Health Services
Planning for Your Baby
When you begin to shop for your baby’s needs, you may feel overwhelmed by all the available products. Do your homework before you go shopping. You can either buy just the basics or plan an elaborate layette and nursery, depending on how much you wish to spend. Most mothers initially purchase the basic needs for their babies because friends and relatives love to buy gifts for newborns. You can always "fill in" following birth
The following lists some of your baby’s basic needs:
| • | A thermometer |
| • | Diapers come in a variety of fabrics and styles, including disposable diapers of all sizes. There are advantages and disadvantages to both cloth and disposable diapers. On an average, most newborns use 10 diapers per day. Therefore, you will need 70 disposable diapers per week or three to four dozen cloth diapers. Each baby uses approximately 2,200 diapers a year. Whether you use cloth diapers with plastic pants or super-absorbent disposable diapers, you need to change diapers frequently to prevent diaper rash. |
| • | Four bibs |
| • | Four fitted crib sheets |
| • | Four gowns or kimonos |
| • | Four knit sleeper/play sets |
| • | One or two warm shawls or bunting, depending on the time of year |
| • | One sweater, cap and bootie set |
| • | Several pairs of booties or socks |
| • | Six receiving blankets (babies love to be wrapped snugly) |
| • | Six undershirts (or "onesies") |
| • | Two crib blankets or quilts (a blanket sleeper is wonderful for winter) |
How to Feed Your Baby
You must make several decisions before the arrival of the baby, and now is a good time to be thinking about them. You must decide if you want to breast- or bottle-feed before the baby arrives. Babies eat often, so how you will feed your baby is certainly a decision that requires some thought.
Breastfeeding
If you have decided to breastfeed your infant, you have taken an important step in providing for your baby's health; a mother's milk is perfectly balanced for the newborn’s needs.
It will be easier to breastfeed your baby if you are adequately prepared. Discuss it with your physician, learn about it in prenatal and parenting classes, and check the library for books and articles on the subject. The support of the baby’s father will be helpful, so be sure to include him in the education.
The basic guidelines for breastfeeding successfully call for eating a well-balanced diet, drinking plenty of fluids and getting lots of rest — all of which you are probably doing now. Breastfeeding will be easier if you prepare your nipples: wash them daily with plain water. Do not use soap; it removes the natural oil produced by the breasts and could cause the nipples to dry and crack when nursing begins.
If your nipples are somewhat turned inward or inverted, do not be discouraged from nursing. You can wear special breast shells, available at medical supply stores, made for this purpose. If you feel that you have inverted or flat nipples, talk to your physician or nurse about wearing breast shells.
Breastfeeding can be a rewarding experience for both you and your baby. Advantages associated with breastfeeding include:
| • | Breast milk is specially designed for your baby's needs and is an extension of the way in which your body has nourished the baby in the uterus. |
| • | It is sterile and less expensive than formula. |
| • | It is "ready mixed," so there's no formula to prepare, and it is always the right temperature. |
| • | Babies digest breast milk easily and quickly. They tend to have fewer colds, stomach upsets and allergies. |
| • | The baby's sucking stimulates the uterus to contract, and the milk production helps use up the fat stored in the body during pregnancy. |
| • | Breastfeeding is enjoyable for both mother and baby. It helps the mother develop the bond with her baby. |
| • | Breastfeeding is a learned behavior for both you and your baby. Nurses in the hospital will help you breastfeed your baby. |
Some disadvantages associated with breastfeeding are:
| • | Breastfeeding after going back to work may take some commitment and planning but, generally, working moms believe it is worth it. |
| • | On rare occasions, a mother cannot breastfeed because of medications she is taking or a disease she may have. |
| • | High demands and less rest could cause stress and lower milk supply. |
Bottle-feeding
Advantages associated with bottle-feeding include:
| • | The mother does not have to be available for every feeding; fathers can help. |
| • | The baby eats more at each feeding, thus requiring less frequent feedings. |
Some disadvantages:
| • | You must buy equipment — bottles, nipples and formula. |
| • | Formula must be heated to the correct temperature. |
| • | The risk of infection and allergies is greater than with breastfeeding. |
| • | There is a potential for choking if the bottle is propped and not held. |
| • | There are fewer interactions between the mother and child than with breastfeeding. |
How you will feed your baby is a decision you will want to think about while weighing the advantages and disadvantages according to your own situation and needs. Discuss this with your physician or the physician who will take care of your baby.
A Physician for Your Baby
Choosing a physician for your baby is also an important decision. For first-time parents, the thought of needing a physician for their child may not become a reality until the child is born. This choice should not be made without preparation. It is important to make an informed choice before the "big day."
When choosing a physician for your baby, you should explore the options. Neighbors, relatives and others can often give you information about their own children's physicians. Some families use a family practitioner to meet the needs of their entire family. Other parents have specialty physicians for their children called pediatricians.
However you choose your child's physician, it is important you feel secure and satisfied with that choice. One of the best ways to make the birth of your baby a joyous occasion is to be prepared, and having the physician of your choice ready to care for your newborn will give you an added sense of security.
Helping Big Brothers and Sisters Cope
Just as you and your partner must prepare for the new baby, your other children need preparation for a smooth transition into their new roles as big brothers and sisters. A new baby affects everyone in the family. The behavior of children toward the pregnancy and the new baby will vary according to their ages, sex and personalities.
Children under the age of 6 are the most vulnerable. Their world is centered on their parents. Common reactions to the new baby may include hostility or aggression toward the baby or mother, regression in some areas of functioning and increased efforts to gain attention. Often, a child becomes jealous before the baby comes. They may think that their parents are not happy with them and want a new baby to replace them. Also, the loss of contact between the child and the mother during hospitalization can contribute to rivalry.
Although older children may be jealous, they also may express great pleasures in having a new baby in the family. They often have more patience than adults do when caring for or playing with an infant. Because older children have learned how to verbalize their feelings, inappropriate behavior is less prevalent than it is in children under 6. Older children still need praise, however, and some individual attention from their parents. It is important to make children aware of their special privileges as older siblings and give them moments of undivided attention.
Here is a list of things that can be done to prepare your children for the new baby:
| • | Tell them about the new baby early in your pregnancy. Let your child's questions guide your explanations. As time goes by, you may be asked to explain more about the baby. | |||||||
| • | Allow time for changes in the child's environment. If you have to move an older child's bed, for example, be sure to do it well before the baby arrives. | |||||||
| • | When talking about the baby, emphasize the joys, but also present some of the difficulties from a child's perspective. You can point out, for example, that babies cry, sometimes smell bad and take a lot of time to care for. | |||||||
| • | Tell older children how they were taken care of when they were babies — how they were fed, held and cared for. Emphasize that they are still cared for, but in a special, more grownup way. | |||||||
| • | Allow older children to help prepare for the baby — and, when buying something for the new baby, buy something for them, too. | |||||||
| • | Read them books about babies. | |||||||
| • | Explain to them that the baby could be a boy or girl, and that you have no control over the sex. | |||||||
| • | Prepare them for your hospitalization. Wrap packages with meals and snacks so they can remove some each day, and tell them, "When these are all gone, I'll be home." | |||||||
| • | If possible, allow the child to stay in a familiar environment when you are in the hospital. | |||||||
| • | Discuss realistically how they can help with the baby. | |||||||
| • | Allow older children to participate in prenatal care. They could exercise with you. | |||||||
| • | Get an infant seat for transporting your baby. | |||||||
| • | Make the child aware that there may be complications for the baby, and that babies sometimes get sick just like they do. | |||||||
| • | Assure them that they can visit you in the hospital and that they will be among the first to see and hold the new baby. | |||||||
| • | Call Great River Medical Center right away to register for the Sibling Preparation Class. This class is for children ages 2 to 10, along with their expectant parents. The class is designed to help children understand what is happening with the family and how they will fit into the new environment. The classes include a tour of the Obstetrics Unit. The children can dress up in hospital gowns, masks and caps and see where their mother will be in the hospital. The goals of the class are to: | |||||||
|
A Polaroid photo is taken of each child attending the class. These photos are placed in the mother's file. After the baby is born, the photographs are taped to the side of their new baby's bassinet in the hospital Nursery. How proud these big brothers and sisters are when they see themselves so prominently displayed next to the newest member of the family.
With thoughtful preparation, the transition to this "new" family can be a pleasant growth experience for all. Sibling Preparation Classes are offered each month at Great River Medical Center and there is no charge. The telephone number is (319) 768-4000.
Preparing Your Pets for the Baby
Do not wait until you take your baby home to prepare your pets for the new arrival. Your dogs and cats may not initially accept your infant, but you can take steps to make the transition easier. Before you leave the hospital, send home one of the baby's blankets or items of clothing for the pet to sniff. Getting to know the baby’s scent will help your pet adjust to the baby before meeting the baby face-to-face.
Supervise all early contacts between your baby and your pet. Reassure your cat or dog whenever the baby cries or screams; the noise will upset the animal until it becomes accustomed to it.
Dogs and cats are creatures of habit. Keeping your pet’s routine as normal as possible will help it accept the unsettling changes more quickly. Treats and praise will help. Remember: Your pets need your love and attention, and they are used to receiving it. Spend a little time with your dog or cat every day.
How Are You Feeling?
The second trimester of pregnancy is often the time when a woman feels best. Morning sickness and frequent urination usually subside by the fourth month. Increasing weight due to the pregnancy is not a problem yet, and interest in sexual activity may be increasing. You may begin to feel the baby move between the 16th and 20th weeks of pregnancy. This feels like the "fluttering of butterflies," "bursting of tiny bubbles" – or gas.
You may experience discomfort caused by increased perspiration, and this can be controlled with more frequent bathing and use of a nondrying soap. If you become constipated, exercise daily, drink eight glasses of fluid a day and include fruits, vegetables and coarse breads in your diet. You may need a stool softener to keep your stools from becoming hard and difficult to pass. Take a laxative only when ordered by your physician.
Some pregnant women develop varicose veins due to the increased amount of blood circulating. Avoid tight, constricting clothes, wear support hose, and take frequent rests with your legs elevated. Hemorrhoids, which are varicose veins of the rectum, also may be a problem. Try not to strain during bowel movements and, if possible, avoid becoming constipated.
Pressure on the stomach can cause heartburn. Eat small, frequent meals, avoiding fatty, fried foods. Ask your physician to recommend an antacid. You also may be suffering from flatulence (gas). This can be reduced by thoroughly chewing food and avoiding gas-forming foods, such as fried foods and beans.
Poor posture, extra weight gain and restless sleep may cause fatigue. Take frequent rest periods, eat a balanced diet, take prenatal vitamins if your physician recommends them, and sleep in side-lying positions. A pillow between your knees will decrease the strain on your back.
You may begin to notice stretch marks, which are caused by the skin stretching over the abdomen and breasts. Some mothers can have eight children without a mark, while others develop stretch marks extensively with the first pregnancy. Stretch marks are not preventable but there are some things you can do to minimize them. A daily application of moisturizing lotion, gently massaged into your stomach, will ease dryness and help keep your skin pliable as the baby grows. Gain weight gradually, and support your abdomen to decrease sag and stretch. Ask you physician about support garments.
Your weight gain will probably be about one-half to three-fourths of a pound a week. As your body becomes heavier, you may often feel off balance. To help your balance and improve your appearance when walking, hold your head high, keep your shoulders back and your feet straight ahead.
When you are climbing stairs, keep your shoulders up and your body tall, using your leg muscles to lift your body from step to step. Do not pull on the handrail. This could strain your back muscles. If you find yourself becoming short of breath, stop and rest while taking slow, deep breaths. In late pregnancy, such exertion may mean you need to take an elevator, but for now, a flight of stairs is good exercise.
By the end of the second trimester, you are probably looking very pregnant. The increase of hormones has given a healthy fresh look to your face. That, plus the joy of anticipation, causes the "pregnancy bloom."
Growth of the Fetus
The Fourth Month
By the end of the fourth month of pregnancy, the fetus has grown to four inches in length from head to toe and is easily recognizable as a tiny human being. In the next 30 days, the baby will begin to double in length and quadruple in weight. The physician now can hear the baby's heartbeat with a stethoscope. A fine downy hair called "lanugo" begins to cover its skin. The baby has developed a sense of touch, and could curl fingers and toes if its palms or soles of its feet were touched. Your baby can even grip with fingers and thumb. The baby’s kidneys have begun to secrete urine into the bladder, which is discharged into the amniotic fluid.
The Fifth Month
In the fifth month of pregnancy, the fetus is now about 10 inches long and may weigh up to 16 ounces. Your baby is beginning to move about, and you have probably noticed a weak fluttering feeling in your abdomen. Physicians call this "quickening."
The baby’s heart rate is about 120 to 160 beats a minute. Although its eyelids have been sealed shut since the ninth week of pregnancy, eyelashes and brows are beginning to form.
The Sixth Month
Most of your baby's organs are completely developed now, even though it is only about a foot long and weights about 1.5 pounds. At this stage, the baby’s hearing is well developed, and it is comforted by the sound of your heartbeat. The baby can be startled by loud noises nearby. Lanugo covers its entire body, and finger and toenails are emerging.
Modern Miracles
It is indeed a miracle when you can look at a video screen and see a picture of your baby in the womb. How reassuring to see that your baby is alive and well! The picture you see is from a sophisticated ultrasound machine in Great River Medical Center's Diagnostic Imaging Department.
Remarkably clear and sharp, the ultrasound picture in the baby's first trimester can measure the number, size and location, and the presence or absence of uterine abnormalities. During the second and third trimesters, ultrasound can show fetal viability, growth pattern and the gestational age of the baby.
The ultrasound test is very simple for the mother and causes no harm to the fetus. No preparation is necessary other than a full bladder, which supports the uterus for imaging. A liquid gel is placed on the mother's abdomen and the technician slides the ultrasonic scope over the skin. A picture of your baby in the womb is projected on a screen. Photographs then are taken of the projected picture for your physician to "read" and diagnose the baby's condition.
Fetal heart monitoring is another example of advanced technology in obstetrical care. With the advent of this technology, the fetus now can be viewed as a separate patient from the mother. The fetal monitor determines the condition of the fetus by measuring and printing the heart rate of the infant and the mother's contractions during labor. When a physician suspects that labor is not progressing normally, the information provided by electronic monitoring helps the physician decide what action to take.
When a pregnant mother is at risk or when an infant is born at risk, Great River Medical Center is equipped and prepared to provide all the support systems necessary. The Neonatal Intensive Care Unit (NICU), located within the Obstetrics Unit, has the latest technology available to care for the littlest miracles.
Special Miracles – Premature Babies
Physicians in Great River Medical Center’s NICU are performing miracles with premature infants. Eight out of 10 of these tiny infants died 25 years ago. Today, the odds of survival have shifted to favor the tiny "preemies." Technology has computerized and geared down respirators, monitors and diagnostic equipment to fit the needs of these very small patients, making their chances for recovery excellent.
Physicians recognize the need for parent-child bonding in the NICU, so parents are encouraged to touch and talk to their tiny offspring. Parents from out of town who have infants in the NICU may stay in special motel-like rooms in the Mercy Plaza next to Great River Medical Center. These rooms are inexpensive and may be a convenient solution for parents wishing to stay near their infant until the baby is dismissed.
Neonatology units endeavor to recreate an environment in which the baby can grow much like it did in the uterus. Premature babies, with paper-thin skin and no fat deposits to keep their bodies insulated, lose their body heat rapidly. An NICU provides this warmth. The unit also helps babies breath, monitors their vital signs, and administers special medications and feedings. Nurses who have had special training in neonatal care are always in the unit. The nurses explain all of the procedures and activities in the NICU and make every effort to keep parents informed of their baby's progress.
Recommended Reading
Pregnancy, Childbirth and the Newborn. Penny Simkin, Janet Whalley, Ann Deppler. Meadowbrook Press.
What to Expect When You're Expecting. Arlene Eisenberg, Heidi Murkoff, Sandy Hathaway. Workman Publishing.
Labor and Birth — A Guide for You, 2nd Ed. Linda Todd. International Childbirth Education Association.
<