Friends -
I am sure that you are getting a million suggestions from a million voices. But on the other side of first three months, I couldn't resist sharing some of my findings. All are things to try; know that there is no straight path.
The Realm of Ideas
Feeding is hard for every parent; there are things to do to make it less so: Of the 15 or so couples I’ve talked to about feeding, everyone has had trouble. More than half our neighborhood parents support group is bottle only (often with expressed breast milk). Every couple we know ended up seeing a lactation consultant at least once. The things that come up are highly varied - too much milk, too little milk, babies rejecting bottles, babies mouth too small etc. In our own case, Elia developed jaundice, which started a cycle of not feeding / not sleeping and became the worst night of my life. Some things can make it better or help save you this pain.
1. Plan to use a lactation consultant. Ideally, schedule an appointment before you leave the hospital. Problems will really only surface when milk comes in (3+ days post birth), making most of what you’re taught in the hospital important practice.
2. Be prepared to syringe feed and bottle feed. As I said before, breast feeding is extremely difficult for the majority of parents. This means you need to be ready with a backup plan. Make a hospital nurse show you how to both bottle and syringe feed. Syringe feeding is great for the first few days, but gets tiresome when you child needs more than an ounce or two. Note that there are a lot of bottle techniques. The one we found most effective was putting Elia on her side on our lap, so we could watch how much she was getting and she could spit up easily if she got too much milk.
3. Bottles and nipples are not the same. First, nipple have sizes. If your baby is even a week or two early, get preemie nipples. Additionally, Advent and Dr. Browns size 1 nipples are slower flow than other nipples. An NICU nurse we consulted recommended them to us with great success. Too big a nipples, and your baby will be drowning in milk. In the long term, babies (not parents) choose the bottle brand and nipple they like, so do borrow a few bottles from friends before buying. Elia has switched favorite bottles 3 or 4 times.
4. Warming milk takes time, which sucks with a screaming baby. My favorite technique is to warm a bowl of water in the microwave and plop the cold bottle in the warm water for ~3 minutes. But there are lots of good ways to warm bottles. A lot of people use bottle warmers. One of our friends uses his sous-vide machine...
Doulas work. The outcomes with doulas are pretty good (NIH Study). My experience (we had Ariel’s MD sister in the room) was that you’ll have to make a few decisions while going through the birth process. A doula helps lower the stress of those decisions and advocate for you. If you have the chance, arrange one (or to have a medically literate friend on call)
Skin-to-skin works. The results from skin-to-skin are really good (write-up of a few studies). My take is that new babies are terrible thermal regulators and you are a great one. So being wrapped up with you makes their early life much easier and lets them concentrate on the important stuff like breathing. I took a few button down flannel shirts to the hospital. They made it easy to put Elia on me for skin-to-skin and get her to be warm and comfy.
Thoughts on Comforting a Crying Baby. You will do this a lot and get good at it:
1. Run a cycle of solutions - Feed, Burp, Diaper change, skin to skin, colic hold, repeat. You're being a detective trying to figure out what is wrong. Happiest baby on the block has more details, including the "5 S's".
2. Baby Wearing Works. Baby wearing hits a bunch of root causes of crying all at once - it is warm, compressing, noisy (heart beat), involves a rocking motion and keeps the baby upright to help her gravity fed digestive system work. If little else works, we put Elia in our moby wrap and walk around.
3. Colic / Colic hold. Colic is defined by lots of unexplained crying in the evenings. A colic hold sometimes helps. I use this one and walk around / bounce her in it. I don't do the massage thing they talk about. I've found it to effective when other things don't work.
4. Babies cry for no reason... a lot. In some cases, you just have to hold them as they cry. Or put them down and walk away.
5. Baby reset button. If your kid has had a tough experience (a shot or pinch) you can distract her out of her crying. Dr. Robinsons baby hold is magic. It is like a party trick. Additionally a few big slow swings / overhead presses with your baby distract them. Note - support the neck and never shake a baby.
Probiotics Have Great Outcomes. Headline number from the studies is a 95% reduction in colic with babies who take Lactobacillus reuteri. HFS! We use biogaia + vitamin D. Ask your pediatrician when to start.
Swaddle. Babies love it and it helps them sleep better. Learn to do it. The nurses at the hospital are a great teaching resource. But also get a few self-swaddling blankets, as they save time (Elia likes both the halo and the "swaddle up"). A warning for self-swaddling blankets, a small baby won't fit into them (you can wrap her in a blanket before putting on the self-swaddle to make them work or get a preemie self-swaddle).
Co-Sleeping / Bed Sharing. If you are primarily breast feeding, falling asleep with your baby will probably happen a few times. (1) studies show it is safe as long as the bed is properly set up and everyone is in a normal state of mind (ie., no drinking) (2) regardless of study outcomes of bed sharing, we didn't think we would be able to forgive ourselves if something did happen, so we try to keep it at a minimum. We primarily use a "sidecar" arrangement. The take away is set up your bed as if you will do bed sharing, but make your own call on how often to do it. More info here.
Hair Dryer Trick (on the Changing Table). Elia used to cry a lot when we changed her. A friend recommended keeping a hair dryer close by when changing her. It keep things warm while changing, gives her white noise and you can use it to dry off her bum post wipe down to cut down on diaper rash. I ended up fixing a $20 hair dryer to the end of our changing table using some strong magnets and gorilla glue.
Baths / Showers. I'd wait until your baby is a few weeks or so old, but we quickly switched to just putting Elia in our bath with us (one partner hands her in / fishes her out). It works great and Elia will even breast feed in the bath. We have friends who do a similar thing with the shower too. Have a 2nd set of hands around and take the obvious precautions around water temperature, soap in the water and slick squirmy babies.
Get Family / Friend Help. Having someone there who can hold the baby while you shower / nap is huge. Having grandparents involved improves outcomes too - so you can tell them it is science that they need to help out.
Night Nurses - Lavish and Awesome. Going back to work, we hired a night nurse twice a week. It’s a great stress reliever as we knew we'd get at least a B+ night of sleep. If we could do it again, I’d have had a night nurse on call the week immediately after the birth. An experienced set of hands during the night of jaundice and no eating would have saved an immense amount of pain for Elia (and us). Note that night nurses often aren't nurses, just someone with a lot of baby experience.
Wonder Weeks App. This app kindly calls out when babies enter fussy periods / acquire new skills. Its a nice sanity check. "oh, she doesn't look at me because she only sees 10 inches or so in front her... got it"
Books and Other Resources. Strongly recommend watching Ali Wong's 2nd Netflix special, Hard Knock Wife. She speaks truth where others don't. We've liked Baby 411 and Brain Rules for Baby. We use a lot of advice from happiest baby on the block, though don't own it.
Material Things We've found quite a few products to be life savers. Yes, they are material things. but when they work as intended at 3 AM and get you back to bed 30 minutes sooner, they are wonderful. Some key ones:
Baby wraps. Brand doesn't matter (Moby, Solly etc). These things are proven magic that has been working for more than 3,000 years.
Keekaroo Peanut. Your baby will pee on you. With the keekaroo peanut, at least all the pee collects in one side of the changing table, letting you finish changing her on the other side of the table. It also pops out and cleans up easily. We'd normally put a swaddle on top of it to keep it warm / comfy.
Dock-a-Tot. Compact, easy mobile bassinet. With it, I've put Elia on everything from the floor to a cutting board. It is also great for travel and safe for co-sleeping / co-napping.
Bottles / Nipples. Have a bunch of bottles to try. Your child chooses the nipples that work best with her mouth... so it makes a lot of sense to borrow a few types of bottles from friends. Advent and Dr. Browns size 1 are supposed to be the best at birth. I'll add that a friend of friend spent $100+ on fancy bottles... their kid ended up rejecting all bottles and was only willing to drink milk from a shot glass. It is useful to get a syringe as an option early on (I think we snagged one for free from the hospital).
Spectra Pump. Ariel (and all of her friends) liked the spectra pump much better than the Medela pump.
Cloth Diapers (as Burp Cloths). Cloth diapers inserts make great burp cloths. Super absorbent, better and cheaper than any burp cloth on the market.
Milk Catchers. You will soon learn that every drop of milk is pretty precious. We use the Haakaa over breast shells, but people swear by both.There is a lot more than can be put in email (traveling, dealing with parents etc). I'm always a phone call away. As a final word of advice as I sit here with Elia asleep smiling on my lap - it gets easier. The first weeks and month are terribly difficult but the reward is wonderful.
Good luck and great love,
Dave
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