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Kindle Notes & Highlights
by
Emily Oster
Your choices can be right for you but also not necessarily the best choices for other people. Why? You are not other people. Your circumstances differ. Your preferences differ. In the language of economics, your constraints differ.
If you have a vaginal delivery, you’ll probably spend two nights in the hospital. If you have a caesarean section, or any complications during birth, this might be three or four nights.
One of the benefits of skin-to-skin contact seems to be increased breastfeeding success. Perhaps for this reason, breastfeeding success also seems to be increased by delaying the bath past the first few hours.
Circumcised boys are much less likely to get these. About 1 percent of uncircumcised boys will get a UTI during childhood.
Uncircumcised boys can also develop a condition called phimosis, where it becomes impossible to pull the foreskin back.
In light of this, it is now strongly recommended that infants have some type of pain relief during this procedure. The most effective type seems to be a penile nerve block (typically called a DPNB), which involves injecting a painkiller into the base of the penis before the circumcision. Your baby’s doctor may also use topical anesthetic in combination.14
People with this condition lack a particular enzyme that breaks down the amino acid phenylalanine into another amino acid. For people with PKU, eating a low-protein diet is crucial, since protein contains a lot of phenylalanine.
In a person with PKU, protein can build up in the body, including in the brain, and cause extremely serious complications, including severe intellectual disability and death.
There is an increasing emphasis on early detection of hearing loss, as early intervention (for example, with hearing aids or implants) can improve language acquisition and decrease the need for intervention later.
rooming in will mean less sleep, but maybe it’s good for the baby. This is your first sleep test. Is rooming in beneficial enough to warrant some lost sleep in the first days?
women who keep their infant with them are more likely to breastfeed,
Every twelve hours or so they’ll weigh the baby and possibly come back to report any change in weight to you.
nearly all infants lose weight after birth, and those who are breastfed lose even more.
Weight loss is not an issue in and of itself, but excessive weight loss can indicate a problem with feeding—that breastfeeding isn’t working successfully, for example.
When I had Penelope, the rule in the hospital was if the baby loses more than 10 percent of their body weight, you supplement.
Supplementation would rarely be recommended before 48 or 72 hours, so it’s useful to pay attention to your baby’s weight before that.
The major concern about weight loss is that it is a signal of dehydration. But this is also something you can monitor directly. If your baby is peeing with some frequency and does not have a dry tongue, there’s a very good chance he’s not dehydrated.
Jaundice is a condition in which the liver is unable to fully process bilirubin, a by-product of breaking down red blood cells.
Infants are at higher risk for this just after birth for a few reasons. There are more blood cells being broken down shortly after birth, increasing the load of bilirubin presented to the liver.
Jaundice is also very common, especially in breastfed newborns: about 50 percent of newborns will have this condition to some degree.
The primary sign of jaundice is that your baby’s skin will turn yellow
Bilirubin levels typically increase over the first few days after birth, so doctors will compare your baby’s test results with the normal range for the number of hours old your child is.
Daily (or more frequent) blood tests keep the doctor updated on how things are progressing.
Excessive newborn weight loss is a risk factor, as is bruising in delivery.
There are, therefore, no known risks to a vitamin K shot, but clear benefits from it.
While swaddled, the babies slept longer overall, with more time spent in REM sleep.
This paper also identified the mechanism: swaddling improves sleep because it limits arousals.
A common definition of colic (although not the only one) is the rule of three: unexplained crying for more than three hours a day for more than three days a week for more than three weeks.
If you really cannot bear to leave them, call your best friend and tell them to come over and hold the crying baby.
It is also important to say that this is “self-limiting”: colic will go away, typically around three months. Not all at once, but things will start to improve.
One is supplementation with a probiotic, which a number of studies have shown to reduce crying. These effects seem to show up only in breastfed infants.
Keeping track of when the baby is eating can be valuable early on since it’s easy to forget when they last ate.
virtually all doctors will suggest you try to avoid exposure to illness in the baby’s first couple of months. One reason for this is simply that the smaller the child, the more vulnerable they are to serious complications.
With very young babies, doctors have a harder time distinguishing between high- and low-risk fevers.
If you do tear, the degree is ranked from first to fourth degree. A first-degree laceration is minor tearing, which heals well on its own with no stitches. Second degree means there is more involvement of the perineal muscles, but the tear doesn’t extend to the anus. Third- and fourth-degree tears extend all the way from the vagina to the anus but differ in how deep they go, with fourth-degree tears extending into the rectum. Third- and fourth-degree tears must be repaired with stitches, which will dissolve on their own after a few weeks.
abdominal massage. Over the first hours after birth, the uterus should contract toward its pre-pregnancy size. If this doesn’t happen, there is an increased risk of bleeding. Uterine, or “fundal,” massage has been shown to assist this process and lower the risk of bleeding.
Regardless of how you gave birth, for the first couple of days afterward, you will bleed a lot.
For the first day or two, this bleeding—in particular, the clotted blood—can be a little scary.
about). By extension, this means that clots smaller than that—but not much smaller—are common. Passing these isn’t typically painful, but it is jarring.
The passing of clots will die down after a couple of days, but you’ll keep bleeding—first like a heavy period, then a lighter period—for weeks.
If you had a vaginal birth, it will hurt to pee.
At many hospitals, they’ll give you a squeeze bottle of water, the idea being that you squeeze water on while you pee so the urine is diluted and not as painful.
It will also likely hurt to poop. This depends, again, on how traumatic your birth experience was.
After a caesarean, doctors generally want you to either poop or at least pass some gas before you leave the hospital; this is to ensure that you can have a bowel movement after what is basically major abdominal surgery.
If you had a vaginal birth, the most significant lingering physical consequences are for your vagina. As one medical description puts it, “After birth, the vagina will be capacious.”
every C-section, planned or not, is major abdominal surgery, meaning it will be painful to do anything that involves your abdominal muscles. This includes walking, going up stairs, sitting, picking things up, rolling over, etc. Everything you do just hurts.
Many cultures have a tradition of women basically doing nothing for a month or so after birth, while older women in their family take care of them.
There are a few specific red flags to look out for: Fever Severe abdominal pain Increase in bleeding, especially bright red blood Bad-smelling vaginal discharge Chest pain or shortness of breath
it is safe to resume exercise “within a few days” after a normal vaginal delivery. This isn’t to say you will be running interval workouts a week later, but some walking may be feasible.
tearing. In the case of a caesarean, the standard recommendations include some walking within the first two weeks, introducing the possibility of abdominal curls or other related exercises by week 3 and a resumption of “normal” activities by around week 6.3
