You and Your Newborn Baby (part 3)

Caring for Yourself after a Cesarean.

Each woman recovers in her own unique way after cesarean birth, just as after vaginal birth. Pain medications can help during the first few days (the medications given are considered safe during breastfeeding). The nurses will assist you in getting up the first time, learning to cough or huff to keep your chest clear, dealing with the gas that can follow surgery, and learning to hold your baby in ways that are comfortable for you. If assistance is not available when you need it, press your call button and ask for help.

All new parents can benefit from assistance at home after childbirth, but for a woman who has had a cesarean birth such help is essential for at least the first week. Not only are you undergoing a transformation to a nonpregnant state and learning to care for your new baby, you are recovering from major surgery. Adequate help, allowing you to rest often during the day, can make a great difference in how quickly you feel strong and well. Taking care of yourself and your baby should be your only duties until you feel ready to take on more.

These activity restrictions are usually recommended:

Limit stair climbing as much as possible.

Don't lift anything heavier than your baby for the first two weeks.

Ask your mate or a friend to do laundry, vacuuming, and other tasks that require bending, lifting, or pushing for at least the first few weeks after birth. Then resume such work gradually.

Do not drive a car for the first two weeks.

Take showers instead of tub baths until the incision is completely healed and dry.

Ask your doctor or midwife for specific instructions on the care of your incision.

Accepting Your Initial Responses to Your Baby.

Like her labor, a woman's initial response to her baby is something she remembers for a lifetime. Women greet their babies in as many ways as there are mothers. Before they give birth, most women anticipate a rush of loving feelings, or even tears of joy. others anticipate instantly "feeling like a mother." Some women actually experience these things. Many do not.

Sometimes, a woman experiences a temporary holding back from the baby whose birth caused pain or emotional trauma. A new mother may have a feeling of distance-which in retrospect may seem like disinterest. Or she may feel a strong need to attend to herself, pain and exhaustion compete with interest in the baby. in retrospect, she may see herself as selfish. Coolness, distance, self-centeredness-none of these fit with any woman's conception of a "good mother." Because of this, many women say they feel guilty about their initial responses to their babies.

Many women speak of feeling outside of themselves after labor. It is as though one's personal boundaries are hazy. Is it any wonder that women feel they are not taking their babies in-"as they should?" They can hardly take themselves in! This is to be expected. Most women say it takes days to come back into themselves. This is the natural rhythm of things. Something amazing is going on. As boundaries are reclarified, they are also redefined. You are now a mother. Your baby is no longer one with you, as in pregnancy. But the new boundaries are extended, to connect you for a lifetime to this other person. This connection is the essential work of the first months of parenting. You may have all the loving feelings you anticipated, but if you do not, give them time to evolve, as you do the work of taking on your new role.

Signs of Illness in a Newborn.

Many parents doubt whether they will recognize if the baby is sick. When you have no experience with babies, being told that a sick baby behaves differently from a well baby is of little comfort. if everything about your baby seems unfamiliar, it is hard to have confidence that you can and will recognize changes that indicate your baby is ill. Besides, healthy babies can cry for a couple of hours each day. Crying does not tell you as much in the first weeks as it will when your baby is older. So how will you know if your baby is sick? Asking yourself these questions may help:

Is there a change in the baby's behavior? Is the baby crying more than usual? Has the tone of the cry changed? Is the crying at a different time of day than usual? Is the baby more irritable than usual? Is the baby sleeping more or less than usual? Does the baby seem lethargic or listless?

Has the baby's appetite or digestion changed? Is the baby eating less than usual? Has the baby vomited more than once? If the baby is vomiting, is the vomiting forceful? (This is called projectile vomiting.) Are there signs of constipation? That is, are the stools hard or more solid than usual? Are there signs of diarrhea? That is, are the stools watery, or more runny than usual? Are they more frequent than usual? Is the baby urinating less frequently than usual? Has the color of the urine changed?

Has there been a change in the baby's breathing? Does the baby seem to have trouble breathing? Does the baby sound congested? Does the baby have a runny or stuffy nose? Is the baby coughing?

How does the baby look? Is the baby's skin pale or flushed? Is there a rash anywhere on the baby's body? Do the baby's eyes look glassy or dull? Is there any discharge from the eyes?

Does the baby have a fever?

Any of these changes could indicate illness. if you notice any of them, or other worrisome changes in Your baby, call your baby's care- giver. When you call the office, be prepared to describe:

	The signs of illness about which you are concerned.
	How long the signs have been present.
	What you need: to have the caregiver return your call; to speak to the caregiver immediately, if you feel this is an emergency; or to arrange for the baby to be seen as soon as possible.

CRIB SAFETY TIPS if you have a used crib or are considering buying one

Make sure it has no corner posts. older infants can catch clothing on these.

Check that the crib slats are no more than 2 3/8 inches apart. Never put a baby in a crib that has missing slats.

Make sure that the mattress is firm, and that it fits tightly within the crib rails, with no more than a 1-inch space (two fingers width) between the rails and the mattress.

Assure yourself that all guide rods and support brackets are firmly in place and secure, and that no screws are missing.

Check the locks and latches on the crib. They should be smooth, and tight enough to prevent accidental release.

Be certain the paint used on the crib is lead-free. If it isn't, the old paint should be removed. if you're pregnant or nursing, have someone else do the stripping, preferably away from your home, or at least outside the house and away from any play or garden area. New paint should be a high-quality, lead-free enamel recommended for children's furniture. Some babies do chew on their cribs, and ingesting lead can cause brain damage.

If your crib is new, remove and discard all plastic packaging materials, including the thin plastic mattress cover. As with a used crib, check the guide rods, support brackets, locks, and

latches, and make sure no screws are missing. With any crib, new or old

Place the crib out of reach of any cords, electrical sockets, or other hazards.

Keep crib rails up at all times when the baby is unattended.

As soon as your baby can pull himself or herself up, move the mattress to the lowest position. There should be at least 22 inches between the mattress and the top of the rail.

If you plan to use a bassinet or cradle instead of a crib, many of these same safety tips will still apply.