Surviving the 1st week home with my newborn

The first week home with my newborn almost shattered me. I've never done anything so difficult in my life. There are things I would've done differently, knowing what I know now. How much would you pay for your sanity and sleep? What I've learned is that there are just 2 things you need to get that will buy back exactly that, and they are:

• A good confinement nanny (if not, get family members to help out)
• A good double breast electric pump

The confinement nanny solves the sanity part because she can help with taking care of the baby, from changing to feeding, bathing, and letting the baby stay in the nanny's room overnight so you can get some good night's sleep. 

The double breast electric pump will save you from fatigue of breast feeding since you generally pump for 15 min total, both breast at the same time, whereas breast feeding can take up to 1 hour at a time. Your shoulders and arms also get so sore from holding your newborn in one position for long durations. And remember, this has to be repeated every 2-3 hours for the newborn's feeding schedule. 

I wished I could travel back in time and tell that ambitious yet exhausted self of mine, freshly discharged from the hospital, that these 2 things did the trick. It could've saved a lot of tears. 

Sticking too hard to recommendations 

One of the biggest problems I had was that I stuck way too hard to recommendations. I made them into hard rules that only drove everyone crazy. They were things like "don't pump your breast till the milk production is stable around 5-6 weeks" or "don't bottle feed your newborn until after you've established a good feeding routine around month 1" or "don't overfeed your newborn, feed every 2-3 hours". 

These were instructions or recommendations given by doctors and lactation consultants. The thing is, these are good practices, but if you don't do them, your baby won't die. It's different from "Don't shake your baby violently because it can cause brain damage and injure their weak neck." 

I stuck to breastfeeding for all 4 days at the hospital and the first week home, every 2hours, like clock work. The problem was, my milk production wasn't enough, and since I wasn't pumping, I couldn't gauge how much my son was getting. (He's supposed to eat around 90ml, but I produce anywhere from 60-110ml per pump). What happens when you have a hungry baby? You get a delirious crying baby who won't stop no matter what you do. We got no sleep because of this. We went through every scenario we could each time, check his diaper, burp him, play some white noise tracks, swaddle and hold him... We just concluded he's gassy and uncomfortable, but I was feeding him nonstop, sometimes it would be on and off but for 3 hours straight where he got no sleep and I had no rest. Then I imposed a hard 2 hour feeding cycle rule, and when he cried, I'd hand him to the nanny or my mom to calm him while I regain some sanity. I thought I'd overfed him since he was spitting up. (Which I later confirmed with the paediatrician that it's hard to overfeed a baby, they stop when they don't want anymore, and you should only stop if a baby projectile vomits. Some dribble is fine.) The reality was, my baby wasn't getting enough food, and he's hungry. 

At 2 weeks after my son was born, I threw the recommendations out of the window. It was 2am when I unboxed my all-mighty Medela Freestyle double electric breast pump. 

I had a mini meltdown because it honestly made me feel like a cow on a dairy production line. But this thing is a lifesaver, and I love it now. Even if I have to wake up in the middle of the night, it takes only 15 minutes to get all my breastmilk out. I'm not compromising on giving my son the benefits of drinking breastmilk, and that's good enough to exchange for my sleep.  

Once I figured out my milk production volume, I did 2 things:

• Top up with formula 
• Asked my OB for breastmilk production supplements

Thank god for formula. The guidelines are also clear, 90ml for up to 2 weeks, and 120ml for 2-4 weeks. That means if I have 80ml of breastmilk, I just make some extra with formula. I also had to get over the fact that I'm not a failed mother if I don't produce enough breastmilk, the majority of what my son is drinking is breastmilk, so I'm doing the best I can. 

Some other god send products that are highly highly recommended for breast feeding are:

Philips Avent Nipple Shield

(For sensitive/cracked nipples) 

Avent Nipple Cream

(Again, for sensitive/cracked nipples) 

Lansinoh Disposable Nursing Pads

(For keeping your bra dry from breastmilk leak in between feeds and pumping. I've sampled so many brands, these are the most comfortable and effective) 

Haenim UV Sterilizer 

(Saves so much time for sterilizing bottles) 

Visitors 

The first visitors after my son was born were my parents, they stayed for around 10 days and my god was that a mistake. 

There were some other visits from friends that lasted for no more than 1hour, and I'd say this is the more ideal scenario. 

The main problem with visitors is that there is a potential for them to completely knock the routine out the window. The baby becomes over stimulated, doesn't sleep well, gets fussy, and you're in for a horrendous night of no sleep a lots of crying. And though the intention is good, and grandparents are probably the most excited people about the kid being born (yes, sometimes more than the parents themselves), boundaries need to be set hard a clear. 

Examples: The baby shouldn't be woken up and passed around to multiple people like a guinea pig at a petting zoo. And we do not need 3 people to supervise a diaper change or a bath.

And also, what was good practice 30 years ago may not be good now. For example my mom kept saying how she let me sleep face down in the same bed as her overnight all the time, or after each feeding of breastmilk they gave some water for the baby to drink etc. My god, have you not heard of SIDS and water poisoning in new borns? I've read through 2 thick 400 and 800 page books written by top notch paediatricians who are also parents, I think medically speaking, I know what's best for my baby. Again, grandparents mean no harm, but you really have to be firm with how the baby should be handled, and you should respect the parents' way of raising the kid. 

If you haven't read through books, you should trust the confinement nanny's judgement, especially if she is a very experienced one. Mine was the same age as my mother, but she has been taking care of babies for 15 years or so. Her knowledge on best practice on taking care of newborns is up to date, and she also knows the best products to use. So just trust your nanny, more on that later. 

(Left: tiny naps in bed is fine during the day as long as the parent is awake, and you don't do this as a routine. Right: nail trimmers/buffers are a thing, they are safe and super easy to use, better than a nail clipper)

Nail trimmer from Lolla, linked here

 

Confinement Nanny, and asking her for help 

You've probably heard of scary stories about the traditional confinement for one month where you aren't allowed to go outside or wash your hair and that you should stay in bed. Well, that's all in the past, at least I hope so, it doesn't sound very healthy or sanitary. 

The job of a confinement nanny is basically 2 things: make nutritious meals to ensure your recovery, and help you with taking care of the baby so you can not only learn but also get some rest. 

 

At first I was reluctant to ask the nanny for help with the baby. On one hand as new parents it's hard to let go of your baby, on the other hand we are both people who don't like burdening others. After the first week though we caved and let the baby sleep with the nanny each night so we can get some proper rest. Talking to her later, she said almost every parent she's worked with is like that. 

Also, my nanny has 15 years of experience with new borns, and she is so good with them. There are so many things I'm learning each day just watching her, and now I don't hesitate to ask her questions. Our baby had a painful looking diaper rash that covered most of his butt, she recommended this one cream called Desitin (you can pick this up at any Watsons or Guardian), and after using for 2 days it was gone (so turns out the diaper cream I picked up during the 3rd trimester was pretty useless). She also burps and calms the baby like magic. I might make a list later as a separate blog post, but there are just too many things that books don't tell you about, and the best way is to learn from the nanny. 

Reading my son's cues & finally creating a routine

Communicating with a newborn is frustrating, because all they can do is cry and make some noises. But not to worry, overtime you will figure out what exactly it is that they want. They cry of "I'm hungry" and "Please change me" both sound frustrating but are different. If my son is waiting for his (bottled) milk for too long, he also lets out a loud and short almost shout like cry to let me know he's angry, similar to when he's having a hard time latching if I'm breastfeeding. 

Then there are different noises and cues for when he is gassy. And I can now differentiate if he's trying to poo, needs to be burped, or passing gas. It's in the facial expressions, the movement of the legs, and the grunts he's making. 

In terms of creating a routine, I find that if the first priority - a well fed baby - is met, then everything else falls in place. A 2 week old baby should drink around 90ml, be it breastmilk/formula or a combination. A 2-4week old baby should drink 120ml. Sometimes this can be less or more, but make sure the baby won't suck on your knuckle when you stick one of your finger knuckles in his/her mouth, that means they are still hungry, and you are going to have a hard time calming them and putting them to sleep. Once my baby boy was well fed, he sleeps 2-3 hour stretches at a time, sometimes even 4 hours overnight. 

After feeding, the next priority is to resolve gas. Babies can't burp on their own, and if the baby is fussy about lying down flat, or just won't go to sleep even if their diaper is changed, they haven't slept for a while, and is fed, most likely they need to be burped. Trapped gas is very uncomfortable for them, and sometimes if I've tried burping my son for a while and he's still uncomfortable, I find that letting him sit up at a 45 degree angle really helps. He tends to fall asleep in my arm at that angle, but the moment I put him down on a flat surface he wakes up and cries. After the baby has been asleep in that angle, and there's time for the gas to pass down as a fart, then you can put the baby flat on it's back in the crib. 

A well fed baby will happily fall asleep, no matter where, even if there's noise. 

  

Baby boy has his hands in his mouth, that means he needs more food. 

Another thing on making routines is swaddling. In the day time we either don't swaddle him, or lightly swaddle him where he can have one or both arms out. At night though he is fully swaddled and snug, so he can differentiate the time of day. We try to have his baby cot out in the living room during the day time as well so he can understand the brightness and sounds around the house means day time. 

 

Doctor follow up visits: OB and Paediatrician
One week post delivery, or a couple of days after you leave the hospital will be the first follow-up visit with your OB and the paediatrician. 

For the OB follow-up, since I had a C-section, it was time for a dressing change. The waterproof bandage they put over my bikini line was sticking on my pubes that have now grown out, removing it was like getting a wax downstairs but not the end results. I was worried this whole time I might have ripped my wound, turns out it was the tape ripping on my hair. The scar was beautiful, looked like the fold on the bottom of my belly from being pregnant, so now I have 2 lines on my lower abdomen. 

On bringing the baby out though, man was I not prepared. I was exclusively breastfeeding still at week 1, so we did not prepare any pumped out breastmilk or bottles of formula. And guess what, the kid decide to have a shit fit right before my appointment at the OB, then dad had to change 2 poopy diapers, then I had to breastfeed him again before we could calm him enough to go to the Paediatrician. 

The paediatrician check-up at 1 week is just to weigh him and make sure he's regained his weight back. Babies lose some weight in the first week after being born and it's completely normal, but they should mostly gain it back after week 1 if they are fed properly. After that the paediatrician showed us the vaccination schedule, answered questions we had about the baby feeding and crying and that was it!

What I would've done differently on preparing to go out with my newborn is definitely prepare some formula, at least 2 bottles. And 2 diapers is clearly not enough. I also packed a spare onesie, a swaddle just in case, and a stroller blanket. Before going out, make sure the baby is well fed and changed into a clean diaper. 

My amazing OB who delivered my baby and sewed me up beautifully 

Going out for the first time post surgery

I went out at the end of the first week home with my newborn, so he was almost 2 weeks old at that point. My belly had shrunk just enough to fit into normal size clothing, so I felt someone more dignified. You go through a lot of emotions seeing the state that your body is in postpartum. The frustration of facing "The fourth trimester", the fact that pregnancy had not quite ended yet and the crazy journey of parenthood is just starting can really get to you. 

Being able to fit into the same size outfit pre-pregnancy is a huge mood booster. I was also pumping breastmilk at that point, so heading out for 2-3hours and letting the nanny take care of the baby was no issue. Sitting at our usual brunch spot, I finally felt more like myself again. 

I bought my outfit and bag from ezBuy. It's a platform where they resell items from the Chinese eCommerce site TaoBao. ezBuy removes the need to be able to read Chinese or have a Chinese bank account to purchase items. I was able to get a discount code from them, $10 off for any purchases of $20 or above. Please use it via the link here: bit.ly/ezarielland

I was also hoping to be able to bring my baby out for a walk, but we haven't had good timing yet. It's tricky because Singapore is always so sunny and babies have sensitive skin, so we can't take him out during most of the day. It'll have to be sometime during sunrise or sunset. But I purchased this baby carrier I saw online called Konny. The carriers are super easy to use and comfy to wear, they have XS to XL sizes so both mommy and daddy can use them. It holds the newborn close so there aren't neck support issues. And I like the fact that it's a all-in-one piece, with no clips and complicated straps. Hopefully I'll get to give this a try soon! 

The Glow Baby (Premium) App

I almost never pay for apps, but this app has so many good number tracking and analytical features, I just paid for 1 year membership from the start.

During your stay at the hospital, if your baby was rooming-in with you, questions from the nurses that keeps repeating to a point where it drives you nuts are "When did yous start feeding? How many minutes on each side? Did he pass urine? Did he pass motion? (poo)" 

Well there's actually a point in tracking this. You will be able to better put the kid on a good routine if you know when the last time he sept is, if he's slept for 3hours+ during the initial weeks it's probably good to wake the baby up during day time to feed.. etc 

This app allows you to track feeding, sleeping, and diaper changes. Additionally you can also track how much pumping you've done, the baby's weight/length/head circumference, any temperature changes etc. The premium version gives you charts, reports, and compares that with other users to see how your baby is averaging. 

This app is super handy since the Paediatrician will most certainly ask you the same questions the nurses ask: how much is the baby feeding and pooing each day. Instead of trying to count and remember or pulling up a note with lines of words, a chart is so much easier. 

(Below) Premium version of the app, giving you a nicely colored chart of his daily routine. If you click on the day, the bottom displays the summary. 

You can track how the poo looked like

On feeding, the first tab is "Breast" which gives you a timer function, or you can enter it manually. "Bottle" which is the tab below allows you to track bottle feeding for both breastmilk and formula milk. The third tab "Solids" for when the baby is older, allows you to track what ingredients the food had and the baby's reaction such as loved it, hate it, or allergic reaction. 

Another feature are moments or developmental milestones on what the baby can physically do. 

(Below) This is an example of a premium feature, it analyzes the average of everything you track on a daily and weekly basis, then it gives you a comparison of how other babies and mothers on this app average out. 

Every parent and every baby is different. What may work for me may not work for you. But like what everyone else says, and I firmly back it is that it all gets better. The first week home will be one of the most challenging weeks in your life, but it will be rewarding as well. Don't be afraid to reach out for help, and don't try to do everything on your own. 

Happy Parenting!