Monday, 2 January 2012

Working in the community

Before Christmas I was working in Community which I do love. I particularly like it when I see women before and after the birth of their baby, or to see women on their first day home and then to see them when they are being discharged. In both situations, I have witnessed many changes in the women. I have witnessed the nervous woman become a confident mother, and I have witnessed the confident professional become very unsure and lost when faced with a tiny helpless baby. Babies are certainly unpredictable and it doesn't matter how many books you read before they are born, you simply can't be fully prepared.

One of the most common questions to be asked as a Midwife is "is this normal?" - this might be during pregnancy or after the birth but it gets asked a lot. 99% of the time (a guess, I haven't sat and worked out a statistic)  I would say yes, that it is perfectly normal. Babies are born with their own personalities and all we can do is respond to their needs to the best of our abilities. In the early days this often means trying to guess at what they need...mentally going through the checklist - hungry? nappy needs changing? too hot or too cold? tired? It's all guess work really until you can begin to learn your baby's cues.

Frequently new mothers ask about how to get their baby to sleep in the moses basket/crib/cot...anywhere rather than lying on Mum. Don't worry I did the same myself, in fact I think I spent the first 2 years of my eldest's life wondering and worrying about how to get her to sleep anywhere but near or on me - she had to be in contact in some way, whether lying on me or just having a hand on me. Generally I advise new mothers to cuddle their babies...shocking I know...but the baby has spent 9 months inside Mum, able to hear her heart beating as a constant sound, and never before having experienced hunger, temperature, gravity and yet we expect babies to suddenly sleep by themselves. Birth is a shock to them and they need reassurance and comfort. I also advise trying putting something that smells of Mum in the crib, warming the crib with a hot water bottle (ensuring to remove it before baby goes in) so it's not suddenly cold on their back, giving baby to Dad to settle for sleep, a slumber bear if they can afford one but what works for one baby won't work for another, and sometimes what works one night won't work the next, and sometimes it feels that nothing works at all. It can simply be a case of give it certainly was the case with my eldest daughter. My younger daughter was far easier - she'd sleep anywhere! I certainly don't believe it was anything I did that made her more likely to sleep, just that she was born with that kind of personality. So give it time, cuddle your baby, try these things by all means but I promise that at some point, your baby will be able to go to sleep by themselves. I have been on the receiving end of such advice and at the time it felt like useless advice, the tiredness was relentless, and that even one more night was one night too many but I hope it brings comfort to know that yes this is normal for many babies.

I seem to have wandered into the realms of sleepless nights and generic advice but it is something that new mums ask about so often that I feel it's worth discussion. Certainly I feel that the lack of sleep I endured when my children were younger has prepared me well for night shifts as a midwife. As a breastfeeding mother helper, helping to run the group, the women that came along would frequently ask for help with sleep and their babies. We live in a society where "sleeping through the night" appears to be main focus, the ultimate goal, particularly in the early days and then with some desperation as time goes by. However if were simply to accept that babies wake in the night for an indefinite period of time, is it not easier to cope with? That actually the norm is not for babies to sleep through the night, but for them to wake regularly to feed and that at times they will sleep for longer and other times they will wake more frequently, such as during growth spurts which again are normal. I know that I found it far easier to deal with my second child's nightly wakings because I was prepared for it. I was still exhausted at times, and I still complained about it but I didn't waste energy trying to fight it or find an answer to it. I tried things to see if it helped but I didn't worry if it didn't, I just recognised that she wasn't ready yet. However I did have the advantage of not working at that time, I wasn't yet a student either. My eldest spent mornings at nursery so I used that time to catch up a bit and rest.  I think we have a tendancy in this country to try and push ourselves back to normal as soon as possible and actually we'd do well to stop and learn about our babies, spend time with them, allow time to recover from the birth properly...focus on what's important...not on having a show home, or getting out and about as quickly as possible, make use of friends and family to help out if you can. This is of course all very idealistic and I do realise that but I can dream, at least when I'm allowed to sleep that is. At the very least I think this is useful advice for those very early days....stop, rest, recover and cuddle your baby.

Photos courtesy of Marie Donn Photography