Expectations
Nurse-Midwives
of Indianapolis
Birth
Center News
By Ruth Stark
Will I ever get a good night sleep again? The answer is yes, with a few qualifiers to it.
There are two major physiological factors at play in the newborn which account for his around the clock schedule. First, infants do not sleep the same as adults, or even older children. Little ones have much more light sleep, or REM sleep, and it is not until about four months of life that a baby's sleep patterns begin to resemble what we call "normal" patterns. Secondly, babies, both breast-fed and bottle-fed, continue to need nourishment in the night hours. Their bodies are experiencing a surge of growth and development, which will not be matched in any other period of life. They might look like they just lie around all day, but they are using calories at a tremendous rate - energy which must be replenished constantly to ensure wholesome development.
Many newborns will nurse every two hours or so in a 24 hour period for the first seven weeks of life. Such a schedule has great benefits for both mother an child during postpartum period. But after six weeks, if baby is gaining well, the time between night feedings can be lengthened to six or more hours. Often by this time, baby is sleeping a longer stretch on his own. For those who are not, it takes a little more work to eliminate one or two night time feedings but it can be accomplished. For women who become over-full easily, it should be done gradually to prevent engorgement.
To begin to end night feedings, one must start during the day. Concentrate most of baby's feedings in the mother's waking hours, which may mean increasing daytime feedings for some. Do not let your little one sleep too long during the day, especially if he is one to wake up every two hours at night. A nap should not be more than three hours in such a case, and it should be proceeded and followed by a nursing. Studies also indicate that increased daytime holdings help the baby sleep through the night.
Let's say baby is already sleeping a longer stretch, five or six hours, but he goes to bed at 8:00pm and you go to bed at 11:00pm. That still leaves you with only two or three hours of unbroken sleep. You need to adjust baby's patterns to you. Wake the baby up, change his diaper if necessary, and feed him about one half hour before your bedtime. Within a few days baby's longer sleep pattern will shift and you will both get unbroken sleep before baby wakes around dawn ready for another nursing.
Let's say baby isn't sleeping a longer stretch as yet. Along with the daytime hints, consider the following: little ones often wake up quite a bit during the night but can easily put themselves back to sleep. If you hear baby stirring you may interpret his noises as a need to be fed, but especially by this time, it may not be so. Don't pick him up at first-wait to see what happens. If he does fuss, try rubbing his back, or rocking the baby instead of feeding him. A baby might also be waking because he is too hot or too cold, or because his diaper is too wet. Using disposable diapers during the night, or double diapering can help eliminate the latter problem. Keep the lights off if at all possible. Do you have a closet light or a night-light you can use instead? Do not talk with or play with baby in the middle of the night. Dads can sometimes put a baby back to sleep much easier as there is no association with nursing when baby is with him.
If all these measures fail to comfort baby and put him back to sleep, then breast-feed him, but shorten the length of feeding a bit. Don't give up entirely for at least three or more days. If the efforts to eliminate a night feeding becomes too much, you may want to assume that you are trying to do it too soon. Wait a few weeks and try again.
Bear in mind that in the first year of life, night feedings are never eliminated permanently. Your baby will experience growth spurts, may catch a cold or flu, start teething or go through anxiety periods where he needs you closer more of the time. The degree of sleeplessness experienced by new parents, especially the mother, is one of the greatest shocks of parenthood. Developing a good attitude and acceptance of this ancient fact of life goes a long way to helping you sleep better.
Ruth Stark is a volunteer lactation counselor for Nursing Mother's Counsel, Inc.
Once thought of as the choice of "fringy" alternative-health advocates, midwifery is going mainstream. In a University of Michigan study of women who received maternity care at the university hospital, 40 percent chose a certified nurse-midwife rather than an obstetrician-gynecologist to deliver their babies. "Women may be attracted to nurse-midwives because of their reputation for supportive, comforting, holistic care," says Deborah J. Oakley, PH.D., a professor of nursing and co-author of the study. Other reasons they shunned doctors: a desire to be cared for by a women (more likely with midwives), and a need for more control over their own health and birth experience.
[from Redbook, April 1995]
The Importance of Folic Acid for Women of Childbearing Age
By Helene Menard, RN
Pregnant or considering becoming pregnant? Experts agree that one of the most important nutrients is folic acid, a trace B vitamin found in dark green leafy vegetables, broccoli, asparagus, peanuts, citrus fruits, mung bean sprouts and liver. Getting enough folic acid may cut by 50% to 70% a women's risk of having a baby with a neural tube defect, a condition in which the brain and spinal cord form improperly.
The government recommends that ALL women of childbearing age consume 400 micrograms of folic acid every day. However, pregnant wonen should consume 1000 micrograms (one gram) of folic acid each day. At the end of February, 1996, the Food and Drug Administration ordered that most bread, flour, pasta and other food from grains must be fortified with folic acid. This change in effect earlier this year, will mean women will get about 10% of the daily requirement of folic acid from every serving of these foods, making it easier to get enough to ensure a healthy pregnancy. Taking a prenatal vitamin, even before conception, ensures a women's intake, as does including at least two servings a day of foods high in this nutrient.
The recipe featured below has an abundance of spinach which is full of Folacin (folic acid) and iron, along with eggs and cheese for an added protein and calcium punch! The added bonusit's delicious and easy to prepare. Eat well and ENJOY.
Here's a challenge for you. If you have a recipe that fulfills the RDA for folic acid and you and your family really like it, share it with us! Just bring, or send it to the Center, we'll choose one and publish it in the next newsletter, anyone can participate, whether or not a client of the Birth Center. Get out those cookbooks!!! There may even be a prize awarded for the best recipe!
Spinach Souffle (makes 4 servings)
2 pkgs. Frozen spinach (10 oz pkg)
2 cups low-fat cottage cheese
2 eggs
2 tbsp butter or margine (may omit if watching excess fat)
9 oz. American cheese, cubed (may use a good quality fat-free or fat-reduced American cheese)
Mix. Place in 8"x 8" casserole sprayed with cooking spray. Bake at 350 degrees for one hour. Enjoy!
Kathy Napolitano
(reprinted with permission from Woman to Woman, the newsletter of the Reading Birth & Women's Center)
You're at the end of your rope. Your new baby has been nursing for what seems like the entire day, and when she's not at the breast, she's crying. You wonder if maybe you aren't producing enough to satisfy her. How can you tell when your baby is getting enough? The amount of milk a mother's breasts produce is dependent upon the effectiveness and frequency of sucking her baby does at her breast. The more often and effectively her baby sucks, the more milk is produced; This is accomplished when the hormones, prolactin and oxytocin, are released by her pituitary gland. Prolactin is the milk-producing hormone, while oxytocin causes the "letdown", or milk ejection reflex. Many mothers worry that they do not have enough milk. You can be confident that your baby is getting enough milk if the following conditions are present: Your baby has two to five bowel movements and six to eight very wet diapers per day (for the first six to eight weeks). In older babies, the number of wet diapers should remain the same but the number of bowel movements may decrease. Your baby is nursing frequently- at least eight to twelve times in a twenty-four hour period, or approximately every two to three hours. While some babies nurse less frequently and others more often, there is not a problem unless your baby is not gaining well. Your baby is gaining an average of at least one pound (453 grams) per month, or four to seven ounces per week. This is an average; some weeks your baby will gain more, others less. Remember that some babies take two to three weeks to regain their birth weight. If you have questions concerning your baby's weight, discuss them with your baby's doctor. Your baby appears healthy. He should have good color and muscle tone, and appear to be "filling out" and growing in length.
If you remain concerned about your milk supply, perhaps your baby is displaying one of the following behavior patterns, and sounding a "false alarm": Your baby seems hungry soon after being fed. As breast milk is more easily digested than formula, breastfed babies need to be fed more of ten than formula fed babies. Your baby nurses "all the time." Perhaps your baby has a strong need to suck or be held. Your baby's frequent nursing will guarantee a good milk supply. Your baby is fussy. Many babies have a fussy period at the same time each day, while others fuss all day. If nursing doesn't help, try rocking or walking him, using a sling or front carrier around the house, or perhaps swaddling him. Your breasts seem softer. This happens as your milk production adjusts to meet your baby's demands.
Your baby suddenly nurses more frequently and/or for increased lengths of time. This could be due to your sleepy newborn "waking up" or, if the increase occurs at two weeks, six weeks or three months of age, it could be the result of a growth spurt. Your baby is simply increasing your supply through his increased sucking. Your breasts no longer leak. Once your supply is established, leaking between feedings may no longer be a problem. Leaking is not related to supply. Your let-down sensation doesn't feel as strong as it once did, or you've never felt it at all. Some mothers never feel a let-down, but by observing their baby's pattern of swallowing and sucking they recognize when it is occurring. Your baby suddenly decreases his nursing time. Now that your baby is an experienced nurser, he may be able to extract the milk more quickly. You and your baby may experience several or all of these occurrences during the course of breastfeeding. If you continue to have questions concerning your milk supply, be sure to get in touch with a La Leche League Leader or other breastfeeding specialist. In many cases, improved breastfeeding techniques will quickly resolve the situation. Your happy, healthy breastfed baby will prove ample reward for your efforts. For further information, see: The Womanly Art of Breastfeeding, published by La Leche League International, P.O. Box 1209, Franklin Park, Illinois, 60131-8209; Establishing Your Milk Supply, Reprint No. 81 and/or Increasing Your Milk, Reprint No. 85, both from La Leche League International; or call your local La Leche
Women's Health and Childbearing Center
2110 W. 38th Street, Indianapolis, IN 46228
Phone: (317) 328-0671
Fax: (317) 328-0674
E-Mail: midwives@indianabirthcenters.com
Expectations
Women's Health and Childbearing Center
1506 W. White River Blvd., Muncie, IN 47303
Phone: (765) 281-9497
Fax: (765) 281-9498
E-Mail: midwives@indianabirthcenters.com:
Women's Health and Childbearing Center
1506 W. White River Blvd., Muncie, IN 47303
Phone: (765) 281-9497
Fax: (765) 281-9498
E-Mail: midwives@indianabirthcenters.com:
