Parenting & New Baby Advice Blog

Archive for October, 2007

Your initial supply list will look something like the one below. We’ve noted the reasons for some items, and we’ve also listed other items parents frequently assume they’ll need, along with our reasons for not having them on hand.

Syrup of Ipecac [replace every three years]

Children’s acetaminophen

Children’s aspirin [never give a baby with a suspected viral infection aspirin. It has been implicated as a possible cause of Reye’s syndrome.]

Rubbing alcohol

Petroleum jelly

Baby lotion and baby oil [optional]

Cornstarch and baby powder [To use, dust it onto your hands and then spread it on the diaper area. Never pour or squirt it on, if inhaled, the particles can be very irritating to the lungs. Also keep the container out of baby’s reach.]

Ointment for diaper rash [after thoroughly cleaning the diaper area, ointment should be applied heavily to protect irritated areas against urine. Application without cleansing merely seals irritants against your baby’s skin.]

Cotton balls [Never use cotton swabs to clean nose or ears. Swabs may introduce infection and even puncture eardrums.]

Diaper pail [and disinfectant, if you’re using cloth diapers]

Plastic garbage bags to line diaper pail, [if you’re using disposable diapers]

Diaper liners [helpful in early weeks if you’re laundering diapers at home]

Toilet paper for changing table, [Easier on plumbing than towelettes or tissues].

Nasal aspirator

Rectal thermometer

Vaporizer, cool-mist type [optional]

Baby scissors with rounded points

Bar or liquid soap [ Liquid soaps are easier to use with one hand. All soaps should be used sparingly to preserve the baby’s own skin oils; a mild, non-drying soap is best]

Washcloths [six is a good number to start with]

Hand towel [two or three]

Baby shampoo

Brush and comb

A Bathinette or portable baby bath

A word or two about bathing. Newborn infants do not appreciate baths because of the abrupt temperature change. It’s important to keep newborns warm and secure during bathing; sponge baths given under a blanket or towel are best for the first month.

You don’t really need to go out and buy a special tub for your baby. You can use the kitchen sink. However, specially designed baby bathtubs have slanted support areas for the baby that is covered with non-slip foam pads. These may be more comfortable. Their disadvantage is that they’re difficult to move once they’re filled, but if you can place the tub next to the sink on the counter, it won’t be a problem.

When buying a baby bathtub, look for one with smooth rounded edges. Don’t buy one with all sponge cushioning, since the sponge part can be torn off an eaten. Make sure the support area ahs a non-slip surface and check to see if the tub is sturdy and will hold its shape when full. It will be a plus to find a tub that has recessed water channels on the sides so you can bathe the baby without immersing him.

Just what are the risks of giving birth outside the hospital? There are two classifications of risk: true obstetric emergencies, and other conditions that might require a less critical transfer to the hospital for assistance with the birth.

Even though true emergency conditions are uncommon, they are factors that must be considered by anyone who is contemplating an out-of hospital birth. It should also be remembered that even in a normal pregnancy and labor, unexpected situations could arise after delivery. For example, respiratory distress or cardiovascular problems of the newborn infant are true emergencies that can best be dealt with in a hospital setting.

Non-Emergencies Requiring Transfer to the Hospital

Women are also transferred to the hospital for conditions that are non-emergent in nature. Sometimes, if a complication [such as anemia, high blood pressure, diabetes, twin pregnancy, or breech presentation] is discovered during pregnancy, the woman is no longer a candidate for out-of hospital birth. If labor is prolonged, or if it looks as though the mother pain medication, forceps assistance, or other intervention, she is transferred to the hospital. Under these circumstances, the transfer is not an emergency, and there is usually time to try various solutions and, if necessary, decide whether and when to go to the hospital. While it is never pleasant to give up plans for an out-of-hospital birth, and transfer is uncomfortable and worrisome for the parents, it is not usually associated with danger to either mother or baby. Of women who choose out-of –hospital birth, approximately fifteen to twenty-five percent of first time mothers and five to fifteen percent of second time mothers are transferred to the hospital during labor or after delivery. The possibility should be considered when parents are deciding on the merits of out-of-hospital birth.

When inquiring about out-of-hospital birth services, find out what drugs and technology they use in their birth practices such as pain medications, intravenous fluids, oxygen, and fetal monitoring. Ask what emergency equipment they have with them for all births. You will want to know about the backup hospital and the backup or consultant physicians. You should know about transfer arrangements. For example, is an ambulance available? Or are the automobiles of the staff and clients the usual transportation in case of transfer? How far away is the backup hospital?

Advantages of Out-of-Hospital Births

The advantages of out-of-hospital births are that parents may have more control over their birthing experience. There are few routines that must be followed. Parents have the freedom to move around, visit with friends, or go outside the home, and do household activities and other things during labor as much as they like. In addition, few interventions are used. Contact with the baby after birth is unlimited and in accordance with the parent’s wishes.

Women who choose birthing centers often find a sense of community and fellowship. Classes and social gatherings are often held at the birthing center, contributing to a sense of security and friendliness. Women who choose home births tend to find great appeal in the familiarity of their own surroundings.

The costs associated with home births are by far the lowest of the tree environments, birthing centers cost less than hospitals. For those parents where finances are an important issue need to look into the actual costs involved in all three options.

Many uninsured people with low incomes find home births the only affordable option. But if a planned home birth winds up as a transfer to the hospital, it may turn out to be more expensive than a planned hospital birth.

Some health insurance policies do not cover home birth or birthing center care, even though it is much less expensive. If you have insurance, make sure to investigate ahead of time the possibility of being reimbursed for those expenses.

Disadvantages ofOut-of
Hospital BirthThe major disadvantages of out-of-hospital birth are primarily related to the lack of available appropriate medical care should emergencies occur. Such situations can arise quickly, for example, hemorrhage, seizures, mucous aspiration, or any severe fetal or maternal complication that might place either baby or mother in jeopardy. The value of proximity to the full range of modern medical care should not be underestimated.

You can begin the search for classes by asking your care-giver, your friend with babies, or the hospital’s maternity department for suggestions. Then call and ask the providers of childbirth education to describe their classes. Find out who the teachers are. Is it possible to interview the teacher before registering in a class? You can learn a lot in a brief phone conversation. Is the teacher an independent certified childbirth educator who sub-contracts her services? Or is she an employee of a hospital or group? Does she belong to one of the local and national organizations of childbirth educators?

Ask about the teacher’s qualifications. Some sponsors require a medical background, such as nursing or physical therapy. Others require a college degree, sometimes in a related field, such as psychology, social work, education, or biology. Some have no specific educational requirements. Many sponsors require that their teachers have a child. In addition to background requirements, most teachers have received training in childbirth education. Training may be minimal [for example, the teacher may be required only to observe a series of classes] or it may be rigorous. Certification by one of the national or international childbirth education organizations may be required. Some community childbirth education organizations provide their own training and require their own certification. The certification process may include classroom sessions or workshops, written work, examinations, observation of childbirth classes, attendance at births, and teaching under supervision.

Find out the number of classes in a series. They range from about four weekly classes to as many as twelve. Classes may last from one and a half to two and a half hours. What topics are covered? [Possible topics include self-care in pregnancy, preparation for normal and complicated childbirth, caesarean birth, newborn care, breastfeeding and bottle-feeding, and the beginnings of parenthood]. You should know how much time is spent on learning and practicing techniques for coping with labor, such as relaxation, breathing patterns, massage techniques, and methods of visualization and focus.

How large are the classes? Classes may range in size from private sessions for one or two couples to very large classes for forty or fifty couples. A small, intimate class may be important to you, or you may prefer a more diverse larger group. If the group is large does the teacher have one or more assistants to provide more personal contact with the students? Is there room for everyone on the floor? Is personal contact by phone or private consultation available if you wish it?

Will there be a reunion of the group after the babies have been born? If so, it indicates the teacher is aware of the importance of the group support. It also shows the teacher has an interest in following up on her students.

Specialized Classes

In many communities specialized classes are offered-for example, early pregnancy classes, home-birth classes, refresher classes [a shortened series for those who have had childbirth classes during a previous pregnancy], cesarean preparation classes, classes for single mothers, lesbians, parents with a language barrier, parents with impaired hearing or vision, and teen parents, classes for women planning on giving up their babies for adoption, classes on vaginal birth after a previous cesarean, sibling preparation classes for other children in the family, grandparent classes, adoptive parent classes, and breastfeeding classes. Postpartum classes for parents with their infants are also offered in many communities.

Professional and Other Labor Support

Professional staffs provide one kind of support during labor; their expertise and perspectives give a woman confidence that she may not otherwise feel. But professionals are also busy with other responsibilities, such as recording information  in the chart, listening to fetal heart tones, taking blood pressure, doing vaginal exams, placing electronic fetal monitors and intravenous tubes, preparing for delivery, and even caring for other women at the same time. Nurses may not be able to supply much emotional support because of the other demands on them. Today many women are also supported through labor by one or more loved ones. In addition to a nurse or midwife. These support people, if prepared, can do things the nurse does not do-foe example, give the woman continuous, loving encouragement, help with creature comforts, like rubbing her back, mopping her brow, and bringing her water and juice, and will help with relaxation and with techniques for coping with labor.

Pregnancy will be an experience full of growth, change enrichment, and challenge. It is a time when you as a couple will confront your fears and expectations about becoming parents and will begin to determine your own parenting style.

Although there are certain similarities in all pregnancies, each pregnancy is special. Shifts in your body image, changes in your hormones and your attitude towards cultural pressures and expectations will all combine to make your pregnancy unique.

Each of the physical landmarks of a pregnancy is accompanied by specific physiological issues that will affect your perception of that particular part of your pregnancy. For example, if your pregnancy was planned and wished for, you and your partner will respond with joy and anticipation to the news that you have conceived. If the pregnancy was unexpected, you will initially have mixed feelings about it.

Interactions between your body and your mind will occur throughout your pregnancy. For example, a high level of stress in your life or negative feelings about being pregnant may contribute to some of the nausea that occurs in the first trimester [Three months]. Conversely, the nausea and vomiting may make you feel less than enthusiastic about your pregnancy. The important thing to remember is that because of this interaction between mind and body during pregnancy, trying to maintain a positive outlook may actually alleviate some physical ills.

Dreams during Pregnancy

During pregnancy you may find that you are much more vulnerable to certain fears and concerns. For example, pregnant women are often more anxious about the possibility of bodily harm. Things ordinarily taken for granted, such as riding in a car, or engaging in sports, may provoke some anxiety. These anxieties may surface in your dreams. Dreams may be realistic representations of your fears, or they may take the form of surrealistic nightmares. Dreaming about your worries is normal and may help you to deal with them during the day. Be reassured that dreams do not represent life as it is-or as it will be once the baby is born.

There is a progression in changing themes in dreams that may occur throughout your pregnancy. Dreams about pregnancy and babies often begin in the first trimester. Uncertainties about your role as a mother may surface in dreams about not being able to care properly for your baby. Such dreams are normal.

Pregnant women often dream about being trapped, and in many ways this is a direct representation of fears and concerns about the future. Especially if you have worked outside the home, you may be frightened about what having a baby will do to your ability to continue your outside interests.

Many mothers-to-be dream about having a child of one sex or the other. These dreams may reflect your preference for a child of a particular sex, as well as your concerns about your own sexual identity.

Another common theme in dreams is looking foe a child or having lost a child. These dreams usually occur during the end of the pregnancy when you begin to anticipate the delivery of your child. In reality a loss is about to occur; the loss of the fetus who will become your baby.

Assault is another theme that may occur in your dreams about pregnancy, reflecting your worries that if you were to be assaulted or injured, the consequences may be harmful to your baby, as well as to yourself. Also as the pregnancy continues and your body enlarges, you may worry that you will not be able to react quickly in a dangerous situation.

Perhaps the most relevant anxiety about assault that a pregnant woman has to deal with is the loss of control over her body. Clearly, you are not in control of your body’s changes during pregnancy. Especially for a first time mother. These assault dreams may reflect your fears about what your labor and delivery will be like. Then, too, the assault dreams may reflect your feelings about the “stranger” that is within your body.

Remember that having these frightening dreams is normal and should not worry you. In fact, because of the love you feel for the baby inside you, your concerns about his or her fragility, as reflected in your dreams, are not at all unusual.

As a father-to-be, you may also undergo a psychological process during a pregnancy. Although there is no physiologic basis for this, it is nevertheless very real and to some degree, predictable. A father-to-be, particularly in the third trimester, may feel a need for a creative outlet. You may want to paint or decorate the nursery, make a cradle, or begin a garden as a way of becoming involved in the forthcoming birth.

Men, as well as women, bring to a pregnancy their own emotional “baggage” as well as the echoes of their childhood fantasies about the mechanics and significance of pregnancy, birth and parenthood. How the father-to-be perceived his own parents can directly affect his feelings about becoming a parent himself. For some men, being able to father a child may also create a heightened self-esteem regarding their masculinity. Conversely if there were previous losses or a history of infertility, the father-to-be may see the creation of life as a fragile phenomenon.

Impending fatherhood also seems to bring with it all the memories and emotions of a man’s relationship with his father. In some ways becoming a father means giving up the idea of being a son. It also means reconciling the experience that one had as a child with being a father. It seems that these feelings are stronger during the pregnancy than the months following the birth of the child.

During most men’s childhoods there was little emphasis on learning fathering functions, except perhaps the provider role. Television and cartoons from the 1950’s and early 1960’s portrayed fathers as helpless and inadequate in handling a young child. Women were seen as having the primary duty of raising their children.

For fathers-to-be there is no internal reality-no physical changes to feel. You must rely on your partner’s reports about her feelings in experiencing the pregnancy. Perhaps not until fetal movements are obvious will you perceive the fetus as a growing child, and often this does not occur until the seventh month of gestation. Participating in prenatal visits may be a way to allow greater awareness of the reality of pregnancy. If an ultrasound study is indicated, viewing the ultrasound scans can be an invaluable experience because on the screen you will have visual conformation of the existence of your baby.

Pregnancy can elicit feelings even in a man who has had previous children. It provides an opportunity to think about the kind of father he has already been to the children that he has, as well as the increasing responsibility he will be facing. If the father-to-be is proud of his prior fathering experience, and if the new child is wanted, he may feel extremely happy about the new pregnancy.

It is still rare for men to admit openly that they have concerns, fears, and perhaps ambivalent feelings about their partners’ pregnancies, yet, those feelings are nearly universal. Studies indicate that more than one out of ten men will have psychogenic [having an emotional or psychological origin] physical symptoms in relation to a pregnancy. These symptoms tend to appear by the beginning of the second trimester of pregnancy. There may also be increased feelings of anxiety and depression.

The relationship between you and your partner may also undergo profound changes from your perspective. Previously, you may have had a sense of predictability in your partner’s reactions, but her reactions may change significantly during the pregnancy. You may also have significant feelings about the changes in her body proportions, as well as her shifting sexuality. While you are wrestling with the feelings of added responsibilities of fatherhood, you may have to simultaneously “mother” your wife. This is particularly true in our culture, where the extended family is often not ready to provide support.

The father-to-be’s task during the first trimester include both acceptance of the pregnancy and provision of some emotional support for his wife. Many men are ecstatic about being perspective fathers, but some may be frightened by this as well. The mother-to-be has a role of shaping her partner’s attitude and initial reaction, but mutual support, open lines of communication, and reassurance are the responsibilities of both partners.

By the end of the first trimester the obligations of becoming a father may weigh on you. You may reevaluate your job, salary and savings. It is important for you and your partner to begin talking to each other about your fantasies, anxieties, and expectations at this time.

During the second trimester, you will be able to feel the baby moving. Concerns about sexual activity any begin during this time, and obtaining reassurance from the doctor can be very important. On the other hand, a man may not be sexually attracted to a woman’s body that seems to be so different from the woman he married. It is critical that you and your partner talk about your sex life, if you are having problems adjusting to the pregnancy.

During the third trimester, many couples experience a renewal of their relationship in a romantic bond that may have been missing during the previous few months. However, the woman’s increasing size may present an obstacle for comfortable sexual activity. A physician or childbirth educator may be able to offer some suggestions for coping with this temporary problem.

If you participate in a prepared childbirth class, you may have some heightened concerns about your ability to coach during labor. Again, talking with men who have previously had this experience can be valuable. Often, childbirth education classes provide this opportunity.

Just as it was assumed in the 1950’s that no father could adequately participate in the labor and delivery experience. It is now assumed that most fathers should. If you, however, feel that you will not be able to participate in the labor and delivery, this should be discussed and resolved prior to the event. Further, you should not feel that your decision is in any way wrong.