Self Care

I used to hate the phrase "self care". It felt New-Age and entitled and brought to mind a woman in a bubble bath with cucumber slices over her eyes. Now I think of self care as anything that makes my day easier, like a piece of dark chocolate or 15 minutes sitting in the sunshine. Is it possible to practice self care with a newborn? Yes, but we need to re-frame what this means. Aphorisms like "sleep when the baby sleeps" or "take time for yourself" or even "you can't pour from an empty well" can make new moms feel discouraged and inadequate. Here are some basics and above all, know that you deserve this.
How about beginning with things you are not going to do? Here are some examples:

• Minimal social media (check Facebook for 5 minutes at the beginning and end of the day, e.g.)
• No attending social events you don't like
• No checking work email after 6pm

Exercise is good for mind and body, but let's be realistic:

• Walk to the mailbox daily
• Use home equipment 10 mins per day
• Carry baby in a sling or carrier 

Eat right but make it easy:

• Keep frozen meals and veggies on hand
• Make up a dozen hard boiled eggs at once 
• If friends/family ask what they can do to help, say "a meal would be great" (trust me, people want to know)
• Keep a small basket with a granola bar, water bottle and your phone - grab it when it's time to nurse and take it with you

Avoid isolation:

• Call or text someone every day (this is tough but you can always ask a baby question!)
• If you can get out, go to the library once a week - baby-friendly, nice bathrooms, and always temperature controlled!
• If you'd like to go to a mother's group but it feels like too much, try an online one

SLEEP (Just because you have a baby doesn't mean you don't deserve sleep!)

• Rest your body when you can - **remember that this helps, even if you are not asleep
• Consider getting a weighted blanket (not for baby) - this can help reduce anxiety and let you get a better quality sleep, even if for a short time
• When baby is sleeping, get into your bed (under the covers, etc.) and rest **

What is Perinatal Mental Health?

I recently became certified in perinatal mental health, a field that I am passionate about. I see so many moms struggling through the first year with a baby, trying to juggle the demands of home, work and relationships while usually getting very little sleep. Postpartum depression and associated mood and anxiety disorders are much more common then you think. It's estimated that 20% of all new mothers are suffering and if baby is in the NICU that number doubles. The problem here is that perinatal mental health is different from general mental health care in that you are treating two people (more if multiples)! Many psychiatric practitioners are not fully educated in prescribing medication for pregnant or breastfeeding women and OBs are often not comfortable stepping into a psychiatric role. The result is that new mothers are not getting the help they need and the effects of untreated mood disorders for both mom and baby can be disastrous. What can we do and how does breastfeeding affect maternal mental health? The first and most important thing any practitioner can do it to listen to mom, let her talk about how she feels and what scares her, and let her know she is not alone. We know that when breastfeeding is going well, the risk for PMADs is lessened. However, in moms who want to breastfeed but are struggling or in moms who did not intend to breastfeed but feel pressured to do so, the risk is multiplied. How many times have I heard moms say that they felt pressured or guilty or even shamed for not breastfeeding. We need to do better. We need to support parents where they are and understand that a happy, healthy mother contributes to a happy, healthy baby. This may mean breastfeeding, supplementing or formula-feeding but moms need support first and foremost.

Holidays and Plugged Ducts

The winter season is upon us, and one thing I always like to talk about is plugged ducts. No, really...we see them so much more around holidays! Often it's because well-meaning friends and family want to hold and enjoy your baby and then feedings are delayed. Moms can also get run down, with too much activity and not enough rest. If you feel yourself getting a plugged duct (hard, sore area that may be reddened), do these three things: rest, use warm compresses (or a hot shower w/ massage), and feed very, very frequently. The secret to heading off a plugged duct before it moves to mastitis is to keep emptying the breast. In my old La Leche League days, we used to say, "Go to bed with the baby and don't stop nursing!" Now of course, co-sleeping is discouraged by the AAP, but you can still rest and feed all day long if you are able. If you begin to develop a fever, chills, or generally feel like you have the flu, call your doctor (OB or your primary care doc). You may need antibiotics, but DO NOT stop breastfeeding! If your doctor tells you your antibiotics are incompatible with nursing, DO call you lactation consultant  - many docs are not up on the latest research around medications and breastfeeding and we can give mothers information to take back to their doctor. If it is simply too painful to feed at the breast, you can pump, but try not to use bottles in the first month (there are other feeding methods). Finally, a plugged duct and/or mastitis should serve as a sign to slow down, take care of yourself, and maybe dial back the holiday frenzy a bit. I always say to moms - "It just has to be good enough" and it's true. Use the packaged pie, the ready-made cranberry sauce (who doesn't love that anyway??), and if people are coming over - just make sure the bathroom is presentable. You are doing something no one else can do for your baby and that's pretty damn important!

Breastfeeding Uncovered

I am loving this new video out of the UK!

Making a Plan

Childbirth is one of those things that you can plan for, take classes about, talk over with your friends and prepare for but in the end, nothing may go as planned. Breastfeeding can also be this way and in fact, some parents tell me they are preparing for pain and difficulty in the beginning (it shouldn't be painful!). Does this mean you shouldn't prepare? Absolutely not. A breastfeeding plan, like a birth plan can help to make your wishes known to the staff at a time when you may be tired and overwhelmed. A colleague sent this one  and the  information is simple and straightforward. Just to recap: you can plan, prepare and pack a cute bag, but things may change in the moment, particularly if you or your baby need special care.

Podcast Love

I am in love with podcasts. If that sounds like a bit of hyperbole, let me explain that I have a 45 minute commute to work and, as my co-worker Shelly says' "That song you like gets old pretty quick". I listen to things about breastfeeding, maternal health, science, and more. There is so much to choose from but here are a few of my favorites: Born to be Breastfed , Breastfeeding Medicine, Hidden Brain, Only Human and Terrible, Thanks for Asking (all on NPR). Yesterday, I was listening to Marie Biancuzzo's podcast about infant crying (from 4/24 - listen here). Marie feels that infants cry for two reasons: to meet an immediate need and to relieve stress. I tend to think that every infant need is immediate, in that newborns are not trying to manipulate you into feeding them sooner, or changing them on a whim. The needs and the wants are the same! However, the thought that a baby may be crying to just blow off steam is very intriguing..and much like our experience as adults. Remember how cathartic it can feel to have a good cry? Not when you are in physical or emotional pain, but when you've had a bad day, or the stress of life is just getting to you. Do infants feel this way? Is it frustrating to be out in the world after spending 9 months inside mom (a snug, carefully controlled, dim environment filled with white noise)? What Marie proposes is to let babies have

these moments, but hold them at the same time. We can't always meet our babies' needs, but we can hold them through it. Think of coming home at the end of a long, somewhat frustrating day at work. Maybe you were stuck in some traffic, and maybe the dog woke you in the early morning (yeah..I get that one!). You arrive home, have trouble finding your key, and start to cry. Your partner comes to you and, without trying to make you stop crying or distract you, he/she just holds you. Can you imagine how nice that might feel? How much better you'd feel afterward?

This is Your Baby

I teach a newborn care class and one of things I always say is, "This is your baby." I want parents to know that they can and should advocate for themselves and their child. This starts in the hospital: Do you want rooming-in? Are you wondering why your baby is being given a bottle? Would you like to help give your baby her first bath? Parents often tell me they feel like they have no control over what is happening to their baby (and to Mom) in the hospital, and that this is scary and confusing. The hospital staff has mother and baby's best interests in mind, but they do this every day, and may not be thinking about the  bewilderment of new parents. Feel free to ask questions, get involved in your baby's newborn care, and express any concerns you might have. Nurses and doctors appreciate direct communication and everyone will be happier if expectations are understood. Most of all, know that this is your baby and you are her parent, advocate, and caregiver - you can do this!