Lil General cried incessantly for two days this week. Wondering what made him restless I tried quite a few things such as feeding him repeatedly, making sure he wasn't too cold or too hot and comforting him all the time. But nothing worked. That's when I decided to review my diet to see what had changed. I had tea to soothe my infected throat those 2 days. So I decided to stop it and see if he was doing fine. That did wonders ..the rest of my diet remained the same. Apparently caffeine causes restlessness in babies. To my surprise a cup of coffee that I have every morning suits him just fine. If you want to continue with your limited intake of caffeine you might want to have atleast 8 glasses of water so that it doesn't bother the baby much. This is ofcourse only if you are breastfeeding your baby. There are no diet restrictions if your baby is exclusively on supplements.

Thursday, January 25, 2007

Pain relief in labour : Epidural Anasthesia

Here's a great article in this week's Hindu on Pain relief in Labour. Unlike Supriya, I never worried about the pain during labour as every day during those 9 months in the pre natal period itself was a struggle. I never fathomed how painful the delivery process was going to be and always imagined it would be a breeze and the kid would be out in no time. My husband Vivek mentioned about Epidural Anasthesia to me earlier and how it made labor less painful. I wish I had done some more research to find out which hospitals did that or spoke to my gynaec about that much before. Believe me, delivery through normal process is very painful and the pain just goes exponentially as the hours tick by. The pain is something that I cannot equate to anything else, something that you would have never experienced before. One thing that helped a bit during the labour pain was deep breathing.

Continue reading ...

Here is the full article:

Supriya has been talking to her friends. She is apprehensive about going through labour. As her due date approaches, her anxiety and fear increase exponentially. Some of her friends and relatives have used some ill-chosen words to describe the travails of labour. She is really frightened about going through labour. Will she be able to tolerate it? Her husband has promised to be with her through the labour but she still needs reassurance that there will be pain relief offered to her during labour and delivery. Supriya need not worry. Modern obstetrics offers her many choices.

In every language in the world, the words for childbirth and labour are synonymous with pain. The joy of giving birth is always coloured with the fear of pain during labour. Some women dread childbirth to the extent of demanding a caesarean section instead of going through natural childbirth.

There are many ways to lessen pain during labour and the birth of a baby. Being prepared with knowledge of the birth process is the first step towards being able to handle labour pains. Labour preparation classes for the couple are important. There are also safe pain-relieving drugs that can be given as an injection. Newer methods include epidural analgesia, which cuts off the pain of labour without interfering with the action of labour contractions.

The type of pain relief that is right for you depends on your pain threshold. Some women can tolerate pain to a greater extent than others. Some women have a low threshold for pain and this, combined with the fear of labour pains, can make them intolerant of the slightest pain. A woman's physical fitness, having taken labour preparation classes, the length of labour, the intensity of labour pains, and the size of the baby play a role in the ability to handle the pain of labour.

What types of drugs are used for pain relief?

Pain relief offered during labour is safe for both the mother and the baby.

Narcotics (such as Pethidine) may be used during the first stage of labour to help you relax. Narcotics are usually injected into a muscle (IM) or into a vein (IV). They affect the entire body. Narcotics lessen the pain and can help you feel less tense or anxious.

Regional anaesthesia lessens or completely blocks the pain in a specific part of the body. The epidural block is a commonly used type of regional anaesthesia during labour. Spinal anaesthesia is also a regional block but is used only for a caesarean and not for pain relief during labour.

With either narcotic pain relief or epidural anaesthesia, there is no loss of consciousness, so the mother can actively participate in the process of delivery.

What is an epidural block?

For an epidural block, pain-relieving medicine is injected into the lower part of the back. Usually a small tube (catheter) is inserted into this area of the back. The medicine can be repeated through the catheter when the effect of the medicine wears off.

In low doses, an epidural block eases the pain of contractions and numbs the birth canal during labour and delivery. The pressure of the contractions is still felt with an epidural block but the pain component will be minimised. In higher doses, an epidural may be used for caesarean sections.

Are there any risks?

Because a narcotic like pethidine affects the entire body, both the mother and the baby may have mild side effects from this drug. Drowsiness and feeling dizzy are the commonest side effects. They are usually not used when the baby is just about to be delivered so that the baby does not have any difficulty.

The medicines used in epidural analgesia are less likely to pass to the baby and affect the baby because the medicine does not enter the bloodstream. An epidural may cause the blood pressure to drop. This may slow the baby's heartbeat. To help stop this from happening, fluids are given through a drip before the block is given.

How can pain during labour be relieved without drugs?

Each woman has a different threshold for pain. How a person deals with the pain depends on her attitude to labour. Attending labour preparation classes help relieve the anxiety about labour. Breathing exercises are an important part of pain relief during labour.

Your husband's presence in the labour room is also important. Your husband can encourage you as you go through labour and it is a strong bonding experience.

You and your husband can take classes to learn about childbirth, body conditioning exercises, and methods of relaxation. All of these techniques can be used with other treatments for labour pain.


Saturday, January 20, 2007

Cracked or sore nipples?

To say that the first few weeks as a new mom has been challenging is an understatement. It brings with it a lot of unknowns, situations you have never been subjected to before and more and more questions for which you have no answers. Ignorance is definitely not bliss when it comes to your kid. Every time our son cried, we thought he was angry. That was the most easiest thing to presume and I would feed him.

In situations such as this, it is quite possible that breastfeeding may possibly make your nipples feel a little sore at the beginning of a feed during the first few days. This can also happen if your baby is not latched on properly or if you are feeding him after a long interval. Due to hunger, kids become restless and hurry for the feed. This would cause your nipples to crack or bleed and the pain is very intense - a needlelike pain. Here is what was prescribed to me and what I suggest:

  1. Get medical attention as soon as possible. Even before your delivery talk to your doctor about any care you need to take.

  2. Do not use syringes to extract milk on cracked nipples.

  3. Do not use soaps or lotions on the cracked area.

  4. Massage it with warm water using a clean cloth.

  5. Medication : Most importantly this is what helped. A Lanolin based ointment like Nipcare (in India) can be applied before and after the feed to the breasts. You can do this even before delivery. This will help the pores open up. It is safe to feed the baby with the ointment applied.

Thursday, January 18, 2007

My baby's diet : First month

Mother's feed. Exclusive on-demand breastfeeding. I do not go by the clock. Feeding is erratic and the intervals or the duration of the feed is not set. I feed LG as long as he wishes to and looks satisfied.

Mother's feed. Exclusive on-demand breastfeeding. I do not go by the clock. Feeding is erratic and the intervals or the duration of the feed is not set. I feed LG as long as he wishes to and looks satisfied.

Saturday, January 13, 2007

Abdominal cramps

Pranav cried last night continuously for over 2 hours. This is the first time this has happened so we didn't know what to do. Tried a lot of things like feeding him, comforting him, rocking and walking him but nothing worked. I got so tired at the end that there was no energy and patience to take it any further. He would start all over again. Mom applied vasambu ( native medicine) over his tummy but that didn't work. Luckily I remembered the Paediatrician mentioning that if ever your baby cries for long one of the reasons could be stomach pain. In which case, you can give "Colimex" drops. So dad and Pravin found a medical shop at 11:30 p.m. and got this. After giving 5 drops of this, he settled down a bit and slept soon afterward. What a relief when a crying baby goes to sleep! Sometimes, it helps when your Paediatrician prescribes in advance for possible causes such as this.

I started noticing small red spots that resembled prickly heat on the creases and forehead of my baby's skin. The number of spots increased the next day. It made me wonder if it was a mosquito bite or due to heat. So we tried bathing him in lukewarm water instead of very hot water, dried him completely and applied Johnson's baby lotion to these areas. This helped a bit. The doc confirmed it was some allergic reaction which usually happened in kids and if it aggravated, he advised me to use Nivea Face cream or Johnson's baby powder/lotion. The skin folds are very sensitive and should be kept dry at all times. Avoid using greasy creams and lotions to these areas such as groin, hand and leg folds.

I'm told bathing and massaging your baby builds a special bond between the mother and kid. With time, the mother and baby enjoy this activity so much so that it brings a smile to both theor faces and long for the same the next day.

However, it takes a while for the mother to get used to handling the baby and bathing him/her well without letting the baby slip off. In the olden days, it was generally the grandparents who bathed the baby by sitting down and keep the kid in between their legs. My gyanec advised that the baby be bathed the easier way - using a small bath tub and placing the baby inside the tub while holding his head with one hand. This is convenient but bathing between the legs is quoite enjoyable. My mom bathes her grandson.

When and how should you bathe the baby?

  1. Bathe your baby only if it is a sunny day. Bathe newborns in the mornings and soon afterward show him in the sunllight for 20 mins.

  2. Use Johnson's baby/any baby product soap and shampoo to bathe the baby.

  3. Do not give oil bath during winter. Do not apply oil to the head.

  4. Give oil massage only for the body and not during winter.

  5. Do not use home made products to bathe the baby such as payatha maavu for the first 6-8 weeks until the umbilical cord wound heals.

  6. do not use sambirani to dry your baby's hair.

  7. It is advised that eithe you YOURSELf or ganrdparents bathe the baby.

  8. Use a bathtub.

  9. Keep the towel ready to wrap your baby in before you take him to bath. Keep the dress and powder ready as well. Do not expose your baby to cold air after you take him out of the tub. keep him warm. Wrap him in a towel, dry him completely and powder him well.

Even mothers should exercise caution while washing their hair if they are feeding the baby. Feed your baby before washing your hair. Dry your hair completely before feeding the baby again else he might catch a cold.

I was very worried when our son passed yellow mustard colored stools with a consistency of water about 3 times in 2 hours. Thank god this happened while in the hospital. I got one of the nurses and she said this was perfectly normal and infact healthy for the baby. If the stools are dark and solid, then it is a cause of concern. If your newborn excretes a lot, then it is a good sign he is getting good feeds and his intake is healthy. Only if he passes motion more than 20 times in a day, then you need to rush to the doctor for dysentery.

Urinating 6-7 times a day is good again though my lil one has his tank open when he is awake and I can very well win any nappy changing competition now.

All grannies would unanimously respond with a YES for this question. And all doctors these days advise mothers not to give native medicines to newborns - especially sugar water and gripe water. These were generally given in the olden days to soothe babies when they cry because of a tummy ache. A nurse in the hospital I delivered screamed on seeing paladai assuming it was used to give sugar water. due to the adulteration in food these days, doctors advise not to give any of these to prevent infection.

If you are wondering what to do when your baby suffers from a tummy ache, ask your paediatrician before hand. He/she might prescribe some drops. Before I got discharged from the hospital, I made a list of what should I do if he sneezes, passes stools more than so many number of times a day etc etc. And that kind of helped. What is apparently normal for a kid causes concern for us. And we tend to get all the more worried if it is at night.

Wednesday, January 10, 2007

Gassiness in newborns

If you are breastfeeding and your newborn is farting like there is no tomorrow, then there is a good chance that you are eating something spicy, coconut or tomato. watch what you eat as that has a direct effect on your baby. Stay away from foods that produce gas so long as you are feeding your baby. I was surprised to learn that Idli produces immense amount of gas.
I'm told some babies produce gas that is very smelly. It hasn't been smelly in my baby's case but the gas production can sure light a city. When the doc was examining him, he produced gas with such a sound effect that I was embarrassed. To control this and his digestion, the doc has given a digestive drop to be given once before feeding in the morning and in the night. So you might want to check with your paediatrician if you are experiencing the same thing.

A newborn is a bundle of mystery. Anything out of the ordinary which is sleeping, perplexes me. the first few days I was dashing to the nurses room every half an hour with a concerned face, "He has hiccups now. He has sneezed more than 4 times. Does he have cold? and such." I was told at the hospital that hiccups, sneezing and burping is quite common among newborns and infants. It is not a cause of concern when your newborn hiccups. My boy hiccups quite frequently through the day and the probability of one occurring after a good session of feeding is high. This I believe is attributed to the intestines not being fully developed.

Though no course of action is required, it can be quite a discomfort for the baby and you. You can make him suck or give him a small feed and this stops the hiccup. water is generally not recommended for newborns. So you might want to check with your doctor before giving water.

Pranav would just stare blankly beyond a certain distance. He would not acknowledge one's presence or look at object shown to him within a foot's distance. His vision has improved beyond the 12 inches circumference now and for the first time today he saw eye to eye while I was standing and looked down at him on the bed. This is a feel-good milestone. For once, I can feel him as a real person who can respond to his senses and not someone who just drinks every alternate hours, pees and poops.

Lil General (as we fondly call our son Pranav) had his first immunization shots for Polio and BCG on the 3rd. These are to be given within 30 days of the bith of the child.

During this visit, the doctor wanted us to take Lil General for the Pulse Polio immunization drops programme held on the 7th as well. This is an initiative undertaken by the Indian Govenment every year to erdicate Polio. I was wondering if this is something that will be harmful for the kid if not given. I found out that these are only additional to what the hospital/paediatrician gives. However, it has been made mandatory. Concerned if it would take a long while to get these drops as these are given to crores of kids across the country in various centers, I went in early this morning at 7:30 a.m.. I was pleased to find that it didn't take more than 5 mins and we were the only ones. Seeing LG they even took a picture of him and myself. This has tobe followed up by another shot on the Feb 11th. This year it is on the 7th Jan and Feb 11th.