What to Expect the First Year (6 page)

BOOK: What to Expect the First Year
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• Easy-to-track intake. Bottles come with calibrations to measure baby's intake, breasts do not. A formula-feeding parent can tell at a glance how many ounces have been consumed, a breastfeeding parent can gauge a baby's intake only from output (counting dirty and wet diapers) and weight gain. The upside of easy-to-track intake: less stress over whether a baby's taking too little or too much at feeds. The potential downside: Parents may push those last ounces in the bottle, even after baby's had enough.

• More freedom. To breastfeed, mom and baby must be in the same place at the same time—not so when feeds come from a bottle. A formula-feeding mom can work for the day, meet friends in the afternoon, take a business trip, or grab a weekend getaway without worrying about where baby's next meal will come from. Of course, the same holds true for a breastfeeding mom who chooses to pump or opts to supplement with formula.

• More rest for the weary. New moms are tired moms … make that, exhausted moms. While bottle-feeding mamas can buy themselves a nap or a good night's sleep by handing off some feeds to daddy or another secure set of warm arms, breastfeeding moms can't. And although breastfeeding is far more convenient than formula feeding, especially at 3 a.m., it's also more physically draining.

• More daddy time. Dads of nursing newborns clearly don't have what it takes to feed their little ones—that is, unless they're giving supplementary bottles of formula or breast milk. Bottle-fed babies, on the other hand, will happily let their fathers do the feeding.

• No fashion don'ts. Breastfeeding moms learn early to put function (easy, discreet access to breasts) over form (read: no one-piece dresses that don't button down the front). When you're bottle-feeding, anything in your closet that fits is fair game.

• More contraception options. For formula-feeders, most types of hormonal birth control are usable—not so for breastfeeders. Still open to breastfeeders: the progestin-only “mini-pill.”

• More menu options. Eating well while breastfeeding definitely comes with fewer restrictions than eating well during pregnancy (the sushi bar is open once again, and hamburgers no longer have to be served up gray), but a formula-feeder still has more freedom of eats (and drinks). She can say yes to that second round or that third coffee, eat garlic with abandon (some, though definitely not all, breastfed babies object to certain pungent flavors in mom's milk), and never worry about whether the meds she takes will be shared with her baby. She can also fast-track her weight loss—within the scope of what's sensible for a tired new mom—while a breastfeeding mom should take it somewhat slower (but may end up losing weight more easily, since milk production burns so many calories).

• Fewer awkward moments for modest mamas. While public breastfeeding is protected by law in more and
more states, it isn't always protected by public opinion—which means, unfortunately, that a mom nursing her baby still can attract some uncomfortable stares or even glares, especially when she chooses not to feed under cover (as is increasingly her right). Bottle-feeders, on the other hand, can be buttoned up about feeding—literally. No unfastening, untucking, or redressing required—and no worries about baby kicking off that napkin midmeal. Of course, hang-ups about public breastfeeding usually get hung up pretty quickly—as they should be. After all, there's never anything inappropriate about feeding a hungry baby … ever. And nursing cover-ups have come a long way, baby.

• Potentially, more fun in bed. Breastfeeding hormones can keep your vagina dry and sore, making postpartum sex a pain (plenty of foreplay and even more Astroglide can ease reentry). Bottle-feeding may speed a return to lovemaking as usual—that is, if you can rise above the spit-up stained sheets and crying-baby-interruptus.

Your Feelings

Maybe you're convinced by the facts, but nagging doubts are still keeping you on the breastfeeding fence. Here's how to work through a few common negative feelings about breastfeeding:

The feeling that it's impractical.
So you'd like to give breastfeeding a shot, but you're afraid it won't fit a demanding work schedule? As many moms have discovered, even an early return to work doesn't rule out breastfeeding. So consider giving it a try. Whether you end up fitting nursing into your work schedule for just a few weeks or for a year or more, offer breast milk exclusively or in combination with formula—any amount of breastfeeding is beneficial for you and baby. And with a little extra dedication and planning (okay, maybe a lot of extra dedication and planning), you may find that mixing business with breastfeeding is a lot easier than you thought (
click here
).

The feeling that you won't enjoy it.
Having a hard time picturing yourself with a baby at your breast—or maybe you're just not that into the idea of breastfeeding? Before you write off breastfeeding entirely, here's a suggestion: Try it, you may like it. You might even love it. And if you're still not feeling the breastfeeding love after 3 to 6 weeks of best breast efforts (that's about how long it takes for moms and babies to sync up into a good nursing rhythm), you can quit, knowing you've given your baby a head start on a healthy life. No harm done, lots of benefits gained, especially in the form of antibodies that will boost your little one's immune system, and particularly if you've given breastfeeding a full 6 weeks. Every feed counts, no matter how many or how few baby ends up racking up.

The feeling that your partner's not on board.
Studies show that when dads are supportive of breastfeeding, moms are far more likely to stick with it. So what do you do if your partner's not on board with breastfeeding—either because he's turned off by it, unsettled by it, or feels threatened at the thought of sharing you in such a physical way? Try to win him over with the facts—after all, they're pretty compelling stuff. Talking to other dads whose partners have breastfed their babies will also help him feel more comfortable, and hopefully more amenable. Or suggest
a trial of breastfeeding—chances are you'll be able to turn his feelings around quickly, and if not, you'll still be giving your baby and yourself the best health benefits possible, something he's bound to appreciate.

If you choose to give breastfeeding a try—no matter what facts, feelings, or circumstances bring you to that decision, and no matter how long you end up staying with it—chances are you'll find it a rewarding experience. Emotional and health benefits aside, you're also likely to find it the easiest and most convenient way to feed your baby, hands down (and eventually, hands free) … at least, once you've worked out early kinks.

But if you choose not to breastfeed, or you can't breastfeed, or you can or choose to breastfeed only for the briefest of times, there's no need for second-guessing, regret, or guilt. Almost nothing you do for your baby is right if it doesn't end up feeling right for you—and that includes breastfeeding. You can offer your baby as much nurturing and share as much intimacy during bottle-feeds as you could with breastfeeding—and in fact, a bottle offered lovingly is better for your little one than a breast offered with reservations, or a side of stress.

Choosing to Circumcise or Not

Circumcision is probably the oldest medical procedure still performed. Though the most widely known record of the practice is in the Old Testament, when Abraham was said to have circumcised Isaac, its origins probably date back before the use of metal tools. Practiced by Muslims and Jews throughout most of history as a sign of their covenant with God, circumcision became widespread in the United States in the late 19th century, when it was theorized that removing the foreskin would make the penis less sensitive (it definitely doesn't), thus making masturbation a less tempting pursuit (it definitely didn't). In the years that followed, many other medical indications for routine circumcision have been proposed—including preventing or curing epilepsy, syphilis, asthma, lunacy, and tuberculosis. None of them have panned out.

So are there any proven medical benefits to circumcision? It does reduce the risk of infection of the penis (but cleaning under the foreskin once it is retractable—usually around the second birthday—does just as well). It also eliminates the risk of phimosis, a condition in which the foreskin remains tight as a child grows and can't be retracted as it normally can in older boys (between 5 and 10 percent of uncircumcised males have to undergo circumcision sometime after infancy because of infection, phimosis, or other problems). And studies show that the risk of developing a urinary tract infection (UTI) in the first year of life is higher for baby boys who are uncircumcised (though the actual risk of an uncircumcised boy developing a UTI is very low—about 1 percent). The rates of penile cancer and STDs, including HIV, may also be slightly lower for circumcised males.

Wondering where the experts come down on circumcision? Actually, most don't—and that includes the American Academy of Pediatrics (AAP), which maintains that while the health benefits
of circumcision outweigh the risks of the procedure, it's still a decision best left to the parents. They recommend that parents be advised of the risks and benefits of circumcision and then make the unpressured choice that's right for their baby and their family—factoring in what matters most to them (whether that's having their son match up with dad, following a religious or cultural tradition, or just the belief that baby boys should be left intact).

Just over half of all boys in the United States are circumcised—the rate having dropped considerably in recent years. The most common reasons parents give for opting for circumcision, in addition to just “feeling it should be done,” include:

• Religious observance. The religious laws of both Islam and Judaism require that newborn boys be circumcised.

• Cleanliness. Since it's easier to keep a circumcised penis clean, cleanliness is next to godliness as a reason for circumcision in the United States.

• The locker-room syndrome. Parents who don't want their sons to feel different from their friends or from their father or brothers often choose circumcision. Of course, as the percentage of circumcised babies steadily declines, this becomes less of a consideration.

• Appearance. Some maintain that a foreskin-free penis is more attractive.

• Health. Some parents just don't want to take even the slightest added risk when it comes to their newborn's health.

The reasons why parents decide against circumcision include:

• The lack of medical necessity. Many question the sense of removing a part of an infant's body without a really good reason.

• Fear of bleeding, infection, and worse. Though complications are rare when the procedure is performed by an experienced physician or medically trained ritual circumciser, they do happen—and that's enough reason for some parents to be understandably apprehensive about circumcising their newborn.

• Concern about pain. Evidence shows that newborns circumcised without pain relief experience pain and stress measured by changes in heart rate, blood pressure, and cortisol levels. The AAP recommends that circumcision be done with effective pain relief (such as topical EMLA cream, dorsal penile nerve block, or the subcutaneous ring block).

• The locker-room syndrome. Some parents choose not to circumcise a newborn so he will look like his uncircumcised dad or like other boys in a community where circumcision isn't widely practiced.

• A belief in a newborn's rights. Some parents prefer to leave this important life decision up to their son—when he becomes old enough to make it.

• Less risk of diaper irritation. It's been suggested that the intact foreskin may protect against diaper rash on the penis.

If you remain undecided about circumcision as delivery day approaches, read about circumcision care
here
and discuss the issue with the doctor you have chosen for your baby—and possibly with relatives, friends, or social media buddies who have gone either route (keeping in mind that the debate between pro and con camps can get pretty heated).

Diaper Decisions

Cloth or disposable? While you don't have to decide which type of diaper you'll use for your baby's bottom until there's a bottom that needs covering (and you can always change your mind once you start changing diapers), thinking about your options now makes sense. For a heads-up on all the bottom-covering options and features out there,
click here
.

Choosing a Name

So, maybe you've been settled on your munchkin's moniker since you were a munchkin yourself. Maybe you devoted notebooks to baby names in high school—or later, cocktail napkins. Maybe your baby's name became as clear as a 4-D ultrasound the first moment you learned “it's a boy” or “it's a girl.” Or maybe, if you're like a lot of other parents approaching delivery day, you're still playing the name game … late in the game.

Whether you're looking for something classic, something meaningful, something quirky, something trendy, or something completely different, whether you're sure you'll know the right name when you hear it or wondering if you'll ever know it, deciding what to name your baby can be a pretty daunting challenge. After all, a name is not just a name—it's an integral part of your child's identity. And, it tends to stick for life—from the cradle to the playground to the homeroom to the workplace and beyond. Add to that awesome responsibility the drama and debate, which can get pretty heated between some couples (and among other opinionated family members): The name your spouse is set on may be the name you're set against. Your cousin delivered first and took your favorite name with her. Both grandmas are lobbying for different family names. A coworker burst out laughing when you told him the name you had in mind. And the name you love best is the one you're afraid no teacher will ever be able to pronounce. Or spell.

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