3 ways to get more sleep with a new baby

Make the most of your sleep and your baby’s sleep with these three tips that are based on human evolution and anthropological research. We are primates and we are evolved, after all.

Tip #1: Give your baby unhindered access to your body. This applies to mothers and fathers. Breastfeed when the baby wants and needs. Want and need are the same for any infant. Babies don’t follow the sleep cycles of an adult. Babies expect to be held in a womb like environment for 18 months after being born. So carry your babies as much as you can. Wear your baby as much as you can. You cannot spoil a baby ever.

Tip # 2: Breastsleeping aka sleeping with your baby on or alongside the same surface. Provided you have a smokeless gestation and you are sober. Breastfeeding is better when lying on your side, because you get more rest while feeding your baby. There are safe ways to share the bed with your baby and they do not involve buying expensive gadgets.

Tip # 3: Know what is normal. “Babies are never supposed to sleep outside the context of a responsible adult.” as told by Dr. Sarah Blaffer Hrdy.

Solitary sleep is not normative for babies and it is a threat to the right of democratic choices of both the parent and the child.

Babies who sleep separately from their mothers have high levels of stress hormone, the main one being Cortisol. Sleeping away and crying for long periods of time releases cortisol.

Cortisol floods their little brains and kills the synapses that were made in the baby’s brain that promote pro-social development and behavior. This can lead to change in baby’s physiology and gene expression.

Dr. McKenna has very aptly said this, ” Ask not what your genes do for you, but what you do for your genes.”

The mother is the baby’s physiology, because a human baby is the least neurologically mature primate. To expect a baby to sleep alone is destroying a human infant’s habitat because it is the mother’s breast that is the optimal environment for a baby to be well and grow well. Even the babies who are not breastfed need to have their mother as their environment.

Follow your baby’s lead, listen to your instincts and do not give in to the fear mongering messages thrown out at every new parent before they even begin their new journey as parents. You know your baby more than any of the experts.

References:

http://cosleeping.nd.edu/articles-and-presentations/articles-and-essays/

Cosleeping and Biological Imperatives: Why Human Babies Do Not and Should Not Sleep Alone

http://www.hup.harvard.edu/catalog.php?isbn=9780674060326

https://www.psychologytoday.com/blog/moral-landscapes/201407/parents-misled-cry-it-out-sleep-training-reports

 

 

 

Babies need their hands!

Mother breastfeeding her five days old baby
Babies need their hands !

It is very tempting to put mittens on your newborn’s hands when you see a scratch on their face or their nose or their scalp. As painful as it is to see the scratch mark, it is easier if you just file a newborn’s nails. The reason I say this is because babies need their hands to feel their world around them.

They need them to seek and find the mother’s breast. They need them to smell their food, they need it to calm them when they are trying to self-soothe. They also need their hand friends to tell you that they are hungry or tired. I urge new parents to get rid of those mittens.

As a student in lactation and a postpartum doula I feel like it is my duty to educate new parents about the vital role of a baby having access to his or her hands. Don’t we all need our hands for everything anyways even as adults ?

Birth experience of the baby !

When I listened to Karen Strange, CPM for the first time, I wanted to meet her. I met her this July at an Integrative Neonatal Resuscitation Training in Portland. I was happy I could meet her within such a short time and in person. Even though I did not plan to get certified in NRP, it was worth my time to meet this amazing woman and Anne Frye, CPM, a midwife who is another amazing woman. All the attendees were really doing great work in the birthing and breastfeeding communities in their respective areas.

“ BIRTH IS STIMULATING”, not just for mama but for baby too. In Karen’s workshop I learned that a baby’s experience of birth is completely different from her mother’s experience.

   The point is what are the babies feeling ? As a postpartum doula, who is not involved in birth directly, I value the work that birth doulas do and try to know about how was the birth for that mother who is asking me to work for her postpartum. Babies have implicit memory or cellular memory upto 18 months of age.

There is more and more evidence that is showing how birth trauma is prevalent and the imprints of birth practices are present on these babies. Karen, said that when you are in a situation where a newborn needs help with taking that first breath, “ IT IS NOT WHAT YOU DO THAT MATTERS, BUT RATHER HOW YOU ARE ON THE INSIDE.” A baby’s brain grows when they feel safe. Cortisol in the brain stops all brain growth.

     A pregnant woman is two people having an experience and not just one. So respecting that fact and letting the baby know what you are doing when you work with babies is very important. Parenting and peace on earth begins before birth. She also talked about thermoregulation of the baby and I cannot emphasize enough how much skin to skin contact with mother helps with that. It was really another affirmation for me.

    I also learned that when a baby needs resuscitation 100% oxygenation at the beginning of newborn resuscitation  should be avoided, contrary to previous evidence. Babies undergo oxidative stress and the 100% oxygen also turns off the chemoreceptors that turn on respiratory drive.

Outcomes improve when a baby starts with room air. Babies in utero are at 60% spO2 and babies passing through the birth canal are at 10% spO2. Babies are meant to handle that low oxygen saturation. So too much oxygen is toxic, regardless of the age of the baby and what the table in the book says, even for brief periods of time.

   Karen also talked about how delayed cord clamping can be so vital to a baby’s need for survival. The two things that happen when a baby’s cord is cut are, baby does not get its full blood volume and baby goes into shock. We need to have compassion for our babies.

“We tend to do what we were taught to do.” We have to KNOW NORMAL. The sequence of birth is an embryological blueprint. This blueprint unfolds according to a sequence and within this sequence are PAUSES. Pauses that are less complex to more complex. Pauses that build potency to do the next step. Transition in birth is often a BIG PAUSE. If you think of the embryological forces, they also occur at a much slower pacing. All healing and trauma work occurs at slower pacing too.

We have to be mindful of where has the sequence been interrupted in a birth. The moments after birth are also filled with an extremely complex and precise interaction between the mother and the baby. It is a genetic and an instinctual process. All of the babies senses are being turned on.

    As a postpartum doula and a student in lactation, I see babies who refuse to latch at the breast. I wondered why ? This happens when that self attachment sequence that is present in all of us is interrupted. We need to give the mother that pause. We need to give baby that pause.

Trauma is defined as, “more is going on than you can integrate and you get overwhelmed”. All babies who have had some sort of trauma have survived but in this class it was not about just surviving, it taught us about OPTIMAL SURVIVAL. Birth exactly as it was meant to be.
Finally to quote Karen Strange, I would love to end with her statement, “ everything about birth is a story.” Let us all try to make that a beautiful one.

Transition begins with support

I teach a newborn care class at our local Babies R Us store every month. One of the few points that I mention while I am teaching, that has nothing to do with newborn care, is how a partner,a friend or a family member can support the new mother. My love for the work I do as a postpartum doula does not just come from being able to care for the newborn but it comes from caring for the mother for the most part. When a mother’s recovery is given a priority, the impact of that support goes a long way for the entire family. A mother who feels loved and supported can be a better mother and a better partner. The more I work in the postpartum world, the more I realize that for mothers in our country being independent and rugged is considered the norm. I strongly disagree with this practice.Having support from the partner, friend, family or a postpartum doula can prevent the challenges of future health issues whether they are physical or psychological. In this case, prevention is better than cure. The increase in incidence of postpartum mood disorders is a big red flag that tells us that something needs to change in the way we care for our mothers.

A partner can provide support, understanding, organization and patience for the mother who is recovering from birth. This also applies to partners who have the privilege of supporting adoptive or surrogate mothers.  We need to remember that there is invisible healing that takes place along with external physical healing that all new mothers go through in the first 6 to 8 weeks postpartum.  A new mother’s mind and body are as fragile as her new baby. A new mother needs to rest and digest,to keep the stress level down. A partner can bring her snacks and make her a plate of healthy food. A partner can remember to keep her water cup or bottle filled. A partner can bring her a cup of hot tea. A partner can hold the baby while the mother takes a shower or a nap. Did you know that a partner who believes in breastfeeding is a marker of how successful a new mother is going to be at breastfeeding?  The faith and energetic support of the partner is vital for the new mother.

A friend who is planning a baby shower for the new mother can communicate with the people on the guest list about organizing for postpartum support. Some of the best gifts for a new mother are not toys or things for the baby. Instead, if a new mother gets postpartum doula hours, housekeeping service gift certificate, massages, meal deliveries or even a friend or family who can come and do laundry once a week, she will find that more helpful than any gift. Trust me, I know this because my clients have told me so! Instead of investing heavily in the care and relationship of the mother and baby, we are investing in fancy toys and decor for the baby.

Postpartum doulas can provide emotional and physical support to a new mother. They can also educate new parents and provide targeted breastfeeding support. 92% of new mothers report at least one breastfeeding concern three days postpartum. When a mother has the support of a postpartum doula she can be rest assured that her postpartum doula will try to find the best resources to help the mother if she cannot take care of it herself. When a partner needs extra sleep, a postpartum doula can make that happen too. Meal preparation, running errands, baby’s laundry, light housekeeping and newborn care are just a few things that are on a postpartum doula’s to-do list. I have been fortunate enough to work with some of the most wonderful families who trust my knowledge and experience. I have only become more convinced about the value of the work I do as a postpartum doula.

Without good postpartum care practices, new mothers in the developed world will be “Failure to Thrive”.

Culture of care

The end of this year and a beginning of new 2015 as I write this post. Today I wanted to revisit the care I received as a new mom and the care I remember given to my mother when she gave birth to my brother. How being in USA has changed me and how I saw postpartum care in India ? My brother was born in 1981 in a municipal hospital in my hometown. From what I remember, we lived in the government quarters provided by the municipality with our grandparents. My mom came home quite sore and tired. I was excited to have a baby brother to play with and so was my sister. My mom slept on a khaatlo ( a traditional bed made of interwoven cord of twines), it was a special bed I had seen a few other times with new mothers in our family and friends’ homes. The bed did not have a mattress but it had a thick quilt placed on top and I remember wondering why my mom could not sleep upstairs in her bedroom.

Curiosity aside I realized later that underneath the khaatlo (aka BED) there was a metal container filled with dried cow dung cakes which were lit but did not release smoke. It was a mild heat that kept oozing under the bed where my mom slept. It was a comforting smell at that time and still makes me feel warm and cozy. My brother was born in November which is the beginning of winter in India. Now I also know why they had the cow dung heating up my mom’s back. It was improve the healing of my mom’s postpartum body, a form of hot fomentation. At times, my grandma would move the heat source up and down so her entire body felt the warmth.

Going back to my postpartum time, I came to a cold home, even though the heater was on. I did not have the energy to climb up a flight of stairs to go to my bedroom. I was so sore and swollen up from the extra fluids that the hospital had pumped in me. My husband managed to get the mattress and box spring downstairs in our family room. I remember not wanting to be in that room but did not have any other option. No heat under my bed. My mom did manage to put a heating pad under my back.

I also remember that I did not see any new mom without a scarf in India. They say the ears should be protected for the first 40-45 days from cold air. I listened to my mom and kept it on for a week. I should have done that for longer. A belly binding regimen was not something my mom had suggested and I don’t remember if she had a belly binding thing done with my brother. I need to ask her about it next time I talk to her.  There was a lady who used to come to our home in India, everyday to give a full body massage to my mom and my brother. She was quite quick and efficient at her job. She was not a therapist or a qualified masseuse but an older female who knew her stuff. She would also follow the massage with a hot bath for my mom and my brother. In my case, no time for massage because my mom was the cook, the maid, the postpartum doula and my sounding board for everything. She made me all the postpartum foods that I would have consumed if I had delivered in India. By the way, all of them are so yummy. Warm and comforting food. Lots of ghee, greens, easy to digest foods. Did I see my mom having postpartum depression symptoms ? NO.

Not the same in my case. I had a traumatic birth, forceps, extra fluids, 3rd degree tear, sleepy and tired spouse. Even with all the things that my mom helped me with and fed me, I was not happy. I had postpartum depression and did not get help from a professional for that. My mom never asked me to get any help either, but my dad on the other hand did say that I needed a psych consult. To top it all, I got mastitis and did not go to the doctor to ask for medicines. WHY ? YOU ASK ? I was not in my right mind and did not advocate for myself. Part of me was scared of my spouse, because I knew he did not believe in taking medications. Part of me, did not trust the doctor who took care of me during labor and after that. Part of me, was scared that if I listened to my parents ( both of whom are doctors by the way), it would hurt my relationship with my husband. My hormones were no help either.

The most foolish reason, of all, was I had thought that I am supposed to take care of myself and my baby without any other help from friends. Boy was I wrong. I thought I was super mom. Well I don’t think I would use the word SUPER MOM at that time but I did have this thought and assumption that I should be able to do this on my own. NOT TRUE. ABSURD. I did not help anyone by thinking that, specially I lost the time I could have bonded with my first born. I have made up for it but if I had listened to my body, my parents and people who offered to help I would have been in a better place. After all is said and done, the whole reason for this post is to let everyone know why I became a postpartum doula and why new moms should feel empowered when they ask for help.

Touch, teach, learn, Trust

Touch is one of the first sensation a baby learns when it comes to the world. The midwife, OB, birth worker who delivers the baby is the first person to touch the baby and at that time the baby is still in transition. The mother’s touch should be the first touch that a baby experiences. In our modern world, complicated healthcare systems have managed to make this quite difficult to attain. How can we give our babies this wonderful touch after all the interventions that happened before ? The answer to that is MASSAGE. You do not need to be a massage therapist to touch your baby and massage your baby.

Infant massage classes are vital for parents who want to learn it from professionals. For the parents who are committed to doing infant massage regularly, these classes are taken before the baby’s arrival. For parents who have already come home with a new baby, you won’t have the time to go to a class. But it is never too late because giving the baby the gift of touch is the second best gift to breastfeeding. Did you know that you get to talk to your baby when you give them a massage ? A baby relaxes and this will relax mama and papa or whoever the caregiver is. Your baby looks at you directly and learns that this is what a safe touch feels like. You get better at reading your baby’s cues. You don’t feel overwhelmed when your baby cries because you will know why he or she is crying.

Touch is invaluable to any mother and baby dyad. Dads should try it too. Dads, if you feel left out because you cannot breastfeed or if you feel that the baby responds to mama better. Trust me. Incorporate a daily massage, it does not have to be a big charade, just gentle massage before bed. You will see that your baby responds to you as well. There is so much research done by people in the field of massage and its effects and you can find the literature in books, journals, articles, online as well but the one thing I know for sure as a mother, aunt and postpartum doula is I am yet to meet a baby who does not like infant massage. The trick is to do it early and often just like breastfeeding.

To Do list

A mother’s desire to rest after birth is not just a want but a need by her body to revitalize itself from the birth. No mother can and should do it on her own. If a mother does manage to go through the postnatal period on her own it comes with a huge cost. Mothers have an innate desire to care for their newborns and family. Mothers put their needs last and the time after birth is the time for the family to put the mother’s need first. How can a family help this new mother ? If you have a new mom in the family, a new mom who is a friend think of three main things in regards to helping her. Three basic needs to be met are food, water and rest. Rest is undervalued so much in our culture. Postpartum rest is totally overlooked. You can cook a few meals and deliver it to the new mom without knocking on their door or waking the new parents up to receive the food. You can go to visit at a time when a mom can take a shower while you hold her baby, or you can throw in a load or two of laundry for the new parents. The point is to CARE and how you show it does not matter but what you DO for that new mom matters.

Family members often try to get excited about the new baby and want to hold the baby. Instead of expectations as family member what you can do is, go into the home with the pure intention to help. After all, if you are a grandma, grandpa or an aunt or uncle you can love the baby by caring for the mom. The new mom will always remember what you did for her not what you said to her, even the kindest words cannot replace kind actions. You have to walk the walk when you are family. Grandmas have a lot of wisdom they want to share but to have the comfort of talking to your daughter or daughter-in-law does not come easy. Grandmas are there to provide support to the mother and that is how they should be showing love for the baby. Can you load and unload the dishwasher ? Can you sweep the floor ? Can you make the bed or change the sheets while mom is taking a shower ? The answer is YES to all the questions. If you do little things to show the mom you care, it gives her ample time to care for herself and her baby. Let us all be a part of the new mother’s life by being a village around her and always make her feel cared for. Spouse, sister, brother all of us can help a new mom. Postpartum doulas are skilled professionals who help for a few hours during the day or an overnight but ultimately it is the family that makes a huge impact on how a new mother sees the world around her.

Hey partners, have you checked that all the areas where your partner will be nursing your baby have water and snacks near her nursing nest ? Hey Grandma, have you checked that all the pump parts are put together for her next pumping session ? Hey sister, have you checked that your sister (the new mom) has fresh fruits cut and put in ready to eat bowls ? Hey Grandpa, did you check if the new mom needs help watching her older child ? Hey brother, can you run a few errands for the new parents ? Hey friend, can you be a bouncing board for this new mom who wants someone to listen to her without judging her ? Hey neighbor, can you make sure the recycling bin is taken to the curb and put away after trash and recycling day ? Hey postpartum doula, can you make sure mom is taken care of and mama and baby are having fun getting to know each other ? So much more to do and so much more to learn.

Fathers and their feathers

My post has a funny title today because it is about fathers and the importance of doing skin to skin contact with their newborns. A very common myth among new parents and sometimes grandparents is that it is not the same when a father provides kangaroo care to his newborn infant. Then there are fathers who are willing to completely submerge themselves in the care of their child and I admire and respect them very much. Kangaroo care or skin to skin contact can be done by dads too. One question I got asked was what if the father has a hairy chest (hence the feathers in the title), the baby does not have a preference when it comes to kangaroo care. The choice between going in an incubator versus being on dad’s warm (and in some cases fuzzy) chest is easy. Fathers cannot give birth, but they can provide the same safety and comfort to their newborns by doing kangaroo father care. Research has shown infants who are put on their father’s chest skin to skin are able to regulate their temperature, heart rate and breathing very well.

Fathers have been shown to have a stronger bond with their infants by practicing skin to skin contact. Mothers who have given birth by C-section undergo a surgical procedure and take some time to recover from it. That is the time when a new baby should be on the father’s bare chest until the mother is ready to take charge. Fathers can also help by being the guardians and keeping watch on the mother and infant when the mother is providing kangaroo care but still recovering from the birth and is exhausted. The continuity of kangaroo care is of utmost importance not only for premature infants, but for any full term infant.

Here is just one story of a father and kangaroo care

http://www.kangaroomothercare.com/justins-experience.aspx

A disclaimer: This post is NOT meant to suggest that incubators are hazardous. There is a place for incubators in special cases.

The infant-mother connection

The bond between an infant and mother is the purest form of unconditional love. A postpartum woman not only needs tender, loving care, but someone who is knowledgeable enough to give her the guidance she needs to care and connect with her infant. I distinctly remember the time after my daughter was born. I wish I could say it was purely magical, but it was not. First of all, I experienced a traumatic birth after being induced at 37 weeks due to a health condition. After the birth, I had my mother, father and my husband as my support network. I was so excited to meet my first-born that even after a traumatic birth I could not keep my eyes closed that night and kept looking at my daughter despite my mom telling me to rest. My husband on the other hand was fast asleep after a long 22 hour labor. The connection between me and my child had already been made.

Breastfeeding on the other hand was not simple at all. Hospital staff, nurses and doctors trying to check the well being and safety of me and my infant were all part of the medical care team, but I was not prepared for the time at home.

I thought I was prepared for childbirth, newborn care and breastfeeding by going to the childbirth education course for new parents. I wish I had known to be prepared for a tornado of hormones sweeping through my postpartum body. That tornado not only swept me off my feet, but changed my entire idea of mother-infant connection. I wish I had known the importance of skin to skin contact, the golden hour, and a whole list of other things. I cannot go back in time and change all that for myself, but I can certainly make a difference in the lives of new mothers and babies.  I want to help new mothers who have taken the classes like I did, but still feel lost in the stormy winds of the postpartum tornado, have a shelter in the form of knowledgeable help so they land on their feet and not feel lost like I did. Postpartum doulas, not only make the mother and infant connection stronger, but make it enjoyable. As I read a book called NEW PUBERTY by Louise Greenspan, MD and Julianna Deardorff, PhD, there is a quote that resonates with me the most. The little box in the book says ” The strength of the infant-mother bond can influence when a girl goes through puberty.”