Pregnancy
Welcome to the most wonderful experience of your life…well for some. Pregnancies range from a complete joy to a total nightmare. The most important thing to recognize is that most pregnancies come with challenges and you should not feel like there is anything “wrong” with you if you are having difficulties.
Finding an Obstetrician (pregnant lady doctor) is the first step to helping your baby grow and develop as it should. There are tests that can be done while in the early stages to determine in the mom is a healthy vessel for carrying a child or help add needed medications or dietary changes to help achieve that goal. Babies get exposed to almost everything the mother consumes so making sure that you check with your obstetrician about medications or supplements you may be taking, reviewing your diet and nutrition, and working to eliminate alcohol, drugs, and tobacco from your life will help keep your baby healthy and safe.
Genetics
Are there genetic conditions that run in your family? Do you have a child with a genetic condition already and want to know if your next child will also have it?
It is important to meet with a genetic counselor before becoming pregnant if there are conditions that run on either mom or dads side of the family that are concerning for the health or survival of your baby. During pre-pregnancy a genetic counselor can test parents for these genes and can determine probabilities of passing on concerning traits or conditions. Not all conditions can be determined especially not ones that do not have known genetic markers.
Breastfeeding versus formula- A pediatrician and human approach
There is always the question of to breastfeed or not to breastfeed? However, what is more important to consider is how much or how little to breastfeed?
The most important timing of breastfeeding is in the first few days of your babies life. Your initial breast milk is called colostrum is full of immune cells and antibodies (to help build the bodies defense system) and proteins that will get your baby off to an amazing start in life. Plus, if you are in the hospital with your in-laws or parents watching your other children and not much else to do, the time commitment required for breastfeeding is not much of an issue. Take advantage of this time, its a great way to bond with your baby and provide them with an excellent source of nutrition.
Now, going home can be a whole different issue. Breast milk contains higher amounts of whey protein than formula which is the best source for brain development and nutrition. However, breast fed babies usually eat about every 1-2 hours for the first few weeks of life and generally feed for about 10-15 minutes per breast per feed. What does that look like in from a timing perspective… 15 minutes x 2 breasts = 30 minutes of total feeding time. Now if you if your baby wants to eat every 2 hours well that leaves you 1.5 hours between feeds to do all of the other things that you need to accomplish. This can be very difficult for both working mothers and moms who stay home. There are many things to be accomplished and if you are feeding a baby every hour and a half it can become difficult. That’s why I say the true question is, how much or how little to breastfeed. There is no rule that you must do all breast milk or all formula.
Breast feeding not only provides your child nutrition it is a time for just mom and baby, usually quiet and uninterrupted. Therefore, if you can only do it in the mornings and evenings, or only 3 times per day that’s fine. Keep it up for as long as you can. Keeping it up can come with its own challenges. The more you breast feed the more milk you produce and the less you breastfeed the less milk but if you are feeding or pumping at least a couple times per day you should be fine with production.
So the short of it is, there is no all in or all out. There are different factors that influence your ability to breastfeed your baby. It is not for everyone but my recommendation is try it, at least for the first feed or the few days you are in the hospital. From there as much as you can and as often as you can. For whatever reason if it does not work for you formula is an excellent substitute. It provides babies with all the nutrients and calories they need. So don’t get down on yourself or let others feel like you are not doing the right thing, the right thing is what works best for you and your baby.
The Don’ts and Don’ts of Co-Sleeping
This is a topic that is near and dear to my heart. Having lost a patient due to co-sleeping it is so important to to get the message out that co-sleeping is a dangerous and risky move that no parent should make with their baby. By co-sleeping I am referring to sleeping on the same surface (bed, couch, air mattress) as your baby. As doctors it is something that is brought up, usually during the first visit and then rarely spoke of again. I think that one of the barriers to this conversation is that parents have such strong feelings about co-sleeping, especially if it is something that they practice, and thus the conversation can become uncomfortable. Luckily this is what this site is designed to do, get a little uncomfortable so that all children benefit in the long run.
Co-sleeping myths and explanations:
- Facilitates breastfeeding (myth)- How does co-sleeping facilitate breastfeeding? Well it makes it easier for the mom to wake up in the night and feed that baby. How does it make it easier for the baby? That the mom is willing to breastfeed because it is more convenient to do so. What are the alternatives? Placing the infant in a bassinet next to the parents bed where they can have their own safe space to sleep and are easily accessible to the mother. Risks versus benefits…having your child potentially be injured or worse suffocated by a parent, blanket, or pillow in order to have them just a few inches closer versus having to sit up and reach over next to you while your child is comfortably resting on their back in a bassinet without risk of harm.
- Increases parent-child bond (myth)- You are not bonding with your baby while you are sleeping, you are sleeping and so are they. If they are close enough to hear your heartbeat then they are too close and at even greater risk of injury when you roll over while entering REM sleep. Have you ever had an important meeting, early morning flight to catch, or financial or family situation weighing heavily on your mind? During those times you get less sleep because your mind is actively thinking about other things leading to frequent awakening and less deep sleep. This is how it is when you sleep with your baby. If you are constantly readjusting to make sure you are aware of where you child is in the bed then you are not sleeping as well. This can lead to daytime sleepiness and irritability which decreases coping skills and makes it more difficult to bond with your baby during the day when you are both awake. Net effect…decreasing parent child bonding.
- Allows parents to keep a close watch on infant and respond to their needs (myth)- As mentioned above you are sleeping not watching your child when you are sleeping. The most you are able to do is occasionally sense movements or twitches while your child sleeps that you may not if they are sleeping in a bassinet or crib away from you. Why is this important? It’s not…babies make multiple movements and twitches associated with sleeping that are normal. Most babies are still sleeping or fall quickly back to sleep after making these movements. If you are consistently awakening with each movement and worse yet waking up the baby then neither of you will be rested.
- Decreases nighttime awakening (myth)- As discussed above co-sleeping with an infant can actually increase night time awakenings for both parent and baby. Baby will sense movements of parents and easily awaken as well as parents responding to every innocent twitch baby may make.
- Have done it with all my other children without any issues (myth)- Co-sleeping like gambling and riding in a car with you seatbelt on is a game of chance. Sure some people do it and their babies grow up to be happy, healthy, productive children, then teeneagers, then adults. For those people, good for you. But others are not so lucky, no because they are less skilled at it or because they have bad luck but because bedsharing increases the risk of sudden infant death and infant injury.
The most important thing to realize is that there are ways to be close to your baby that does not involve sleeping in the same bed with them. There is nothing worse than the loss of a child, but the loss of a child unintentionally at the hands of a parent in a situation that is completely preventable is devastating. Providing your baby with a safe place to sleep provides you the opportunity to snuggle them for life, taking that away has the potential to cut that time short. Why risk it?
For more information and specific studies related to this topic see the following links: