Friday, October 29, 2010

The Baby Timeline, 0-6 Months

A couple of years ago, by request, I hammered out a new baby timeline for a friend.  I have recycled it many times since.  Today I planned to update it for a pregnant blogging buddy.  She didn’t ask, but it sounds like she and I are similar, mommy wise, so I thought I’d save her some trial and error.  Since I’m updating, though, I might as well post it.  So after the jump, find my New Baby Timeline.  The pronouns are female because the girlfriend I originally wrote this for had a girl, and I don’t see the point in replacing them all.  Also, I give nursing info, lots in 0-2 weeks, because that’s what I know.  If you plan on bottle feeding just ignore the nursing bits.  You will want to talk to a friend who did bottles.  Nursing and bottles don’t follow the same program, practically speaking.

This timeline aims for having a well and happy baby—well fed, good sleeper—and a happy marriage by the time the terrible twos hit.  (The first signs of that show around 12 months and are usually roaring by 18 months.)  Sometimes the action I suggest will seem a little premature; it certainly isn’t the popular route these days.  For instance, why fret over sleep times at 3 months when you can still cart Peanut out to dinner in her car seat?  But while a 3 month old is easy to distract or entertain in public, when they aren’t sleeping, that is, a 9 month old isn’t, and an 18 month old—wow.  The bedtime routine that I suggest at 3 months has little to do with getting Peanut to sleep then but rather training her sleep pattern so you can get her to bed at a year.  She’s just easier to train at 3 months. 

A few recurring ideas:

  • Kids won’t want to do things they’ve never been exposed to.  These days moms tend to not introduce an idea, solid food, potty training, sleeping, etc. until the baby shows she wants to do it.  Then they get confused and frustrated when the baby doesn’t master it quickly.  Don’t be pushy and make Peanut do any of these things, but don’t hold off introducing them either.  
  • Calm and firm often saves the day.  Have a plan.  Keep your head. This will calm many a storm.
  • Sleep begets sleep, or tired babies don’t sleep well.  Over stimulation and over tired are your enemies.  Make sure Peanut gets all the sleep she wants.  Lack of naps means early rising and interrupted nights.  Be on the lookout for too much stimulus—loud, crowded, bright places, or prolonged game playing, or toys with noise and flashing lights, holiday events. Peanut will seem to enjoy them, and you can’t/shouldn’t avoid all of them but woe unto you when she gets tired. 
  • You’re going to be tired for a long time to come, but here’s the 411 on true sleep deprivation.  For about 2-3 weeks you’re just tired but not completely crazy.  You’ve got the endurance to be sleep deprived for 3ish weeks.  Your hormones are running the show, anyway.  Just play through.  Around 3 weeks if you aren’t getting at least one 3 hour stretch, then you start to get really moody and angry.  True sanity requires about two 3 hour stretches.   When you get at least one 4 hour stretch, you are still moody but things start looking up.  When you get your first 6 hour stretch, you’ll think you won the lottery.  (Yes, 6 hours.  It’s called sleep deprivation for a reason.)  You’ll try to clean the whole house or go for a 3 mile sprint.  You’ll still be tired and sometimes moody, but your husband won’t need to consider having you committed to an insane asylum. 

The first 2 weeks:
Let Peanut run the show.  The only thing you should care about is having her meet her birth weight at her two week checkup.  When she is born, try to nurse her as soon as circumstances allow, but by no means worry if you can’t nurse right away.  Most docs won’t bat an eye if the baby just doesn’t eat for the first 24 hours.  Look up “brown fat” if you’re worried.    
If you have problems, ask for one of the nurses or lactation consultants.  (If you are a UK mum reading this, ask an experienced mom in the ward with you.  We’re usually happy to help.)   Nursing is a practical skill.  It requires a little hands-on (not a pun) training from someone with experience.  I’m not a fan of lactation classes while you are pregnant.  You don’t need nursing theory--a friend’s husband called the class “Boobies for Dummies”--you need nursing practice.  Also, I know it sounds sweet and romantic, but if you do choose to take a nursing class, don’t drag your husband along.  I am not PC so I have no qualms stating that some things are women’s work.  Birthing and nursing unequivocally fall into that category.  If you are inclined to want to share everything with your husband, have him be a part of every step, I suggest that might not work out the way you planned.  When you are tired and hungry--you only thought you were hungry during pregnancy--with sore nipples and your chipper-just-wanting-to-be-involved husband critiques your latch, after you throw him a look that could freeze fire, you might regret this doing everything together bit.  There is plenty for him to do.  Nursing class isn’t one of them.
Nursing often fails because Mom doesn’t know enough, or thinks she knows better, about a baby’s feeding pattern.  They hear that a baby eats every 3 hours on average.  They think that means you can feed the baby and then, if you had enough milk, she won’t be hungry for 3 hours.  Nope.  Or maybe you’ve heard about keeping blood sugar levels even, so they need evenly spaced feeding.  Nope, unless you have a preemie or your doc otherwise instructs you.   “On average” is true as math goes but not in practice.   First, the first day or so, they don’t each much, or for long.  This is fine and perfectly normal.  Once your milk comes in a few days later (you’ll know) then newborns cluster feed a lot.  So they’ll wake, eat for 10 minutes, sleep for 30, eat for another 5, sleep for 20, eat for 15, sleep for an hour, eat for 10, and then sleep for 3 hours.  Some newborns just keep eating.  Christopher Robin could do 30+ minutes a side, so his clusters seemed like a 3 or 4 hour marathon feeding session.  Don’t worry about a pattern, there won’t be one yet.  Don’t worry about how long she eats, or when.  If she seems sated, if you have milk, and if she’s pink and peeing then let her eat and sleep whenever and wherever she wants.  She probably won’t, but don’t let her go for more than 4 hours yet.  You sleep whenever you can.  
If you’re waking every time she stirs--or breathes since babies have stuffy noses for about 6 weeks and therefore sleep shockingly loudly--then move her bassinet into another room so you’ll only wake when she actually cries out.  BTW, don’t be shocked if your head starts dropping like your in hour 2 of a boring lecture as soon as she latches on.  The let down hormones make you instantly sleepy.   If your boobies have problems call a consultant or an experienced friend.  Get some lanolin cream.  Use it after she nurses.  Look up “breast shields.”  If it hurts when she latches on, count to 10.  If it still hurts, take her off and try again.  If you use a pump at all, know that the first few times you use it you will likely only get a few drops; half an ounce is par for a first pumping session.  It doesn’t mean you don’t have milk.  It means that babies are more efficient than pumps.  It doesn’t mean that you can’t sustain nursing by pumping, either.  If you pump often, your boobies will adapt.  If you manage to nurse, you will be seriously impressed with your boobies adaptability.  
Do not be tempted to have someone do a night feed so you can sleep.  If you are bottling feeding, this is an option.  If you want to nurse, it isn’t.  Boobies work on supply meeting demand.  This is critical the first few weeks.   You can’t miss a feed.  You can have somebody give the baby a bottle, but you have to pump around the same time to equal the demand.  As babies tend to have a cluster around 2 am, that’s a big demand curve to try to pump over and, regardless, you still have to get up.  Worse, if you try to skip night feeds a few weeks later, when your milk supply is rolling, then you might need to look up “mastitis.”   (Most of my friends who got mastitis tried going for longer no-nursing stretches too early.)  
If you have family or a maternity nurse helping you at night, have them bring the baby to you when she cries.  Once you feed her, your helper takes the baby back to do all the nappy changes, swaddling, rocking, etc. while you go back to sleep.  I have seen many an otherwise successful nursing mom give up because they can’t get in front of the baby’s demands by 6 weeks or so because some helpful person feeds the baby at night.   The trade nursing and bottle feeding make are sleep and efficiency.  Once started, nursing is convenient and cheap, but it means less sleep in the beginning.    

As you might have surmised from the forgoing, the first few weeks are all about sleeping and eating, and you and the baby are still kinda one unit.  So your husband might feel left out and detached.  Here are great jobs for him.  
  1. Diplomacy.  Decide before the baby comes how much social contact you want, visits from friends and the like.  He controls all of this from fielding phone calls, to answering doors to politely pushing people out the door to airport pickups for family.  This is more complicated than it sounds.  You might think you want everyone around only to change your mind by day 5.  It is his job to gauge your mood and adjust all of that accordingly.    When his sister and your mom get into a little snit about the diaper cream you use, he runs defense.  Like I said, easier than it sounds.
  2. Life Administration.  Grocery shopping, bills, dog walks, calling the plumber, replacing loo rolls,…  All of those are little things that you just can’t deal with well the first few weeks.  Then there are Target runs for extra baby things: the Gerber blankets are a better size for swaddling your Peanut than the Circo ones, Peanut likes the silicon dummies, you prefer the zipper PJ’s to the snap ones, you didn’t know to pull the nappy extra tight on a little boy so everything soaks through every time he pees so you need a dozen more onesies…. Hubby to the rescue.  He won’t do it the way you do, by the way.  But don’t complain about tarnished silver.  
  3. Feed and Care of Mom.  This is a big job.  The appetite of a lactating woman resembles that of a 14 year old boy in a growth spurt.  He’s got to keep the food coming and the fridge well stocked.  
2 to 8 weeks:
Peanut still runs the show, mostly.  If she met her birth weight at 2 weeks then you’re off and running.  Around this time you may notice the semblance of a feeding pattern.   Perhaps she feeds every 2-3 hours with two distinct clusters of about 3 hours each with her longest sleeps coming after the cluster.   This is good but sets up the next nursing confidence pitfall.  You think your getting into the groove and then at 3 weeks, almost to the day, Peanut will hit a growth spurt and her first milk demand.  She’ll want to eat all the time.  Just go with it, and it will last about a day.  Fight it and she’ll get cranky and demand more feedings,  You’ll worry that you aren’t making enough milk.  Both of you will cry.   Look up “milk demand” if you are curious, but Peanut is getting all her milk during a demand.  Your boobies just respond by making more milk in the first instance rather than having her feed longer.  
Once you get through the 3 week demand then the pattern you noticed will return.  Just keep going with it, with one exception.  Often one of the clusters is around 2 am, and Peanut might be very alert at this time.  This is called Day/Night reversal.  It will make you cry.  Here’s what you do: if she seems remotely hungry during the day, feed her.  Whenever she is awake (they still sleep most of the time until around 6 weeks) during the day, coo at her, play with her toes.  Coo and sing to her while she eats.  Read books. (It’s never too early to start.)  Take her for walks in the sunshine.  Open your curtains.  Keep house noise level normal.  
Do the opposite at night.  When she cries, don’t run to her immediately.  (Unless it is THAT cry.  But I don’t really need to tell you that.  You’ll know.  There are some cries a baby makes, and you won’t remember how you got to her bed.  You’ll teleport.)  Go to the bathroom.  Or brush your teeth.  Or just count to 60 and see if she falls back to sleep.  Sometimes she will.  When you do feed her, keep the lights low.  Feed her, change her nappy, and put her back to bed.  If she needs you to rock her a bit, or if she wants to sleep in the swing or car seat, fine.  Do whatever she wants to get her to sleep, but don’t play.  If you do this then the problem will go away by around 6 weeks.  She’ll still eat in the wee small hours of the morning, but she’ll go right back to sleep. 
This process also helps her learn to comfort herself a little.  That skill will grow, but not if you don’t give it a chance.  If you’re lucky you should get your first 6 hour stretch around 7 weeks.  You’ll get one, then go back to 4-5 hours for a few days, then you’ll get another, and after about a 2 weeks she’ll sleep for 6 hour stretches consistently.   If you have found this post after your baby is 6 weeks, and your wee one is too alert at night, this method will work, but it gets harder as the baby gets older.   If the baby is over 6 months, then getting her to sleep will require some letting the baby cry it out.
Do not worry about nipple confusion.  I know of no baby that had nipple confusion.  To the contrary, the babies knew exactly what nipple was what.  If she takes an occasional bottle or sucks a pacifier, whoop di do.  In fact, if you don’t introduce a bottle a few times early on, like 3 weeks, then she’ll refuse a bottle later.  I can’t tell you how many friends fought bottle refusal, confused because they introduced a bottle “early” around 6 weeks.  Actually, I don't have to tell you about my friends.  The Times of London had a story about bottle refusal.  You don’t have to do the bottle regularly, or even a lot.  Just a few times to let Peanut know that food comes in other packages.  And at room temp.  Seriously, don’t train Peanut to be picky.  
Bottle introduction is a perfect job for Daddy.  Peanut will likely protest if you try it, and Daddy needs to get some baby time.   After the first milk demand, start involving your husband more with the baby.  For instance, have him watch the baby while you take a walk.  Leave the house.  Get out of his way.  Only go for 20 minutes or so (you won’t be loaded with energy, but you will be loaded with milk—you ain’t goin’ very far for a while).  Soon call up a friend for a quick lunch and leave him for an hour.  Later, go for a night out.  You get the idea.  
Hold your tongue about tarnished silver.  If, for example, he gives the baby a bath, do not offer any comment or instruction unless he is in danger of flooding the house or drowning the baby.  He will put the diaper on wrong, and it will leak.  Shut up.  You learned that lesson only 10 days earlier.  He will likely be rougher and louder with her.  This will annoy you.  Shush.  Learn to trust him to watch the child he would gladly die for. Do this, and the payoff will be HUGE.  Be aware, though, of the difference between ‘Let him get a taste of how hard this is!’ and ‘Let him get his own rhythms with Peanut.‘  You are facilitating his bonding with his child, not launching a score keeping war. It is a little bit of mental pruning that you must do for the health of your marriage.
Sometime around 3-4 weeks, on top of, or because of, your hormonal cocktail, many women start to despair that they’ll go nuts being at the mercy of a baby.   You’re going to be very tired and strung out--and you’ll smell like cheese.  Hang tough.  Peanut will start to even out.  You will sleep again.  If you start to fight and try to control her too much, then you’ll either set yourself up for an epic battle of wills or you’ll burn out from frustration and throw in the towel on discipline within a few months when it starts to count.  This is how early the indulgence of modern motherhood can start.  Calm and firm saves the day.  Put your feet up and hang with the baby.  Once this period is over you’ll actually miss it. 

2 to 4 months:
Mommy starts to take charge.  If you’ve followed the previous, then you should start to see a good pattern of eating and sleeping.  There may be another milk demand or two, but otherwise you’ll be able to say when eating happens.   The main clusters should have collapsed into one large feeding each.  Peanut will likely sleep for one 6+ (and growing) hour stretch at night, take three naps, and eat about 8 times a day.  If she’s not doing this, then start to push this because f you don’t start enforcing meal times, then you’ll be nursing all the time.  You’ll be at the mercy of her lack of sleep in a few months. 
If she eats multiple times after waking in the morning and before her nap, then just declare that nap time is 8:30 and feed her at wakeup and 8.  Then put her down.  If you’re calm and firm and give her plenty of time to eat at wakeup and 8, then setting this should only take a few days.  A similar stragety will work at night.  Fill the baby with plenty of milk for dinner and before your chosen bedtime.  If she doesn't start sleeping for long stretches, then wake her again at 10:30ish for more milk.  That should start to push the 2 am feeding later in the morning, and eventually the 10:30 feed will disappear, usually after solids are introduced.  You have to feel your way through this stage.  Once she sleeps from the 10:30 feed to 6 am or some such, then be aware of how much she is actually taking at 10:30.  If she sleeps through that feed, let her.  See if she still sleeps until 6ish.   By 6-7 months most babies can sleep for an 11+ hour stretch.  If she's not doing that, then you likely have a trained night feeder.  If you let that continue, you may well find yourself doing midnight feeds and other battles well past her second birthday.  
Now is the time to start putting Peanut in bed for sleeping.  Start trying for consistent naptimes.  Don’t run errands, or use the car or walks to put her to sleep.  Rock her if you want as part of settling down, but don’t rock her to sleep.  If you follow nothing else, follow this: pick a bed time and bedtime routine and do it every night.  A decent bedtime is essential for mommy and marital happiness.  If you want bedtime at 7:30, do it at 7:30.  Don’t fret if Peanut wakes again at 9.  Keep with the bedtime routine.  Once bedtime sets then the other sleeps and events start to fall into place.  

4 to 6 months:
Mommy in charge.  Around 4 months Peanut will get better eyesight and will have her first separation anxiety.  This will make naptime and bedtime a bit more difficult.  Stand fast.  Set the eating schedule.  Set the sleeping schedule.  Stick to them, especially the bedtime.  Don’t go nuts that she has to eat at noon on the dot, but don’t deviate more than a half hour or so.  This will seem silly at the time, but you’re setting her pattern for later when she’s more difficult.  You will fall back on this schedule, and especially the bedtime ritual, often--after holiday craziness, after sickness, whenever Daddy is out of town, at Spring Forward and Fall Back, etc.  She’ll still have two naps, probably until a year or so.   
At some point around now, if you’re still nursing, she’ll start a milk demand that keeps going.  Start solids.  Follow the 411 book, but don’t worry about one new food a day nonsense unless you have existing allergy worries.  Just feed her.  
If you’re going back to work, you can wean her to only wake up and bedtime feedings.  Your bobbies will be efficient machines by now.  You can train them to do whatever you want.  Just don’t wean her cold turkey, unless you like pain.  Decide what you want to do and give yourself at least a month to wean her. 
At this stage there is a danger of not setting enough limits.  This is where mothers who never sleep, husbands and wives who never go to the movies, babies who cry and whine incessantly—all that stuff that you don’t want really starts.  Perhaps you’re burning out from early control issues or perhaps you just don’t think she’s old enough to cry for a bit or go for more than an hour without nursing.  Don’t indulge her every demand for rocking or feeding.  Take away dummies.  Give her a chance to settle herself.  You want to have a good sleeping and eating schedule by 6 months—or else.  This is the last time this kind of training will be easy, and it’s not that easy to begin with.

1 comment:

Kacie said...

This post is brilliant! I love it, and I'll bookmark it and refer back to it. You're right, it's very useful!