Dear Dr. Wong: We will be welcoming our first-born son; my due date is in a couple of months. We are in our 30s, and nervous about having children. Do you have any advice for us?
Answer: Congratulations. It is exciting and nerve-racking to be first-time parents; unfortunately, babies don’t come with an operational manual. It will take time before you feel confident in what you are doing. I have been a paediatrician for four decades before retiring recently. You are the first parents to ask for advice before your child’s birth. I have given some thoughts before writing this column.
The most important thing for you to do now is to eat a healthy and balanced diet, and stay physically active. Vitamins, especially folic acid, is important for normal development of the fetal brain and spinal cord. Keep up the prenatal visits to monitor his progress.
We have an excellent health-care system. Most deliveries are in hospitals, with teams of nurses, family physicians, specialists, and sometimes midwives. Delivery is still a high risk process; much can go wrong suddenly. That is why most hospitals have one staff staying with mothers in labour.
If everything goes well, he should be delivered naturally, through your birth canal. He will swallow vaginal fluid, which contains healthy germs that will grow in his intestines. Of course, if there is problems, appropriate interventions including Caesarian section can be performed quickly.
All newborns are offered blood tests to screen for uncommon, but serious, congenital conditions. Most of them are not apparent at birth; early detection and treatment are crucial.
If you are considering breastfeeding, I would encourage you to try. Although it is natural, you will need to learn proper latching technique. Many obstetric nurses and lactation consultants can assist you; many communities have La Leche League, which helps breastfeeding moms.
Breast milk is uniquely suitable for your baby, providing him with nutrition as well as antibodies and immune cells that protect him. He will also ingest normal bacteria from your breasts, further enhancing the microbiome (whole variety of healthy germs) in his guts.
Breastfeeding is your job. Dad can help to burp and change diapers. It doesn’t mean that you will be stuck with him at home. Many public places have nursing rooms; after some experience, you can nurse with a blanket covering him for privacy. You can also pump and store breast milk when you leave him with his dad.
All babies spit up, some more than others. Don’t be scared, he won’t choke on his spit. You can pick him up and burp some more. It is important not to put him on his tummy to sleep: this is unsafe. Always put him on his back. He can have tummy time when he is awake and alert. Let him sleep in a bassinet or crib close to you; it is easy for you to reach over and check him. I don’t recommend taking a young baby to sleep in bed, the blankets can suffocate him.
The first few weeks will be exhausting; when he sleeps, you sleep. Take time to bond with him. He can see your face right after birth, and can hear your voice. He has been listening to your heartbeat throughout pregnancy. He will calm down when he lays on your chest, or on his dad’s. Hold him with gentleness and love. Rock him to sleep, you won’t spoil him this way.
Some babies just sleep and eat, others are more demanding. Children are born with different temperament. If you cannot console him, see your doctor to make sure nothing is wrong. Don’t get frustrated, make sure he doesn’t have a dirty diaper. Never handle him with force; never squeeze or shake him. These can cause serious and permanent damage. If you are frustrated, leave him in the crib and walk away to cool off.
If you are considering circumcision, you should know that there is no medical indication for this operation in newborns. He should have regular checkup by his family doctor or trained nurse practitioner to monitor his growth and development, as well as immunization to prevent serious infections.
Finally, look for programs that teach parents about basic CPR (cardio-pulmonary resuscitation) for children, just in case if something serious happens. Enjoy this new chapter of your life.
Dr David Wong is a retired paediatrician in Summerside and recipient of 2012 Distinguished Community Paediatrician Award of Canadian Paediatric Society. His columns will appear in the Guardian on the last Tuesday of every month. You can see a collection of his previous columns at askdrwong.ca. If you have a question for Dr Wong, please mail it to Prince County Hospital, 65 Roy Boates Ave, Summerside, PE C1N2A9.
