Preventing Fatigue and Exhaustion
For many mothers the first weeks at home with a new baby are often
the hardest in their lives. You will probably feel overworked,
even overwhelmed. Inadequate sleep will leave you fatigued. Caring
for a baby can be a lonely and stressful responsibility. You may
wonder if you will ever catch up on your rest or work. The
solution is asking for help. No one should be expected to care for
a young baby alone.
Every baby awakens one or more times a night. The way to avoid
sleep deprivation is to know the total amount of sleep you need
per day and to get that sleep in bits and pieces. Go to bed
earlier in the evening after your baby's final feeding of the day.
When your baby naps you must also nap. Your baby doesn't need you
hovering while he or she sleeps. If sick, your baby will show
symptoms. While you are napping take the telephone off the hook
and put up a sign on the door saying MOTHER AND BABY SLEEPING. If
your total sleep remains inadequate, hire a babysitter or bring in
a relative. If you don't take care of yourself, you won't be able
to take care of your baby.
The Postpartum Blues
More than 50% of women experience postpartum blues on the third or
fourth day after delivery. The symptoms include tearfulness,
tiredness, sadness, and difficulty in thinking clearly. The main
cause of this temporary reaction is probably the sudden decrease
of maternal hormones. Since the symptoms commonly begin on the day
the mother comes home from the hospital, the full impact of being
totally responsible for a dependent newborn may also be a
contributing factor. Many mothers feel let down and guilty about
these symptoms because they have been led to believe they should
be overjoyed about caring for their newborn. In any event, these
symptoms usually clear in 1 to 3 weeks as the hormone levels
return to normal and the mother develops routines and a sense of
control over her life.
There are several ways to cope with the postpartum blues. First,
acknowledge your feelings. Discuss them with your husband or a
close friend as well as your sense of being trapped and that these
new responsibilities seem insurmountable. Don't feel you need to
suppress crying or put on a "supermom show" for everyone. Second,
get adequate rest. Third, get help with all your work. Fourth,
renew contact with other people; don't become isolated. Get out of
the house at least once a week--go to the hairdresser, shop, visit
a friend, or see a movie. By the fourth week, setting aside an
evening a week for a "date" at home with your husband is also
helpful. Take-out food and a rental movie can help you tap back
into your marriage. If you don't feel better by the time your baby
is 1 month old, see your healthcare provider about the possibility
of counseling for depression. If the blues are making it
impossible for you to care for yourself and your baby, get help as
soon as possible.
Helpers: Relatives, Friends, Sitters
As already emphasized, everyone needs extra help during the first
few weeks alone with a new baby. Ideally, you were able to make
arrangements for help before your baby was born. The best person
to help (if you get along with her) is usually your mother or
mother-in-law. If not, teenagers or adults can be hired to come in
several times a week to help with housework or look after your
baby while you go out or get a nap. If you have other young
children, you will need daily help. Clarify that your role is
looking after your baby. Your helper's role is to shop, cook,
houseclean, and wash clothes and dishes. If your newborn has a
medical problem that requires special care, ask for home visits by
a public health nurse.
The Father's Role
The father needs to take time off from work to be with his wife
during labor and delivery, as well as on the day she and his child
come home from the hospital. If the couple has a relative who will
temporarily live in and help, the father can continue to work
after the baby comes home. However, when the relative leaves, the
father can take saved-up vacation time as paternity leave. At a
minimum he needs to work shorter hours until his wife and baby
have settled in.
The age of noninvolvement of the father is over. Not only does the
mother need the father to help her with household chores, but the
baby also needs to develop a close relationship with the father.
Today's father helps with feeding, changing diapers, bathing,
putting to bed, reading stories, dressing, disciplining, homework,
playing games, and calling the doctor when the child is sick. The
father needs to be his wife's support system. He needs to relieve
her in the evenings so she can nap or get a brief change of
scenery.
A father may avoid interacting with his baby during the first year
of life because he is afraid he will hurt his baby or that he
won't be able to calm the child when the baby cries. The longer a
father goes without learning parenting skills, the harder it
becomes to master them. At a minimum, a father should hold and
comfort his baby at least once a day.
Visitors
Only close friends and relatives should visit you during your
first month at home. They should not visit if they are sick. To
prevent unannounced visitors, the parents can put up a sign saying
MOTHER AND BABY SLEEPING. NO VISITORS. PLEASE CALL FIRST. Friends
without children may not understand your needs. During visits the
visitor should also pay special attention to older siblings.
Feeding Your Baby: Achieving Weight Gain
Your main assignments during the early months of life are loving
and feeding your baby. All babies lose a few ounces during the
first few days after birth. However, they should rarely lose more
than 7% of the birth weight (usually about 8 ounces for a 7 pound
birth weight). Most bottle-fed babies are back to birth weight by
7 days of age, and breast-fed babies by 10 days of age. Then
infants gain approximately an ounce per day during the early
months. If milk is provided liberally, the normal newborn's hunger
drive ensures appropriate weight gain.
A breast-feeding mother often wonders if her baby is getting
enough calories, since she can't see how many ounces the baby
takes. Your baby is doing fine if he or she demands to nurse every
1 1/2 to 2 1/2 hours, appears satisfied after feedings, takes both
breasts at each nursing, wets 6 or more diapers each day, and
passes 3 or more soft stools per day. Whenever you are worried
about your baby's weight gain, bring your baby to your healthcare
provider's office for a weight check. Feeding problems detected
early are much easier to remedy than those of long standing. A
special weight check 1 week after birth is a good idea for infants
of a first-time breast-feeding mother or a mother concerned about
her milk supply.
See also:
Feeding: Breast Milk
Feeding: Formula (Bottle)
Dealing with Crying
Crying babies need to be held. They need someone with a soothing
voice and a soothing touch. You can't spoil your baby during the
early months of life. Overly sensitive babies may need an even
gentler touch.
For additional help on this subject, see Colic.
Sleep Position
Remember to place your baby in his crib on his back. As of 1992,
this is the sleep position recommended by the American Academy of
Pediatrics for healthy babies. The back (supine) position reduces
the risk of Sudden Infant Death Syndrome (SIDS).
Taking Your Baby Outdoors
You can take your baby outdoors at any age. You already took your
baby outside when you left the hospital, and you will be going
outside again when you take him or her for the two-day or two-week
checkup.
Dress the baby with as many layers of clothing as an adult would
wear for the outdoor temperature. A common mistake is overdressing
a baby in summer. In winter, a baby needs a hat because he or she
often doesn't have much hair to protect against heat loss. Cold
air or winds do not cause ear infections or pneumonia.
The skin of babies is more sensitive to the sun than the skin of
older children. Keep sun exposure to small amounts (10 to 15
minutes at a time). Protect your baby's skin from sunburn with
longer clothing and a bonnet.
Camping and crowds should probably be avoided during your baby's
first month of life. Also, during your baby's first year of life
try to avoid close contact with people who have infectious
illnesses.
Medical Checkup on the Third or Fourth Day of Life
Early discharge from the newborn nursery has become commonplace
for full-term babies. Early discharge means going home in the 24
hours after giving birth. In general this is a safe practice if
the baby's hospital stay has been uncomplicated. These newborns
need to be re-checked 2 days after discharge to see how well they
are feeding, urinating, producing stools, maintaining weight, and
breathing. They will also be checked for jaundice and overall
health. In some cases, this special re-check will be provided in
your home.
The Two-Week Medical Checkup
This checkup is probably the most important medical visit for your
baby during the first year of life. By two weeks of age your baby
will usually have developed symptoms of any physical condition
that was not detectable during the hospital stay. Your child's
healthcare provider will be able to judge how well your baby is
growing from his or her height, weight, and head circumference.
This is also the time your family is under the most stress of
adapting to a new baby. Try to develop a habit of jotting down
questions about your child's health or behavior at home. Bring
this list with you to office visits to discuss with the healthcare
provider. Most physicians welcome the opportunity to address your
agenda, especially if your questions are not easily answered by
reading or talking with other mothers.
If at all possible, both the mother and father should go to these
visits. Most physicians prefer to get to know both parents during
a checkup rather than during the crisis of an acute illness.
If you think your newborn starts to look or act sick between the
routine visits, be sure to call your child's healthcare provider
for help.
See The Sick Newborn: Subtle Symptoms
Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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