by Nate Dallas
My advice may be easier said than done. There is no way to sugarcoat it. This topic is rough. Having your baby in the NICU is awful. When it’s all over, and those professionals saved your newborn’s life, you will be eternally grateful to them. They are a special breed of people. Not many people can do the work they do. Be sure to show appreciation for it. Bring goodies for them, or ask if they need coffee when you head out to get one. Let them see your diligence and gratitude. Hang in there. Try to be a solid rock until the storm passes, even if you don’t feel strong enough.
Sticky Milestones
Um, do you have another pack of wipes for this diaper change? There are only 23 left in this one, and I think I need a few more.
Now that we covered the hard stuff that I pray you will never need, let’s return to the expected routines for every baby. The first poop after delivery is a victory for the baby. It may be a big relief when mom has her first one too. It’s common for women to have some painful trouble for a few days. The newborn’s first bowel movement is one of the milestones that will be monitored by the staff. When this comes, it will probably be different from what you had expected, even if you have changed diapers before. The foreign stuff in the first movement is called meconium. It’s different than all of the ones that will follow. It’s so strange because it is made up of the substances that were ingested while in the uterus, which will never be consumed again. The first stool looks more like a tar ball from an oil spill than something that a human would produce. If an adult had a stool like this, they would speed to the nearest GI specialist to find out what went so horribly wrong inside of their digestive tract to produce such an alien substance. It’s dark and sticky. No single baby wipe, or beach towel for that matter, will be sufficient to finish the changing job on this one. Each subsequent diaper will change as time goes on and things will normalize once the little guy is on a new meal plan. Just don’t be alarmed with the toxic sludge-looking excrement when it arrives. You will handle it fine. I just wanted you to know about it. The hack that I have for this event is to use the interior of the diaper itself to wipe as much as possible, then move to as many baby wipes as you need. You may want to make a two-ply sheet by putting two wipes together. Over the first week, the matter will gradually transition from a dark, thick, black color to a thinner, yellowish substance. In time, the diaper changes will require fewer wipes and less facial grimacing from parents.
You Love ‘Em. She Hates ‘Em
The lactation consultant is a woman… right?
Feeding is a simple subject that can get dicey and blindside you before you ever knew what hit you. Hopefully, you have already discussed whether you plan to breastfeed, bottle feed, or a mixture of both.
Breastfeeding has been proven to be healthier for many reasons, and I encourage you to do your research. From nutrients, to immune defense, to hormonal benefits, breast milk is a superior product when it’s available. Unless there is some serious physical or medical reason not to do so, everyone should probably give breastfeeding an honest try for their newborn. Many professionals, celebrities, and lay people have made it their mission to educate the world on the benefits, and there is some significant social and political clout that comes with the subject. It’s like a religion to some people, and there is no shortage of dedicated evangelists. There can be a lot of pressure surrounding this process and choice too.
The truth is that many women have a terribly difficult time breastfeeding. The problem is that women don’t know how hard it can be until they try it. Some ladies cannot breastfeed or are very limited because of prior surgery or trauma, hormonal troubles, nutrition problems, or anatomical issues. Babies can struggle with breastfeeding too. Some children can’t get the technique down because of anatomy, muscle tone, pain, or other unforeseen complications. When it’s difficult or impossible, a woman can get very upset and feel defeated or inferior. It can leave her feeling like she has failed as a new mother. When you turn on the atomic blender of emotions, hormones, and exhaustion, her feelings reach a nuclear level. This is the first major duty she has taken on as a mother, and if she feels as if it’s not going to work, she will be upset. These feelings of inadequacy or defeat are common and can be seriously depressing for a mother. Don’t be surprised at intense responses to the breastfeeding struggle.
Breastfeeding can also be physically painful. A mother may be able to work through the discomfort, and it become more bearable over time. Sometimes it’s just a matter of building a tolerance for it or finding the right position. There are also some products on the market that can help ease the pain. Other times, it never improves, or it gets worse. Some women trudge ahead and endure the pain, and some simply cannot continue.
If your wife, who is recovering from a heroic and bloody war, gets harassed or disrespected by staff at the hospital, defend her. Do not let anyone bully her, belittle her, or discourage her. I’m speaking from direct experience after an impatient, aggressive nurse trampled over my wife in a time of difficulty. Some people champion breastfeeding to such an extent that they will act like fools, lacking compassion and empathy for a new mom who is trying her best to work it out. Encourage, cheer, support, and if needed, defend and fight for your wife. Let her know that you are proud of her, no matter what the outcome. Only one person can do this work. Give her the space to learn the skill, and acknowledge the sacrifice and struggle she is undertaking.
Regardless of your zeal for breasts and an eager willingness to help, your wife will probably still need some professional guidance. A breastfeeding coach of some sort will be available to assist in learning the proper techniques. Most hospitals call this a lactation consultant. I have no idea of the requirements to don this title, but I do not think that a medical degree is necessary. Nonetheless, a good breastfeeding trainer is one that is patient and encouraging. Hopefully it’s a woman who has been through it a few times herself and maybe even had a hard time mastering it. A bad advisor can be downright mean and degrading. I recommend being there during all the training and trying. This will allow you to be both the bodyguard and the emotional support.
A valuable husband hack is to have a knowledge of what products are available to make breastfeeding easier. If you are a big time overachiever, anticipate there being some problems and have a bag of items already packed for the hospital beforehand. A trip or two to a supermarket or baby store will be very educational. There are products for pain, like covers, shields, and topical ointments. There are products for alignment and latching issues, like cups, shapers, and props. There are supplements for low flow, pads for leakage, and thermal pads for painful engorgement. None of these are very expensive, but one or two could make a big difference for that woman who is working so hard right now. If it all works easily for mom and baby right off, consider it a big blessing. Some women lack a sufficient supply of milk. Some newborns already have several teeth the day they are born. Ponder that for a minute.
The milk flow on the first few attempts will be sparse or even nonexistent. Healthy breast milk can take a few days to develop, and a delay should be expected. The milk production is based on hormone changes after delivery and takes time to work up to an adequate level. Pure breast milk usually takes a few days to show up, but breastfeeding is still necessary before it arrives. The first few precious drops to be consumed by the newborn are a thicker, yellowish substance called colostrum. It may have begun to ooze a bit before childbirth. This nutrient-rich, magical substance is premium fuel to a new baby. It’s easy on his delicate digestive system and functions to eliminate bilirubin, which is the waste product of red blood cells that causes jaundice. It also helps produce the first meconium. Colostrum contains protective immune cells and antibodies that are passed from mother to baby and strengthens his immune system. This is like a built-in force field for infections and viruses. It’s amazing stuff! So even if there is a bottle feeding plan for later, getting colostrum in your baby’s system is a huge win and should be pursued. Every drop is beneficial.
The staff will let you know when it’s time to feed and will help out getting everyone on board, no matter what method you choose. Just so that you have a heads up now, the next few weeks will require feeding every few hours. Did you catch that? I mean like every two hours! That’s all day and all night. Sometimes a feeding can take a full hour. So by now, an astute, masculine guy like yourself should realize that there will be no lengthy breaks for a while. It will gradually get longer and longer between feedings. You will make it to an easier routine eventually, but not immediately. Many dads are not expecting this demanding schedule. My goal is that you are fully prepared for it. You will be ready to handle it with a few hacks that I will share later.
In the coming days, the breast milk availability will increase. The baby’s needs for the fluid will grow, and the supply volume will hopefully increase in proportion to the demand. Usually, as the milk supply increases, so do the size of her breasts. This may excite one, both, or neither of you. It may frighten one, both, or neither of you. Just know that it’s coming, and be respectful about it. Many women like the new changes to their breast size during pregnancy, then quickly despise the enlarged body parts when full milk production starts. If you are a typical male that produces testosterone, you will likely want to touch, and maybe grope, the newly up-sized objects. Be gentle. This can be a very painful time for her, especially in that area. The fuller they are, the more sore they become. Her nipples will likely be extremely tender, even at the lightest touch. Sometimes feeding is a great relief to her because of the decrease in pressure that can be so uncomfortable as it builds. Pumping may also be a great relief. We will cover that a little later, after you make it home.
Tiny Bottles and Big Burps
Eat, burp, spit up, burp, repeat. Not you, the baby!
The hospital staff will give you a hands-on demo to learn how to feed with a bottle. At first, only a tiny bit goes in between burping sessions. Drinking little sips and stopping for several minutes every half ounce to burp takes a while. This may be reminiscent of your old college days. Baby feeding is a time consuming endeavor. It can be testy and tedious. The repetitive routine can get tiring and boring. The baby’s doctor will tell you the current time and volume goals for each feeding. Every baby is different, but your doctor will have a recommended target amount that your little guy needs to consume in order to thrive. This number will grow as the baby does. They will teach you the numerous ways to hold a baby while feeding, what warning signs to look for, and hopefully teach you several positions and techniques for burping your little one too.
I have no doubt that you will get the feeding part down. The hack that I want you to master is how to get good burps every time. There is a superior method. A lack of proper burping can cause discomfort for the child, more spit up, and hours of fussiness during and after feedings. Inadequate feedings and unrest from the baby leads to frustration, stress, and exhaustion for everyone. A tired, hungry, irritated human is hard to rationalize with, at any age. A good burping technique is paramount and will make feeding easier on everyone.
Over the years, I have mastered the burping methods and always get a happier, less messy, and more productive feeding session than when someone else does it. Either research online or ask someone on staff to teach you at least three positions for burping. The ace in the hole for me has always been to use a burping technique with the newborn in the sitting position. This is also the one that people use the least. Obviously, the baby can’t sit up yet. He can’t even hold his head up. What you do is sit him on your leg while you are in a comfortable seated position. He should be now “sitting” 90 degrees from your seated position, being supported by your thigh and hands. Let his legs sit toward the middle of yours. Make a C-shape with one hand, and cradle it under his chin, supporting his head, chest, and neck. Lean the little guy slightly forward with his face and torso resting on your hand. With the other open hand, you will gently pat him on the back. A lot of dads never learn this position. I have found that it will produce a burp when the traditional, over-the-shoulder position or the stomach position will not. For the best results, get proficient at each method, and use all three. If one spot isn’t producing a good burp, change to another one for a bit. Alter the patting rhythm and position. Stop occasionally just to rub his back up and down with your open hand. If you notice that he’s irritated and can’t burp, pausing for a little bit just to get him horizontal usually helps. You will have to see what works best for him. It may be face up or face down (obviously without covering his face) that renders the best results. These little pauses help to change the air pressure in his little belly, and movement between the three positions helps get the air moving out. Mix it up until you master the process and learn the unique patterns for best results. Try not to force more fluids until you get a good burp. Putting extra volume on top of a big bubble will likely result in the baby returning it all on your lap when the burp finally rises to the top. One more hack related to feeding and burping is to keep a bag in the car with a change of clothes for all of you. You will need them at some point, or many points, over the next year when an unexpected bomb erupts from one end or the other.
Always have a burp cloth with you, especially if you are wearing your favorite polo or overpriced hipster shoes. These guys can expel a lot of fluid at any second. Always be ready for it. You will be impressed at the instantaneous trajectory and velocity that someone with such tiny muscles can produce. Keep the cloth in a smart catching position at all times, just make sure it’s not blocking or covering his face. The one second that it’s not in place will be the exact moment that you will get a crotch full of wet, vitamin-rich, milky goodness.
2 DAYS AD
Snip Snip
Delaying the circumcision for eight days suddenly seems like a genius proposition, and I’m not even Jewish.
If you do have a boy, you will have to make a decision on circumcision. Whether to do it, when to do it and whom should do it are all options that must be discussed. For families that just delivered a baby boy without religious reasons to defer the procedure, it’s usually part of the standard process while at the hospital. Pay attention here. This hack is another money saver. It may also be a pain, blood, and bandage saver.
Most circumcisions are performed by the pediatrician that is making the daily rounds while your little one is in the nursery. If you want it done, your bundle of joy is on the daily list when the doc comes around. Your offspring, along with the other tiny newborn males on the list, all get the treatment during the rounds. You can ask specifics about the actual procedure, but I can tell you that they get it done quickly and efficiently. It is technically a surgery, but it’s approached in a nonchalant sort of way—without sedation, anesthetics, or special operating rooms. It’s a big deal for you to think a
bout, but the staff will treat it as just another routine procedure. The thought of your perfect, extremely vulnerable, newborn son being cut with a scalpel is unnerving and a little heartbreaking. I don’t have any big tips for how to deal with these sentiments. Sorry.
What I do have is a rarely considered hack that may make it considerably cheaper, and possibly reduce the healing time and potential complications. It’s simple. Don’t have it done at the hospital. Wait until a week later, and have it done at the next checkup with the pediatrician, in his or her office, or even with the OB/GYN. Yes, the OB. Here is my rationale:
When you have it done at the hospital, they will eagerly tack on a litany of hospital charges, including highly technical things like fees to “transport” the baby (pushing the cart) to the “surgical suite” (corner table of the nursery). They will also add aggrandized codes for the “sanitary surgical bed” (puppy pee pad), a “sterilization fee” (alcohol wipe), “infectious waste disposal” (tossing the aforementioned, soiled pad in the trash), “topical medicaments” (Vaseline™), “surgical dressing” (gauze and tape), “anti-inflammatory treatment” (cool water rinse), and who knows what else. All of these things look good on paper until you notice the premium pricing. My first two sons had $600–$1,200 worth of fees associated with their circumcision procedure alone. Both of them also had extended healing times and bleeding issues. I didn’t know that at the time because I lacked a baseline comparison for the post-operative wounds and the recovery time. My latest two heirs to the family throne had this step done at the OB’s office, a week later, after a well checkup, instead of at the hospital the day after being born. It was only about $300 there. Not only was it considerably cheaper, but it also looked beautiful and healed quickly. Maybe it was a coincidence that the two procedures went so much smoother outside of the hospital. I think that it went better because of the setting and expectations. Instead of being one of nine procedures that needed to be done in an overbooked hour in the hospital nursery, Baby Dallas #4 was the only one they had to do that entire day, maybe even all week. The procedure wasn’t rushed in the OB’s office. I think that the operator wanted to do an exceptional job to impress us, and I think he was excited to use a skill set that demanded some expertise and attention to detail that he doesn’t get to do every day. Ask your pediatrician and your OB what the options are for you.