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.

With all the choices available, how are you going to decide what kind of care and what kind of person will be best for you? Following are some questions you can ask to help determine whether the care-giver you are considering provides the kind of care you need or want. Begin by “shopping” over the phone and talking with the office nurse. You might ask about the background and training of the care-giver, how long he or she has been in practice, in which hospital he or she has privileges, and the cost of care. If the person you are considering provides home births or birthing center care, ask about backup arrangements-which hospitals and physicians are used if transfer or consultation becomes necessary. If the care-giver is involved in a group practice, find out how likely it is that your own care-giver will see you during your prenatal appointments and be present for your birth. In some group practices, you meet all members of the group; in others, you see only one, even though the others may attend your birth. Some groups are so large that the chances of a woman having her own care-giver during the birth are really quite small. If you do not like that, and there are no other overriding reasons for choosing such a group, you might decide to look for a smaller group or an individual practitioner.

Other questions for the office nurse concern the prenatal appointments themselves. How much time is scheduled foe each prenatal appointment? Who sees you if your birth attendant is called away during office hours?

Sometimes a colleague sees you; sometimes the office nurse sees you. In both those instances, the substitute care-giver may not be willing or able to answer questions about policies, philosophies, and usual practices.

Sometimes in a busy practice a woman comes in several times without seeing her own caregiver. This can be very frustrating, especially if her partner has arranged time off from work in order to meet the care-giver, or if she has questions that only the care-giver can answer.

Ask whether the care-giver encourages natural or prepared childbirth, if that is a desire of yours. Also ask if your partner is welcome to attend prenatal appointments with you.

If your phone conversation with the office nurse gives you a positive impression, make an appointment with the care-giver. [You do pay for these appointments] Plan to use this appointment as an interview rather than a first prenatal visit, which includes an extensive physical exam and many costly laboratory tests. Make it clear when you set up the appointment that you are in the process of choosing a care-giver, and would like the opportunity to meet and ask a few questions of this person. The charge for such an appointment is usually less than an initial prenatal appointment.

During such an initial interview ask the care-giver questions about topics important to you. You might want to know how he or she feels about a birth plan prepared by you. You might ask what interventions and diagnostic screening are normally used during labor. For example: Do all women receive intravenous fluids and electronic fetal monitoring? Are women free to walk, move and take showers throughout labor? What about the use of medication and anesthesia? How often does the care-giver perform cesarean sections? Are episiotomies usually done? Does the care-giver recommend childbirth preparation classes, and if so, which ones? Other questions might center on the father’s or partner’s participation throughout labor and birth, even cesarean birth. Are other support people also welcome? When does the care-giver usually arrive during labor and how much time does he or she spend by the bedside during labor? If not the care-giver, who provides professional support and care during labor?

Other questions might be about level of skill and training, ability to detect problems [prenatal and neonatal], and policies on induction of labor. You might ask how often and for what reasons labor is induced and what precautions are taken to avoid premature induced labor.

If you are planning a home-birth, ask when your care-giver normally arrives during labor. You will want to know what equipment your care-giver carries for normal care and for emergencies, and what his or her policies are on transfer to the hospital if problems arise. Can the care-giver continue to provide your car in the hospital or remain as a support person and advocate while an obstetrician takes over the management? Or does he or she not accompany you to the hospital.

You also will want to know any limitations on the scope of practice of your caregiver. For example, only some family physicians and no midwives perform cesarean sections. Few physicians attend out of hospital births. Midwives do not provide care in complicated labors, nor do they use forceps. Some midwives cannot perform episiotomies or repair either episiotomies or lacerations. Who would do these things if they were outside the scope of your care-giver’s practice? Some midwives cannot give pain medication during labor.

Finally, ask questions about the routine care of the newborn immediately after birth. Does the newborn usually stay with the parents, or is the baby taken to the nursery very soon after birth? For how long? For what reasons? Can some newborn procedures be delayed, especially those that interfere with the contact that allows “bonding” to take place between parents and baby? These include the use of eye ointments [which can blur the baby’s vision], the use of nursery heaters to maintain body temperature, and the immediate admission of the baby into the nursery for routine procedures, such as weighing and measuring. Some of these can be delayed, which would give the parents time to admire and cuddle their new baby, if the baby’s condition permits. What about circumcision? Ask if your care-giver recommends and if so, why? Does he or she do circumcisions?

Strengthening Exercises for Pregnancy and After Delivery Strengthening Exercises for Pregnancy and After Delivery All exercises should be performed at least three times a week, on alternate days, on a firm surface. Perform in order. Be sure to breath normally during all exercises, don’t hold your breath. During abdominal exercises, it may be easier to exhale on exertion, that is, inhale when you are down and exhale briskly as you perform the lift. Remember don’t lie on your back for longer than one minute by the clock. The following exercises work all muscle groups. Don’t skip any!

Hamstring Lift

Start with five, increase to twenty.

1. Rest on hands and knees, with back flat and abdominal muscles squeezed tightly [do not let abdominal muscles “hang loose”].
2. Extend left leg straight behind the foot flexed [do not point].
3. Keeping back flat, lift leg up until it is level with back. Weight should be shifted to left arm.
4. Lower leg. Repeat several times.
5. Change sides and repeat, shifting weight to right arm.

Inner Thigh Lift

Start with five and increasing to twenty repetitions.

1. Lie on side with bottom leg straight, inside of leg toward ceiling. Bend top leg with foot resting, flat, in front of bottom leg at the thigh. [Alternatively, top leg may be bent with foot resting behind bottom leg].
2. With foot flexed, lift bottom leg slowly two to three inches. [As far as it is comfortable].
3. Lower bottom leg slowly to the floor-do not drop it!
4. Repeat several lifts. Be sure to stay on your side, not rolling back on your buttocks.
5. Change sides and repeat.

Outer Thigh Lift

Start with five and increasing to twenty repetitions.

1. Lie on side, head resting on hand, and body straight [no flexion of hips]. Bottom leg may be bent at a forty-five degree angle for balance.
2. Slowly lift top leg straight up and slightly back. Hold for a slow count of five, and then lower slowly.
3. Repeat several times, change sides.

Chest Muscle Exercise

Start with five and increasing to twenty repetitions.

1. Raise elbows to shoulder height, place palms together.
2. Press palms together for a slow count of five.
3. Locking fingers pull against fingers for a slow count of five. Do not hold your breath. [This stage of the exercise actually strengthens muscle in the upper back.]

Pelvic Rock on All Fours

Start with five and increasing to twenty repetitions.

1. Rest on hands and knees, with back straight and knees comfortably apart.
2. Picture yourself as having a tail. Tuck your” tail” between your legs, rocking your pelvis under and arching your lower back. Hold for a slow count of four.
3. Return to starting position, without allowing your back to sag, tuck and release slowly, do not jerk. Hold the tucked position for a full count of ten. Squeeze your pelvic floor at the same time for an added benefit.

Note: Do not allow the lower back to cave in.

Diagonal Knee and Arm Reach

Five to ten times.

1. Lie flat on back with knees bent and feet flat.
2. Flatten lower back to floor, raise head [straight up towards ceiling, not with chin down on chest.], shoulders, right arm and left knee all together slowly.
3. Lie back slowly. Arms may reach and crossed on chest or behind head [do not pull on neck].
4. Repeat raising left arm and right knee.

Pile

Start with five, gradually increasing to twenty repetitions.

1. Stand with feet about two feet apart and toes turned comfortably out.
2. Slowly bend the knees, keeping back flat. Buttocks should never lower past the knees. Knees should be over toes-don’t let them fall in.
3. Rise slowly, concentrating on the leg muscles as you push upward. Heels should remain flat during the entire movement.

Note:  To advance the exercise, stay down for fifteen to thirty seconds, and then rise slowly.

Sit Back

Start with ten, increasing to twenty repetitions.

Sit with soles together and comfortably away from body, arms held parallel to the floor in front of you.

1. Tuck chin to chest and curl back slowly until you are half to three quarters of the way down, keeping edges of feet on the floor and back rounded. [do not attempt this with a straight back]
2. Return to sitting position. Exhale as you curl back [if this is easy to perform, do the exercise with arms crossed over chest] does not try to curl back to the floor and up again.

Curl up

Five to twenty times.

1. Lie on back, with knees bent and feet close to buttocks. Press back down, inhale slowly and deeply.
2. Exhale slowly; at the same time, lift head and shoulders. Perform slowly and with control [no jerky movements]. Head stays in line with spine, do not throw head forward. Relax jaw and neck muscles. The “lift” comes from the shoulders and should be straight up with face toward the ceiling
3. Slowly return to starting position, inhale as you do so.

Pelvic Floor Squeeze [Kegel Exercise]

Twenty sets per day

1. Sit or stand comfortably [you can do this exercise in most positions]. The farther the legs are apart the more challenging.
2. Thinking about the vagina and perineum, tighten the pelvic floor as if to lift the internal organs or to stop urination in midstream. Hold as tightly as possible for a slow count of five [be sure to breath]
3. Relax completely.

Note:  Because these muscles fatigue easily, repeat in sets of three or four squeezes throughout the day, anytime, anywhere. Concentrate on the sensations of tension and lifting, relaxing and lowering within the pelvis.

Trunk Roll

Five to ten times.

1. Lie on back with hips flexed, knees bent, shins parallel to the ceiling and arms on floor straight out from your sides. Feet may be off the floor, or alternatively on the floor.
2. Keeping shoulders down and knees together, roll legs over to the left, touching left leg on the floor.
3. Roll legs back to the starting point, and then to the right. Make sure knees are not bent too close to the chest.

Push Away

Start with five, increase to twenty.

1. Stand with hands on wall slightly farther apart then shoulder width. Move feet back from wall about two to three feet. Hold arms and body straight, and tuck hips under body.
2. Lean toward wall allowing arms to bend. Touch one cheek to the wall.
3. Push body [still straight] away by straightening arms. Do not arch your back. Hands should stay in contact with wall at all times.

Exercises to Avoid

If you are pregnant, avoid the following exercises and heed precautions until after delivery.

1. Double Leg Raise – [any exercises which both legs are raised or lowered together]; this exercise puts too much strain on the lower back and on the ever thinning abdominal muscles. In fact, double leg raises are not recommended for anyone, pregnant or not.
2. Full Sit-ups – They can strain the lower back. Also, in pregnancy, a full sit-up may pull on the round ligaments in front of the uterus, causing a sharp, off to the side abdominal or groin pain. Halfway up and halfway back is enough to strengthen abdominals anytime.
3. Any Exercises That Causes Swayback. [Requires that you arch your back].
4. Humping, Hopping, Skipping, and Bouncing. These may cause pain and strain in hip and pelvic joints, especially in late pregnancy. If you are in an instructor-led class for non-pregnant persons, perform these movements with one foot firmly on the ground, don’t try to be the perfect example or “Superwoman and pregnant to”; be sensitive and listen to the messages your body sends you.
5. Exercise/Dance Movements that Require Good Balance and Quick Moves. Your centre of gravity shifts as the baby grows, and all joints [including knees and ankles] are looses and less stable.
6. Any exercise that requires you to be on your back for a prolonged period of time [over one minute].

Set the mattress at the lowest possible level to give maximum side-bar protection.

Always keep the drop sides of the crib up to safeguard against accidents caused by faulty hardware or forgetfulness.

Use bumper pads for the first five months.

Use the crib for sleeping only. Never allow jumping or playing in or around the crib.

Place the crib away from walls and furniture to eliminate the danger of entrapment in case the baby falls from the crib.. also make sure the crib is not near curtain or blind cords, which could entangle or strangle a child, and make sure these cords are out of baby’s reach..

Keep loose clothing or soft toys out of the crib, they could cause suffocation. As the baby gets older, remove toys that could be used by him as stepping stones for climbing out.

Once your baby appears able to climb out, buy hospital netting to cover the top of the crib or consider another sleeping arrangement, like putting the mattress right down on the floor or on a small frame designed for a baby mattress.

Do not use plastic bags as mattress covers, especially dry cleaning bags or others that could cause suffocation.

Remove mobiles once a baby can sit up, since a baby could be hanged on the side straps of one. Mobiles are designed for visual stimulation, not for handling.

Changing Tables

Changing tables provide a safe place to diaper and dress your baby. However, if you don’t want to spend the money, an alternative will do.

To be functional, a changing table should be at a height comfortable for handling a baby without having to lean over. It should have a waterproof pad and enough space for open storage of shits, plastic pants, and diapers, or you’ll waste time gathering needed items for each change. There should be a safety belt that is wide and easy to use [but not so easy that the baby can release it]. Never use the table without using the safety belt-it takes only a few seconds for the baby to fall when your back is turned. However, don’t trust a “belted” baby to be safe if left unattended.

Commercially available changing tables usually have a long, slender padded area for changing and an area of open shelves underneath for storage. Most of these changing tables fold for storage.

When buying a changing table look for one that has high sides around the changing area to prevent your baby from rolling out. The covering on the foam pad should be of thick, smooth vinyl, which will make it easier to clean. Make sure the table is sturdy and doesn’t wobble or flip over easily. Many parents find it extremely frustrating to assemble these tables and get the legs balanced, so we suggest you purchase yours pre-assembled. Shelves should be spacious and open and very easy to use, many popular models have small, narrow, half-open boxes for shelves, which can be very hard to use. Look for a model that features stable side shelves for holding washcloths and other items. Attachable side pails for soiled items are also very useful.

A changing table is only useful for about the first two years, so if you’re on a tight budget you may want an alternative. You can use a wide table or even the padded top of a dresser instead. You can buy a special top that secures to a dresser to convert it to a changing table. But if you are going to use a top of a dresser, don’t put your baby’s things in the dresser- it’s dangerous to go rummaging through drawers to find things while holding the baby steady with one hand. You will want some kind of an open shelf system nearby, instead. Some parents construct a wall to wall shelf in a closet at the appropriate height and top it with a vinyl covered pad; you might also use a portable crib, raised to its highest position.

When using a changing table, keep diapers handy and ready for use, but keep all pins closed and out of the baby’s reach. Have a container of water handy. A roll of toilet paper attached to the wall and out of the baby’s reach and a wastepaper basket nearby will make the arrangement more workable.

Drawers and Shelves

What you use for drawers and shelves is up to you. There are lots of nice baby chests on the market. Don’t feel you have to buy one; it’s largely a matter of taste and budget. If you’ve already opted to buy a changing table, there may be enough space on the shelves below it, and you won’t need additional storage. If not, consider putting a used baby chest, or perhaps a used dresser that you can refinish for your baby’s room.

If you are buying a new chest, shop as you would for any other piece of furniture. Look at the workmanship inside and out. Are you planning on having a large family? If so, you may want to invest in a high quality chest to use for each infant. If you’re not planning a big family, will you want to use the chest as the child gets older? If so, you may want to buy something that will eventually look good in an older child’s room.

If you are using a chest of drawers, it is a good idea to install safety latches so a small child can’t pull the drawers out and have them fall on her. Also, once your baby is walking, you’ll want to be sure you don’t leave things like pins, on top of the dresser that your child could reach or pull down on herself.

Bassinets

If you are looking for a bassinet, here are some guidelines to keep in mind:

Make sure it’s stable and not shaky.

There should be no sharp edges.

Check for any hinges or clips that your baby could catch her fingers on.

Since many bassinets are wicker or rattan, you’ll want to be sure there are no sharp or rough edges that could be scratchy or itchy for a baby; adding a bumper pad to the inside might help. If the bassinet folds up make sure the legs have an effective looking mechanism, so they don’t accidentally fold when the bassinet is being used. Also, periodically check to be sure all screws and bolts are tight.

Remember that a bassinet’s usefulness is limited because your baby will quickly outgrow it. If you must watch your budget, you probably don’t wish to buy a bassinet.

Rocking Chairs

Some mothers could not do without a rocking chair; others couldn’t care less about them. Again, it’s a matter of personal choice, taste, and budget. You can buy one new or used. If it’s going to be in the baby’s room, you’ll probably want a style that fits in well with the décor and other pieces of furniture.

The major thing to consider if you’re buying a rocking chair is comfort. Will it be a comfortable place for you to nurse? How will it feel to sit in the chair and hold your baby? You’ll probably want one with an armrest.

A drawback to having the rocking chair in your child’s room is that once he can crawl, there’s a possibility he might get caught in the frame or push the chair and get hi in the head by it. There’s also the possibility that he will put his tiny fingers under the rocker while the chair is moving. For this reason, you might want to remove the rocking chair from his room once he is crawling and walking, or be certain you are keeping a careful watch on his activities. Or you can make special stops that keep the chair from rocking forward and backward.

Cradles

Cradles have a romantic aura about them, perhaps because they are historically associated with mothers and babies. They provide a gentle rocking motion, which can lull a baby to sleep.

If you’re buying a cradle, or if you inherit one, look for the following safety features: the slats should be no more than 2 3/8 inches apart, like crib slats. Cradles are commonly suspended by hooks, which can sometimes stick out and can injure your baby as you put him in or take her out of the cradle. Make sure the hooks don’t protrude. A locking mechanism is a definite plus; it will prevent an unattended cradle from rocking and possibly cause a sleeping baby to become wedged against the side of the frame due to the shifting weight.

Your birth plan should also include a newborn birth plan. Many mothers wish to hold their baby skin to skin immediately after birth. Skin to skin contact provides warmth for the baby and satisfaction to the mother. Some parents want their baby to have a relaxing float in a Leboyer bath soon after birth. The baby might be placed in a heated unit in the nursery if the mother prefers or if the baby is chilled.

What about feeding your baby? Do you prefer to breastfeed or bottle feed? Do you want to provide all the feedings for your baby [which would mean that the baby should receive no water or glucose water from a bottle]? Do you want to feed on demand [that is, whenever and for as long as the baby seems to want to nurse]? Many nurseries restrict demand feedings unless the mother states that demand feeding is her preference.

How much contact do you want for your baby? Some hospitals provide a private postpartum room, and even aloe the father to rent a cot and stay all night. Other options are to have the baby with you during the day only, or for feedings only.  The less time you spend with your baby, the less well you will know her personality and how to care for her.

It should be remembered, however, that the amount of time you will spend with your baby is dependant on several factors. The most important of these are the health of the mother and the health of the baby. For example, it may be medically necessary for a premature infant to be placed in the hospital nursery where her condition can be carefully and continually monitored.

What about circumcision of your baby boy? This surgical procedure involves removing the foreskin of the penis. Since the procedure is optional, it deserves your consideration.

When will you and your baby leave the hospital? You can stay a few hours to a few days after the birth. An early discharge or short stay means that you leave within six to twenty-four hours after the birth. One obvious advantage is the financial savings involved. Hospitalization costs are calculated by the day or fraction of the day; obviously, the longer you stay in the hospital, the more it costs. Find out how the billing is done so you won’t inadvertently stay longer than you can afford. Other considerations besides costs, however, are your need for rest, your need for medical care, and your desire for teaching and medical supervision for the first couple of days. Find out if your hospital sends a nurse to visit all women who have had a short stay, or if they at least make a phone call t0o check on them. Is instruction available for those wishing a short stay, so that you know what observations to make to make sure everything is going well for the both of you? Another factor in your decision is whether you will have help at home. Sometimes the father can take time off from work or a relative or friend can come in and help extensively; sometimes parents hire helpers to come in daily for a week or two after the birth. In the absence of any help, you might prefer to spend a couple of days in the hospital before going home to all that responsibility.

If your baby is premature or ill and needs extensive medical care, she will either stay in the nursery or be transferred to a different hospital with more sophisticated facilities for newborns. Time with the baby and breastfeeding may be postponed until she recovers or becomes strong enough to suckle. State in your birth plan that you want to feed the baby yourself and if you want to spend as much time as possible with your baby.

Unexpected Loss of a Baby

One of the greatest difficulties we face is the possibility that the baby may not live. Every perspective parent worries at times about losing a child. Although it is uncommon, some babies die. This very sad ending to the pregnancy leaves the parents stunned, grieving, depressed, and angry. After losing a child parents are in no state to make important decisions. If you have thought through how you would want a newborn death handled, then, should a death occur, such decisions will have already been made by you at a time you were calm.

Many counselors recommend that couples have private time together with their baby who died. Seeing and holding the child gives the parents a chance to say goodbye to the baby. In addition, pictures, footprints of the baby, and perhaps a lock of hair are mementos that mean a great deal later.

Having a memorial service or funeral for the baby allows friends and relatives to also acknowledge the baby’s life and death. Formal ceremonies can often give people a vehicle through which to express their grief and their support for the bereaved parents.

The question of an autopsy often comes up, if the cause of death is unclear, sometimes an autopsy is beneficial, both in answering questions and in preventing the same thing from happening in the future. It would be worthwhile to think through in advance whether you would consent to an autopsy in such a case.

Strollers and Carriages

Having a stroller will make long walks a lot easier. If you’re going to be packing the stroller in the car, you’ll want to invest in a high quality , lightweight model. These strollers are known as umbrella strollers because of the handles which look like umbrella handles. They have lightweight aluminum frames and weigh as little as five pounds.

If you live in the city, and you’ll primarily be using the stroller for walks over cracked sidewalks and curbs, you may want a standard size stroller for its sturdiness. The larger models will also hold more packages than umbrella strollers, and they often have trays that hold toys or snacks, sunshades, multiple-position reclining seat backs, and plastic windbreakers to cover the sides.

You can get both the collapsibility of the lightweight umbrella-handle strollers and the postural support and durability of the larger, heavier models by buying one of the new medium-weight models.

Strollers are not without hazards. In one recent five-year span, there were more than forty thousand stroller related emergency room visits in the United States.

The major cause of injury is babies falling out of strollers and hitting their heads. Baby’s fingers can become entrapped or crushed in the scissoring action of the joints as the stroller is being folded. Babies have also been injured by falling into protruding sharp edges of bolts or other metal parts. Also many strollers, particularly umbrella styles, are unstable and can fall over backward when a baby stands or attempts to stand in the seat.

The Juvenile Manufacturers Association has established a voluntary safety standard for strollers and carriages. Since these standards are voluntary, not all stroller manufacturers have adopted them. And don’t get lulled into thinking that the standards are what they could be. There are no provisions for the restraining belt or latch. While the standards require brakes, there are no safety measures to prevent another child from accidentally releasing them. Also there is no protection offered from the scissoring from joints or from sharp holes in the metal tubing that could capture a child’s fingers, nor is there any specification for how securely caps or other protective devices must be attached to the stroller’s tubing and hardware.

Strollers and carriages that do meet safety standards:

Shouldn’t have any exposed coil springs that could pinch, or otherwise injure a child.

Should have a locking device that prevents accidental collapse.

Should come with safety belts that are attached securely to the frame or upholstery.

Should be stable and unlikely to tip over when on an inclined surface with a child inside.

Should have permanently attached warning that reads “Caution: Secure child in the restraint. Never leave child unattended.”

When shopping for a stroller, look for the following features:

Steering ease

Try pushing the stroller around to see how well it turns corners, and how easily it maneuvers if you only use one hand. The stroller should handle well without veering to one side. A stroller with a single crossbar is easier to handle than one with umbrella type handles.

Stability

The stroller should be stable and unlikely to tip over when in use. If the stroller has a reclining seat, it should not be able to tip backward when the baby lies down.

Collapsibility

Don’t hesitate to try opening and collapsing the stroller before you buy it. You should be able to fold the stroller and open it up again in one or two steps as you hold your baby. If a stroller is going to be difficult and time consuming to operate, you need to know that before you buy it. Make sure there’s a locking device so the stroller can’t collapse accidentally.

Seating

Compare the thickness of vinyl upholstery on several different models by pinching it. The vinyl should be thick and all seams should be well finished. The crotch belt, in particular, should be reinforced where it joins the seat. The seat should be shallow enough to provide back support for a six to eighteen month old baby.

Reclining feature

Very young babies tend to hunch forward in a sling type stroller seat. Tots, too have a hard time napping in an upright position. It’s useful to be able to move the stroller seat into a reclining position. If the stroller does recline, it should have sides to prevent the child from rolling out, even in the lowest position.

Seat belt

The seat belt should actually make contact with even the smallest baby’s waist. The belt material should be strong, and the latches either heat-welted or sewn with multiple seams. The latch should be simple enough for you to operate and yet require enough pressure to open so a curious tot couldn’t release it accidentally.

Front padding or tray

Some strollers have plastic trays. Those that feature small balls fastened by plastic or thin wire aren’t satisfactory, since the balls could splinter or be ingested if they were pulled loose. If a bumper pillow replaces the tray, check underneath to see that it’s securely fastened to the front bar. Pads often pull off, tearing out the screw bed so they can’t be refastened.

Sunshade

Some strollers come equipped with a sunroof, though often the roof is placed so high that it’s useful only during the noon hour. If you plan to use the stroller in the sun, you may want to invest in a flexible-arm umbrella shade, which is offered as an option by some manufacturers.

Wheels and suspension

Wheels with plastic spokes do not hold up well. Opt for steel or aluminum hubs. Suspension systems are seldom available on medium-weight models, but heavy-weight models may offer springs or other types of shock absorbers, which will give your baby a less jarring ride.

Brakes

Brakes should offer a position grip on the tires so they can’t be dislodged. The child should not be able to release the brakes while seated in the stroller.

Baby carriages conjure up images of prams and nannies and walks in the park. A carriage allows you to take long, leisurely walks, even when the baby is very small. Its high sides and hood help protect the baby from side-drafts and bright sunlight, and the soothing bounce from the carriage springs often helps babies sleep.

However, before you run out and buy a carriage, consider a few things. Carriages are quite expensive, and you’ll use a carriage for the first few months. They weigh quite a bit, making them awkward to use and awkward to store. If you bring one along for a trip, you’ll have to collapse it to get it in the trunk of your car. Unless you live where there are winding country roads, traffic and curbs present maneuverability challenges for carriages.

If you decide to purchase a carriage, look for the following features:

Fabric

Choose a thick, moisture resistant fabric, such as one coated in vinyl that can easily be wiped clean.

Steering

Try rolling the carriage around to see how easily it maneuvers. When you press on the bar, you should be able to raise the front wheels high enough to get up and over curbs.

Mattress

If the mattress pad is covered in vinyl, test the thickness of the vinyl by pinching it between your fingers; it should be difficult to crease. Check the finishing on the pad to see that the seams are tightly sewn with no danger of unraveling. The pad should fit flush against all sides of the interior of the carriage.

Brakes

The brakes should hold firmly, preferably on both back wheels, and should not disengage even when you attempt to push the carriage forward. The brake handle should be easy to reach without having to let go of the carriage handle.

Interior safety

There should be no sharp edges from frame hardware inside the carriage bed that could hurt a baby’s head if she’s jostled during maneuvering.

Folding ease

The most economical unit is a two-piece carriage that doubles a carry bed. Try collapsing and setting up the carriage to see how easy it is to handle. Examine the safety locks to make sure they will prevent the carriage from folding accidentally and will hold the carry bed securely. There should be no sharp edges that could hurt the baby’s fingers or your own.

Frame safety

Avoid carriages that have a sharp scissoring action of metal against metal x-joints. These joints could cause crushed fingers when collapsed.

Whether you choose to buy a carriage or a stroller, you can protect your investment from rust by coating chrome areas lightly with petroleum jelly.