Children: the User’s Manual

(Warning: I will randomly switch pronouns from “he” to “she” as the mood strikes me. My kid was male, but babies can be either.)

Chapter 1 Infants

The nurse puts the baby in your arms, makes you step out of the wheelchair, and then she takes the wheelchair and goes away. I was terrified. Here’s this little red squeaking thing with a cone head, and we didn’t have the faintest idea what to do next. We didn’t know how to hold him. We didn’t know how to dress him. I had basically failed my breast-feeding lesson. We figured out that our car seat was the wrong kind as soon as we got him into it. And vaguely, in the back of our heads, the knowledge dawned that people would blame us if we couldn’t keep him alive successfully, and that if we didn’t nurture him properly he would discuss it indignantly with his therapist in twenty or thirty years.

In this awkward situation, many couples consult useful books which disagree with one another. Another approach is to just transmit whatever pathologies your parents practiced on you. My husband and I decided that if this was going to be our major project for the next twenty years, we had better talk about it a lot and try to figure out what we really were trying to do—even if we didn’t always do it right. We decided our goal was to be conscious about what we were doing and as consistent as we could be in execution.

Along the way, I developed some theories, had a whole lot of fun with child rearing, and raised a pretty good kid.

This book is not a text by an expert. It is partly a narrative of my own story, and partly an attempt to show how childrearing can be a deep and richly rewarding adventure in connection and authenticity. Pretty lofty, eh?

This first chapter is divided into Concepts, Skills, Bits of Useful Information & Advice. But do go read standard books by experts too (and I’ll reference along the way any books I found particularly useful). Pediatricians, nurse practitioners, experienced moms, and other experts can be incredibly helpful for inexperienced parents, especially in that blurry first few weeks. I am making no attempt here to transmit technical information about babies. The point here is to talk about the human condition, & that includes babies.

I. Concepts.

There are several main goals for the first 8 weeks of the baby’s life. The first, and really only important one is not to kill it. (This is simpler than meets the eye. The little suckers look incredibly fragile, but actually they are programmed to survive. It is true that terrible things happen from time to time, but it is amazing all the things they can survive. In fact when babies die it is generally just because of a birth defect or strange illness--one of the tragedies of life-- & not the parents’ fault.)

In order to not kill the baby the first couple of months all you have to do is learn how to feed it, remember which things that go wrong with a baby are serious (most of them are not) and don’t let it get infected. (Hug it a lot too.)

The first few weeks is also a time, in between feedings, to think about what you are trying to do in raising this infant to be a productive and reasonable adult. Here’s mine:

The THEORY (which affects every aspect of how I approach childrearing) has three parts: 1) Treating other humans, even small ones, with respect, and requiring mutual respect.

2) Consciously supporting the development of their self-esteem by loving them and connecting with them; and 3) Giving choices wherever possible, while setting limits when necessary.

“This is pretty heavy stuff,” you might think, looking down at your squirming little blob of protoplasm. In the first few weeks there are times when you may think that the child is just a little milk ingestion & poop excretion machine. But there is actually a whole lot more going on.

Here is how these concepts affect the first two months of the infant period, in which a little alien morphs into a family member:

1) Respect: The mute disabled genius theory. Many people treat babies as little objects. They do things to them, but don’t relate to them as humans. I think this is 100% wrong. I tried to think of Andrew as being a fully intelligent alert member of the family. I treated him as though he were a full-fledged family member who happened to be temporarily quadriplegic, extremely inexperienced, and unable to speak English. My job from day 1 was to do physical therapy, teach him language, and then use language to help him in acquiring experience. But in the meantime I treat him with the respect I would treat my husband if he were suddenly disabled & lost his language skills.

So, for example, when the baby cries—it is because he has some problem that is making him urgently unhappy. You may or may not be able to fix it, but it deserves your IMMEDIATE attention. I would run down the hall to get there as quickly as possible. I also developed a tradition of singing a song (always the same song) as soon as I heard him crying so that he knew I had heard and was leaping to attention. The benefit of this little technique is that by the time he was six months old he would stop crying the moment he heard me begin to sing, because he had faith that me singing meant I was on my way & that his needs would be met as soon as I could reasonably get there.

Using this concept makes you think differently about how you act with the baby. I talked to him all the time—part of my job as his English tutor. I also commiserated with him about the horrible & traumatic experience he had just come through. Bad as labor is for the mom, it has got to be worse for the kid. I made sure, especially in the first few days, that he spent a lot of time on my belly listening to my heartbeat, because that would tend to be the only thing that he had heard before and so would probably be comforting. I looked into his eyes. Mostly I talked in a normal voice, the kind of voice I would like him to respond to—not the high squeaky voice that humans use when they talk to pets. (That doesn’t mean I never used baby talk at him, but only when I was adoring him, not when I was conversing.)

2) The self esteem goal. In the first month, the main goal is to convince the baby that you love her. It is up to you to consider how love is to be expressed in your family. Every family has different rules about that. Your Child’s Self Esteem (by Dorothy Corkille Briggs) says that self esteem consists of feeling competent and feeling loved. If you make them feel loved but not competent they won’t have self esteem & if you make them feel competent but not loved, they won’t have self esteem. In the first month, there is not much they can feel competent about except nursing, so you need to make them feel loved. Don’t worry about getting on with your life for a while. The reason doctors approve six or eight weeks maternity leave is not so that you can go do things. It is for lying about in your bathrobe, with the flaps on your nursing bra down, curled up on the bed in a circle around that baby and telling him that he’s the very best and cutest baby that there has ever been in the whole world, and kissing him a lot. Both of you, not just the mom. (The dad doesn’t have to wear the nursing bra, but he’s got to adore the baby too.)

3) The choices goal. My job as a parent is to get my kid ready to be a self sufficient, competent member of humanity by the time he is 18. That means I need to distinguish at every point when it is appropriate for me to tell my kid what to do and when I should let my kid choose. A one month old baby has almost no ability to wait, or to choose how to react. It is almost all programmed. So at 1 month, they get to choose everything—which is when to eat, when to sleep and when to poop. The only choices you get to make are breast versus bottle and disposable versus organic diapers. (I chose breast and feel it is important in the first month because of the allergy protections; I chose disposable & feel guilty about it.)

The odd thing, of course, is that they also get to choose nothing during this period. They can’t choose what they wear, or how you hold them. They can’t tell you that their diaper chafes or that they have gas. So it is detective work to really think about them, put yourself in their place, and see if you can figure out whether they always cry when they wear the green play suit, and are happy in the yellow one. (The green one may be scratchy). Or if they cry less when wrapped tightly in a receiving blanket. Begin the process you will continue for the rest of your life of trying to see your child as an individual and respect her opinions in the areas where you can.

There are various skills that you need to learn if you haven’t ever dealt with before. There are books that teach them. Buy some. Also ask older women who have done this before. Penelope Leach’s Your Baby and Child can’t be improved upon for the first month. Get it. Read it. Several times. Do what she says. Here is a brief & inexpert summary of the skills that you need to know:

1. How to pick up a baby. It is really important in month one (and particularly the first couple of weeks) to support the head at all times. Their neck muscles are not strong enough to hold that big old head up. (They can’t sit in a regular car seat even—you have to have an infant car seat that leans them back.) When you pick her up, put one hand holding the head and the other hand holding the body and then when you cradle her in your arms one hand supports the head or if you hold her up against your shoulder, one hand supports the head. She’ll let you know when she doesn’t need it any more. (By the way, do not freak out if your baby doesn’t do skills on the time schedule in baby books. Babies are wildly inconsistent about when they develop some of the skills. Ask your doctor if you get worried, but keep your ego out of it.)
2. Umbilical Cord. They come to you with this icky looking umbilical cord stub. It is ugly and black and oozy and you have to take care of it so that it doesn’t get infected. They will tell you how to take care of it in the hospital and also Penelope Leach says what to do. It will fall off after a while & then you’ll have a nice belly button to clean. Just do what they say and don’t freak. It doesn’t last long. The great thing is that during this period, you don’t really have to bathe the baby because you don’t get the wound wet.

3. Bathing the Baby. Babies don’t actually get all that dirty. Some books go mad about hygiene, but heck these babies spend all their time lying around pooping and drinking milk, but otherwise not getting that foul. And they are really hard to bathe. I’d go way easy on it the first month. Get a little baby bath, but if you just make sure you get the poop off their butts and the dried milk off their faces and wash them with soap every now and then, I would lay off the whole baby bathing procedure until she can hold her head up and is less squirmy.
4. Breast Feeding. It is important because the kid doesn’t come out with an immune system that is very good & your breast milk gives it some protection. Also helps protect against allergies. Also it is easier once you get the hang of it and so you can get the baby satisfied quicker without dithering around in the middle of the night trying to heat a bottle. It’s also fun, in a weird way, to see this kid launching himself towards you like a lamprey eel and then sucking contentedly away. Getting started is tough because your tits get chapped and hurt. There are various creams but the only thing I found that was any good was cocoa butter, available in large tubs at the pharmacy.

It is also not intuitively obvious how to get started with breastfeeding, and mostly the doctors don’t know, but the nurses and especially the nurse practitioners do. (My experience was that nurse practitioners are goddesses and know everything.) So ask the nurse at the hospital to show you how a couple times. Basically, you put your thumb on the baby’s chin and pull their mouth open and then clamp their head down so their mouth really goes “chunkily” around the nipple and then their instinct will take over & they will suck. What is tough is getting the mouth open. I didn’t get it right at first, but when my nurse practitioner came for the home visit she fixed me up.

Some people really CAN’T breast feed, so if you can’t, just give it the old college try for a few days and then switch to the bottle. Don’t panic. When you do switch to the bottle it is important to work out a technique so that it is easy and straightforward. I kept the expensive canned stuff around and made up a bottle in advance & kept it in the fridge so I could just spend 30 seconds heating it up and get the milk into the baby. (And I sang my song all the while—so we still call it the “milk song.”) Basically if feeding is taking too much time away from adoring the baby, it probably is wasting time. Adoring the baby is the top priority. Food should be easy both for the baby & the mom.

5. Sleeping. This can be a nightmare for families or it can be straightforward. It appears to be random whether the kid is a good sleeper or not, & there are many theories about how to fix it. I absolutely HATE the theory about letting the kid cry till they get over it because it treats the child with disrespect. I recommend starting immediately with a routine. I don’t mean a routine about when the kid sleeps. The kid controls that and it depends on when she gets hungry. Instead, define a concept of “night” as being distinct from “day” and make it clear from the time the kid comes home from the hospital which is which. We made an arbitrary decision about when “night” began. In our case, because I’m a morning person, night began at 8pm and day began no earlier than 4am. (Since the child will need to go to school with other kids, it won’t work to define night at beginning at 3am and day at noon. )

When the kid wakes up after “night” has begin—whether or not the parents are awake—you feed her in a darkened room, snuggle her in silence, and curl up with her in a dark bed or put her back in her crib. That is, you meet her needs, give her love, respond to her, but you don’t talk to her. When the kid wakes up and it is “day”—whether or not you WANTED it to be day—you get the baby up and play with it in a lighted room. After a month or so of this, the baby will begin to sleep longer periods at night and shorter periods in the day, and that means that after a few months you will stop being sleep deprived.

We lucked out. Our kid started at 2 weeks sleeping solidly from 6pm to 4am. This meant I had to get up an hour or two earlier than I wanted—but it seemed a reasonable compromise to get 10 hours off. So we let him make this choice—and for about a year “day” began at 4am. We had lots of nice dawn walks when he got a little older. And we were not sleep deprived at all.

6. Changing the Baby. What you do depends on what kind of diapers you use. The key here is to remember the first concept of the mute disabled genius discussed above & do as you would be done by. How do you feel about wet or stinky pants? Well, babies don’t like them either. Change her more often than necessary, dry her more thoroughly than obvious. She doesn’t like feeling that way and would prefer to be dry, thank you. I used the pants I would prefer to wear if I were incontinent, though I recognize that the environmentally pure approach is more complicated than that.

Pediatrician

Spend time on choosing one. It is important to get a pediatrician that you like. Ask your obstetrician to recommend a few, and ask friends who have children whether they like their pediatrician. Ask your friends what questions you should ask in interviewing the pediatrician. Then it is OK to call the pediatrician and ask to meet with them and interview them. If you have strong opinions about key issues (like, say, breast feeding or circumcision) then what the pediatrician thinks. If the pediatrician has a nurse practitioner this is, as I have said, good. Nurse practitioners are great because they tend to be very experienced and have good practical advice. And, oddly, they are also cheaper. My pediatrician had a policy that at week 2 the nurse practitioner made a house call so that the baby and mother could be seen without the baby being exposed to germs. I found this really helpful. (This is something to research in the 9^th month of pregnancy when you can’t do much else anyway because you feel like a beached whale.)

Be careful about illness the first month or so. Little babies can get very sick very fast. The symptoms of stomach flu (which is no big deal) and the symptoms of spinal meningitis (which can kill them) are about the same at 1 month—they stop eating and stop peeing and sleep all the time. If you feel inclined to call the pediatrician, do. If you feel inclined to go to the emergency room, do. It is much better to be safe than sorry. When the kid can talk & can tell you what hurts, then you can be less alarmist, but not at months 1 & 2, especially not at month 1. When in doubt, call.

Information & Advice. Babies don’t DO much the first few months, and there is considerable variation from one normal baby to the next. So sure, get child rearing books, and you will find out that they are supposed to raise their head and look around, bat at objects hung over their crib, (first by reflex & later intentionally). Eventually they recognize you and smile at you (an extraordinary moment), and towards the end of 8 weeks they might (or might not) grab something. But mostly they are a mouth and an intestine, but with eyes & a great big smile and a true personality.

The personality can assert itself unbelievably early. On Day 1, when Andrew lay, rather calmly, on my stomach in the hospital and we looked at each other “with a wild surmise” for several hours, I saw snippets of who he was and how we could relate, and that sense of him hasn’t changed. I remember the moment I fell in love with my baby, and it was the most transforming moment of my life.

That isn’t to say there aren’t bad points to this whole child rearing experience.

Some babies have colic & colic really sucks canal water. Basically babies with colic cry all the time—I mean ALL the time--and can’t be comforted. The trick is to do whatever the pediatrician or nurse says if you have a colicky baby and avoid your friends without colicky babies, who will give you condescending advice which is wrong. The only people to talk to if you have a colicky baby are people who have survived colicky babies. I know three former colicky babies (ages 15, 18 & 52) and they have stopped crying, though their parents have some fairly vivid memories. If your baby has colic it is not your fault. The baby won’t die of it and you won’t die of it. Pay people to hold your screaming colicky baby while you go have a double gin & tonic or go to the movies or whatever suits you.

Here is what my friend Kathy said about her colicky baby:

The only thing that saved us was being told that colic almost always ends at three months, which it did. A friend or caregiver to provide a break is, I think, the only real key to survival. Just someone to hand the baby off to so you don’t have to deal with her for a while, even if the friend is no more successful at shutting the kid up than you are. But you really do feel like placing the kid in the middle of the front lawn and just walking away. that was my fantasy after 52 straight sleepless hours. Easy to forget in the endless dark hours that you want to make the kid feel loved.

Non-colicky babies also cry, and it is very upsetting because they can’t tell you what’s wrong. I got some excellent advice from a friend about what happens when the baby cries and won’t shut up. Basically, the baby is trying to explain that it has a problem & it is your job to figure it out by inspiration or by elimination. So try these: 1) Feed her. 2) Change her; 3) See if she is too hot or too cold. 4) See if a pin is sticking her or something rough in her clothing. 5) Carry her. 6) Rock her. 7) Sing to her. 8) Burp her (they get gas stuck & it hurts). 9) “Bundle” her tightly in a blanket by wrapping one end around under their butt and then tightly bringing the other end around, like a straitjacket. Carry her that way. 10) Put her in her crib in a darkened room and go pour yourself a nice cup of tea. Or a martini, if that suits you. But not 2 martinis. (You will need to go through steps 1-9 in another few minutes if she doesn’t stop crying.)

Sometimes nothing works. Eventually they get exhausted & stop.

It is helpful to have a 2^nd person around the house in the first couple of weeks. It should be clearly understood, though, that your job is to bond with the baby and their job is to cook interesting meals, serve them to you in bed, and do the dishes afterwards. Having a baby is hard work and learning to deal with a first baby is hard work, and you may not be able to do much else. If you don’t have an appropriate friend or relative, hire somebody to come in and clean a couple of times and maybe do grocery shopping for you. It is worth it. Do not try to be superwoman. I tried to be superwoman and I ended up passing a softball sized blood clot at the end of week one and darn near ended up having to have an emergency hysterectomy. Rest. Relax. Adore the baby.

You need an unbelievable amount of things to take care of a baby. Car seats for each car (because it’s a huge pain to switch back & forth). A crib. A stroller. A backpack or tummy pack. Changing blankets. A horrid little syringe-like snifter thing for when he has a cold. The list goes on forever.

The key thing to remember is not to spend a lot of money on this stuff. They don’t stay babies for very long & unless you are planning on having a passel of kids, you will be giving it all away in a few short years. Instead, borrow or beg or buy cheap. Ask your friends with kids—they all have used stuff in the back room. Some pieces of equipment are optional. A changing table is fine, but any old table will do, & besides once the kid starts to roll it is easier to put down a towel & change them on the floor then to try to keep them from rolling off the changing table. So don’t spend money on these acquisitions. Spend money on people to come in and take care of you the first week instead.

Baby clothes are also mostly silly. They grow out of them about every fifteen minutes, and the cute things you got at the baby shower are generally difficult to put on and take off. I kept Andrew in various sets of pajamas until I no longer felt clueless about dressing and undressing him.

The first few months are tough for the baby too. He has had to leave his nice womb and go out in this air, and learn to eat a whole new way, and deal with all this light & sound. I think it is important to think about how you would feel if this had happened to you and treat the baby the way you would like to be treated. Some babies are portable & don’t mind going places, but others really just need a while to get used to this “life” stuff.

I didn’t take Andrew anywhere much the first month, and I didn’t encourage a whole lot of visitors, and never for very long. I didn’t go out to dinner or go shopping even, until I felt like he was happy and calm and ready to see the world. I know other moms handle this differently, and their kids seem to grow up OK, but I really tried to look at it from his point of view and figure out what he would enjoy and do that—especially the first few weeks.

Main bit of advice: Don’t panic. They are way easier to take care of by month 3. Sixty days is not very long to feel like an idiot & then after a while you will start to feel competent & have fun. This really is fun, mostly. Oh—and take lots of pictures.