The Fourth Trimester. Susan Brink. Читать онлайн. Newlib. NEWLIB.NET

Автор: Susan Brink
Издательство: Ingram
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Жанр произведения: Медицина
Год издания: 0
isbn: 9780520954519
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on April 3,” Dr. Linda Gilkerson says. “I remember on July 4 [three months later], I was upstairs in the bedroom. I had my feet up like this,” she says, demonstrating the classic infant-holding, knees-up posture, “and it was a moment of discovery. There was a sense of no barriers, limitless joy. I think it was just those cheeks and the sparkling eyes and the ability to sustain the engagement.”12

      She had already been hooked, in love with him since his birth, but now she felt he loved her in return. She could see it in his eyes, in his recognition of her, in his relaxed pleasure as he lay in her lap. It is a moment that all parents feel, when love moves in both directions and, for a lifetime, grows on both sides.

      BABY ANNIE'S STORY: what is wrong with this baby?

      Annie was born to John and Courtney Bowles on September 18, 2009. She was an inconsolable bundle the moment she came home. “That first night, she cried and cried. Nothing seemed to soothe her,” said Courtney. As a hospital social worker, Bowles had seen hundreds of newborns. But they seemed to sleep all the time, and she just wasn't prepared for Annie's crying. Her expectation had been that if Annie needed a diaper change, she'd cry for a few minutes, then coo with gratitude once clothed in a clean diaper. If she were hungry, she'd cry until she was fed.

      Instead, she cried with a wet diaper, and continued crying with a dry diaper. She cried when she was hungry, and continued crying after she was fed. She cried when lying down, when sitting up in her infant seat, and when held this way and that.

      Courtney and her husband tried swaddling, but Annie hated it, kicking through the tight wrap. Courtney talked to her, stream-of-consciousness talk that grew increasingly anxious—with an edge of fear to her voice—as Annie kept crying.

      John would take her into the bathroom, the darkest room in the house, and flip on the fan, trying for a white-noise effect. They experimented with how they held her: upright with a face against her head, or in the traditional cradle position while pacing, pacing the hallway of their Chicago apartment. If something worked, they kept it up: three paces forward, quick turn, three paces back, quick turn. Cradled against an adult's pounding heart, Annie seemed to like the pacing—until one unpredictable moment when she didn't and cried some more.

      “We worried that something was medically wrong,” says Courtney. “Every time Annie started crying, it panicked me. It affected me to my core.” After about six weeks, Courtney was crying almost as much as her baby. “I would doubt myself. I'd think, ‘I don't know how to soothe my own child. I'm a failure.’ “ For the first five weeks of Annie's life, they were weekly regulars at her pediatrician's free walk-in clinic. Annie would be declared wide-eyed, alert, and growing normally.

      Courtney's mother, who had moved in to help with the newborn, had to leave after four weeks. At six weeks, when Courtney found herself panicking the minute Annie started to cry, she decided it was time to get help. She called the Fussy Baby Network's Warmline in tears. The next day they sent an infant specialist to the Bowles home. “By the time they see us, they're at their wits’ end,” says Michelle Lee Murrah, infant mental health practitioner with the Fussy Baby Network.13 They've read every parenting book they can lay their hands on, they've called their pediatricians, they may have rushed to the emergency room, they've heard the conflicting advice of their own parents, in-laws, and friends, and the baby still cries a lot.

      When Murrah arrived at the Bowles's apartment, she attentively watched as Courtney and Annie did what they normally did. Courtney fed the infant and then put her on the floor. Mother and baby were down playing with the infant gym when Annie started crying. Murrah saw a yawn that Courtney missed. She wondered with Courtney what could be happening for Annie. Together, they continued to watch, and Murrah helped Courtney see Annie's sleepy signs. “She's tired,” said Murrah, and suggested she put Annie down and leave her alone. Courtney had never, for an instant, let her baby go to sleep without holding her. Murrah encouraged Courtney to give her just a few minutes to see if Annie could comfort herself to sleep. The two women talked while Annie cried in her crib. Courtney said she felt guilty, inadequate, a mother who couldn't comfort her child. Within a few minutes, Annie was sleeping as the women continued to talk.

      When Murrah left, Courtney practiced swaddling Annie in a looser fashion, the way she had tried with the support of the specialist—and it worked. She began to pay closer attention to Annie's yawns and other signals that she was tired, putting her down at the first signal. Courtney recalls, “I started paying attention to cues like yawning, rubbing eyes. When I thought she couldn't be tired, [Annie] was telling me she was tired. When I thought she couldn't be hungry because she just ate, she was telling me she was hungry again. It was a matter of learning how to really listen to her.” Right about that time, Annie stopped crying. Not completely, of course. She just developed a normal, recognizable pattern of crying that her mother could now decode. Also, as Courtney grew less fearful and more confident, Annie could relax and feel that her mother was ably in charge.

      WHAT'S THE ANSWER?

      There is no magic formula. Babies are human, and all humans are different.

      The first three months of a baby's life are not about training him to be an independent person. That comes later. The first months are all about helping him to shift from depending on the comfort of the womb to adjusting to the world he's been born into. What he needs to know is that when he is distressed, someone who cares about him is there—even if his problem is inexplicable. The response he gets as he makes his transition from womb to world is his first lesson in how life can be expected to respond to his woes.

      Maybe an infant is telling her parents that their best-laid plans might not suit her needs. Dr. Heidelise Als, director of the Neurobehavioral Infant and Child Studies program at Children's Hospital in Boston, has seen thousands of babies and their parents. She says,

      I've seen parents, often professional, who had everything planned. They had their careers going, the house ready, the nursery ready, everything on schedule. They expected the baby to fit in.

      Then the baby screams, and they're befuddled and don't know what to do, because he's not doing what they want him to do. I see that baby as a strong baby. He's asking, “Are you there for me? How much time can you make for me?”

      We can be so pushed now. Women can be so focused from pregnancy on to get things scheduled. And that's not how parenting goes. That's not how growing up goes. I would prefer to support parents earlier, to tell the truth. This is a big step. This will reorganize your whole life, your whole emotional life. You'll gain a ton from it, but it's a dimension that a nonparent can't appreciate.14

      A study of 157 infants, whose mothers recorded the duration of their crying for a full year, found that when mothers responded rapidly to crying, infants cried significantly less.15 The sound of an infant's cry has been found to increase heart rate and blood pressure in adults, and to elicit feelings of anxiety and irritation. The common adult reaction is to run to the baby and try to relieve his distress. When a baby is described as “easy,” caregivers still have increases in heart rate and blood pressure, but not as great as those in parents who describe their offspring as “difficult.” According to research from the University of Michigan, those with “easy” babies were more alert and attentive to a crying infant than those with “difficult” babies. In other words, nonstop crying, excessive crying, and the crying of premature babies—which occurs at a higher and more irritating octave than that of full-term infants—can turn parents off, to the point of making them slower to respond.16

      While that is understandable, it's important to try the opposite approach. Rather than shutting out the sound, try to provide comfort. Those attempts can be clumsy, but nevertheless they provide the kind of visual, auditory, and tactile stimulation that promotes infant development. Even the most bumbling attempts to soothe a baby, when performed as calmly and consistently as possible under jarring circumstances, have a positive effect. The infant is learning that someone important takes his distress seriously.

      Newborns provide plenty of clues to how to care for them. And evolution has equipped people, whether biological parents, adoptive parents, or other adult caregivers, with the right instinctive responses: they hold their newborns close, offering soft words, kissing