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Modern parenting is a joy but a challenge. We're here to help you accept and problem-solve the painful parts of mommying so you can move on to really enjoying life with your kids, spending less time on your to-do list and more time on the things that really matter.
January 11, 2018
You’re there in the hospital, a new mom, just trying to get your feet wet with the whole baby feeding thing. Well-wishers, relatives, hospital staff -they all have a ton of advice. And, given the gravity of the situation, the sinking feeling that you are now responsible for another human being and that his or her safety depends solely on you, it’s understandable you would be a little overwhelmed.
There, in the sea of recommendations and guidelines, one crucial principle often gets missed. It’s critical to early breastfeeding success. It’s a simple rule that, with incredible fatigue and postpartum recovery issues, can be hard to concentrate on: babies need to eat.
On the surface, that may seem over-simplified. I mean, OF COURSE, babies need to eat. You knew that already. But the specifics of what they need and when they need it can be a bit more complicated:
In the first few days to weeks, babies need to have a feeding attempt at least every three hours. We call it “three hours start to start” in my office – that is, it should be no longer than three hours from the start of one feeding to the start of another. Babies will often want to feed WAY more often than that, which is great and perfectly okay, but at the very least they need that every three-hour cueing.
Why? Breastfeeding is a two-way feedback loop – The first feedback loop is for the mom; the more a baby’s suckling stimulates the breast, the more milk the mom’s body makes. The second feedback loop is for the baby: the more the baby eats, the more food it takes in, the more alert and hydrated the baby, driving hunger and allowing the baby to eventually regulate its own feeding needs.
You may have heard two things that contradict this advice, so let me address them both:
First, people talk all the time about the fact that babies should feed, “on demand” – that they should drive their own hunger and can do so. That breastfeeding should be natural. That’s totally true…eventually. But, in the beginning, a baby needs help to get their system going. Breastfeeding IS natural, but it’s not usually easy in the beginning for a new baby or a new mom – both have to learn new skills and how to “rev up the system.”
Second, there’s a lot of talk in prenatal classes about how a baby’s stomach is really small at first and they don’t need much milk. About how they really only need the tiny bits of colostrum in the first few days. That is absolutely true. Babies are often sleepy in the first 24 hours after they are born, mom’s milk hasn’t come in yet, the system is set up so that there’s a little grace period. But here’s the catch – that is the time to prime the pump(s) by nursing frequently so that the milk actually does come in and so that baby is alert enough at day three to four so they can take the milk mom starts making. In some cases, if that doesn’t happen, blood sugar levels can drop, making babies lethargic and harder to feed. Babies can get dehydrated, contributing to jaundice (the yellow color that can develop in a baby’s skin).
Alright, so you’ve got it – you’re planning on feeding often. All set, right? Well….. you’re going to want to do THESE things, too:
Keep your baby active at the breast. You may need to stimulate your baby (tickling baby’s feet, using a cool washcloth at the forehead, getting baby undressed down to the diaper, rotating her arm gently) to get your baby to feed effectively (otherwise, they may burn energy on sucking without getting much back in return).
Get lactation help. Of all the advice I offer, this is the most important. Get help from the get-go with latch. Ask your nurse at the hospital to position correctly. Ask for a lactation consultation if you have any concerns at all (this is pretty much every new mom I meet, so don’t feel like you have to have major worries in this area to justify getting extra assistance. Sometimes, you don’t realize the questions or issues you have until an expert helps you out). Like I’ve said before, if you lived in a home with all of your breastfeeding friends and experienced breastfeeder family members, you wouldn’t need all this outside help but, the reality is, you probably don’t.
New parents care the most about one thing: making sure their babies are safe and healthy, but the newborn period can feel a little hectic and confusing sometimes. That’s normal. Even if you follow every single piece of good advice you hear, not all postpartum issues are avoidable. Part of having a baby is problem-solving on the fly. Even so, it pays to concentrate first on getting a good feeding cycle in place and getting help when you need it – so many other infant care issues will fall into place if you do.
Want more? Read more about being a new mom and the ups and downs of feeding a baby (including not allowing breastfeeding success to define your worth as a mother) here.
January 4, 2018
It’s sick season. That means, in pediatrician offices across the country, lots of congested, coughing kids (and lots of worried parents). I’ve officially joined the ranks of all those snot-covered, sleep-deprived moms and dads this month. Four weeks ago, my littlest came down with Croup and spent three nights hacking away like a baby seal. I came home from work to her lying on the rug in my living room, curled up in a tiny ball, clutching a stuffed animal while my husband rubbed her back. Then, New Year’s Day, she wound up in Urgent Care after waking from a nap with a 103 fever and labored breathing, bless her little heart.
Needless to say, the mama inside me outweighed my medical degree both of those evenings. I had to force my mind to “think like a pediatrician.” I also had to take a deep breath and try NOT to think about all the work I would inevitably miss, the wasted childcare dollars I would no doubt forfeit and the sleepless nights I was bound to encounter before she recovered from her respiratory illness.
It made me think, as I reminded myself to stay objective, of all the sick kid parenting pearls I try to share with my patients’ parents in clinic week after week, but especially during sick season:
Follow your gut. If you are worried about your child, call someone. Make an appointment. Get them in front of a medical professional. You know your kid best so, if they seem off to you, listen to that little voice inside your head telling you to take action. Pediatricians aren’t irritated when a parent wants their child to be seen “just to be sure everything is okay.” Actually, we would much rather that than the alternative – a serious condition gone unchecked. Kids tend to rally well at first with sickness but then can crash pretty fast. It’s better to get the advice you need early on so you don’t get to a more critical point.
If you’re a new parent, that may mean you call as soon as your child gets a small cough. No problem. Your doctor or their nurse can guide you through what to expect and what to do- consider it your sick kid mini-education. As you get more and more experienced, you’ll gain confidence, you’ll know the basic ways to handle minor illnesses and you likely won’t need as much assistance.
Whenever possible, you want a medical provider caring for your child who really knows their stuff – someone trained specifically in pediatrics (obviously, if you are on vacation or in an emergency situation, that’s not always realistic). When you do have a choice, choose pediatric-trained providers so they can get the most accurate medical history possible and can provide the most up-to-date care.
Understand Honesty is Important and Details Matter. If your child has had a fever for one day or for five days, those are completely different situations, each of which triggers different levels of testing and medical interventions, depending on age. As I sat in the urgent care clinic with my daughter last week and watched a practitioner shrug a little when I said she had just developed her fever, it was tempting to try to sell how bad her illness was. Sometimes, I know, it feels like elaborating a tiny bit to get the attention of medical providers will help when it comes to a sick kid, but that can backfire. You don’t want your child to have extra bloodwork, imaging (X-rays, etc) or medications when they don’t need them. It can lead to unnecessary and sometimes harmful side effects and even hospitalizations.
Believe That We Believe You. I cannot count the number of times someone has brought their febrile child into my office, completely miserable, so that I can see how sick they really are. No fever-reducers on board, the poor kids and their parents must have had a horrible time on their car ride over to clinic. But there’s no need to show us your child at their worst. It’s fine to give your son or daughter acetaminophen or ibuprofen (these medications can be age- and condition-dependent – check with your health professional if you’re not sure) before your doctor’s visit. In fact, the best way for medical professionals to accurately assess how your child is doing can be to see them WITHOUT THE FEVER when possible, since they sometimes look worse than they actually are when febrile.
Use Antibiotics Judiciously. Sometimes, a parent will seem disappointed when I tell them their child has an upper respiratory infection (aka a cold) and doesn’t need antibiotics. Remember, it’s a GOOD thing if there isn’t a need for extra medicine. You don’t want antibiotics unless you really need them. Every drug has side effects and, if we give antibiotics for colds, a. It doesn’t change a thing about how fast a child gets better, b. It may give them issues with diarrhea and c. It contributes to antibiotic resistance (when an antibiotic stops working against the bacteria it was designed to treat and makes it harder and harder to treat serious illnesses). It’s hard to wait out a viral illness, letting the storm pass until the sun comes out again, but it’s worth it to concentrate on comfort care if your doctor prescribes it versus fighting for an unnecessary medicine.
Accept Illnesses Can Change Quickly. When we see you in the office, we’re catching your child at a moment in time. We hear about what has happened so far and we base our diagnosis on our exam that day. It’s one data point. Often, though, an illness can change within hours or days and, without a crystal ball, it’s impossible to predict which direction a sickness will go. It’s not surprising to us when we need to schedule a re-check appointment to make sure things are improved or when a parent calls us back to say a child is still sick. That’s why we give so many contingency after-visit instructions. Most of the time, we can solve an issue with one evaluation but it can take a bit more complex problem-solving with multiple visits at other times.
Find a Provider Who Welcomes Your Questions. Part of my job as a pediatrician is to make sure I translate all the medicalese for my patients and their parents, assuring they leave with a solid understanding of what’s wrong with their child and what they can expect as they recover. I know it is sometimes terrifying (or sometimes just super inconvenient) to have a sick kid and that parents need answers and explanations. I’m used to it. ALL doctors are. So, ask away. Clarify. Pull out the list of worries. Let us know the underlying issues (like, “When will my child be better and when will I be able to go back to work?”). We’re all ears and, in the end, it’s easier for all of us to be on the same page from the get-go than to let frustration or confusion play a role in your child’s illness.
I’m not gonna lie – having sick kids is one of the most challenging parts of modern parenting. The schedule re-arranging, the miserable little one, the scary unknowns of illness – it all adds up. Remember, pediatricians know how hard it is to care for sick children (I do it myself all the time!) and we want your child to get better as fast as possible, too. Access the resources you have, get the answers you need. Above all, follow your gut – if you’re worried, get help (or just peace of mind). ’Tis the season for sickies and sickness and you’re not alone in just checking to make sure everything is alright.
December 28, 2017
We’re excited at Modern Mommy Doc to introduce our new, re-branded, re-designed website. It has been a huge labor of love and took the effort of so many talented people. Personally, it marks the culmination of 15 years of planning, hoping, and dreaming. Finally, I’m able to marry my two major passions (medicine and writing) with the hope of:
moms who want to win at parenting without losing themselves.
Now, over six months in, it’s time to take this side project to the next level, expanding our free mini-courses to include help for parents-to-be, parents of toddlers and parents who need help getting on the road to self-care (that’s all of us, am I right?).
Of course, we’ll continue providing tons of practical, realistic guidance and perspective via our regular blog posts and comprehensive self-care and newborn care programs.
Welcome to the New Modern Mommy Doc!
With lots of gratitude and respect,
December 22, 2017
December 22, 2017
The Holiday Season comes with all kinds of feelings – warm cozy feelings as we listen to sappy winter classics, wistful feelings as we think about how preciously short the time is that we have with our families… and creepy feelings about Mommy Fraud: that sense that we’re not the mom we should be and that one day everyone will figure it out. Mommy Fraud is like the third sister in the Mommy Guilt and Mommy Shaming family – and she’s the meanest.
The Holidays are prime time for Mommy Fraud. For most moms I know, there’s a special pressure to be completely organized, to be a gift-giving guru AND to create traditions that bring peace and hope to our homes at all times. It’s like the season has set us up for failure. We even have songs about how idyllic this time is supposed the be. The truth is, I can’t keep up. My guess is you feel sometimes like you can’t either.
Case in point: My Thanksgiving turned out to be way less than idyllic this year. At the dinner table, my 15-month-old grabbed every utensil she could get her hands on, spilled my mom’s wine in her lap and pushed her feet against the table so hard, she knocked her high chair back, almost hitting her head before I caught the piece of furniture in my arms. My older daughter got so overwhelmed by the crowd and the noise that she ate, in just her underwear, at a pop-up coloring table in the hallway, out of everyone else’s view. She refused to join us all until someone bribed her with dessert and, even then, proceeded to cry through half the meal. It was a disaster.
My husband looked around and chuckled, “We have a parenting course we’d like to sell you on Whitney’s website since we’re such experts if anyone is interested.”
I felt embarrassed, frustrated and like a total fake in that moment. And I know I’m not alone. You may not be a doctor, you may not give parenting advice all day long like I do, but you’ve had those moments when you are just not able to meet others’ parenting expectations. The feeling starts early, even before we have our babies, when we don’t feel glowy and beautiful during our pregnancies. It keeps on going – when we’re struggling with how to get our newborns to sleep, our toddlers to potty train or our teens to stop arguing with us.
You can probably already guess why. We live in a society where perfect motherhood is mystified and celebrated. Our social media posts are just a little too glossy and polished. Our celebrities make motherhood seem like a goddess dream. Magazines sell us on the fake assumption that if we get all the right gear and plan it all out, we’ll get an A+ in parenting class. Set that in contrast with the messy reality of our day-to-day lives? We’re bound to be uneasy and a bit ashamed.
Overwhelmed by the Motherhood Goddess Myth herself, New York City mom Margaret Nichols said it well when she spoke about the pressure to do things “just right” in Time Magazine’s cover story on the issue:
“What I’ve learned is there are some things you can control, but there is a lot you can’t. We just have to give ourselves a break and do the best we can.”
With Mommy Fraud all around us (and especially during the Holidays), I’m making a change this year in how I handle what has historically been one of the most stressful times for moms nationwide:
It’s simple, really. My husband and I are fully sharing the holiday planning responsibilities this year.
We’re dividing and conquering. His job is Christmas gift shopping for extended family and friends. I’m offloading the tasks that tend to make this season feel like a really long, expensive checklist. I lovingly passed the baton this year (Ok, actually I told him, “I need a break from all of this, there’s too much, we need a new plan.” And he said, “Sure, no problem.”).
It kind of shocked me he would have taken on the Christmas shopping for the last 13 years of our marriage without so much as a shrug, but it proves my point – here I was feeling all “woe is me” because my mental overload was at a level ten and he would have been happy this whole time to share the responsibility. I just had to ASK (and expect that even The Holidays could be a co-parenting opportunity). He definitely won’t buy the gifts I would have bought and they may not even come in time, but, in the end, it really doesn’t matter. And, the reduced stress is a breath of fresh air for all of us.
My job is planning the touchy-feely parts of the Holidays. I’m planning a special grandma-granddaughter Holiday Tea. We bought family tickets for the local presentation of The Nutcracker. Though we’ll be away from our own house when Christmas Day arrives, we still made it a point to go to the farm and pick out a very Charlie Brown-esque tree and to decorate it as a family. I now have the bandwidth to figure out family opportunities for community giving and other-centeredness as well.
I’m also using this season to think about all of the other ways I let Mommy Fraud own me, about the ways it owns all of us. About other opportunities to reduce my mental overload so I can be more present for myself and my family. About how, if we could just be real about the fact we don’t know everything or don’t have it all together, we would all be a lot more happy and whole.
Want to be the perfect mom? Society, your Mommy Guilt, Mommy Shame, they’ll never let you do it make it BECAUSE MOTHERHOOD IS NOT PERFECT. It wasn’t designed to be. Instead, let your kids watch you make choices that bring you joy. Let your parenting failures be your trophies, hard-earned awards you’ve earned from trying to wrangle your imperfect kids and manage your imperfect self. Especially during this season, but through the rest of the year, too, drop the superhero act all together, letting your flawed, unfiltered self, take the lead role.
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