ADVICE FROM A BABY NURSE

 
- Liane Weintraub, Editor-in-Chief

Luiza Desouza has been working with children for more than 35 years, more than half of those years as a newborn specialist. While looking after hundreds of infants, she has had the opportunity to repeat the same kind of care time and time again, improving and honing her skills as she became more knowledgeable about babies’ behaviors and their special needs.   She can even distinguish the many different types of babies’ cries and knows how to respond in a manner that best serves both mother and child.

As a professional baby nurse, Ms. Desouza has had up-close experience with almost every possible situation that may arise in the early stages of a baby’s life – both the most wonderful of times and, unfortunately, the challenges that some families go through.  All of this has given her an extraordinary perspective for which her clients – especially the first-time parents – are very grateful.

It’s simply a fact that newborn babies don’t come with instruction manuals, and while there is a great deal of information available on the Internet, in bookstores, from old-wives-tales, etc., pursuing getting advice about what to do with a colicky baby, for example, can be a minefield.  For one thing, many readily-available recommendations conflict, which is confusing and unsettling to parents; for another, it’s hard to know which sources to trust.  So, parents with access to a trusted resource such as an expert baby nurse with a lifetime of experience are truly blessed.

Although Ms. Desouza has a long waiting list of parents who would love to hire her, she knows that most people do not have the luxury of being able to hire a full-time baby nurse to help them through the transition of bringing their babies home for the very first time, which can be as traumatic as it is wonderful.  As a result, Ms. Desouza has written a book, The Beginning of Life, which is essentially an “owners manual” for parents and caregivers.  In the book, she

focuses on birth to 3 years of age, and while she uses supporting information about health and child development from experts and research, the how-to care is based on her own extensive experience.

“The Beginning of Life” will be published in Ms. Desouza’s native Brazil next year, and she hopes to have an English language version available in the near future.  Meanwhile, she was gracious enough to share some of her remarkable knowledge of newborns with Tastybaby.

Tell us about your background.  How did you wind up as a baby nurse?

When I was a teenager in Brazil, my cousin got me a job at the hospital where she worked and I was assigned to the maternity ward.  I fell in love with babies.  One of the doctors there had a sickly baby who I took care of while he was in intensive care, and when the baby was released (still with many health challenges), the doctor hired me to live with his family and care for the baby.  From there, I went on to work for many families in Sao Paolo.  
I moved to Europe and lived, studied and worked in Italy and England, before coming to the United States.  When I first moved to this country, I spent 4 years working as a special education teachers’ aid at San Diego Unified City Schools. That experience expanded my knowledge greatly. I went on to study child development, and truly honed my research skills, but it wasn’t until I returned to caring for newborns that I found the practical knowledge I have used ever since to guide new mothers and hired caregivers to do what I believe to be the most important job in our culture. I truly believe that the only way to have a better world is by giving the right foundation and love to our children from day one...

What would you say is the most important thing in caring for a baby?  

There are a lot of important things, but love and affection are the building blocks of a healthy emotional child, much as a healthy diet forms the foundation of a child’s physical well-being.  A child that lacks love and attention may become weak both emotionally and physically.

Do you find all the babies you’ve cared for to be similar or different from each other?

Every baby is very much an individual!  Even by the end of the first month, a baby is probably already showing some aspects of his or her personality.  For example, babies who enjoy action will calm down when rocked or walked, while babies who prefer noise or songs will calm down when someone sings or when they hear natural sounds like falling water, the ebb and flow of ocean waves, the whistle of the wind, etc.

There are so many conflicting philosophies about caring for babies.  How do you help parents cope with the confusion?

Usually, I know that the families I work with share my basic values because we usually have a long interview process.  This is for them as much as for me, because we all have to feel comfortable with each other.  I explain that I consider myself a baby expert because of my experience, but I am not a doctor or a registered nurse.  My knowledge comes from a lot of hands-on experience with over 100 babies, and my own research.  They need to feel that their baby is in safe hands, and I want to know that my thinking is in-line with theirs because I would never be a part of doing anything I think is harmful to a baby.

Like what, for example?

There are lots of things that people believe in that are simply not part of what I do.  It could be anything from over-medicating to ignoring basic cleanliness around a baby that could put that child at risk.  Basically, I am very open to the idea that every family is going to be different – that is what makes each job so interesting and rewarding.  I am learning from each client.  But we still have to agree on the basic approach, and I’ve been doing my job for 35 years, so I’m not going to make drastic changes to what I do.

Ok, so let’s address a few of the areas that parents find most perplexing.

What’s your opinion about breast versus bottle feeding?

The majority of my clients choose to breast feed, and I help them through the process, which is a wonderful source of both bonding and nutrition.  Of course, there are many instances when breast feeding is not an option – I have worked with many adopted babies, as well as mothers who didn’t produce enough milk.  I would say that a large number of my breast feeding clients also supplement their babies’ diets with formula.  I would rather see a baby getting enough calories by adding formula, than insisting on strictly nursing if the baby is always hungry.

Where do you stand in terms of whether to put a newborn on a schedule?

A newborn (the first 29 days of a baby’s life) really doesn’t need a real schedule.  They need to eat very regularly, and I do establish set bath-times, etc., but the most effective schedules are created when we observe the baby to learn what his or schedule should be.  The baby will show you what works for him or her; then it’s my job to interpret this and set up the schedule that is best for that child.  I do believe that schedules and routine are very important.

Getting some babies to sleep well can be the most challenging thing of all.  What’s your approach?

Making sure that babies are eating well is very important.  If they are not getting solid feedings, they will wake up hungry more often.  Many babies tend to “snack” at the breast, so I try to get mothers to keep them awake by taking off their warm clothes, tickling their feet – whatever works.  

A routine is also very important because if a baby remembers that ‘sleep time” comes right after a massage, for example, they’ll be more likely not to fight it.  (By the way, massage is a very important, soothing thing for babies, and I feel strongly that it is important to put your hands on your baby – that intimacy and contact is very healthy.) I very much believe in swaddling, and I have my own technique.  However, I have seen some parents discover swaddling as a way to keep their children still and asleep, and there can be a tendency to abuse this.  Parents rarely realize that if they keep their babies swaddled too long and too tightly with arms pinned at their sides, they run the risk of limiting their babies’ mobility.  I always leave a little slack in the swaddle, and once babies are sleeping pretty well and they have grown out of having a “jerk reflex,” I release their arms from the swaddle completely.
A very few comforting items like a pacifier or blanket can be soothing, but I never leave much in a baby’s bed.  It’s just too dangerous.  And, it’s not the end of the world if a baby cries a little before sleeping, although I don’t let young babies “cry it out.”  

Do you believe in the “Family Bed” concept?  (Having babies sleep in bed with their parents)

This is not something that most of my clients do, although much of the world practices it.  I do think it is crucial for babies to learn to sleep on their own – actually, they need to know they can be alone in their cribs and feel safe and secure.  I am very much in favor of parents bonding with their babies, so snuggling and napping together is important, but there are safety hazards that come up when you sleep in a big, adult bed with a baby.  I would prefer a co-sleeper or having a bassinet next to the bed.  That is convenient for nursing and feeding, too, but the danger is that if mom and baby are half asleep during the feedings, this will lead to ‘snacking” (not full feedings) and these babies tend not to sleep for long stretches.

Vaccines?

This is a very personal choice for parents, and I really let them make their own decisions.  I usually go along to early visits to the pediatrician, and the best doctors present lots of information and let parents make their decisions.  This is a tricky one.  I need to be there as a guide, but not to insist one way or another.

How do you feel about traveling with very young children?

I have done a lot of travelling.  I’ve worked for quite a few celebrities, and their careers can involve a lot of travel, so I’ve been in every kind of travel situation with my babies.  If it’s a necessity, we make it work.  I try to keep the routine consistent for the baby, no matter where we go.

Would you say that you’re germ-phobic?

I do not think I am unreasonable.  Babies are very sensitive to germs, so I keep things very sanitary.  I am not “phobic,” but this is part of my job.

What about starting babies on solid foods – what’s your approach?

I like to make as much food as I can – of course, this was before Tastybaby!  (My latest client is now exclusively feeding her baby your food, by the way!)
My approach is to start slowly and carefully, making sure to eliminate any possibility of allergies.  I strongly believe in only using the best, organic produce.  I slow-cook fruits and veggies (separately at first) at low temperature in a steamer, and then finely puree it.  In food preparation, I’d say being “germ-phobic” is important.  It is very easy for bacteria to form when you are making baby food at home.

Is it hard for you to move on from job to job?  Do you get attached to the babies you take care of?

Yes, I get very attached, so I try to stay in touch with the families.  I love my babies very much, and we form a special bond.  I often go back to take care of 2nd and 3rd babies, which is wonderful.  But this is the career that I have chosen, so even when it’s hard to say goodbye, I know that it’s the right thing to do.  I am a baby specialist, not a toddler expert, so, even though so many of my clients have begged me to stay, it’s best for me to move on to a family that