Don't Freak Out Advice

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Just a reminder:, PSP member posts are not checked for accuracy. The content is for general informational purposes only and is not a substitute for medical advice.  ParkSlopeParents.com is not intended to, and does not, provide medical advice diagnosis or treatment.  Never disregard professional medical advice, or delay in seeking it, because of something you have read on the PSP Yahoo! Group or on the http://www.parkslopeparents.com/ website.  Never rely on information in an e-mail or on our web site in place of seeking professional medical advice. 

EPIDURALS:

• "This one is not something I wish I'd been told but something I wish more moms were told, about getting an epidural.  After the epidural is in, you might have a drop in blood pressure and/or the baby's heartbeat might get low.  This is really common, and your doctors and nurses will ask you to change position and/or give you oxygen and/or increase your IV fluids and/or give medications to help with your blood pressure. When I worked in Labor & Delivery, I always told people that because I think that if you aren't forewarned, it can be really scary to have everyone doing all that.  I think it's better to know what to expect!"

BREASTFEEDING / NURSING / MILK COMING IN:

• "If you are breastfeeding, don't throw in the towel!  It can be hard as heck (not to mention painful!) in the beginning, and it takes time for you and the baby to figure it all out, but it'll happen if you both stick with it (in most cases)!  It's a lot easier after 3-4 days when you get actual milk (as opposed to colostrum) which the baby will be way more into.  Use the lactation consultants that hang out in the hospital!  Once you both get the hang of it, it's a piece of cake."
• "I think that even if you are doing it correctly, breastfeeding just hurts in the beginning, but it does get better.  And I agree with all of the pro-lactation consultant comments.  I needed one for my second baby but not my first.  Different babies latch on differently."
• All babies lose weight at first after birth.  Breastfed babies can lose up to 10% of their birthweight before doctors get concerned.  This is because your breastmilk doesn’t come in for several days after birth.  The baby will get colostrum (milk formed in the breast during pregnancy) until your milk comes in.  It’s important that the baby nurse early on, even though it will only get drops of colostrum, in order to stimulate breastmilk production.
• "If you have a C-section, your milk may take a little bit longer to come in.  Mine did with my first baby, and I didn’t want to supplement.  The result was that she was crazy jaundiced and dropped a bunch of weight.  They did let us leave the hospital but made us come back to get her bilirubin level tested, which was a bummer.  With my second baby (and second C-section), I supplemented with formula from the get-go.  He was a bit yellow, but the formula flushed it out immediately.  Moral:  if you have a C-section and your baby is a bit yellow, stuff him or her with formula for the first few days!"
• "Don’t worry if the baby doesn't nurse much for the first 24 hours. They're born completely hydrated and are good to go for a while.  (We couldn't wake up daughter number 1 to nurse the first night in the hospital and had a lot of unnecessary worry and sleep loss because of it.)"
• "If your milk hasn’t come in after a few days, it IS okay to supplement to keep the baby hydrated."
• "Even though I am a HUGE breastfeeding advocate, if [your] milk is not totally in (which it won't be at first) you should give your baby some formula to supplement and, most importantly, to keep the baby hydrated.  If you're still in the hospital and the baby is dehydrated and spikes a fever (very common), they will take it to the NICU for a minimum of 48 hours and run a battery of tests...all awful.  There will be no nipple confusion and formula is NOT evil; most of us grew up on it and we turned out okay!"

BABY WEIGHT LOSS / JAUNDICE:

• In the first 24 hours the baby doesn't need to consume much and might not nurse as much as he or she will after that first 20-24 hours, and babies only need 10 to 100ml in the first 24 hours, so this is fine and no reason to be pressured to supplement!  This chart is really helpful [PDF download] (and even though I already knew that, the second time around I still needed to be reminded of it by my midwife!)
• If the doctor in the hospital is concerned about the baby's weight loss (even though all breastfed babies lose weight), you can give formula through an eyedropper instead of in a bottle which can complicate the latch process so early on.
• If bilirubin lights are recommended [for treatment of jaundice], most insurance companies will pay for lights to be delivered to your home, so you don't necessarily have to stay in the hospital or go back to the hospital if you feel more comfortable being at home.  "The lights showed up on our doorstep without our having to pay a dime.  That was in 2003 and 2005."
• "Consider the possibility that your baby could end up in the NICU for whatever reason.  My daughter had high bilirubin levels, and while most hospitals keep those babies in the regular nursery, the hospital I delivered at kept those babies in the NICU.  I really didn't expect anything to go wrong, but I should have, considering the emergency C-section."

POSTPARTUM DEPRESSION/ HORMONE CHANGES:

• "I wish someone had told me about the post-baby hormone thing.  For about two weeks or so after birth, I thought I was going nuts, having all kinds of weird thoughts and feeling generally bluesy and off-kilter.  Turns out this is normal, but I wish I had been given the heads-up about it!  The good news is that for most people (from all that I have read), this goes away after a week or two.  I guess for a small percentage of women it doesn't go away, and that's when you have to talk to your doctors about it because it may be postpartum depression, and they can talk to you about treatments and stuff."
• "About C-sections:  I had an emergency C-section with my first child and postpartum depression as well.  In my case, I don't think it was 'failure' that brought on the depression, though being thrown onto a gurney like a slab of steak doesn't give one a sense of control, quite frankly.  I think there is a hormonal and chemical element, something that is released into your system during vaginal birth, maybe?  Just be aware that it may not be in your control to 'avoid' PPD, so don't blame yourself if it does occur--just get help!  (Even if that help consists of pampering in bed when you get home.)"

POST-C-SECTION ADVICE:

• "I recommend getting up and moving as soon as they take the catheter out of you."
• "If you have a C-section, they won’t let you eat solid food until you pass gas, which, following the first C-section, was several days later.  I was starving and cranky and full of orange jello.  For my second C-section, 24 hours into it the nice nurse said, "I can give you something BUT YOU MUST ASK ME FOR IT" (wink wink nod nod).  So I asked.  I got.  I ate.  All good.  Just ask."

ANTIOBIOTICS/THRUSH:

• "Nobody warned me that because of the antibiotics, after a C-section, there is a good chance that you and the baby will get thrush.  What happens is the antibiotics you are on kill the good bacteria as well as the bad bacteria.  The good bacteria help prevent fungus that cause thrush, which in turn makes you more susceptible to getting thrush.  I am pretty sure I had it for at least a month or two before I realized what it was.  It's a real bitch to get rid of."
• "I was glad to get the advice about antibiotics and their horrible after-effects.  I never considered that at all.  The prospect of being given drugs which create/activate thrush--on top of the usual postpartum delights--is depressing."

TESTS/PROCEDURES FOR BABY UPON DISCHARGE:

• All babies will have a PKU test before leaving the hospital--it’s mandated by law.  Unfortunately, the test is not valid in babies less than 24 hours old, so if you have a 12-hour discharge, they will do the PKU, and your pediatrician will repeat it at your three-day visit.  The PKU consists of a heel stick and the extraction of five drops of blood onto a card.  Some of the nurses are better at this procedure than others, and if it seems to be going slowly or the baby is very distressed, you should ask for another nurse.  Be sure the staff warms the baby’s heel before the stick, as this helps increase blood flow.
• The nursing staff will want to take the baby's rectal temperature before you are discharged.  If you do not feel comfortable with a rectal temp, you can ask them to take an auxiliary temperature (in the baby’s armpit).  The rectal temperature is more accurate, however, so if there is concern about a fever, it may be best, but the decision is yours. 
• Before you leave, the nurse will change the cord clamp on your baby and apply gentian violet, an antiseptic and drying agent.  There is no real harm in the gentian violet, except that it is bright purple and stains for a few weeks.  It is certainly optional, so you can refuse it.  Just know that they apply it so quickly that you need to speak up fast if you don’t want a purple belly!

FLUID RETENTION:

• "Once you have the baby, all the fluid you've accumulated over nine months starts to leave the body and apparently travels downward first, so for a week or so, you will have massive cankles!  Don't panic!"