All in a day's (hard) work

"The purpose of life is the expansion of happiness and the ability to love and have compassion." - Deepak Chopra

What do you think of when you read this? I'm thinking of you.

...how much work you do everyday for your baby (babies). Going to work outside the home and pumping 2-3x a day while you're there, even at JFK as you head home from yet another work trip. Or staying home with baby and rearranging your day from wake to sleep around them and every little thing they need.

...how much love and energy you put into making sure they are thriving. From the visits to the pediatrician to the choosing of another nanny to the choosing of different pediatrician. You are tireless when it comes to making sure she is getting everything she needs, the best you can afford, the best you can find, the best you can offer.

...how much care you take when you change and bathe your baby. New wipes, on the go or at home, with every. single. diaper. change. Fresh, clean diapers, whether disposable or carefully laundered, with every. single. diaper. change. Checking to make sure the water in the bath is just right. Gently washing tiny fingers and toes.

You expand your baby's happiness every single moment of every day...whether you are with him or whether your partner or another caregiver is. I know you do; you love like you invented the word. With all your heart, head and soul. Every action you take, every decision is seeped in compassion for this little being. Because you are not only caring for her but teaching her a lesson about how to love and what happiness means. But don't forget there's another piece to the lesson: turning these actions on yourself too.

Caring for yourself at work- Asking for the raise. Taking a walk at lunch. Stepping away from a meeting to get fresh water. Heading out of the office for 15 minutes to meet a colleague or community partner for coffee. Getting the supervision, mentoring you deserve.

Pour energy into your own physical and emotional health- Going to the chiropractor for an adjustment. Connecting weekly with friends for a run. Talking to a coach, therapist or other support person for reassurance, advice or with any concerns you have. Schedule time alone.

Personal self-care- Shut the bathroom door and let your partner worry about the baby. Shower everyday. Get a haircut or a pedicure. Take a hot bath occasionally. Toss clothes that don't work; buy ones that do. Take deep breathes & vitamins. Eat foods that make you feel good.

You can't expand anyone's happiness or even teach anyone that their happiness is important unless you're willing to show yourself some. As a mom, it can't usually be a 1-1 thing. It can be a 3-1 though: 3 parts doing for your baby, 1 part for yourself. Any less than that and you risk your baby (who will be a watchful, smart child before you know it) learning a different sort of lesson: happiness comes from someone taking care of us and if that doesn't make us happy, something is likely wrong with us. Ugh. Who would want their child to learn that?

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Book Review: Body, Soul & Baby

During one of my early visits with my ob, I asked her for a recommendation for a good pregnancy book to read. She told me about Body, Soul and Baby by Dr. Tracy Gaudet, the former director of Duke Center for Integrative Medicine. I've read a dozen pregnancy books since then and this is still the best one. 

Perhaps from the title you can tell that _Baby Body and Soul_ is a different sort of pregnancy preparedness book. The emphasis isn't "just the facts" although there are plenty of those. And its' focus isn't "touchy feely" or overtly spiritual although those factors are also present.  Gaudet  talks about the book as a guide to becoming aware of the transformation that a pregnant woman is undergoing. Not only physical but also emotional and spiritual. _Baby Body and Soul_ urges the reader to look at her whole person. Gaudet argues that by examining all aspects of ourselves (emotionally, physically, spiritually, etc) we will take care ourselves in a way that nourishes us authentically, from within and not in a perfunctory, automatic way. The difference between these approaches can be explained this way. Consider the woman who gets to know herself during her pregnancy, pays attention to what her body is saying, and what her emotional self needs vs. the woman who goes into autopilot when pregnant, dutifully taking prenatal vitamins and going to her doc visits. Both may start out feeling overwhelmed, surprised, etc. but one takes the time & energy to explore those feelings while the other sort of hopes they go away with time.

Tanya & team at Daisy Cakes made these lovelies for one of my baby showers.

Early on in my pregnancy, I felt alone and scared. I didn't know any other "older" pregnant women and we decided we wouldn't tell anyone that we were pregnant until we were well out of our first trimester. Other than our conversation, there wasn't much connecting my pregnancy to reality. As a result, I felt unattached to the baby. _Baby Body and Soul_ is full of exercises that are designed to connect you to your baby, even if it feels unsafe or scary. In Chapter 3, "Ten Tools for Tuning In", Gaudet talks about "dialoging" and "baby quick pics". It was with the help of these tools that I first connected with our daughter. This was a huge turning point in my pregnancy, from an emotional perspective. Suddenly, she was real. With these exercises, I begin to see the baby as a warm, yellow sun (before we knew her sex). From that point, until her delivery I called her "Little Sun".  

There are only two gaps to this book in my mind. The first is that it hasn't been updated since it's publication in 2007. The information is still timely and relevant but best practices in prenatal care change all the time so it would be wonderful to have a new edition. The second is that for all its holistic approach, there is no mention (that I can recall) of how past trauma like sexual abuse or domestic violence can affect not only the choices that a pregnant woman makes but also how she does "pay attention" (Gaudet's language in the introduction) during pregnancy, childbirth and the postpartum period. As an educator and speaker about how issues like DV and SA affect a pregnant woman, this is a huge miss in my mind.  That said, it likely wouldn't be a miss for others and non-survivors. 

If you're the kind of pregnant woman who wants facts but also a little more in terms of emotional exploration and building connection to this new small life, _Baby Body and Soul_ might be a good choice for you. _Baby Body and Soul_urges you to slow down, take the time to feel what you're feeling and then make decisions based on those internal matrixes. It's not a Thanksgiving meal to be stuffed on; it's more of a dessert tasting menu at your favorite cafe which encourages you to savor and taste deeply.

Outside The Mom Box rating: 5 stars out of 5

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March's new mom group conversation

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. Starting this month, my goal is to write a follow-up blog post featuring some of the highlights of our conversation. This month we discussed "developing a routine with a new baby". We talked challenges, the impact of our shifting identity (from "me" to "we") on a routine, the must-know's or need to accepts and some solutions.

We isolated the very clear challenges with developing a new routine. Those included: the basic issue of having to bring another human being along with you who can't support himself, stand by herself, feed or change himself. That's A LOT in and of itself!  We acknowledged that because "the answer changes all the time," it can be hard to plan time to do _____ or count on having dinner at 7:30 pm each night. The fact that there is such a substantial learning curve with having a new baby complicates every decision, let alone when we might have time to exercise, for example. An employer expects it to take a while for a new employee to learn the ropes of a new job. Moms don't get any such concession with a baby; they are thrust right into the thick of it! The bar is set very high with often little time and few resources or support.

Routines, we acknowledged, are safe. They are safe because we know what we can expect and count on. So when we don't have a routine, life can feel unpredictable and scary. So they are important, We talked about how developing a new routine was essential. Wearing our new "mom" hat instead of our old, familiar "(insert your name here)" hat would ground that new routine. Ideally with this "mom" hat on, we will start to accept realities like "it's not the end of the world if dinner doesn't happen at 7:30 each night." whereas before that might not have felt like an option. Wearing our "mom" hat will hopefully allow us to sink into that new identity and perhaps get used to asking for help more often, for example.

Some "need-to-know's" that we came up with were:

• Our time is just more limited. Even the smallest tasks will take much longer.
• "It" won't be like "this" forever but it will be for a while. So reframing can allow us to accept a different kind of meaning for "routine".
• We will never be able to get it all done. There will always be something to do.

A few solutions:

• Creating "anchor" tasks to help offset the frazzle.  Examples: shower every day, use a meal planning service (this one was recommended) , exercise certain days of the week not 5 days perhaps but maybe 2-3.
• Limit the number of "yeses" that we agree to. Some things are just not realistic any longer. And that's okay.  It's temporary and it's okay.
• Watch our use of "should". "Should" often carries obligation or guilt with it and we don't need any more of that!
• Be kinder to ourselves. Letting go of what people think or what "should" be happening.
• Find a community of support. Whether that is a group of moms like this one, new moms in your neighborhood or a LLL group, it's essential to be connected to other moms who are in a similar place.
• Ask for help more. People want to help. Whether that mean someone else lifting our baggage into an overhead bin as we settle into a plane with baby or "just" taking someone up on their offer to walk the dog, accepting help more often will take the pressure off us while making someone else feel good for doing good.  A win-win!
• Self-care.  Let's get more of that in there. Exercise, time away from baby, a massage perhaps! Make sure we are taking good care of ourselves.

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 April topic is: travel with baby.

Dear reader, what would you add?  Or is there something that you wished was discussed?  Leave a comment below.  

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Are you at risk for a postpartum mood disorder?

It's a little bit of a trick question because postpartum depression can affect any new mom. But it's important to note that there are some populations that are at a higher risk for postpartum mood disorders in general.  Here are some of those groups:

Women who have had health-oriented /physical challenges in their past:

• Survivors of intimate partner violence;
• Survivors of sexual assault, rape or childhood sexual assault*;
• Women who have suffered / suffer from disordered eating behaviors;
• Women with a history of depression;
• Women with a history of bipolar disorder;

Women with the following specific social or economic challenges:

• Women with limited family support;
• Women who are poor or lower income;

Lastly, there are factors related to the baby that put some women at a higher risk:

• Special needs babies;
• Colicky babies;
• Chronically ill babies or babies with life-threatening illnesses.

[Author, IBCLC and speaker Dr. Kathleen Kendall-Tackett talks about all of the above challenges and more in greater detail in her book, Depression in New Mothers. I highly recommend it if you are interested in reading more about postpartum mood disorders.]

I would also add women who have suffered from chronic pain, after reading this article.  This is just my opinion but I can't imagine how suffering from constant pain wouldn't make you predisposed to a postpartum mood disorder. Finally there is a new study out that says that women who fear childbirth are also at greater risk for postpartum mood disorders.

With all of these risk factors, I can't help but wonder why more women aren't diagnosed with a postpartum mood disorder.  But of course, as we know, postpartum mood disorder screenings aren't thorough, perfect or even often enough.  The onus is, once again, on the new mom herself to come forward.  But when you're in a haze of confusion, pain, sleeplessness and perhaps anxiety, it can be hard to sort through whether your feelings are normal.  Also not helpful is the fact that you don't see your OB until six weeks after you have your baby/babies.  That may not be early enough (postpartum depression can happen anytime in the first year) or it may be too late. 

Here are three things you can do, if you happen to fall into any of this categories of higher risk:

1. Make finding a good local new moms group, like mine, a priority for yourself before the baby arrives.  Good social support is ESSENTIAL as a new mom.  You will need to know that you aren't alone, that you (and your worries) are normal and that many new moms share your fears, wants and concerns.  . 
2. Consider hiring a postpartum doula.  They have the distance and the expertise to recognize problems before they arise.  Postpartum doulas are trained in, among other things, recognizing signs that mom gives...whether spoken or unspoken.  Postpartum doulas aren't counselors but they can refer out to a qualified professional.
3. Speak up.  If something is upsetting to you, talk with your partner, friend or another trusted mom about it.  If you need something, ask for it.  Too many of us suffer in silence, or just as damaging resentment, when it would be better for our physical and emotional health just to talk about it.

A postpartum mood disorder isn't a life sentence or something to be ashamed of.  Let's keep the conversation going so we can all stay better informed and in doing so, be better advocates.