How many people does it take to make a baby really sick?

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We have an interesting conundrum. Our offspring (______) is due on November 20th. This places the likely date of birth just prior to Thanksgiving. This causes many people to get very excited because they get to see and play with the new baby. I wonder how mad at me all those people are going to get when they find out I might not let that happen?

I’m not entirely sure what we are going to do postpartum. I’m quite interested in advice, so please do make your suggestions below. I’d especially like the advice of the MD’s and Public Health Scientists in the vicinity. Or anyone with relevant experience.

The reason advice is needed is two-fold. First, although I’ve raised a child before, I’ve not had charge of an infant during a pandemic. Second, few other people have either, and the nature of advice, common knowledge and practice about things in general and health related issues in particular is not usually rational, in my opinion.

We’ve already decided to skip the usual Huge Thanksgiving Get Together for the simple reason that there will be thirty or forty people there, and it simply does not make sense to wander into a crowded house full of people with a new baby during a flu pandemic.

An alternative has been suggested. This is a smaller, more limited Thanksgiving dinner with just a few family members, and that’s all. But there are three problems with this emerging, at least in my mind: 1) At least two people who will be there have rather proudly declared (and I love you guys, but you are way off on this one …) that they don’t do vaccines. They are not denialists, they just think the vaccines will make them sick. And of the other people who might visit I’m not sure who or who else might have the vaccine; 2) There will be at least one, possibly two, other vulnerable individuals who will also be at the get-together, so this may not be a good idea for them either. (Though they are older than what seems to be a high-risk cutoff for Novel A/H1N1 Swine Flu, and by that time will have been vaccinated.); and 3) I’m not sure that spending five hours in a house with one person who is sending out flu infectoids is much different than spending five hours in a larger house, more densely crowded, with, maybe, a dozen people sending out the infectoids. In fact, the way social events like this work, it is quite possible that the expected number of people woud grow rather than shrink. Will it be eight people? Ten? Fourteen? All these numbers are less than 30 (the best guess for the main Thanksgiving event) but I’m not sure if I care about that difference. Yes, I understand that exposure for longer periods and to more infectious sources should be more highly correlated with actual infection across many instances, statistically, so the probabilities are different. But …

We are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu. But with just one …. I’m not so sure that aggregate values and probabilities are of any great interest to me. My baby does not get to be several thousand dots on a graph only a few of which will get sick. He is allowed to be only one dot.

My current plan is to monitor the situation, and consider a visit that falls short of staying around for hours and having dinner, but would allow the people to see the child and visa versa. Although the unvaccinated will be wearing those scary masks and everyone will be washing their hands every few minutes.

As I suggested above, there is likely to be a certain amount of irrationality in a decision making process like this one. I’m not sure what will emerge in this particular case, but for the more general circumstance of family meeting baby vs. limiting exposure to baby, here’s a few items that come to mind:

First, if you read the “how to not screw up your baby” literature, you’ll see a common question addressed: When is it “safe” or advisable to “take your baby out” after it is born? The answer in this literature strongly implies that new parents are often too shy about going out with baby. It is perfectly OK to cart around a properly swaddled new-born. Just don’t let sick people touch it, and be smart about what you are doing. In fact, you will see comments in this expert advice literature such as “It is probably healthier to get your baby … and yourself! … out of the house early and reasonably often! Don’t be a hermit.” and so on.

And of course, that is all true. But, this advice addresses a question other than: “When is it safe to bring my baby into contact with other people who may have the Pandemic Flu?”

And, the advice does not specifically mention my baby. Here, we are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu because I took them out because some FAQ on taking care of new borns told me to. But with just one …. I’m not so sure….

A second feature of this sort of discussion is the necessity and importance of the family visit, of the “coming out” of the new born for all to meet and stuff. Obviously, this is a very important thing to do, but it is possible that the importance of everyone getting to meet and greet the new baby is not quite as great as the baby surviving his first several weeks of life, despite one’s desire to avoid social awkwardness of any kind.

Let me be quite stark about this: Cousin Jeeter may feel great about meeting the new baby now, but how is Jeeter going to feel if the next day he suddenly comes down with the flu, and two weeks later finds out that he probably gave the flu to his infant cousin, who has died, and no, Jeeter is not invited to the funeral. I understand that dead baby comments are in bad taste and there will be people mad at me for making the stark link between this decision and that outcome.

Tough. We are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu. But with just one …. I’m not so sure that someone’s sensitivity to facing the stark reality that this flu … this pandemic flu we are having now … appears to be potentially deadly to anyone under 18 years of age is of any great interest to me. Yes, the chances that an infant will die from the flu are low. A week or two in the NICU should take care of him, and organ damage caused by such a major infection early in life won’t matter for … decades, if at all. But we are talking about my baby, so I might be a little picky about this.

A third fallacy that is of great importance is that if everyone washes their hands, there won’t be any problem. While it is good to wash hands a lot to reduce flu transmission, this only reduces transmission to some extent. The flu is transmitted very nicely by flying through the air. Even if an infected person coughs into his or her sleeve, the air that comes out of the person’s mouth has a zillion tiny saliva spaceships each occupied by thousands of eager flu viruses, which blow around the sleeve and into the air. Those tiny, microscopic droplets float around in the air for many minutes, possibly hours. They are then breathed in by other people in the room. They can also land on surfaces such as … candy in a candy dish, the rims of drinking glasses, the nipple of a baby’s bottle, the cat, or on someone’s hair.

Yes, a really good way to get the flu is if an infected person coughs slimy stuff into his hand, and shakes your hand thus putting the slimy stuff on your palm, then you wipe your nose with the palm of your hand or maybe you lick your palm or something. But for the most part, the way flu actually gets from one person to another is when there are two people in a room, one is infected and the other not, and they both breath for a while, with the infected person coughing or sneezing now and then.

Am I exaggerating the air borne infectious nature of this flu? Maybe, maybe not. Conditions vary, the flu varies, it is all a game of complex interconnected probabilities, so there is certainly a calculable probability of infection via direct hand to hand (to mouth) contact vs. airborne only.

But we are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu transmitted via the air. But with just one …. I’m not so sure that aggregate values and probabilities are of any great interest to me.

I feel very lucky that all the close and more distant family members in our case will be totally understanding and supportive of whatever decisions we make (though everyone really should get vaccinated). The problem is, what exactly should that decision be?

So, what are you doing for Thanksgiving? What do you think we should we do?

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70 thoughts on “How many people does it take to make a baby really sick?

  1. Well, speaking as a complete and utter non-expert in any relevant field, skipping the big Thanksgiving dinner seems like a no-brainer to me. Unless evidence is presented that such family gatherings do not, in reality, increase the risk of transmission among infants, it seems that given the nature of the flu it is extremely likely that there is a noticeable increase in risk.

    When the kid is 6 months old, you can get them flu shots. Until then, while we have pandemic flu floating around, it just seems to me a no-brainer that the small but palpable risk is quite enough to make some small sacrifices. There will be other Thanksgiving dinners, after all.

  2. I doubt that the little one will appreciate Thanksgiving, coming to it a few days after birth. I should think that a happy second Thanksgiving is a better idea, and keep him home to make sure that he gets one. Whether the adults are disappointed at not seeing him would count as zero with me. But then I’m just a cranky old woman who nearly didn’t survive a couple of flu pandemics in my youth.

  3. I say you make it mandatory to get vaccinated to see the baby. It’s for everyone’s best interest.
    This phrase: “They are not denialists, they just think the vaccines will make them sick. ” does not compute, assuming they don’t get anaphylaxis type reactions to egg or something.

    My Dad and I were speculating about it. There’s a good chance he’s already had H1N1 (went to the Dr. and got tamiflu, but without a PCR who really knows…). He and my mother got sick just before they came out to help me with the newborn. I was worried about it, but the fevers had passed and they were feeling better and so on. I got a respiratory illness right after I gave birth. Amanda will probably get sick before baby _____. Assuming she’s breastfeeding, that might not be such a bad thing. Most of the breastfeeding mommies I’ve talked to have said that babies tend to get a lighter version of some of the things they got, but tended not to get everything (at least, pre-daycare they didn’t, and with the exception of ear infections for some kids). Probably mommy getting the antibodies first is good. Obviously, if she’s vaccinated and breastfeeding, the odds are probably much better baby ____ will be safe, though I have no quantitative data.
    So, anyway, my dad was speculating about it. He said “I was wondering if I should get vaccinated” (keeping in mind he may have already had it) and I said “well that depends, do you want baby to come home for Christmas?”
    I’ve been getting seasonal flu vaccines for years, because I’d feel crummy if I went from work (at a medical center), drove the 12+ hour drive home and got all stressed and susceptible, and infected my older parents (who smoke and have respiratory issues, and yeah I’ve nagged at them to stop and yeah it’ll never happen). If I do it for them, they can do it for baby.

    Also, it was -23 degrees F below zero the day I was born. A very cold winter. My mom was a hermit and it was ok. OTOH, I imagine I would have gone completely nuts (moreso than as it was). See how Amanda feels when you get to that point.

    Also, what little science I know suggests that the flu is one of the best for airborne dispersal. Seasonal flu spaceships love winter weather (one of the reasons they’ve speculated seasonal flu is so seasonal). I bet it hasn’t been done for H1N1, but you’re probably a smidge better in uncommonly humid weather (if droplets get too heavy I think the spaceships sink).

  4. I’m no expert in anything other than telling people what to do, so I’ll stick with that. Don’t go. ONE person is enough to get your baby sick. Even if everyone’s vaccinated, there are those for whom the vaccine won’t work or who got it too late and don’t realize they are sick, or feel like they might be sick but come anyway because “it’s not that bad.”
    No. Just tell people you “don’t think you’ll be up to it” what with the new baby and all, and then don’t go. And put up quarantine tape around your house.

  5. My son was born 6 weeks premie, and was quite fragile for his first few months. I wouldn’t let anyone near him who seemed to have a cold or hadn’t been fully vaccinated for his first 3 months, or so. It mildly offended some people, but tough! this was *my baby* we were talking about.

  6. Take lots of pictures and pass those around, not the baby.

    I would also tell everyone, no matter who they are:

    “if you are/were recently sick, do not come”.
    “If you were with someone recently who is/was recently sick, do not come”.

    No exceptions.

  7. I agree with everyone else, don’t do it. There will be time to have big dinners after the newborn phase. Also, you and Amanda are going to be tired. And, you will also be nervous about handing him off to all those germ carriers, or even having the germ carriers in his air space. Even if they don’t have the flu, per se, who knows what else they could be breathing into his tiny, fragile, still developing lungs. This is what the internet is for. Send out pictures/announcements and tell your relations you’re having a fine time getting to know your son, and they can just wait.

  8. I’m kind of imagining that your wife will be a bit too tired for a large gathering, too. Personally, I’d skip the whole holiday.

  9. Obviously I’m not a medical expert but I would go with a lot of the other commentators – virtual quarantine for Thanksgiving. Coming so soon after the baby’s due date I just don’t think it’s a good time to be exposed.

    The problem, as I see it, is not that a child is more likely to get sick at say 7 days rather than 7 months or 7 years. It’s that if the child does get sick then the small size of a new born :

    a) Gives the child that much less margin to fight off the infection.

    b) Limits the options that medical staff have, should hospitalization be necessary.

    My recommendation:

    Enjoy Thanksgiving with just the three of you, plus a chicken. It’s the only way to control the situation.

  10. I think you made a serious flaw in strategy here. You are saying:

    �Here, we are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu�

    You should have said:

    â??Here, we are talking about my baby. If I had a hundred babies I would still hate to lose even a single one to the flu.â?

    You have just greatly reduced your chances of ever having a hundred babies. No self-respecting woman is going to choose a man who wonâ??t care if her baby dies of the flu so long as he has plenty of extra ones.

    Let me go on record here, that no matter how many babies I have, hundreds or even thousands, I would mind very much losing even a single one, and would take great pains to try and ensure that does not happen.

  11. As the parent of a preemie born in March, do whatever makes you comfortable. If you are really worried about the baby getting sick (and it’s a rational concern) then don’t go and ignore all the people whose feelings will get hurt. (And they will be hurt, trust me on this one. Been there, done that, painted the spare bedroom 8 months ago.)

    We have friends whose baby was born two weeks ago, also premature. And the grandparents are deeply insulted that our friends want to have a bris that’s just family.

    I mean, how *dare* the parents of a *premature infant* be concerned about pandemic flu???? Don’t they know that the rights of adults to sneeze and cough on a preemie are paramount???


  12. daedalus2u- This is going to sound horrible, but if I had 1000 babies, I wouldn’t mind losing a few. I don’t have 1000 nipples here.

  13. Clearly, you have to put your baby’s health first. I have no idea why people go on the “baby tour” shortly after a kid’s birth — though I wonder if maybe it’s to confer onto the baby the sicknesses that are floating around in your population, to build immunity. Something like the “we kiss to pass immunity” hypothesis. Hmm.

  14. Congratulations by the way! A while back I read an article about how expecting parents (both mom and dad) experienced increased levels of oxytocin, which leads to the OCD like behavior (like getting up in the middle of the night to see if child is breathing) which is protective and natural for new parents. (Sorry, I looked for the link, but can’t find it).

    Why? IMO it’s because baby’s and toddler’s have an amazing ability to get sick and into trouble and you need OCD like symptoms to give them the minimal amount of safety (at least until preschool). (Maybe that’s just my kids, though).

    When I was younger, it was pretty much assumed that parents were not going to take newborns out into public (malls, parties, etc) If you wanted to see the baby, you called ahead to visit (in couples or small groups), you brought food and you expected the parents to be exhausted and you didn’t hold the baby unless offered. Things seem different now, but my children were both adopted as toddlers, so I don’t know.

    I would not plan to have people over for the holidays. That is too much work and you can’t control the situation. If you do want to make an appearance, make plans to attend someone elses small holiday gathering and make it clear you may not attend if you, child or mom aren’t feeling up to it. If you decide to attend and you don’t feel comfortable with someone holding the baby leave the baby in the carrier (if you have a sling or front carrier, you have even more control)and tell people “I just got him settled, I want to let him rest for a bit or we think she might be coming down with something, etc” If people are being too pushy, wrap it up and go home.

    One phrase I found helpful. “The doctor says I shouldn’t or should…” People find it very hard to fault a parent for listening to their pediatricians orders and they don’t seem to take it as personally. I’m sure you can find a doctor who will tell you whatever you want if you don’t feel like fibbing.

    Personally (I may be horrifying many), I don’t go in for the extreme version of anti-germ ultra cleanliness that some mom’s are into these days (fabric protector’s and sanitizer for every shopping cart). I think that it’s good for kids to catch the occasional bug and eat the oreo that fell on the floor 30 seconds ago.

    BUT this opinion does not apply to newborn and infants. Colds and flu are much riskier for them (I think. Once again don’t have personal experience).

    Best of Luck and Congrats again!

  15. I remember reading advice somewhere to not have any meet-the-baby parties until this blows over (or possibly until the baby has had a flu shot). I don’t know where I read it, though.

    My sister-in-law just delivered her baby yesterday (Evi Sophie). I usually use the car to go to work, but this week I’m in training and commute by public transport. As a result, I’m not going there to look at my niece until I’ve had at least a couple of days in ‘quarantine’.

    I understand it’s going to be hard on your family and friends, so you should try to make it up to them with lots of pictures and other promises. But keep as many of them as possible away from your son. If possible, don’t put a message in the card itself, but use a separate insert. That way, you won’t be reminded of the pandemic every time you see the card.

    Perhaps you can get a doctor (family doctor, gynaecologist, obstetrician) to write up something for you, to act as a scapegoat so you cab be ‘just the messenger.

  16. Yes, I do find the one hundred babies comments and dead baby comments quite disturbing. Please stop it. You will give me nightmares. And you are killing my (mental image of a) sweet little baby face buzz.

  17. Congratulations on your impending arrival. I suggest you offer the carrot of a baby blog (maybe make it private, password protected if you prefer) and keep it up to date so people have something to see what is happening. My family is all overseas so I’ve been babyblogging for nearly 2 years. Mainly for the grandparents at this stage, I think!

  18. I agree with most of what has been said. You could also point out that the newborn stage is the least interesting stage to observe a baby in. Since there isn’t much action, it’s pretty well captured on film.

    Your baby will be more interesting to observe when he is older. He also will be more interested in people later. You wll be more desperate for adult conversation and a pair of arms to park the baby in later.

    This seems like a win-win situation. I’m not sure where everyone got the idea that the baby must be viewed immediately by everyone the parents know/ are related to.

  19. Don’t know what your wife’s preferences are, but I was not eager to bring my baby into any sort of gathering during those first few weeks. This was not out of any rational calculation, but simply because I craved the quiet bonding with my newborn. When I did go out, it was without child. Both of my children were born in the middle of the winter, which gave me a great excuse to hide away with them.

  20. How many? One.

    The question is, “which one?” At which point you’re doing statistics, and as I recall you can do those yourself.

    HOWEVER stacking the deck is a Good Thing. Flu vaccination is Highly Recommended for pregnant women. What’s better, they can provide passive immunity to infants both in utero and via lactation. Short of moving to a cave, this seems like an option worth considering.

    I’m taking for granted that, since you plan to be in regular contact with Slightly Laden, you are yourself getting the shot (and as a caregiver you qualify as a priority.)

  21. Okay, you DID ask for advice from healthcare folks — my family’s like the medical mafia, our dinner conversation is not for the squeamish, and I have kids who were both born during flu seasons . . . so here is the solicited advice.

    You wrote: “Although the unvaccinated will be wearing those scary masks and everyone will be washing their hands every few minutes.”

    EVERYBODY needs to wear the scary mask (hey, they can draw a smiley face on the front, right? After everybody washes hands and the Sharpie is sprayed with Lysol, of course). Really the baby shouldn’t be around a lot of people, but don’t piss off the grandparents. 😉

    With a baby that young, you won’t be having much of a Thanksgiving any way. Frankly y’all will probably be way too sleep-deprived to have or attend parties around the holidays any way.

    Masks for everyone, and make sure everybody washes their hands, washes their hands, washes their hands for a loooong time with lots of soap and water and fresh towels. And spray doorknobs, phones, flush handles, faucets etc with disinfectant often.

    If people get miffed, they’ll have to get over it. You can always laugh it off as the anxiety of a new parent . . . as you hand them their mask and ask them to wash their hands vigorously.

    Baby can socialize more broadly after he/she gets his/her own immunizations. And for FSM’s sake, do not take the baby to the mall or in public places before baby gets those vaccinations. (Drives me crazy when I see brand new babies out in densely packed public spaces like that.)

    Good luck, and I hope there’s a follow-up post on how it goes. I’m sure new parents will appreciate hearing about that. Congrats!!

  22. I can weigh in one this one with confidence as both a PICU and NICU nurse with many years of experience (having started when birds were still dinosaurs!). No, you should NOT take your newborn infant to a family gathering at this time. Not only are you risking other family members making your infant ill, you are risking making your older child ill, who may then pass it on to his beloved brother! Little children are bug factories with immature immune systems and can pass along ‘gifts’ while still appearing healthy themselves. As well as seasonal flu and the unwelcome H1N1, there is also the specter of RSV. While RSV can look like a mild cold in an adult,it can be devastating to an infant. I’ve cared for infants on ECMO from RSV (rare, but it happens). Ask your pediatrician about it.If the family is pissed off..tell them doctor’s orders!

  23. In all seriousness don’t do it. Stay at home and rest. Maybe accept a basket of food if it is dropped off outside and the person dropping it off leaves before the door is opened. You can use the flu excuse, but stress reduction is the main goal.

    Going through birth is an extreme stress. It needs to be recovered from even if the adverse effects are not immediately apparent. I think that physiology has evolved for women to hide how they feel just after giving birth, even from themselves (that makes hiding it from everyone else that much easier).

    What any kind of stress does is reduce the rate of recovery. The early postpartum period is a time when a lot of things happen which are not fully understood. Postpartum depression and even psychosis are not uncommon and are going to be made worse (maybe even much worse) by any kind of stress.

    Another way to perhaps get out of it is to ask if anyone has any good recipes for placenta. That you want to bring a “special” treat to the Thanksgiving meal.

  24. daedalus2u wrote: “I think that physiology has evolved for women to hide how they feel just after giving birth, even from themselves (that makes hiding it from everyone else that much easier).”

    Ay de mi. I must be incredibly unevolved then. I was sore, sleep-deprived and crabby. And this was not a secret from anyone, either.

    However, Breyer’s chocolate ice cream seemed to ease my stress significantly, as did the children’s father taking childcare shifts.

    I’m just sayin’.

  25. Your wife should get vaccinated. Then, if the kid breastfeeds, her antibodies will protect him in the coming months.
    I don’t think that by Thanksgiving enough of the population will have been vaccinated and had time to mount a response for it to be safe for your kid to be around many people in November. I don’t know how it is where you are, but in WI very few people have gotten the H1N1 vaccine and the school children will not be vaccinated until late November. Assume 7-9 days for the antibody response to come up. I think you’re looking at Dec at the earliest assuming everybody gets vaccinated.

  26. It seems to be that you are chosing between staying in the house with no visitors vs. going to a dinner with five or ten people, whereby you go before dinner and leave before food, or after dinner for a visit.

    I would go for the second choice just to get out of the house but go early in the day so the virus carriers have not yet had a chance to spit on every single thing.

  27. We have very few vaccines here. My wife is vaccinated for H1N1. They used up all the vaccine on the preggos, which is good, but the rest of us are starting to get jealous.

  28. – As gwen pointed out, it’s not just baby getting directly infected, but indirectly through family members.
    – The more people the more fomite.
    – I believe Revere covered a report early in the outbreak of (I think) an infected tour group where the interpersonal contacts were traced in great detail, and hinted at a strong aerosol component over a moderate distance.
    – Even if people around were vaccinated, would it have taken, and had loong enough for them to develop an immune response? I don’t know what vaccine availability situation is for you, but I don’t see myself as even having the possibility of being vaccinated before Thanksgiving.

    – Downside: Baby won’t be able to be vaccinated for some time, and the flu season will, probably, only get worse.

  29. @ Greg,

    Well, we are at least agreed that Breyer’s ice cream is the critical element here (aside of course from co-parenting).

    I am not sure if her preference for mint over chocolate means that she is more or less evolved than I am. No doubt that would have the potential to spark off furious scientific debate, if there were any ice cream left.

  30. Stay home for thanksgiving. Alone. Post videos of _____. EVERYONE WHO MATTERS WILL UNDERSTAND!. According to our ID docs at Regions, this virus is especially dangerous to children and young adults because it is causing a heightened immune/inflamatory response, which is typically strongest in the young and healthy. That’s why the older and elderly are not being sickened so severly; their immune responses are weaker. It is the body’s own chemical immune/inflamatory modulators that are doing the damage; the stronger the immune response, the worse the illness. That said, new babies do not have strong reactive immune systems, but they do have tiny tiny airways, and ANY inflamation is dangerous. BTW, many of us OTD people have lived thru a pandemic, called Polio. Nobody went anywhere with kids. I suspect you may be feeling bad about missing out on a wonderful opportunity to present your new baby to lots of important people in your life, and of course, why wouldn’t you? Just not worth the worry, or worse. In my opinion. Hope everything continues to go well for you guys.

  31. Tell them to google ‘4th trimester’. It’s not just for your baby, but your baby’s parents’ sanity.

  32. One of my happiest memories is of the look on the face of my elder daughter (then aged two and a half) when we let her hold her sister, then aged a bit less than one day. The look was of awe, joy and shear wonderment. Try not to deprive yourself of such moments.

    Some years later when said elder daughter produced her daughter the hospital rules said only Mum, Dad and hospital staff could touch baby. I can understand that even though it meant doting grandparents had to wait until the child was at home. However, I will be disappointed if my granddaughter doesn’t get a chance to hold her sibling the way her mother did.

    When said granddaughter was about four months old, her mother found out there was a whooping cough epidemic in Sydney and said we couldn’t see the granddaughter until we were immunised. (I had had whooping cough as a chiled and assumed I was immune, but apparently that is not the case.) However, there was no problem, just turn up at the doctor’s, say, `I have a grandchild’ and get it for free. (Similarly for the swine flu immunisation, there’s no shortage here and it’s free.)

  33. Anne, I don’t think you are less evolved than anyone else, you must have been in incredibly bad shape for you to only be “sore, sleep-deprived and crabby” and to feel safe enough to be able to share that with everyone around you. Hiding when you are in bad shape is SOP for most people and organisms. My ex hid what kind of shape she was in. It was only years later that she told me â??she almost diedâ?.

    Ice cream is good, it contains xanthine oxidoreductase which can reduce nitrate to nitrite to NO. More NO in the postpartum period is a good thing (within limits). Get lots of lettuce too (contains nitrate). A high NO and low stress status pre-infection will tend to reduce the severity of the cytokine storm (NO inhibits NFkB).

  34. I heard on NPR this a.m. that young kids are not showing sufficient antibodies at 10 days and 21 days post H1N1 vaccination, so they will probably need TWO vaccinations, whereas pregnant women are fine with one.

    I’d go for no more than a few people around the baby regularly for the first 8 weeks. Normally I’d say 6 weeks but with this pandemic it makes sense to expand it.

    And I LOVE the idea of telling unvaccinated folks (unless they are allergic to eggs) that they can’t hold or breath on the baby. We have GOT to start cracking down on all this anti-vaccine nuttiness.

  35. If I had a newborn now, I’d have a big sign on my door saying, “No entry to anyone who has not had the H1N1 vaccine. No exceptions. Thanks for understanding.” And stick to it.

  36. I agree with the ‘quarantine the baby and take lots of pictures to share’ theme. However, don’t forget the possibility the baby may not be ready to come out until after the holiday. So you may get to go after all.

  37. First, many congratulations.

    Second, screw the flu – think of Amanda. Assuming that young (insert name here) arrives on time, by November 25th Amanda will have been out of the hospital for only 2 maybe 3, days. She’ll be smack in the middle of her hormonal letdown, tired, probably cranky, and probably not up to having crowds invading her personal space.

    Third, back to the flu – keep away from anyone who even might be sick for at least two weeks after the birth. Chances are little (insert name here) would be fine, but that’s not a lottery you want to buy a ticket in.

    Best wishes

    Lee Harrison

    (PS – don’t worry about pissing off grandparents. If they are ill, make them keep away – they’ll do it gladly and be every bit as happily gooey when they get better and finally get to see the evolutionary fruit of their respective ancestral loins.)

  38. Just as an aside, with all the talk of staying at home and away from people, anyone staying at home without visitors for weeks, possibly months, with a baby will go insane. All that miraculousness and wonder only goes so far.

    Schedule things so the primary caregiver can go out and hang with friends, go to the mall, gym, whatever. Even better if you can get someone to watch baby occasionally during nap to nip out together for lunch a walk or something.

    Even without hormone shifts the change from being out working with people to being home and isolated can be very depressing.

  39. You’re due the 20th. Thanksgiving is, in the States, on the 26th (if I’m not mistaken). The average primip goes 8 days overdue, which means you may very well still be expecting for the grand event. Your wife should get vaccinated now if she isn’t already, because pregnant women in their 3rd trimester are at 5x greater risk of hospitalization with H1N1. This risk continues to one month post-partum (because your immune system doesn’t snap back like an elastic with the birth of the baby, obviously).

    So, if you’re still pregnant and you don’t have to travel far, and she’s been vaccinated at least 10 days prior, go to the dinner.

    If you’ve had the baby and you’re less than two weeks post-partum, DO NOT GO. I’d say this even if there wasn’t a pandemic. This is not only for the baby’s health but for that of your wife. Women often think they should get right back into normal activities after giving birth, and many of those that do, get sick. She’s still at risk for post-partum hemmorhage in that period, is likely to be seriously sleep-deprived (you, too — baby won’t have figured out days and nights yet) and you both will still be adjusting to this new life of yours. You’re going to be exhausted. Breastfeeding starts around 4 days post-partum and then she’ll be at risk for mastitis (which happens more often when women are tired and trying to do too much). Mastitis looks exactly like the flu, FYI.

    So… even if you both feel great, take it easy. Rest. Enjoy your baby-moon. 🙂 Your wife will have just gone through a tremendous physical ordeal, pandemic or no. You’re all at greater risk for H1N1, and anyone who badmouths you for cloistering your family at home for a bit is definitely not worth listening to.

  40. Heather: The average primip goes 8 days overdue, which means you may very well still be expecting for the grand event.

    We are hoping for later for a number of reasons, but on Thursday the midwife noted that Amanda is quite effaced and said with some certainty “You will deliver before your due date”… so, well, whatever.

    Regarding vaccinationfor H1N1 … Amanda got that.

    Two weeks seems to be emerging as a cutoff point.

    I’ve seen mastitis, and I’ve seen women die from it.

  41. Several caveats here, firat don’t take medical advice off the internet. There are regional differences in swine flu distribution and the circumstances around your baby can make very large differences in care. Second caveat is I am only a medical student so my knowledge is much more academic then experianced. Really ask your pediatrician about what would be best. However, as mentioned new born babies aquire the mother’s antibodies. She should be vaccinated which protects against aquiring the disease, but also makes the illness much less severe. So the odds of a dead baby are low very low. I would be much more worried about an unvaccinated toddler or even child at such a gathering. Likewise and this is in agreement with the above we tend to worry about the exotic low risk crcumstances then the familar much more likely outcomes. Post-partum depression should be much more of a concern then swine flu. If the two of you would like to see a few people during Thanksgiving then that should be fine just take care of each other, and do whatever you can to help her through a difficult stressful but amazing time. Congratulations

  42. I agree with the folks who say screw the flu angle, just don’t go because both of you are going to be exhausted. It’s entirely true (you will be: the delivery is just the beginning, and babies don’t know from clocks) and it sidesteps all people who will want to show what good hygiene they are capable of.

    You will have to continue to deal with this through many more months, even after flu season. Get used to saying with a smile, “Nice of you to stop by to see the baby, hand soap and towels are by the sink.” Be prepared to repeat it, too.

    Congratulations on the pending new arrival.

  43. How about setting up a baby cam at home and a monitor in the main gather room where family can go and watch him/her and a donate button so folks can oogle the dear one from a safe distance and help start his/her college fund at the same time?

    My vote. Do not take your newborn to a family gathering mere days after birth. Not only for baby’s sake, but for mommy’s as well. Trust me, sitting and yakking for hours is NOT going to be something she is really up for yet.

  44. Skip the celebration until next year.

    Even when H1N1 is not factored in, anyone who won’t give a pass to a woman who went through childbirth the week before a huge family celebration is a jerk.

  45. I agree with MS2 “Post-partum depression should be much more of a concern then swine flu” so skip thanksgiving, but don’t let swine flu fears trap Amanda inside and alone.

  46. I’m thinking, gee, wouldn’t it be wonderful if someone were to announce they don’t want flu carriers at the Turkey Day fest, and so I’d have a perfect excuse to stay home, eat my own turkey, send felicitations to everyone and avoid the crush. You might be more popular than you imagine if you put limits on who can visit . . .

    But you ask:

    What do you think we should we do?

    Isn’t it obvious? You say you’d be less concerned if you had a hundred babies. You need to acquire 99 more kids by Thanksgiving.

  47. My wife & I have an almost-5-month-old little girl, who’s probably the most adorable baby on the planet at the moment, sleeping against my chest in the carrying sling while I type this. Which is to say, I know where you’re coming from with the “just one” mantra….

    Even before the pandemic fired up, we kept her generally away from the public; very few visitors, and (even in France, where normally there’s a lot more kissing) neighbors and friends have been increasingly careful about protecting her from possible exposure to anything nasty. We get out of the house all the time (at a bare minimum, she comes with me to walk the dog); we just don’t usually go near people.

    We had planned a grand voyage this month to go see her three grandparents who can’t travel to visit us — two in Malaysia and one in the US — plus other loved ones in both places. We were a bit hesitant about the plan to begin with; the pandemic pushed the idea off the cliff (the airports… the long hours in closed airplanes… and the assholes who just *have* to travel even though it’s blazingly obvious they’re coming down with something horribly contagious).

    So, are family members sad we aren’t coming? Sure, but everyone has encouraged us to stay home — and we’re doing what we can to bridge the distance with live video, videos online, and lots of photos and phone calls.

    That’s better than just a short visit, anyway — they are getting to see her change and grow, not just the one possibly-cranky moment when they happened to be physically there.

    If anyone does object, just be sympathetic and drop some magic phrases like “pandemic”, “possibly fatal”, “undeveloped immune system” and “our pediatrician was pretty emphatic about it”.

    I’ll echo the advice to breastfeed, as well, though it can certainly be a PITA to get started. My wife & I both came down with an unpleasant cold one after the other about a month after the birth (due to lack of sleep, etc…) and the baby never showed signs of it at all, despite being inundated by our germs; my understanding is the breastfeeding was the main protection as work there.

    I’m not sure where the “two weeks” thing came from in other comments; our pediatrician basically just told us at our last visit (@ 4 months) that if we were bottle-feeding we didn’t have to sterilize it anymore. Right now is about when I’d normally be putting her into gradually more contact with the public; we’re just putting it off a bit until after the flu gets under control.

    Good luck and courage!

  48. How many people does it take: Just ONE person in the early stages of flu … the virus shedding but not yet feeling bad stage is all it takes.

    I vote for staying home and having a quiet moment of bonding with the infant and re-bonding with your wife.

  49. Before our firstborn was born, we read somewhere a suggestion that said something like ‘Make sure you get the first two weeks to yourselves to get used to being a family – things will be difficult enough without entertaining every man and his dog’. How true that was. We had *no idea* how physically exhausting the first few weeks, (months actually) could be. But guess what? My wonderful inlaws took exception to our right to decide what to do with our own lives and our baby and effectively cut us off. In week two, when I called the inlaws specifically to invite them up, my sister-in-law was “too busy”. They’ve been too busy now for 16 (sixteen) years. So I can best repeat the sound advice given by ‘Stephanie Z’ at #4 :
    “Anybody who gives you grief about this is thinking about themselves, not the baby. Fuck ’em.”
    but … caveat, the repercussions could last them a long, long time. And no, I don’t miss them.

  50. Even if H1N1 weren’t going around, I wouldn’t bring a < 1 week baby to a big family gathering. For lots of reasons. One is the infectious disease issue (and it's not like H1N1 influenza is the only thing going around). But there's also the fact that the kid will get absolutely nothing out of it, is too young to interact in any meaningful way with what to him/her are just a bunch of total strangers, and will likely not even have a good feeding routine established yet anyway. What's more, *you* will likely be far too exhausted to appreciate the party, given that your baby will not yet be sleeping through the night and indeed will still be adjusting to the very concepts of "day" and "night". Even if the party is completely sterile, it'd be tough to enjoy more than a brief visit with a brand new baby. One month, then they get to where they'll sleep through the party and it's fun. But at least with my two babies, those first two weeks were rough. It was hard just to make *myself* presentable, to say nothing of the baby. 😉

  51. Isn’t it obvious? You say you’d be less concerned if you had a hundred babies. You need to acquire 99 more kids by Thanksgiving.

    Ladies and gentlemen, we have a winner!

    Sounds like a great plot for a movie too. Kids would be difficult, though. How about dogs? Dalmatians, perhaps?

  52. Newborns are boring. They just sleep and bide their time, waiting for other people to sleep so they can scream.

    Get a doll. No-one will be able to tell the difference. It’s win-win.

  53. Errr, get a doll for the family to coo over, I mean. Not get rid of the real kid. You need to keep that one, obviously. They get better over time.

    At 6 weeks (s)he may start to smile. It will be all that saves the critter’s life, in my experience. Evolution knows that this is the point that woods, wolves, and the appeasement of the old gods are thoughts entering a parent’s mind.

  54. Hi, Greg. Just to chime in from a medical (nurse-midwife) point of view: Stay home and rest. We used to try to encourage our patients to be “Princess” for a week, if not two, depending on family help. That meant they ate, slept, breastfed and relaxed. Someone else did the cooking, cleaning and laundry. Mom and baby get a good start on breastfeeding, mom stays rested so she stays healthy, and dad gets to enjoy the happiness of a rested and calm mom and baby.

    H1N1 aside, you just don’t need the extra company. I had a baby in mid October and STILL had trouble dealing with Thanksgiving company. Make them wait till next Thanksgiving.

  55. In my family, coming out for a baby generally seems to occur at about six months, and rather than being a big gathering, it takes more the form of a trip where the parents go and visit all the other relatives and grandmothers, great aunties and experienced aunties take care of the baby while they get a good night’s sleep on the couch. Works for everyone and you can avoid risks on a case-by-case basis.

  56. In no way should you and your newborn be expected to show. Every person is a potential infection vector for your baby. H1N1 and flu viruses can both be life threatening for your baby at its age. The best thing you can do for it is have your wife get both flu and H1N1 vaccinations shortly after she has recovered from the pregnancy, and then BREASTFEED the baby so he/she can pick up the anti-bodies from the milk. There are plenty of studies out there that show breastfeeding your kid reduces their chance of being sick for the first 6 months.

  57. Also I forgot to comment that you and your wife should not go yourselves as well. Weeks 1-2 you should consider your wife as “recovering”. Also for each person you come in contact with, you become a potential disease carrier for your child. I don’t mean to put a barrier between you and society (that’s just silly), but you should become more aware of who around you is sick. You can not protect your baby from everything, but you can make the smart plays when it comes to intervening between you and your baby. Hand sanitizer is a must this winter.

  58. I also like the idea of telling the unvaccinated to stay away. One of the consequences of that decision (assuming they aren’t allergic or otherwise unable to get it, of course) is that they knowingly put others at risk.

    And one of the consequences of putting other people at risk is that they aren’t as nice to you as you might like them to be.

  59. Leni (and other who have said similar things): Yes, absolutely. In our case, relatives once informed of the situation immediately became pro-vaccine. However, THEY RAN OUT OF VACCINE!!!!11!!

    So, what do we do now????

  60. Stay home, get rest, e-mail ’em baby pictures, insist that the paediatrician said to be cautious. You’ll be exhausted.

    I also second breastfeeding if possible: it might be a little hard to get started, but its wonderful to have milk warm and ready without even getting out of bed or scrubbing bottles afterwards. Your contribution can be to get out of bed and bring the baby to mother.

    The La Leche League has experienced mothers who will share advice and experiences with new mothers and help them to breastfeed successfully.

    One of the best things for new mothers is to have someone else take over for a few hours so they can sleep or take care of themselves; also to be taken out for a drive or walk and to see some adult faces.

    Best of luck to you all!

  61. I am and have been quite the germaphobe for years. I have raised 5 children and all healthy to date. When my first was born, she’s 23 now. I can still rememeber the day I took her home and had only three relatives at the house and they were poking and prodding my child. I started balling and asked them to go home. I spent countless hours a day cleaning and washing my hands until they were raw. I did lighten up by the time my youngest was born (she’s almost 11 now). At that time there was not an flu pandemic happening.(I guess I was a bit extreme)

    I think that we can’t help if we are unfortunate to fall ill to H1N1, but we can do everything possible to minimize the risks. I certainly would have no problem letting people know that I wasn’t comfortable with company. I think, if it is, so incredibly important that they come over, than I would mandate visitation only to those who have been vaccinated or had a confirmed case of H1N1 and had at least 3 weeks to have developed immunity to it. I would also limit the numbers to those you feel it is important for your newborn to eventually build a life long relationship with. Upon entering your home I would ask them to wear a mask and wash and sanitize their hands. I would not allow them to hold the baby, just look at it. This seems extreme I know, but I think better to have the child around to have and hold later then to lose that incredible apportunity. When children go through the oral fixation phase and start crawling around on the floor, that is indicative that thier bodies are ready to start building immunity to all kinds of viruses and infections. Until that day comes, keep your child safe, you have an obligation to do that as a parent and being afraid of an uncomfortable situation that might hurt the feelings of others is really thier problem not yours.

    On another note, I have a friend who just had a baby. She actually went to the hospital two weeks before she was due because she thought she might have H1N1. Turned out she didn’t have it, but she ended up needing an emergency C-section for another reason and had a healthy baby boy. During that time it was our (Canadian) Thanksgiving and of course the whole family was excited to see that new baby. She and the baby were quarantined until the test results came back negative and the family just had to accept that and they did. There was a baby shower planned for the 14th of November and I just talked to her today and she informed me that the shower has been cancelled because it just isn’t worth the risk. I stand behind her decision 100%.

    Good luck to you in dealing with the situation. On Thanksgiving you and your husband and newborn should be thankful all by yourselves, have a great dinner.

  62. Do NOT under any circumstances go!! In fact, plan on skipping Xmas and New Years. Our baby was in the hospital for four days at 2 months old with RSV. Google it, it’s not fun by any means and us scary as hell for mom. A child under three months with any fever is basically instantly rushed to the hospital because they have NO immune system with which to fight off anything. We didn’t take our baby out or anything, but drew the short straw in that my husband who rides the train probably brought it home with him. It was horrible and I caution any parents who have winter babies to make like bears and hibernate. It’s sooooo not worth watching the nurses come in every two hours to use the suction hose attached to the wall to suck the snot out of your baby so he can breath. No no no no no!! STAY HOME!!!

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