Sunday, December 8, 2013

WHY Pacifiers (Seem to) Work

For parents handling newborns under a couple months, we all know how helpless and nervous it makes us when our babies cry, weep, sniffle, and cry non-stop. And as you get to increasingly understand and decode your baby's expressions, we feel better in control. However, even then, there are times when you know you cannot do anything but wait or endure - ie. driving with the baby in the car seat, giving the baby a bath, etc. To mute a crying baby, we invented the all-mighty pacifier.  

When I first used pacifiers on my son, it almost seemed like black magic. It was from on-to-off. Loud-to-silent. I finally was able to understand how the name "pacifier" was approved above a "sucker" or "faux nipple". And because of this, it is very enticing to give the pacifier to the baby all the time. But before making the decision, it is important to understand WHY pacifiers work. Well at least for a while. 

The brain of a baby has unlimited potential (as the unused connections still haven't been shut down) which in turn means they cannot record memory and process complex thoughts. This is why babies often rapidly forget why they were crying or what was hurting them. Even so, evolution has given humans the animal instinct to suck to receive food and water and this can be verified by a baby sucking on its mother's nipples minutes after birth. As eating is directly related to survival for babies, ingesting food, everything else doesn't matter including crying.

From this, we can then see why pacifiers work. Babies are pacified because the pacifier makes their brains think that food is being ingested. It does not solve the cause. It just makes the brain temporarily triage the problem as low priority. 

Knowing this, it is then easy to know how to safely use this magical instrument. Although the baby's brain thinks that it is eating, it actually isn't. So as parents, we have to ensure that the baby is getting enough to eat, even if it may not be expressing hunger (due to the pacifier). This means checking for dehydration (6+ wet diapers a day) and monitoring weight gains (1 oz a day). Also, its more than just food. We have to cognizant of other reasons for the baby crying and make sure those problems are resolved. 

Even with this understanding of pacifiers, I am increasingly feeling that pacifiers may only seem to work. 2 weeks into this world, my son is now outwitting the pacifier. He sucks on it for a few seconds, then immediately spits it out. And the time to rejecting the sucker keeps getting shorter. I'm not sure if its because of he's memorized the shape or the temperature, or because he knows that nothing comes out of it. I'm planning on experimenting with other pacifiers including my finger to outwit him. I'll record the results on another post.  

Wednesday, December 4, 2013

WHY Pee Outweighs Poop

2 weeks into raising a newborn, we all become pros in changing diapers. We do this 7~8 times a day, even when we're half asleep at night. At first, I prided myself to be able to change diapers with just one hand (yes, it can be done!) but even that got boring soon. Recently, I find myself playing guessing games with my wife whether the diaper will contain (1) pee, (2) poop or (3) both. 

This brings me to today's topic of pee'ing and poop'ing. When my son was at the maternity ward for 48 hours after being born, the nurses and doctors constantly made us record the pee / poop cycle. When I asked them why, they said it was an important health indicator. As a matter of fact, my son didn't pee until almost 36 hours after birth and the nurses were getting really worried. Common sense tells us that a living organism should excrete waste, but for babies it has much serious implications. 

As we visited our pediatrician, the staff unanimously reminded us not to worry about poop cycles but focus on that of pee'ing. We were to monitor that the baby is wetting its diaper at least 6 times a day. Which then made me wonder, WHY pee and not poop? What do pee cycles tell us about the baby?

Humans need water and food (nutrient) to survive. For babies, breast milk (or formula) provides both and us mindless parents don't have to worry about forgetting one. This means that if they are peeing frequently, they are getting enough water as well as getting enough nutrients in their body. What a wonderful confirmation to get from a living creature that cannot speak their needs! 

Like my wife, the mother's breast may not be making enough milk in the immediate weeks after giving birth. During this time, even if the baby is "breast fed" for a good 20~30 minutes, there may have not been enough milk. To make matters worse, the baby probably wouldn't cry because it is sucking and the mother could believe that she has fed it enough. That is why nature has given us pee, and modern day humans have decorated it with the beautiful blue wetness indicator on diapers. We get confirmation that the baby is getting enough to eat and drink, not once but 6+ times a day. 

Oh, yes, we forgot about poop. Yes, it is important to monitor poop. Not too much the frequency but the color, texture, and the wateriness of it. Babies that are breast fed would typically have a yellowish curry-like texture and the color can be impacted by what the mother eats. Poop may tell you certain conditions about the baby but for vitals, there is nothing more important than pee. 

Sunday, December 1, 2013

WHY Babies Cry (a Practical Analysis)

By title, this is an ambitious post. I'm attempting to discuss the fundamental communication methodology for infants that has evolved with mankind for millions of years. If you are a father, and I have been for the past 10 days now, you know how daunting and scary crying can be. Imagine your baby crying and screaming every half an hour for a day or two. To keep your sanity and the baby's, it is critical to understand WHY babies cry

From reading various books and articles, yes, I understand that the baby is trying to tell you something: "I'm hungry / cold / hot / uncomfortable / scared / pee'd / poop'd ..." And it is up to you to decode it. If you can't, you won't be sleeping. But trust me, when you are sleep deprived and walk towards the crib like a zombie for the 17th time in a night, you don't want to be playing cryptographer or mathematician.

So in this post, I want to attempt at this question with a practical method. From my experience, when raising a newborn under normal circumstances, three reasons make up 99% of why a baby cries (proven with my son). I've broken down each below. 

"I am hungry" (90%)
When in doubt, your baby is hungry. Keep in mind that a stomach of a newborn is less than 50ml or roughly 1.5 oz. This means that they will digest this quite rapidly and be hungry again. In addition, if you are breastfeeding, there is no guarantee how much milk was ingested from the mother regardless of the frequency and duration of the feeding. The mother's breasts may not be ready to produce enough milk, and in this case, you can supplement the feeding with ready-to-feed formula. Once again, don't ever rule out this reason by thinking you've fed the baby enough. And if you are afraid of over-feeding, don't worry. The baby will not swallow when full.
"I am sleepy" (7%)
Once you ruled out hunger, you should then consider putting the baby to sleep. The life of a newborn is quite simple - eat, sleep, pee/poop. And babies will express the need to sleep as they need to sleep 16+ hours a day. There are many ways to help the baby sleep, and thus stop them from crying. Some school of thought say the baby should be held tightly and patted on the back, essentially be coddled. Other theories say they should be left alone. Either way, you should create a decently quiet environment, place the baby on a safe surface, and make sure it is warm. My son seems to like two things: touching his cheeks with mine and my brushing his hair lightly. 

"My diaper needs changing" (2%)
Diaper technology has come a long way with increased capacities to hold pee and/or poop. There are even diapers that show you the amount of pee contained via an external stripe! Even with how often babies pee/poop, diapers only make up 2% of the crying cause because babies are only discomforted by a large amount of excretion accumulated. Furthermore, you'll be changing diapers as part of eat, sleep, pee/poop routine. Also, know that babies can pee/poop any time. Diapers can be wet even seconds after changing them. 

And then of course, there are the remaining 1% that you should not ignore. The baby might have a fever, they might have a wound, their arm might be stuck in a weird way in the shirt, etc. But once again, you want to be diagnosing the situation with the most probable causes first!