NEWBORN PARENTING: BREASTFEEDING, BABY POOP, AND OTHER ADVICE

One of my hot button issues is learning about things that “nobody ever told me about” with an eye towards developing a body of knowledge and sharing that with others.

Parenting offers the me opportunity to learn funfacts about newborn babies. After 30 days as a parent, I am starting to compile my findings. Below is a brief synthesis of things I have learned so far that I share with other friends who are first time parents. This is broken out into (1) Breastfeeding (2) Poops (3) Crying (4) Sleeping (5) Other Funfacts.

Please let me know if there are online resources or funfacts I should add to this article.

UPFRONT CAVEAT: The two veteran parents who reviewed this article for me BOTH reminded me that parenting is an art, so I would take everything you hear from other veteran parents with a grain of salt. Not all advice is good advice, and not all good advice applies to your PARTICULAR CHILD who may, for example, hate bottles or pacifiers or swaddles. To quote a friend of mine, “I love doing research and one thing I learned about parenting is that you will get a ton of different viewpoints, which leads to emotional debates (parenting is extremely emotional)…which leads to this…I’ve learned that parenting is not an exact science (although I contend some approaches are more effective then others)”

That said, there are some common advice and keywords that I found useful and that I wish people had told me, and that is what you will find below.

1. BREASTFEEDING –

• Just after birth, before the breast milk comes in, there is actually something called *Colostrum* that is super-nutritious and helps baby with immunity.
• Colostrum is super nutritious, a fact I learned when I googled colostrum and came up with a google image of a really muscular guy who drinks COW COLOSTRUM.
• The baby’s stomach is really small at first, like as big as a large marble, so you are basically giving your baby drips at first.
• The baby’s initial ferocious sucking/feeding is not solely to drink the colostrum, but it is also important as a signal stimulating mom’s brain to tell it to produce milk. There is a cool diagram out on the internet showing how sucking triggers hormones (oxytocin and prolactin) that lead to bonding and milk production. Some lactation consultants encourage new moms to pump above and beyond what baby needs, to stimulate milk production. The milk comes in at around day 3 to 5.
• kellymom.com is the layman’s go-to source for breastfeeding advice. I can’t say enough about kellymom. they have a facebook page that you should join. some topics to research on kellymom are:
  • adequate latch
  • how feeding frequency and volume change over time
  • cluster feeding (4 hours of fussy feeding AT ONE TIME!!!)
  • letdown
  • foremilk / hind milk
  • positioning (football hold versus cradling)
  • when to use a shield / syringe / feeding tube
  • strategies for using a breast pump to stimulate milk production
• There are other resources for breastfeeding, to include the following
  • Stanford University ABCs of Breastfeeding –> https://med.stanford.edu/newborns/professional-education/breastfeeding/abcs-of-breastfeeding.html 
  • Academy of Breastfeeding Medicine (protocols page)  http://www.bfmed.org/Resources/Protocols.aspx
  • Jack Newman — http://ibconline.ca/information-sheets/
  • Jack Newman videos — http://www.breastfeedinginc.ca/content.php?pagename=videos
  • La Leche League — http://www.lalecheleague.org/
• Every lactation consultant has different recommendations because breastfeeding is not an exact science; all babies are different and keep changing as they grow.
• Breastpumps are a great tool. Most health insurance plans will pay for one, but they might not pay for “the best” model. A lot of people try this free model before buying a “gold-plated” model.
• There is no shame in supplementing with formula, but once you start doing that, you might have to pump or else the breastmilk supply will dwindle as the body stops receiving the “signal” to produce milk.
• Getting help. There is no shortage of support for people who choose to breastfeed. Lactation consultants bend over backwards to have you call and text them at all hours of the day with ALL QUESTIONS (there are no dumb questions). Also, most veteran moms who breastfeed have lots of advice for new moms and are good for commiseration with the frustrations of baby refusing the boob.
• Feedings can be from 10 minutes to an hour depending on how lazy your baby is.
• You might have eight to 10 feedings per day. Some lactation consultants say to expect “12 feedings in 24 hours” which is not the same as “one feeding every 2 hours.” It might be every 2 hours in the day time and then once every 4 hours at night. What nobody tells you is that sometimes babies cluster feed, which just means that they might spend 3 to 5 hours feeding at one time. You should just pray that they do not cluster feed from 2 to 5 in the morning. Listen to your lactation consultant, but be aware that they might say something slightly different to different babies in different situations. AND YOUR BABY MIGHT BE DIFFERENT EVERY DAY!!!!!
• The point is to make sure the baby gets nutrition, stays hydrated, fills the diaper with poops and pees, and gains weight. (Also there is some bonding going on, so RELAX)

 

2. POOPS

• MECONIUM is baby’s initial poop, which is made in the womb. As the fetus drinks the amniotic fluid and sucks up the LANUGO (fetal body hair), VERNIX (something like in utero skin lotion) and excess cells, it congeals into meconium. The first poop is dark and tar-like.
• Transitional poops…
  • When your baby is feeding on colostrum, she will continue to have dark poops until the breast milk comes in… then it starts to lighten up. This middle state is called transitional poop.
  • The end goal for breastfed baby poops is “dijon mustard yellow with small blobs that look like seeds.”
  • Baby poop is soft and mushy… they do not create turds until they start to eat solid foods.
  • If the poop is green after being dijon yellow, you should talk to your lactation consultant or pediatrician. (This may be normal or it may be a serious medical issue)
  • Formula-fed babies do not have dijon poops; they do more “green pea soup” type poops.
• Poop and pee frequency
  • The 1-2-3 rule is that on the first day, baby should poop once, day 2 = twice, and day 3 = three times. The truth is that babies poop whenever they want. You should plan to track how many “Stools” (poops) and “Wet Diapers” (pees) baby makes and report this to all the doctors, nurses, pediatricians, and lactation consultants that will ask you multiple times a day in the hospital and at ped visits.
  • There are apps that will help you track poops and pees, as well as paper handouts. If you make your own paper tracker, you might want to track poops, pees, feeding time (and whether the feeding was on the left or right breast), sleeps, fussiness, and drugs administered.
• Parents of newborns spend a lot of time changing diapers, duh. But which diapers should you buy?
  • The hospital and most parents I talked to use PAMPERS SWADDLERS at least at first. They do not leak and they are available everywhere.
  • Diapers come in something like 6 sizes (N for newborn and then 1, 2, 3, 4, 5).
  • Typically you are in N size for the first 6 to 8 weeks (size N is for babies under 10 lbs, and size 1 is for babies between 8 and 14 lbs.)
  • Currently (2016) Newborn diapers cost about $0.25 per diaper. Size 5 cost about $0.45 per diaper.
  • My poop frequency estimate for a newborn is 12 diapers per day.
• Barrier cream (Aquaphor!) and BUTT PASTE is a thing. you don’t want your baby to get diaper rash. Some people swear by old fashioned Vaseline for everything from diaper rash to small cuts.

3. CRYING

• When babies are born, they are not being manipulative, they cry when they need something. It might be food, a diaper change, reassurance that someone is around.
• To calm your baby, use Harvey Karps’s  five S’s:
  • Shush
  • Sway
  • Swaddle
  • Side-lying position.
  • Suck
• There is a whole debate about pacifiers, but as long as your baby is able to feed correctly (google keyword: nipple confusion) most people have told me they think pacifiers/ soothies / “non-nutritive sucking” is an excellent way to soothe a baby (particularly after the first two weeks).
• Crying can be frustrating to a parent who is trying everything, but (as they said in my Dad Boot Camp) NEVER EVER shake a baby… it is better to let an inconsolable baby cry alone in their crib than have them aggravate you to the point of doing something dumb.

4. SLEEPING

• At first, parents should expect to feed baby every 2 to 4 hours. It makes sense for dad to change the diaper and mom to get ready to feed. That means nobody gets sleep.
• Somebody might have to hold baby for 30 to 60 minutes after a feeding, and that person is not necessarily the mom.
• Some good advice: SLEEP WHEN BABY IS SLEEPING. The caveat is that baby sleeps like 15 hours a day and you only need like 8 to 10.
• Take naps.
• Did I mention CLUSTER FEEDING. Train your baby to eat more in the day so that she sleeps at night.
• Babies like to be swaddled. Learn how to do a basic swaddle (see diagram below).
• Because you are sleep deprived, you are worse at decisions and so is the other parent. Be especially graceful to each other as you muddle through life and do irrational things.  (This is probably good advice for people who are not sleep deprived as well!)

5. OTHER NEWBORN PARENTING FUNFACTS

• When you are in the hospital, you are surrounded by experts. You should learn all you can from them by asking lots and lots of questions. They will teach you how to breastfeed, how to change a diaper, burping techniques, and other stuff you didn’t know that you didn’t know.
• It is normal to be terrified that something bad will happen to your baby. Babies are delicate, but surprisingly resilient.
• Baby breathing is weird. They go really fast and then they basically stop for five seconds. Did you know this? I didn’t. At first I was terrified, thought our baby was gasping for air. It is normal.
• Sudden Infant Death Syndrome (SIDS) is a thing, but it is not the same thing as suffocation. It is actually a mystery that nobody knows why it happens, but there are steps you can take to  reduce the probability that your infant will suddenly die (!!!)
  • Don’t sleep with them in your bed
  • Avoid drugs and alcohol
  • Don’t use pillows and blankets; instead, put them in warm pajamas (the rule of thumb is to have them wear ONE LAYER more of clothes than you would be comfortable in).
  • Put them on their back (not their front like your parents used to do)
  • I don’t need to list all the things, but just read the handout that every pediatrician gives you about how to avoid SIDS.
• It is easy to think that you have to be “doing something” every minute (changing, feeding, laundry, dishes, texting photos to friends and family, researching green poop on the internet, etc) but there is something to be said for just sitting there and enjoying the company of the child in your lap.
• Unless you have a degree in babies, you probably don’t know what you are doing. Apparently “not knowing” is normal and acceptable for new parents. 
• Because you probably don’t know what you are doing, there is NO SHAME in calling your pediatrician / Lactation consultant / veteran parent friend with your “DUMB” QUESTIONS, especially if there is something you are concerned about regarding your baby. How are you supposed to learn these things unless someone tells you?  Everyone already expects that you are an ignorant, scared, sleep deprived parent, so ask all your questions and they will be very understanding and give you good advice.

Please let me know is there is anything I need to add to this list of advice. I hope to provide it to my pregnant / expecting friends.