Going Gray

Sometimes as a new mom, we get into a damaging "all-or-nothing" mindset.

Does this sound familiar? We eat healthy or we don't. We practice self-care or we don't. We're a good mom or we're not. Perhaps you already know that this way of thinking can wreak havoc on our self-confidence and our need to feel competent as a person and a parent. If this sounds familiar, then let me take this moment to remind you that there is a large middle ground in each of our lives called "gray". And if you're meeting "gray" for the first time, you're in for a real treat.

Neither black of white, gray is where possibility and practicality meet. It's a place where feelings of capability and worthiness are encouraged. Success happens more often there and feels better when it does. Gray allows small risks, then the chance to evaluate how they work out and take larger ones if the effort seemed worth it. Compared to it's more rigid pals of black and white, grey is flexible. 

What does gray look like in reality?

Gray is opting to do one vaccination at a time instead of the usual 2-4 because it still feels responsible but a lot less scary or painful.

Gray is deciding to go wheat-free as a trial period but eating the homemade bread that your brother-in-law proudly brought you as a housewarming gift.

Gray is acknowledging that you likely can't make a weekly playdate but will attend as many as you can.

Gray is working a 15 hr a week job doing something you like because having your own money is important to you.

Gray sets you up for success. It allows space for error, changing our mind and wrong turns without making us feel like an idiot. When we adopt a gray mindset, we give ourselves a safe space to be vulnerable trying something new. This is a good thing because what isn't new when you're a new mom?!  As a new mom, gray is crucial. We're learning who we are as a mom. Compassion not only matters but makes this journey more bearable.

What does gray look like for you?  Leave a comment below.

Thank you as always, for reading. I'm glad that you're here.

{new #OutsideTheMomBox post} Touring The Birth Place at #Duke Regional Hospital - Part II

In this post, we continue where we left off and will tackle what happens from delivery to discharge. Part I of this post was published here.

After you have delivered your baby, you will spend only about 2 hours in your labor & delivery room. Then onto the mom & baby rooms. Before that your nurse will help you get up at some point and use the bathroom. At Duke Regional, the labor and delivery rooms are separated from the mother and baby rooms by the nursery. It's a nice quick jaunt to get from one to the other. However you'll likely be in a wheelchair. If you delivered vaginally, you may find yourself to be ravenous (I was!) and you are encouraged to eat. Your IV will be removed. If you delivered via csection, it will be a slower progression to get to foods but the goal is to get you back on a regular diet. 

This is a L&D room from the 1960's. Thanks News Tribune Attic for this photo.

Once you are in your new room, you can expect to stay there for 2 nights if you delivered vaginally or 3-4 if you delivered via csection. It is your right to leave after 24 hours but this is discouraged for many reasons, not least of which is due to helping you figure out breastfeeding. An IBCLC at Duke Regional will come after the first 24 hours because after the first 24 hours is when a feeding challenge might show up and because newborns are super sleepy in the first 24 hours so may not be as interested in feeding. These rooms are private and simple, not fancy. They don't offer much in terms of comfort for your partner i.e. there are "reclining chairs" not a sofa for them to rest on. There were be pretty regular interruptions as staff come in to check on your and baby's vitals but they will try to be mindful of your rest. The nurses will teach you how to swaddle, diaper, bath baby and also help with breastfeeding. They will likely show you the movie "The Period Of Purple Crying" and perhaps offer a copy for you to take home or...share with your nanny or other caregiver. Circumcision, if you have decided to go that route, can happen anytime but like the hearing test, baby will be removed from the room for this. The newborn screen includes a bilirubin test as well as the hearing test. Finally, the carseat will need to be brought into the hospital on the last day of your stay. You cannot leave the hospital without a carseat so my guess is this extra schlepping is simply to prove you have one.

A couple of other miscellaneous bits of information:

• If you do't have a breast pump, you can buy one at the gift shop at Duke Regional with a 35% coupon that comes in your tour packet. I advise checking which brands they stock and the price. THEN comparison shop a bit at places like Buy Buy Baby or somewhere similar to make sure you are getting the best deal.
• There are options for photography in your room, at the hospital, if you are interested in that. It's free, easy and confidential. I've blogged about wishing I had more photos of myself and Elisabeth during the first few days so I think this is just a terrific service.
• There are no set visiting hours at The Birth Place but there is a very strict security system. Your baby gets a little bracelet that, if it falls off or is removed, will alert staff to come and check on baby as well as lock down doors (although perhaps not immediately). 

As always, one of the most important bits of advice I can offer is to make sure that you have good support before, during and after childbirth. That means a birth doula, childbirth educator, postpartum doula and IBCLC. But good support i.e. a birth doula, during labor, increases your satisfaction with your birth. Greater satisfaction with the birth process (feeling heard, listened to, appreciated, understood, comforted) helps decrease the chances of a postpartum mood disorder. 

What have I missed? If there is something you wish I had included here, please leave me a comment below and let me know. Thanks for reading.

April's #NewMoms group conversation: Introducing Solids

The second Saturday of the month is my support group for new moms and babies. Each session starts out with introductions and then goes in our main topic. We leave about 30 minutes for Q&A, then close. With some of regular attendees getting closer to the six month marker, our topic this month was "introducing solids". We talked signs of readiness, dangers of early introduction, purees vs. baby-led weaning and how to tell if baby appears to be sensitive to a certain food. Here's the gist of last Saturday's conversation-

I like to start by asking, "what have you heard?" about whatever our topic is, or a similar question. Moms in last Saturday's group relayed what they had heard from outside sources like their mom or pediatrician's about introducing solids. Some of which was "start with cereal" and "the earlier the better". These answers provided a perfect lead-in to a conversation around signs of readiness. 

Science, evidence-based information, when it comes to information for pregnant women and new moms is very important to me. Anecdotal evidence serves its purpose but when you're seeking real knowledge and not someone's opinion or experience, evidence-based information feels like the only real option in my mind. For the topic of introducing solids, I relied on my breastfeeding bible book (the best book on breastfeeding and beyond that I have found yet) _Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers">Breastfeeding Made Simple_by Kathleen Kendall-Tackett and Nancy Mohrbacher. This dynamic duo recommends the following four signs of readiness before introducing solids:

• Baby can grasp food in hand;
• Baby is interested in food;
• Baby has lost tongue thrust reflex;
• Baby can sit on her own.

Some of these just make sense, right? Giving baby food when he can't sit upright can be a choking hazard. These signs of readiness generally show up around six months. But if they aren't there, don't panic. Tongue thrust is usually gone by four months and baby is usually pretty interested in foods around five months but sitting independently and holding food are trickier. They will come in time. And, yes, do wait for all four signs of readiness. Introducing solids too early can lead to allergies, ear infections and digestive issues. Baby's system is NOT ready for solids earlier than around six months, when each of the previous signs of readiness are apparent.

Once you're ready to go, you just need to decide purees or baby-led weaning. Purees are what you think they are: pureed foods given to baby, just like your parents fed you. BLW is a bit different. The Baby Led Weaning book is a terrific resource. I also wrote a bit here about my early experiences with BLW when I first tackled it with my daughter but some basics are:

Give baby a large enough chunk of food, not tiny bites. Baby will work on as much as they want and leave it when they're done. The result is baby dictates when they have had enough instead of dad or mom trying to guess how many spoonfuls are enough.

• Baby learns to chew, even without teeth!

• BLW believes that early introduction can help eliminate chance of allergies or food sensitivities. There is little evidence to support this but I can say from an anecdotal perspective, I've found this true for my daughter and other babies I know.

• No special meals, no special equipment or longer prep times.
• Anything goes...except honey. Just make sure it is size-appropriate.
• It'll be messy! Pro tip: I use Shout on every.single.piece of clothing that my daughter stains. It works 9 out of 10 times.

Another key point: try and introduce one food at a time, especially early on. If there are reactions like a red bottom (kind of like diaper rash), redness near the mouth other concerning evidence, you will be in a better position to deduce what food might have caused the reaction. And of course always call your trusted pediatrician if you see something that worries you.

Big takeaways from Saturday-

• Solids are just fun for the first year. Think of them as another activity for you and baby to engage in. Your milk or formula is ALL THEY NEED for the first year.
• You're the expert. Do your own homework when it comes to what is best for your baby. 
• Cereal for babies is like cereal for us: filler and yummy tasting. It adds no nutritional value for a baby nor does it teach them how to chew.
• Solids DO NOT help baby sleep better. This is a myth.

I hope this summary is helpful for a new mom who may be interested in attending and as a refresher for those who did attend. Our May (5/10) topic is: summer!

If you liked this post, would you click the heart below?  Thank you!  And if you really liked and want to hear more, I hope you will subscribe here or join us next month.

Concerns about breastfeeding impact time baby is breastfed

New moms intent on breastfeeding have a lot on their plate.  Breastfeeding is exhausting, emotionally and physically.  Add in pumping, issues of over or under supply or "just" the mountain of challenges that you can face as a new breastfeeding mom and you can see why moms can get overwhelmed.  A new study (10.13) by the journal Pediatrics looks at the relationship between mom's breastfeeding worries impacts how long she breastfeeds the baby.

The study concluded that new mom concerns about breastfeeding directly affected the length of time that mom breastfed.  Makes sense, right?  If you're worried about something that you're doing, you may be less inclined to continue doing it as time goes on.  The predominant new mom concerns are the usual suspects:

A post-partum doula always looks at position of baby's body, his body language & "attitude" and mom's breast to troubleshoot any challenges.  What do you notice about those things in this picture?

1. difficulty with baby feeding at the breast (this can include latch, tongue tie, oral aversion issues, etc.);
2. pain (breastfeeding should never hurt but it often does, especially when we're trying to figure out "how" to do it in the early days);
3. quantity concerns (is baby getting enough to eat?)

These concerns are normal but still scary for the new mom. If breastfeeding is an important piece of the fourth trimester for you and your family, you might consider hiring a post-partum doula.  The concerns above are issues that are addressed by a post-partum doula*.  [Note: these concerns can also be addressed by a lactation consultant.  Lactation consultants specialize in breastfeeding. ] A post-partum doula is a generalist who does three things for her clients: offer evidence-based information, hands-on help and unconditional support. So one takeaway of the article is the importance of hiring an experienced post-partum doula to help with breastfeeding in the early days.  

The study is available by subscription only (of course!) but you can see the abstract here.  You don't need to read the whole article though to get the recommendations by the study authors on how to close the gap between concerns and duration.