Sample Childbirth Class #5

 Breastfeeding Secrets, Baby/Mama Care after birth, infant CPR

Baby and mama massage

 

Breastfeeding : Dr. Jack Newman breastfeeding tips.  Bing.com/videos                                           

            Is she/he getting enough milk?

            Creating good sleep patterns…. Getting a good sleep period!

            Crying, what does it mean?

            Latch

                                 

                             Mama care

                                       Bleeding – how much is too much?

                                        My milk is coming in…. suggestions for engorgement and care of breasts

                                       Warning signs

                                        Postpartum Plan Work sheet

 

           Baby Massage  -  Lavender oil  1 drop to tablespoon of oil

                                        Use after bath for relaxation ready to sleep routine

                                        Use in I L U pattern on tummy for colic or gas bubbles

                                         Cradle cap remedy

 

After the Baby Comes

Common Questions about Taking Care of Your Newborn:

            Having a baby outside of a hospital setting is a very special way to give birth.  In addition, comes the added responsibility of assessing your newborn for emerging medical problems, including infections. 

We recommend that you take your new baby in to be seem by a physician.  Our newborn exams are very basic.  We suggest that you make an appointment as soon as possible with the doctor of your choice.

 

 Here are instructions for helping you keep tabs on your baby in the first few days:

            Temperature:  Taken under the arm is fine.  Ranges from 97.7 to 98.6 are within normal.  If baby is on the cooler side, warm them up by adding layers of clothing and holding them close to your skin.  If baby is hot take off layers of clothing.  Baby should have on the same layer of clothing you do, with the addition of one layer.  (If you have on jeans and a shirt, baby should have on a tee shirt and one-piece.  OR Jamies and thin blanket.

            How often should I take my baby’s temperature?  Unless there is a reason to believe that your baby has an elevated temperature or is too cold, taking your baby’s temperature in the first few days can be done 3 times a day.  If there is a problem, recording the temperatures on a piece of paper may be helpful for your care provider, should you seek help.

           

How much breastfeeding is enough?  – Baby should eat every 2 hours, with a longer stretch at night, if he will sleep.  If baby is very small, then every 2 hours is important to maintain baby’s weight.  Larger babies may be hungrier and feel like sucking a lot.  Use of a pacifier to keep them happy may be necessary if you are going to get any sleep. Larger babies also have more of an appetite, so their feeding needs may be larger and harder to satisfy until your milk comes in.

            Fussy babies:  Sometimes babies swallow air along with crying, feeding or sucking on a pacifier.  Rocking baby in a chair, holding baby upright and patting back, standing and jiggling baby up and down while lying against your chest, are all good ways to help baby bring up air that is trapped inside.

           

Sleeping?  How much should baby sleep?  Baby will sleep for longer stretching the first few days, and then settle into a routine of sleep/ awake/ semi-sleep/.  The important issue is that momma learns to sleep and rest while baby is sleeping. 

           

Can I spoil my baby by holding them too much?  Newborns are helpless, and need our assistance for everything.  Holding, comforting when crying, and meeting their needs will not spoil them for the future.  In fact, newborns need to be reassured that their needs will be met, to associate trust with their mommy and daddy. 

            What to look for if my baby is sick: Rate of breathing:  One of the first signs that a baby is coming down with an infection is an increased rate of breathing.  Normally a baby will take 30 to 60 breaths a minute.  Breathing rates above 75 while baby is resting is a warning sign.  Please call your midwife.

                        Behavior:  Baby should be alert / alternating with sleeping and feeing.  An overly sleepy  baby – one that is lethargic,  that is having a higher respiration rate, is not feeling well.  Please call a care provider immediately.

                        Color:  Baby should maintain a healthy pink coloring (even bright pink or red).  If baby is pale or seems paler than the day before, along with above signs, contact your midwife.

                        Muscle tone:  Babies that are healthy have mostly a flexed muscle tone, with arms up against chest and movement with hands that is almost constant, unless sleepy or sleeping.  If a baby’s arms are floppy and hang down away from chest or they don’t seem to be “collected” while awake, then this may be a warning sign.

                        Eating:  Baby should be interested in eating after 2 – 3 hours.  If he is hard to wake up or deviates from his normal eating pattern, he may be hungrier, but usually not less hungry… unless you have a ton of milk and he is over-stuffed and it has only been a little while since you fed him.  Still, his tummy is only the size of his/her fist and empties after 2 – 3 hours.

                        Temperature:  Baby needs to be able to maintain their temperature after birth.  While they were inside us, we kept them warm.  Now they have to generate their own heat.  A baby who has a temperature over 98.6 under that arm has a temperature and we should look for obvious reasons.  Is baby dressed too warmly, is it hot in the room?  If not, baby may have a temperature and it can be a sign that something is wrong.  Please call your midwife or have baby seen by a physician.

           

 What should my baby’s poop look like?  A baby’s first poop is a blackish, greenish sticky substance called meconium.  Your baby will have several large poops the first few days.  Within the first few hours after a baby is born, it is a good idea to spread a thin layer of diaper cream or Vaseline all over diaper area to help get the meconium cleaned up from the skin easily.

           

How many wet diapers should my baby have?  Baby should urinate within the first 24 hours.  Over the first few days, look for several wet diapers, as soon as your milk comes in.  Baby should have 6 or more wet / poopy diapers a day.

             Who can hold my baby?  As far as family members, deciding who holds baby should be based on ability to support baby’s neck and who is not sick.  If Aunt Sue comes to visit and has a cold, politely choose to nurse your baby until she leaves, or honestly share with her that you are looking forward to having you hold baby when she is feeling better.   

            If is very natural for moms to feel very emotional and protective about who holds their baby.  This is normal and should be respected. When baby gets older and mom is feeling better, may be a better time to let others old baby that may be itching to coo and caress a newborn that they already love!

Taking Care of Mom

******DAD–If you have insurance, please contact your HR Department about adding your new baby to your insurance policy. This needs to be done this week.

 

            Temperature:  Taking your temperature in the first few days makes good sense.  If mom is coming down with an infection, taking proactive action can not only save her life, but make the next few weeks much more enjoyable with her new baby.

            Look for temperatures staying around 98.6 (97.6 under the arm).  A slight rise in temp may be normal with the few hours after birth, but should return to normal within 24 hours. A slightly elevated temperature, along with a flu-like feeling, may be a sign of oncoming infection.  Please seek medical care.

            Any temperature over 100.0 should be look at as a sign of possible problems coming on.

             Bowel movement – sometimes after the birth of a baby, poop can become impacted in the rectum.  If you are finding yourself constipated, drink more water, take a one-time, light laxative, or eat those foods that cause you to be looser.  Sometimes that first poop after a baby is born is fairly firm and you may need to gently assist in its removal. As the bowel movement descends out, support around your anus with a warm washcloth to avoid further damage if you have hemorrhoids from the birth.

             Urinating– The passing of the baby through the birth canal can cause a temporary nerve damage to the ureter.  Patience and diligence on sitting on the toilet brings good results.  Some tricks are:  using peppermint oil to smell, close bathroom door and turn out the light, warm water over the urethra as you are attempting to pee, sitting in a sitz bath with warm water, standing to pee over the toilet, using a rolled up towel while you are nursing.  Retained urine can cause bladder infections and promote bleeding from your uterus.  A distended bladder is painful to the touch.  If you are trying to go pee and the urge is stong, yet you cannot get any out, call your midwife to consult.

             Breast care:  Within 48 hours after birth, most women experience a big difference in breast size as their milk comes in. You may have a slight fever and tender breasts.  Your baby will be acting very content!  But you may be feeling pretty full.  The more your baby eats, the more milk you make.  So, be careful about how much milk you express to relieve the pressure.  Using a warm wash cloth or the shower, hand express  just enough to make your breasts less painful.  Nurse as often as baby wishes, within reason.

            It is very important to nurse correctly.  There are some great resources about how to nurse so that you can avoid nipple soreness.  The biggest secret is to make sure baby is lying tummy to tummy with you, if you are using the Madonna hold for nursing.  Make sure your baby gets a huge mouthful of nipple, with the nipple reaching way into baby’s mouth.

            If your breasts feel sorer than you are comfortable with, call your midwife to talk about what you are feeling.  Some women become engorged or even get mastitis (a very painful infection) and need more help than normal.  Rest with your baby.  One of the signs that you are doing too much, will be that your breasts become engorged or feel very tender. 

             If you are experiencing trouble with breastfeeding in anyway, our LLL leader for Libby, MT is Linda Lee.  She is very willing to help.  We encourage you to call her and have her come to your home for a visit.

            Dr. Jack Newman is one of most informative and reliable breastfeeding resources.  He has an outstanding DVD on the secret to good feeding… latch.    www.breastfeedingonline.com is his web site.  www.drjacknewman.com  is also another really good site.

             Pain – After pains are normal, and can increase after each baby.  Taking Tylenol or Motrin or your customary pain alalgesic can be helpful in the first few days.  However, care needs to be taken that other warning signs are not masked in an attempt to stay pain free.  After pains lasting more than a week after baby is born can be sign more is going on than normal.  Please contact your midwife if you are concerned at any time about pain and its location.

             Pain from tears or stitches. – Use of an ice pack can reduce swelling and may help you heal quicker.  Carefully rinse area with a peri-bottle with warm water when using the bathroom.

             Bleeding –   How much is normal?  After your baby is born and the placenta delivers, your bleeding should decrease by a whole bunch.  If you feel you are bleeding like you were when the baby was born, please call your midwife immediately.  Your uterus feels like a round ball inside your abdomen and should be kept firm at all times, as you remember.  Self-checking can help you recover fast and bleed less.  If you are having a hard time finding your uterus, lay on your back and rub deeply and firmly until you feel a hard ball.  Your uterus should descend in size and be lower and lower in your abdomen within the first week after baby is born.

At first your bleeding will be bright red and normal or slightly heavier than a period for you.  If you are filling a heavy pad within an hour, please call your midwife.  If you are bleeding non-stop, even just a trickle, please go to the emergency room for help.  You may be hemorrhaging.

After a few days, your bleeding will become lighter and pinker in color, with more mucus.

Within a week, your bleeding should become more brown and then lighter and lighter, until it becomes a creamy white with occasional brown or slight pink coloring.

Bleeding after you stopped, is a sign that you are over doing your activity.

 

How much should I lift?       Lifting no more than your baby is a good idea for the first 10 days….definitely not your toddler.  Sit in a chair and cuddle with your bigger babies.  That’s what they want anyway!

 Resting – Getting sleep is going to be tricky the first few days.  The secret is to sleep when your baby is sleeping.  You should plan on having help for the first week to 10 days so that you can adjust to breastfeeding and a new schedule with a new one in your household.  Accept offers of help as gestures of love and enjoy your baby.  You care for the baby and let others do the housework and cooking.

Use your body as a guide as to how much you can do.  Are you bleeding more, are your breasts sore, are you running out of milk at the end of the day?  Be honest with yourself and be in tune with how you are doing.  Reduce activity.  Go to bed with your baby.  Hire someone you trust to care for baby and children so you can get a nap, if Daddy is not home.  Rest is the secret to happy mothers.

Am I eating too much?  While nursing, most moms experience a big shift in appetite.  You need to be eating around 3,000 calories a day to maintain milk supply.  Now is not the time to diet.  If you have questions about your diet, your midwife and help you assess your needs.  Nursing takes more calories than pregnancy for many people. 3,000 calories is not too much.  Steady nursing also takes off added pregnancy pounds.  Major on fresh, quality vegetables, a good portion of meat and dairy products.  Stay away from white sugars, white flours, partially hydrogenated fats, high fructose corn syrup and other highly processed foods.  Be good to your body and it will reward you with plenty of milk and energy for being a mom.

 

Here are some postpartum warning signs that you need to remember:

 Call the Midwife if you have any of these  in first month after birth:

  Passage of a blood clot larger than a lemon.

  Heavy bleeding: soaks a maxi pad in an hour.

  Fever of 100.4 or higher.

  Problems with urination: Burning, or blood in urine, inability to urinate.

  Very foul or fish-like odor to vaginal discharge.

  Increased pain at site of episiotomy or tear.

  Swollen, red, hot, painful area on the leg, especially the calf.

  Sore, reddened, hot, painful area on breast, along with fever or flu-like symptoms.

  Postpartum Emotional Concerns

 

Postpartum Plan

        A postpartum plan is much like a birth plan.  It assists you in determining and planning for a smooth transition adjusting to you new family dynamics in the first few weeks.  Keep in mind, flexibility is key when considering all the potential conditions and “personalities” that are unknown.

       The most important element is the “babymoon” phase.  This is a special time that you will experience only once with this baby.  It is during this time that good nursing habits are established, and emotional bonding takes place on a greater level.  Make it count for you and your family – all else that was there, needs to be reconsidered at a later time.  Honor this time as your special God-given opportunity to welcome your baby.

 

Sleep and Rest

Normal pre-pregnancy sleep requirements (# of hours per night) __________________

Who will get up with the baby at night? _____________________________________

 

Physical Recovery

What is important to you when determining how you expect to physically recover from the birth? (self-care, exercise, weight, etc.)_____________________________________________________________________

 

______________________________________________________________________________________

 

Exercise plan after six weeks will be ____________________________________________________________

 

Breastfeeding / Infant Feeding

Anticipated method of feeding _____________________________________________________________

 

My expectations for feeding the baby are (check one)  ____________on cue   ________scheduled

 

I feel this way because: ____________________________________________________________________

We will have a feeding / elimination chart    Y  /  N  

 

Nourishment for immediately after baby is born:

We plan to  (check all that apply)

_________  Have meals planned ahead of time and stored in the freezer

_________ Prepare meals day-to-day ourselves

_________ Prepare meals day-to-day with help

_________ Order-in ______times a week

 

 Nourishment for 6 weeks after baby is born:

We plan to  (check all that apply)

________  Bring in outside help to cook

________  Prepare meals ourselves

 

Caring for baby

We plan to:

 

_____   Have help for a professional doula, so that we can spend our time with the new baby and silblings (if any)

_____   Have help from family, so that we can spend our time with the new baby and siblings (if any).

______   Hire a nanny to look after the baby and siblings

______   Care for the baby and siblings ourselves and manage the house – we do not expect any outside help.

Sleeping Arrangements

______   We plan to co-sleep

______   We plan to have the baby in the same room in a cradle / bassinet beside us

______    We plan to have the baby sleep in his/her room

 

Redefining Roles

Who will do the caring for the baby during the day?_______________________________________________

Who will do the caring for siblings _____________________________________________________________

Who will do the cleaning _____________________________________________________________________

Who will do the cooking _____________________________________________________________________

Who will do the laundry _____________________________________________________________________

Who will be at home ________________________________________________________________________

Who will do the shopping ____________________________________________________________________

Who will run errands ________________________________________________________________________

Who will transport the siblings to various places ___________________________________________________

 

As the mother I will expect my partner’s role to be _________________________________________________

 

 

As the partner, I will expect the mother’s role to be __________________________________________________

  Relationships

It is important to our relationship that we: _________________________________________________________

  Siblings

It is important to maintain ______________________________________________________________________

 Pets

It is important to maintain ______________________________________________________________________

 Family & Friends

Who is going to be involved in your support over the postpartum period?

  Visitors

We expect to have ___visitors the first week.

We expect to have _____visitors in the second week.       

 

The most important thing to remember from birth mom’s perspective:

 

 

The most important things to remember from birth dad’s view point:

 

 Other Special Details To Remember: ___________________________________________________________________

 ______________________________________________________________________________________________