Buch lesen: «Gentle First Year: The Essential Guide to Mother and Baby Wellbeing in the First Twelve Months»

To my parents, who are the best; to my boys, who make me

want to be the best.

Contents

Cover Page

Title Page

Dedication

Foreword by Stella McCartney

Introduction: A Shared Journey for Mother and Baby

Part 1: Recovery

1 - The First Week

Embracing Motherhood

Bonding with the Baby

Sleep Bonding

Water Bonding

Touch Bonding

Play Bonding

Breastfeeding

The Different Stages

How to Make Great Milk

Emotional Minefields

Baby Blues

Postnatal Depression

Birth Acceptance

Visualization

Baby

Post-partum Care

Mother

Birth Recovery

Birth-specific Treatments for Mother and Baby

Episiotomy, Vaginal Bruising, Ventouse

Caesarean Birth

Pre-term Babies

2 - Two to Twelve Weeks

Baby

Crying

Crying as Communication

Sleep

Overtiredness

Getting Your Baby to Sleep

Cot Death

Massage

Massage Routine

Play

What is Baby Play?

Baby Care

Weeks One to Three

Weeks Four to Seven

Weeks Eight to Twelve

Vaccination

Mother

Getting Your Body Back

The First Six Weeks

Weeks Seven to Twelve

Ayurvedic Diagnosis

Ayurvedic Recipes

Menu Choices

Exercise

Pelvic Floor Exercises

Sleep

Postnatal Insomnia

Mother’s Care

Birth Recovery: Two to Six Weeks

Pregnancy Recovery: Seven to Twelve Weeks

Treatment Summary for Practitioners and Partners

Part 2: Discovery

3 - Three to Six Months

Baby

Sleep

Physical Independence

Teething

Dental Routine

Mother

Sexual Relationships

Body Image

Breastfeeding

Schedule for Dropping Feeds

4 - Six Months to One Year

Baby

Weaning

When to Start

First Foods

Allergies

Meal Ideas

Separation Anxiety

Mother

Returning to Work

Pre-conceptual Care–Getting Ready for Next Time

5 - Mother & Baby Health A–Z

Baby

Neonatal Conditions and Illnesses

Mother

Common Postnatal Conditions

Support & Resources

Further Reading

Searchable Terms

Copyright

About the Publisher

Foreword

It has taken me far too long to try to think of what to say about Gowri. How do you describe a lady who you feel changed your experience of giving birth, a woman who thinks of her mothers and readers as if they were her children, someone who you believe contributed to you and your child?

I honestly believe that Gowri is a one-off and I feel so lucky to have been able to learn from her great knowledge and affection. It is brilliant that everyone can now share the Gowri experience through her books: becoming aware that we are animals experiencing mother nature’s magic, learning how to open your body to its journey ahead and to connect with the most amazing thing inside you – your little baby. Both before and after birth, Gowri teaches you to visualize what is going to happen to you, and to understand how to make that as easy as possible through diet, exercise and just taking the time to breathe and pause! Gowri taught me what was happening physically to me and my baby and she also opened my mind to what was happening spiritually.

There is so much information available to us now about how to optimize our pregnancy that we can almost forget that there’ll be a baby at the end of it! It’s as if the journey becomes the destination. And that journey has continued after my baby’s birth as well. There is so much to absorb and learn in the first few months of becoming a mother, and I have been so grateful for Gowri’s support and expertise. She had lots of tips for soothing the baby to sleep and her medical training meant that I could really trust her advice when he was out of sorts! But as much as anything, my greatest comfort was knowing that my post-natal recovery ensured that I could dedicate all my energies to being the best mother I can be. I am sure that by reading this book you too will experience the Gowri phenomenon and enjoy the most important journey life can ever give you – the gentle first year.

Stella McCartney

Introduction

A Shared Journey for Mother and Baby

At every birth, two people are born – a baby and a mother.

Ancient Indian wisdom

It’s a common complaint that after nine months of getting seats on the bus and foot rubs by night, the mother is all but forgotten when the baby is born. She might have a sore perineum and afterpains, but this just can’t compete for attention with the baby’s patch of fuzzy hair and ten perfect toes. This sudden neglect has always seemed strange to me because in India, where I grew up, the birth is regarded as a rebirth for the mother too.

Motherhood reveals a woman’s best self, ready to nurture and compromise for love of her child.

All new parents aspire to being and doing their best for their babies, and it’s important to recognize the journey the mother has to take, as well as her baby. This fundamental oversight is repeated at many different cultural levels, and it’s not just partners and new grandparents who are at fault. Have you noticed how most baby books take sides? Some empathize with the baby – tiny, exhausted and completely dependent upon you; others go with the mother – huge, exhausted and completely dependent upon the midwife. The principal ambition of this book is to tell both sides of the story, because you and your baby both have a lot of growing and learning to do in this first year.

Those of you who followed the programme in my first book, The Gentle Birth Method, will know I regard pregnancy as a shared journey between mother and baby, and that I use a variety of different techniques – such as visualizations and self-care – to promote deep bonding in utero. The Gentle First Year builds on this foundation by nurturing your emotions every bit as much as your body, and showing you how to do the same for your baby.

the importance of bonding

If these twelve months are a mountain you must scale together, the success of the climb rests on the preparation made at base camp.

Bonding underpins both my prenatal and postnatal programmes. I believe that the more you can do to cultivate it (massage, songs, eye contact, play), the more mother and baby will thrive. If these twelve months are a mountain you must scale together, the success of the climb rests on the preparation made at base camp. I believe that the best start for every mother and baby is an intensive and exclusive confinement period in what I call the ‘red tent’, which eclipses everything other than getting to know each other. And I’m not alone in thinking this – I’ve got the weight of history on my side too.

the red tent

Much of my first-year programme is rooted in this ancient postnatal concept. The red tent has been passed down from the nomadic communities of the Jacobi era in the Middle East and still exists in modified form in my native India. The red tent refers literally to the tent to which the women retreated during their menstrual flow. Men were prohibited from entering, and all duties – cooking, cleaning and sexual relations – were suspended until they re-emerged three or four days later.

Why is this relevant? Well, apart from being used for this monthly hiatus, the red tent was also a post-partum retreat, where the new mother and baby rested, recovered and were restored from the birth for 40 days. During this time, the mother did not come out of the tent, but literally fed and slept with the baby, and was massaged and tended to by the other women.

It is still customary in India for the expectant woman to stay at her parents’ home from the 28^th week (seventh month) of pregnancy, and then for three months after the birth. The mother rests in a specially designated room where she is nourished, nurtured and allowed to heal in much the same way as advocated by the ancients. I grew up seeing at first hand the restorative effects of such intensive post-partum care. It is my wish to prescribe to my mothers a unique, powerful – and empowering – postnatal programme, which integrates these philosophies of the red tent with mainstream medical practices.

creating a cocoon

Of course, for the Western lifestyle, a literal interpretation of the red tent confinement is unrealistic. Many mothers try to discharge themselves from hospital the day after the birth, so convincing them to stay in a room for three months is hardly a viable option. But what is relevant is the idea of ‘cocooning’ yourself, drawing a metaphorical curtain around you which shields you from the demands and pressures of daily life. Life is not normal in those first three months – your sleep is broken, your body may well feel battered and bruised, and you face great challenges as you ease your baby into this noisy, bright world. But recovery and discovery lie before you, and the bond you cultivate with your baby has the transforming power to change both your lives.

tips for moving beyond the red tent

The wisdom behind the confinement of the red tent is to promote rest, recovery and deep bonding. My strongest advice to new mothers is to stay at home as much as possible – certainly for the first three weeks, ideally up to six weeks and, in my dreams, up to three months. But there invariably comes a time when the outside world must become part of your lives again, and although you might have to go out with the pram to do the weekly shopping, it’s also lovely to go for a gentle walk around the park. When you do start to go out together, dab a drop of Australian Bush Flower remedies – such as Angelsworth or Fringed Violet or the easily available Rescue Remedy – on the baby’s fontanelle. This will soothe the baby from the cacophony of outside stimulus and can become a comforting ritual on your first excursions together.

how this book will support you

I feel this book will have succeeded in its purpose if it helps you to receive physical assistance in the early weeks after the birth, and emotional support for the developmental and nurturing issues which come thick and fast in the first year. You will find that the emphasis of this book naturally shifts as the baby grows.

In the first three months, the principal issues are physical. We can, together, help treat and heal any specific trauma you may have suffered from the birth; advocate treatments that fine-tune your body’s transition out of the pregnant state; as well as addressing and resolving your emotional issues surrounding the birth. For your baby, we can explore how to make him or her feel emotionally held and secure; advise physical treatments that eliminate any residual pressures from the birth; boost natural immunity; and offer practical tips to help soothe, calm and settle your baby into deep slumber.

After navigating this intense healing period of the first three months, the emphasis moves to a more emotional plane, showing you and your baby how to enjoy each other. I am opposed to the hot-housing trend, which places undue pressure on early achievement, and firmly believe that babies thrive when nurtured by delighted and committed parents.

It’s not the ‘big’ things that matter – like speaking French or sleeping through the night – but the delicious little gestures that convey love, security and comfort.

To paraphrase John Lennon, ‘Life is what happens to you whilst you’re busy making other plans,’ and there couldn’t be a better sentiment for parenting. It’s not the ‘big’ things that matter – like speaking French or sleeping through the night – but the delicious little gestures that convey love, security and comfort. A cashmere teddy bear may be intended as a big show of love, but a bedtime massage feels just as blissful to your baby; what’s more, it is profoundly bonding and can become a much-loved part of your daily routine. So find the extraordinary in the ordinary, and look for joy – not perfection – in the details.

If having a baby takes away many things – freedom, independence, sleep, seats on the bus – it also gives back so much more: a sense of wonder, bold curiosity, seeing the world with fresh eyes again. A rebirth, perhaps!

PART ONE

CHAPTER 1
The First Week

Embracing Motherhood

Bonding with the Baby

She knew very well how babies smell; she knew precisely. ‘Well,’ the wet nurse began. ‘… They don’t smell the same all over, although they smell good all over. Their feet, for instance, smell like a smooth warm stone, or like fresh butter … And their bodies smell like a pancake that’s been soaked in milk. And their heads, up on top, at the back of the head, where the hair makes a cowlick … here is where they smell best of all. It smells like caramel. Once you’ve smelled them there, you love them whether they’re your own or somebody else’s.’ Perfume, Patrick Suskind

Having delivered thousands of babies over the years, one of my favourite moments is watching the new mother smelling her newborn baby’s head for the first time. Most are hardly aware they’re doing it, but in that split second when the mother inhales the exquisite scent of new life, she falls in love. After nine long months, she can at last see her baby, touch her baby and hear her baby, but it’s when she smells her child’s pristine dewiness that the cocktail of bonding hormones really starts to fizz. And it’s not just a temporary kick. Years later, mothers can be found wistfully sniffing talcum powder bottles in supermarket aisles and wearing talc-based perfumes (astute perfume houses cottoned on to our nostalgia long ago).

Happily, it’s a requited love. Whilst it takes weeks for the baby to decipher faces and sort out voices (everything sounds muffled in the womb), a newborn infant can detect the smell of her mother’s milk almost immediately. It has been shown that a minutes-old baby, placed on the mother’s tummy, will grapple, heave, shake her head from side to side, nuzzle into the mother’s breast and find the nipple to suckle, led entirely by smell.

It’s an amazing thing to see in action. At every birth I attend, I’m always looking for that transforming moment when the fundamental survival instinct and urge to protect becomes something deeper and more spiritual; an impulse that takes a parent beyond the instinct to merely raise a child to maturity, and actually nurture, cherish, indulge and adore the child to its best possible self.

We all know this as bonding, of course, the pop-psychology buzzword for the modern parent. But whilst bonding is indeed an inherent part of parenthood, we don’t always acknowledge that it is not an automatic response. If you want a deep, nourishing relationship with your child which soothes your soul, then it will need tender cultivation, shared experience and, yes, a smattering of hormonal alchemy.

There’s a line in Lucy Atkins’ book, Blooming Birth, which really resonates with me: ‘Birth is just the start – parenting’s the biggie.’ She’s absolutely right, and the biggest help you can have when negotiating the myriad minefields of toddlerhood, pre-pubescence and adolescence is the solid bond you establish with your child during your pregnancy and at birth. Bringing with it an empathy, sensitivity and kindness that endure throughout the myriad experiences life throws at you, it starts right here, with your newborn and her soft, fuzzy head.

why bonding matters

The endorphins released mutually by mother and baby during the birth process are very important for the deep bonding and mutual attachment necessary for the survival of the infant. This is one of the reasons why I work so hard to deliver gentle births that will promote greater levels of endorphins being released at birth. In the interests of mother–child bonding, health professionals should be geared towards preventing fearful births where the fear hormone, adrenaline, inhibits endorphin production.

Sleep Bonding

My Mother came to me and lay down beside me, and the warmth of her body comforted me. Secure in the knowledge of her love, I began to cross over into sleep.

The Red Tent, Anita Diamant

The bonding power of sleep is profound. Sleep is the ultimate surrender, when we are most vulnerable, and it’s impossible to attain if we do not feel relaxed, safe and warm. As adults we wouldn’t dream of sleeping with – or even near – someone we didn’t like or trust, and it’s very much the case with babies too.

In every respect, you are your baby’s protector. I am a firm believer in the emotional and physical benefits of mother and baby sharing a room – if not necessarily a bed – in the early weeks. Hailing from the red tent culture, I have seen at first hand the evident security this arrangement bestows upon the child. After all, having spent nine months drowsily curled up in the womb listening to the regular thud of your heartbeat, the immediate touch, sight and smell of you, the slumbering mother, is the next best thing to those warm, cosy waters. For mothers and fathers too, there is no greater sense of joy and peace than when their baby is blissfully asleep in their arms.

Shared sleep is indicative of shared love, and if you find that you can sleep through the grunts, snuffles, chatters and snores of a sleeping baby, then there is nothing more wonderful.

BEDSIDE CRIBS

A crib next to the parents’ bed is the ideal scenario in my opinion; or even better, a bedside cot with one side that opens out completely to annexe to the mother’s side of the bed. These save the mother from climbing out of her warm bed (especially in the cold, dark winter months), and she can easily slide the baby back into the safety of the cot’s confines after the feed. All the big baby chain stores like Mothercare and John Lewis sell these bedside cots, but check the height before you buy. The height of the cot may not be compatible if you have, say, an iron or a sleigh bed.

BED SHARING

Sharing a bed is a trickier issue. In principle, it seems the most natural option, but that doesn’t mean it’s the safest – there have been various tragic incidents in which the mother or father has inadvertently smothered the baby in their sleep. Alcohol, drugs, medication and extreme exhaustion are all risk factors, but there have even been instances when the baby has been suffocated by the mother’s milk-swollen breasts. UNICEF and the Royal College of Midwives recommend no co-sleeping under three weeks of age. The advice I give to my mothers is to share a room, not a bed, with the baby at night.

Case History: Karen and Ollie

I had read all the books saying not to rock/feed/carry your baby to sleep but Ollie was a restless baby, and in the early weeks that was the only way I could get him off to sleep. Still, by the time he was about eight weeks old, I knew I had to start to teach him to sleep without relying on stimulus from me. So, at his morning and afternoon nap, I began to lie on the bed with him. I turned him away from me so that he wouldn’t think he was getting a feed, and would curl my arms and legs around him, with the top of his head nuzzled under my chin, and just the feel of my body, my warmth and my smell to reassure him.

For the first couple of attempts to put him to sleep, he cried for up to 40 minutes on and off, which was pretty hard to bear. But I stuck with it and very soon he understood that when we lay down together, he was just going to have a little sleep. I didn’t sleep with him at night, so it was absolutely blissful to share that 30-minute nap with him in the day. We both slept so heavily – I’m sure our pheromones must have knocked each other out – and it kept me going at that point when the broken nights were really beginning to take their toll.

Strangely, I would always wake about 30 seconds before he did; he never once woke me up. I could actually hear his breathing change once I started to stir. When I moved him to sleep in his cot, a month later, he was absolutely fine about it and went straight to sleep without crying, but I still needed the naps too – my husband jokes that he sleep-trained me, rather than the other way round! But I’ll always treasure our baby naps together. I’m convinced they contributed to the powerful bond between us.

interesting fact

Many of my mothers claim to wake in the night moments (up to two minutes) before their baby. We still don’t know why this happens, but anecdotal evidence suggests there is a higher likelihood of it occurring where there’s a strong bond between mother and baby.

BABY HAMMOCKS

In India it is traditional to tie a sari lengthways as a long, low-slung hammock from a ring on the ceiling, so that the baby is suspended about 30 inches above the floor. The sari tied in this way is called a thottil (‘cradle’) in southern India. The thottil creates a soft cotton sling for the baby, rather like the one depicted on birth announcement cards showing the baby being carried in a sling by a stork. Sometimes, a long piece of cotton can be used to tie the thottil instead of a sari. This is called a dhoti, which men wear like a sarong. The baby feels very comfortably held within this soft cotton sling. It allows good circulation of air, and deep sleep is promoted by the baby’s spontaneous movements that rock the cradle.

Mothers who work in the fields in India resourcefully tie a sari onto the branch of a tree to create a cradle, and place their infant within. It is common for tourists travelling through India to be charmed by the sight of babies hanging in thottils from the trees!

The thottils are most commonly used in villages and in traditional families, but rocking cradles made of cane are also the prized possessions of many mothers. My mother had a rocking cradle for me and my siblings. I remember her rocking my youngest brother to sleep, and I often crept into the room to rock the cradle.

And it’s not just an Indian tradition. The Mexican culture has historically endorsed hammock sleeping too, and now Australia is following suit. Neonatal units there have studied the positive effects of babies sleeping in baby hammocks and have reported many positive benefits, particularly better quality sleep. Mainly this is because of emotional security, as the baby feels snug and held, as if the sling is an extension of the womb or loving arms. But head support – and comfort – seems to play a role too. In particular, it was noted there was a dramatically reduced incidence of Flat Head Syndrome, a phenomenon increasingly seen in the West as a result of neonatal advice that babies must only be laid on their backs. I do not contradict this advice at all, but I do advise those mothers whose babies show signs of developing Flat Head Syndrome to place them in a hammock or thottil for a couple of hours each day. I recommend buying a baby hammock from www.babyhammocks.com as these have passed all safety checks.

SEPARATE ROOMS

London is a city of lanky Georgian and Victorian terraces, and I inwardly despair when I hear my London mothers relate their middle-of-the-night stories with the baby ensconced on an entirely different floor in the house. Not only is the baby isolated, but also the poor, exhausted mother is trudging up and down several flights of stairs each time the baby stirs. Some of my mothers consider this the easier option, however, and I do sympathize when they say they simply cannot sleep in the same room as their baby. Hormones are running at such a state of high alert anyway that every whisper and sigh their baby emits can drag them out of sleep and leave them permanently exhausted. This is no good to anyone and can compromise the quality of the mother’s milk.

If you do choose to place your baby in a separate room, there is still plenty you can do to make sure the baby feels secure:

 Respond to the baby’s waking cries quickly. She needs to see you and smell you as soon as she can, as this will reassure her that you are always at hand when she needs you.

 For the first few weeks, put the baby to sleep in a swinging crib or place the baby’s Moses basket inside the big cot, beneath the mobile.

 When the baby has outgrown the Moses basket/crib (by around twelve weeks) put the baby to sleep in the big cot, under the mobile, which by now should be familiar.

 Place the baby to sleep on a baby sheepskin. These really do comfort babies, making them feel held, and they seem to sleep more soundly on them. The baby sheepskins are sheared to an extra-short length but, if you like, you can place the sheepskin under the baby’s cot sheet.

 To make the big cot seem smaller, roll up two clean cellular pram blankets and lay them either side of the baby’s waist, like mini bolsters. These help the baby feel more secure and confined, again echoing the womb. Equally, you can buy special baby mats, which have attached bolsters at the sides.

 Another tip is to roll a larger cellular cot blanket lengthways and loop it in a U shape. The U-bend should pat up against the baby’s bottom, with the baby’s legs hanging bent over the blanket and the blanket running up the baby’s sides. This really helps the baby to feel held.

 If you have a cuddle cloth, tuck it next to your skin in your bra so that it absorbs your smell. Then you can tie this to the cot and help reduce any separation anxiety.

SWADDLING

One of the hardest things for the new parent – particularly the new dad – is getting used to the tiny proportions of the newborn body. An adult’s big hands and strong arms can easily feel clumsy when that little body is flailing and wriggling about. But swaddling can really minimize that awkwardness. Swaddling is an age-old custom that crosses nearly every culture in the world – from Eskimo babies in sealskins, African babies in kakoi slings to Japanese babies swaddled into the silken folds of obi wraps. Swaddling is fantastic for helping a baby feel secure. Keeping the arms and legs bound in a secure wrapping mimics the confines of the baby’s beloved womb. When the baby is born, one of the most pronounced birth reflexes is the Moro, or startle reflex, when the baby suddenly throws out her arms and legs when startled. The Moro reflex is an involuntary response to threat and acts as the earliest form of ‘fight or flight’ response. This is generally more pronounced in boys than girls, and begins to fade away gradually from three weeks. It can be alarming for the baby who, at this point, has no idea that those flailing arms and legs are actually her own and often scratches herself, hence the need for scratch mittens.

I recommend swaddling the baby in a cellular cotton blanket for the first three weeks to give her the feeling of the continuity of being held in a womb. After this time, the baby usually starts to wriggle out of it. You can then move on to swaddling the baby under the arms so that the body and legs feel held but her arms can stretch out. After a couple of days of contented sprawled sleeping, the baby is ready to go into the now-popular baby sleeping bag.

note

Only ever use a cellular blanket for swaddling, as the intrinsic holes within the cellular blanket will provide a crucial air supply should the blanket go over the baby’s face. The risk of this increases as the baby gets bigger and stronger, as the increased wriggling dislodges the blanket off the shoulders and moves it up around the face, risking suffocation.

how to swaddle

1 Take a cellular blanket and fold one corner up to the opposite corner, making a triangle.

2 Place the triangle so that the longest straight edge is arranged at the top.

3 Lay the baby down on the centre of the blanket, with her shoulders just an inch or so below this long edge.

4 Check that the lip of the blanket doesn’t protrude so high above the shoulders as to cover the baby’s mouth when she turns her head to the sides.

5 Take one corner from the right or left (whichever is shortest, depending upon how centrally you’ve placed the baby on the blanket) and snugly wrap it around the baby’s body. Make sure the baby’s arm is placed down at the sides, and pull the blanket down and around so that the corner can be tucked under the baby’s bottom. Keep the tuck as flat as possible so it’s not bulky and uncomfortable beneath the baby’s body.

6 Pull over the remaining corner – again in a downward direction, with the baby’s arm down at the corresponding side, and tuck under the baby’s bottom. Again, keep the tuck as flat as possible.