Monday, June 6, 2011

Letter to a Friend

I have two friends about to give birth to their first baby. I always feel sad when my friends live far away and they have babies. I'm not sad about them having babies obviously, but because I love taking care of postpartum families, I want to be close to and care for my loved one's when they are having babies.

So as I was thinking about these special people in our lives experiencing the joy of meeting this new little human, together, the beginning of a journey. I love new babies, I love seeing mommies become mommies and daddies become daddies and mommies and daddies coming together to love and protect this new little complete person. And I get all teary thinking about people I love saying, "Hello little one, I knew it was you inside this whole time." I wanted send them an email saying, "Here's what you need to know for postpartum that they don't tell you when you leave the hospital."

But then I realized that I have never made a post about this and so instead of sending out two emails or letters I thought it was about time to make this a post. So I share with you all what I teach in my postpartum classes. I put the class together over a year ago and have been teaching it for a while. What I teach is not new in the postpartum doula world, but every time I teach a class my parents who have had babies before always say, "Why did no one tell me this before? My OB never said this stuff."

So here is what your OB will never tell you as you prepare to have a baby:

Your Rights
You have rights as a patient in the hospital. Thanks to Bill Clinton and his administration all people entering any hospital in the US has Rights and Responsibilities. When giving birth here are yours:
1. The right to completely understand what is being done to you. You have the RIGHT TO ASK QUESTIONS before any procedure is done to you.

2. The right to know the risks and benefits of these procedures.

3. The right to know about other options.

4. To be with your baby at all times. This also includes if your baby is in the nursery, the dad can go with that baby. AND YOU HAVE THE RIGHT TO HOLD YOUR CRYING BABY. If your baby is laying in the little warmer, or cradle waiting for an exam or something, and getting upset you have the right to hold your baby (and your baby should be held, skin to skin always). **Obviously if your baby is needing some life-saving procedure you will know the Doc's need to be examining your baby. But you can continue to speak to the baby which is one of the most calming ways to care for your new baby.

OK on to the other things I want to share with you:

Bed Rest
When you give birth you MUST submit yourself to FIVE days (this is the minimum) of bed rest. Five days is not a random number, and if you had any "trauma" (i.e. c-section, forceps, tears/stitches) add 2 more days. You are on bed rest for five days because of what your body is doing in those five days.

1. Recovering from pregnancy. During pregnancy all the nutrients and energy of your body goes into the health and survival of the baby. This is the way all female mammal bodies work (this is why the "pregnancy cold" lasts so long).

2. Recovering from birth.

3. Stop bleeding. The longer you bleed the less energy you have to produce milk.

4. MILK PRODUCTION! As a first time mom your milk will come in between days 3-5 and as late as day 7. You need a lot of rest and nutrition and water to make this process work.

HEY DAD-- this is the best way you can care for mom during her first few days home. Protect her by making her rest. If she moves from the bed to couch, you bring baby-water-snack-pillow-blankets whatever she needs. Every time she sits down bring her a snack and glass of water. In those first five days home she needs someone taking care of her. The more she is cared and the greater her support system, the quicker she will heal, recover and have greater success breastfeeding. And the less she will experience "baby blues" or worse postpartum depression.

While most hospitals offer a breastfeeding class, there are a few things most leave out.

Breast Production
1. The breast needs to be stimulated at least 8 times in the first day. This will establish your milk supply. If your baby does not have a good latch, the mother can use a pump or hand to stimulate some of the colostrum to come out.

2. You Are ENOUGH for your baby. Your baby needs NOTHING but you. YOU ARE ENOUGH!!!!

3. Ask your nurses to not give your baby a pacifier until you and baby have learned how to successfully latch. (That is usually a few days into nursing). The reason for this is that the rigid-ness of the pacifier will teach the baby how to suck the breast nipple incorrectly. Both of my babies are paci-babies. So I am not judging anyone who chooses to use a paci. But for the sake nursing success don't use the paci until you and baby have learned to latch.

Owen Thomas learning how to nurse

4. When you deliver at a hospital you will be given IV fluids. While there are many benefits to these fluids there is one that is very negative. To be crass it will shrink your nipples. Yep, its true. It will swell up your breasts and cause your nipples to invert. Thus you can see the problem arising for an infant. There are two solutions to this potential problem; the most common is the breast shield. However once again you are dealing with a rigid nipple that will teach your baby how to suck improperly (not all, but most women who are shown how to nurse with a shield have low supply because the baby never learns how to draw the nipple into the back of his mouth and thus it does not properly stimulate the milk responders). The second solution is to warm your hands and press on the breast around the nipple and the nipple will come back out. That easy.

5. Natural does not equal easy. Both mama and baby have to learn how to nurse. Its an awkward little dance in the beginning and there can be complications, like tongue tie, or like my first child being born with TEETH! I always hand out all the phone number of every lactation consultant in our town. You need to find out who your's is. Not the one that the hospital offers because you have to go in for an appointment. Its better to pay a local lactation consultant to come and see mama and baby in your home. It is worth every penny you will pay to have her come in your home and work with mama and baby and help them nurse together. Its the best investment you can make. Find your lactation consultant today and write her number on a slip of paper and put it on the fridge. This goes the same for your local Le Leche Legue leader. Know her number, give her a call and chat over the phone about your questions. The number one reason I say this is because every LLL leader is also a mother and has nursed therefore she is a peer and understands what you are going through. She really does. When it seems no one else understands what you are going through your LLL leader does and she is an advocate for you too.

6. Most nurses have never been taught how to teach breastfeeding to new moms. If your nurse is not being helpful you have the right to ask for another nurse who knows how to teach you how to do this. Or better yet ask for the lactation consultant. If mom is getting frustrated, flustered, scared, or upset she needs someone to help her calm down and remember that she can do this, that she is ENOUGH for that baby. Sometimes nursing is fun and easy and sometimes mom's cry a lot, and baby cries a lot and its not so fun. But it can become a wonderful and beautiful experience and of course the benefits of breastmilk cannot be matched. It is your responsibility to know your resources, very few hospitals do. Visit a LLL meeting before you have a baby. Seeing other mamas nursing and hearing their stories is soooooooooo helpful to a new mama.

HEY DAD!--- you can help with breastfeeding too. You can bring baby to mama, help her situate pillows, bring her a glass of water each time she nurses, she needs snacks too. Another way dad can help is to learn how to calm baby while baby is waiting (secret, use your pinky finger. Turn the bottom of your pinky up and touch the roof of your baby's mouth with it. Ohhhhh baby's love this, usually).

OK this will be two parts I'll do another post another date. Taking a two hour class and putting it into writing is too difficult and too long. I covered my two big topics.

More soon. Man now I'm in the middle of my Natural Cleaning Month and Postpartum Readiness. That's a lot!


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