Heading Home With Your Newborn: From Birth to Reality

Heading Home With Your Newborn: From Birth to Reality

by Laura A. Jana, Jennifer Shu

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Now in a fully-updated second edition, Heading Home with Your Newborn has everything new and expectant parents need to know about caring for baby in the first few months after birth. Written by two pediatricians who are also parents, this awarding-winning guide covers feeding, sleeping, changing, bathing, dressing, traveling, sickness, child care options, and much more.

The second edition features new chapters on vaccines and choosing a child care provider, plus a robust new section devoted to early learning, with chapters on baby brain basics, baby sign language, fun and games, books and babies, the sounds of music, and the effects of media on the very young. Also included is new or updated information on car seats, safe sleep, cord blood, what to keep in your medicine cabinet, postpartum depression, vitamin D, organic formulas, disposable vs. cloth diapers, newborn hearing screening, and more.

With wit and humor, Drs. Shu and Jana allay the feelings of anxiety, guilt, and inadequacy that inevitably plague first-time parents home alone with a newborn, providing authoritative yet compassionate advice for the sleep-deprived and overwhelmed!

Here are a few special excerpts from Heading Home With Your Newborn as featured on HealthyChildren.org:

Sleeping by the Book
The Many Colors of Poop
To Bathe, or Not to Bathe

Product Details

ISBN-13: 9781581105599
Publisher: American Academy of Pediatrics
Publication date: 07/01/2010
Sold by: Barnes & Noble
Format: NOOK Book
Pages: 372
Sales rank: 1,145,921
File size: 4 MB

About the Author

Laura A. Jana, MD, FAAP is a pediatrician, author, and national health communicator. Having co-founded The Dr. Spock Company in 1999, Dr. Jana has been actively involved in national parenting media for over a decade and is the co-author of Heading Home with Your Newborn (AAP) and Food Fights (AAP). She now lives with her husband and 3 children in Omaha, Nebraska where she also owns and operates an educational child care center called Primrose School of Legacy.

Dr. Jana is a member of the AAP's Executive Committee for Early Education and Child Care, part of Dr. Nancy Snyderman's BeWell/LLuminari Expert Network, an early literacy advocate for Reach Out and Read and co-founder of Amazing Me Books, a certified child passenger safety technician, and a consultant to several corporate, academic, and government organizations on a broad range of topics related to the health and well-being of children. She is also on the Advisory Board for American Baby magazine and the Walt Disney Internet Group, has appeared nationally on shows including NPR's The Parent's Journal, the Today show, CNN's Nancy Grace, ABC News, and Fox, and is well recognized as Omaha's parenting expert for her local NBC affiliate.

Jennifer Shu, MD, FAAP is a pediatrician, author and mother in Atlanta. As the medical editor for HealthyChildren.org, she serves as an expert on parenting issues and provides oversight and direction for site in conjunction with the Managing Editor and staff.

An enthusiastic and experienced writer and public speaker, Dr. Shu is frequently featured as a medical expert in numerous national and local television and radio shows, Internet articles, parenting magazines, newspapers and medical publications. Dr. Shu is editor-in-chief of the American Academy of Pediatrics’ Baby & Child Health and co-author of the award-winning books Heading Home with Your Newborn and Food Fights, both published by the AAP.

Dr. Shu received her bachelor’s degree at the University of Virginia and her medical degree from the Medical College of Virginia. Dr. Shu completed her pediatric training and chief residency at the University of California in San Francisco. She has worked in the private practice setting as well as in academics, as a former director of the normal newborn nursery at Dartmouth-Hitchcock Medical Center. Dr. Shu has been a leader within the medical profession as a past national chairperson of the young physicians sections for both the American Medical Association and the American Academy of Pediatrics.

Read an Excerpt



As with most aspects of parenting, the most significant contribution we stand to make to your breastfeeding success is to start you off with realistic expectations. To do that, we want to take time to address many of the common breastfeeding myths and misconceptions that tend to weigh new parents down. We have found it particularly helpful for new and expectant parents to get started by reminding themselves of two reassuring facts.

• Millions of mothers before you have been able to breastfeed their babies successfully.

• The first couple weeks of breastfeeding are by no means representative of what your entire breastfeeding experience will be like.

While a handful of fortunate new moms ease into breastfeeding as if they were born to do so and are quickly rewarded with an overwhelming sense of accomplishment, in reality there is usually a period of self-education and on-the- breast training. Consider this time to be one of trial and error — a "get acquainted with and accustomed to the process" phase in which breastfeeding your baby may take a bit more time, thought, and effort than it will in your not-so- distant breastfeeding future. However, with a few safety precautions and an eye on the prize, you will likely be able to dodge many common obstacles — both perceived and real. And if you're coming to us already frustrated and all but resigned to giving up any hope of breastfeeding altogether, we hope to offer you a new lease on your breastfeeding life.

A Comment on "Breast Is Best"

As you enter the world of parenthood, you will undoubtedly encounter the phrase "breast is best." That's because it has become an almost universal slogan that graces the pages of parenting magazines, Web sites, medical textbooks, and formula packaging alike. Given that breast milk has thus far proven impossible to duplicate, and the health benefits it offers invaluable, we wholeheartedly support the recommendation of the American Academy of Pediatrics (AAP) to feed your baby breast milk as long as possible — exclusively for about the first six months and ideally continuing for one year or longer. With that as a backdrop, what we have to say about your decision to breastfeed may, therefore, come as a bit of a surprise — especially from two pediatrician-moms who are fully aware and in support of the idea that there are great benefits to breastfeeding. We feel the need to mention that we have come across instances in which breastfeeding has not always worked out for the best. Now lest the preceding statement be regarded as a letdown to breastfeeding advocates everywhere, let us explain.

The standard consideration in favor of breast milk is very straightforward. Breast milk has long been and continues to be unrivaled as the ideal food for infants. Not only is it considered to be a perfect mix of nutrients, including the fatty acids DHA (docosahexaenoic acid) and ARA (arachidonic acid) that are thought to play an important role in brain and eye development, the infection-fighting antibodies it contains can't be bottled in even the most expensive of commercial formulas. Breast milk has also been shown to reduce a newborn's chance of developing everything from asthma, allergies, diarrhea, and ear, respiratory, and urinary tract infections to diabetes, obesity, lymphoma, leukemia, sepsis, and potentially even sudden infant death syndrome. There are also health benefits for breastfeeding mothers. Just about the only caveat we feel compelled to mention is that for some caring and devoted new mothers, when it comes to putting recommendations into practice, sometimes breastfeeding just doesn't work out right. Whether it's a matter of modesty, attitude, medically related issues, or the disappointment of unsuccessful attempts, breastfeeding can be a potential source of frustration for some new moms. Worse yet, difficulties with breastfeeding can cause some serious feelings of parental inadequacy, leaving some mothers questioning their overall ability as parents. Too many of these new parents are led to believe — either by convincing themselves or by being told by others — that to be a good mother, breastfeeding is an absolute requirement.

We will now say to you what we suggest to every new or expectant mother that comes to us with questions or concerns about the early days of breastfeeding. First, decide for yourself whether you are looking for breastfeeding help or secretly hoping someone will tell you it's okay not to breastfeed. If you've already made the informed (and by informed we mean understanding all the facts and options and ideally discussing them with a qualified health care professional) decision that breastfeeding is not for you, then you have our full support in flipping directly to the formula-feeding discussion of our book without experiencing unrelenting pangs of guilt. If, on the other hand, you've never given much thought to breastfeeding, you find yourself questioning your ability to do it successfully, or you have run into a few bumps on the road to what will almost surely be breastfeeding success, we hope you will read on. We hope to boost your confidence and make sure your breastfeeding experiences are not only successful but also enjoyable.

How Far We've Come and How We Got Here

Anyone looking at breastfeeding popularity in the United States over the past several decades is sure to notice what we like to call a roller coaster phenomenon — up in the '70s, down in the '80s, and back on the upswing since the '90s. And, of course, what was considered to be "best," not to mention socially acceptable, has varied considerably not only over time but also based on many other factors such as what area of the country parents live in, their age, and their background. While we've certainly come a long way from the days when breastfeeding moms were the exception to the rule and ostracized for their choice, we have not come so far that there isn't still an occassional outdated, hard to believe, or even downright comical law that prohibits public displays of breastfeeding still on the books.

Getting Started

What's "Natural" Doesn't Always Come Naturally

Yes, the act of breastfeeding is "natural," but the truth of the matter is that it doesn't always come naturally. All too often, new parents expect to be handed a newborn who gracefully latches on, nurses no more than 15 minutes on each breast every 3 hours, and delights in a plentiful supply of breast milk within a few short days. While we can only wish this scenario for all of you, clinging to this idealistic picture of breastfeeding bliss is all but guaranteed to set most of you up for perceived failure. If in the introductory weeks of breastfeeding, however, you prepare yourself for the distinct possibility that your newborn may lack interest or sucking stamina, that each feeding may be different, and that your nipples may be a little worse for wear early on, well, then you only stand to be pleasantly surprised. The most likely scenario: breastfeeding may be natural, but expect it to be a learning process for you and your baby over the first few weeks or possibly longer. Some babies are quick learners, while others take their own sweet time.

Advice Abounds

As you try to educate yourself or start your on-the-job training, you're almost certain to find that anyone who has ever breastfed (or been remotely involved in breastfeeding) considers themselves a full-fledged expert. Some of the advice you get will undoubtedly prove to be very helpful. But be aware that you'll probably get your fair share of unsolicited suggestions and contradictory, confusing, or just plain wrong advice — even when it comes from moms who have breastfed a virtual litter of children, are highly intelligent, and have the best of intentions. Just keep in mind that, at the end of the day, there are only a few universally accepted facts about breastfeeding (which we've made a point of gathering for you throughout this chapter). The rest of what you do and how you do it will be a matter of establishing your own breastfeeding style.

Sending Out an SOS (in Search of Support)

Breastfeeding really does have its rewards, but it also can be a demanding and tiring 24-hour-a-day job. If you find yourself experiencing feelings of frustration, isolation, or even entrapment, one of the worst things you can do is try to cope alone. Of course, it's not any better to find yourself in the company of a well- meaning colleague, friend, or family member who is just waiting for the opportunity to tell you how easy formula feeding would be in contrast. Please take a moment and tell yourself you are absolutely not alone and don't need to figure out the tricks of the trade the hard way! We strongly suggest that if what you really need is a supportive shoulder to lean on, put down this book and find one (or several). It may seem like yet one more thing you don't have time for, but finding that you don't have to learn to breastfeed alone can make all the difference in the world.

Find an International Board-Certified Lactation Consultant (IBCLC). Board-certified lactation consultants are credentialed breastfeeding specialists with knowledge and training in breastfeeding support, some of whom may also be nurses, doctors, or other health care professionals. Ask your hospital or baby's doctor for the name of a local lactation consultant, or visit www.ilca.org to find an IBCLC near you.

Get help from your hospital. Labor and delivery staff (including your obstetrician, midwife, or doula), nurses in the mother-baby unit, and hospital lactation specialists are a great place to start exploring what types of support are available in your community before, during, and after you deliver.

Turn to your pediatrician for advice or assistance. As pediatricians, we routinely observe newborns breastfeeding in our offices and are very accustomed to providing practical advice and troubleshooting tips. Be sure to ask your pediatrician for advice or for a referral to a lactation consultant or other breastfeeding resources in your area.

Check out La Leche League International, which has local chapters throughout the world. Check their Web site (www.lalecheleague.org) to find area leaders and meeting places and times.

Call the National Breastfeeding Helpline. Through this resource, the National Office on Women's Health reportedly makes available trained breastfeeding peer counselors for phone support. Although it's not a substitute for direct medical attention or advice, feel free to access this support or find additional breastfeeding answers and resources at www.womenshealth.gov/breastfeeding or by calling 1-800-994-9662.

Don't be afraid to enlist your spouse, partner, friends, family members, or neighbors — anyone you think might be able to lend a hand or offer emotional support. Even though no one else can breastfeed for you, we've never met a new mother who doesn't appreciate the offer of help with other items on the family's daily to-do list, whether it's in the form of cleaning, cooking, running errands, doing laundry, or simply watching the baby for a bit so she can get a break every now and then.

Join a support group. In today's connected world, in-person and virtual breastfeeding support groups abound and are easily found through a quick search on the Internet. Of course, as with any Internet activity, you'll want to be careful about any private information you divulge online and look for credible sources of information, such as from hospitals, trained consultants, or La Leche League chapters.

My Baby, My Breasts, and I

Becoming a new breastfeeding mother really does involve a fundamental shift in one's view of the world — a shift that is lifelong in the sense of awe you get from nurturing a child of your own but more immediate in a practical, concrete way. That is, you are suddenly thrust from a world primarily focused on "me, myself, and I" (or perhaps "me, my spouse/partner, and I") to one that inevitably is structured around "my baby, my breasts, and I." As you set out to master the fine art of breastfeeding, you are likely to look at your breasts in a whole new way and give them far more consideration than ever before (regardless of how significant they were to you in your pre-breastfeeding past). In fact, we are of the strong belief that if your baby's health care provider doesn't ask you how you, your baby, and your breasts are doing in your early days of breastfeeding, he or she has, for lack of a more tactful description, missed the boat.

First Attempts

Assuming all goes well with the birth of your baby and both of you are doing well in the minutes and hours immediately following delivery, the best time to attempt your first breastfeeding is as soon as possible. While this may seem obvious, it's easy to find yourself feeling like you have little to no say or control in what takes place during your hospital stay, much less in your delivery room. If you wait for someone to tell you what to do and when, then whether you are encouraged to breastfeed right away will depend on your hospital's attitudes toward breastfeeding.

Helping Hands at the Hospital

Your goal for breastfeeding in the delivery room (and throughout your stay at the hospital) should be to make sure you and your baby work out the concept of latching on correctly. At some hospitals, it is standard for labor and delivery nurses not only to bring mothers their newborns within minutes of delivery (if not immediately) but to offer plenty of breastfeeding instruction and encouragement. At other hospitals, however, it is still routine for newborns to be taken off to the nursery to be cleaned up and even given a bottle while their mothers get some rest. If you want to get breastfeeding off to a good start, don't be afraid to take things into your own hands and give it a try while you're still in the delivery room. Many babies tend to be temporarily wide awake right after delivery. After all, they've just been through a pretty eye-opening experience right along with you. If and when you get the chance, take advantage of your baby's temporary state of alertness (which we liken to a honeymoon period). Within a matter of hours, you may well find you have a very sleepy baby on your chest.

Getting Comfortable

Given that just about all new moms are prone to focusing their attention on their breasts (and their babies) when they first sit or lie down to nurse, we also want to remind you to take a moment and make yourself comfortable. Supporting yourself with extra pillows, making sure you have on convenient and comfortable clothing, and having anything you might want or need within arm's reach (a glass of water, a book, the phone, or the TV remote control) before getting down to business can definitely make the experience more enjoyable. When it comes to the actual position you try, the choice is up to you. In case you aren't aware of them, we will briefly describe several of the most popular options.

Cradle hold (Figure 1-1). This is the position most novice breast feeders start with and the one that many new moms prefer. The most common exception is new moms who have just had cesarean deliveries and find, for obvious reasons, that they want to avoid having their newborns pressing on their bellies. While sitting up (preferably with lots of comfy pillows and good back support in place), you simply lay your baby across your lap sideways so she is facing you with her head in line with your breast. In the typical cradle hold, you will use your right arm to support your baby's head and body while she nurses on your right breast (her head resting in the crook of your right arm with your hand supporting her bottom) and your left arm for support while she is nursing on your left breast. To help ease strain on your back, shoulders, and neck, try putting a regular or specially designed breastfeeding pillow or two across your lap to help raise your baby up to the level of your breast. While you may be content with cradling your baby in your arm(s) as she breastfeeds, trust us when we tell you a few well-positioned pillows placed under your arms can work wonders and spare you some unnecessary aches and pains. As you get into the finer points of positioning, you also can try what is referred to by breastfeeding experts as the cross-cradle hold. With your baby lying across your lap ready to nurse on your left breast, you can use your right arm instead of your left, as in the typical cradle hold, to support your baby's head and body. For either type of cradle hold, whichever arm you are not using to support your baby's head and body is free to help position your baby's mouth onto your nipple.


Excerpted from "Heading Home With Your Newborn"
by .
Copyright © 2015 Laura A. Jana, MD, FAAP, and Jennifer Shu, MD, FAAP.
Excerpted by permission of American Academy of Pediatrics.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents

Getting Ready to Head Home,
CHAPTER 1 Breastfeeding,
CHAPTER 2 Formula for Success,
CHAPTER 3 Bottles and Nipples,
CHAPTER 4 Going With the Flow,
CHAPTER 5 To Pee or Not to Pee,
CHAPTER 6 Poop Happens,
CHAPTER 7 Other Unmentionables and Inconveniences,
CHAPTER 8 Spitting Up and Vomiting,
CHAPTER 9 Sleeping Like a Baby,
CHAPTER 10 Crying,
CHAPTER 11 The Art and Science of Diapering,
CHAPTER 12 Baby Bath Basics,
CHAPTER 13 Clothing and Accessories,
CHAPTER 14 Taking Care of Yourself,
CHAPTER 15 Baby Brain Basics,
CHAPTER 16 Do You Understand Me Now?,
CHAPTER 17 These Hands Were Made for Talking,
CHAPTER 18 Fun and Games,
CHAPTER 19 Books and Babies,
CHAPTER 20 The Sounds of Music,
CHAPTER 21 Media Matters,
CHAPTER 22 Car Safety,
CHAPTER 23 Flying the Family-Friendly Skies,
CHAPTER 24 Choosing Child Care — Insider Tips for All Those Who Care,
CHAPTER 25 Finding the Right Baby Doctor: A View From the Inside Out,
CHAPTER 26 Head to Toe and in Between,
CHAPTER 27 Fever: Trial by Fire,
CHAPTER 28 Seeing Yellow: Jaundice,
CHAPTER 29 Getting to the Points: Vaccines, Your Baby, and You,
CHAPTER 30 Birth Memories,
CHAPTER 31 Commemorative Birthday Creations,
CHAPTER 32 Capturing Moments Along the Way,
CHAPTER 33 Sharing the Memories,
Parting Insights,

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