Two Weeks of New Life

Let me take you through some of the stuff that happened in this almost-two-weeks. This is kind of a rambling post with a lot of different stuff in it.

I talked before about how becoming a parent happens instantly. With it of course come a whole ton of changes, all of which also happen instantly. Before my son was born, my day on a weekend consisted of getting up whenever, eating lunch whenever, doing some household chores or work, playing some video games or watching a show, maybe reading or writing some code, eat dinner and watch something, maybe play some more games, and go to bed.

Pretty much zero of those things happen now, at least not with any degree of certainty, and I'm not sure when they'll start up again. The first thing I had to learn to forego was sleep, of course. It's a cliche, the sleep-deprived new parent, but it's real. Newborns don't distinguish between day and night, so they're on a 24-hour eating schedule, which means we're on a 24-hour schedule, too. Every three hours he needs to eat, so we wake him up from his nap, feed him (and other care tasks), then either hang out with him, keep him up while we do stuff, or put him back to sleep.

As an amusing side-note, this blog post was originally titled "One Week of New Life." Heh.

Depending on how long feeding took, this might give me up to two hours of possibly-interrupted "free time", but most of the time, that is spent either getting ready for a future feeding or doing something else baby-related. It's like it crowds out everything else, and the short intervals seem to absorb all the time in the day. I sound like I'm complaining, but I don't mind; this is what I signed up for, and over time we'll build up the muscle and efficiency to squeeze more time out of the day in conjunction with his own changes from growth.

I think there are probably many different approaches here. The one we found that we like is to try to stick to a schedule. I have a sense that this is pretty controversial, but a lot of people do this successfully, and so far it's already working well for us. What this means is we try to set the baby's internal clock and start teaching him about the difference between day and night, but in a way that also meets his needs.

Practically, it goes basically like this: he feeds every three hours. After each feeding, he either has about an hour and a half of "awake" time followed by an hour and a half of "sleep" time. But in the night-time feedings, he doesn't get any awake time. After feeding we put him straight back to bed.

When we say "awake" time, we mean any time that's spent out of his crib, out in the world. Calling it "awake" time is kind of funny, because about half the time he spends it napping somewhere or another. But my wife had a good explanation for it. You know how you can nap on a plane? Technically, you're sleeping, but man, it's nothing like the kind of sleep you get in your own bed. So we make sure the baby gets both time where people are talking loudly over him and dogs are barking and whatnot and time when he's in a quiet, dark, familiar place and can get restful sleep.

To reiterate, we're waking him from sleep every three hours. Who ever knew you're supposed to wake the baby!? That's not intuitive at all! Yet, that's what we do.

It takes 45 minutes to an hour from the time we start waking him to get him alert, have him eat, burp him, change his diaper, and re-clothe him, so he gets half an hour or 45 minutes of awake time before back to napping. Just before putting him back down for a nap we'll check his diaper again and make sure he isn't cueing for hunger. We'll also soothe him a bit if he's agitated (though he rarely is!).

It took us some days to figure out what worked for waking him up to feed. If he's too sleepy and groggy, he won't eat, so we start each wake-up by undoing his swaddler and sleeper, and by checking his diaper. Even this little bit of interaction is enough to get him moving. Often the act of simply touching his tummy after getting him out of his crib is enough to make him start pooping vigorously. That's fun.

Then we get some adorable "big stretches" out of him, and then he starts getting hangry (hungry and angry about it at the same time). This means he's sometimes hollering by the time he's ready to eat. I think eventually he'll get a little more patience and be able to tolerate our ministrations before food. After all, we stick to the same routine every single time.

We're really lucky that he hasn't been an especially picky eater so far. We had a scare with his weight dropping too much in the first week. He's fine now, but to get back on track we had to give him pumped breast milk or formula from a bottle. We are lucky enough that he was really tolerant about this, because we gave him cold (refrigerated!) breast milk and tried three different types of cold formula (some of them bloated him up with gas). He took every one of these without any complaint--whew, we can give away that bottle warmer we got. How convenient!

This is going to be a big detour here, but I'm going to go into it now. The weight drop in the first week was our first scare, really. We found out when we went to the pedatrician's office about 3 days after we were discharged from the hospital. It's okay for babies to lose up to 10% of their birth weight by that point, but he'd lost 12.5%. We were shocked and confused. He'd been breastfeeding exclusively so far, but he'd happily sit for long stretches and seem to be eating. "Seem to be" is the key qualifier there, because he was actually "comfort sucking" or "non-nutritive sucking", basically using the nipple as a pacifier and not getting any milk out.

Here's a wacky thing I didn't know until our childbirth class: breastfeeding is complicated. My non-dad brain thought that babies came instinctively programmed to be able to suck breast milk, but nope, there's a ton of technique to it. They have to make coordinated motions with their tongue, make a good mouth shape to keep suction, and be able to swallow and breathe in rhythm. A lot of the times they won't get a good "latch", which is both painful for the mother and inefficient or ineffective for the baby. In fact, there are specialists at most hospitals to help mothers teach their newborns how to breastfeed. They're called lactation consultants, and it's a full-time job!

In our child's case, the problems he was having nursing were at least in part due to something else: he was tongue tied. This is the second wacky thing I found out: being "tongue tied" is an actual medical condition. The flap of skin that connects the tongue to the bottom of the mouth (the frenulum) extends too far forward and prevents the tongue from the range of motion needed for effective breastfeeding.

The lactation consultant helped diagnose it, and the pediatrician performed the routine, totally painless procedure to snip the frenulum and unlock the full potential of his tongue. It's painless because there are very few nerves in the frenulum at this stage of development. Accordingly, though he was already crying from being bothered in the doctor's office, when the snip came he didn't seem to even notice. Unfortunately, he hasn't had to use his tongue properly so far, so we have to teach him how it works.

During the few days prior we had been bottle-feeding him because he couldn't afford to lose more weight. We got a special nipple for the bottle that acts as kind of "training wheels": unlike a regular bottle nipple, which he can just chomp on easily to get milk out of, this one requires him to make the correct sucking motions to get any milk out. He doesn't like it very much, because he has to work a lot harder to get milk, but now he's getting totally used to it. Hopefully in a few days we can start him up on breastfeeding again.

In the meantime, back to the schedule. What I like about it so far is it gives us a decent degree of predictability. By keeping a log of his activity, we know when the baby is going to be hungry and when he's going to have a diaper to change and how much he eats in a sitting, so we can detect when something changes, either because he's sick or if he's growing out of it. We can also provide this data to a doctor--"we know that he peed eight times yesterday, and here's the proof!"

We've also been using the schedule to take outings. If we try to time the trip to the doctor's office during his awake time, we know he won't be cranky for food or distracted by random stuff. Or we know when he next needs to eat, so if we're out of the house we can pack enough milk and the right supplies to keep him happy.

One way or another, our life has settled into a nice routine, and by taking turns on the "night shift" (which we can now do, due to bottle feeding), we can both trade off on sleep and even have time to watch some shows or, ahem, write some blog posts every day. It's pretty great.

That's enough about schedules for now. I tend to take my time doing all these repetitive care tasks, because what else is more important right now? What would I be rushing off to do? I'm lucky enough to have vacation to take and paternity leave to look forward to next year, so I can tune everything else out right now and just immerse myself in learning these basics of newborn care. So I slow down and really enjoy them. I see them as bonding time with him, even though he can barely show it yet, seeing as how he can hardly even control his arms and legs.

A lot of what we do as we parents is watch his cues and behavior. Feeding time, especially, is packed with them. When he's hungry he starts trying to do backflips by pushing off with his legs, he turns his head this way and that with his mouth open, as if seeking any source of food, and he tries to gobble up his hands if they stray too close to his mouth. When offered the bottle, he practically pounces on it and sucks hungrily. After a few minutes of drinking he always needs a burp break. He pulls his head back and twists like he's trying to escape it, then leans back and purses his lips thoughtfully. While burping him between bouts of furious feeding, he'll even start letting me know with his hunger cues that he wants to get back to it.

Newborns have their own language, and a lot of it is really obvious if you know what to look for. Today we had an episode where we really didn't know how to read him and consequently couldn't help him. We woke him up for an afternoon feeding as usual, but he cried and cried and was inconsolable even though he wasn't cueing for hunger like he normally does. He arched his back strongly for minutes on end and constantly blew little bubbles with his lips.

Eventually he tired himself out and took a nap, having eaten very little. That was worrying to us because we hadn't seen that behavior before, and because we want him to eat consistently to regain his birth weight. Later, my mother-in-law suggested those sounded like cues for bad gas. Sure enough, before his next feeding he farted like twelve times in a row and went on to eat heartily. If only we'd known, we might have been able to squirt him a little "gripe water" (gas relief juice). I know soon enough he's going to have periods of crying that we won't be able to explain or solve, but it sure is tough to watch helplessly.

I'll finish this one up with my favorite thing I did in the last week or so. I'd just changed his diaper and fed him, but he'd peed on his onesie so I'd need to put him in a new one. Instead, for his awake time, I took him out into the living room and lay on the floor with my shirt off and just had him lie on my chest. He was pretty drowsy and fell asleep a minute later. With his head on his side and his ear to my chest, he could probably hear my heart beating and hear me talking quietly, which I'm sure reassured him, too. They say this kind of "skin-to-skin" contact is good for the baby, but it's also great for the parent.