Preparing and Packing for Birth

For many expectant mothers, labor is a big and scary looming event.  At the same time, you are excited to finally meet the little person growing inside you.  There are some things that can make your birth experience easier.

How to Prepare:

Go to a birth class.  Go to a good birth class that meets over the course of several weeks and covers breastfeeding initiation and coping techniques.  Yes, they take more time.  Yes, they sometimes cost more money.  But you will know a lot more about your own labor and the various tools midwives, doctors and doulas use to help your baby come into the world.

I’ve said this before, and I’ll say it again: hire a doula.  Even if you plan to get an epidural, even if you end up with a scheduled c-section.  Doulas do more than just help you cope with a natural labor—they can suggest positions that speed up progress with an epidural.  They can help you have a gentle c-section, and walk you through the process as it occurs.  And they can help you establish breastfeeding, which can sometimes be a challenging experience without lactation support.

If you plan on having a natural and intervention-free birth, then you really need a doula.  A doula can help you through each phase of labor with a wide range of knowledge about coping techniques, optimal baby positioning and pain management tools.

Packing your bag:

We packed wayyyyy too much for our son’s birth.  Here’s a list of what I felt we should have packed:

Your own clothes.

Slippers.

A list of restaurants that deliver.  Trust me on this one.

Something to relax/pass the time.

The basics: cash, your camera, toiletries, a going home outfit for you.

Breastfeeding Made Simple. 

Phone numbers for your lactation consultant and your placenta encapsulation specialist, if you choose to encapsulate.

Stuff for the baby: A few onesies and some non-toxic baby shampoo.

What the hospital provides:

Really, you don’t have to bring anything.  Most hospitals have gowns, mesh undies, baby clothes, diapers, toiletry products and baby care products.  When you leave, I highly advise you to grab, um, a few free samples on your way out.  Extra mesh undies, extra gigantor pads for postpartum lochia, and most importantly, AT LEAST TWO BULB SYRINGES.  The bulb syringes from the hospital are far better at sucking out snot than any bulb syringe you will find in the store.  Your insurance is going to pay for that stuff anyways, might as well milk as much as you can out of it.

On Rice Cereal

“When will she start on rice cereal?” asked my dad, later the same afternoon. (Yes, I’m calling out my dad again. Hi, Dad!)

“Oh, never!” I replied (yes, smugly. Again). “We’ll be doing Baby Led Weaning! It’s this really great thing where you just start the baby on real foods. But that’s not till six months. The World Health Organization, and also the British and Australian medical authorities, recommends exclusive breastfeeding to six months, then continuing to nurse to two years or more. The American Academy of Pediatricians is a little fuzzier. They say 4-6 months [since revised to ‘about 6 months’] and one year…”

When I paused for breath, my father asked, “Ah, so when do babies start rice cereal?” I fear, gentle reader, I may have dived right back into my sales pitch. (And a worthy pitch it is. If you would like to hear it some time, I am happy to expound.)

“Ah, yes. I understand. But I was just thinking, and it seems like you were about this age when we put rice cereal in your bottle. To help you stay full longer.”

“Yes, you probably did. That was standard advice at the time, and is still much used, especially in formula-feeding families. But more recent science says it’s not helpful and may hurt.”

Here, reader, is the “more recent science.” Rice cereal added to a bottle does not help babies sleep through the night sooner. The thicker texture can lead to aspiration (that is, inhaling the liquid instead of swallowing it), which can in turn lead to chronic respiratory disorders. And the extra calories can interfere with baby’s natural ability to self-regulate portion sizes, leading to overweight in infancy and perhaps beyond. Some physicians recommend thickened feeds as a treatment for infant reflux, but even here the research is mixed.

Rice cereal is, however, a good source of iron. So once your baby is ready for solid food, go ahead and spoon her some rice cereal if you wish. Personally, I can’t be bothered to spoon food for someone else (really, check out Baby Led Weaning; it’s awesome! especially if you’re lazy like me), so my babies ate lots of beans and meat instead. Not as many leafy greens as I’d like, but they do love kale chips. Perhaps I’ll post my recipe here some time so you too can trick your toddlers into eating their vegetables… Watch this space!

[Update: As promised, Jackie’s Kale Chip recipe!]

Kroger Baby Food Aisle

It’s a whole grocery isle I’ve almost never walked down!

Navigating the Second Trimester

Ah, the second trimester; you are finally starting to show a little bit of cute pregnancy belly, the morning sickness is mostly gone, and the hormonal swings have calmed down for the time being.  This is a great time to take some time for yourself and get yourself comfortable before that baby starts taking up space.  You may notice a few aches and pains near the end of the second trimester as your hips and ribs expand to make room for your growing uterus.  If you have an exhausting day, sit back with a cup of tea and a good book; your body is doing more work than you even know!

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Choosing your birth and breastfeeding class

By the end of the second trimester, you should be ready to sign up for your Lamaze birth class and breastfeeding class.  Ideally, you will find a class that covers both topics together.  A good class will give you more time to ask questions, get to know other expectant families, and practice natural laboring techniques.  Even if you plan to get an epidural, you should still have some tools to cope with pain for two reasons. 1: some epidurals don’t completely take, and you may still be stuck feeling a couple things. 2: you may not be able to get your epidural the second you start feeling labor pains, so it is good to know how to cope until anesthesia can get to you.  Remember, the more you know about birth, the more you can be empowered and have control over your birth experience.

Tips, tricks and favorite products:

Clothes

As your body changes, you may find that some of your old clothes don’t fit.  You will definitely want to invest in some comfortable supportive bras, maternity pants and dresses.  Trust me on this; by the time you get to your last month, you will be thankful for the dresses because nothing else will feel good.  Also, invest in a nice pair of slip-on shoes one shoe size bigger than your current shoe size.  You will thank yourself when you can’t reach your toes.

Books

Now is a good time to start reading up on the birth process and breastfeeding.  Yes, it will be covered in your birth class, but you will be so overwhelmed with all the new information that it will be hard to absorb.  If you start the learning process on your own late in the second trimester, you will have time to ask questions about the parts that you truly don’t understand.  Most birth books are pretty good at covering the process, but I liked The Complete Book of Pregnancy and Childbirth and Breastfeeding Made Simple.

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Fitness

As your body grows, you may find that your regular exercise routine is getting a little uncomfortable.  Prenatal yoga is a great way to keep your body in shape and prepare it for birth.  Most yoga studios offer special rates for expectant mothers, so give it a try!  It will help you relax and stay fit for your little one! And you can always stock up on DVD’s if your budget is tight!

Your body

As your body grows, you may find that sleeping starts to get a little more uncomfortable.  If you are burying yourself in a mountain of pillows, you might want to consider getting a pregnancy body pillow.   Oh, and don’t forget to keep drinking water.  Dehydration can cause all sorts of issues in pregnancy, and it is so easy to prevent!

See also:

Navigating the First Trimester

Navigating the Third Trimester

“Didn’t You Just Do That?” On Nursing Frequency and Newborns

When my firstborn was just under two months old, we were visiting my father for the afternoon. The baby began smacking her lips, and I began to hike up my shirt.

“Didn’t you just do that?” asked Dad.

“Huh? No, that was, like…” I looked at a clock. “Twenty-five minutes ago.”

“Yeah,” he agreed. “She can’t possibly be hungry after half an hour. Maybe she’s just making faces.”

Gentle reader, she was hungry.

Gentle reader, your newborn is hungry. I know you only just clipped your bra, sprinted to the bathroom to brush your teeth and refill your water bottle, didn’t even get a chance sometimes to pee. And still. Your newborn is hungry.

Here’s the thing about newborns, and about breastmilk: Newborns are used to the steady intravenous nourishment of the umbilical cord. Hunger is an entirely new sensation to them and, I think you will agree, it is not a particularly pleasant sensation. It is, however, one with which they are rapidly becoming familiar. After all, on the first day baby’s stomach holds only 1/2 tsp of milk; by a week it holds a scant quarter cup; by a month half a cup. This may seem a considerable size, given the small size of an infant. However, babies this age are growing and developing faster than they will ever again in their lives, so they need more calories per bodyweight than they ever will again.

Human milk is magnificently rich in calories, including all the nutrients a healthy baby needs for the first six months of life, plus a plethora of immune factors. Moreover, it is uniquely digestible, which means all those calories are maximally beneficial. Yay, right? Well, yes. However, “highly digestible” also means it passes from baby’s stomach fast. And then baby is hungry again. For real and true, not as some sort of elaborate manipulation (worry not, that will come later, when you are parenting a toddler).

That sunny afternoon on my father’s porch, I was thankful (and, I’ll admit, smug) that I’d read as much as I had before my daughter’s birth about breastfeeding. This was the first time anyone had questioned my breastfeeding practice, and here I was with the knowledge to respond. Knowledge, gentle reader, is power. Do read up on lactation before your baby’s arrival.

If you are not expecting a baby, either because your baby has arrived or because you plan not to have one soon/again/ever, go ahead and read about lactation anyhow. Breastmilk is the natural food of our young, and we should all have at least a passing familiarity with this basic biologic function. Study after study finds that one of the primary determinants of a mother’s ability to meet her breastfeeding goals is the quality of professional and social support she receives. Be part of that social support, for yourself or for someone else.

What Should I Do?

From the moment you find yourself standing in a pharmacy staring at the eight bazillion home pregnancy test choices (plus or minus? one line or two? digital?), parenthood is an unending parade of decisions that need making.

Where's the plus sign??

Doctor or midwife? Hospital or home? Cloth or disposable? Breast or bottle? Amniocentesis? Circumcision? Vaccines? Soft cheeses? Stay home or return to work? Work from home? Prenatal yoga? Postnatal yoga? Moxibustion? Caffeine? Weekly vaginal checks? Herbal supplements? Placenta encapsulation? What if you go past your due date? What if the ultrasound indicates a problem? What if your kid drops out of high school, or is gay, or likes football? How will you discipline? Which car seat should you buy? What color should you paint the nursery? Are you even allowed to paint the nursery?

It is the great blessing of the time in which we live that answers are only a few keystrokes away. I know only one person, a music librarian specializing in the obscure, who has in the last decade managed to query Google and get zero results. When it comes to pregnancy, birth, and parenting, every question has been asked, and every question has been answered. There are dozens of reputable websites staffed by credentialed medical professionals providing answers to all the common, and most of the uncommon, maternity questions. There are forums, blogs, Facebook, and the lady behind you in line at the grocery store, too. And, as you will know by the time your pregnancy shows, they all have opinions.

Obviously some of these sources are more reliable than others. Late in my first pregnancy, the teenager bagging my groceries scolded me for buying a 40-pound sack of cat litter. My CNM, on the other hand, had told me to continue my normal activities, just taking a little extra care of my balance and posture. Trusting that my provider knew more about the matter than the bagger, I went ahead and lifted the sack of cat litter. (I also would have taken her advice that people who have lived with cats all their lives, and do not currently have kittens, are at low risk of a toxoplasmosis infection and can safely change cat litter—except cat litter is already one of my spouse’s chores.)

But what happens when the opposing recommendations come from less clear sources than midwife vs. grocery clerk? What if it’s your mother in law versus your best friend from high school? One pregnancy book versus another? Google answers versus a moms’ group on Facebook? What’s worse: a 1:100 chance of mildly bad outcome, or a 1:10,000 chance of very bad outcome? What happens when your sense of what’s best for society doesn’t align with what’s best for your family?

You can try to seek information, you can make lists of pros and cons, tabulate prices and time commitments and what the neighbors will think. But often there is no one right way. In fact, there is almost never a bright and shining sign from the heavens: “Go this way, Mother, and your child will be well, you will be well, and no one will wind up in therapy.” The secret of parenthood – perhaps of life – is this: you do the best you can. You learn, you listen, you reflect, and the you decide. You do the best you can with what you’ve got. Maybe later you learn something new, something that would have made you choose differently. That’s okay. You did the best you could. Maybe your kid grows up to deal hard drugs to children. That’s… Well, that’s not okay. But you couldn’t have known that would happen when you chose the pregnancy test with the + sign.

So cut yourself some slack. Allow that sometimes you’ll be wrong. Sometimes there will be no right. Sometimes you’ll do everything right and things will somehow still go wrong. Sometimes you’ll wish you’d chosen a celibate life as a crazy cat lady and never seen that dratted + sign at all. Except in the next breath – or more likely in the same one – you’ll never wish that at all.

How the YMCA and the Village People can help your Breastfeeding Relationship

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I don’t know anyone who has breastfed; how will I get the support I need?

You will have to build your own support network, but don’t worry there is help out there!  There are many online communities like kellymom.com as well as local support groups like La Leche League that can help you connect with other nursing mothers.  I like to use the acronym YMCA to help other moms find some village people to help establish the support they need:

Y-Your family (your husband and mom can be very influential cheerleaders)

M-Medical professionals (find a lactation consultant and a good pediatrician)

C-Community groups for breastfeeding (La Leche League, Breastfeeding USA)

A-Any breastfeeding moms you know (new mom’s groups, church, high school friends, etc)

My breastfeeding story

To illustrate, I’d like to share my breastfeeding journey, and how the Village People and my YMCA saved my breastfeeding relationship. You might have a baby who is an expert nursling, but you might also need all the help you can get!

3rd Trimester

The Road Block: Lack of Knowledge

The Village People: Birth Class

The Support:  My husband and I signed up for a birth class that offered a FULL CLASS of breastfeeding education, and an introduction to the concept of a doula, who was essential to our birth and breastfeeding support.

The birth

The Road Block: A broken tailbone and a baby who wouldn’t latch

The Village People: A doula and my husband

The Support: Our doula went above and beyond, stayed for FOUR HOURS after our birth and called her mentor for instructions on how to teach my husband to hand express colostrum while I was out of commission.

The first few days

The Road Block: A refusal to latch, jaundice, weight loss, painful engorgement

The Village People: my mom, 2 IBCLC’s, a lactation counselor, and our pediatrician

The Support:  The hospital lactation consultants worked tirelessly to help us out, and my mother supported me through tearful phone calls at all hours of the day. At our first Ped appointment, our pediatrician could have just handed us a can of formula, but instead she rushed us into see a lactation counselor, who taught me how to use a breast pump to relieve engorgement and how to feed my son a bottle until we could get a latch.

Six weeks

The Road Block: Pain, and lots of it

The Village People: My husband, our childbirth educator, an IBCLC, and a cranial-sacral therapist

The Support:  Thanks to the pump and bottle, our son was gaining weight, but the latch was still wrong.  I thought about giving up, but my husband encouraged me to speak to our childbirth educator, who referred me to an IBCLC.  She diagnosed an upper lip tie and taught me how to adjust my son’s latch.  It helped a little, and combined with a referral to a cranial-sacral therapist, our son was finally latching pain-free within a month.

2 months

The Road Block: Colic and later, projectile vomit after every feeding

The Village People: A lactation consultant, a pediatrician and a mommy friend

The Support: The lactation consultant was able to diagnose an oversupply issue and the pediatrician suggested my son might have a dairy allergy.  A mommy friend helped me adjust to the new diet, and within days the hours of endless screaming had stopped.

4 months

The Road Block: Teething and biting

The Village People: Nurse and Chat

The support: Within a few minutes at Nurse and Chat, a lactation consultant gave me several tips to help me nurse a teething baby who was using me as a teething ring. It was that easy, but imagine if I had never gone in!

8 Months:

The road block: A lack of sleep from a babe who wanted to nurse all night

The Village People: La Leche League, New Mom’s Group, and our pediatrician

The support: Old friends from my New Mom’s Group suggested I read the No Cry Sleep Solution, and my local La Leche League had it to borrow from their lending library.  Our pediatrician gave us words of encouragement at our son’s nine-month appointment, and it really helped to lift our spirits.

And beyond:

I know that as my son approaches toddlerhood, our nursing relationship will change again.  Because I have my own personal YMCA, I will know whom to call to get my answers so that I can have true success feeding my child.  For all you expectant and nursing mothers out there, I hope that you can also build a network to support you through your breastfeeding years