Advice for Expecting Mothers
by Lisa Davenport
I had a baby in January 1999. She is the most beautiful child in the world, and I love her dearly. This document is a list of things I learned the hard way about childbirth, breastfeeding, and the care of an infant. I hope that by publishing this document I can spare some women the problems that I encountered after giving birth to my daughter.
Most childbirth course instructors will try to convince you to give birth without any pain medication. They will try to scare you with stories about how an epidural can slow or stop the progress of labor, necessitating the administration of pitocin, a drug that induces and hastens labor. However, they will not tell you the most common, although less serious, side effect of an epidural. The epidural eliminates the sensation of having a full bladder and prevents you from relaxing the sphincter muscles to urinate. A cure for this is to have a catheter put in to drain the urine from your bladder. This puts you at an elevated risk for getting a urinary tract infection after giving birth. This is not meant to discourage you from seeking relief from the pain of childbirth, it is simply additional information that you should consider as you make your choices.
Giving birth (and breastfeeding, see below) can make you very susceptible to infection, so it is important to pay attention to the signals that your body gives you. If you feel at all ill or feverish, take your temperature. It is also a good idea to take your temperature at least once a day for the first week after giving birth, even if you feel fine. Report any fever to your doctor at once.
Wherever you look you can find the same few platitudes about breastfeeding: breast is best, it takes about six weeks for mother and child to become good at breastfeeding, proper positioning and latch-on are the keys to a good breastfeeding relationship, if you absolutely hate breastfeeding you can stop after 6-8 weeks because it is better to bottle-feed with love than to breastfeed with resentment. But beyond this there is little other information available for first-time mothers. Breastfeeding is incredibly difficult. Because this fact is not publicized, every woman who has problems feels that she is somehow inadequate and alone. It is very important to realize that you are neither.
My first piece of advice is to check your nipples to see if they are flat or inverted. If so, I recommend contacting a lactation specialist during the third trimester to find out what you can do to make your nipples protrude to facilitate latch-on.
Next, I recommend purchasing Lansinoh or any other brand of purified lanolin to apply to your nipples and areolas after every feeding and every shower. Don’t use soap on your nipples, as it will dry them out. Lanolin will keep the skin on and around your nipples moist and prevent cracking. Different people will give you different advice on this topic ranging from using nothing at all to using vitamin E oil or tea bags. The important thing is to keep your nipples from drying out and cracking, because if your nipples crack you will be at high risk of contracting mastitis, which is a staph infection of the breast. Mastitis is painful and difficult to get rid of. It requires a 10-day course of antibiotics, and you may have three or four occurrences of it before you are completely cured.
The first few times that you breastfeed your baby you will feel uterine cramping. This is because nursing releases oxytocin, a hormone that helps your uterus shrink down to its original size. This cramping can be as painful as labor, and it is important that you treat this pain so that you can feed your child and develop a good breastfeeding relationship. The best medicine for cramping is ibuprofen (Motrin or Advil). The hospital will more likely offer you Tylenol or a narcotic, such as codeine or Percoset. Tylenol is insufficient to the task, and narcotics will make you sleepy and constipated. Whatever medicine you used for menstrual cramps before you were pregnant will probably help you now.
Once you have your baby at home with you it is very important to count the number of wet diapers that you change. If your baby does not seem to urinate very much, he or she may not be getting enough milk and will become dehydrated. Dehydration is very dangerous for newborns. Because your life will be very hectic when you first bring your baby home, and many people may be helping you, it is very important to keep a written record of wet diapers for the first couple of weeks.
One piece of advice that you will frequently see is to introduce your child to a bottle somewhere between four and six weeks of age. You should not do it earlier for fear of causing nipple confusion, and you should not do it later because your child may be more likely to reject the bottle when he or she is older. What no one will tell you is that you need to give your baby a bottle frequently thereafter, because the baby will quickly forget the bottle and be much less likely to accept it again later. If you have the time and energy to pump frequently and to give your baby bottles of breast milk a few times a week, that is great. If you don’t have the time or inclination to pump that much, you can give your baby the occasional bottle of formula to keep him or her in practice.
Infant sleep issues
As you’ve probably heard a million times by now, "Back to sleep, and tummy to play". The current wisdom is that babies should sleep on their backs to reduce the risk of SIDS. This is a noble goal, but no one will tell you about the downside of this policy. Children who sleep on their backs are deprived of the chance to be on their stomachs and do push-ups in their cribs. These push-ups are important exercise to build up the muscles needed for crawling. Babies who sleep on their backs are developmentally delayed in this respect and crawl at least two months later than their peers who sleep on their stomachs. In addition, many babies never get used to sleeping on their backs and will only sleep well on their stomachs. You need to carefully consider which sleeping position to employ and be sure to use it consistently. You should also consult with your baby’s pediatrician for the latest information on this topic.
Another adage you will frequently hear, usually without an accompanying explanation, is to make sure to put your baby down to sleep with his or her eyes open rather than putting the baby to sleep in your arms before putting him or her in the crib. This is because babies need to learn how to put themselves to sleep. If they don’t master this skill, you will be getting up with them in the middle of the night long after they stop needing a 2:00am feeding. The longer you delay teaching your child to put him or herself to sleep, the more difficult this process will be for both of you.
Many first time mothers hate the isolation that motherhood temporarily imposes on them. They are used to spending every day in an office filled with people and adult conversation. Now they are at home with a small, demanding person who doesn’t talk at all. The two most important things you can do to overcome the isolation that comes with having a newborn are: join a new mothers’ group and learn to breastfeed in public. Other new mothers are a great source of support and friendship, and the ability to breastfeed comfortably in public allows you to go anywhere with your baby, whenever you want to leave the house.