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Parenting with Love and Knowledge - Judi Orion - Oct 2005

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Following are notes taken from one section of the Workshop.  Notes kindly provided by Jessica Scrimes.

SYMBIOSIS

The period immediately following birth is very special and important for the baby and the family.  From the predictability of the womb, the child goes through the birth experience. 

Childbirth education classes often include movies of birth. This is not necessarily helpful, as it sets people up for what birth is like. Expectations of birth are often unhelpful as they do not give us the freedom to meet our own birth experience. We are often set up for disappointment or a feeling that birth should be a certain way.

Babies come however they come, but they are certainly not passive participants. They need to move and rotate to move through the birth canal.  Unless it is a caesarean birth they are very active participants. 

The birthing mother and other support people go through a very intense time at transition as they are handling the contractions of this period.  There is often a change in behaviour of the mother, and then a veil of amnesia comes over and the pain is forgotten. Every birth is a phenomenal miracle.

A doula is a person who is not involved in the delivery but is there as a support person for the birthing couple. This may be a wonderful service to hire.

Any kind of medical emergency precludes the following ‘ideal’ of birth. Ideally, the baby is placed on the mother’s tummy until it stops pulsating. The cord is then cut, and the baby is allowed to move up the mother’s body to find the breast.  The mother’s hand can be placed under the baby’s feet, and the baby will gradually move up the mother’s body.  The baby might smell and lick the nipple, or may choose to attach and suck.  If the baby sucks, it stimulates the expulsion of the placenta. A hormone called oxytocin is produced.  This first hour after birth is a very awake time. The baby is alert and the parents are captivated.

The first hour of life does not require the intervention of medical checks. Ideally these checks could be postponed for an hour. 

After about the first hour, the newborn often will go into a deep sleep, which could be for up to 6 hours, if uninterrupted. After this sleep the baby will then attach and suck strongly.

For a first-time nursing mother, help may be needed to assist the baby to latch onto the breast properly.  If no help is given, the mother may end up with seriously cracked or damaged nipples. Early nursing experiences also assist the uterus to contract back to its normal size as well as reducing the bleeding areas and blood loss.

Being attached to the mother is a way to reassure the baby that the mother is still available.   Hospital practices may assist or hamper this process.  Medical intervention may be required in some circumstances, but efficiency is not the most important thing throughout the first hours and days after birth.

To check a baby’s breathing or heart rhythm is self-evident as the baby’s colour changes to pink after birth. The Apgar
score is non-invasive and gives an excellent indicator of the baby’s health.  It does not require manipulation of the baby. It only requires observation. The one-minute Apgar score gives an indicator of the baby’s birth stress levels. The five-minute Apgar shows the strength of the baby’s body systems, comparing the change from the one to five minutes. The score also tells the birth team whether the baby is fine, might require intervention, or is critically ill.

The period directly following birth needs to be protected.  If the mother has been given drugs during labour, depending on the type and time of administration, the mother or baby may still be carrying the effects of these drugs. Mother and baby may need some extra time.

Breastfeeding usually requires some support. This can be through an experienced family member, doula or lactation consultant who can reassure, encourage and support the new mother, using words such as, ‘you are doing a great job, perhaps you might like to try this way…’ The role of a support person is not to relieve the parent of the baby. The parents need time to get to know their baby and to learn to care for his or her needs.

In the first two weeks, help from others can be accepted to take care of chores, other siblings, etc. Help is also required to protect the new family unit from unwelcome visitors to run interference and protect the special time the family needs together.

The baby needs the opportunity to experience his or her points of reference from the prenatal life.  The baby needs to be able to touch his or her face.  The baby might choose to suck his or her hands. 

One of the supports that a new breastfeeding mother might require is the knowledge that sucking is not an indicator that the baby is hungry.  It usually takes 2 to 2.5 hours for the milk to be digested by the baby, provided that the baby is emptying the breast properly.

The first milk has almost zero fat. It is high in protein, water and energy.  The foremilk contains antibodies, fluid and proteins.  The hind milk carries more fat, and so the baby needs time to take this milk.  A more placid baby may not empty the breast in a limited period of time. A more energetic sucker might need less time.  Limiting feeds according to the clock may not allow the required time for the breast to be emptied and the baby to be satisfied.

The breast will produce as much milk as is taken away.  The system works on demand=supply.  What are the indicators of good supply?  8-12 wet nappies per day shows that the baby is getting enough fluid.

It takes 2 to 2.5 hours for breast milk to be digested.  Breastfeeding mothers produce different quantities of milk during different times of the day. There is an abundant supply of milk early in the morning and mid morning. In the afternoon and early evening, there is a lower supply. The baby might feed more frequently in the afternoon (cluster feeding).  The frequency of feeds also depends upon how much the baby moves and how much energy is burning off. The individual variation of number and times of feeds should be supported by the adults.

We call the first two months after birth (6 to 8 weeks) “Symbiosis”.  It takes about 6 weeks for the mother’s body to return to a pre-pregnant state. This is the time when the baby’s psychological foundation is laid.  The mother and baby are able to create a very strong bond if the mother is psychological available.  This will also happen if she is emotionally present.  During the first 6 to 8 weeks, there is an opportunity for falling in love.  As the baby nurses, there is no one else in the world but the mother.  The baby makes absolutely no response to noise, actions or other interruptions.

The baby will cry for many reasons.  The first 6 to 8 weeks is a time for the parents to learn the meaning of all the different cries of the baby. If the parents are very involved, they can recognise the variety of different cries of the baby within one week.

The way in which we respond to the baby’s cries will send psychological messages.  Parents must meet these cries immediately to encourage the ‘basic trust’ which is developed in these first few weeks.  ALL BABIES need their cries met immediately during this period.  For the mother, experiences of holding her baby are an opportunity to re-create the ‘oneness’ experienced during pregnancy.  This aids the adjustment of the mother to the changes in her own body.

Role of the Father: One of the roles of the father is to protect the mother and baby from interruption, for example encouraging people to phone beforehand rather than just turning up for a visit. The father provides a protective barrier around the mother-baby dyad.

It is helpful if the father also finds a ritualistic experience that can help build his own special relationship for the baby. This can be anything, such as a special time when they sit and sing, play music or engage with each other. This ritual allows the baby to experience that mum does something one way, dad does it differently, but both are valid.

Sometimes mothers try to micro-manage the relationship of the father with the children.  Sometimes they suggest really specific ways of handling the baby. This is not allowing the father to find his own way of doing things, and it is not fair to the father. 

Topponcino: This is a flat cotton pillow that is placed under the baby.  The baby is held in the topponcino.  Mum and Dad do not use the topponcino to hold the baby, but rather to transfer the baby from one place to another or from one person to another. A topponcino is great for siblings to use.  The topponcino holds familiar smells.

Often when parents come to school and talk about the Montessori approach, they wish that they had known some of this information about the early days of life beforehand.  School communities have the opportunity to create a nurturing relationship around symbiotic families. They can organise meals, assist with picking and dropping off children to school, nurturing this period, shopping, etc.  This is easy if the family is already in the school. Schools could also find ways to do this for first time parents within the community.

The reason why symbiosis is critical is that by the end of this period the child has developed ‘basic trust’ in the world (Erikson).  Mum and Dad represent the world to this child.  The baby’s needs are met immediately.  IF not, the baby might be left with a poor sense of trust in the world.

At the beginning of symbiosis we have a woman, a man and a newborn.  At the end of symbiosis we have a mother, a father, and a child.  This is the birth of a new family.  We need to protect this process to secure the psychological foundations for life-long relationships.