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Bonding With Baby

Over the past several years, much has been written about the importance ofbonding with a newborn, especially in an era when family structures and com-mitments have seemed so shaky. What exactly establishes the deep emotional tieswith a child that will cause a parent to spend untold hours feeding, bathing, rock-ing, changing, and attending to the seemingly unending needs of a new baby? Isthe bond locked into the genetic code of mothers and set loose by the flow ofhormones during pregnancy? Is it biologically preexistent in fathers, or does itdevelop through watching role models in his family, as an extension of his lovefor his wife, or by an act of the will? Does it spring to life when the baby is firstseen at the moment of birth? And what secures the attachment of a newborn tohis mother and father?

Some have suggested that there is a critical time in the baby's first hours oflife when a special connection will be made, especially between mother and child,that will affect the quality of their relationship for years to come. But this as-sumption raises a troubling question: What happens when mother or baby (orboth) have special medical problems and cannot be together during those earlyhours or days? What if the new mother has a cesarean delivery and thus only mo-mentary contact with her baby after birth, not to mention the potential distrac-tion of pain during her recovery? What if the baby is born prematurely and mustspend weeks in a high-tech hospital setting?

The answers hinge on the fact that human behavior is highly complex andnot rigidly stereotyped or predictable like a computer program. As a result,bonding is a process that begins well before the baby is born and continues foryears thereafter. It is certainly influenced by biology, hormones, and genetics. Butit is also shaped by the upbringing of the new mother and father, their personaland spiritual values, their commitment to one another, and some everyday deci-sions they must make. Furthermore, human babies are not like newly hatchedducklings that attach themselves to the first object they see.

Throughout this book we will be looking at the process of building and nur-turing the bonds between parents and children and suggesting practical ways tocarry out this important assignment. Here are several specific ideas for duringchildbirth and the time immediately following it:

If at all possible, keep sedating medications to a minimum during the hour or twobefore delivery. It is indeed nice if both mother and baby are awake and alertwhen they meet for the first time. However, it is not a sign of moral failure to request pain relief during labor (especially in the later stages when discomfort canbecome much more intense). If you in fact receive medication that producesdrowsiness immediately after birth, you will have plenty of opportunity to beginenjoying and interacting with your baby in very short order.

Stop, look, listen, and touch. Whether immediately after birth, a few hours later,or (better yet) many times over the next several months, take the time to sit qui-etly and enjoy your new family member. Study his features. Let him grip your fin-ger. Smile and talk and sing to him. Count his toes. Marvel at the handiwork ofGod's creation and thank Him for loaning this child to you for a season.

Look into rooming in. Continuous contact with the baby in her room can give anew mother more practical and realistic preparation for the first few days athome. A pattern for nursing can be established, problems can be talked over withthe nurses and other staff members, and (more important) there is more time foreveryone to get acquainted with the new baby. Most hospitals today are flexibleabout these postdelivery arrangements, and some will assign a single nurse to at-tend both mother and child in a more coordinated fashion.

Some mothers prefer a variation on this theme, in which the baby spendsmost of the day rooming in and goes to the nursery during the late-night andearly-morning hours. This can be particularly helpful for a mother who has hada long, exhausting labor. Occasionally when one or more small children are wait-ing at home and Mom already knows the basics of feeding and newborn care, shewill actually prefer not to have full-time responsibility for the new baby, in orderto get a time-out and rest for a day or two. However, this relatively quiet inter-lude should include a generous amount of one-on-one time with the newborn,since the other children will want some attention once everyone arrives home.

In one sense, it might seem easier to spend time forming attachments withthe new baby by getting out of the hospital and returning home as soon as pos-sible. But home is also where your responsibilities are. Someone needs to preparemeals, do laundry, feed the dog, maintain order, and tend to any other childrenin the family, all of which could compete with your attention to your newborn.Ideally, prior arrangements can be made with husband, relatives, friends, or live-in help to take on some of these daily assignments. Preparing for this phase ofchildbirth can be every bit as important as all the classes and exercises during thelast months of pregnancy.

Feeding and bonding. There are numerous advantages to breast feeding, whichwill be elaborated on in detail in the next chapter. One that many mothers havedescribed is a feeling of special closeness and nurturing that comes from a combination of skin-to-skin contact with the baby, the satisfaction of providing himnutrients and watching hint grow as a result, and possibly the release of hor-mones triggered by nursing. For these and many other reasons, breast feeding isthe form of nourishment preferred by medical authorities (at least for the firstfew months).

Because of the unique relationship between mother and baby duringbreast feeding, fathers may feel that they have less to offer, at least for the firstseveral weeks. On the contrary, there are plenty of hours left in the day whenthe baby can be held, rocked, talked to, and generally enjoyed by his father. Inaddition, while Dad may be tired from hours of coaching, he will not have suf-fered the same physical exhaustion from the childbirth process that Mom did,and he should be given the opportunity to tend to their newborn child as of-ten as possible.

If you cannot or choose not to breast-feed, you need not lose sleep wonder-ing whether your bonding with your child is going to be impaired. For one thing,both parents can interact with the baby during bottle feeding. And rememberthat feeding is only one of many components of the attachment process.

What about bonding after a cesarean delivery?

The need to deliver the baby by cesarean section may arise suddenly, or it may beknown for some time in advance. The reasons this surgery may be recommendedand the techniques used to carry it out will not be detailed here. (They should becovered in detail in your childbirth classes.) However, in most cases there shouldbe time to carry out an epidural anesthetic, which allows the mother to be awakeand alert during the delivery. Furthermore, the father or coach is typically al-lowed to sit at the head of the operating table, near the anesthesiologist. Only asmall minority are so-called "crash" surgeries, in which an emergency requiresthat a general anesthetic be given.

When your baby is delivered by cesarean section, as soon as her cord isclamped and cut, she will be taken to a warmer for a brief examination. (Whilethis is going on, the obstetrician and an assistant will check your uterus and ab-domen, then begin the process of closing the multiple layers of tissue between theuterus and skin.) If all appears satisfactory, the baby will be brought to the headof the table where you can look at and touch her briefly. Unfortunately, the lo-gistics of a cesarean delivery make a prolonged time with her difficult, and anyattempt to nurse immediately after birth is impossible. After the surgery, you willgo to a recovery area, where you may have further contact with your baby.

The first minutes (or even hours) after a cesarean delivery are usually notwhat most couples hoped for as a postchildbirth bonding experience. But catch-ing up can be done over the next few days. Here are a few suggestions to help theprocess go more smoothly.

Explore your pain-relief options. A cesarean is major surgery, and pain control
will be necessary for the first few days. The traditional injections of meperidineDemerol) or other narcotics every few hours can cause wide swings betweendrowsy relief and wide-awake discomfort, either of which can interfere withyour interaction with your baby. If at all possible (and if available at your hos-pital), consider having the analgesic (pain-relieving) medication given througha patient controlled analgesia (PCA) pump. This is an intravenous system thatdelivers the medication at a rate you control, within specified limits. The effectis smoother, without extremes of pain or sleepiness. Some anesthesiologists willleave the small tube for the epidural block in place, allowing for very effectivepain relief without any drowsiness at all.

Don't give up on nursing. Breast feeding after a cesarean delivery is challengingbecause the usual positions for holding the baby can be quite uncomfortable. Butit can be done and is worth the effort.

Try to recruit some extra help at home. The discomfort and fatigue that are so common in the wake of major surgery can turn the most basic tasks at home intomajor projects, leaving little energy (or enthusiasm) for the pleasantries of bond-ing. If your husband can't take extra time away from work to be home, considerhaving someone lend a hand for a few hours a day or even serve as a live-in totake care of some of the daily necessities. This person could be a relative (perhapsone of the baby's grandmothers), a volunteer from church, or someone specifi-cally hired for this job. (Some insurance plans will help fund this assistancethrough a home-health agency.)