Monday, February 25, 2013

Naming Your Baby

Congratulations! You're pregnant! There are so many things to think about now that you're going to have a baby, from where you're living to your parenting style to how you will handle work and childcare to where your child will go to school. Some of these decisions can wait weeks, months, even years.

Some decisions, though, you'll need to make within a few days of giving birth, and having an idea of what you'll do even before the baby is born will help once you're in the throes of newborn care and adjusting to your new family life. Some of these decisions, of course, are how you will feed the baby and where the baby will sleep. Another is much more basic: What will you name him or her?!

Sometimes, a name comes to you early in the pregnancy, you love it, your partner loves it, and the decision is made. But for many of us, we're still toying with name choices while in labor, and some babies don't even have a name until a few days (or even weeks!) after they're born! It's especially difficult if you don't know the baby's sex until he/she is born, or if, surprise!, you think you know but the ultrasound was unrevealing or read inaccurately.

What are some factors to consider when choosing a name for your child?

One is family tradition. Is there a naming tradition in your family? Is there a name that is passed from father to son, or mother to daughter, or a name that is traditionally given as a first, middle, or nickname? Does your family prefer to honor living or deceased relatives by passing along their names to children and grandchildren? If there is a family naming tradition on one side or the other, the baby's other parent will, of course, have to be in agreement with using the legacy name.

Another is cultural. In your culture, are there certain naming traditions or taboos? Are there names to be avoided or names you are expected to consider? Are there honored leaders whose names are often given to children? Is your cultural background different from the majority of the country you live in? If so, do you prefer to give your child a name from your culture or language or a name that will be more familiar to the majority population where you live, or some compromise? (For example, there may be a name from your culture or language that is similar or identical to a name that would be familiar to the majority population.) If the child's parents come from different cultural backgrounds, it may be difficult to find a name compatible with both sets of cultural traditions.

There's also the religious aspect. If you are religious, is there a particular naming tradition in your religion? Is there a holy figure you would like to honor, such as a saint or leader? Are there certain names or naming patterns to avoid?

Then there's personal preference. Are you a fan of more common or classic names, or do you prefer the unusual? Do you go with trendy, modern names or do you like throwbacks to other eras? Is there a particular historical person or literary character you would like to honor by using their name? Is there a particular family member you wish to honor by naming your child for him or her? Do you like unisex names or not? Do you want to use a nickname or do you prefer not to? If so, do you want to give your child the full name and then use the nickname, or do you want to simply give the nickname as their legal name? (For example, you like the name Alex; do you name your child Alexander and call him Alex, or do you simply name him Alex?) Do you want your child to be one of three by that name in his class or the only one in his generation? How do you want to spell it? Do you want to use a traditional spelling or make up a new spelling? Consider how these decisions will impact your child as he grows - will his name cause him frustration or difficulty? Will people be prone to mispronounce or misspell it? Does that bother you?

These considerations will give you a framework for choosing a name. Once you've picked out a few, try them on with the surname your child will use (whether it's the father's name, the mother's name, a hyphenated version of both parents' names, or something else entirely - by the way, you'll have to figure that out, too!). Make sure it sounds okay, that there aren't awkward transitions between final and initial sounds, that it flows easily. Try shouting it in anger to see how it falls off your tongue. Try out potential nicknames to see how they work for you. Make sure there aren't potential teasing opportunities. Double-check the initials to make sure they don't spell anything offensive or unfortunate. Put "Doctor" or "Supreme Court Justice" before the name to get a feel for how the name will reflect on them in adulthood.

Finally, if you have other children already, see how the new name fits with the ones you've already chosen. Say all the kids' names in a row to see how they fit together. Do your names fit any sort of pattern? Do you want them to? (For example, do all the names start with the same letter, or have a certain number of syllables, or rhyme?)

I recommend having two or three names on your list when the baby is born. Sometimes when you see your baby and try out a name, you find it doesn't fit after all, so having other names you've already considered and agreed upon can be helpful. And, possibly, have a name or two for both genders, just in case!

Wednesday, February 20, 2013

Safety Advice Is Not Parenting Judgment

When I see a child incorrectly buckled or in an inappropriate car seat, either in a picture online or in person, I often have an instinctive reaction to mentally note the problems and an internal debate as to whether to say something to the parent. I rarely say anything, as I don't want to start an argument or offend anyone or seem judgmental.

There was a viral video going around a couple of weeks ago showing a baby sound asleep in her car seat until "Gangnam Style" came on, then waking up suddenly and dancing. It was a very cute video, but many of us on Facebook who are interested in car seat safety were very quick to point out the many problems with the car seat use depicted in the video. The Car Seat Lady (Dr. Alisa Baer, a pediatrician and certified car seat technician), in particular, took a frame from the video and made a graphic showing all of the problems with how the baby and her sister were secured in the car and posted it to her Facebook page. (I can't locate the picture now. Either she took it down, or Facebook doesn't want to show it to me for some reason.) The picture received well over 1,000 comments, and while many comments to the post were along the lines of "Yes, I noticed the same thing!", or "That really bothered me, too!", many others expressed disgust that the Car Seat Lady would publicly criticize the family in this way. Others then commented that once the parents posted the video to YouTube and it went viral, they lost control over the images, and Dr. Baer had every right to use the picture as a teaching tool. There was some debate over whether her producing this graphic was simple commentary or actively judgmental and overly critical.

This got me thinking hard about how I react when I see improper car seat use. Often, my first thought is, "Oy, another kid buckled wrong. Don't they know that X should be Y?" (where X is whatever was done incorrectly and Y is the correct usage). I'm trying to retrain my internal reaction to, "I wonder if they know that their child isn't as safe as she could be. Maybe I should let her know that Y instead of X." I usually don't say anything unless I'm asked, mostly because I like to avoid confrontation.

From there, I tried to think of a neutral, unrelated safety issue that I might want to point out to someone, to decide if commenting on said problem could really be construed as judgmental or critical of their parenting skills. One safety tip I remember from a baby-sitting course I took as a teenager still sticks with me. When cooking on the stove top, turn the pot handles in so that they're not hanging out over the edge of the stove. This way, a toddler can't reach up and grab the handle, potentially dumping whatever's in the pot on themselves and getting severely burned. To this day, whenever I cook on the stove top, I always, always make sure the pot handles are turned in, because my toddler does reach up and try to play with the stove knobs, and if he were just a little taller, he might try to grab the pot handle. It's a real concern!

So, if I saw a picture on a friend's Facebook page, say, of their toddler in the kitchen doing something adorable, like pretending to cook, and in the background of the picture I could see a pot on the stove with the handle pointing out over the edge, would I comment to the parent something like, "Soooo cute! But, hey, that pot handle sticking out like that could be dangerous. My son likes to grab anything he can reach, and I wouldn't want him to dump a pot of hot spaghetti sauce on his head. I've heard you should turn the pot handles inward so the little ones can't reach them"? (Note: I have never actually seen such a picture. This is a hypothetical scenario.)

If I did make such a comment, would that be construed as critical, judgmental, or rude? I don't think so. I think it would come off as genuine concern over the safety of my friend's child. So why, when a car seat technician points out a safety issue with a car seat, is that labeled as uncalled-for or obnoxious?

When G was a very tiny newborn, my mother-in-law and I went shopping. It was a warm, sunny day, and we were loading up the car with our purchases and the baby when a man came up to us in the parking lot. He said something like, "You know, you should get your baby out of the sun. They can get sunburned so fast, and you might not even know they're burned." I was only half-listening, and my inclination was to brush him off and be annoyed that he would have the gall to approach me and judge my parenting skills. G was only in the sun for a few minutes while we put our purchases in the trunk, and I was sure he would be fine.

Thinking about it later, though, I realized that the man was just showing concern for a little baby. Perhaps it happened to his baby, that she got terribly sunburned and was in pain because he didn't know better, and he just wanted to make sure other parents protected their children from the same possible injury. He wasn't saying I was a bad parent or that I was stupid or anything of the sort. He just didn't want to see another little baby suffer like his had.

I think the issue requires a little sensitivity from both sides. If I see a problem with car seat use, my job is to express concern without allowing that concern to grow into judgment of the person's overall parenting skills. On the other hand, if someone points out a problem about car seat use, it's up to the recipient of such a comment not to become defensive but rather to take the kindly given bit of advice under consideration and thank the person for the information.


Friday, February 15, 2013

Lockdown Follow-Up

After my experience with arriving at my son's school to find police cars with lights flashing and the school under lockdown, blogging about it, reading and hearing responses to the story, and thinking about it on and off for a couple of days, I decided to write a letter to the school outlining my concerns and making a few suggestions. It is unusual for me to actually take the step of writing a letter, though I often threaten to, and I was pleased with what I came up with and sent.

Here's what I wrote (redacted for specific references to my son or his school):
Dear [Principal]:

My son [name] is in the first grade at [your school]. I have been very happy with the positive attention and academic support and challenge, as well as the quality of teachers, he has so far encountered. It is clear that you care deeply about the students and staff at [the school] and strive to create a nurturing environment and encourage excellence in every classroom. I am also pleased at the effort you and my son’s teachers make to stay in contact with parents and keep us informed. The automatic phone calls I receive in the evenings once or twice a week are helpful to remind me of what’s coming up and what’s going on.

I was surprised, then, to show up at school to pick up [my son] on Wednesday afternoon and find police cars surrounding the school. I had no idea what was going on. I had not received any kind of communication about a lockdown or emergency situation, and I did not know if I needed to follow any special instructions or procedures or if I needed to be worried about my son. It was clear that some of the parents knew what was going on and others did not. I appreciated that you personally came out to explain the dismissal procedure, but I did not like being in the dark as to the reason behind the precautions.

I picked up [my son] at the back gate as instructed and was entertained by his account of the “practice” lockdown. I was pleased that he obviously knew what to do when a lockdown was called, that he and his classmates had followed directions, and that he was not traumatized or frightened. But I was not pleased that I still didn’t know what had triggered the lockdown and if I needed to be concerned.

Another parent informed me as we walked home about the potentially threatening phone call the school had received. I wondered how she knew about it and I didn’t. It was also a vague sort of report, the kind that can spawn rumors that blow the actual event way out of proportion.

When I got home, I had a message on my voicemail from the automated calling system with your explanation of the lockdown. The message was time-stamped 1:15pm, when I was already on my way home from picking up my son. I was relieved that no emergency situation had occurred and to finally hear more of the story.

I am writing, therefore, to comment that taking over an hour to get the message out to all families is too long. I realize there are limits to how quickly the robo-caller can get to all the numbers on the list. Normally, this isn’t a problem, but in an emergency situation like a lockdown, I think it’s important to get the message out as quickly as possible, especially since it had the potential to impact pickup procedures.

I’m sure the staff at [your school] have already considered the most efficient and comprehensive way to contact parents when news such as this needs to be disseminated. However, there must be a faster way to inform all parents when information is time-sensitive or emergent. Perhaps adding an email, classroom-based phone tree, or automated text messaging system would help to speed up the process, as well as having a better chance at reaching all parents. I would simply like to suggest that having multiple avenues of communication, rather than just a phone call to the home phone, would be prudent in the event of an emergency.

Thank you for your time, and for your dedication to making [your school] the best school it can be. I look forward to enrolling my other sons as they reach kindergarten age.

Sincerely yours,

This past Wednesday, I received a phone call from the principal in response to this letter. He apologized for how long it took to get back to me, explaining that they don't get much actual mail and that it took a while to find its way to his desk. He thanked me for my concerns and suggestions and said I was not the only parent to complain about how long it had taken to get the information that day. He also acknowledged the potential for rumors to start and that it was important that everyone get the same message at the same time to prevent this. He told me that the school district was already in talks with a company that can do mass text messaging and that this incident definitely made them aware that they need a quicker way to inform parents, especially when after-school activities and pick-up procedures may be affected. He did stress that their number one priority is to ensure the safety of the kids, with which I readily agreed.

All-in-all, I really appreciated his response. I was surprised and pleased to receive a personal phone call, that he had read my letter, that he understood and shared my concerns, and that he was already working to improve the system.

When we think about school emergencies, lately, our minds immediately go to incidents such as Columbine and Sandy Hook, but it's reasonable to think of more "mundane" emergencies, as well. What if there were a fire at the school? A water main break, a blackout, a failure of the heating or air conditioning system? There are many reasons the school may need to quickly get in touch with parents, and I'm glad that a non-emergency provided the impetus to make the change, rather than a system failing to perform when lives were at stake.

Monday, February 11, 2013

Some Tips for Finding a Babysitter

When I was a teenager, I spent many a Saturday night vegging on a neighbor's couch, watching their TV and eating their food, while their kids slept upstairs. I saved up quite a bit of cash this way. Occasionally, I actually had to deal with the kids - put them to bed, play with them, keep them from killing each other. This,  I didn't enjoy nearly as much, but babysitting was an obvious and relatively easy way to make money as a teenager, and it sure beat working at McDonald's! I was certain that, knowing what a responsible and reliable teen I had been, when I had kids I'd have no problem with hiring a local high school girl to watch my kids so I could get out of the house.

My how our perspective changes when we have children of our own!

Though I quickly found and enrolled N in a daycare when he was a baby, it was a long time before I was able to find someone to stay with him so I could leave the house at other times. Part of this was financial - hiring a baby-sitter can get expensive quickly - but part of it was the difficulty of leaving my son with a stranger, leaving that stranger alone in my house, and entrusting my son's care to an unknown element. It was hard, at first, to know where to begin looking for someone, when I was new to the city and didn't have many friends.

As I've grown as a parent, and as I've added to my family and my responsibilities, I've learned the importance of getting away for a bit. It's important to be able to step out and see a movie with your partner and without the kids. It's nice to have an adults-only dinner once in a while, to attend a meeting with other adults, to go to a special event, or simply meet a friend for coffee and not have to interrupt your conversation every five minutes to attend to one or more children. Being able to network with friends with deeper roots and older kids helped - they could recommend a babysitter, or even provide one if their kids was old enough.

Most recently, I needed an all-day babysitter a while back so that I could leave my kids at home while I attended a business lunch about two hours away. It was intimidating for me to have to interview and choose someone to entrust my precious kids to when I knew I wasn't close enough to run home right away if something (G-d forbid) were to happen. In the end, a friend I know well and trust implicitly said she was available for the job, so it was a relief to know that my kids (and home) were in good hands.

Now I'm in the process of hiring a new person to watch G for a couple of weeks so I can work more full time than usual. It's less stressful to hire someone knowing that I'll be home with them if something arises, but I'm still working with that "unknown element" fear. Though I'll be able to supervise the baby and the baby-sitter, there's the problem of being sure she'll show up on time, that she'll be proactive with the duties I assign her, that the baby will like her, that I'll like her, etc.

I have found that it's easier now that two of my three kids are old enough to tell the sitter about their routines, to tell me about anything that might have happened while I wasn't there, and to be a help to her.

So, now that I've been there a few times, some tips for finding and hiring a baby-sitter!

If you have friends with kids, ask them for a recommendation. The surest way to know what you're getting is word-of-mouth. Ask about reliability, what kinds of activities the person does with kids, how they interact with the parents, and how independent they are. Ask your friend what kind of vibe they get. It's best to ask a friend who would be looking for similar traits in a sitter - not everyone has the same needs.

Use a sitter-finding site such as or*. I have used a few times now and have been pretty happy with the number of responses I get to my job postings. I like that I can be very specific about my needs and easily weed out applicants who don't meet those criteria. I also like that I can get access to background checks, view the applicant's profile, and see reviews by other users who have employed the applicant. When I contact someone to come in for an interview, I look at how carefully they read the job posting and how they responded. Then I see that they show up on time for the interview and I watch how they are with my kid(s). I chat with them, ask questions pertaining to the tasks I'll be asking of them, and try to get an overall subjective sense of how I feel about them. Do our personalities mesh? Do the kids like her? Is she genuinely happy to meet and play with them? Does she take the initiative to get down on the floor and interact with the baby? What other babysitting experience does she have?

I like to bring a potential babysitter in for a trial day before the "official" start of the job. This way, we don't have the "first day" pressure of trying get our bearings and me trying to get my stuff done as well. Also, I think it's important for the kids to meet and get comfortable with a new caregiver before I disappear so that they'll be happy to see her when she comes again. This also gives me one last chance to change my mind if I'm not comfortable with how she performs.

(I keep saying "she" because most applicants for babysitting jobs are women and girls. That's not to say that men can't be babysitters, but it does seem to be less common.)

There are some really great babysitters and nannies out there. Remember when looking for recommendations that what you need is not always what your friend or neighbor needed. For example, perhaps your friend wanted someone who could do a little preschool-like work with her three-year-old, but all you need is someone to take your first-grader and toddler to the park while you run errands. Your friend might not have been happy with how the babysitter did or didn't teach her child letters and colors, but you might be thrilled with how that person plays tag with your six-year-old and pushes your baby on the swings.

There are some basic traits you'll want to look for, though, and I think these are pretty universal. I'm looking for someone who is reliable, who will show up on time, who will keep my kids safe, who will clean up her messes, and, most importantly, who loves children. I hope my latest hire works out well and that I've found someone who I can call upon to watch my kids whenever I need help.

I am not receiving compensation for endorsing any of the websites mentioned, nor was I asked to review or endorse said sites. I'm simply passing along information that might be helpful based on my own experiences.

Monday, February 4, 2013

On That Episode of Downton Abbey (Spoilers)

If you've seen it, you know the one I'm talking about. If you haven't, stop reading NOW. I was grateful no one spoiled me for this one, and I'd hate to inadvertently spoil anyone else. This is Episode 5 of Season 3, which aired January 27, 2013 in the United States. (I'm trying to write enough that the preview of this post will not show any spoilers.)

This episode was fascinating to me, for obvious reasons. Birth in 1920 wasn't handled all that differently from today, except considerably fewer births took place in the hospital. I'm reminded of reading Cheaper by the Dozen when I was in sixth grade, which takes place around the same time. The mother decided to try having one of her babies at the hospital, though all her other babies were born at home. A few hours there, and she came traipsing back home, saying that a hospital was no place to have a baby. At the time, I had no idea that babies sometimes weren't born in hospitals, and I had no idea that there was such a thing as a "home birth."

It's funny to think that now, less than 100 years later, giving birth at home is the unusual way.  Times change.

And yet.

If you watch the episode from the point of view of birth advocacy or knowledge of birth, watching the two doctors argue over the best course of action was eerily similar to what happens today. Watching Lord and Lady Grantham disagree over which doctor to listen to, watching poor Tom's distress over his wife's potential fate, watching the sisters try to understand what was going on - well, those kinds of panicked discussions happen just as much today, when the doctor raises the question of fetal distress or other potential birth emergency that may necessitate a cesarean or other intervention.

Dr. Clarkson, the beloved village doctor, wanted to take her to the hospital for a cesarean. There was no way to know, of course, whether it might already have been too late. (And, of course, this is all fiction, so the writers could have taken this in whatever direction they wanted. But let's pretend Lady Sybil, Dr. Clarkson, and Sir Philip were real people, just for the sake of discussion.) There was no way to know whether the cesarean itself would be more risky than allowing labor to continue. They didn't have the option of Pitocin to move things along, or magnesium sulfate to prevent seizures, or fetal monitoring to see how the baby was doing. But they had seen toxemia (preeclampsia) before, and they had seen eclampsia before, and how painful it must be to see those seizures begin and know the patient is going to die and know there's nothing you can do. Eclampsia is still a major cause of maternal death, and it is still unknown what causes an otherwise healthy woman to have a spike in blood pressure, organ failure, and seizures leading to death. It is known that the only way to prevent it is to deliver the baby before the pre-eclampsia becomes eclampsia.

Dr. Clarkson's recommendation to attempt a cesarean section in hopes of saving Lady Sybil's life was not made lightly. He knew the only way to avoid eclampsia was to deliver the baby as quickly as possible. He also knew that a cesarean section was extremely dangerous, a last resort. Until the 1970s, c-sections were performed extremely rarely (4% or fewer of cases). It was known that the risk of infection to the mother was high for surgery performed in a public hospital. Obstetrician-to-the-nobility, Sir Philip, who Lord Grantham hired because he wanted his daughter to be in the best of hands, was aghast that Dr. Clarkson would even suggest such a thing. He felt the risks associated with a cesarean section were higher than the risk of eclampsia. It's possible professional pride prevented him from admitting that he, too, saw the signs of toxemia. It's also possible that he felt labor was progressing well enough that no intervention was required. When the baby was delivered healthy and Lady Sybil appeared to be fine, it looked as though Sir Philip had indeed been correct. Unfortunately, hours later, we learned that Dr. Clarkson's dire prediction was to be borne out.

A case like Lady Sybil's today would probably have been a no-brainer. She would have been taken in for an emergency c-section, and very likely both she and the baby would have been fine. By the end of pregnancy, a woman receiving regular prenatal care would be seeing her doctor or midwife weekly. Her blood pressure would be monitored, and if there was any suspicion that her blood pressure may be rising or that she may be at risk of preeclampsia, she would be told to watch for symptoms such as those described by Lady Sybil - sudden swelling of the ankles and hands, headache, disorientation, visual disturbances.

With both my first and second sons, my blood pressure rose toward the end of my pregnancy, and I was given weekly or even twice-weekly reminders to call my doctor immediately if I should experience any of these symptoms. As it happened, though I was not diagnosed with preeclampsia, my blood pressure was high enough, and stayed high enough, at my 37-week appointment with my second son, that the decision was made to deliver him to protect both of us. Fortunately, a Pitocin induction, in my case, worked perfectly, and my son was born healthy and full-term, and I was fine. My blood pressure came down immediately upon delivery and I experienced no further symptoms that would suggest preeclampsia.

As with any medical decision, decisions regarding birth and interventions during labor require a weighing of the risks and benefits of action or inaction. Sometimes the safest route really is to simply wait and see. Other times, an emergent situation changes the balance in favor of intervention, up to and including immediate surgery. As the helpless viewer of Downton Abbey, we could yell and scream at the TV to go do the cesarean, or that no, she'll be fine, or however we felt, but we couldn't affect the outcome. I could see they were leading up to something when Sybil complained to Mary about the swollen ankles and headache she was experiencing a few days before she went into labor. I was puzzled that Dr. Clarkson didn't mention anything about her blood pressure at that point, since they specifically showed him taking a measurement. I don't know enough about 1920's medicine to comment on his knowledge of the significance of blood pressure in pregnancy. In any case, as committed as I am to allowing labor to take its course in most cases, it became clear that we were supposed to root for Dr. Clarkson's proposal and to be angry at Lord Grantham for agreeing with Sir Philip.

In 2013, a c-section is a relatively safe option in a first-world hospital setting. However, as with any medical or surgical procedure, it carries risks, including infection and complications. The issue, as always, is whether those risks outweigh the benefits of performing the procedure. When the life of the mother or baby is clearly in immediate danger, the benefit of mother and child surviving is obviously greater than the risk of infection, for example. It is important to know what the risks are to both mother and baby of performing a c-section under various conditions and to consider whether the benefits truly make those risks worth taking.

Of course in Lady Sybil's case, the risks of c-section were considerably higher than they would be today in a modern hospital setting, so the decision was nowhere near as clear-cut.

There's a lot of discussion these days about encouraging doctors and hospitals to be more hands-off during birth, to allow nature to take its course, to trust in the birth process. The issue of eclampsia and other life-threatening complications of pregnancy are a stark reminder that modern medical practices during birth also save lives, and that there is definitely a time and place for these interventions. We can hope that, in the future, there will be a better balance between the use of interventions when necessary and relaxing and letting things progress normally when appropriate.

As a side note, I did spend quite a few minutes wondering who is feeding the baby?! when everyone was tending to Sybil and the baby was nowhere to be seen. I was glad when they mentioned that they'd found a nurse for her, though it seemed a throwaway line just to cover that detail. That was the main option for a family of means when the mother died in childbirth. Today, the idea of wet-nursing seems odd, but they didn't have the fancy formulas we do today. Though rudimentary formulas and other infant-feeding options did exist, including simply feeding sheep's or goat's or cow's milk directly, a wet-nurse, if the family could afford and find one, was a better option.