labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Saturday, September 1, 2007

A Revisit of Helpful Hints

It was requested that I repost some of the things that I mentioned on Life & Times that you may find useful when preparing for a new baby. I also have the list of what to bring and not bring to the hospital somewhere, so when I find it I will post that next.

I have added more thoughts to the original post in blue.

Labor Nurse's Hints From Heloise, or Useful Shit

I have been asked here on the blog as well as at work and in my childbirth classes what a new mom should buy, read, and avoid. I list what comes to mind, but remember that this is just personal recommendations, not professional. You know, blah blah blah, don't be upset with me if you follow something and don't like it.

1. Good God, get that car seat out of the box. Do this before you are 36-37 weeks. Trust me, trying to figure out one of these contraptions on the day of discharge is no picnic, and your nurse might not be able to help you legally. People who are working within a professional role who are not car seat safety certified can not touch the car seat, and especially can not place the car seat or its base in the car for you. So read the damn manual and figure out how it works. If you are anticipating an early delivery, don't be surprised when the nurses tell you the standard car seat you have is not appropriate. Many hospitals are now testing babies that are less than 37 weeks gestation or less than 5 1/2 pounds (about 2500 grams) in car seats. The purpose of the car seat testing on babies in these categories is to make sure they do not stop breathing or drop their heart rate while in a car seat. In the rare case of a baby who "fails" the car seat test, a special flat lying seat will be required.

2. Do not place anything into the car seat that didn't come with the car seat. Believe it or not, this is a sensitive topic for some parents because they can't imagine placing a baby in the seat without one of those plush head supports or some sort of dangling entertainment from the handle. Keep in mind that if you were to get into an accident and the car seat failed, and you decide to take action against the manufacturer, and there was something attached to the seat that it didn't come with then you are out of luck. Besides, the reclined position will keep the baby's head from rolling forward (doesn't matter that their head is to the side, they can still breath and clearly its not bothering them if they are sleeping) AND those little toys could turn into a weapon in an accident. They can come loose and whip across the cabin of the car, hurting anyone present. I can't stress enough that I am not trying to be mean and make your baby uncomfortable or insinuate that you are a bad parent for buying or using car seat accessories. This one set off a few readers the first time around. It's just the recommendations of car seat manufacturers and the American Academy of Pediatrics (although don't quote me on that one, I'll have to double check that) and as a nurse I must inform parents of these safety recommendations. It is completely your choice whether or not to follow it. At my hospital, nurses have to document how the baby left the unit. For example I would have to write in the baby's chart: "Infant discharged with parents in car seat following recommended guidelines" OR "Infant discharged with parents in car seat with after market added head support. Informed parents of car seat safety guidelines, parents both verbalized understanding and stated they prefer to keep after market accessories in car seat." We even have to get the parents' signatures on this documentation (in both scenarios) to ensure that there is full understanding. Of course, when I have to document scenario #2, parents think we are writing something against them, certifying them as official bad parents. Unfortunately, in our lovely litigious society, if that family was to get in a car wreck on their way home and something terrible happened to their baby because of an after market accessory we have proof that they were aware of the guidelines and therefore the hospital is not liable.

3. Once you follow #1 & 2, go to your local fire or police department for an official car seat safety inspection. Most people, even those who read the manual, do not install the base of the car seat properly.

4. Be wary of the gimmicks. First time parents are usually the most vulnerable to this... certainly all good parents must have the Pee Pee Teepee's for their little boys, or the ultra soft and sensitive silk with woven gold fiber crib sheets. When you shop at the baby stores, look very carefully at the layout of the store. Notice that all the essential baby items (diapers, cribs, car seats, strollers) are all at different corners. This ensures that all parents coming in to shop must walk through countless aisles and sections of the nonessential but must have to look like a good parent sections. I've recently noticed that even Target has re-done their baby section and placed essential items in the back while all the cutesy non-essential stuff is placed up front.

5. Stock up on diapers. In all sizes. Don't bother with buying the newborn size. Most babies these days can go right into a size 1 diaper, and all those newborn size diapers are a waste of your money.

6. Speaking of diapers, consider having a diaper baby shower as opposed to the traditional shower where people buy useless cutesy items that you are likely never to use, or baby will never wear because its impractical, too small, or too big for the season its meant to be worn. People can bring just diapers and some can even become quite creative with it.

7. Although, probably not a good idea to plan your own baby shower (you look very greedy), but you can always drop hints.

8. Newborns do not need special lotions or other skin care products. As a matter of fact, newborns should not have anything put on their skin because it is so sensitive. Just wash the vital parts once a day (face, hands, diaper) and a tub bath just every 2-3 days.

9. Most baby needs are simple. Food, comfort, warmth. Which brings me back to #4.

10. Avoid What to Expect When You Are Expecting like the plague. Who cares that its a number one best seller for years. Its loaded with anxiety provoking sentiments like, "That twinge you feel near your groin is likely just growing pains, but it could be uterine detachment or uterine rupture and your fetus is now outside the womb tangled up in your intestines. Call your physician." One of the things that Dr. Wagner writes in his recent book Born in the USA struck me as a great piece of practical advice for pregnant mom's looking for books: if the book has the mantra "Trust your doctor" put it back; if the book has the mantra "Trust your body" then it's a keeper.

11. DO NOT, hear me, DO NOT buy a home fetal doppler. It's a waste of your money. The ones in stores almost never work. All you will hear is static and possibly the playings of alien transmissions. The dopplers in your doctors office are $600 - $800 or more dollars, which is why they work so well. Go ahead and buy the professional one if you have the money, but if you don't mind spending big bucks for something you'll use only a few times contact Tom Cruise and see if you can buy his ultrasound machine.

12. 3-D ultrasound is not better than the ultrasound your doctor or midwife has you get around 18 weeks. The ultrasound "centers" that do these 3-D ultrasounds for the hell of it are making a huge profit off you just so you get a few glimpses of your baby. What most people don't realize is that ultrasound is used for medical reasons, not just so you can find out the sex of your baby. Places that perform ultrasound for non-medical reasons are crossing the fine line of ethical "treatment".

13. Attend a non-hospital based childbirth program. You should know why.

14. Hire a doula, or ask a female friend or relative that you trust to be with you for continuous labor support. Ya, I know, Dad is going to be there, but he's likely to be scared to shit and not really know what to do. Women trained to give labor support, or even those who have gone through it seem to do a better job.

15. Get yourself a very comfortable, supportive bra without wires. Sports bras are great for those who are going to bottle feed. When you become engorged you are going to want lots of comfortable support. (And ice... ice those puppies several times a day until the engorgement is gone.) For the breastfeeding mom's, get a comfortable nursing bra without wires. Trust me, you won't want to wear that little Victoria's Secret push up.


kristina said...

LOVE this list. (And thanks for #14.)

razorbackmama said...

Re: #2...

DEFINITELY nothing hanging from the handle while the seat is in the car. The handle should be DOWN when the car is moving. The whole point of a rear-facing seat is so that when there is a collision the seat will move up and back against the back of the seat, with the baby inside the little "shell." This protects the baby. If the handle is up, the car seat WILL NOT work properly in a collision.

And the same with the cushiony things that go around the baby's head. If you're concerned about jr.'s head flopping over, take a receiving blanket, roll it up, and place it next to him.

CrankyProf said...

I'm going to add to #15 -- don't cheap out on the nursing bra. A GOOD one, well-fit, won't be less than 30 bucks. It's worth its weight in GOLD.

In fact, buy two or three.

codeblog said...

I agree with CrankyProf. I went back to the maternity gift shop to get a nursing bra (employee discount!) about a week after giving birth, and they went all out measuring me, etc.

It was the best bra EVER.

Anonymous said...

Now that is the funniest and most useful blog I have seen yet!

Anonymous said...

Great list!

As a former certified carseat tech...I whole heartedly agree with your carseat advice. The whole concept of "certified techs" actually started because of two infant deaths in hospitals near to where I live--one was a baby put in front of an airbag because the outdated video (produced before airbags were common) the mom had watched in the hospital suggested putting a fussy baby in the front seat. The other was a baby that actually died on the ride home from the hospital from a seat that was too upright--head tipped forward and baby couldn't breath. I'm pretty sure a member of the hospital staff had installed the seat.

Anyway, I agree, ditch the after-market products!

I just about died the other day when I saw a "carseat cover" made of satin with gold embroidery that parents could purchase for $70. This is not one of those "keep the baby warm things" (which are often objectionable too), but rather a vanity item to make the carseat "prettier." At a CONSIGNMENT store for Pete's sake. I'm shopping at a consignment store because I can't afford baby boutique prices first of all...but lets count the ways that putting any after-market carseat cover on the carseat is a bad idea, let alone satin around a baby who spits up and occassionally blows out a diaper...

Oh...and on item #4--LOL! As it was, my girls did target practice on me more than my boys did, particularly my first born. But a friend had advised me with boys that you should just crumple up a Kleenex and throw it at the penis. It would stick, and if Jr. decided to empty his bladder, the Kleenex would absorb it.