Archive for June, 2010
It didn’t take me long to draw this parallel. Raising a baby is a lot like working in tech support.
Our job is to be on call at all hours of the day for assistance should it be called for. It doesn’t matter what the request is, the customer is always right. We can ignore requests, but at our peril, because complaints will only get louder with time. At best, the mood of the customer is placid, at worst irate. There’s really no getting showered with compliments.
This is what makes being a parent so tough in the beginning. It’s the most taxing breed of customer support. The only feedback mechanism, at least for now, is negative. If Joshua is unhappy he lets fly with a fairly heart-rending wail. If he’s happy, he just sits there. Or he sleeps. There’s no cooing and smiling and snuggling. Janelle and I have no positive reinforcement outside of our own self-satisfaction and the encouragements of friends and family.
The cry of a newborn has been engineered through many, many years of evolution to cause distress in a parent. If hearing your baby cry seems to sting particularly well, it’s because it’s supposed to. Maybe it frustrates you (as it does me), maybe it calls forth all your fears about parental failure (as it does Janelle). However it affects you, that is the intent. You are meant to sit up, take notice and feel compelled to resolve the scenario.
Making matters worse is that there may not be much you can do to resolve the scenario. It takes practice and exposure to become immune (or at least (inured) to the crying. It was about two weeks before I could listen to his crying with a bit of detachment. At first every time he cried at night and I couldn’t calm him I couldn’t avoid the feeling that all I was doing was failing consistently. I’m not a savant, but I am not accustomed to trying very hard at something for days on end and never being able to improve. Now, though, I can sit and type this blog post while he cries in Janelle’s arm and be okay with the fact that he’s crying because what else can he do?
Our options are limited — we can feed him, rock him, try and put him to sleep, walk with him, and that’s about it. His options are limited — he can cry, he can sleep, he can eat, he can go the bathroom. That’s about it.
This is the period of child-rearing that is conveniently absent from the collective memory. It may be for the best, as if everyone was walking around discussing how hard the first couple months of raising a child can be, perhaps there would be less children. But my motivation behind pushing this issue is less to dissuade anyone and more to head off the very dangerous notion that you are failing as a parent if your child is not content at all times.
You’re in tech support. And tech support is always its own reward. Your satisfaction must be that you’re doing the best you can in the face of a screaming mob. Try and stay tough, because before too long, your screaming mob will soon become an adoring public and then you graduate from tech support into the role of rock star.
Raising an infant is hard work. The books you read will not tell you this. They will tell you how to solve problems, but they somehow manage to skirt around the fact that it’s not just the problems that are difficult. Everything is difficult. Judging how Joshua is now and how long I know it will take him to shed some of his pesky reflexive infant responses and gain actual control of his motor functions, it will be difficult for about 6-8 weeks. In the grand scheme of things, that’s not much time. But when you’re working 24-hour days, minimal sleep and staring down starting back up with real world things like jobs and errands and chores it may as well be several millenia.
It’s a tribute to how rewarding children become that no parents seem to remember how hard the start of things is for very long. I don’t want to scare anyone away from the idea of kids, but I also don’t like the notion of seeing people get blindsided. So, here’s a look at some of the hard numbers with raising a newborn.
Assuming your baby is getting a good amount of food and is processing it well, you’ll be changing a lot of diapers. Formula-fed babies less so, but with a breastfed baby, you can expect to be changing from 6 to 12 diapers every day. Joshua runs a pretty steady 8-10 every day. Changing a diaper is not a complex process, but it is hazardous. Moreso with boys. Babies will pick very inopportune times to relieve themselves. With Joshua, it tends to be when I’m picking his legs up to clean his bottom. This gets him in perfect position to pee directly into his own face. He has done this three times in as many weeks. To fix this issue, I’ve perfected a hold that gets fingers around each of his feet while I lift him and another that tangles a washcloth up and keeps in place so that when I lift him, if he pees, he pees into the cloth that can no longer slip out of the way. It’s a good thing I’ve learned this hold, else he’d have peed on himself 5 or 6 more times.
Babies also have a hard time figuring out where to focus when they’re pooping. Well, nothing like a jolt from a cold baby wipe on your bum to remind you that that’s where the magic happens. It’s pretty common that wiping your baby clean will be just what prompts your baby to have to go again. Since things with breastfed babies tend to be pretty runny, you’ll want to make sure to clear the blast radius. You can expect distances of 6-8 inches if your child is ambitious. My face managed to not escape the spatter zone once. I know better than to kneel in front of him while changing, even if I am tired.
Lastly, babies don’t like to be cold. Everyone has this image of babies that love to be naked and love bathtime and other such nudist activities. Well, newborns don’t really regulate temperature well, and they like it warm. Removing clothes upsets that delicate balance. Chances are your baby will be very angry when it’s diaper time. This will involve kicking and flailing and crooked limbs and general unpleasantness. This does not speed up the process.
All told, with the warm up (prepping your materials – have your new diaper open, your wipes ready, your washcloth and ointments at the ready), the undressing, the change and clean-up, the new diaper and the redressing a diaper change is a minimum 5 minute affair. Things get complex or messy and you could be seeing 10 minutes. We’ll split the difference and assume 7 minutes. So, 7 minutes and an assumed 10 diapers a day (wet diapers and messy diapers alike), that means you’re changing diapers for 70 minutes every day. Just diapers.
This one is super variable. It depends a lot on your baby and how well he feeds. Joshua is a sleepy snacker. He starts out eating vigorously for about 5-10 minutes and then dozes off. Then he sucks on and off as we poke at him. Until we had him weighed at the lactation consultant’s office (they weigh the baby before he feeds and then again right after to see how many ounces of milk he’s been taking in), we had no idea if he was getting enough milk when he would feed. So, since he would sleep so much, we’d keep him on a long time. This mean our feedings lasted 40-60 minutes. Remember the time between feedings is measured from the start of the feed. We’ve found that Joshua lasts between 3 and 4 hours between feedings before he gets fussy.
With that kind of spacing, that’s roughly 7 feedings each day. At the outside then, that meant that Janelle would spend 7 hours in a 24-hour period feeding Joshua. 35-hours a week is, in most surveys I’ve ever seen, enough to qualify for full-time employment. 7 hours. Just let that soak in. That’s a lot of time.
But, as I said, very variable. Now that we know Joshua is eating well, and we have some more tricks we try with him, we’re down to shorter feedings. Shorter still means about 30 minutes of feeding, which is still 3.5 hours every day, and that’s if everything goes well, or if he doesn’t get hungrier more than normal.
It’s not expected that a baby will sleep through the night until they weigh around 12 or 13 pounds. It’s at this point the baby’s stomach is presumed large enough to hold enough milk to allow them to not feel hungry in the middle of the night. Babies average in at 7.5 pounds at birth, and doctor’s hope to see them gaining an ounce a day in weight. 16 ounces to a pound. That means you’re looking at about 72 days until your baby is likely to sleep through the night. At just under 21 days, we have a long damn way to go.
Even allowing Joshua to set his feeding schedule at night, he’s never gone more than 5 hours between feedings, which means the most sleep we’ve been able to get in a solid chunk since he was born is about 3.5 hours. But wait, you ask, if feeding took you at the most 60 minutes, why didn’t you get 4 hours of sleep? Ah yes. You assume that your baby has a regular person brain and wants to sleep when he is tired. Watch now as I laugh at you.
The great dilemma of the infant is that when a baby becomes overtired, as in: so tired they are upset about it, they will actually be unable to sleep. Yup. So tired you can’t sleep. Ahhh babies. Your best bet at this point is that they get so angry that they exhaust themselves and just plain give up.
That’s the worst case. Even in the best case, though, putting a baby down is hit or miss. Sometimes we put Joshua down immediately and he goes right to sleep. Sometimes this is because he is already asleep, but sometimes he’s just peaceful enough to lie awake and then soothe himself into dreamland. More often, though, I will rock him about for 5 minutes or so until he seems drowsy, then I will place him in the crib. I will hover there for a couple minutes, keeping a hand on him to reassure him and shushing lightly in his ear. Then I’ll wait for 3 or 4 minutes to see if he’s happy lying down. Then I’ll head back to my bedroom and read a book for a couple minutes and listen to make sure he’s still okay before I get into bed. Then I get into bed and look at the ceiling for a bit. Then I close my eyes. Then he starts to cry.
So, be prepared to spend as much as 90 minutes a night trying to get your baby to sleep and only around 4 reliable hours of sleep a night yourself.
You have been warned.
Breastmilk vs. Formula
When doing research about raising a baby, you’ll find a lot of equivocation surrounding many controversial topics. The books tend to tread lightly so as not to seem too polarizing and thereby limit their audience. A chief area where you’ll hear a lot of back and forth is the debate between breastfeeding and formula feeding. I’ll break it down square for you.
Breastmilk is without question the better choice for your baby. It is not, however, the most convenient choice and nor is it a choice that every woman will be capable of choosing due to various physiological reasons.
Formula has made many strides over the years, but there are vast quantities of helpful agents that are present in breastmilk that simply cannot be synthesized with modern medicine. Rather than break down all the particulars, I’ll give a quick anecdotal illustration. Breastmilk produces antibodies to fight illness. Let’s say Dad goes out to the store to pick something up and manages to have a flu bug latch onto him while he’s out. He comes home, the baby is exposed. When the baby nurses with Mom, she is also exposed. Since breastmilk is just this side shy of magic, when the mother is exposed to this flu bug, her breastmilk will begin to fill with antibodies to that illness, which are then passed onto the child while nursing. There’s a good reason why breastfed babies don’t get sick nearly as often as formula fed babies.
When the question of “What is best for the baby?” is in play, the answer is always breastmilk. But breastmilk sometimes just isn’t possible. Some babies can be allergic (a very small percentage), some mothers don’t produce enough milk for a baby to gain weight properly, some mothers have nipples shaped in such a way to make breastfeeding impossible. In many of these cases, using a breastbump to express milk and then bottlefeeding is usually a fairly simple solution (which also has the benefit of shifting some work over to Dad). The only issue with the pump is that it simply isn’t as effective at maintaining a mother’s milk supply as a nursing baby.
So, while formula is far from a bad choice, it’s just not the best choice. Is it wrong to choose formula over breastmilk? No. It’s just not the best choice.
That being said, I’ll really only be speaking to breastfeeding, as that’s my area of exposure.
The Useful Facts
Janelle and I had a hell of a time getting consistent info regarding breastfeeding. Here’s the info you need:
In situations where babies may not be gaining weight as easily as hoped, babies should be fed every 2-3 hours. You measure intervals between feedings from the start of one feeding to the start of the next (rather than end of one to start of the next).
Once a baby is confirmed to be gaining properly (usually this is determined to be once they have gained back their birth weight, or close to it), it is safe to allow the baby to sleep until they are hungry. However, it is still a good idea to feed every 2-3 hours during the day to ensure that the baby sleeps longer at night. Even allowing your baby to sleep at night, though, don’t expect more than 5 hours between feedings for a couple months.
Do not introduce bottles or pacifiers earlier than 6 weeks, to prevent nipple confusion. If a baby learns to prefer the firmness of an artificial nipple, or the ease of feeding through a bottle, he will begin to turn away from the breast.
Do not wait longer than 3 months to introduce a pacifier or a bottle. At that point the baby will fight taking those items.
Babies have growth spurts around 2 week and around 5-6 weeks. During these times your baby will likely be hungrier than normal. Feel free to feed more regularly as well.
Every time a baby cries, it doesn’t mean he’s hungry. If your baby is crying and turning his head and opening and closing his mouth like he’s searching for a breast, he’s hungry. If he’s not crying, but is sitting around opening and closing his mouth and smacking his lips, that’s your first sign he’s hungry.
There’s no real problem feeding a baby before they exhibit signs of hunger… but don’t feed them too often. Feeding every hour (as a rule, not during a growth spurt, where this may be needed), may train your baby to eat in small, snacky doses. This is bad due to the composition of breastmilk. There is foremilk and hindmilk. The hindmilk is what holds most of the calories your baby needs to grow, and he will only reach this with longer feedings.
If your baby sleeps during feedings, it’s not a big deal, and doesn’t mean that he’s not getting milk. He may be an efficient feeder. Imagine if you ate real fast and then had someone snuggle you up all warm and cozy. It’d be nap time for you, too. However, to ensure that you baby isn’t dozing too quickly, the easiest way to keep him active as a feeder is to lift his arm. If he looks asleep, but upon moving his arm around you feel some muscle resistance, he’s still awake and the disturbance will likely prompt him to begin eating again. If you move his arm and just get no resistance at all, you have a sleeping baby. At that point you may want to try switching breasts, or (PROTIP) use this sleepy time to change his diaper. You may be able to get in a fuss-free changing and then get him back on the breast just as he’s waking up for some reinvigorated feeding.
It’s important to note that poop from a baby on breastmilk matches many of the descriptions books will give you of diarrhea. Baby poop from a breastfeeding baby will be green, yellow or sort of mustard-orange and will seem to have little sort of pellets in it. This is actually milk curd. It will be fairly runny. Diarrhea will likely just be a more liquid form of the same. But again, with a breastfed baby, chances of diarrhea are low.
The perception of breastfeeding is that’s something strictly for the mother. Bonding time that she has alone in a quiet, dark room with her baby while the father does something else in the other room. Well, believe me when I say that this sounds much more exclusionary before having a baby than after. Afterwards, you may relish the notion of some downtime. But I digress…
Breastfeeding certainly does not need to be a female-only affair, and at the start probably should not be. Breastfeeding is difficult. There are many factors for the mother to keep track of. Is she seated comfortably? Can she support the baby for the length of the feed? How is the baby positioned? How are his lips positioned? His tongue? Is he swallowing? Is he still awake? On and on. Performing poorly means that your child doesn’t thrive and that you will be parcel to some unpleasant side effects like cracked or sore nipples or afflictions like mastitis. Until things become second nature for Mom, it’s best if Dad is around to help out.
For Janelle and I, it started out very much as a team effort. While Janelle would get situated, I would get Joshua prepped. Getting him unswaddled and undressed (skin to skin contact helps babies with the nursing process). When she was ready, I would hand him over and let her get him positioned. I would hold Joshua’s hands out of the way to make sure he didn’t interfere with his own lunchtime, which he is apt to do. When breastfeeding begins, Mom’s breasts will be very firm and the milk will not come easily. It needs to be massaged out until her tissues get more accustomed to just releasing it naturally. So, to keep her arms from getting too tired, I would massage her breast tissue and help with expressing milk. Then while Janelle would get cleaned up, I would change Joshua’s diapers and get him redressed. It made things less stressful for Janelle.
Now, a couple weeks in, she’s practicing tackling these changes without me, since I’ll be returning to work months before she does. But I was part of the process. I helped get breastfeeding established and I know that while it would have happened without me, there would have been far more tears and frustration. So, I’m happy enough to sit on the sideline while Janelle gets her alone time with the little guy because I’m aware of how to contribute to the process. All father’s should consider helping Mom out with the breastfeeding, just to get an idea of how tricky it is.
While “Is he eating enough?” might be the biggest dilemma for the breastfeeding mother, “How can we get through the night?” is likely the cross of the new father to bear.
Sleep is a precious commodity as a parent. Your day is no longer measured from sunup to sundown. Your are on a 24-hour clock and you need to sleep when you can. That sleep will come in fits and starts, as well. At the start, expect to see anywhere from 60 to 120 minutes of sleep at a time at the most. Anything else means you are lucky, an outlier (unless you’re getting less, in which case you are unlucky). And while sleep is precious to Dad, it needs to be even moreso to Mom, and she likely isn’t as focused on it as she needs to be.
Mom will be concerned about the baby and want to ensure that he gets down to bed properly. You can have her wait in bed and try to sleep while you tend to the infant, but she won’t be able to sleep, not while he’s crying. But she needs to sleep. The production of milk turns new mothers into factories. Just sitting on the couch and eating bon-bons, Mom is now burning 500 extra calories a day producing milk. To give you an idea of how much that is, I’ve gone to the gym and run (not jogged, RUN) on a treadmill for 30 minutes, covering several faux miles, and only burned in the neighborhood of 300 calories.
Do not think of the baby as a barrier to your own sleep. If you think about the process as being one of problem solving, regardless of the timeline. You’ll do fine. As soon as you expect a result, or view the baby himself as the obstacle, you’re on the road to frustration and ruination. Come prepared to not sleep until he sleeps and you’ll be golden before you realize it. According to this piece from Runner’s World, Janelle would have to run over 6 miles to equal that kind of caloric burn rate were she not breastfeeding. What the what?! Basically Mom is training for a half marathon on about 4-5 hours a sleep a night, assuming things aren’t going too poorly.
So not only is getting through the night important, but the responsibility of making it happen is something that falls chiefly to Dad. How to manage and control an infant that cannot be controlled? It’s mostly a matter of managing expectations. If you go into your nighttime routine expecting that your baby will go down to sleep quickly and easily and will be calmed quickly and easily should he awake in the middle of the night then you will be primed for disappointment and frustration.
Be ready when you go to put your baby down that you’ll be spending 15-20 minutes getting him calm enough and sleepy enough to actually feel like falling asleep. Similarly, expect the same each time you need to wake up to help him get back to sleep. If you expect things will take a good bit of time, any time that it happens faster is a bonus. Not only have you earned some more sleep for yourself, you get a nice little confidence booster for being so awesome.
Also be prepared to be mobile. Calming a baby in the crib will only work for the most minor of fusses. You can either just lay down some calming shushing noises, or turn the baby onto his side for a bit (they like the side—beats me) and let him calm himself down. More likely, though, you’ll have a potential crying disaster on your hands and it will require more drastic actions. When you pick your baby up from the crib, try and do it gently and quickly. You want to be quick to act, but you don’t want to jostle and take him farther away from sleep. To start, see if body heat, some gentle shushing and simply the innate reassurance that someone is there to help try and calm the baby. Failing that, you might need to bust out the fancy tricks. Swinging him around, bouncing him, burping him. Maybe you need to head out to the living room and let him sit in his bounce seat. Maybe the car seat is magic. Maybe the car seat and a ride around the block in the family sedan is the thing.
How do you discover the magic nighttime tricks that will put your baby to sleep? I don’t suggest midnight experimentation. You’re likely tired and probably on your way to frustration. Not the best breeding ground for great ideas. Take note during the day of what does the trick. The two times that I’ve put Joshua into a front carrier and taken a walk around the block with him he has passed out hardcore. Mental note. Extra blankets for extra heat tend to make him nod off easier as well. Good to know. He likes to sit upright, and likes to be swaddled. Sounds like a car seat to me.
Once your baby is in a deep enough sleep, you don’t need to continue your tricks until dawn. Place him back down, walk away and cross your fingers. Chances are you’ll have to pick him up again, but again, try the gentle approach first. If that fails, though, start the cycle over and keep going until he’s been down enough times to get the point.
Now, the problem here is that I’m writing to the assumption that your baby is being fussy for the sake of being fussy, or because he’s tired. That’s really the only time that any tricks or tips will get you anywhere. All the other reasons will require a specific response. Dirty diaper? Gotta change it and hope that doesn’t cause more problems than it fixes. Hungry? Time to wake Mom (assuming the timing is right—check out the next post for tips and tricks on breastfeeding). Upset tummy? Well… you’re just screwed aren’t you?
The upset tummy is one of those things that you just can’t do a damn thing about. Similarly, while the above tricks may work and are good starting points, there’s no fast guarantee that they will get a baby to stop crying. Most of the methods described are reasonably foolproof as they activate triggers in the baby’s brain that they should be cool. Did the kid throw any tantrums in the womb? Nope. Why not? Tight space. Warm temperature. Well fed. Rocked constantly. Perpetual white noise. Using any of these tools is likely to send your baby back to the good old days when he lived in a luxurious square foot apartment. Likely—but not guaranteed.
With an upset tummy, all you can really do is hope. Try burping your baby, try laying him on his back and pumping his knees up to his chest to help with gas. Trying switching up positions to crunch his tummy and push those air bubbles out to the surface. But consider the very real possibility that you just need to ride it out. Just as babies don’t know how to use their limbs for some weeks (hell, they don’t even realize those arms belong to them for awhile, something just keeps hitting them in the face), they don’t really know how to poop or pass gas. There’s a good chance that at the same time you kid is trying to push down to work out some gas he’s also clenching his little butt for all he’s worth to keep it in. Now if that isn’t just the picture of hell, I don’t know what is.
Expect putting your baby to sleep to take time. I’ve found that I need to stay awake while Janelle feeds so that when it’s time to put Joshua down, I’m awake and ready for the throwdown. If I tried to sleep until the main event, I would wake up both groggy and on stage and I would just be too damn grumpy to do either of us any good. I’d ask him why he felt the need to be so difficult and what, after all, the big deal was. He’s a baby. Life can’t be that bad. But a Michael that’s awake and ready to go is a Dad that’s ready to be patient and keep trying different positions to hold the little dude until it’s actually bedtime.
Crying it Out
Letting a baby cry themselves to sleep at night is not something I ever considered an option. It is, however, a fairly popular idea thanks to the research of Dr. Richard Ferber. Ferberizing a baby isn’t quite as simple as letting babies cry until they fall asleep. It involves staging up the amount of time you let a baby cry before you soothe them, and when you soothe them the point is not to pick them up. This is intended to teach a baby to calm itself and to sleep through the night.
But, really, what’s the point?
The Ferber method assumes that you child is a manipulative little monkey. The presumption is that your baby likes to be held and so will wake himself up from sleep and cry just to get you to come and comfort him. So, you take your infant and you begin withholding care from him. If you’re going to go ahead and make the assumption that you baby knows enough while this young to mess with you, then you also need to make the assumption that your baby knows enough to understand that you’re simply not coming. That’s not a lesson that I like the sound of. I’m not trying to raise John Connor here. “Learn to sleep while you’re young, little dude. No one will be there to hear your screams in the middle of the night.”
It’s not even an approach you can really consider economical, as it involves ever increasing intervals where you wait before trying to calm the baby. You start at, for example, 3 minutes. Then up to 5, then 7, then 10, then 15, then 30, etc. You’re looking at an hour of essentially hoping that your child stops crying. What if their tummy is upset and what they need is being held upright for 3 minutes so it can settle? Or if some extra body heat will be just the thing to push them over the edge into sleep? Picking a child up and trying a few options to see what calms them down or puts them to sleep could be the kind of thing that takes you 2 minutes.
The notion is that the Ferber method will train a child faster to sleep through the night, but considering that you’re looking at a couple of months before the kid is ever going to be likely to do that anyway, you’ve probably got an idea of how to calm him anyway. So… why abandon those methods?
The Ugly about having a baby isn’t ugly by default. It’s more a look at the potential for ugly to happen. It’s an old joke that you need a license to drive a car, but not to have a baby. Despite how tired this conceit has become for comedy, it remains fairly astonishing. Other than having a modern medical system (though the U.S. does not stack up super well in global infant mortality rates), there’s almost no preparation needed in the U.S. for individuals who are looking to have a baby. There are certain resources available, but these are all voluntary. If you wanted to have a baby without having any notion at all as to what’s required to raise a child, you can. No problem. Babies aren’t even terribly expensive to have, with medical insurance.
Janelle’s policy (pricing may have been lower for us since she has Kaiser insurance and we delivered at a Kaiser hospital) left us paying only $250 for a 5 day stint in the hospital. Cheap as hell for the price of a whole new baby. So there’s not even much of an fiscal impact for having a baby. Granted there’s one for raising a child… but that again assumes you’re out to do it right.
Most egregious to me is the fact that mothers are released from hospitals into the world with their new babies without so much as a second glance from our medical institutions. Sure, there are plenty of follow-ups for the child, but as long as a mother isn’t bleeding profusely or unable to feed her child properly, there’s basically no focus placed on the parents. Janelle could be suffering from a crippling case of postpartum depression and the only person who would be able to diagnose her would be me, because it’s just not something hospitals or pediatricians check on. Compare this to the U.K. where mid-wifes will visit new mothers for a period of around a week after their baby is born. They will check in daily to answer questions and calm fears. They transition parents into parenthood. By contrast, we blow them out of the goddam airlock.
The impression everyone has of babies is that they are tricky, but manageable. After all, we were all babies. We turned out okay. Even people we’re pretty sure aren’t qualified to wash cars manage to have babies and raise them. No problem! Incorrect. In addition to the time constraints surrounding babies (which I will devote an entire post to breaking down), there is the fact that babies simply do not conform to any system you may have set out for them.
Both the Baby Whisperer and Happiest Baby on the Block (both books with information I found very useful, don’t get me wrong) present baby care as something that, if contained within the systems they present, is simple and quick. Simple observation and adherence to particular practices will spell hassle-free child-rearing. For the Baby Whisperer, as long as you keep your child on a relatively structured schedule where feeding, activity and sleep happen in the same general blocks of time each day you will always know why you baby is upset, based on what time of day he cries. Is it during the sleeping block? He’s tired. The eating block? He’s hungry. Simple. For Happiest Baby, the notion is that by performing simple functions (swaddling, shushing, swinging, etc.) you can recreate a womb-like environment and calm a crying baby in moments. Easy as pie!
Each of these books are both totally correct and dangerously incorrect.
Caring for Joshua during the day is usually very easy. At night, however, it gets hard. He cries without reason and at times without means for consolation. He is a newborn. This is what newborns do (another post on this coming up as well). I presumed that I had educated myself about babies and how to handle them. I was employing all the tricks these experts presented me with, and they weren’t working. What was left for me in my sleep-addled mind was that I was simply incapable of consoling my child properly. I looked at Janelle, both of us with red-rimmed eyes, and announced that it was pretty clear to me that I was not good at this… that I had been so sure that I would be a super dad and here I was unable to figure out why my baby couldn’t stop crying. I had come into the arrival of my son raring and ready to go, filled with knowledge and hopes for heroic, epic-level parenting. Now that I am in the trenches I realize that there’s no way to come out of parenting without getting dirty. It’s why there exists such a global fraternity among parents. We have all been hazed.
It has taken a couple of rough-ish nights (after all, he’s not a colicky baby… at least not yet) and some pep talks from my Mother to really get it into my brain that sometimes I will be unable to help Joshua despite my best, totally valid parenting efforts. There are times where he will want to cry. He will defy all systems and methods presented to assist him. He’s a newborn. This is what newborns do.
This is the greatest failing of childcare preparation here in the States (in the world? I don’t know. I imagine it’s not much different anywhere). Babies are now presented as a closed system that can be “hacked” for lack of a more graceful term. We have figured out all the curves babies can throw us. Babies can be understood and their crying can be fixed. A parent who is handling things correctly is a parent who is the master of their child’s wails. Our available education tells us this. Spending days in a hospital surrounded by nurses who care for literally thousands of babies and wield them effortlessly and unflinchingly tells us this. We are shot out into the world alone but for whatever support system we have cobbled together believing this.
I will tell this to you now. You child will not start out easy. Your baby will cry and wail and that wail will pierce your mind at times and tell you that you are a failure. But as long as you are trying to learn why your baby is crying, you will never be a failure as a parent. When you stop caring, then we can review that statement. Your baby will be difficult and your baby will sometimes be nothing like what the books describe and nothing like your baby is like 99% of the rest of the time. Your baby will be difficult, and this will not be your fault. Keep trying different methods. Hunt to find what you baby likes, however outlandish. Do not try and adhere to timelines. There’s no pit crew waiting to see how quickly you can get that baby down. It takes the time that it takes, and that is not your fault. Remember that.
I had been hearing for years now what a singular and life-altering moment the arrival of a firstborn is. Everyone framed it to me as an epiphany. A recognizable moment when the skies opened up and a new father was struck with the revelation of his deep love and commitment to the new life that was before him. It was the kind of story that I was skeptical of because it so sounds heavily melodramatic, but it was a story I heard repeated 100% of the time from new fathers. Some would be more restrained about their phrasing of the event, but if I presented it to them in this manner, none of them shook their head that “No, it wasn’t like that.”
It wasn’t really like that for me.
The moment Joshua was born had a bit of its thunder stolen in our case. When he arrived there was still the feeling of awe and wonder that here was a new life, a whole PERSON and that Janelle and I had created it and that here Janelle was fulfilling a positively ancient rite. There was also the surprise of exactly what little Joshua was, as we had kept his gender a secret from ourselves the entire time. Finding out Joshua’s sex, though, was immediately overshadowed by wanting to know how he looked, how he sounded and even though he was brand new to this world, did he already know who his parents were and did he love us already?
The big moment for me, the moment when I knew the gravity of emotion behind my relationship with Joshua came about eight hours before his arrival.
At around 9am on May 31, Janelle and I were discussing, as much as you can have a discussion with someone on the verge of total exhaustion, whether or not to abandon a natural childbirth and get Janelle an epidural. It was coming down to a question of stamina, if we decided to wait, could she handle waiting longer? And then could she still muster the strength to push him out if we did? The longer we waited, the more the omnipresent C-Section lingered. While we were flexible on anesthetic, we were adamant about avoiding surgery. So we made the call. We’d like the epidural.
A nurse came back in a few moments later and we were in the middle of telling her the news when the constant lub-dub sound from the external fetal monitoring device watching Joshua’s heartbeat seemed to just stop working. The nurse immediately moved her stool up to Janelle’s side and took on the look of someone who has just gone into efficiency mode and I could feel touches of panic on the edge of my mind. When the nurse turned to me, pointed behind me and asked me to get something that my brain parsed as “oxygen mask” I knew there was trouble. When I turned to find that mask and found myself staring into a cabinet of fairly benign-looking medical apparatus and had absolutely no idea what she had asked for, that’s when the panic hit in earnest.
On cue, several more nurses and the on-call emergency OB burst into the room and immediately began going to work on Janelle. They moved her flat to her back and dropped her bed down flat from its sitting-up position. They swirled around me and recovered the oxygen mask from the cabinet that I had managed to pull off of its connection to the oxygen feed in my misunderstanding and fluster. Janelle was given oxygen and status updates were called out from the nurses to the OB.
I could tell I was in the way and so I stood back, ran both hands through my hair in the most classic expression of helplessness I’ve ever made as an adult and I was broken.
My baby had gone into distress. He was in the kind of danger that warranted a medical emergency. I could not help him. And just on the eve of getting to meet him, I felt for the first time ever that he might be lost to me forever.
It’s still hard to think about.
It took everything I had left in me to not collapse on the floor, sobbing. There was a part of my mind that realized that for whatever reason, Janelle didn’t yet look like she understood the gravity of what was going on around her, and seeing me lose my grip would certainly bring it home for her. So I stood up and stood back and tried not to cry too hard in front of a room of medical professionals.
In the words of Oliver Grigsby, “Spoiler alert.” Joshua is fine, as you well know.
Even before arriving into the world, Joshua was ahead of schedule on things. His bag of waters broke before labor had even started and I’m pretty sure the reason Janelle was so overwhelmed by the urge to push her entire labor was that the kid just plain wanted out. When Janelle stalled out dilating at 8cm, Joshua’s position in her pelvis was at 0. Positioning for babies about to be born is measured by the placement of their head in relation to the pelvic bones of the mother. The range is from -2 (far back in) to +2 (on your way out). What Joshua had done at that 9am timeslot was drop himself down from 0 to +2 in one movement. Not common.
What is more common, however, unbeknownst to me, is that when baby’s drop down in the pelvis like that, it’s not unusual for their heart-rate to drop in response to the stress and compression they are experiencing. In Joshua’s case he fell from a healthy and happy 150 beats per minute down to something around 30. The concern at that point is only how temporary that drop will be. Almost always it’s a short drop and for Joshua it was no different. In less than a minute (I’m assuming, that moment is basically eternal in my recollection), he was back up to the 140-150 beats per minute range.
Hopefully I’ll save someone else a moment of crushing drama, but I have the impression that foreknowledge will not save you in a scenario like this.
This moment, when I thought I could lose my baby, was my big epiphany. I had not met him yet and I could feel with certainty that losing him would destroy me and would wreak heavy damage to Janelle and I. It would be the kind of event most people don’t come back from. I knew then how much I cared for him and how much I would work to protect him and how important he would be in my life from that point forward. That moment was so revelatory for me that when he actually arrived, it felt more like an introduction.
We’ve covered the Good about having a baby (there is of course more than that, but there will be many posts to come outlining those items as they develop), but now I want to get into the Bad. These are the things that the baby books you read won’t tell you and the parents you talk to will not remember because they are caught up in baby bliss by the time they talk to you and they love discussing things with new members of the International Fraternity of Parents.
Your baby will not be how you expect it to be.
Your baby will still be wonderful and unique, but it will not be exactly what you have envisioned and nor will it conform to any real images of a baby that you have been fed in any books you’ve read or seminars you’ve attended. Your baby is here to bust up expectations and chew bubble gum… and he’s all out of teeth with which it would be possible to chew bubble gum so he guesses he’ll do that other thing instead.
Many books will simply give you a general over of “baby” as a sort of Platonic absolute. They will then list off things presented as sort of problems or variants from the norm and detail how a new parent should deal with them. Other books (notably The Baby Whisperer) will break down types of babies: Angel Baby, Textbook Baby, Touchy Baby, Grumpy Baby, etc. It is then presented that your baby will be one of these types of babies.
This is a wild mishandling of an expectant parent’s envisioning of their future. Your baby will be all of those things in its time, sometimes in the span of a few moments. By all accounts Joshua would qualify as a pretty Textbook Baby. He’s hitting his developmental milestones (few though there have been) and he doesn’t really have any health problems. But that’s where that match ends. There are times when he’s an Angel Baby, happy to sit and flail about and gaze at Mommy and Daddy. There are times when noises make him jump and flinch like any Touchy Baby and there are times when he will simply refuse to be calmed, a classic Grumpy.
Setting a parent up to believe that there baby will match a category can lead to some real parental frustration. “But I have an Angel Baby most of the time, what must I be doing wrong to make him cry now? I’m failing as a parent!” While it may be true that some babies have a tendency to display a certain temperament, that does not make them a Happy Baby. That makes them a Baby who is happy.
That’s my general lead-in. It’s important to remember that you don’t have a baby you read about in a book. You have your baby, and you could write a book about just them alone. Which is basically what I’m setting out to do.
Now, onto the specifics about Joshua’s birth and some of the general information that might benefit you one day.
Joshua came out a bit jaundiced. It wasn’t something that really noticed at all until after his treatment had started, but blood tests revealed that his billirubin levels (a yellow byproduct of red blood cell breakdown that is normally processed out by your liver – but can stick around and cause jaundice) were high. With babies, it is expected that their billirubin levels will rise as they start life, typically peaking at the third day. Since they measure danger levels of billirubin in the blood on a scale like this, if a baby has a level of, say, 9 on Day 1 that may place him in the high risk zone, but that same level on Day 3 means he’s safe and sound, since his levels did not elevate as they were expected to. This was the case with Joshua.
However, to help ensure his levels didn’t rise, he was given UV treatment. The treatment is simply that your baby is placed in a plastic container (pictured below). Lights are directed on him from above and the mat he lies on also emits UV rays. His eyes are guarded and he is intended to stay in that light for three hours at a time, and then to be taken out and fed to keep him hydrated. Then, it’s back into the light box. It’s important to keep a baby fed during UV treatment, as billirubin adheres to bile and urine and so the best way to have the baby flush his system of billirubin is to have him poop and pee it out. The better he feeds and excretes, the better his treatment will go.
This makes for a pretty miserable treatment for a newborn. There are constant bright lights, which goggles are meant to prevent, but which surely creep in at the edges of vision, especially as your baby shifts about. There’s constant heat which dries the skin. There’s no chance to swaddle your baby to help prevent him flailing about and scaring himself awake. There’s no chance to really hold him outside of placing hands on him to soothe him. The box removes all creature comforts from a new baby outside of warmth.
If your baby is in UV treatment in the nursery and away from your room, you will be blissfully unaware of any discomforts, and so will the nurses, but more on that in a moment. However, if you can lobby to get the light box in your room (bonus of having the box in the room: they don’t put roommates in with you if you are in a shared room), you are pointedly aware of all these things and ministering to your child will become a constant task. It will be hard to watch him be forced to suffer and difficult to convince yourself that it’s a necessary treatment for a health problem that seems so esoteric.
Making matters worse for us was that our light box began to overheat. The ideal temperature in the box for a baby of Joshua’s size was 29.1 degrees Celsius. Under normal operation, this temperature would rise very, very slowly assuming all the little gates and ways to reach in and touch your baby are closed. Once opened, though, the temp should regulate itself back down. With our unit, however, it began to have issues regulating its internal temperature. I timed it. The box would take 5 minutes to heat up from its baseline temperature of 28.8 degrees to 30.6 degrees, the point at which it begins to issue forth an alarm that the temperature is too high. It would take three minutes for it to cool from the high temp back down to the minimum temp. Getting the unit to begin heating back up on its own before dropping below its minimum temperature setting was important, too. If it dropped below that set temperature, it would kick on its heater, exacerbating the timing for heating up and cooling down.
The net effect of this on Janelle and I is that in the middle of the night, for something like six straight hours, we were expected to, basically every four minutes, open up the door to the light box or close the door to the light box as we waited for it to begin to regulate itself properly again. When I informed the nurse that this meant that I would have to perform this function 80+ times over the course of the night, she nodded and said “I know.” And that was that. It was a rough night.
After 24 hours of UV treatment, babies are tested. If their levels are clean, they are taken out of the light and then tested again 6-12 hours later to see if they have remained stable. It is only after that final test shows positive results that you may be cleared to leave. Your baby will not be cleared of jaundice, but will have reached a point that his body will be able to take care of the rest on his own without much chance of danger.
The UV treatment was a rough patch for us, but it mostly illustrated a few problems with hospital care that I’ll get into now.
Ease of Care vs. Good of the Child
There’s a real disconnect in the hospital between what makes caring for a baby easy and what makes for the best care for your baby. A big problem with the care we received in the hospital was that providers used different philosophies in the care of the baby. Some will seek to educate parents on the best and most comprehensive methods, some will simply arrive and perform their functions and leave again. Some are focused on what is best in the long term for the baby, some are focused on making sure his immediate care is comfortable.
It is not necessarily that ensuring immediate comfort is wrong, it is just frequently counterproductive. In the case of Joshua, he wasn’t taking to the breast very well. Breastfeeding sessions (there will be a whole post on this) were really traumatic experiences to start. Without lingering on the topic too long now, breastfeeding is the mother’s first chance to bond in a true physiological way with her baby outside of the womb. It’s also her first chance to feel like an abject failure as a mother. I would not be shocked to hear that post-partum depression and breastfeeding troubles are closely linked.
Physically, Janelle’s body was well-formed to handle breastfeeding. Joshua, however, would simply react to her breast as if there was nothing there. He wouldn’t latch properly and when he did, he would stay on for about two minutes at most before twitching himself into a tantrum. Heart-wrenching and a big problem when he’s in the midst of UV treatment and requires nutrition on a tight schedule. We ended up being forced to supplement formula at the breast. This was done by taking a syringe filled with 10mL of formula and then connected that to a thin plastic tubing. That tubing would then be slid into Joshua’s mouth as he latched onto the breast. I would then slowly push formula through the tubing so that he was getting nourishment as he sucked, making him less likely to become frustrated and stop nursing.
Before we were able to get the UV light box in our room, the nurses would bring him back from the nursery every three hours to feed, and we’d deliver him 20-30mL of formula and breastmilk. Then they would take him back again. Well, as we learned ourselves after we got him in the room with us, he was super fussy in the light box. How did the nurses handle that? Weren’t they too busy to pay him constant mind? Did they just let him cry it out? Turns out they stuffed him full so he would pass out. A tried and true method of putting babies to sleep, but in this case directly counterproductive to our needs and his long-term good.
After the nurses took him back to the nursery, they would finger feed Joshua additional formula, giving him more formula so he was having 50mL in total at a time. This is an amount that Janelle’s body simply cannot compete with, so he was being trained to expect more food that his mother could possibly naturally provide. Also, since he was being finger fed (the same process of supplementing with formula described above, but the tube is inserted alongside your finger rather than a nipple), he got used to the feeling of a finger for feeding. Your fingertip is going to be much firmer and larger than a nipple, and therefore easy to grip onto. This is why when we worked with the hospital’s lactation consultant she remarked that it appeared that Joshua simply didn’t recognize Janelle’s totally normal in every way nipples. He had been trained to find something else palatable.
It makes sense the nurses would take this route when left to their own devices, as well. Babies are a lot of work and an easy way to put them to sleep is to tank them up and let them doze. Easy work, easy care. But what it caused for us were hours of a screaming baby and a heartbroken new mother. Better yet, the nurses actions were ones that the hospital’s own lactation consultant didn’t agree with. Warring factions.
Many people made reference that we should stay in the hospital as long as possible. It was even something covered on NBC’s The Office. Two characters set to have a child delay arriving at the hospital to the very last moment so that they can extend their post-partum stay there.
I straight up cannot understand this, but I can envision a set of circumstances where someone would want to stay.
If you were going for a C-Section, bottle feeding and don’t mind if the nurses take the baby away from you for every single test that they run so you can have some alone time, then the hospital works out great. But if you want the comfort to care for your baby in the way you see fit, you want the hell out of a hospital.
There’s a pretty good chance wherever you’re going will have you sharing a room. This is fine in and of itself, but space becomes a major issue. In a space that is probably 8′x8′ you have to fit a large bed, a movable tray for food, a bassinet, a privacy curtain and a chair that will fold out into a bed. This leaves, for Dad, about an 8′ stretch of space to move through. You will be uncomfortable and finding and organizing the things you need for a hospital stay of any real length gets very tedious.
Care in the hospital is competent, but as I have explained already, inconsistent. During the course of labor alone we rotated through three different OBs and four nurses. In post-partum, we had eight+ nurses, all with different ways of handling just about everything. In some instances it was great to get different pieces of advice, but each time there was a shift change it was a gamble to see if we would get someone that we liked.
To my mind, once we had time with a lactation consultant (which took three days, though every day we were promised she would be by soon) and once we had learned one really effective swaddle from a nurse, I was ready to get the hell out of there.
Coming Up: This three part breakdown will be a four-parter now. I’m going to devote special attention to a section I call The Drama, and then we’ll look at the items I consider to be the real danger zone items in The Ugly.
Many of you already know this, but for those who the news has not reached, Joshua Lucas Scarpelli was born on May 31 at 4:52pm. He measured 21 inches and 8 pounds, 9 ounces. He is a healthy baby, other than UV light treatment to break up some jaundice in him, which is a pretty common thing for newborns.
Our stay at the hospital lasted from Sunday May 30th at about 3pm to 5pm on June 3.
This is the first part of a three-part post discussing the Good, the Bad and the Ugly related to Joshua’s arrival. There simply isn’t much to say about the Good, other than to share it. We have a baby and he is healthy and wonderful. I’ve found that we grew adept as new parents remarkably fast. We are only seven days into his little life and we already know his cues and are plotting out his routine and care. We are fast on diaper changes, a mean breastfeeding team and can soothe him from a tantrum to silence in about 30 seconds flat (when he is of a mind to be soothed).
The Good, however, isn’t something I need to educate you on. You’ll know the good. You’ll feel it radiate through you once you’ve hit your stride. You’ll simply walk around feeling a sense of accomplishment that is rare. It’s something that is rarer for me than it should be. I don’t sit back much and think to myself what good work I’ve done, but I find myself doing it all the time with Joshua and the care we’re providing him.
What I do want to educate everyone on are the many niggling little items that none of the books I’ve read about having a baby seem to cover, or the things that they play up so much that you think that if you’re handling it differently, you’re handling it incorrectly.
The biggest learning tool in the Good category for us has to do with our flexibility. In another way of looking at it, this could very easily be considered Bad or even Ugly, but I think it showed that we know how to flow with the course of the birth, which is exactly what so many of our friends had advised us to do. We went in, as you well know if you’ve been reading along over time, wanting to do a fully natural childbirth. We took Bradley method classes to get us to that point and read books on the practice and did exercises at home, the whole nine yards. Bradley was effective for us while we could use it, too, but we couldn’t use it very long.
Janelle had a “non-textbook” labor process. The notion of textbook labor is a bit asinine and I should have probably realized that more, but that’s what Bradley really prepares you for. This is not to say that the Bradley lessons would never have helped us. In fact, they probably enabled Janelle to fight through her labor as long as she had. We just were not able to do much beyond cracking a tiny bit of the toolchest available to us from our Bradley learning.
Prior to heading into the hospital on May 30, Janelle had dilated to 3cm (in case you’re not a medical or pregnancy buff – the cervix needs to dilate to 10cm before the doctor’s consider the mother’s body ready to deliver the baby) all on its own, without her really being aware of the work her body was doing. Then, the next thing we knew, her water broke at about 2:15pm on May 30th, about a week before his due date. We went in to the hospital, and they let us know that we were going to be there until we had the baby.
Right away, our expectations were off. The Bradley training tries to get you to labor as much as you can away from the hospital so that you can labor in the manner of your choosing… but after your water breaks, chance of infection in mother and child end up increasing more over time. Doctors want the baby out, or for significant progress to have been made, within 24 hours to keep risk minimal. So, before our labor process had really even started in earnest, we already could not follow some of what we had spent months prepping for.
But the hits kept on coming. Janelle began to feel her contractions around 5pm. So, after she was gowned up, we would walk loops around the delivery ward, stopping every few minutes so that Janelle could lower herself to the ground in a squatting position to alleviate the discomfort. Things were going along just like the labor that had been described to us would go. Janelle would be able to walk like this and allow her labor to progress in relative speed and comfort. We were handling it as we had been taught and things were looking good.
By 7pm, she could barely move, and she stayed that way until 9am the next morning. Rather than being able to move and adjust her position to increase her comfort, her discomfort was so intense it prevented almost any and all movement for her. She ended up sitting in a rocking chair, or propped on the hospital bed with her eyes closed, trying to focus on being relaxed as I ceaselessly massaged the round ligaments at the front of each of her hips (I mean ceaselessly, I massaged that area for about 12 straight hours without more than a few seconds pause). For her, labor pains manifested themselves as a strong urge to push… but you are explicitly told you cannot push until the time is right, when you have dilated to 10cm. So, for 14 hours, Janelle fought this urge and it rendered her inert and unable to call upon any of the preparation we had done for labor.
The final straw came at 9am on May 31. Through our sleepless night, Janelle had been progressing at a rate of 1cm of dilation for every two hours of labor. When we checked at 9am on the 31st to see her progress, she had stalled entirely. No change. That far along in labor, with the 24-hour infection care time limit approaching and Janelle having reached the limit of her endurance, we opted to get her an epidural.
An epidural, not something I covered much in the blog to date, means that we had to give up on the plan of natural childbirth. An epidural involves insertion of a plastic tube into the base of the spinal cord. Via this tube, anesthetic is delivered and sensation to the nerves at the base of the spine is numbed, reducing pain for the mother by about 80%, so they estimate. The decision to move away from natural childbirth was a tough one. It came at the end of 27 hours without sleep, most of which involved considerable discomfort for Janelle. She was barely in any shape to make decisions, and I was faced with the traumatic task of either telling her that she needed to continue to suffer, or give up on the dream birth that we had envisioned.
Suffice it to say, this was a bit of a tipping point for my breakdown. I spent a good two hours that morning trying not to just be a sobbing mess on the floor. It was much harder than I had anticipated to watch Janelle suffering as long as she was, to listen to her tell me that she didn’t know if she could carry on and how intensely uncomfortable she was and then to tell her she just had to be strong and let it all happen.
We opted for the epidural knowing that a birth that was filled with this much discomfort and anguish wasn’t the kind of birth we wanted, principles be damned. Also, and more critically, we knew that getting Janelle’s body to relax would mean our chance of avoiding a C-section and having a healthy baby would increase. After it was administered (far easier than expected… but the discomfort of getting a NEEDLE IN YOUR SPINE didn’t really phase Janelle at all, which is not surprising considering what she had already been putting up with) we were both able to sleep. We both promptly passed out (I have no actual memory of falling asleep, I just remember waking up again) and rose three hours later. Soon after that, Janelle was ready to begin pushing and we commenced.
She pushed for almost the entire three-hour maximum the hospital will allow before they intervene. It’s not good for a baby to be trapped in Mom’s pelvis for too long as she tries to push him out. With each contraction, he’s getting compressed pretty well, so if those contractions aren’t moving him downward, they’re just kind of a hassle for him. For new mothers with an epidural, they allow three hours for pushing, instead of the two to two-and-a-half they allot for all other mothers. After the end of that timeframe, if the baby has not arrived, they will suggest either a vacuum-assisted delivery (literally, they use a suction cup to help pull your baby out as Mom pushes him out) or a C-section if the baby can’t be reached for vacuum assist.
For the first 90 minutes that Janelle was pushing, Joshua didn’t move in the slightest. This is where the problem with the epidural comes into play. It numbs so much sensation below the waist that it was very difficult for Janelle to locate the specific muscle group she needed to be focused on in order to be pushing Joshua out. Thankfully, before the pushing began, we directed the staff to cut the medicine rate being delivered via her epidural in half, specifically so she would regain feeling. After that first 90 minutes, she began to be able to feel the proper location to push and it was fairly quick work after that.
90 minutes later and I could see Joshua’s head began to ease his way out of his Mom. I hadn’t been expecting that I would want to watch that happen, as there is much ickiness that occurs, but once I could begin to see his head, I couldn’t really stop from watching. Partially, it was nice to be able to give Janelle very honest encouragement about how close Joshua was to being born, but it was just fascinating to see the scale of things.
Baby heads are really malleable and so when they are being pushed out of their mother, you are bound to get a bit of a conehead effect for them. But what the net effect of this is for the observer is that it makes the head appear FAR smaller than it actually is as it is emerging, because all you’re seeing is the round little top of the head, being pushed out and sqooshed out as the vanguard. When Janelle gave the final push that popped the entirety of Joshua’s head out, my reaction was pretty close to a “Holy shit!”
And that was that. The nurses immediately hoisted him to Janelle’s chest where they toweled him off and suctioned fluid from his mouth and nose and then he began to wail in earnest, always a good sign and something encouraged for the first few hours to help expel fluid and other gunk from the lungs. We both just looked on in awe for a bit, listening to him cry and trying to memorize his little features (almost pointless since brand new babies can sometimes look very little like couple day old babies which can look very little like year-old babies).
We tried to have him nurse right away, with minimal success (more on this in another post), and ended up needing to give him about 20mL of formula right away as his blood sugar was very low. Babies of diabetic mothers come out with a higher insulin count than most babies, and as such tend to have low sugar numbers. Joshua was around 49 right after birth, and their cutoff for “too low” is 45. An hour after birth he was at 39, and it was time to get nourishment into him quickly and any way we could. He downed the 20mL of food with a speed that I now understand was pretty staggering. The bottle was bone dry in under a minute flat.
We have a hungry little boy.