Didn’t the hospital nurses just make it look oh, so, easy, when they changed your newborn’s diaper in 10 seconds, burped him with ease, and made swaddling look like a walk in the park?
For many new mums, reality hits when they take their newborns home from the hospital. Indeed, life will never be the same again once you have a wailing little human being to care for.
To walk you through the essentials of surviving your first week at home with bubba, we spoke to Dr Wong Boh Boi, assistant director (clinical) and senior lactation consultant at Thomson ParentCraft Centre.
Do you see a lot of anxiety among parents taking their baby home for the first time?
Dr Wong: Yes, many first time parents are concerned and anxious more than anything. They actually know what to do, but they are frightened. They often just need someone to reassure them, have patience in what they are doing, and of course,s some new skills on caring for their baby. They need to learn these skills, but information from books and website is never the same as hands-on learning. Holding a brand new baby can be awfully frightening ― some parents hold their babies too tensely or rigidly, because they are afraid to drop the baby, so the baby feels uncomfortable.
What’s the right way to hold a newborn then?
Dr Wong: The most important thing is to be careful of the baby’s neck. Use the C-hold to support your baby under her neck with one hand, with the other hand under her buttocks. Gently swing the baby on the crook of the same arm as the hand under her buttocks – that’s the cradle hold. Swing the baby towards your waist, and that’s the football hold. Support your baby’s bum, then hoist her gently over your shoulder, and you have the upright hold. A baby carrier can be a good idea for mums, to give additional support.
Always ensure that your baby’s face is not in the mum’s cleavage to reduce the risk of suffocation. Holding the baby is more about confidence than anything else. If you have fear, the baby can sense it. After enough practice, your baby will get used to you holding her.
Why is it that some babies can sleep so well, but some just can’t?
Dr Wong: In general, newborns can sleep up to 16 hours. By 3 months, this number reduces to 14 hours and by 12 months, they may sleep just 12 hours. Some babies can’t sleep well for several reasons ― if they are hungry, bloated, or perhaps they are not comfortable in the environment and the temperature. Check if the clothes are too thick or too thin. If you have a good bedtime routine, like a good soak in the evening, it will help baby to relax and sleep better. Be flexible ― you don’t need to stick so strictly to the schedule – 10 or 15 minutes later won’t make much of a difference.
Some babies have sleep disorders but this is rare. Usually, babies don’t sleep well at night when their biological clock isn’t set yet ― so, she sleeps in the day but wakes up every hour during the night. What you can do is to make it noisier and brighter in the day, but darker and dimmer at night.
Holding the baby is more about confidence than anything else. If you have fear, the baby can sense it.
So, do you have any tips for better sleep?
Dr Wong: Research has shown that babies sleep deeper and longer when in their parents’ room. It also allows the parents more rest, particularly if you are fully breastfeeding ― you don’t have to keep going into the next room to pick baby up. Emotionally, your baby bonds better with you and this builds your relationship. Don’t let you baby sleep in the same bed with you, as this increases the risk of SIDs. Place the cot right next to your bed, where it’s easy for you to reach out to her. Make sure that the sheets are made of breathable cotton and there isn’t anything in the cot that can cover your baby’s face and cause suffocation.
As a bedtime routine, give your baby a quick soak in the evening before bed, a rub down and a massage. Feed her, then swaddle her for the night. Swaddling allows her to sleep much better because when babies are born they have the startle reflex, and they get a shock and wake from their sleep. Don’t feed the baby till the baby is asleep. If she falls asleep on the breast, but wakes up alone in her cot, she will be scared when she wakes suddenly. And make sure that your baby has been burped properly, so that she doesn’t feel gassy and can sleep comfortably.
It’s one thing for the baby to be able to sleep well, but what about the mum? How can she get enough rest in her first week?
Dr Wong: If you baby sleeps well, you’ll likely be able to sleep well, too. But it’s not always up to the baby. Sometimes, mums make it hard for themselves to sleep: If you don’t bathe or wash your hair, you drink wines and tonic that makes you break out in rash, binding your tummy to the extent that you get hives, there’s no way you’ll be able to sleep.
I recommend mums to take a nice warm shower three days after giving birth, and shampoo and blow-dry your hair. Wear comfortable clothes, and be comfortable ― even in an air-conditioned room, if you need it. Don’t overeat ― make sure you have your fruits and veggies, so you don’t get constipated. Don’t worry too much about your baby, you’ll be able to hear her if she is sleeping in the cot next to you. You don’t need a baby monitor, or to leave your baby with the nanny in the next room ― if you let the baby sleep with the nanny, you will be in trouble when she leaves because your baby won’t be used to sleeping with you.
Is there a right or wrong technique when it comes to changing your baby’s diaper?
Dr Wong: You need to ensure there’s no infection, so, use the right technique ― wipe front to back. And never hoist your baby’s legs up too high ― if you overdo it, your baby may injure her back, or vomit if she has just drunk milk. You don’t have to use cotton wool and water to wipe your baby’s bum ― this was a practice in the past when parents didn’t have the option to use baby wipes. These days, wipes are gentle and biodegradable, which makes things easier for the parents. I’ve seen parents who clean a baby’s bum with cotton wool, and after cleaning once, they dip their fingers back into the water and clean again – that’s how infection happens.
If your baby gets a diaper rash, it’s important to air their buttocks and change the diapers frequently ― don’t let their skin soak in wet diapers for too long. If the rash is bad, you can use a little diaper rash cream. Also, if you don’t use the diapers properly, the frills can cause irritation to your baby’s skin.
When can you start cutting your baby’s nails?
Dr Wong: Fingernails should be cut from six weeks onwards. Before that, your baby will be wearing mittens, so you don’t have to cut her nails. Never file her nails because the nail bed is quite weak, and the nails are very soft. Cut her nails after six weeks, because she should remove the mittens by then, so she can practise using their hands and fingers.
Click through for tips on what to do when your baby can’t stop crying!
What do mums have to know about feeding their baby?
Dr Wong: It’s the mum’s choice whether to breastfeed or bottle-feed. If bottle-feeding, you need to know about sterilising and cleaning the bottles, and it’s a good idea to check up on your family’s history of allergies. Read up about the different types of formula ― hypoallergenic formula might be more suited for your baby.
For total breastfeeding, it’s important that you start skin-to-skin early to get the milk production going. Whether you’re using the bottle or breast, you need to burp the baby. You need to check the flow of milk, especially if your baby is choking on milk, or her own saliva.
To know whether your baby is drinking enough ― monitor the number of wet diapers she has. I’d say a 1-day-old will pee at least once a day, a 2-day-old will pee twice a day, a 3-day-old will pee three times a day and from 4 days onwards, she will pee six to nine times. The poop colour also changes. Your baby’s fontanelle and whether her lips are dry are also indications of whether your baby is dehydrated. Sleep alone will not tell you if your baby has drunk enough. She may be too hungry and too tired, and so goes into deep sleep to preserve her energy. If you are fully breastfeeding, it’s also good to be aware about how to use syringes, cups and other nursing systems. If you baby is not getting enough milk, he may get breastfeeding jaundice.
So, what happens if you think your milk supply is low?
Dr Wong: New mums may face problems including sore nipples due to a poor latch. Breastfeeding mums need to learn to give the baby a deep latch. Watch to see if your baby is swallowing well, and check to see if your baby is emptying the breast. If they can’t remove the milk, you can get breast engorgement. Go to a lactation consultant for help if you have problems.
What tips do you have for parents when it comes to bathing their new born?
Dr Wong: Bathing is a great way to help your baby relax, and a good way for parents to bond with your baby. One thing many parents don’t realise is how crucial the temperature of the water is. It has to be the same temperature of the womb ― 37 deg C ― because that’s the temperature they had been soaking in for almost 40 weeks. Anything below 36 deg C or over 38 deg C will make your baby scream and scream. Get a bath thermometer to determine the exact temperature. Your hands, or elbows won’t do.
The amount of water is important too. Your baby should be in water up to the neck level. You don’t need to rub too hard, and just put one drop of non-rinse bath solution into the water. You can place a small towel on the baby’s tummy to give him a sense of security.
You don’t need a fancy tub with a sling support or contours – just a flat base will do. Do a proper bath in the morning and a soak at night. Your baby should be bathed from the day he is born as we are in Singapore and it’s hot!
The most common cry is because of gas ― the cry is short and shrill, her legs can be drawn up and her stomach is bloated.
Some mums find that their newborns keep crying. Is this normal?
Dr Wong: Absolutely! It’s their way of communicating. Crying three hours a day is normal. If your baby has colic, you can expect even nine hours of crying. It can be quite scary for new parents. Your response to her cries is important. Your touch, the way you carry her, means a lot to her.
Understand the different types of crying – it could mean different things. Hunger cries can be loud, sudden and urgent, and your baby will be rooting, looking for food. The most common cry is because of gas ― the cry is short and shrill, her legs can be drawn up and her stomach is bloated. Other reasons can include loneliness, like they want to be talked to, or carried. If you don’t respond, they will scream louder. They may also cry when they are over-excited or over-stimulated. Try different ways to solve the problem. Take your baby to different spots in your home, or use white noise. Let her go into the stroller, move her around in it in the house, for instance, or rub her tummy. The crying will decrease after 6 months.
Could the crying be a sign of something more serious, like reflux?
Dr Wong: Reflux may be why your baby is crying a lot. But a lot of it has to do with handling the baby wrongly. Your baby’s sphincter may not be properly developed yet, so if you burp the baby in the wrong direction, lift her legs too high while changing the diaper, or bounce around too much while carrying her, she will throw up. If your baby really has reflux ― when she screams every time she is fed, and vomits soon after, the only way is to thicken the milk. After she is fed, raise her head for 30 minutes to let the milk settle. It’s a good idea to bring her to see the doctor.
Is it important to do a “confinement”?
Dr Wong: “Confinement” basically means that you have to rest. In particular, if you have a wound, like a C-section wound or a perineum tear, you need to make sure you don’t take foods that are too heavy, like tonics. Take light, nourishing foods with a lot of fluids, especially if you are breastfeeding. You are still bleeding (lochia), so you need a lot of rest.
After three or four weeks, you can start to take richer food that will “warm” you up and build up your strength. She can also take galactagogues, foods that increase breastmilk production. Without having to bind your tummy, or do anything else, your womb will naturally shrink down to its original size ― this will take around six weeks. While breastfeeding, your uterus contracts more ― plus, you lose 500 calories a day!
Is there anything else that new mums should watch out for?
Post-natal depression is always a hidden condition. You can sometimes see signs of it, even during the prenatal period. I’ve seen mums who never had much family support ― that could be a cause. It can also occur because of sudden, unwanted pregnancies, family unhappiness, or a previous history of depression. Hormones also play a part, too.
Some mothers also have very high expectations of themselves as mums. And when their expectations aren’t met, they get upset. Husbands should look out for signs like crying a lot, and self-blaming ― when the mum thinks she is not good enough for the baby. The mum may even blame the husband. In a very bad case, the mum can reject the baby. The mum needs an understanding family, and she should seek help. Get to the root of the cause and you’ll be able to get through it.
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