A parent's motto should be oberve, observe, and oberve your child some more Amber Pawlik



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All Things Baby: Preparing for Your First Child

Be sure to check out my book on raising an infant, The Lucky Mom: How to have a Happy Infant through Respect, Observation, and Understanding

When I became pregnant and had to make some decisions about what to buy for my baby, I was completely overwhelmed. I had no idea there was so much contradictory and controversial advice on how to raise an infant. Bumper pads—risk for SIDS or necessary to prevent injuries? Swings—a Godsend for busy parents or a cheap babysitter? Diaper pails—vital to keep a nursery smelling fresh or glorified trash cans? There are also bigger questions, such as to stimulate the child or let them grow more naturally? This first article, "All Things Baby," is an attempt to answer the most vital, biggest questions about raising an infant.

First, if you are considering or actively trying to become pregnant, my advice is to start reading books now. I provide a list of recommended reading at the end of this book. I had read many books on raising children, and I thought I was fairly prepared. But most of my reading focused on children who were 3 or over. The problem was that I would first have to tackle the challenge of raising a 0 – 3-year-old. I did not realize there was so much controversy and decisions to be made about raising an infant. All they do is sleep and eat, right? Wrong!

There are many competing philosophies over how to raise an infant. How you resolve these controversies, I believe, will affect who your child will grow up to be. If a child is raised in a more independent environment where they are allowed to be alone sometimes, or if the parent follows the "attachment parenting" philosophy, will affect who they become as a 3-year-old, which will affect who they become as a 7-year-old, which will affect who they are as a teenager, and so on. If the caregiver is gentle and loving or rough with the child; if the child has a predictable routine or a chaotic one; if they are in the hands of a competent person or not—all these will affect who the child grows up to be. There are a myriad of personality types and they start in infancy.

Another thing about reading about newborns is how overwhelmed I became with the contradictory advice in the mainstream baby books. It was frustrating. However, I learned to embrace it. I learned to start asking why one book advocated one thing while another advocated another. I found by doing this, I could get to the real heart of an issue. I was able to get more precise advice over when and why to do something in particular.

Finally, I want to add that I originally wrote this first article ("All Things Baby") while still pregnant. I added greatly to it after delivering my first son, John. I largely left the original text of this article so I could address the kind of questions I, and presumably others, had before delivering. I think this offers a unique perspective: it is like a very new mom in the throes of motherhood having a conversation with a very inquisitive pregnant woman, giving very detailed explanations to all questions.    

Overall Parenting Philosophy

I added this section after delivering my son because, after having a child, I developed a very general philosophy of parenting that caused me to re-structure this entire article. This philosophy quite simply is that a parent should find out what is wrong with the baby when fussy and address it.

Most professional books on babies state that they support this advice. One book, Happiest Baby on the Block, however, is totally opposite. Happiest Baby advocates that the best way to calm a fussy baby is to essentially distract the child. It is a wildly popular book now, supported by many medical professionals. Hospitals give classes based on the book to educate parents on how to handle a baby.

Happiest Baby on the Block advocates using the 5 "S"'s to calm a baby: sucking, swinging, side lying, swaddling, and "SHHH"ing the baby.

First, I think it is madness that a movement was started and millions of dollars were made by showing parents how to get in their child's face and say, "SHHHHHHHHHH!"

But, further, I am wholly opposed to the message it sends parents. The message is: if your child is crying, don't try to figure out what is actually wrong. Instead, try every gimmick known to man to get the child to stop crying.

Sure, these things "work." I have found for instance, that bathroom fans—which is white noise, which is what "SHHH"ing the baby is—get infants to fall asleep. I used this trick (emphasis) with my newborn only occasionally so I could take a shower. But otherwise I believe that when an infant cries, a parent should take with solemn seriousness the job of trying to figure out why he is crying and respond appropriately.

Based on experience, for a very young baby (0-3 months old), fussiness or crying is almost always due to either hunger or sleepiness. It is sometimes gas for a very young baby or sometimes a dirty diaper. As such, feeding and sleeping are the most important things to figure out regarding your newborn.

To understand hunger and sleep, one of the most important things to learn as a parent is to read the signals your child is giving. It was said to me that you will get to know what cries from the baby mean what. I disagree with this. Crying is the last sign that something is wrong. Don't want until the baby cries to respond to the baby, but rather look at their behavior. Here is a brief overview of behaviors: If he is licking his lips, sticking his tongue out, putting his fist in his mouth, gnawing on anything within reach, he is hungry. If he is kicking his legs, bringing his legs up to his belly, or turning red, he is gassy. If his eyes are drooping, his activity is slowing down, and/or he has been up for longer than 2 hours (for a very young infant), he may be sleepy. 

To deal with hunger and sleep, I recommend two books. One is The Blossom Method, which teaches a parent how to "read" their child for hunger cues. The other is Healthy Sleep Habits, Happy Child, which teaches parents what to expect in normal sleep development for a child and how to watch for drowsy signs as to establish good sleep habits.

Although these books require some skill development, they are much better books than Happiest Baby on the Block. Happiest Baby may teach a parent how to somewhat deal with a fussy baby such that they don't shake or otherwise hurt the baby. I will also say that it encourages parents to calm their babies when fussy, instead of stimulating the child, which is often a natural reaction. But I don't think Happiest Baby provides the very best solution. A parent's motto when it comes to their child should not be "how do I get this child to shut up?" but rather should be: observe, observe, and then observe some more.

Let me also give my enthusiastic recommendation for the book, Wonder Weeks. It describes 10 predictable "leaps" your child will go through, starting with Week 5 (from the due date). Right before each leap is a fussy period; the child may be clingy, fussy, or cry a lot. Their sleeping and eating are often disrupted. Their brain is growing at this time. When the fussy period is over, they have new skills. The book promises the leaps can be predicted to within a week. I have found that they are very predictable, calculating from the due date. The book also gives recommendations for toys and games to do with your child at age-appropriate times. Really, it's a great book—a gemstone for anyone studying the natural timeline of the development of children. Keep these fussy periods in mind as you learn to read and observe your child.

Another philosophy on parenting that I disagree with, which was usually preached to me by other parents, is that the parent should "train" a child, such as making him wait to eat so he is on a "better" schedule or making him stay awake so he "sleeps at night" (which, by the way, doesn't work). I find "training" a newborn or denying him what he needs to be a totally cruel and awful parenting philosophy. I try to never irritate my child, on accident and certainly not on purpose. People who do irritate their child, I think, are rationalizing something. I cannot wrap my head around why they think denying their young baby something is enlightened.

The overall philosophy is this: the child should be regarded as an independent entity with a specific identity, which is to be understood and respected, not manipulated. For a newborn, observe the child, figure out what is needed, and respond appropriately. You cannot spoil a baby, whose only desires are the extremely luxurious and pretentious needs of feeding and sleeping.

I have adopted this philosophy of observing the child and responding appropriately, and I can attest that we had the very happy baby. Not the happiest baby "on the block," because I hope all babies on the block are happy. Many people told us that we had a very calm baby. At first I thought they were just saying that to flatter us. But after going out in public, I have noticed that other babies are quite fussy to the point of even screaming—something which, other than in the first 2 weeks of life, I never heard my son do. Our stock response to people who say this about our son is that the baby cries for a reason. They are hungry, sleepy, or gassy. We address the actual problem, and then the baby is happy again.

By 2 months old, our son was frequently smiling at many things around him. I think by providing for his needs, we created a world for him that is benevolent. Providing a loving environment where his needs are taken care of is, in my opinion, the first and best thing you can do to create a child who sees the world as a fun and happy place, i.e., has a "benevolent universe" premise (as presented by Ayn Rand). The child naturally bonds with his environment, whether it is a good one or a bad one. Make it a good one.

As such, the most important things to figure out as a parent of a newborn are feeding and sleeping—the two essentials in a newborn's life.

Breastfeeding

I will cut right to the chase: The most important thing about taking care of a newborn is making sure they get enough to eat. All other topics in this article—bumper pads, pacifiers, swings, etc.—pale in comparison to the importance of feeding properly. This is where I recommend your focus should be when researching about a newborn, with sleep being a very close second.

To estimate if the baby is getting enough (or, rather, the right amount), most advice revolves around how long you breastfeed and how often. I found this is not good enough to estimate proper feeding. Just because your newborn was at your breast for 40 minutes doesn't mean he was getting milk the whole time. Trying to judge it this way is like going to a car dealer and having them tell you what your monthly payment will be instead of telling you the total price of the car.

Based on the advice of professionals and my own experience, if you are getting 5 very wet diapers a day and the child is not unreasonably fussy, he or she is probably getting enough to eat.

But if there is even the slightest problem with feeding or if you think that the fussiness is not within the realm of reason for a young infant or the diapers you are changing are routinely dry, I would recommend more accurate and objective methods.

The best advice I got for feeding a newborn was a table that showed how much the newborn weighs and then how many total ounces of food per day he or she should get. Based on the advice that an infant needs 2.5 - 3 times their body weight (in pounds) in ounces of formula or milk per day, I made a table with the number of ounces of formula or milk that an infant needs based on weight. It is at the end of this article.  There may be more sophisticated calculations for estimating total ounces in one day, but they cause confusion in my opinion. The estimate in the table combined with your baby's cues should get you to the right amount.

If breastfeeding, to get the very best idea on if you are giving your child the right amount, make an effort to know how much you are giving your child and compare it to how much he should get. This is the best metric possible. In order to know how much milk you produce, one easy way is to use a breast pump and see how much you produce in one feeding. Take one feeding to pump instead of feed from the breast and calculate that what you pump is about what you produce with the baby. Another way is to weigh the child before and after feeding, a service often offered at breastfeeding luncheons. Then write down every time you feed. This is especially necessary if several people feed the child, so that people are communicating when the child fed last (and it is easy to forget when all you fed the infant.) My favorite sheet to do this had each day laid out horizontally with every hour and half hour listed so you just tick off when you fed the baby and write underneath it information about how long or how many ounces. I found this sheet on seewhatyouread.com, which requires a subscription. Doing all of this should tell you about how much the infant got in one day.

Another way to determine that the child is getting enough, as noted, is that, starting around Day 3 – 5, when mom's milk comes in, there should be at least 5 wet diapers a day and the diapers should be very wet. The number of soiled diapers per day varies greatly and does not matter as much.

You can also tell how much the infant is getting by weighing the infant. The advice given is a young newborn should gain ½ to 1 ounce every day and should be back to birth weight by 2 weeks old. This will be monitored at each pediatrician visit. However, I propose that it shouldn't have to come to weighing the infant to know if he is gaining enough weight. If he is not gaining weight or losing weight, the health of the child is already compromised. But to get a ballpark estimate, a bathroom scale can be used to weigh the child. Weigh yourself then weigh yourself while holding the baby.

To feed an infant properly, it is important to recognize hunger signs. Most crying in the first few weeks of life, provided you are letting the child get ample sleep, in my opinion, is due to hunger. Crying however is the last sign of hunger. I recommend The Blossom Method by Viviel Sabel. Sabel was raised by a deaf mother and learned how to read non-verbal cues as a form of communication. She used that skill to understand infants. The book is primarily directed at learning about infants 0 - 3 months old. It teaches how to read not just signs of hunger but how hungry a child is.

To judge how much your child should get in one feeding, if your baby is still crying after eating, he is probably still hungry. Breastfeeding advocates often say that a newborn should only get 0.5 - 1.5 oz. But as early as Day 3, a newborn may be up to needing 2 oz at each feeding. Our son very quickly went from 2 ounces to 3 ounces (at 3 weeks). He stayed at 4 ounces for quite some time. He finally went to 6 oz around 3.5 months and stayed there until well after 6 months. We only occasionally offered 8 oz at a feeding, not starting until around 8 months.

If your child is crying for extended lengths of time in those first few weeks, please consider the food issue and make sure, based on solid numbers, that is he getting enough to eat. It is not gas; it is not an upset stomach; he does not need swaddled; he does not need "SHHHHd”; he does not even need held; he needs fed. This is how to have the "happiest baby on the block." Well-fed and well-rested babies are happy babies.

It was very shocking—and frustrating—to me how many relatives or friends helped me with the baby and always wanted to attribute his crying  to "gassiness" or "teething" or an "upset stomach." Instead of offering food or putting the baby to bed, they would stuff teethers in the baby's mouth or try to burp some "stubborn bubbles." My normally happy baby, who I often got told does not act like a fussy baby, turned into a "typical" fussy baby that needed constant attention. When feeding him properly and letting him sleep when he wanted, he was happy, content, and (comparatively) low maintenance. Under the care of others with a different philosophy than mine, he needed constant attention. I have often been told I am "lucky" to have such a happy baby. But when under different caretakers, my baby acted differently. It was not luck: the different approaches mattered.

The second strong bit of advice I have for breastfeeding is plan for help with breastfeeding immediately after birth. I found that no amount of lactation consultations or reading could prepare me for breastfeeding. In fact, I think the consultations and reading were detrimental. The easiest way to do this is to hire a doula to help with breastfeeding.

I didn't hire a doula for delivery because I thought a doula was an insult to my husband, suggesting I would want a doula, not him, as my labor coach. Indeed, actual delivery went well with my husband and I would not have wanted a doula for that. However, breastfeeding can be very difficult. Neither Dads nor moms are usually equipped for it. You really have no idea what to expect—you are meeting your baby for the very first time. If you want to breastfeed immediately, having a trusted, competent person there will help immensely. You are otherwise at the mercy of whatever nurse is on duty when you happen to deliver—an experience, I can tell you, that may be miserable.

A doula can also be given a list of things to do after delivery, perhaps phone calls that need made or paperwork that needs filled out. This will allow mom and dad to rest and enjoy baby. If you've never been through delivery, you will not be able to fully appreciate what I am saying when I say it is exhausting. But once you go through with it, you may very well thank me for suggesting getting some help to take care of these tasks, which seem like they should be easy—unless, well, you've just had a baby.

Doulas can also provide a handy way of dealing with pushy nurses: tell the nurses they are relieved of the duty of monitoring breastfeeding because you are in the hands of the doula. It is standard practice now to force mom to try to feed the baby every two hours. I have written an article on this, "Newborns Should Not be Forced on Their Mother's Chest Every Two Hours After Birth." A quote from the article: "Everyone needs to just plain STOP. Let mom and baby REST." I think the aggressive tactics of hospital staff who try to enforce a rigid schedule of feeding every 2 hours is unnecessary, frustrating, and only serves to create panic. Babies are tired after birth, not hungry (except for the very first feeding within an hour after delivery). There is no need for such an aggressive schedule until mom's milk comes in, around Day 3-5. Until then, let you and your baby sleep in the first few hours and days, something that used to be standard practice: you've been through a lot!

Finally I want to add that a newborn's feeding schedule is relentless and exhausting. The first weeks are very, very difficult. New moms are not told this, but should be. The sleep deprivation is through the roof. No matter how hard you think pregnancy is, the 4th trimester is the hardest. I believe most postpartum problems are due to extreme sleep deprivation. A child may want to feed every 2 hours. If one feeding takes 40 minutes, do the math on how long you will be breastfeeding each day. Mother and baby may also run into technical issues with feeding, such as low milk supply or latching problems, which complicates everything all the more. There is a reason why rich women of the past sometimes handed off breastfeeding duties to a wet nurse.

Perhaps there are women with few technical issues and whose babies feed quickly; something I sincerely hope for all new moms. I am not trying to undercut breastfeeding but, really, moms-to-be need to be told how exhausting it can be. And, no, contrary to some people's belief, nature does not automatically work perfectly, despite "years of evolution." People should be reminded that until fairly recently, women sometimes died during birth. If you want to know why most births now go mostly well, it is due to modern medicine, not the hardening of women due to evolution. Similarly, breastfeeding is not an automatic process without complication. If you are aware of how difficult it will be though, you will be better prepared.

Really—consider what you are going to do to make things easy on yourself. Set yourself up for success in every way possible. Talk to your spouse about your feelings on how often you plan on feeding. Tell him about hunger signs and appropriate amounts of food an infant should get so he doesn't panic when it seems like the infant is not getting enough. (I have heard this happening many times.) Again, I strongly recommend hiring a doula or lactation consultant to help you at birth and in the hours after.

I am of the belief new moms should be babied after delivery. Friends, relatives, and dad can take care of all household chores, cooking, and non-feeding baby chores (the latter preferably staying with dad) while mom does nothing except focus on breastfeeding. Of all the practices that could actually encourage women to continue breastfeeding past 1 month, I think this would work the best. To get through those exhausting weeks, I would often tell myself, "The only thing I am going to do today is focus on breastfeeding." Realize also that the first 6-8 weeks are the hardest. If you can make it past this, everything should start to get easier. Consider it a milestone to get to: Get to it, then worry about anything after later. And don't beat yourself up if you occasionally supplement!

Breast Pumps

Lactation consultants are very aggressive now (2012) with pumping. In my experience, there is no need to pump before your milk comes in (around Day 3 – 5). I found a baby can extract colostrum—the thick substance produced in the first few days after delivery—but a breast pump cannot. Lactation consultants argue that, even before your milk comes in, you should stimulate your nipples by using a breast pump. Let me ask you: is this "stimulation" really worth the enormous effort they are asking you to put in—10 minutes on each breast every 2 hours (4 hours a day!)—in the hours after you just went through labor?  It is extremely exhausting and frustrating to pump and have nothing come out. If a lactation consultant comes in to your hospital room and wants to leave the breast pump in your room, I recommend declining it.

Also, I found the hospital grade pumps were not any better than the Medela Pump in Style that I had at home. I have never gotten a good explanation on why hospital grade pumps are better. I don't recommend renting one. My experience with that was awful. First, those things are rentals and like all rentals, they are not taken care of. To turn it on, I had to blast it at maximum strength then wind back down to a comfortable suction. That felt awesome on my nipples. Further, the paperwork to get the contract kept getting messed up. I continued to get call after call about the rented pump in the days after I left the hospital, waking me from sleep or getting me out of the bath—not something any sleep deprived mom will like.

Low Milk Supply

I would like to add an insight for any woman who is at risk for low milk supply, from breast surgery or other reasons, and wants to breast feed. I recommend taking very careful measurements of how much you are feeding your child and to plan on pumping. Pumping accomplishes two goals:  establishing the best possible milk supply and knowing how much you produce. In this unique situation, you really, really need to know how much you produce.

This is what I suggest to do: pump every 3 hours once your milk comes in, which is not until Day 3 - 5. If you pump aggressively like this, it will help establish a better milk supply. Also consider drinking mother's milk tea which really does increase milk supply. I recommend being familiar with how much a baby should get in one day, and then comparing how much you produce to how much the baby needs. Feed the baby what you pump, supplementing with formula as needed. Perhaps bring the baby to your breast at least once or twice a day so he is used to it. Once you are confident with how much you produce and how much you need to supplement, you can perhaps stop pumping (regularly) if you want. The cycle may need repeated as the baby grows in his feeding needs. No, this may not be the most ideal solution, as breastfeeding provides a bonding experience that the breast pump does not. But this is a unique situation and some sacrifices will likely need to be made.

Boppies

I recommend getting a boppy. If you are bottle feeding, it gives a pillow to set the baby down at a nice angle in which your other hand can even be free. Get one for the upstairs and downstairs. If getting a "boppy" for breastfeeding, I recommend the "BrestFriend" pillow. They snap around your whole torso and you can attach it just below your chest like a shelf.

Bottles

Even if breastfeeding, I would recommend getting some bottles. They can be used as a backup in case breastfeeding doesn't go as planned. Also, if you pump, they store the milk. And bottles allow dad to get involved.

But finding a good bottle is maddening! There is pretty much no bottle on Amazon that has 100% glowing reviews—each of them has several negative reviews.

I think I have figured out why there are no good bottles. It has to do with the BPA scare. This Amazon review explains the different plastics used in bottles really well. In short, bottles used to be made with Polycarbonate plastic, which is a hard, sturdy, clear plastic. However, due to the BPA scare, most manufacturers no longer use this for baby bottles. Most instead use polypropylene. Polypropylene has a milky appearance (like a milk jug) and is flimsier. To accommodate for this, extra parts must be added to the bottle, making it more cumbersome to use and clean. Also, the bottles must be assembled with more care. If they are not assembled correctly, they will leak.

As such, many of the reviewers on Amazon show their frustration with the bottles. Many ask, "Why can't they make a clear bottle?" or "Why can't they make them with less parts like they used to?" Many of the reviews complain about leaks—a problem much more likely to happen with the clunky BPA-free plastic bottles.

Of course every mom wants what is best for her child. So when there is a scare about BPA, the overwhelming majority of women will go out of their way to avoid BPA. However, as a fairly scientific person (I work as an engineer) who has followed some of these environmentalist trends, I believe the BPA scare is the usual unfounded fear-mongering to be expected from environmentalists. It is all based on theory, not actual proof of damage. This report gives an excellent overview of the BPA scare:

BPA has never been shown to have any sort of health effect on humans in the extremely low doses we are exposed to from plastic bottles, can liners, or eyeglass lenses. This is true for all ages, even babies. Rats? Maybe, in high-dose experiments. Humans -- no, not a single soul.

To get around the BPA scare problem, I used glass bottles. I was originally worried glass would be too heavy but I did not have a problem with that whatsoever. Glass however is not accepted at most daycares.

Before getting pregnant, I had several questions, such as: what is a vented nipple? Many nipples say they are "vented" but for the life of me, I could not find the vent. The only exception was NUK nipples. There is a hole, below where the baby's mouth covers, that lets air out and acts as a vent. Others seem to have little slits where the baby's mouth covers, which is their "vent." I am no plastics engineer but I don't see how these can actually vent air. We indeed found the NUK nipples the best for venting air (for standard sized bottles). We would break suction semi-routinely with other nipples to release air.

Another question I had was the mix and match ability of bottles: how well would a nipple from one brand fit on the bottle of another? I found there are essentially two sizes: standard and wide-base. Standard bottles can, in theory, be mixed and matched. The threading on certain bottles don't work quite as well with others sometimes. The wide base are convenient for dumping formula in as there is a wider diameter to work with. A particular company's wide base bottle probably will not work with another company's.

As an FYI, there are some bottles that are designed for babies with colic. They have a very complicated system with an insert and there are many parts to assemble and clean. For me, I had them on reserve as something to try if my baby had colic. Some brands that are designed for this are Dr. Browns, BornFree, and MAM anti-colic bottles. The reviews of these usually complain about all of the parts but these are designed for a special purpose and it is difficult to get the best of every single world.

After working with the bottles, one strong recommendation I have is to buy nipples with slow, medium, and fast flow rates. Slow is typically for a 0 - 3 months old; medium for 3 - 6 months; and fast for 6 months or over. It really does make a difference and yes, time will fly. Your baby will be 3 months, then 6 months in seemingly no time at all! Unfortunately, not all nipple products clearly mark the rates. Evenflo nipples do not mark the nipples clearly. The currently popular Avent bottles do.

I found mixing formula to be difficult. At first I had to shake the bottle vigorously to get it to mix. I found that if the bottle was tipped upside down and at an angle, it mixed like magic.

When going out away from home, we found ready-to-feed formula was a real convenience. Especially convenient were formula bottles that acted as its own bottle with threading at the neck thus only needed a nipple put on it. Similac is the only brand I know of that offers this. There are two-ounce and eight-ounce bottles. This suggestion out of the way: if you want to breast feed in public, I am 100% for your right to do this, in whatever manner you find most comfortable!

If you have the opportunity to go to a baby expo, definitely go! Perhaps there are mothers you know and you can take a look at their bottles. Shopping for bottles without being able to get them out of their package and look at them is difficult. Also, once you buy them, I strongly encourage you to practice or at least understand how to make a bottle of formula. You may never need the skill. But when you need to do it at 3 am when you first bring your baby home, it comes in handy.

Sleeping

A very close second important topic after feeding is sleeping. Want a happy, alert baby? Make sure he gets good sleep.

The two main competing philosophies about a sleep schedule are on-demand sleeping versus a schedule. Being a person who favors routine, I was totally on board with a scheduled routine. But in reading about babies, I have found that it may not be that simple and as with all things with baby, it is time sensitive.

The recommendation given in Baby 411, a book written by 2 pediatricians, was to do whatever you have to in order to get the baby to sleep (holding, rocking, etc.) in the first 2 months and especially the first 2 weeks. At 2 months, you can start to transition the baby to a schedule. The transition should be complete by 4 months.

The argument is that a less-than-2-month-old is not self-aware and is not neurologically ready to soothe himself in order to go to sleep. The Baby 411 book was very clear on their position that letting a 0 - 2 month old infant "cry it out" was cruel.

To get better answers and a full picture to sleep questions, I read the book Healthy Sleep Habits, Happy Child. I found it somewhat difficult to follow the book's recommended timelines for sleep advice. It was very difficult to pin down exact times. To try to get a full picture, I highlighted every single instance where it mentioned a time-sensitive sleep milestone then tried to put them together to form a consistent picture. Here is the highest level, simplest overall timeline that I could come up with of sleep milestones that are repeated frequently throughout the book. Also note that these times are calculated from the due date not the birth date:

To summarize, in the first few weeks, the baby's sleep schedule is pretty much chaos. The baby will sleep for 2 - 4 hours at a time and be up for 1 - 2 hours. Fussiness will gradually increase, especially at night. Week six is a turning point. Fussiness is at its peak but will start to die down. The baby will start to sleep longer at night, 5 hours straight at first, gradually increasing such that the bedtime is earlier and earlier. At 12 weeks, the daytime sleep organizes with the morning nap appearing at 9:00 am first, followed a few weeks later with the afternoon nap at 1:00 pm. At about 15 months, the morning nap should disappear. At 3 years or later, the afternoon nap disappears.

This is a more expanded outline with similar information and how to respond as a caretaker.

If you are like I am and panicked a little when you saw that sleeping would be chaotic in the first few weeks, you can rest assured that the author promises that responding properly in the first few weeks by avoiding the over-tired state and soothing to sleep will prevent sleep problems in the future; something that was music to my ears. The over-tired state is when the baby has gone past drowsy to over-tired and, just like adults, stimulating hormones kick in at this stage. It makes it very difficult to fall asleep.

Probably the most difficult question to answer in this was "when can the baby self soothe?" This means letting the baby fall asleep on his own, without soothing techniques such as holding, rocking, and sucking. The earliest that Healthy Sleep Habits recommends this is at 6 weeks old. But at 6 weeks, the book says only to let the baby go a few minutes while crying and evaluate after that. The author says in another place that he wants to be "very clear" that self-soothing does not occur until 4 months. By this, I think the author means the full-fledged cry-it-out method where the baby is left to cry for an undetermined amount of time at night.

Advice that I thought was really good, which was in both Baby 411 and Healthy Sleep Habits, was to watch for drowsy signs in your child and put the child to bed while drowsy but awake. The child then gets used to falling asleep in his own bed. This is advice that can be practiced from Day 0. In Healthy Sleep Habits, it says to go ahead and do this "if possible" in weeks 0 - 3. It also says that in young children, older children, and teenagers, this is really the ideal time to go to sleep. Basically, this advice always applies, probably even for adults. But after a certain age, going to bed "by the clock" becomes an acceptable estimate, and watching for drowsy signs from the very start is one of the most important parts of sleep training.

In Healthy Sleep Habits, it promises that "perfect timing" in as far as watching for drowsy signs will produce "no crying" at night. The perfect time is when the baby or child first starts to get tired, which can be observed by a slight decrease in activity or a slight fading of the eyes among some other signs. Crying is the last symptom that a child is sleepy.

Around 8 weeks, we started putting the baby in his crib after the 9:00 pm feeding. He fell asleep easily for us and slept at first for only 3 hours, then 5, then 6-7 hours at 3 months old. At 4 months, he was out like a light at 6 pm, which is the time when we started noticing sleepy signs. He indeed slept for about 9 hours (until 3 am) at this age. No crying! It is noticeable that he is in a very deep sleep at nighttime; it is different than sleep during the day. Really, good sleep training from the very beginning does in fact lead to (nearly) no crying.

I found an elaborate bedtime routine was unnecessary. There is nothing wrong with a bedtime routine but I found it was not necessary. We watched for drowsy signs, changed him, and put him to bed. That was all we did, and he was routinely out like a light bulb at bedtime. While the routine is fun in many ways, it can also exhaust mom and dad night after night. We started a bedtime routine at 18 months.

Ultimately, a well-rested baby is a happy baby. It is not normal for a child to get irritable at the end of the day. This is a sign of a child not getting enough sleep or is over-tired. I have seen parents yell at their child when the child is very ill-behaved late at night, "Do you need to go to bed!?" The answer is yes and as a caregiver you have failed your child by letting him stay up so late. Healthy Sleep Habits also argues that the effects of lack of sleep get progressively worse, so the same bad habits will create an increasingly irritable child. The book argues that most children are kept up too late or skip naps for the selfish pleasure or convenience of parents. Really, don't worry about all of these details I've laid out too much. After 4 months, when a schedule and self-soothing is possible, a wise, principled approach, free of typical parental politics, with your child's best sleep habits in mind will produce good results. If sleep training has occurred up until 4 months, crying will probably be minimal. If no sleep training occurred until 4 months, you may have to deal with a wailing baby for 45 minutes or more. But most medical books say this is okay for the baby and advocate it as a method. They all promise getting a good sleep schedule will happen shortly—in just a few nights. I can attest that I've seen children respond extremely rapidly to sleep routines.

As far as letting the baby sleep in bed with mom and dad, I am completely opposed to it. I will sleep near my child in those first few tumultuous weeks but not with my child. You could tell me the baby will grow up to be the next great scientist and Olympic athlete if the baby would sleep with mom and dad, but I still wouldn't do it. I am worried about smothering the child, but more—that is our marital bed and it's just not happening.

A bit of advice that made sense to me, from Baby 411, was that the crib should have nothing except a mattress and a tight fitted sheet in it. No blankets, toys, or anything extra. To keep the baby warm, a sleep sack can be worn (get a fun color!), or a sleeper, and also some people advocate swaddling. We also bought darkening curtains to give the baby the best environment for sleep possible. I am very strong in my belief that the nursery should be boring—void of stimulating things such as mobiles—in order to give the best chance for sleep. When the baby first awakens, to reinforce sleep patterns, open the curtains to let sunlight in and do stimulating activities. When it is time for bed, do the opposite by calming the baby and darkening the room.

As far as swaddling, I was often told that it makes the baby "feel like they are in the womb" and thus comforts them. I don't really buy the argument. It sounds decent in theory but is it grounded in fact? Parents, including ones who swear by swaddling, tell me their baby wiggled their way out of the swaddle. I did not find swaddling to work for us. My son would break out of it before I could finish it. Granted, I didn't have the heart to do it very well. When the baby is gassy, he kicks and moves to get gas bubbles out. I think it is important the baby have freedom to do this. If you do swaddle, bear in mind it will likely only be useful in the first 3 months.

Bumper Pads

One of the very first controversies that I came across when researching infants was bumper pads. Bumper pads are pads that go around the crib. They are meant to provide a soft environment for the child.

I read two books that were both written by medical professionals that had different advice. One was The Mayo Clinic's Guide to a Healthy Pregnancy. The other was Baby 411, which is written by two pediatricians. The Mayo Clinic book said to have the bumper pads. Baby 411 said to get rid of them.

At first, I was very, very frustrated by this. But then I started to ask why each had different advice. The Mayo Clinic book said a child could kick and punch and the bumper pads would provide a soft environment to protect against bumps and bruises. The Baby 411 book said the extra padding in the crib can increase the risk of SIDS.

By asking the "why" for each argument, I was able to come up with a clearer picture about bumper pads. If the worry is the child will kick and punch, infants really don't start moving around until they are older, rolling over at about 6 months. Our son first rolled over at 4 months and routinely started rolling over at 5 months. The risk for SIDS, however, is highest when the child is 0 - 6 months. When more information is found out about both positions, a clearer answer comes into view: Don't use bumper pads for the first ~6 months when the risk of SIDS is higher, but when they are older and rolling and kicking, consider using bumper pads. Some bumper pads are made of mesh, which reduces the risk of SIDS. There may be some overlap between the time when the risk of SIDS is still present and they are kicking and punching. Parents will have to decide which risk they would rather take.

One of the things I wish these baby books would do a better job of is giving a timeline of when their advice would apply. Usually they have an age in mind, but they don't state it. I have found that infants go through very rapid changes and the parent must anticipate and expect them. Bottom line is everything about child raising is time sensitive. Advice on babies should always be time-stamped.  

Baby swings and bouncers

One of the things I did when I started to look for baby products was to go on Amazon. First, they have their "jumpstart" items where they recommend 15 baby items that every new parent just has to have. Amazon also has customer reviews of products. It was at first very persuasive to me to take the recommendations of users.

One of the jumpstart items on Amazon is a baby swing. Also, the reviews of many of the baby swings are glowing. It was really easy to think I just had to have one.

However, most baby books advised against baby swings (even, ironically, ones that happily advocate Happiest Baby on the Block, which advocates swinging as one of the 5 "S"s). The conflicting advice, this time between regular parents and medical professionals, frustrated me. I found if I asked "why" I could get a better picture.

What I found is that baby swings may make things easier on the parent but they are not necessarily best for the baby.  The baby books often describe the swings as like putting the child in front of the TV. If the baby is fussy, a parent may put him in the swing. The swing rocks him and puts him in a zombie-like state, completely distracting the baby over what was upsetting him. Swings also provide entertainment for your child. One of the bouncers on Amazon is literally named "Babysitter Balance" (emphasis mine). 

This kind of advice is constant from other parents. There are many products that they rave about from swings to jumperoos. But look at why they like it—usually they say, "it lets me do the dishes!" or "the baby is entertained for hours!" Personally, if the baby is crying or fussy, I want to find out why and address the actual issue, not put him in a swing. Also, I want to actively engage my child, not fix him up with some device that is going to provide entertainment for him. While at first it may be more effort to tend to a child's needs, I believe if the child learns to entertain himself, the dividends will pay off in the long run.

I have read that for extreme cases, such as an extremely colicky baby—where  there is unexplained crying for 3 hours or more per day at least 3 days a week—a  swing can be useful. I am sympathetic to the parents of a colicky baby and do not judge them for doing what they have to in order to calm their baby. Baby 411 recommends probiotics for colic, boasting a 95% reduction in crying. I cannot personally attest to if this works or not.

As such, in general, I suggest taking Amazon reviews with a grain of salt. Once you know what product you want, by all means check out reviews, but don't let the reviews drive what product you buy.

I do, however, recommend getting several very comfortable bouncers like this one or a sleep rocker like this one. Put them in whatever room the baby might be in, such as the living room, bedroom, and bathroom. They provide cozy little beds that you can put the baby in. When the baby can roll and move, he can be on the floor, allowed to be free. Until then, you will probably use some kind of baby holder.

As far as any worry about putting the baby in an uncomfortable position that might disfigure the child, the worst offender is the car seat. Car seats are designed for safety and that is all; they are not designed for comfort or ventilation. I cannot believe parents keep their children in car seats when not in the car. Bouncy seats usually keep the baby straight from rump to head. I would not worry about disfigurement from bouncy seats.

Walkers

I read the book Welcome to Your Child's Brain. I didn't really like the book … but I digress. In this book, the authors argued that if the baby's feet are stimulated more, the child will walk sooner. They gave the example of people in different cultures who do aggressive stretches and exercises with the baby's feet and the babies walk sooner.

I accepted the advice at first. I thought about a way I could stimulate my baby's feet and I thought of a walker. However, walkers are strongly advised against now. The American Pediatrics Association advises against them. They are, first, a safety risk as the child can get into more or fall down the stairs. Also, they are known to cause developmental problems as the child tries to learn how to actually walk.

Really, as far as trying to stimulate my baby's legs and feet, I was just being lazy. Even if I wanted to do this, there are better ways to do it than using a walker. I personally know a child that fell down the stairs after running around in a walker. I am not planning on getting a walker. (Have you noticed my baby registry was really cheap!)

This cuts at the core of a major parenting issue, which is letting the child grow naturally or stimulating him. In this issue, using the walker, the baby is able to "walk" at an earlier stage but with the aid of a prop. I have come to the conclusion that, even if my child's accomplishments aren't as impressive as, say "walking" at 8 months of age, I want his accomplishments to be real. Instead of, for instance, aiding him up the stairs at a young age, let him crawl on his own. I think this will help instill self-confidence and genuine independence. 

Instead of buying a walker, why not buy a walker wagon? The walker wagon gives the child an aid to support his weight, but the child himself must push the wagon. It gives an assist to the child without having parental involvement by trying to hold the baby's hands and walk—and parents typically walk too fast for the little one. Our son used his wagon to stand up at 5 months, which he loves, and to walk, supported, at 8 months.

Pacifiers

Pacifiers are not favored by most books on raising an infant. Baby 411 advises if you use them at all to wean the child off of it by 6 months.

Magda Gerber in Your Self-Confident Baby recommends against them altogether. She argues that if a child wants to suck on something, they can suck on their thumb. Their thumb is always available, giving them total control of when they use it. A pacifier can fall out and the child is not capable of putting it back in their mouth. It was described in Baby 411 as falling asleep with a pillow but then waking up in the middle of the night with it gone. It frustrates the child just like it would frustrate you.

I found the argument of "let the child suck his thumb" to be persuasive. However, the other piece of advice was to let the child suck on your fingers if nothing else is soothing him. I didn't really want to do that, at least not all of the time. As such, I got a pacifier. I recommend having a pacifier right from birth—but only use it for the first 6 weeks of life.

The advice about pacifiers should be to use them but don't abuse them. I mentioned that I would use the bathroom fan, white noise, to calm the baby so I could take a shower. I use this trick in a limited way for a specific reason. The same should be applied to pacifiers. A pacifier is a great assist in numerous situations. For instance, there may be times when you, as a mom, are home alone, and you need to do something before you can tend to your child, say prepare a bottle. The child will wail and wail. A pacifier can help greatly to calm him down while you can't get to him. Or, while changing his diaper, he may cry. A pacifier comes in handy.

There are some parents that use a pacifier as their only tool to get a child to calm down. This is wrong in my opinion. Most of the time, a parent should be able to evaluate their child and figure out what is wrong and address the actual problem, not just put a pacifier in their mouth.

I found that a pacifier was mostly not needed past 6 weeks. After 6 weeks, I only used it in extremely unusual circumstances. I am shocked when I see children as old as 3 years old with pacifiers!

Breastfeeding advocates argue giving a pacifier in the first weeks of life will interfere with breastfeeding. I think the advice of breastfeeding advocates when it comes to things like pacifiers is a little overzealous and, unfortunately, a bit loud. I am a proponent of breastfeeding, but their advice is often too broad. If anything anywhere can be abused, they want to wholesale advise against it for all women in all situations despite what value something might have. From either books on breastfeeding, breastfeeding classes, or lactation consultants, I have read / been told all of the following: don't give a pacifier in the first weeks of life, don't introduce a bottle right away, don’t get the epidural, don't use a boppy, certainly don't use any breastfeeding position except the standard ones taught, and let the baby breastfeed as long as desired. They say it is to prevent "nipple confusion" or a host of other reasons, but really I think they are worried moms will stuff a pacifier in the child's mouth when what he or she really needs is to be fed.   

Baby carriers

Before I got pregnant, I thought a baby carrier would be unnecessary as, if I had to do chores, I thought I could just put the baby down for some alone time. I didn't understand why others wouldn't do this. I found out why: the baby won't let you! He is fussy (probably gassy or going through a "leap") and wants to be held—or, at least, being held calms him down. Before I had the carrier, if he was fussy like this, I would have to walk him around and around … and around. I bought a baby carrier and during fussy times where he is not hungry or sleepy but just wants held, I strapped him on me and walked around and did chores. At least I was able to get something done while he was fussy. It is admittedly harder to do certain chores with a baby strapped to you. The need to calm the baby down like this probably only applies to a very young baby, for the first 6-8 weeks. At this time, the baby is unexplainably fussy sometimes.

I also use the baby carrier when shopping. Shopping carts simply don't hold a car seat well. I also use the baby carrier on vacation, especially at amusement or theme parks. On most attractions, you are not allowed to take a stroller through the line. Without a baby carrier, you would otherwise have to hold the baby the whole time.

Nail and Skin Care

Since I've seen so many people complain about drawing blood when cutting their infant's nails and also not understand why you might need a nail file for a baby, I am including a section on nail care. I have read more than once that a newborn's nails are usually scraggly but their nail and skin may be fused. Thus, if you use nail clippers, it may draw blood. This is why a nail file is suggested for the first few weeks. I found this electronic nail filer. I found this filer worked well enough for the very first nail trim. It was under powered though, and it took forever. I only had to use it once. After the baby was about 2 months old, I used nail clippers exclusively and successfully.

For bathing, a bath is usually only recommended 2-3 times per week. More than this interferes with the baby's natural oils, but do wash the baby's hair at least twice a week, otherwise the baby may get cradle cap.

Here are some videos that I found useful for newborn care:

·         Sponge bath

·         Umbilical Cord Care

·         Circumcision Care

·         Diapering

Personally, I think that competently handling all of the everyday stuff with your child is one of the most important things you can do. All of the other stuff about independence versus attachment parenting or stimulating the child or not is much less important than if the child is in competent hands. I think it would very much affect the child if, in the course of your care for him, you are drawing blood or otherwise hurting the child. As such, I want to make a suggestion of how to become competent at everyday care: Buy a lifelike newborn doll and practice on it.

I have read online moms wanting to do this and other moms mocking the woman for wanting to do it. "A doll can't mimic a fussy baby!" No, it doesn't, and that's why it is perfect. I work in the field of modeling and simulation, specifically using modeling and simulation to train people, and let me make my pitch for why practicing on a still doll is better than practicing on a fussy baby. When practicing on a model, it removes all clutter and distractions and allows the person practicing to focus on the essentials of what they are doing. If practicing on a fussy baby, instead of focusing on how to do it right, you are distracted by the fussing and crying and you probably just want to get it over with. By using the still doll, you take your time, think of questions, and set up good habits to do it right. If you practice several times over, it will become habit. You will do it effortlessly and without thought. Then add the extra complication of a moving baby.

I found going through the videos and practicing on a doll was useful. It highlighted exactly what materials we were missing and had to go shopping for. It made us think about where we would do some of these activities and it allowed me to get dad involved and confident early on. I think it increased our confidence at least by 30% and reduced any possible frustrations, such as not having materials, by probably 200%.

Diapering

There is something to be said about investing in good diapering products. We bought the highest recommended diapers. We have more expensive wipes, which have lanolin in them, which is a powerful moisturizer. We put petroleum jelly on our child after every soiled diaper, and we bathed him at least twice a week. He stayed diaper-rash free, even when he had the stomach flu. During periods of the stomach flu, I used Triple Paste very frequently to stave off diaper rash.

Here is a tip: If you have an Amazon.com baby registry, 5 weeks after your due date, they give you certain products at a discount, but they had to be on your registry for so long. So, put many, many wipes and diapers on your registry. Perhaps people will buy them for you. If not, you can buy them in bulk at a discount.

I wasn't sure how many of each size diaper to buy before delivering. I am not sure why I did not just do the math! Newborn diapers are recommended up to 10 pounds; Size 1 from 8 - 14 pounds; Size 2 from 12 - 18 pounds; Size 3 from 16 - 28 pounds. I would recommend defaulting to the bigger size when the sizes overlap, e.g., go to Size 1 at 8 pounds. The average newborn weighs 7.5 pounds. They will double their weight (to 15 pounds) at 5 months and triple their weight (to 22.5 pounds) by one year old. A child goes through about 7 diapers a day. Knowing everything I just wrote allows one to predict the number of diapers needed. I estimate, for the first year, about:

·         100 Newborn

·         588 Size 1

·         588 Size 2

·         1323 Size 3

There are, of course, a lot of variables. These are just estimates. Here is a chart showing what I just described. I could not fit the newborn diapers on the chart.

 

When we first diapered our newborn, we would diaper first then feed. This was to try to wake him up to feed as he was falling asleep on my breast. But he would cry and cry when being diapered. We switched it to feed then diaper. He happily had his diaper changed and even smiled at us. Diapering, as crazy as it sounds, was a very fun time!

Diaper pails

I had read an online article that said diaper pails were glorified trash cans. But, as a mom- to-be that didn't want a smelly nursery, I considered them. They all put some type of chemical on the diapers to reduce the smell and try to lock in the diapers to keep out the smell.

When shopping, I simply wasn't able to find a diaper pail with a design I like. The "Diaper Pail" that uses baking soda didn't have a foot pedal to open it. The reviews of the Diaper Genie said it breaks often, which is also what other moms I know personally have told me. Also, I couldn't help but notice that they all depend on refills, which can get expensive. So I just plain didn't get one. We used a normal trash can, emptied twice a week, and did not have much of a problem.

I have my own suggestion for this: Use a normal trash can and attach a febreeze to the lid.

Bath tubs

Quite honestly, when shopping for a tub, I would look at them and wonder how they worked. I then watched videos on how to give an infant a bath, painstakingly trying to figure out what all materials I needed and how to maneuver an infant in the plastic tub to give a proper bath. When I gave my son his first bath, I found he didn't much enjoy being put into the tub. He liked getting splashed with water but the experience could have been better.

Instead, I often preferred to bring him in the bathtub with me. I found taking a bath with the baby was most beneficial in the early weeks—when I wanted a bath but never had the time to get one. It is a 2-for-1: you get clean and the baby gets clean, and it's a great bonding experience. Experts now push skin to skin contact and this is a method to get that skin to skin bonding in. If you buy the "the baby likes to feel like they were in the womb" argument, then being in the water will be comforting to the babe. If the baby has colic, this may be a very relaxing way for the parent to calm the fussy baby down. Just make sure the water is a comfortable temperature for the baby; get in the tub first then grab the baby (say, from a sleep rocker), and be careful to not let the baby fall into the water. Don't do it when exhausted such that you might fall asleep in the tub!

I did, however, use the "Whale of a tub" when the baby got older. It is quicker and I don't have to get in if busy. Once our son figured out how to splash, bath time was pure hilarity!! It is hard for me to believe that before I had my first child, I thought bath time would be a chore!

Here is a tip on taking a shower: Bring a bouncer into the bathroom and put the baby in it. Turn on the fan. It will calm the baby so you can take a shower. The sound of the shower will also calm the baby. This only works for the first few months.

Regarding baby towels, they are flimsy. I didn't really like them. I just used a regular towel and wrapped the baby in it. It is big and warm and fluffy and cozy.

Finally, buy lots of wash cloths. Have them absolutely everywhere throughout your house. This is great for cleaning up milk that dribbles down the baby's chin. I did like baby wash cloths; they are delicate and better for cleaning the baby's soft skin. Normal-sized adult washcloths also come in handy though. If making a gift basket for a new mom, she can never have too many washcloths.

Clothing

For some reason, everyone always seems to think babies are cold. It is a source of major henpecking from other women to mothers: you better keep your baby warm! Women near me in Florida worry about what mittens to buy. What kind of blizzard do they think they are going to encounter in Florida? (Although mittens may be convenient to stop a baby's nails from scratching himself or mom and dad.)

I have to wonder: have these women ever held a baby? Babies are piping hot! Absolutely every bit of professional advice that I've gotten has said that babies are typically kept too warm and this is a source of heat rash. The advice from both books and classes I have taken is that the baby's ability to regulate heat is similar to an adult's and thus what you wear, the baby wears.

Not only do I think you should not put layers of clothes on your baby, I have read and recommend letting him be without clothes as much as possible (diaper or naked)—if at your house and if warm of course. It helps the baby have more precise control over his body.  

Getting sick

I wanted to be prepared if my child were to get sick. I am a hyper note taker and documenter but I stopped myself from writing down all of the advice in all of the books I was reading. Instead, I got a handy reference. I recommend this book: My Child is Sick: Expert Advice for Managing Common Illnesses and Injuries.

For stomach problems, pediatricians commonly recommend probiotics now. They are available over the counter. Popular brands are Culturelle and Florastor.

When your child is 15 months, which is when they can probably walk and follow simple instructions, I strongly recommend teaching them how to wash their own hands, using a two-step step stool. When my son started going to a Montessori school at 18 months, they emphasized hand washing and he never got sick one. A strong commitment to hand washing can go a really long way towards preventing illness.

Vaccinations

I am only touching on this topic because I know many other mothers who either don't want to vaccinate their child or are drawing out the vaccinations. I don't support either position. Drawing out your vaccinations leaves your baby at risk for a longer than necessary amount of time. I think mothers of today are completely unaware of the risk they are taking by not getting vaccinations. Whooping cough, mumps, and measles—none of them are pretty and can be deadly. There may be a small risk and also a discomfort to the child when vaccinated but it is nothing compared to the alternative. Also, by not vaccinating your child, you are putting other children at risk, particularly ones who are too young to have gotten the vaccination yet and are at the same doctor as your child. Really, if you tell me you are hesitant to vaccinate your child, expect my stock response: "Keep your child away from my infant."

Delivery

One of the very first books I ever read about babies (well before becoming pregnant) was Montessori books. In particular, The Absorbent Mind is a good one to read because Montessori describes in scientific detail all of the wonders and maturation of a child, from conception. It is a really great book to make you appreciate the miracle that is life.

One of the things argued in this book is that any amount of mishandling the child at delivery can cause problems for the child into adulthood. The first hours of life are the most sensitive. It argues that the first minutes/hour of a child's life should be handled with intimacy and care and to forget measuring the child right away, shuffling him or her around from one set of busy hands to another. That advice was with me for a long time; it was long something I wanted to do.

I was worried that hospitals wouldn't respect this. For a period of time, they probably wouldn't have. But I have good news: things are changing! They are changing just now in fact. The hospital I was with is transitioning to make "Skin to Skin" standard procedure. I am giving you the term so hopefully it can help you discuss what you want with your doctor. The baby, once born, is immediately put on mom's chest, skin to skin. All medical tests are done while the baby is on mom's chest. The baby stays there until the first feeding, and it is the baby that indicates he is hungry by rooting for the breast. When that happens, you can feed the baby. It is in my opinion much better than having the baby rushed off then coming back perhaps 1-2 hours later and having a nurse try to force the baby onto your breast.

Like I said, the transition is just taking place now. When I asked about it in February of 2012, my doctor said she had done it for just the past 5 deliveries! The hospital is pushing to making it standard practice. I encourage you to ask your doctor about it.

We did skin-to-skin contact when my son was born and I am so glad we did. When my son was born, of course he was crying. They put him on my chest. I kept talking and talking to him trying to calm down. Then there was a moment when, I swear, he looked me in the eyes, seemed to recognize me, and calmed down. It was obvious that while on my chest, he was looking at stuff, with each of his senses being activated.

My husband took notice of how well prepared I was for delivery. I had some things that are not typically recommended that I think helped a lot:

·         Indoor slip on shoes: Something to walk around the hospital in. If you have a pair of indoor shoes for your house or a favorite pair of comfortable sandals, those are perfect. I don't recommend buying anything new for the hospital; bring what you are already familiar and comfortable with.

·         Organized electronic chargers: In our house, we organized all phone, iPad, and Kindle chargers in one place so we always know where they are. My husband liked that he knew to just grab them and take them.

·         Adult diapers: Okay, this may seem laughable and weird, but after you deliver, you will be gushing blood. The hospital will give you mesh panties with gigantic pads to wear. This is basically an adult diaper, except it's a poor one. May as well bring good ones.

·         Ear plugs: We did not bring these but wish we did. There is a lot of medical equipment in the delivery room. If you are trying to sleep, ear plugs may help.

·         Nipple shield: This may help breastfeeding. One mom I know called these "training wheels" for breastfeeding. If you deliver late at night, the hospital will probably not have these available right away. I recommend buying one, knowing how to put it on, and having it in your hospital bag.

·         Baby Wipes: Hospital wipes aren't that good. We brought and used our own.

·         Squeezable Vaseline: The hospital will provide this but I just wanted to mention that in order to put Vaseline on a circumcision or a baby's bum, the squeezable kind is better. If you buy some and have it in your bag or house, get the squeezable stuff.

·         Pillows: A nice pillow from home will beat any hospital pillow.

·         Baby outfit that buttons or zips in the front: Our son had an IV in his arm when he went home so we could not fit a onesie on him. Thankfully, one of the outfits I brought buttoned down the front so we could fit his arm in the sleeve.

·         Know how to use the baby gear: Be sure to have at least the car seat installed by week 36. Make sure to know how to use the stroller. Really, this is much more important than decorating the nursery!

·         Don't bring: You will be in a hospital gown most of the time so don't bring a lot of clothes. Your baby will be in a diaper and blanket most of the time so he does not need a lot of clothes. Dad will need a lot of clothes.

Also, if you don't want phone calls, I recommend putting your phone on silent. I was able to sleep during some parts of labor and a phone ringing was not welcome. People thought it was okay to call my husband's phone but not my phone. Do they not think he is in the exact same room as me? If a couple is in labor and they haven't called you yet, don't call all the time for an update. But since you cannot control your friends and family, you can, if desired, turn the phone off or on silent. Text messages are okay and even welcome, but I hated to hear that damn phone ring.

Arranging for Help After Delivery

Before delivering, I was very conflicted on if I would need help after delivery. The answer is yes. First I want to stress that delivery is a major medical event. It is similar to having major surgery. If you've ever had major surgery, you can compare it to that. You probably won't be able to get around very well; every muscle in your body hurts; you will get very bad cramping; and a host of other potential problems. You will likely be unable to do even light household chores. After being in a hospital, you may even catch an infection. I caught two—first a sinus infection and then a stomach infection. They kicked my butt and while I was violently throwing up every 20 minutes, I wanted to yell uncle.

Now add on top of this a completely chaotic schedule. You may think you are going to get up and eat breakfast … until a doctor calls who needs something, and the baby starts wailing or needs a diaper changed, not to mention the number of friends and family who want to call you. Your spouse can only carry so much of the load. Someone to cook for you, do your dishes, drive you around, and deal with phone calls will probably be welcome. Plan for help for the first 3 weeks at least.

In my opinion, mothers should be babied immediately after delivery. Surrounding people should do everything for her including house chores and non-breastfeeding baby duties like diapering (the latter preferably done by dad—to keep baby chores with the parents), leaving mom to focus on nothing except breastfeeding. Breastfeeding is exhausting. It is physically demanding on mom and she has to do it every 3 hours, for weeks on end. Really, this is the source of postpartum problems, very real problems that are not fully recognized or understood. Now is not the time to play super hero. You created life; you already are a super hero. Set yourself up for success and get the help you need.

I will warn though that inviting relatives into your home can result in a fight over how to raise the baby. I have heard of this happening over and over again. Dear relatives: Just help the new parents by doing things; don't lecture on what to do or not to do.  Let mom and dad tend to most baby chores while letting relatives do everything else. If you are a relative and you want to help the parents observe their child, don't interpret the signals but simply state what signals you see: the child is licking her lips or her eyes are droopy or her face is red. Let the parents do the interpreting. Parents will love when you take interest in and notice things about their child!

Even though taking care of the child is hard, keep all duties pertaining to the child with mom and dad, not relatives. It is really important that parents and baby get good one-on-one time in those first weeks so mom and dad can observe their baby and correctly interpret the baby's signals. If relatives take over, it drives a wedge between parent and baby. The best scenario is to have someone you already know, trust, and get along with come help you, who you have fully talked with about what their role should be.

Someone said to me once that they would not want to come in the first few days of life as to not disrupt the bonding time between parents and baby. But if the relative comes and simply do chores like cooking and cleaning, there should be no risk of that. In fact, it should strengthen bonding between parents and baby as the parents are liberated to focus solely on the baby. The problem is most relatives don't see their role as simply supporting mom and dad but as interfering with the baby. If you make it clear that they should only cook and clean, then help in the first 3 weeks is most critical. Yes, it will be hard to do all baby chores yourself. But if you have help, it is easier. I really recommend not giving up baby chores, no matter how hard they are.

I recommend arranging for a massage within one week after delivery and a dentist appointment within 4 weeks. Here is the reality: after delivery, every muscle in your body will hurt. Staying in a hospital bed can be taxing. From holding and looking at the baby, you may develop a kink somewhere, perhaps in your neck. You can't take care of a baby while in this pain. Seriously, do it. Also, while pregnant, your teeth will take a beating. Your overall hygiene in the hospital and when you get home will probably take a hit. It is a good idea to get a teeth cleaning as soon as possible.  

Finally, if I could do it over again, I would spend more time focusing on making freeze-ahead meals for myself for the weeks that followed delivery. It was on my list of things to do, but I delivered 3 weeks early. Really, I should have made this a top priority. It would have come in much handier than a clean house or a pristine nursery.

Cord Blood banking

If you are pregnant, you will be barraged with advertisements to store your child's cord blood. The cord blood is the blood in the placenta/umbilical cord and is rich is stem cells. It can be used to grow organ tissue for transplants. It is reportedly better than using bone marrow. It can save lives for children who suffer certain illnesses, such as leukemia.

I chose to publically donate my child's cord blood. The risk of leukemia happening to my child is so small and the expense of private collecting so high, I did not think it was worth it to privately save it. Unfortunately, I have read that using the cord blood from a stranger, even attempting to find a good match, has only about a 30% success rate. But I'd rather have a 30% chance of saving another child's life than keep it for the 0.005% chance my child would need it. Though, if everyone stored their own cord blood, this is the best possible solution to finding a good match, as your own or a relative’s cord blood is the most ideal to use.  

Some hospitals do cord blood banking right at the hospital. Unfortunately, most don't. I found an organization that will come pick up the cord blood for you: Lifeforce Cryobanks. Their enrollment page is here. You have to get your doctor's consent as they, or their staff, have to collect it. You have to fill out the form and send it by 34 weeks.

I was, however, very disappointed in Lifeforce. We went out of our way to get the cord blood; something that had many bumps on the way. We called them to arrange pickup and they did not come. We called them to ask and they said the driver had reported he had picked it up! We sent him back to come get it.

I was impressed the nurses grabbed the kit right from my hand and started to work on it without me even having to explain it. They were used to ViaCord though, not Lifeforce. Although I asked them to fill out the blue sheet that should be filled out at delivery, I went through 3 shifts of nurses and the final delivery nurse did not fill it out. Although I was really prepared and had a 1-page sheet with just a few things of what had to happen on the day of delivery, I was too exhausted to get the sheet out and make sure everything on it happened. I am a long supporter of blood donation and I really wanted to do this, which I … think … I did successfully but I recommend saving yourself the hassle. I would only recommend publicly donating cord blood if it can be done right at the hospital.

Childcare

The overwhelming advice from baby books is to stay at home with your child. For many, this is not a financial reality.

The main alternative options are a nanny, an au pair, daycare, or a relative. A nanny is the most expensive. If you have a place in your house where the au pair can stay and you don't mind someone living with you, an au pair is the least expensive option. If you have a relative that you can trust, it may work. This may be problematic if you and your relative have different ideas on raising children. Most people will choose daycare.

I chose the child care I did because they did not use any swings or walkers with the babies. I had thought all daycares would use them since they make things easier on the daycare workers. The children were allowed to roam free most of the day, to the great benefit of their physical development.

Some general things to look for in a daycare are the staff and the room setup. A staff that is experienced and has been with one daycare for a long time is desirable. Ask to interview with the daycare staff to ensure you like them and feel you can work with them. Another desirable attribute is for the (infant) room to have a separate sleep area. Otherwise, an infant is in a brightly lit, noisy room that is not ideal for sleep. When the children are older, daycares put the children on a set schedule and turn the lights off during nap time.

I was very displeased with my experience at daycare. It seems no one wants to talk about why daycare has a bad reputation so let me outline some of the problems I had. I would ask that they put my son in a sleep sack, because he used the material to suck on and help self soothe him. I was met with a woman biting her lips, nominally agreeing with me, and week later I found the sleep sack in perfectly pristine (unused) condition in my son's basket.

My daycare hired a woman who was probably 20 once. I walked in on her cussing a young infant out because somehow liquid had spilled. I did not confront her or even management, because I was afraid she would take it out on my son. Within about a month, she was fired. I deeply regret not threatening to remove my son if she was not fired instantly.

It didn't happen to my son but one time I overheard an older boy crying in the daycare playground. I went over to find they had went inside without him. When I told an administrator, they yelled at the boy, as if it was his fault!

Children seem to simply not get the care, sleep, and attention they need in a daycare. Keep in mind known fussy periods: These are sure to frustrate adults and a daycare worker will not respond with the love that a mother would. For the first 3 years of a child's life, they seem to simply need a little extra attention and love. Because of their high need for naps throughout the day and because they tend to not play well with other children until about 3 years old, I would recommend to any parent to stay at home with their child until the child is at least 3 years old if possible. At 3, I would recommend a high quality preschool, such as Montessori, which can actually be greatly beneficial to both your child's development and your sanity.

Some stay at home mothers have told me they would do things like purposely leave lights on when their children napped or they purposely didn't guard against diseases so their children wouldn't get too "spoiled" and would be better exposed to the "elements." Meanwhile, mothers of children in daycare would love it if they could give their children better sleep than they get at a noisy, brightly lit daycare and if they could guard them from the many illnesses that their children catch while there. Really, if you are a stay at home mother, recognize that you have the ability to provide the very best care for your child. Take advantage of it! Why purposely irritate your child? There will be plenty of challenges that your child will face later that will develop their character—ones that don't compromise their health. 

 

Toys

The best advice I have found about toys is that passive toys encourage an active child; active toys encourage a passive child.

A passive toy is, for instance, blocks. The child must actively pick them up and manipulate them when playing with them. An active toy is for instance the TV. The TV is very active while the child sits passively being entertained.

A popular toy is a little handheld toy that plays Mozart. I think the idea that playing Mozart will improve your child's intelligence is truly a mark of laziness. I just don't think stuffing Mozart in a baby's face will make them smart. Children are active learners, not passive ones. Playing Mozart may get them to like Mozart and that is about it. The handheld toy, however, may be convenient when out running errands with your child. 

I have read conflicting advice on getting toys that stimulate your child versus letting the natural world around him stimulate him. A mobile is a basic example. It is a brightly colored toy that hangs over the baby and he can look at it. At first, I very much wanted to provide my child with many sensory experiences. But the Magda Gerber book advices against it, preferring instead for the natural world to stimulate the child. What to do!

For the issue of the mobile, I think the crib should be for sleeping only. Gerber describes the mobile as something the baby cannot look away from. She describes how the baby can instead look at light coming in the window for real learning about the real world.

Post baby, I am very glad we did not use a mobile with our son. Instead of looking at the same exact thing 6 inches in front of his face while he lied down most of the day, he moved his head around, absorbing everything in the room. People have commented to me about how very curious and alert our son is. I am very proud of this and I partially credit the fact that we did not use a mobile.

Most baby books do advocate some toys, such as a cloth scarf, soft blocks, keys, and fill and dump toys. But Baby 411 points out that simple kitchen items can be a big hit, such as measuring cups. Who doesn't have a picture of themselves getting into the pots and pans when they were young? The more real a toy can be, in my opinion, the better.

This is also something I read in Montessori books. Montessori discourages fantasy play. For instance, a fake kitchen for a child is an example of fantasy play. The child doesn't actually cook anything. I don't ever remember being enamored with such fake toys as a child. In a Montessori school, the children actually participate in cooking and cleaning.

In general, I think that again everything is time sensitive and should be put in context. I am persuaded by Magda Gerber's argument to let the natural world stimulate your child. However, while I agree with a lot of what Gerber says about infants, I did not like what she said about young children very much at all. She argues that it doesn't matter if a child learned to read at 4 or 5 or 6—that natural play is better than structured learning at this age. The ages of 3-7 are an age when children want to learn. I have known 4-year-olds that tell their moms, "Mom, I would like to learn how to read." You would have a hard time convincing me that I shouldn't be teaching my child stuff at this age. It goes against every instinct in my body about parenting. I think if you don't take advantage of this time, you are really missing a golden opportunity.

If you read a lot of philosophies that advocate natural play, I encourage you to also read books that advocate stimulation to get a balanced viewpoint. One book that I would recommend is The Absorbent Mind by Maria Montessori which talks explicitly about how children's mind are like a sponge at a certain age and how to take advantage of it. Another book by Dr. Montessori is Dr. Montessori's Own Handbook.

I also really recommend reading Wonder Weeks for recommendations of what kind of stimulation to provide at what age. Wonder Weeks even advocates that the first 3 months should be mostly bonding between parent and baby. Stimulation doesn't play a big role until after this, getting more and more intense as the child gets older.

Another good one is Babies Need Books, in which the author excitedly exclaims that "stimulation is in." I like her (Dorothy Butler's) argument that books with pictures are better than showing an infant a photo (or even a real object). The drawn picture eliminates all non-essential parts of what is being shown and focuses on the part meant to be learned. She asks the reader why manuals use drawn pictures instead of photos. It is to put the essential part of what is to be learned on display and remove confusing clutter. This is an author who understands epistemology and how the brain works.

I don't remember the time frame (around 9 weeks), but at some point it became obvious my son loved to hear adults talking. I was home with him alone during the day so I started reading to him. I read long books so he could hear me talking continuously. He totally lit up when I talk or read to him. How proud I was when I read to him for the first time and he let out a loud, sharp, "AHHH!" It was as if he was trying to talk to me! I enjoy reading the "Classic Starts" which whittle down classics like Robinson Crusoe into kid friendly sizes. Fun for mom, fun for baby. However, ironically, at some point you should transition to traditional infant books. The goal is to make speech attractive with nursery rhymes, noise books, etc. 

I can agree that "stimulation" in the form of walkers, swings, TV, video games, and on and on are artificial and not helpful to the child. I can also agree that if my child is actively interested in something "real," I will let him be interested in it and not try to sway him with a toy. However, I believe that stimulation such as books, quality toys, and yes, structured learning, are very good for the child, provided it is age appropriate. I have seen both the following: parents trying to engage their child but the child is so obviously entranced by something real taking place, such as steam coming from the kitchen or an umbrella swaying in the wind, that they ignore the parents' stimulation, but I've also seen children being ignored and obviously bored out of their mind. The children who are entranced by the natural environment tend to be younger. The children who are bored tend to be older.  So, I think the Gerber advice is good for younger children but breaks down for older children. There is certainly no need to provide stimulation to a 0 - 6 week old; everything is new to them. But the older the child, the more stimulation is needed. I have a budding theory that natural play versus stimulation is based on when the child can do things. When the child has control over his hands, give him something to hold. When he has control over his feet, give him something to climb on. When he can read, give him books of his own. And so on. Again, everything is time sensitive.

As I am indeed in the business of training people, I have some more insight. Up until the early 2000s, the thought was that the only way to train people was to make training as real as possible. However, the new thought is that, while virtual training should primarily mimic real operations, virtual training can actually do more than this to great benefit. For example, if training a firefighter, it is helpful to train a novice without a blazing hot fire in their face at first, then slowly crank up this stress in training. Or, a virtual environment can train unusual or emergency situations better. Of course, virtual training allows for training with minimal actual injury. These same principles can be applied to teaching children. Indeed, there should be a strong element in realism in all that a child encounters. But applying intelligence behind the kind of toys and games provided to the child can be a great benefit, sometimes even being an improvement over real world stimulation.

Guarding Against Bad Advice

There are other books about general philosophies of raising children, but that I know I probably would not agree with. A popular one is The Baby Book: Everything You Need to Know About Your Baby from Birth to Age Two. It is the leading book on the "attachment parenting" philosophy. I am for being a 100% attentive parent and responding to your child's needs, but this does not mean I am for attachment parenting. Attachment parenting preaches the baby must be with a parent nearly all of the time via baby wearing and co-sleeping. Being attentive is not the same thing as being literally attached to your child constantly.

I had thought the popularity of attachment parenting may be because these parents were ignored as children, perhaps handed off to nannies, and were trying to do the right, if misguided, thing. But I am coming to realize that it is more about not letting the child interfere with the parent's life. The child is worn so the parent can go to lunch or a party. It is actually to the detriment of the child, whose sleep is interrupted. While I believe being immersed in adult life, especially conversation, is important, I think giving the child alone time so they can move and play is important.

Co-sleeping can also be to the detriment of the child. The child becomes dependent on the presence of a parent to fall asleep. At some point, the parent will want the child out of their bed. The child gets "evicted" when they are fully aware of what is going on and at a time that is convenient for the parent.  That said, I can understand co-sleeping in the first 3 months for ease of breastfeeding. I did not do it for fear of smothering, but I think it is a parent's right to do it if they want.

Be on alert for junk science. Ask what credentials authors have. Promise me, please, please, please, that you will not read, gift, or at least will take with a grain of salt the book What to Expect When You are Expecting. This book has a catchy title and that is all. It is not written by a medical professional and is filled with the typical condescending old wives tale crap. This review and this review explain it well.

High-level good advice

Finally, this is some of the high-level advice I've gotten that makes a lot of sense to me and I plan on following:

From Magda Gerber's book, it is recommended that before you do anything with your baby, tell them what you are about to do. She asks the reader to imagine they lived in a world of giants who pick them up and do things do them without having any idea what is about to happen. It is true that at first the infant won't understand you, but one day they will. It will also teach him to have a bigger vocabulary and make a connection between words and reality.

Treat crying as a form of communication. This advice is from Gerber's book and Parent Effectiveness Training. The goal is not to pacify the crying, but to decode it. There is so much that can go wrong in how crying is treated. If treated as something that needs pacified, it sets the ground work for the child learning that crying is a way to manipulate mom and dad. If not decoded properly, the child's genuine wants and needs are not getting satisfied. He may learn that attempts at communication are futile. I really believe the way a parent treats a child's crying will set the groundwork for how the child communicates in older years.

From Parent Effectiveness Training, decoding a child's cues never stops, even when they can talk. A child may not explicitly say what he wants. Parent Effectiveness Training advocates answering most children's questions and frustrations with more questions. A child may say "when is dinner ready?" Ask why they want dinner—it may be that they are hungry or it may be that they want to go out and play. Don't assume anything. From an early age, I want to encourage my child to verbalize to me what is wrong, even if it is something as simple as "I'm hungry" or "I'm tired." When they go to the doctor, I want them to talk to the doctor about what they are experiencing. As they get older, this skill of introspection and communication will be very valuable and apply to vastly more complicated situations.

My favorite bit of advice is to let children solve their own problems. I could go on and on about this, so I'll limit this to one story. I was playing a game with children that had small pieces. One of the pieces fell behind the bed. I asked one little girl if she could go get it. An adult in the room gasped and thought I was being just so mean. The girl looked under the bed, saw it was dark and promptly went to get a flashlight! She squirmed under the bed to get the piece. Not only did she find the piece, she found another similar piece that had been missing for months. The rest of the children were jealous and wanted to be the one to rescue the pieces.

I have found by backing off and giving only slight encouragement to children to solve their own problems, they will amaze you with their creativity and ingenuity. It may be hard but recognize that this is their journey. The work that has to be done to change from a dependent small child to independent adult has to be done by them.

The overarching high level advice is to treat the child as what he is—a budding reasoning child. No, he can't reason fully yet, but he will make small, directed efforts towards becoming capable of doing so. It will happen faster than most realize. Children are much smarter than given credit for!

Happy parenting!

Amber Pawlik
Last update: May 3, 2014


The Lucky Mom: How to have a Happy Infant through Respect, Observation, and Understanding
Amber Pawlik
This book is a guide to being that "lucky" parent with the happy baby. It is a very concise book with thoroughly cross-referenced information for parents regarding sleeping and eating habits and the intellectual and physical growth of an infant. A philosophy is presented of respecting the child where the parent observes the child for signs of hunger, sleep, or other needs, and responds appropriately. This book will give you much of the information you need as a parent in just a few hours!

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