Knit Your Own Infant Cap. Make a Few More and Donate Them to a NICU!

Newborns often have difficulty regulating their body temperature right after birth. Most hospitals recommend skin-to-skin, or kangaroo, care, in which the naked baby (with diaper) is place on her mother’s bare chest, between the

breasts, with the baby’s head turned to the side. They are then both covered with a light receiving blanket or cover. Mothers should not fall asleep while doing skin-to-skin, so I always suggest having someone else in the room who is planning to stay awake and alert.

But things can be a little more difficult for babies in the NICU. While in many cases, the infants are still encouraged to be held skin-to skin, there are some instances when that contact is limited or delayed because of medical care.

The staff will make sure  your baby is kept warm and monitored and  will put a

cap on your infant. We’ve all seen those cute little blue and pink  striped stocking caps the hospital gives you.

But if your baby has  a protracted stay in the NICU, or  you just want an individualized look, or maybe your baby is born in winter so you need a cap for outings, you might want to knit your own (or ask someone to do it for you!). And you (or your friend) might have so much fun doing it, you want to knit a few more to donate to your nearby NICU. A cap  you donate is given to a baby who takes it home at discharge time.

My neighbor, Maire, knit  these caps using multicolored yarn. She is donating them to our local hospital.

Of course, because it is a NICU, it’s important to follow specific guidelines. Maire used the pattern and instructions (“the infant cap”) at Ravelry.com. You do have to join but it’s free.  There is a $4 download fee for the pattern.

I am not a knitter but am assured it is not a difficult pattern at all.

Maire suggests, if you are planning to donate them, calling the NICU you are planning to donate  to and get any specific guidelines they have, especially about yarn type and washing before you start.

 

 

When Should Your Infant Be Bathed for the First Time?

If you’re a new or expecting parent, you may have heard the term “wait to bathe” for the first bath of your infant after birth. What does that mean, exactly?

When babies are born, they are covered with a white substance called vernix.

This substance, made up of cells from your baby, have antibacterial proteins to protect your baby from bacterial infections during the birth process and post-birth. It also protects the baby’s skin and moisturizes it. It is very beneficial for the vernix to remain on the baby for a period of time post-birth.

Hospitals that have instituted a “wait to bathe” protocol typically have staff wait between 6-24 hours, depending on the hospital’s protocol, before bathing your infant.

Here is a good run-down of the benefits of waiting to bathe from Children’s MD, a website from Children’s Hospital of St. Louis, Missouri.

In a nutshell, waiting to bathe helps prevent infections, and helps babies regulate their body temperature, their blood sugar and bond with their mother.

If you are interested in waiting to have your infant bathed and the hospital you are delivering at does not have a “wait to bathe” protocol in place, you can always ask to have your baby’s first bath delayed.

Returning to Work

For many new parents, the return to work after the birth of your baby can elicit anxiety and stress. There are so many decisions to make, childcare situations to consider, and schedules to keep, and through it all you  want to be able to enjoy both work and family life.

As a lactation consultant in a hospital setting, I usually dispensed a few pieces of advice to every family. The one I usually stressed was the introduction of the bottle. When breastfeeding is going well, often parents want to delay introduction of the bottle as long as possible. While I love that idea, the fact remains that babies who breastfeed well, love breastfeeding, sometimes to the exclusion of anything else. That makes the return to work even tougher than it has to be.

I remember, with my first baby, who only took enough from the bottle so as not to starve, I would have my mother bring my disconsolate baby to the train station, where I would nurse her in the car to finally calm her down. Needless to say, this was stressful for me, my baby AND my mother!

I usually advise, if you know your baby will need to  take a bottle,, don’t wait longer than 2-3 weeks to introduce a  bottle. (I used to say 4-6 weeks, but sometimes even that can be long enough for a baby to resist the bottle, so I’ve shortened the time frame.) Usually one bottle a day is enough to keep the baby in the habit of taking a bottle, while still mainly breastfeeding, until it’s time go back to work. This is also a nice opportunity for dads to help with feedings!

Which brings me to my second point… if you’re planning to pump while at work, a fast, quiet, efficient and effective double electric pump is crucial. In my earlier post on  the Affordable Care Act (ACA), I detailed the current benefits accorded to post-partum mothers, which include a pump.

Medela Symphony hospital-grade pump with attachments

Some mothers get advice from other mothers that they should rent a hospital-grade pump, either Medela or Ameda, because that is the strongest, best pump on the market. And they are the best! However, that does not mean you need the best. For many people, a Honda Accord is perfectly serviceable for their needs; they don’t need a BMW.

The downside is hospital-grade pumps are expensive, usually about $50-75 a month to rent and prohibitively expensive to own for a single user, and often not covered by insurance unless your insurance company deems it medically necessary. They are also very heavy, held in a hard plastic case, and not really designed for transporting back and forth every day.

I usually recommend, unless you have a low milk supply or a history of low milk supply, your baby is not gaining well or you are supplementing with formula, or your baby was premature or spent some time in the NICU, start with your ACA pump and see how that works for you. If not, you can always buy a better pump or rent a hospital grade pump here or here.

A side note, if you find the milk expressed by your pump is not as much as expected and/or it is painful to pump, you should check in with a lactation

An Ameda standard flange

consultant to see if the flanges fit correctly. You can find a nearby lactation consultant here.

In terms of retail pumps to purchase, generally speaking Medela, Ameda and Spectra are very well-received. These are also called single-user pumps because they are designed for one mother only. Read reviews before purchasing, but remember, for frequent pumping, you definitely want to have a double electric pump.

One thing to mention, hospital-grade, or rental, pumps have a barrier against cross-contamination and designed to be used by more than one person. It should be wiped down thoroughly after each use, and each user needs her own set of tubing, bottles, flanges and connecting parts. These cannot be shared.

Some breastfeeding-friendly businesses purchase one or two hospital grade pumps for a lactation room for all pumping mothers in the company to use. They just need to have their own pumping attachments to use with it. Maybe you can persuade your company to invest in a hospital-grade pump!

Here are a few other resources that you might find helpful:

  • Lawyer and mother Lori Mihalich-Levin has a website called Mindful Return, where you can find a blog and e-courses about returning to work after childbirth.
  • Idealistmom.com has a good checklist to follow, especially useful for mothers who are choosing to continue breastfeeding after returning to work.
  • Parents magazine
  • What to Expect   

Keeping Track of Healthcare Benefits

 

James McNeill Whistler (American, 1834 – 1903 ), The Doctor, 1895, lithograph, Rosenwald Collection

As we all know, the current state of health care is probably in flux, but I think it is important to outline benefits that parents of newborns and breastfeeding mothers are entitled to under the current law, the Affordable Care Act, passed under the Obama administration. It is often called Obamacare.

First, here are basic rights your family has under the Health Insurance Portability and Accountability Act (HIPAA) as detailed on the Department of Labor website:

If your plan provides maternity benefits, you should be entitled to a minimum hospital stay of 48 hours following a vaginal delivery and 96 hours following a cesarean delivery.

You cannot be required to get a preauthorization from your plan in order for the minimum hospital stay to be covered.

Your plan must provide you with a notice regarding your rights relating to a hospital stay following childbirth.

Contact your health plan or your spouse’s health plan as soon as possible to find out how to enroll your new baby in group health plan coverage.

As long as you enroll your newborn within 30 days of birth, coverage should be effective as of your baby’s birth date, and your baby cannot be subject to a preexisting condition exclusion. This 30-day deadline also applies to the enrollment of adopted children.

In terms of breastfeeding, one of the most important changes with the ACA is the provision that every new mother is entitled to a breast pump from her insurance company. What kind of pump differs from company to company, but my experience in working at a hospital is most insurance companies were offering good quality double electric pumps.

ObamacareFacts is a good website if you have questions about the ACA.

And here is a good rundown of the preventive care benefits for pregnant and post-partum mothers,  as well as infants.

It’s important to note that lactation services are included in this list. You may never need the services of a lactation consultant after you leave the hospital, but if you’d like some help it’s good to know you can get coverage. Check with your insurance company to find out the details of what it will cover.

It’s very possible that some of these provisions will change under the Trump  administration so I will keep this updated.

For those of you who want a more in-depth view of healthcare news, the Washington Post has a daily update called The Health 202.

What Can I Take When I’m Pregnant or Breastfeeding?

Cornelis Bega (Dutch, 1631/1632 – 1664 ), The Mother, , etching, Gift of Arthur and Charlotte Vershbow

 

Most pregnant or breastfeeding mothers have had the occasion to want to take an OTC medication, be it for a bad cold, allergies or a myriad of other reasons. But, while you might have happily taken the medication earlier, being pregnant or breastfeeding probably gives you pause for thought, and rightly so. How much could this affect the baby, you wonder?

First and foremost, you should clear use of any medication with your OB or midwife and your pediatrician before taking it. This includes OTC drugs, vitamins, supplements, herbal medications and prescription medications. Many drugs are fine to take during pregnancy or breastfeeding, but you always want  to make sure your medical team knows  what you are taking.

Generally, you want to avoid anything with pseudoephedrine if you are breastfeeding because it can diminish your milk supply.

Additionally, for breastfeeding mothers, there is a resource prized by lactation consultants, Medications and Mothers Milk, by Thomas W. Hale, Ph.D, a clinical pharmacologist. It is an exhaustive compendium of medications and the effect on breastfeeding infants. Your medical team may very likely consult this source when you make a query about medications.

And remember, the general rule of thumb is be conservative. If you don’t need the medication, don’t  take it.

 

Crochet an Octopus for a Preemie

Photo: My Nomad Home

If you’re a crocheter, or maybe someone looking for a new hobby, here’s a heartwarming idea — crochet an octopus for a preemie.

This idea was first started in Denmark, where staff in the NICUs observed that hospitalized premies had improved breathing, heart rate and blood oxygen levels when clutching the tentacles of the crocheted octopus. The idea is the curly tentacle reminds the infants of their mother’s umbilical cord.

Thus, the Octo Project was started.

If you want to try, for your own child or to donate to a hospital, you can get some ideas  and download a pattern from blogger Gosia’s website My Nomad Home. Get ready to see some really cute octopii!

The specifications, including the length of the tentacles, are important to ensure that the octopus is not a hazard for the infant.

If you would like to donate the octopus, check out this list to find out which countries have a group to collect them.