, Sharon Mazel, Arlene Eisenburg, and Sandee Hathaway.

Baby Names

Picking a name for your baby can take time. Some know what they are going to name their children before they are pregnant. Others wait until after the baby is born. There are many books and online resources to help you chose a name.

Suggested Readings

1. The Baby Name Wizard: A Magical Method for Finding the Perfect Name for Your Baby, Laura Wattenberg

2. Baby Names Made Easy: The Complete Reverse-Dictionary of Baby Names, Amanda Elizabeth Barden

Online Sources

1. www.babynames.com

2. www.babynamesworld.parentsconnect.com

3. www.momswhothink.com

Breastfeeding BooksCheck with your local library or bookstore. The following books may be helpful to you:

1. Breastfeeding: A Parent’s Guide, Ninth Edition, Amy Spangler

2. The Womanly Art of Breastfeeding, La Leche League International

3. Breastfeeding Pure and Simple, Gwen Gotsch, La Leche League International

4. The Ultimate Book of Breastfeeding Answers, Jack Newman; Teresa Pitman

5. The American Academy of Pediatrics New Mother’s Guide to Breastfeeding, Joan Younger Meek; Winnie Yu

Formula FeedingThe second way of feeding a baby is formula feeding.

Benefits• Anyone can feed the baby with this method.• Some mothers feel they have more freedom with formula feeding.• Some mothers are more comfortable with this method.• Formula provides good nutrition.• It’s easy to see how much baby is taking.• There are choices of birth control methods.• Some are more comfortable feeding in public.

Answers to Common Questions

Q. Which type of formula should I use for my baby?

A. Attend a baby care class to learn about making formula and different types. Ask your medical professional if he/she has a suggestion.

Q. Will my baby get tooth decay if I bottle feed?

A. Do not put your baby to bed with a bottle. Not only will this cause tooth decay, but the baby can choke on his/her milk.

Q. Can I prop my baby’s bottle?

A. No. It can lead to baby’s choking. And this is a special time to hold and bond with your baby. Always hold your baby during feedings. This is important because the baby needs love and cuddling during feeding for his/her normal development.

Q. How long will I need to feed my baby formula?

A. Babies must have either breast milk or formula (or both) until they are at least a year old. Don’t give cow’s milk to your baby until the doctor tells you to. Don’t feed solid foods to your baby until your nurse or doctor tells you.

Q. Are there any drawbacks to formula? A. Yes. Formula: • Provides no immunities or protection against

infection • Can be costly • Must be made unless using ready-to-feed formula

(the most expensive) • Offers no health benefits for mother • Babies may develop milk allergies and formula is

harder to digest.

• Contributes to pollution of environment (formula production, plastics, etc.)

• Leads to more illness (ear infections, diarrhea, upper respiratory infections)

• Does not provide the same nutrients as breastfeeding. All of the nutrients in human milk cannot be reproduced in formula.

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After Your Baby Is Born

In The HospitalThe time after your baby is born is called ‘postpartum.’ During the first hour after your baby is born, the nurse will check your:

• Blood pressure

• Pulse

• Fundus (the top of the uterus)

• Your bleeding (called lochia)

The first time you get out of bed, you may be dizzy and weak. Ask someone to help you get up. Your first time up, you may have a gush of blood. This is not unusual. The nurses will show you how to:

• Check your stomach

• Care for your stitches (episiotomy)

• Feed and bathe your baby

If you have an episiotomy, take your hospital provided care squirt bottle home. Use it to clean your stitches each time you go to the bathroom.

Sometimes you and your baby cannot go home together. If you have a problem where you have to stay in the hospital longer, your baby may go home before you. If that happens, your family may need to make plans to care for the baby. Our hospital staff can help you with these plans. We can offer a home care nurse to go to your house to check the baby. If your baby must stay in the hospital, you will still be discharged home. You are welcome to come back to feed and hold your baby at any time. If your baby has special needs upon discharge, we will help you meet them.

Things to Expect the First Few DaysBleeding – You should expect:• 2-3 days of bright red to brownish red bleeding• 3-10 days of pink discharge

• Yellow white discharge up to three weeks postpartum. It will smell like a period. Tell your doctor if you have a foul smell.

Cramps – You will feel cramps, especially while you breastfeed. This is your uterus returning to normal.

Postpartum “blues” – These occur in the first few days. Symptoms may include:

• Crying for no apparent reason

• Impatience

• Irritability

• Restlessness

• Anxiety

These will usually go away within a few weeks.

Preventing breast engorgement – Your milk will come in 3-4 days after your baby is born. Your breasts may become hard and painful (engorged). Some things that help are:

• Wearing a bra 24 hours a day

• Applying ice packs

• Taking pain medication

If you are breastfeeding, breastfeed your baby frequently from birth. Nurse the baby every two hours during this time. If you are bottle-feeding, do not massage the breasts, apply heat or try to remove the milk. Engorgement lasts about 24-48 hours.

Hemorrhoids – You will experience enlarged veins and swollen tissue around the rectum.

Table of Contents – 3rd Trimester

After Your Baby Is Born ....................... 15

Signs of Illness in Mother Or Baby ............................... 17

Infant Care, Nutrition and Safety ....... 19

Checklist for Dad .................................. 20

Circumcision ......................................... 22

Notes

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Nutrition

Your diet is as important now as it was during your pregnancy. Your body is going through major changes. It needs good food to help it heal. If you are breastfeeding, your baby is depending on you for all the things important to her or his growth. The best way to deal with this is to continue the good diet that you followed during pregnancy. Review pages 80-98 of What to Expect When You’re Expecting. Another helpful source for nutrition advice is the information found in the 1st trimester section of Baby & You (pg 4).

Most of us begin to think about weight loss as soon as possible after delivery. If you are breastfeeding your baby, it is important to remember that the baby consumes about 500 calories per day. Those must be part of your food intake. Doing the following should have you back in shape soon.

• Stick to a good basic food pattern.

• Avoid empty calories such as “junk food.”

• Get some regular exercise (such as walking).

How soon you may begin any exercise program will depend on your condition after delivery. Talk to your doctor, nurse or midwife after your baby is born.

Rest

Your body is going through some major changes. Your baby also demands lots of time. For the first few weeks,

limit your activities to caring for yourself and your baby. Limit visitors as well. Nap when the baby naps. This is very important.

When to Call Your Doctor, Nurse or Midwife

• Bleeding (more than one pad per hour)

• Foul smelling vaginal discharge

• Discharge that increases or becomes brighter red – This may be a sign that you need to lie down and rest with your feet up. If it doesn’t slow down within 1-2 hours, call your doctor, nurse or midwife.

• Pelvic pain (more than occasional cramping the first few days)

• Burning or pain when you go to the bathroom

• Flu-like symptoms along with breast pain

• Fever

• Severe depression – always sad, no joy in your baby, feeling desperate (see previous page), anxiety

2 � For more information about what will happen after your baby is born, read pages 373-411 in What to Expect When You’re Expecting.

Breastfeeding Questions?

Call our certified lactation consultant at (269) 245-8586.

Other Postpartum ChangesYou may have the following changes during the first few months of postpartum.• Increased sweating• Hair loss• Mood swings• Less interest insexual activity – This may be due to being tired, fear of pain or fear of pregnancy.• Postpartum depression – This can occur within days after delivery or slowly show up.

You may have the following symptoms up to one year after birth:

• Nervousness

• Fatigue

• Hopelessness

• Confusion

• Uncontrollable crying

• Over-concern for the baby

• Sluggishness

• Depression

• Poor concentration

• Panic

• Sadness

• Sleep disturbances

• Memory loss

• Anxiety

• Exhaustion

• Appetite changes

• Irritability

If you experience any of these symptoms or are unsure, call your doctor, nurse or midwife.

Contraception

Your first menstrual period may come about 6-8 weeks after birth, possibly longer if you are breastfeeding. If you are not sure what birth control to use, ask your nurse, doctor or midwife before you leave the hospital. Do not put anything in the vagina such as suppositories, douches, or tampons. Ask your doctor about when you can start having intercourse again.

Doctor Visits

You need to make a check-up appointment six weeks after you have your baby. If you had a C-section, you need to be seen at two weeks. Your baby needs an appointment at two weeks, or as your doctor says. Call the office as soon as possible after discharge from the hospital to make your appointment.

Returning to Work

This is also the time to begin planning for your return to work. It is a good idea to go over your workplace policies about maternity leave.

• Are there forms that you have to complete before leaving?

• How much leave is allowed?

• What forms do you have to complete before returning to work?

• Who is going to care for your baby while you are at work?

Unless you have a family member or friend who has promised to care for your baby, it may take time to find a good caregiver for your baby. Begin looking now.

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Umbilical cord - It is important to keep the umbilical cord clean and dry. Use alcohol on the base of the cord 3-4 times a day to speed healing. Continue to use alcohol after the cord has fallen off. The area underneath should be completely dried. This usually takes place 3-5 days after birth. Call your doctor if any of the following symptoms occur around the cord area.

• Area turns red

• Starts draining

• Has a foul odor

Keep the diaper turned down so it doesn’t rub the cord area. Don’t be afraid to move it to clean at the base of the stump. It won’t hurt the baby.

Rashes - New babies tend to get rashes. Their skin is very delicate and easily disturbed by many things. Avoid putting perfumed creams or lotions on the baby. Use mild, unperfumed soap to wash the baby. When doing the baby’s laundry, make sure to do the following.

• Use a mild detergent

• Rinse laundry twice

• Always wash new clothes or linens before using them around the baby

Call your doctor if the baby has any of the following symptoms:

• Gets a rash that does not go away in a day or two

• Skin blisters

• Has a discharge

• Fever

Jaundice (yellow skin or eyeballs) – Before a baby is born it needs more red blood cells than it needs after birth. The extra red blood cells are broken down by the liver. Even a full term baby has a liver that is not fully developed. That liver is now working overtime. If the liver cannot keep up with the removal of extra dead red blood cells, the skin and eyes develop a yellow color called jaundice. For most babies, time takes care of the problem. Frequent feeding and making sure the baby is getting enough fluid helps. Watch your baby for this yellow skin color between 3-10 days old. If you notice that the yellow color getting worse and baby is not waking for feedings, call your doctor.

Vomiting – Many new babies ‘spit up’ a bit after eating. A baby may sometimes vomit all or most of a feeding for no real reason. You should call your doctor if your baby is:

• Vomiting frequently

• Is fussy or not active enough

• Has a fever

Diarrhea – Diarrhea is frequent and watery stools. Call your doctor if your baby’s diarrhea:

• Lasts more than a day

• Is accompanied by vomiting, fever and behavioral changes

If you are breastfeeding, loose and yellowish stools are normal.

Poor Eating/Lethargy – You may notice your baby sleeping more, is hard to waken or is acting weaker. The suck may be weaker, and baby may be eating less. You may notice these as the first symptoms of illness.

Signs of Illness in Mother or Baby

It is important to talk about some things that can go wrong with either you or your baby in those first fewweeks at home.

Signs of Illness in Mother

Bleeding or Discharge – Let’s think first about you, the new mother. One possible problem is bleeding or the vaginal discharge that happens after the baby is born. Remember, this discharge should never return from pink or yellow to red. The amount of bleeding should decrease over time. If your discharge returns to red, it is an early warning sign that you are doing too much. Rest for an hour, drink a glass or two of water, and see what happens. If you have an unusual change in your discharge or if it has a foul smell or you pass clots bigger than a 50-cent piece, it is important you notify your doctor or midwife.

Infection of the breast (mastitis) – Infection of the breast, or mastitis, may occur. The breast is very sore, feels hot to the touch and painfully hard. You also will probably have fever and flu-like symptoms. If you notice these symptoms, and if your breasts don’t feel better after breastfeeding, call your doctor or midwife. This is a condition that requires medical treatment. You should continue to breastfeed. Ask your midwife to refer you to a lactation consultant.

Swelling around the rectum (hemorrhoids) – Hemorrhoids are common during the last weeks of pregnancy and the first few weeks after you deliver. Witch hazel pads, “Tucks,” applied to the sore area will help. You also may try some over-the-counter items like Preparation H. It is important to include lots of fruits and vegetables in your diet and to drink enough fluids to avoid hard, painful stools.

Please call your doctor or midwife if you notice any of the following:

• Fever over 100.4 degrees

• Pain or burning when you pee

• Unusual vaginal discharge or bleeding

• Hot, tender breasts

• Pelvic pain more than mild cramping

• Pain or swelling in your legs

• Severe pain in the area where you have stitches or an incision

• Depression

Signs of Illness with Baby

Fever - If you think that your baby is sick, begin by checking his/her temperature. Now look for other signs.

• Does the baby have a stuffy or runny nose?

• Does his/her breathing sound heavy?

• Is the baby coughing or sneezing?

These symptoms could signal illness. For mild illness, running a humidifier in the baby’s room may help. Call your doctor’s office if the baby:

• Has a fever

• Refuses to eat or drink

• Is having trouble breathing

Remember to write down the baby’s temperature and how you took it (mouth, armpit, ear.) The nurse or doctor will want to know what it is.

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Shopping for Your Baby

Clothes – You will need lots of undershirts, diapers, and receiving blankets. Avoid wool items. Wash all clothes in mild detergent before your baby wears them for the first time. Babies grow very quickly, so buy carefully.

Toys – Babies need different sights, sounds and textures. Your baby should have a variety of toys. Be sure that they are correct for the baby’s age.

While in the hospital, keep your baby in the room with you. You can learn all about the things that make your baby special. Never leave your baby alone.

Checklist for Dad Last minute items for nursery

Crib/bassinet has fresh sheets and bumpers

Rocking chair for mom; lamp/nightlight; nursery monitor; hamper

Diapers/baby wipes/powder/diaper cream

Buy groceries

Make sure bills are paid

Change sheets on mom’s and dad’s bed

Rent or purchase breast pump or buy formula. If you need help, call your wife’s ob/gyn or call our education office at (877) 462-2247.

Lotion for back massages for mom

Flowers for mom

Celebration gifts for family and friends

Arrange for any necessary religious ceremonies including food, flowers, and the rabbi, priest or minister

Consider taking some time off work to help with household chores. The new mother needs to care for herself, baby and to rest. Relieving her of household work will help her get back to normal faster.

Caring for Your Baby in the First WeeksDon’t let anyone other than known members of the nursing and medical staff care for your baby. Ask to bathe the baby with the nursing staff looking on. This will help you feel comfortable with your baby’s care.

2 Please review Caring for Your Baby: A New Mother’s Guide, which will be given to you after the baby is born.

Limit your visitors – This applies in the hospital and in the first few weeks at home. This is the time for you to get to know your new baby. It’s also time for your family to adjust to their new roles. Remember that your new baby needs extra protection against infection in the first few weeks of life. It is important to limit the number of people who handle the baby. Don’t let anyone with a cold or other contagious disease be close to the baby. It is also very important to have everyone in contact with the baby do careful hand washing before touching the baby.

Feeding your baby – Your baby’s stomach is about the size of his/her fist. Your baby will need to eat about every 2-4 hours during those first weeks of life. It is important to hold your baby while you are feeding. The sense of love is very important to your baby’s well being. This will also prevent choking. It is important to note that it is normal and healthy for your baby to want to suck on his finger, fist or pacifier.

Bathing your baby – Until the umbilical cord has healed, you may give your baby a sponge bath as needed, usually every 2–3 days. Cleanse the diaper area with each diaper change. Bathe your baby in a room that is warm. You should have enough space to lay out all things needed for the bath. This should be a happy, playful time for you and your baby. An infant care class is part of prepared childbirth classes.

Dressing your baby – Your baby will be comfortable in clothing similar in weight to what you are wearing. Do not use the baby’s hands or feet to check for warmth. Use the back of the neck. A new baby’s hands and feet usually feel cool. It is important to cover your baby’s head, unless it is really warm outside. Your baby’s head is the largest part of its body, and the baby can chill quickly if the head is not covered. Protect your baby’s skin and eyes from the sun when outdoors.

Prevention

Prevention is the best medicine. It is important, especially in the first three months of your baby’s life, to protect

him/her against disease. These simple rules will help:

1. Minimize the baby’s contact to crowds.

2. Keep sick adults or children away from the baby.

3. Anyone who handles the baby should wash their hands.

In Review

In review, call the baby’s doctor for any of the following:

• Fever that remains for more than eight hours or continues to go up (In newborns under two weeks old, call at the first sign of a fever.)

• Skin sores with a discharge

• Continued vomiting and/or diarrhea

• Difficulty in breathing

• Any lasting illness

• Poor feeding

• Increased jaundice

2 �For further information on this topic, read What to Expect When You’re Expecting. For answers to your questions, talk to your doctor or nurse.

Infant Care, Nutrition and Safety

Preparing Your Home

Now is the time to begin getting your home ready for your new arrival. Here are some key safety factors to consider:

Your baby’s crib

• The crib bars must be no more than 2 and 3/8 inches apart.

• The mattress should be firm and fit snugly into the crib.

• Do not use pillows or waterbeds.

• Be sure that there is no lead paint on the crib or anywhere else around the baby.

• If you cannot afford a crib call 211 for help in obtaining one (Calhoun County only.)

Your baby’s car seat

• Read the directions.

• Know how to use it properly. Practice using it before your baby is born.

• Your baby must be securely fastened into the car seat for every ride – no matter how short the ride.

• Be sure the car seat is correct for your baby’s age and size; read the directions.

• Never leave the baby unattended in the car.

• When you are discharged from the hospital, the person taking you home must have an appropriate car seat for the baby. Car seats are available from many different sources. You may choose either to buy or to rent the baby’s first car seat. Ask your nurse about car seat rental, if needed.

Your home

• New babies put everything they can reach into their mouths. Put medicines, cleaning products and plants up high or in locked cupboards. You can buy child safety locks for cupboard doors at any hardware store.

• Electrical outlets should be covered with safety plugs.

• Your home should have at least one smoke detector. It should also have one multi-purpose fire extinguisher on each floor.

• Ask those who must smoke to go outside.

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Circumcision

Getting ready for the birth of your baby involves a lot of decisions. For boys, one decision that you need to make is about circumcision. Circumcision is the cutting away of the foreskin. This is the skin that covers the head of the penis. Many parents have strong feelings either for or against circumcision. These feelings may be related to family custom, religion. Or it’s the desire to have the new baby boy treated as his father, brothers or grandfathers were treated. Until a few years ago, most baby boys in this country were circumcised. Lately, there has been a lot of talk about the topic. This handout will help you make a decision about circumcision.

Reasons Not to Circumcise

• Routine circumcision is not supported by the American Academy of Pediatrics.

• The procedure seems upsetting and painful for the baby.

• The baby is restrained during the procedure.

• Many babies are fussy for a while after circumcision.

• Possible problems of the procedure are uncommon, but include infection, bleeding, injury to the penis or urethra, and scarring.

Reasons to Circumcise

• The circumcised penis is easier to clean.

• There is less irritation or infection.

• Boys who are not circumcised and do not do proper cleaning of the penis may develop a problem which requires circumcision later in life when it is far more painful to do.

• There are reports which show a lower incidence of cancer of the penis in men who have been circumcised. This is very rare.

• There are also reports which show that uncircumcised babies have a higher risk of urinary tract infection. Less than one percent of circumcised males develop a urinary tract infection.

PreparationIf you decide to have your son circumcised, you will need to sign a consent form giving permission. Circumcision is done before you take your son home. Your doctor will check on your baby and let you know when he is ready. The circumcision takes about 15-20 minutes to do. The baby is taken to the nursery. Nurses will get him ready for the procedure. The area is cleaned with Betadine an orange colored cleaning solution. This may discolor the skin for a short time. Usually the doctor or midwife who delivered him will perform the circumcision. Sometimes your pediatrician will perform the circumcision. After the circumcision, the baby will be watched closely for 2-4 hours. Cuddling and feeding should sooth him after the procedure. The baby’s penis will have a piece of gauze with petroleum jelly (Vaseline®) on it.

Circumcision CareFor the first 24 hours after circumcision, place a piece of gauze coated with petroleum jelly on top of the baby’s penis. The nurse will show you how to do this. This should be done each time the diaper is changed. It prevents the healing penis from sticking to the diaper. If you should run out of gauze just put the petroleum jelly right on the baby’s penis. This should be done at each diaper change until the penis is healed. The penis is usually healed within 2-4 days. Watch for excessive bleeding.

A whitish, yellow covering may be noted for 2 – 3 days. This is normal healing tissue. Do not try to remove it. Cleanse the penis with a damp cloth without soap and pat dry. Keep your infant off his stomach to prevent irritation.

Sleep patterns – Most new babies sleep between 12 and 18 hours a day. A new baby’s sleep is not like that of an older child or adult. Your baby may open his/her eyes and even cry for a little bit and go right back to a sound sleep. Positioning your baby right in the crib is important to their sleep and safety.

2 Refer to Caring for Your Baby: A New Mother’s Guide, which will be given to you in the hospital.

Safe sleep points:

1. Baby sleeps by him or herself in a crib, portable crib or bassinet.

2. Always put baby to sleep on his or her back even when he/she can roll over.

3. Have nothing in the sleep area. No pillows, blankets, comforters, stuffed animals or other soft things.

4. Keep baby’s face uncovered during sleep for easy breathing. Use a sleeper instead of a blanket.

5. Don’t allow anyone to smoke anything around baby.

6. Don’t overheat the baby. Dress the baby in as much or as little clothing as you are wearing.

7. Use a firm mattress with tightly fitted sheet.

Looking at Your New BabyThere are several things that you will notice about your new baby in his or her first week of life. This section is a brief summary of your baby’s looks.

Molding – The bones in your baby’s head change in shape as he/she passes through your birth canal. At first, your baby’s head will show the signs of this “molding” and may also have some bruising. In a few days the head will return to its usual shape.

Stork bites – Many new babies have red areas around their:

• Foreheads

• Eyelids

• Noses

• Or on the back of their neck

These are called stork bites. They will be more visible when the baby cries. Stork bites will go away by themselves during the baby’s first year.

Milia – These look like little whiteheads or pimples. They usually appear on the nose or chin. They go away by themselves in the first weeks of life. Do not squeeze or put cream or lotion on them.

Jaundice – While the baby is in your womb, he or she needed a lot more red blood cells than after birth. Shortly after birth, the baby’s body begins to break down those extra red blood cells. This is hard work. Many new babies get a yellow color to the skin and the whites of the eyes. This is called jaundice. It usually starts 2-3 days after birth and last about 7-10 days. If you notice that it is getting worse, call your doctor. It can be a sign of other problems.

Hormones – For a girl baby, your hormones may affect her. These may cause your newborn to have some breast swelling. They can also have a little bloody mucous coming from the vagina. These will go away and do not require treatment of any kind.

As new parents, you will have lots of questions. It will be helpful to keep some paper handy so that you can jot down your questions. Bring them with you to your baby’s office visit. At that time, the doctor or nurse can answer your questions. Remember that your baby’s first year is a learning process for the whole family. Be patient and take time to enjoy one another.

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NotesReasons to Delay CircumcisionCircumcision is not done if the baby’s condition is not stable. If, for example, the baby is very jaundiced or requires oxygen, the circumcision may be postponed.

If circumcision is delayed, talk to your baby’s doctor or nurse to arrange to have the procedure done.

Care of the Circumcised Penis

1. Make sure you clean all the folds and wrinkles of the genitals after each diaper change. The uncircumcised penis requires no extra cleaning – just wash, rinse and dry it along with the rest of the baby’s bottom.

2. Wash away any whitish secretion (smegma) appearing on the outside of the penis, but don’t try to wash or clean under the foreskin (the skin over the top of the penis.)

3. DO NOT retract (pull back) the foreskin over the glans (the cone shaped tip) of the penis. Forcing the foreskin back may harm the penis, causing pain, bleeding, scarring and adhesions.

4. Separation of the foreskin from the glans normally may take years. Your pediatrician will talk to you about this.

5. If, after reading this handout, you still have questions, please talk to your nurse, midwife or doctor.

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