Love Jack Newman
What Do New Moms Need
Recently I had two different moms who I attempted to help with adjusting to breastfeeding with a new baby. Both moms had had difficult labors and births, but both avoided cesareans. But both babies ended up spending a week in the NICU on antibiotics. Meconium aspiration was the culprit for both. They do not allow a baby to be roomed in with its mom if the baby has an IV. So separation, although not continuous, is a problem. It becomes increasingly problematic when trying to recover and also develop a milk supply and learn to breastfeed since the baby is also being given bottles along the way.
The first mom returned home and her baby was discharged after the week. The baby was nursing some and also being given formula. The mom was only nursing some of the time- some of the time she was pumping and some of the time the baby was being bottle fed. She was concerned about her supply- and rightly she should have been. It is important that a baby nurse from the mom at a minimum of 8 times a day and ideally more like 10 to 12 times a day. The baby had been on a 3-hour feeding schedule in the NICU.
I encouraged this mom to take a babymoon. Crawl in the bed shirtless with only a diapered baby- and nurse around the clock- doing nothing but being waited on by helpful friends and family- fed but doing nothing else but having skin to skin time with the baby and nursing as frequently as possible for 24 hours.
I encouraged this mom to do just that- and give me a call in 24 hours with the number of wet diapers, the number of poops and number of times she nursed.
24 hours later she texted me, “Hey! we didn’t do it today. I had too many people over today.” I replied, “prioritize.” I did not hear from her again. But I saw on social media pictures of the family giving the baby a bottle.
Hey, that works- the baby is being fed, right? Well, sure- but ideally the mom had wanted to breastfeed. I think visitors were fun, but they sabotaged her ability to get a good supply going. And not having a good supply, having nipple confusion with bottles and the mom being a hostess instead of resting is not the way to help her make breastfeeding work. The mom could not find her voice to tell her family what she really needed.
The second mom worked hard to be with her baby in the hospital and was also able to bring her baby home after a week in the NICU. She had great family support in every way except with breastfeeding. Neither of her moms had breastfed so when the first problem with latch began, rather than helping to pay for a lactation support person, they undermined her breastfeeding.
How? By stating how they had dried up their milk quickly with ice packs- only took a few days. By saying how formula and bottle feeding had worked fine for them. By holding the fussy baby and giving him a pacifier when he was showing signs to nurse, but they were attempting to “help” the new mom by doing so.
I wish the family would see that the best way to help is to find supportive solutions that are in alignment with what the ideals of the mom are instead. The second mom reached out to me. I was able to provide postpartum help. The mom realized quickly some things to improve the baby’s latch and also was reaffirmed on what a great job she was doing. And how normal her baby was acting. And she was given time to share emotions and feelings with acceptance.
So, what does a new mom need? REST: Rest. Encouragement. Support. Time. If you want to come and help, then help do the things that need to be done- meals, cleaning, errands, holding the baby while she showers- but otherwise- keep the baby with the mom! Encouragement means giving her courage to move toward her ideals. That means getting her help if you are not an expert in the area she is struggling. Gift her a postpartum doula, a lactation consult, a ride to a breastfeeding support meeting. Encourage her to call an expert rather than undermine her ideas. Support her emotionally by allowing her space to share her feelings without judgment and without dismissing her feelings as invalid. Feed her- make sure she has her physical needs met as well. And remind her it takes a time to adjust to a new situation- to heal from the birth, to learn her baby’s cues and to figure out what works.
If you do not agree with what she is doing, keep your opinions to yourself unless you are concerned for her well being and her baby’s. Then reach out to an expert for advice and input.
Postpartum Honey Do List
A few ideas I have been sharing for many years when you are recovering from having had a baby… and folks want to come by:
Everyone wants to help. But often you are not able to share what you really need. I suggest having a small box or basket in your foyer. In the box are cards of chores that need to be done that can easily be done by a visiting friend or relative. The card may have things like: sweep the kitchen, unload dishwasher, put on a load of clothes, walk the dog, vacumn the living room, dust the family room, fold clothes, get a few items at the grocery store, etc. These are chores that can be adjusted and prioritized in the basket. So when someone arrives and asks what needs to be done, you can gently direct them to the honey do list in the basket.
Remember when folks come by to visit, 15 minutes is the limit. After 15 minutes you become a hostess instead of a mom in recovery mode.
Put two coolers on the front porch. One is red and one is blue. The blue one has ice within it. If someone is bringing food, they can place it in the cooler- hot or cold. You can check the coolers between naps and nursings. Folks can drop off food without disturbing the nesting family.
Remember when folks come by- if you are in your gown and robe, they do not stay long for a visit. Also wearing your bed clothes will remind you, you are in nesting and recovery mode- and will keep you from trying to do too much. You can sit on the back deck in your gown just fine if the weather is good and you need some sunshine. The minute you start getting dressed you will find yourself doing too much.
When you do have something to go to, remember one thing per day- if you are going to the doctor, set your appointment for just after lunch- this gives you time to sleep in if the night was broken up. Don’t decide to head to Target that same day. One thing per day is a way to keep you from overdoing it.
Remember if feels good to help someone. When someone asks to help, let them- you will be helping them to feel good!
Maternal and Infant Mental Health Services
Anne Cumings, LCSW – Maternal and Infant Mental Health Services
When I tell people I am trained in infant mental health, I usually get a wisecrack about newborns sitting on a couch and talking about their feelings. In reality, infant mental health is about working with babies and caregivers together to ensure a healthy transition, for both, to this wild and crazy adventure of life. It encompasses:
• Pregnancy and postpartum mood issues
• Health concerns in mom that impact her emotional availability
• Issues of eating, sleeping and crying (in infants and moms!)
• Regulatory troubles (i.e. fussy babies)
• Goodness of fit between babies and caregivers (Are you a quiet, reserved mom with an active, hyper-verbal, outgoing tot?)
• Relationship concerns that arise due to developmental issues
• Anything else that may impact the relationship between caregiver and baby!
And infant mental health includes pregnancy through age 5, so toddlers count too! If you are a new parent who is struggling, either with your own emotional wellbeing or coping with a challenging baby or toddler, I can help!
I know it’s a cliché, but no woman can truly understand what becoming a mom will feel like until she experiences it. Even so, we all build up dreams of what those first few days, weeks, and months will be like. When the reality of new motherhood is harder than you imagined reaching out for support can help. I offer individual therapy in my Marietta office, postpartum home visits and a free postpartum support group in East Cobb.
You can connect with me through my website at annecumingslcsw.com
Endorphins and the Post-Partum Mom
“Exercise gives you endorphins, endorphins make you happy, happy people don’t shoot their husbands.” Elle Woods
Well said Elle, well said. You forgot one thing, throw in a newborn, a post-partum body that is as foreign as can be, no sleep and for the most part no clue what you’re doing and a so called “happy” person may just want to shoot their husband. As a fitness professional, I have never met a mom who doesn’t come in and say “I want my pre-baby body back.” As a new mom, I said the same thing so I started right back at it. Needless to say, exercising with a post-partum body can be a very humbling experience. Mentally you are ready to go but physically you have to take it slow and work back up. Exercise was my go to, my stress release, now it wasn’t fun, it was miserable and deflating.
I have to admit that for me, having Emma was the easy part. Once I got her home there was a lot of sitting around. We had the typical new born schedule, wake up, feed, sleep, wake up, feed, sleep, over and over again. I started to feel like a prisoner in my own home. I think many people underestimate how lonely it is to be a stay-at-home-mom. I was on an emotional roller coaster, one minute happy as can be and then wanting to hide under the sheets and then just like that I was ready to snap. When the time came I was somewhat actually ready to go back to work, until I realized I barely spent any time with Emma or my husband. Nothing got done around the house, no one got any sleep, I felt like I was barely even getting meals together for us.
Going back to work didn’t make me feel better, I felt like a full time trainer and a part time mom and I hated that feeling. It made me feel so low that I wasn’t there taking care of Emma every day, or at least having some time to play with her during the day. Sure some may look at me and say ‘Hey, welcome to motherhood.’ And yes I agree but for me at the time it was soul crushing. We went on like this for months until one day I actually wondered if there might be something more going on. I never thought about post-partum depression, they check for that at 6 weeks, I was almost 6 months! But I researched and found out it can be up to the entire first year! Thanks for the heads up doc!
I found myself a good therapist to meet with but I also found FIT4MOM. This group of moms was my true lifesaver. I was able to get out of the house, interact with other moms, get a good workout, and have play time for Emma. I honestly can’t tell you what my favorite part about my FIT4MOM group has been, whether it is the workouts, which are challenging yet attainable, or the weekly activities that let me experience things with Emma I would never think of myself. Emma is now a year old and she has been to an indoor playground, a petting zoo, music class, and made countless little pieces of artwork thanks to FIT4MOM.
They say “It takes a Village” and well, someone knew what they were talking about. Sometimes you don’t need a village to watch your baby but a village to hang out with, talk with and know you’re not crazy, bounce ideas off of, to laugh with, to cry with and to help raise your children and you to be the best person you can be. That’s what I have with my FIT4MOM Village. My Village helps keep my endorphin levels elevated so that I don’t shoot my husband. 😉
Stephanie Miller is the owner of FIT4MOM Peachtree Corners as well as a Certfied Stroller Strides Instructor and a Certified Personal Trainer with the National Academy of Sports Medicine. Her daughter Emma just turned one-year-old and loves getting out in the stroller and going for walks. For more information about Stroller Strides and FIT4MOM please visit peachtreecorners.fit4mom.com.
New Parents Need Guidance
Recently a student told me that they felt really prepared for their labor and birth and also for breastfeeding but failed to know what impact having a baby was going to be postpartum. We offer a few classes, but often we do not get enough in the classes for them to “make.” Usually we require at least four couples to make a class. But we still schedule them- the Happiest Family is one such class. But we offer a few others as well. Often when money is being allocated for classes, the idea of needing guidance after the baby comes is low on the list.
What he really would benefit from now as a new family was what we offer in the Soothing Session that we began offering this year. It is a great way to have someone come to your home and assist you with a plethora of new family concerns. The doula will assist you with breastfeeding as well as basic baby help that so many new families struggle with making sure they are doing it right.
And speaking of doing it right. This past week I met with a couple who wanted to come by to just have me check on their breastfeeding technique. She had difficulties with her first baby and had come to see me after weeks of working at trying to nurse her daughter. She was found to have a tongue tie that had not been realized at the hospital. The mom had gone on to breast milk feed since the bottles had worked against having her daughter take back to the breasts. So this time she just wanted me to lay eyes on her technique for confidence. I tweaked a few things but she was doing great with this second child.
Today I received a phone call from a mom with a 15 day old who had issues gaining weight and jaundice in the early days. She did not know that some of the weight loss was normal since she had had IV fluids for more than 2 hours- the study is listed here. And the after effects of the epidural she had received had probably caused the baby to not be a great nurser in the early days, thus meconium had lingered and therefore the jaundice had been more of an issue. And although she did not state it, the use of Pitocin has been linked with more jaundice as well. So now she had come through these issues but she just needed a boost of confidence on how often she needed to be nursing and how to know if he was getting enough.
I happily gave her phone time to discuss these things. I get grief from other birth professionals for not charging a consult fee. But whether it is my old La Leche League Leader experience of always offering free phone consults or my feeling that you get what you give, I am always willing to talk to someone about their concerns for free. I in fact was cooking dinner and shared with her while doing so- so it had not caused me to stop what I was doing. When we were completing the call, she asked me if I made home visits to just lay eyes on how she was doing with the breastfeeding.
We do offer in home breastfeeding consults, but for that the charge is a two hour minimum and is only $10 less than a 3 hour Soothing Session. I shared with her about the soothing session and she immediately said, “Yes, that sounds fabulous.” I do think that a Soothing Session is exactly what most new families would benefit from. Even if you have family helping, having someone who is not invested personally and has evidence based information along with years of experience offering a little bit of guidance is a great reassurance. You get a lot of bang for your buck. And we are finding that it is often a wonderful gift from family members who can not come to help but want to help in other ways.
Love Me Some Jack Newman
I attended the 2014 CAPPA conference this year and got to hear one of my favorite speakers. I have heard him speak several time over my birth career and I never tire of hearing him speak. I love his humor, hit wit and his wisdom! So, I thought I would just give you some of his quips from the two sessions I attended this year.
You can tell a baby is sucking and getting milk by watching for his suck, suck, pause and swallow action. It should be a long pause.
Breast compressions should occur during sucking.
He hates nursing shields. He said he feels they should be banned altogether. Whatever is being attempted to be fixed, there is a better way!
When nursing push the baby’s bum in tight.
Never should it be routine to just nurse the baby on one side at a time.
Moms have more milk in the morning than later in the day. What works in the morning may not work in the evening.
The amount of milk a mother produces is genetically determined- but if we leave her alone, she produces beautifully.
The breast crawl is super important and we need to stop helping moms latch a baby on and let the dyad figure it out without interference.
Problems with breastfeeding are cummulative… one thing leads to the next problem.
Take the multiple blankets off of the baby!
A baby who is too warm will be too sleepy.
If a mom gets rock hard engorgement, the baby is not feeding well!
Breastfeeding is not for only “perfect” babies.
When a baby is nursing from a nipple shield it is not nursing at all!
The nipple shield decreases milk supply because a baby is not latched on when using a nipple shield, it doesn’t stimulate milk ejection properly, but, at the same time depends on milk ejection reflexes.
There is no such thing as a flat nipple- it can pull out with some effort.
Reflux is normal, GERD is not normal. Docs are treating a normal reflux as if it is GERD.
Mirena IUDs, Depo and mini birth control pills can reduce milk supplies… not in all women but it is a strong possibility that women should be told about.
Babies don’t suck out milk- mothers transfers the milk and the baby stimulates the let down reflex.
We need to stop speculating on a mom’s milk supply based on what is produced from pumping.
The breastfed baby is the norm so we need to stop referring to formula fed babies as the norm!
Scales are inaccurate- you can weigh a baby on one scale and the next one shows a huge difference- quit looking at the scale- look at the baby!
We live in a bottle feeding culture and we assume that if the mother’s nipples don’t look like a bottle nipple, the nipples are flat.
Because so many women get so much IV fluid during labor, birth and even after, some women get swollen nipples and areolas that look flat.
A baby who feeds well will let the mother know when he’s ready to feed again.
The mechanization of breastfeeding will cause more and more mothers to abandon breastfeeding.
Babies learn to breastfeed by breastfeeding.
Mothers learn to breastfeed by breastfeeding.
The baby won’t refuse the breast.
There is more to breastfeeding then breastmilk.
Weighings mean nothing since nobody knows what the baby is really supposed to be getting from the breast.
We complicate breastfeeding.
Everyone feels like they have to fit in a box. Babies and moms are all different!
Throw the charts away!
Many physicians seem to believe that only babies on the 50th percentile or higher are normal.
Measuring without understand is meaningless and leads only to trouble and inappropriate interventions or lack of interventions when necessary.
I teach breastfeeding classes. I feel like just like childbirth classes where we have to “unteach” all the junk moms and dads have come to believe or fear, it is the same in the breastfeeding class. We have complicated it so much. Give the mom her baby- -skin to skin at birth. Leave them alone to figure out how to nurse in the first hours after birth. Keep them together. Expose moms to the model of good breastfeeding by attending LLL meetings and being around women who are not all covered up! Keep the mom and baby together in the first month- without interventions and separation. Her job is to nurse the baby when the baby is awake. Don’t look at the clock. Is the baby transferring milk with those sucks and deep paused swallows? Count how often the baby nurses- not how frequently or how long. Eight to twelve nursings a day- real feeds is what is needed. Babies will do that usually on their own if interventions have not occurred to separate them. Take care of the mom so she can nurse her baby. It really is that easy for most moms and babies!
Comments
Post a Comment