What to Expect the First Year (39 page)

If your baby seems to prefer having freedom of hand movement, wrap below the arms. An added bonus to free hands: Your baby will be able to self-soothe by sucking on those sweet fingers. Because being wrapped up can interfere with development as baby gets older, and because a blanket that a swaddled baby kicks off can pose a safety hazard in the crib, stop swaddling once baby becomes more active (by 3 or 4 months). Be sure, too, that the swaddle isn't too tight … and that baby's knees, elbows, and hips are flexed naturally in the usual position for optimal joint development (don't straighten them out before swaddling).

Baby doesn't like being swaddled for sleep? Try a sleep sack or a hybrid swaddle/sack instead.

You've brought your baby home and you're giving parenthood everything you've got. Yet you can't help wondering: Is everything you've got enough? After all, your schedule (and life as you vaguely recall knowing it) is upended, you're still fumbling over feedings, and you can't remember the last time you've showered … or slept more than 2 hours in a row.

As your baby grows from a precious but largely unresponsive newborn to a full-fledged cuddly infant, your sleepless nights and hectic days will likely be filled not only with pure joy but also with exhaustion—not to mention new questions and concerns: Is my baby getting enough to eat? Why does he spit up so much? Are these crying spells considered colic? Will she (and we) ever sleep through the night? And how many times a day can I actually call the pediatrician? Not to worry. Believe it or not, by month's end you'll have settled into a comfortable routine with baby, one that's still exhausting but much more manageable. You'll also start to feel like a seasoned pro in the baby-care game (at least compared to what you feel like today)—feeding, burping, bathing, and handling baby with relative ease.

Baby Basics at a Glance: First Month

Sleeping.
A newborn baby doesn't have much of a pattern to his or her sleep schedule. Baby will be sleeping anywhere from 14 to 18 out of every 24 hours.

Eating.
Baby's getting only breast milk or formula at this age:

• Breast milk. Baby will nurse 8 to 12 times during every 24-hour period, taking in a total of anywhere from 12 to 32 ounces of breast milk (if you were counting). That's a feeding roughly every 2 to 3 hours, timed from start of one to start of next. Feed on demand, rather than by the clock.

• Formula. Start with 1 ounce at a time, 8 to 12 times per 24 hours, in the first week or so (for a total of 12 ounces). By the end of the first month, baby will probably take 2 to 3 ounces of formula per 24 hours, or 16 to 32 ounces total. Since formula takes longer to digest than breast milk, you may be able to spread out meals to one every 3 to 4 hours. Even formula-fed newborns are best fed on demand and to appetite, rather than on a schedule.

Playing.
A newborn baby doesn't really need any toys (your cuddles and caresses are the best toys for your little one), but since baby can see objects 8 to 12 inches away (the distance to your face as you hold that bundle), a mobile or play gym is a good option for stimulating baby when your arms aren't free. Babies love looking at bold patterns and faces, so if you're able to find a mobile that combines both, even better.

This early in the breastfeeding game, your breasts and your baby probably haven't spent much time apart, and that's as it should be for starters. But there will almost certainly come a day (or a night) when you'll need to (or want to) be away from your baby during a feeding—whether you're working, taking a class, traveling, or just out for the night—and you'll be taking your breasts with you. How will you catch a breastfeeding break while still making sure your baby gets the best? Easy: Express yourself.

It's not so much a law of physics as it is a law of busy motherhood: You can't always count on your baby and your breasts being at the same place at the same time. There is a way, however, to feed your baby breast milk (and keep your milk supply up) even if you and baby are miles apart: by pumping (or expressing) milk.

Wondering when you'd need or want to pump? Here are some common reasons:

• Relieve engorgement when your milk comes in

• Collect milk for feedings while you're working

• Provide relief bottles for when you're away from home

• Increase or maintain your milk supply

• Jump-start your milk supply if it's slow coming in

• Store milk in the freezer for emergencies

• Prevent engorgement and maintain milk supply when nursing is temporarily stopped because of illness (yours or baby's) or because you're taking a medication that's breastfeeding-unfriendly

• Provide breast milk for your sick or premature baby in the hospital

• Stimulate relactation if you change your mind about formula feeding

• Induce lactation if you're adopting a newborn

Sure, you can express milk by hand—if you have a lot of time, don't need a lot of milk, and don't mind a lot of pain. But why bother, when pumping makes it so much easier, more comfortable, and more productive to express yourself? With so many breast pumps on the market—from simple manual models that cost a few dollars to pricier electric ones that can be bought or rented—there's one (or more) to fill your needs and fill your baby's supplementary bottles with the best food around.

Before deciding which type of pump suits your expressing style, you'll need to do a little homework:

• Consider your needs. Will you be pumping regularly because you're going back to work or school full time? Will you pump only once in a while to provide a relief bottle (or to relieve engorged breasts)? Or will you be pumping around-the-clock to provide nourishment for your sick or premature baby, who may be in the hospital for weeks or months?

• Weigh your options. If you'll be pumping several times a day for an extended period of time (such as when working full-time or to feed a preterm infant), a double electric pump will probably be your best bet. If you need to pump only occasionally, a single electric, battery, or manual pump will fill your needs (and those few bottles). If you're planning to express only when you're engorged or for a once-in-a-great-while bottle-feeding, an inexpensive manual pump may make sense.

• Investigate. Not all pumps are created equal—not even among those in the same general category. Some electric pumps can be uncomfortable to use, and some hand pumps painfully slow (and sometimes just plain painful) for expressing large quantities of milk. Scout the field by checking websites and stores that carry a wide variety of pumps, considering features and affordability. Ask friends or check out online reviews and posts to see which pumps other moms are pumped up about … and which don't make the grade. Or discuss the options with an LC or your baby's doctor.

All pumps use a breast cup or shield (known as a flange), centered over your nipple and areola. Whether you're using an electric or manual pump, suction is created when the pumping action is begun, mimicking baby's suckling (some more efficiently than others). Depending on the pump you use (and how fast your let-down is), it can take anywhere from 10 to 45 minutes to pump both breasts—not surprisingly, higher priced pumps yield speedier results. Here are the general types of pumps on the market:

Electric pump.
Powerful, fast, and usually easy to use, a fully automatic electric pump closely imitates the rhythmic suckling action of a nursing baby. Many electric pumps allow for double pumping—a great feature if you're pumping often. Not only does pumping both breasts simultaneously cut pumping time in half, it stimulates an increase in prolactin, which means you'll actually produce more milk faster. Electric pumps can cost a few hundred dollars, but if you're pumping often, it may be well worth the investment. (Also, when you weigh it against the cost of formula, you'll almost certainly come out ahead.)

Most electric pumps come in portable models that are inconspicuous (the black carrying cases are designed to look like backpacks or shoulder bags). Some pumps also come with a car adapter and/or battery pack (some come with rechargeable batteries) so you don't have to plug them in. There are even some models that have a memory feature that learns your personal pumping rhythm and remembers it for the next time you express. Another feature: Hands-free pumps attach to your bra and allow you to work, play with your baby, blog online, or otherwise be a mommy multitasker while pumping (there are also specially designed bras that allow for handsfree pumping).

Need a pump that's really heavy duty (for instance, because you're pumping full-time for your preemie or trying to relactate)? There are hospital-grade electric pumps you can buy (very expensive) or rent (more cost effective)—often from the hospital you've delivered in or from a lactation center. An LC, the La Leche League, or an online search can help you get connected to a reputable rental company.

A double electric pump cuts pumping time in half.

Manual pump.
These hand-operated pumps are fairly simple to use, moderate in price, easy to clean, and portable. The most popular style is a trigger-operated pump that creates suction with each squeeze of the handle.

The trigger on a manual pump creates suction with each squeeze of the handle.