1.0 - Preparation for Birth

SHARON’S SUMMARY & CHECKLIST

Sources

1.      The New Contented Little Baby Book by Gina Ford

2.      Guide to Childbirth by Wong Boh Boi

3.      Guide to Breastfeeding by Wong Boh Boi

4.      Guide to Childcare by Wong Boh Boi

5.      Successful Breastfeeding by Kang Phaik Gaik

6.      Your Baby’s First Year by American Academy of Pediatrics

7.      Baby Must-Haves

(3.0) PREPARATION FOR BIRTH

(A) 2 months before EDD

1.      Big cot – Sturdy; Big enough to accommodate a 2-year-old child comfortably; Flat spars (no less than 2.5cm and no more than 6cm); 2-3 different base height levels; Drop-sides should be easy to put up and down without making a noise after several tests; Mattress is at its lowest position, the maximum distance between that and the cot top should be no more than 65cm and there should be a gap of no more than 4 cm around the edge of the mattress.

2.      Mattress – Natural cotton spring interior

3.      Bedding for the cot – 100% white cotton; No need quilts and duvets; No nylon filling; 3 flat, smooth cotton top sheets (avoid flannelette); 3 cotton, small-weave cellular blankets, plus one wool blanket for very cold nights; 6 flat, smooth cotton pram sheets as draw sheets.

4.      Changing Station – look for a long unit, containing drawers and a cupboard.

5.      Wardrobe

6.      Chair – Wide enough with wide arms

7.      Curtains - Full-length and fully lines with blackout lining; Fix them to a track that fits flush along the top of the window and have a deep matching pelmet; No gaps between the sides of the curtains and the window frame; No curtain poles; The room should be very dark when lights are off and the curtains are closed.

8.      Carpeting – A fully fitted carpet is preferable to rugs; Choose the one treated with a stain-guard; Avoid very dark or bright colors

9.      Lighting – Night lights

10.  Bed linen, muslins and towels washed and ready for use.

11.  Bathing: Big infant bath tub, Baby safe bath mat, Thermometer, No-rinse cleansing fluid, Baby towels, Baby washcloth, Cotton wool, Cotton balls, Cotton buds, Anti-bacterial hand wash, Hand sanitizer

12.  Grooming: Cot sheet, Massage oil, Barrier cream, Diapers, Cloth diaper and diaper liners, Baby wipes, Cotton wool, Brush and comb, Nail clippers and scissors, Nasal aspirator, Cord spirit

13.  Breast-feeding: Electric breast pump, Storage bottles, Disposable breast pads, Extra breast shields, Nursing pillow, Nipple cream, Hot/Cold packs

14.  Bottle-feeding: Feeding bottles (0-month, 125ml and 1-month, 260ml), Teats (0-month, 3-month, 6-month), Steam sterilizer, Bottle brush, Liquid cleanser, 3-tier powder container, Formula, Teether, Cup feed, Hot water flask, Drying rack, Pacifier

15.  Essential Clothing: 4-6 Onesies; 4-6 sleepers; 7 Booties, 7 Mittens, 5 Bibs, 2 Hats, 3 Receiving blankets

16.  Preparation and Sterilization Station: Arrange a section of work-top in the kitchen and where all the baby’s feeding equipment can be stored.

17.  Pram – Fitted with good strong safety straps that go over the baby’s shoulders as well as around the waist, and have an easy-to-operate brake; Have hood and apron; Extras – Sun canopy, rain cover, cozy-toes cover, head support cushion and shopping bag; Comfortable handle height; Swivel wheels; ‘3-in-1’ buggy with carry cot.

18.  Car Seat – Have large side wings; A one-pull harness; Easy to open/close buckle; Extras – head support pillow and replacement cover.

19.  Baby Monitor – Choose mobile version; Analogue; A visual light display and sound; With 2 channels; A rechargeable model; With low-battery indicator and an out-of-range indicator.

20.  Stock up on soap powder, cleaning materials and enough kitchen and toilet rolls to last at least 6 weeks.

21.  Prepare red rice wine

(B) 1 month before EDD

1.      Pack Hospital Bag: ID card, Marriage Cert, Admission Letter, Cardigan, Heavy sweater, 2 Dressing gowns, 2 Maternity Bras without under wires, 3-4 Night gowns with front-open type, 2 Sarong, Sanitary towels, 3 pairs of thick socks, Disposable underwears, Make-up and Toiletries, Camera and Charger, Iphone and Charger, Magazines, CDs, Electric pump, Go-home outfits, Breast pads, Snacks, Record book and pen, Baby’s swaddle/receiving blanket, Baby’s go-home outfit (bring 2 different sizes), Hubby’s jacket

2.      Learn how the sterilizer works and how to assemble the feeding bottles using clean pair of tongs.

3.      Learn how to use the electric breast pump.  

4.      Stock up Benedictine D.O.M. and confinement herbs

5.      Stock up extra dry goods and snacks for Sharon and guests visiting home

6.      Confirm the confinement lady commitment and post-natal massage reservation done 6 months back

In the Delivery Suite

1.     Relaxation: Breathing with contractions; Focusing on baby; Visualization techniques; Meditation; Massage

2.     Request for Epidural Analgesia – self-administered (PCEA) or continuous via a syringe pump or top up by the nurse.

3.     Early Labor: Slow Coastal Breathing – Sit propped up and cup your hands over your abdomen. Breathe in through your nose and hold for 3 seconds before you breathe out through your mouth, with your lips gently parted, let your shoulders sag and relax your body.

4.     Active Labour (3-8cm): Pattern-spaced Light Breathing – Sit propped up and support your body. Take a slow coastal breath as soon as you feel the contraction starting. Let out the breath and then switch to saying ‘He, he, hoo’ (Blow, blow, blow). Continue with ‘He, he, hoo’ for 3 breaths and repeat this as many times as you need through the peak of contraction until you feel it going away.

5.     Transition: Do not push the baby out prematurely. Use pant-pant-blow breathing. Avoid holding your breath for longer than 5 seconds, as it will alter the blood gases in your placenta and may compromise fetal circulation.

6.     Second Stage: Midwife will position you and get your husband to help you get ready to push the baby out. Do not hold your breath for more than 5 seconds if you feel the urge to do so. During crowning, doctor will ask you to pant awhile to check your perineum and position of the umbilical cord.

7.     Third Stage: Begin breastfeeding within first hour of birth.

Day 1

1.      Top priority in the hospital is to learn to latch your baby on properly.

2.      Request for rooming in with baby.

3.      Put your baby to your breasts frequently and on demand. This will stimulate lactation.

4.      Request for Lactation Consultant.

5.      Learn to use pump. Before pumping, massage your breasts. Every 5-7 minutes between pumping, massage again.

6.      Rest whenever baby is sleeping.

7.      Baby takes few drops to 5 cc per feeding, few drops to 1 oz (5-100ml) total intake in 24 hours (minimum 1 wet diaper, minimum 1 black tarry stool)

8.      Colostrum milk: Mother’s breasts secrete a thick and sticky substance. Because it is so viscous and there is so little of it, mothers don’t think of it as milk. However, it is so rich that just a few teaspoonfuls are enough for the newborn’s needs.

Day 2

1.      Learn to use pump as well.

2.      Try feeding your baby in more than one position. Begin by sitting up, then lying down. This changes the segments of the breast that are drained most optimally at each feeding.

3.      Massage gently your breast from under the arm and down the nipple. This will help reduce soreness and ease milk flow.

4.      Baby takes 5-15ml per feeding, 1-4 oz (50-120ml) total intake in 24 hours (minimum 2 wet diapers, minimum 2 or more black tarry stools)

Day 3

1.      Baby takes 15-30ml per feeding, 4-8 oz (200ml) total intake in 24 hours (minimum 3 wet diapers, minimum some green stool)

Day 4

1.      Day-4 takes 30-45ml per feeding, 8-12 oz (400ml) total intake in 24 hours (minimum 4 wet diapers, minimum 4 loose yellow stools)

2.      Mature Milk: It begins with bluish white and watery milk. It is aptly termed ‘foremilk’. This quenches the baby’s thirst. As he continues suckling at the same breast for the next 20 minutes, he reaches the hindmilk, which contains more fat, protein and calories, and is rich in antibodies. The hindmilk satisfies baby’s hunger and helps him to gain weight.

3.      Let the baby suckle from the first breast until he is satisfied (about 30 minutes), burp him to keep him awake and then offer him the second breast (5-15 minutes). Achieving a good let-down will ensure that baby receives more hindmilk.

4.      The breasts normally become engorged, and they will feel very hard, tender and often painful to the touch.  The pain is caused not only by the milk coming in, but also by the enlargement of the milk glands in the breasts and the increased blood supply to the breast.

5.      When the milk comes in, it is essential to feed your baby little and often. Not only will it help to stimulate a good milk supply, but it will also help to relieve the pain of engorgement.

6.      You can relieve engorgement by massaging the breasts using small circular movements; start from the perimeter of the breast towards the nipple. Then, press down and stroke towards the nipple. Clasping the edge of the areola gently between the thumb and your fingers, press your breast inwards towards your chest. Express a little milk out to relieve the tension around the areola. This will soften the breast and enable the baby to latch better on the breast.

7.      If the breast is hard and painful, and milk is not leaking, you can soothe it and reduce swelling by applying chilled cabbage leave (10 minutes in the freezer) or cold packs on the affected breast for about 30-60 minutes. Avoid applying cabbage on the nipple and areola. When the breast softens, massage and feed baby. Change the cabbage leaves every 2 hours or when they become limp. The enzymes in cabbage suppress milk production, so do not apply too often.

8.      Taking a warm shower usually increases vascularity, thus enhancing milk flow.

9.      Having a breast massage and manual expression of milk before feeding, softens the areola and helps your baby latch on more smoothly, resulting in successful emptying of the breasts and preventing the onset of engorgement.

10.  At the beginning of the feed, your baby gets the fore milk, which is high in volume and low in fat. As the feed progresses, your baby’s sucking will slow down and he will pause for longer between sucks. This is a sign that he is reaching the hind milk.

11.  Although he only gets a small amount of hind milk, it is very important that he is left on the breast long enough to reach it. It is this hind milk that will help your baby go longer between feeds.

12.  If you transfer him to the second breast before he has totally emptied the first breast, he will be more likely to get two lots of fore milk. This will have a knock-on effect and leave him feeling hungry again in a couple of hours.

13.  Another feed of fore milk will quickly lead to your baby become ‘colicky’.

Day 5

1.      Day-5 takes 45-60ml per feeding, 12-18 oz (600+ ml) total intake in 24 hours (minimum 6 wet diapers, minimum 3 or more yellow stools)

Day 6

1.      Day-6 to 6-month baby takes 25 oz (average 750ml) total intake in 24 hours (minimum 6 or more wet diapers, minimum 3 or more loose yellow stools)

2.      A

Day 7

1.      Make sure baby is given around 25 minutes on the first breast, and offered the second breast for 5-15 minutes, he will be getting the right balance of fore milk and hind milk. It also ensures that baby is content to go between 3-4 hours before demanding his next feed.

2.      If baby is feeding from both breasts at each feed, always remember to start the next feed on the breast you last feed from, so that you can be certain each breast is totally emptied every second feed.

3.      By gently squeezing your nipple between your thumb and forefinger, you will be able to check if there is any milk still in the breast.