Baby care: what you should know

Looking after my second baby girl, now twenty days old, I really feel I have a handle on what this baby-rearing thing is all about. While all babies are unique, it seems to me to be a difference of degree rather than of kind. As I’ve said before, baby care is mostly a case of putting stuff in one end and cleaning it up when it comes out the other, and in the interim making sure she isn’t too hot or too cold. If you keep that in mind, and don’t sweat the small stuff, you should do fine.

That said, becoming a parent for the first time is an incredibly scary, difficult thing. I know that some of my readers are planning on having children, and some are soon to become parents themselves, so for your benefit I thought I’d share my take on parenting – all the facts you need to confidently raise a baby. At least, the facts as I see them, and the things that I’ve found invaluable in my own life.

The General Stuff

  1. There’s a lot of sentimental guff spoken about babies. You hear people on the way out of the delivery room saying, ‘I love her so much, she’s perfect in every way, it’s the best thing that’s ever happened to me.’ There’s this expectation that you’re going to feel an instant connection. In my experience, new born babies look like asthmatic Smurfs – blue-skinned, gasping for breath, and stuffed into oversized hats. You look and think, ‘What on earth have I done?’ If it takes you a few days to warm to the little creature, a few days to work out how you feel, a few days to get your head round things, that’s okay. You’ve got a lifetime of emotions to come – don’t expect too much too soon.
  2. New born babies feed every couple of hours, sometimes for a couple of hours. If it feels like you’re always feeding your baby, you are – their stomachs are very small and with all the growing they do, they use up what they’ve drunk very quickly. Luckily, it settles down and they get into a pattern, sometimes having a big feed and a three hour sleep, sometimes cluster feeding every thirty minutes before drifting off. And when they’re finally asleep, I have one word of advice: sleep!
  3. Baby poo changes rapidly over the first few days, from black tar to green whole grain mustard to yellow mush. This is normal and nothing to worry about.
  4. Babies aren’t made of porcelain. They’re designed to make it through the birth canal, so unless you’re really clumsy, you’re probably not going to break them. But don’t put that to the test!
  5. You might not think of yourself as a particularly violent or jealous person, but you may find that when people pick up, touch, or even look at your baby, you feel like scratching out their eyes. This is normal, but try to remember you’re not the only one excited about your child, and you’ll have more opportunities for cuddles than anyone else can ever hope for.
  6. Even though they seem to prefer lying on their front, when you put your baby down to sleep, always put her on her back. If your relative tells you that the advice in their day was to put them on their front, ignore them – the advice was wrong. Babies on their front are eighteen times more likely to die of cot death than babies on their back.
  7. Though it is lovely to let your baby fall asleep on you, and such cuddling is to be embraced, be sure to transfer them to the cot or Moses basket for a proper sleep – you don’t want to get to the point where they will only sleep on you, or you’re setting yourself up for a very tiring couple of years.
  8. Babies communicate. Try to learn the little signs that they’re hungry (rooting, poking out tongue) or need burping (fidgeting, gasping) or need changing (a slightly shocked facial expression accompanied by the smell of sour milk), and deal with these things before they start to cry – it makes life much more peaceful.
  9. Babies cry as a form of communication – mostly because you haven’t met their needs quickly enough (i.e. within about thirty seconds!). It can be distressing for a parent to hear their child wail, seemingly in despair, but don’t take it to heart – it’s how she’s talking to you. It’s your job to figure out what she needs.
  10. Babies only have a handful of needs. They need to be fed; they need to be winded; they need their nappy changed. Do these things and they are normally happy.
  11. Babies are sometimes unhappy. When they have belly ache or a non-disclosed need, or simply want to hear their own voice, they can cry and keep crying. This can be upsetting for you, but there’s not really a lot you can do about it except rock them and hug them until they fall asleep.
  12. If you suspect something more serious is wrong, don’t be afraid to get advice or seek help. If you go to an out-of-hours doctor or A&E, they’re jam-packed full of new parents with young babies. It’s part and parcel of being a new parent, so don’t ever feel like you’re being neurotic.
  13. In the womb, babies are lulled to sleep by movement, light and noise (i.e. during the day, when mum is busy), and come awake when all is still and quiet and dark (at night, when mum is exhausted). Why, then, do we expect them to sleep in a dark, quiet room? If you’re struggling to get your baby down at night, a Moses basket on a rocking stand at the bedside, a night-light and some quiet music or a radio tuned to static can really help give you some well-earned rest.
  14. Make sure you have plenty of everything. Taking off a poopy nappy at 3am to discover it was the last one is nobody’s idea of a good time. That said, there will be occasions when you need to buy something in a hurry, so be sure to locate a good 24-hour store long in advance of actually needing it.
  15. You’re going to be tired, you’re going to be crotchety, and the baby is going to push your buttons. That’s just the way it is. If you ever feel yourself at breaking point, put the baby into the cot or Moses basket – somewhere safe, at least – and walk away. Take some deep breaths. Make a cup of tea. Ask for help. Don’t keep going until you break.
  16. Forget the housework. Sure, do enough to keep the place ticking over, but you don’t need to live in a show home. Provided it’s clean, don’t get too hung up on it being tidy or spotless, unless you’re prepared to add extra stress to your life in pursuit of perfection.
  17. Babies are better off being too cold than too hot. Older people are paranoid that your baby isn’t warm enough, but being too hot is actually dangerous for babies as their brains are vulnerable to increases in temperature. In fact, the recommended temperature to keep your home with a baby around is 19 degrees centigrade – colder than we like it.
  18. Eat. Drink. Sleep. You might think you can keep going forever, but trust me – if you neglect your own needs, eventually you’ll be good for nothing.

 The Controversial Stuff

  1. Breast is not always best. Since breastfeeding has become something of a sacred cow these days, you might be treated like a pariah by the sisterhood if you shun its self-evident benefits. But not everyone can breastfeed, despite their best efforts, and you shouldn’t be made to feel a failure because of that. Faffing about with nipple shields while you’re tired, the baby’s tired and hungry, and you’re both crying does not help either of you. It can harm your self-esteem and mental well-being, and make it more difficult to bond with the baby. If you don’t feel you can cope breastfeeding then switch to the bottle – it’s as easy as that.
  2. Dummies (pacifiers) shouldn’t be dismissed out of hand. Like bottle-feeding, these simple tools have earned the opprobrium of the ‘all-natural’ brigade, but unfairly so. It’s not a means of making a baby shut up but of meeting her needs. Sometimes, between feeds, a baby needs to suck to soothe, and giving either the nipple or the bottle is inappropriate. As with anything, it’s a personal choice and nobody has the right to judge you for what you decide is best for your baby and family.
  3. Never underestimate the utility of swaddling. A fidgety, unsettled baby can be transformed into a contented sausage roll by wrapping her in a blanket and gently rocking her.

The Little Everyday Stuff

  1. When a baby breastfeeds, if done right, the first part of its body that comes into contact with its mother’s boob is its nose. If you’re breastfeeding, using a bottle or trying to keep a dummy in, and having little success, rub the baby’s nose – it often triggers the baby to latch-on.
  2. If your baby is distressed, has a rock-hard belly but isn’t able to poop, sit with your knees up in front of you and rest her in your lap, facing you and leaning against your thighs. Using two fingers, rub her belly in a clockwise direction centred on her belly button. After a few minutes, switch to gently pushing her knees up towards her chest. Alternate between the two. If this fails to work, pick her up under the armpits and allow her to stretch out in the air – oftentimes, gravity will cause the world to fall out of her arse.
  3. Whether male or female, while changing nappies you will get explosions from front and back. Before removing the nappy, be prepared: make sure you have cotton wool, water, nappy bag, clean nappy, and toilet paper. Keep them out of the way so that if things do go flying, they don’t get soiled too.
  4. Urine has a chemical in it that can’t simply be scrubbed out of the carpet with soap and water. I’ve tried. A couple of days later, you start to smell stale wee and go mad trying to locate the source. If there’s an accident and baby champagne goes everywhere, you need to use a proper cleaning product. I recommend the spray cleaners sold in pet shops as they contain enzymes that neutralize the odour while also disinfecting the area.
  5. When bottle-feeding a baby, an armchair or a sofa with a cushion – or even putting your knee beneath your elbow – prevents you getting a dead arm. Make sure you’re in a comfortable position that you can maintain before you start feeding or you’ll regret it.
  6. Always burp your baby after feeding. Babies have immature digestive systems and inefficient swallowing reflexes, so gulp down a great deal of air along the milk – air that causes wind and discomfort. It’s sometimes tempting in the middle of the night when the baby falls asleep at the breast or bottle simply to place her gently down and return to bed. Don’t. You’ll be getting up again in 5-10 minutes to burp an unhappy baby, right when you’re falling asleep, making both of you grumpy.
  7. Check out Dunstan Baby Language. This is the idea that all babies are born with five ‘words’ that they use for the first three months – ‘neh’ (I’m hungry), ‘eh-eh-eh’ (I need burping), ‘eairh’ (I’ve got belly ache), ‘heh’ (I’m uncomfortable/please change my nappy), and ‘owh’ (I’m sleepy). Though this hasn’t been scientifically scrutinised, it has undoubtedly worked for both of mine, especially the first three words. It makes it so much easier to know what she wants, and this leads to a calmer household.
  8. Make a record of every time she eats, poops, sleeps, for at least the first couple of weeks. You can very quickly spot patterns to her behaviour, and knowing when she last ate or had a bowel movement is very reassuring. It’s also helpful to be able to tell to doctors, midwives and health visitors, in case there is anything wrong.

The Annoying Stuff

  1. If you’re female and you go out with the baby, nobody will bat an eyelid.
  2. If you’re male and you go out with the baby, you’ll be stopped by every old woman you see. But they’ll only ever ask you how the mother’s coping, and then congratulate you on ‘doing your part’.
  3. People will give you advice. Lots of advice. Much of it will be wrong and directly contradict what you’ve been told by the midwife. Much of it will be against your principles. Luckily, advice is free and is not mandatory. You might as well listen, smile, and say ‘I’ll think about it.’ And then do what feels right for you.
  4. People will give you opinions. Lots of opinions. You will feel judged, because they are judging you. But the only expert in your baby is you, and everyone else can bugger off, because opinions are like arseholes – everyone’s got one and they’re mostly full of shit.
  5. People will make out like modern parents are useless because when they were parents, they never had car seats and parent/child parking, or washing machines or paternity leave or Perfect Prep machines. They’re just resentful they didn’t have these conveniences, and criticising us makes them feel better about the fact that their infant mortality rate was about ten times what it is today.
  6. You will feel patronised because people will be patronising. This is my second baby, yet I’m still told to ‘make sure she’s warm enough’ and ‘support her head’, as though without these instructions I would somehow flush my baby down the toilet without realising I was doing anything wrong. Unfortunately, there’s no way I know of not to get annoyed by these ‘helpful’ comments.
  7. Your family and friends will no longer talk to you, except about the baby. They’ll come to see the baby, but not you. And they won’t listen. You can break off mid-sentence and nobody will notice. You’re not going to have a grown-up conversation for a while.
  8. Unless you’re really weird (or single), you and your partner will argue. You’re both tired, you’re both under stress, you’re both trying to adjust to this new life you find yourselves in, so don’t expect your relationship to be perfect. In my experience, you’ll have a crap time for a few months but it’ll pass. Don’t take your disagreements too seriously. Don’t throw in the towel too quickly. It all works out in the end.

The Good Stuff

  1. Being a parent is awesome.
  2. Looking after something that is entirely dependent upon you for its very existence is an honour as well as a responsibility.
  3. You get to use parent/child spaces.
  4. When you hop about, sing, dance and act like a clown, you can say you’re doing it to ‘entertain’ the baby.
  5. You gain a new understanding of your own parents.
  6. You watch more sunrises than you ever knew existed.
  7. You get the morning news before anyone else.
  8. You realise it’s the best thing you’ve ever done and you’re grateful to experience the ever-changing miracle that is your child.

And that, mums and dads, is baby care in a nutshell. Here endeth the lesson. Now go forth and multiply!

Asperger’s, parenting and social care

The provision of social care for adults at the more functional end of the autism spectrum has always been somewhat spotty. If you’re at the lower end – with classic or Kanner’s autism – there’s plenty of help and support, but those of us with Asperger’s Syndrome face a lottery.

You see, as far as care services are concerned, AS falls between the Mental Health Team and the Learning Disabilities Team. It is not a mental health disorder, but then nor is it really a learning disability – it’s a developmental disorder. Nevertheless, autism tends to be within the Learning Disabilities Team’s remit – but they only get funding to deal with the lower end of the spectrum. In terms of care, then, if you have Asperger’s Syndrome there’s nothing the care services can provide.

You are, however, assigned a social worker – well, sometimes. But herein lies another problem. The team to which you are first assigned is the team you’re stuck with. I was first assigned to the Mental Health Team long before I was diagnosed with Asperger’s; as soon as I was diagnosed, I was discharged by the psychologists, psychiatrists and counsellors, but kept the social worker from the team. And as I said before, Asperger’s isn’t a mental health problem and most social workers I’ve met are gobsmacked when they meet me to find I’m not Rain Man. Different end of the spectrum, guys. Thanks for joining us.

The job of the social worker is to give the service user (i.e. me) access to services pertaining to their condition. Since, as I said, there are no services for adults with Asperger’s, this access takes the form of money that can be used to buy support from private care agencies. I was deemed to require six hours of support each week, so they decided to fund me for three, and I pay for the other three. Thus three times a week, for two hours at a time, I have support workers come in to make sure I’m carrying out my activities of daily living – changing my clothes, cooking, cleaning, etc., and to help me with paperwork, budgeting and the various minutiae of modern life I’m thoroughly incapable of coping with.

This is the way it has been for around seven years now. However, things have changed lately because of the arrival of my little bundle of giggles and poop, otherwise known as Izzie. As regular followers of my blog will know, my partner Lizzie (yes, I know it rhymes and in hindsight it’s quite confusing) has struggled with the demands of motherhood. Like me, she has six hours of support each week, and also has a social worker from Mental Health. Since things were so tough over the first six months, we asked for additional hours just to help us out until we managed to find our feet again. Here is the response we received, paraphrased and dramatized:

‘We’re adult mental health social workers. Neither of you has a mental illness. We’re not even sure why we’ve been assigned to you. Unfortunately, you fall down the cracks between Mental Health and Learning Disabilities.’

But it’s not our fault what we have doesn’t fit into your organisational structure. What we’re asking for is additional funding for more hours for assistance. Because at the rate we’re going, we’ll end up with mental health issues.

‘Well, here’s the problem. We don’t deal with children – we only deal with adults.’

But we are adults. Adults who are asking for help.

‘The thing is, before the baby arrived you were both stable on six hours a week. The disruption in your lives has been caused by the baby. Therefore, if you need extra help because of the baby, the baby will have to fund it.’

I’m not sure I understand.

‘Being a parent is not a mental health problem. If you want any assistance, Izzie will have to get a social worker, and be assigned funding from Child Services.’

I see. So will you refer us?

‘I can give you their number…’

To cut a long story short, we applied to get a social worker for Izzie, to get us extra help as her parents, but as she’s at no risk of abuse or neglect, we were turned down. So, no help there.

Another avenue explored was the Perinatal Mental Health Team. Lizzie was assessed by them, and they concluded her difficulties were caused by her autism, not by postpartum depression, and since autism isn’t a mental health problem, they can’t provide any assistance. So if her autism is causing the problem, who can we go to for help with that? Apparently, nobody.

You can now perhaps understand something of our quandary. We have autism, and despite the joys of the past six months, it’s been a real struggle. We are not the same as every other parent, even though I like to pretend we are, but we’re too high-functioning to get any help from public services, too attentive to Izzie’s needs to get access to child services, and not suffering enough mentally to get extra funding.

To add insult to injury, we have just been summarily dropped by the one piece of free support we were receiving. Since I work Tuesday afternoons in a charity shop, and Lizzie struggles to cope at home on her own with the baby, we had an outreach worker from the local children’s centre who would come out and sit with them for an hour. It was useful and we were grateful for it.

We didn’t hear from the outreach worker after the festive period until she texted on Monday 11th asking to come out either Wednesday afternoon, Thursday morning or Friday morning. Since Wednesday afternoon Lizzie was out with her mother, Thursday morning she takes Izzie to baby group (which is beneficial for mother and baby both), and Friday morning we have swimming classes (which cost £110 a term), we said we were busy. Besides, wasn’t the whole purpose of her visits to sit with Lizzie on Tuesday afternoons?

So she texted us again Tuesday just gone to tell us that they are closing our case because we have ‘disengaged from the process’ and failed to make ourselves available and haven’t kept in touch and if we ever want any help from the children’s centre again we will have to get Izzie a social worker and be referred.

This has left us both feeling perplexed and upset, principally because we have no idea which ‘process’ we are supposed to have disengaged from, but also because we don’t understand why we should have cancelled a Thursday morning Mother and Baby group or Friday morning swimming lesson when the whole reason she was coming was to sit with Lizzie for an hour on Tuesday afternoons? Furthermore, the wonderful invention called the telephone could have resolved whatever issues they had with us – what’s all this text message crap?

They clearly have no idea about autism. We like routines and we cannot abide change, so we make plans and stick to them – disruptions to our timetable make us agitated, anxious and insecure. When plans change you feel small and scared, but you can’t rationalise it away because there’s nothing you’re actually afraid of. It’s simply a general, all-pervading fear that all is not right with the world, a feeling of danger and fright when there’s nothing coming for us – just shadows in the dark. That’s why we don’t change plans at the drop of a hat. If people understood that, it might make things easier.

It reminds me of the time before my breakdown, before my diagnosis, when I was climbing the walls and my thoughts were tearing me apart. I was referred to a psychiatrist under the mental health team. But I wasn’t opening the post – I hadn’t for six months –  so when they sent out the appointment by letter, I didn’t open it and I therefore missed it. So they discharged me with the stipulation that if I was referred again I would go to the back of the queue. I only discovered this months after my breakdown when I finally had the energy to face up to opening the huge box of post my parents had kindly collected from my flat. How different things might have been if someone had actually picked up a phone. And how switched-off to the realities of mental health do you have to be to send someone an appointment by post when it said in the referral that he doesn’t open it?

I honestly think that, going forward, we’ll be better off as a family without the interventions of any of these social workers, care providers or so-called experts. The other day, when Lizzie was feeding Izzie during a support session, Izzie choked. We’ve just started her on food with a coarser texture, and choking is par for the course during weaning. The support worker even said that it was entirely innocent, normal, there wasn’t too much on the spoon or too much in her mouth, it was just one of those things. But she still felt the need to report it to her manager, and have it logged that on this day, at this time, during weaning our baby choked. Everybody is just looking for you to fail, and covering their arses in case you do, and that’s not an environment in which I want to raise my child.

Ending on a positive note, the past couple of weeks Lizzie has been so much better, it’s like she’s a different person. She’s far more attentive to Izzie’s needs, supports me more than she ever has, and is suddenly settling into the role of motherhood. And I have finally made peace with the fact that bedtimes and overnight is my domain, because Lizzie will never be capable of getting up in the night. We have different roles to play and given how Izzie is far ahead of the curve in almost every respect, we’re playing them damn well!

It’s just a shame it’s been such a struggle to get here.