New Baby Advice, Part Two

Well gee, so much has happened since I started writing about the first day of your new baby’s life! In just 9 short weeks, I’ll get to do this all over again. Oh joy.
No, no, now that the shock is wearing off, I’m even sort of excited to see what another Colletti-Gonzalez hybrid will look like. Maybe I’ll get my blue-eyed baby! Way back when we were NEVER going to do this again, my husband and I joked that we’d be able to keep the 3rd baby’s sex a surprise because we already had one of each. Now apparently Rick is holding me to that poorly thought out plan. Not that I’m bitter or anything.
So other than an immediate call to all my dearest friends and family to run to BabysRus for appropriate clothes as soon as this baby makes an appearance, what happens in the first 24 hours at the hospital? When your baby is born, the nurses and your obstetrician do an initial assessment in your room—sometimes even while your new baby is lying on your chest! This is commonly referred to as the baby’s Apgar score. There are typically two scores given, one at one minute after delivery, and another at 5 minutes. The baby is given a number score of 0-2 on 5 criteria: skin color, heart rate, response to stimulation, muscle tone, and respiratory effort. The highest score possible is 10. Even pediatrician’s kids never get a 10 for the 1-minute score! As long as the second Apgar score is higher than 7, your baby is doing great. A 1-minute Apgar score that is low sometimes scares families, but generally just means the baby has been stressed by the birth process. A 5-minute score that is still under 7 is more concerning and may mean the baby needs more interventions or an observation period in the NICU. The Apgar scores do NOT predict your child’s future acceptance at Stanford.
If your baby is able to stay with you, and if you desire it, the goal is to allow you to immediately attempt breastfeeding. Some babies are better at it than others. Try not to get upset if your new little one is more interested in sleeping than eating in the first day. We have great lactation specialists in both hospitals to help you figure it out. It’s a little weird to have so many complete strangers playing with your ta-ta’s, but trust me, they know what they’re doing and they’ve seen it all before. If your baby has trouble with low blood sugar or excessive weight loss, we may suggest supplementing with formula. This is not because the formula company pays us some extraordinary amount of money! We wouldn’t suggest it if we didn’t think it was medically necessary. If we do need to supplement your baby, it can be done without using a bottle—ask your nurse for options.
After the baby is 24 hours old, you’ll notice that s/he is much more alert and probably more fussy. Most babies want to be breast feeding or held until your milk comes in. If this is your first baby, you may not produce breast milk until 3-4 days after the birth. That means very little sleep for you and your support staff. You should be producing enough colostrum to keep your little one hydrated, but s/he will still be hungry pretty much all the time. We usually suggest you stay the full 48 hours allowed by law after a vaginal delivery just for this reason. It is very reassuring to be able to ask a nurse at 3 am–when you have had about 2 hours of sleep, are still exhausted from the birth, and are full of raging hormones–if all the crying is normal! We may also have you stay 2 days if you are GBS positive, or the baby is at risk for jaundice. Again, this is not to inconvenience you–our first concern is the health of your baby.
Most new moms will experience the baby blues shortly after the birth. You are not going crazy! Your poor brain is being flooded with hormones. There will be lots of crying. The lack of sleep doesn’t help much either. Cut yourself some slack and start rewarding yourself for the little things, like getting dressed or actually taking a shower. My preferred reward is chocolate, but whatever works for you! If you are feeling completely overwhelmed, lean on your support system—that’s what they’re there for and they want to help. Don’t feel like you have to do every little thing by yourself in order to be a good mom. You can always call us at the office or email us with questions or concerns. Don’t worry; we’ve heard it all. I can’t promise we don’t giggle a little sometimes, but it’s out of love and sympathy, I swear.

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