Newborn 101 Read online

  newborn

  • 101 •

  Secrets from Expert Nurses on Preparing and Caring for Your Baby at Home

  updated and expanded second edition

  Carole Kramer Arsenault, rn, ibclc

  Foreword by William Camann, MD

  Director of Obstetric Anesthesiology, Brigham and Women’s Hospital

  This book is dedicated to my three children, Alex, Cam, and Caroline, and to my niece Emmie.

  “A hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove . . . but the world may be different because I was important in the life of a child.”

  —Forest E. Witcraft

  Contents

  Foreword by William Camann, MD

  Introduction

  Part I—Getting Ready

  1. Preparing for Your Baby’s Arrival

  2. Keeping Your Baby Safe

  3. Making Healthy and Green Choices for Your Family

  Part II—Labor, Delivery, and the Postpartum Period

  4. The Pregnancy Homestretch

  5. Labor and Birth

  6. From Birth to Parenthood

  7. Your Baby’s Condition and Postpartum Hospital Procedures

  8. Parenting a Premature Baby

  Part III—Breastfeeding Your Baby

  9. Bring Your Lactation Nurse Home

  Part IV—The Fourth Trimester

  10. Your Baby’s First Month: A Time for Learning

  11. Your Baby’s Second Month: Getting the Hang of It

  12. Your Baby’s Third Month: The Newborn Homestretch

  13. From Newborn to Toddler: Bring on the Milestones!

  Appendix

  Acknowledgments

  Index

  About the Author

  Foreword

  by William Camann, MD

  Patients encounter a wide variety of personnel when they go to a hospital or seek medical care. Physicians, nurses, various specialists, technicians, receptionists, security officers, parking attendants, and others will all be part of the experience. Each may lay claim to some particular knowledge or insight about what really goes on in the world of health care. And each indeed does have a particular perspective with which they see the medical world. Opinions vary as to who has the clearest view—but it’s my belief that there is no greater vantage point than that of the nurse.

  Thus, it gives me great pleasure to write this foreword to Newborn 101: Secrets from Expert Nurses on Preparing and Caring for Your Baby at Home. Pregnancy and childbirth is something most parents experience only once or just a few times. The experience can be daunting, challenging, and overwhelming, as new parents are often intimidated by their newborns and struggle over even the smallest decisions about their care. Yet professionals who work in the maternity environment see new parents on a daily basis. They know the joys, the problems, the concerns, and most importantly, the questions that are asked over and over again by new parents. In today’s technology-laden world, new parents are exposed, perhaps even overexposed, to an ever-increasing volume of information from family, friends, acquaintances, books, magazines, websites, social media, and other resources. Moreover, in an environment of such information overload, many of the resources are presented with specific agendas, causing even more confusion. “Just who can I trust?!” is a common concern among new parents, and, for that matter, all health-care consumers. And, when all is said and done, it is often nurses who field the majority of questions from patients.

  The critical role of nurses in health care is well recognized by many, including physicians. As doctors, we speak with and examine our patients, look at laboratory test results, X-rays, scans, and monitors, and seek out the advice of consultants. Yet any doctor will admit that there is no more valuable information than the nurse’s answer to a simple question such as “How is the patient doing today?”

  I can think of no more uniquely qualified nurse than Carole Arsenault to help guide first-time parents through the information overload that defines new parenthood. I know Carole from almost two decades of working as colleagues in the labor and delivery unit at Boston’s Brigham and Women’s Hospital, one of the busiest maternity hospitals in the country. In addition to her extensive hands-on experience with women giving birth, Carole also has years of experience as the founder of Boston Baby Nurses, a Boston-area agency that helps parents though all aspects of preparing and caring for their newborns, providing education, lactation support, home care, and more. Carole and her team of skilled, seasoned nurses have seen it all, and Newborn 101 is a compilation of their knowledge. This book covers how to prepare your home before the birth, what will happen in the hospital during and immediately after birth, and how to adjust during the first months of life with your new baby. Written in a practical, easy-to-follow, and conversational tone, this useful manual is a must-read for new parents.

  William Camann, md, is the director of obstetric anesthesiology at Brigham and Women’s Hospital in Boston and the coauthor of Easy Labor: Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth. Dr. Camann is also an associate professor of anesthesia at Harvard Medical School and former president of the Society for Obstetric Anesthesia and Perinatology. An internationally recognized authority on obstetric anesthesia and pain control during childbirth, Dr. Camann has appeared on the Today show with Katie Couric, ABC World News Tonight, and Good Morning America. He lives in Boston.

  Introduction

  I can still feel the excitement and anxiousness my husband and I experienced leading up to and after the birth of each of our three babies—especially our first. Birthing and taking care of a newborn was unknown territory to us, and that emotion-filled time of love and learning was amazing. And as a nurse, lactation consultant, and parent educator to hundreds of families over the past decade, I’ve been privileged to guide moms and dads in their own emotional and educational transitions into the incredible, albeit challenging, world of parenthood.

  The experience of modern parents-to-be is very different than it once was because there’s so much information at your disposal. Just to learn the basics of birth or newborn care, you now have to sort through a mass of often outdated information and decide which pregnancy, birth, and infant products and resources are best and most trustworthy. Keeping this challenge—and you—in mind, I wrote Newborn 101. Applying my professional experience and, just as important, the wisdom that comes only from a mom who has been there, Newborn 101 elaborates on key information and methods you need to make this sometimes overwhelming phase simultaneously one of utter joy. I invite you to discover the answers to all of your questions about the months leading up to the birth of your baby, the birthing process, understanding your newborn’s needs, and how to soothe and care for your infant (and yourself!) during the first three months.

  Every step in this journey you’re on is an important one—something I’ve come to know through each of my professional experiences. I started out by practicing for many years as a labor and delivery nurse at Brigham and Women’s Hospital in Boston, where I learned, day after day, that each mom is unique, laboring and birthing in her own way. Your birth experience will be entirely different from your sister’s, your mom’s, and your best friend’s. I vividly recall, early on, reassuring one particular mom in her mid-twenties as she was about to push her baby out. She had been so calm throughout labor, using her breathing techniques, but suddenly began to feel tired and panicked and decided out loud, “I can’t do this.” Knowing that this was a sign she was nearing the end of her labor, I quietly reassured her she could do this and that she would soon be holding her baby. Her baby was born ten minutes later. The very next day I was at the bedside of a laboring woman of similar age who opt
ed for an epidural to ease the feeling of contractions. When it came time for her to push out her baby, instead of needing calm reassurance she responded to more energetic support. She really gave it her all in pushing when she heard she was being rooted for, and she also met her baby soon after.

  In addition to guiding women in labor and birth at Brigham and Women’s Hospital, I regularly witnessed the bonding and benefits that initial breastfeeding gave to both moms and babies, which inspired me to become a certified lactation consultant. Since then I’ve provided lactation consulting to new moms delivering at many of Boston’s top hospitals, including Brigham and Women’s, Beth Israel Deaconess, St. Elizabeth, Newton-Wellesley, Massachusetts General, and Mount Auburn. Through this work I’ve seen that although breastfeeding is easier for some than for others, it doesn’t just come naturally for any mom or baby. It takes practice and dedication, sometimes needs intervention, and unfortunately is sometimes not possible. Realizing that there were in fact many ways I could help parents through pregnancy, labor, birth, postpartum, and the newborn period, I also began teaching parent education courses and founded Boston Baby Nurses, LLC, a Boston-based agency that provides overnight lactation and postpartum services to women and babies in their homes. I have also found ways to reach out to families by contributing health advice to the online publications bostonmamas.com and thebump.com and by consulting for the Abbott Laboratories Pediatric Advisory Committee.

  I had each and every one of these patients and clients in mind when I wrote Newborn 101, so I could offer moms like you the same support and encouragement I have given to new Boston-area moms over the years. Newborn 101 is my latest venture in my dedication to helping parents-to-be during this special time. It is your comprehensive pregnancy, postpartum, and newborn baby guide: here I share how to choose safe baby products, what to pack for the hospital and what to expect while there, and details about newborn care, breast- and bottle-feeding, soothing, sleeping, and infant development. In addition to the up-to-date baby information, I provide you with the following essential resources to aid you along the way:

  • To save you time in preparation for baby, I include lists outlining essentials to pack for the hospital. I present the must-have baby items and save you money by identifying those you can easily do without. I also provide advice on how to create a safe, nontoxic, “green” home for your baby.

  • To help you settle in on your first few hectic days and weeks home from the hospital and carve out time for you in the ensuing weeks and months, I offer samples of realistic, flexible daily routines to follow.

  • Throughout the book, to answer many of the questions you will inevitably have in the early days of your baby’s life, I use the questions I have heard asked most frequently in my years of experience working with new and expectant parents. I answer each one in depth and share with you the current information I teach to parents in childbirth education, newborn education, and breastfeeding classes and parents I work with as a baby nurse in their homes.

  • To equip you with a range of knowledge for your journey into parenthood, each chapter also includes valuable baby care tips (gathered from my experience with everyday moms and dads who have all experienced this delightfully trying period).

  I wrote Newborn 101 to enable you—to help prepare you for the arrival of your baby, understand each of your newborn’s needs and behaviors, and take care of yourself. Through this book, as a baby nurse and fellow mother, I hope to give you the experience, knowledge, and support that will help you transition into your new role as a parent and care for your baby with success, confidence, and happiness.

  • Part I •

  Getting Ready

  • 1 •

  Preparing for Your Baby’s Arrival

  Congratulations—you’re expecting! So now what? While nine months may seem like an eternity, they provide much-needed time to plan and prepare for life with your new baby, because you’ll be fully immersed in parenthood before you know it! And I know the idea of preparing for a newborn can be overwhelming—I hear this from new and expectant parents I work with on a daily basis—but a little organization up front can help you feel much more in control. Don’t worry if you have a zillion questions, ranging from what type of diapers you should use to car seat selection and safe sleeping—every parent has these questions, whether they admit it or not. This chapter will help you get everything in order for your new arrival, breaking down a few key areas you’ll want to focus on: finding a childbirth class, choosing a pediatrician, planning the nursery, and preparing for the birth. Based on experience both personal and professional, I’ll give you the inside scoop—like which baby items you can do without.

  Prenatal and Childbirth Education

  .............

  The more you learn about the process of having a baby, the more confident you will be during labor and your first weeks at home with your newborn. I recently got a call from an obstetrician about a pregnant patient who suffered from panic attacks. She was very worried about the process of labor and birth. We set up a semi-private childbirth class, with just a few couples, and focused on the fact that birth is normal and not something to be feared, but embraced. I helped her to understand that having a baby in a hospital setting does not necessarily make it a medical event. The support and information she received in the birth class gave her the confidence she needed—she went on to have a “fabulous” labor and called to tell me that hearing all about what to expect straight from an experienced labor and delivery nurse made all the difference. That’s why taking a childbirth class—or several—is a good idea.

  Childbirth classes will teach you what to expect during the many stages of labor and birth and how to prepare your body and mind. The content of childbirth classes can vary, though, so it’s a good idea to review class descriptions prior to enrolling. For example, if you are planning an unmedicated childbirth—one void of routine birth interventions such as Pitocin (a synthetic form of oxytocin intended to speed up labor), fetal monitoring, and pain medications including epidurals—you will want to take a class such as Lamaze or Bradley. (These classes are discussed in more detail later in this chapter.) Other classes on baby care will delve into topics such as breastfeeding and infant CPR.

  Some classes are offered in a series of short sessions (usually over the course of a month or so) while others are completed in just one day. You may want to take one, two, or even more classes to feel prepared and get all of your questions answered; or you can take one general class that will touch upon several important topics from birthing to breastfeeding and baby care. This type of class may be all you need, especially if you have some prior knowledge of infant care and are already confident in your level of birth education and choices.

  Q. My hospital offers many types of prenatal classes. Should I take all of them? How do I know which ones will be the most helpful to me?

  A. Start by discussing the list of available classes with your health-care provider and asking for recommendations. Then do some online research of additional classes in your area, because your hospital is probably not your only resource. Local childbirth educators may offer independent or private classes, and maternity stores and baby centers may run workshops as well.

  Discuss the class options with your partner as well as your health-care provider, and prioritize the birth and baby care areas in which you would like particular guidance. If you are planning or considering an unmedicated childbirth, for example, you might prefer a class that spends more time on nonmedical comfort measures and delivery methods. However, if you are certain that you want epidural anesthesia for pain relief during labor, you may want to enroll in a general birth education class, as the two classes will likely vary in price and duration.

  baby care tip

  One of the best ways to find a good local childbirth class is to simply ask friends and family members who have given birth in recent years. Just be sure the content of the class aligns with your and your partner’s goals.


  Q. I would like to prepare for an unmedicated birth. What type of class should I look for, and where?

  A. Classes on unmedicated childbirth can be particularly valuable because they center on relaxation and breathing techniques, which can help your labor progress more quickly as well as reduce stress, fear, and pain during labor. Because there are various ways to prepare for an unmedicated birth, you may have to choose a method or philosophy before you choose a course. These courses usually take place over several weeks, meeting for a few hours each week. In addition to providing a thorough grounding in an unmedicated birthing method, these classes will also provide general birth education, including your options if an unmedicated birth becomes impossible for you.

  While the techniques and philosophies you will learn in these classes have similarities, each method is different; so it is important to do some research, and perhaps contact the instructors of the courses that interest you, to be sure you choose the class that best aligns with your goals.

  Some hospitals offer classes that focus on natural or unmedicated childbirth while others do not. Start by asking your health-care provider about the classes offered by your hospital. If it does not offer the type of class you’re looking for, chances are your provider will be able to refer you to a few local resources. If not, simply conduct an Internet search for a class that will prepare you for an unmedicated birth.

  baby care tip

  If you’re interested in having an unmedicated birth, along with asking your health-care provider about available classes, be sure to ask about hospital philosophy, policies, and statistics on unmedicated birthing. For example, if you want to have a water birth, be sure to find out if they have tubs available and the means to facilitate your goals and needs.