Calling all moms who were overwhelmed with a newborn!

[doctorjen]

Please, experienced mamas, help me out here. I'm a practicing family doc that does a lot of maternity and newborn care. I also have 4 children myself, all of them nursed past a year, so I have some personal experience.

Recently, I've had several mamas at their very early newborn visits (within the first 2 weeks of life) with their new babes who are just so overwhelmed and sad, and I'm struggling with ways to help them. Usually, the picture is a higher maintenance baby, a professional type mama with her first babe, and the combo is not mixing. The mama I saw today has a baby who seems to pretty well have her days and nights crossed up who is waking a lot at night and is only soothed by nursing, but sleeping well in the daytime between pretty regularly spaced feedings. Baby is 6 days old, and already 3 oz above birth weight, and 10 oz above lowest recorded weight, pooping and peeing lots, and obviously thriving. Mom is still convinced that she doesn't have enough milk and will be up every night for the rest of her life with this baby.

I have tried with the last several moms I've run into who are so overwhelmed to point out how well they are doing, how great their babies are growing, how this is such a short time in your life and baby will not need such constant attention forever. I emphasize that mama needs to be cared for, needs to sleep when baby sleep, that it's fine to have the baby sleep with mama, etc. etc. The last few moms I've dealt with who were this overwhelmed, however, weaned very early (and still had high maintenance babies, by the way.)

I'm wondering, if you had an overwhelming early postpartum time, was there anything a doc could have said that would make you feel better? Any advice that would have made you feel better about sticking it out and helped you get through it? Preferably something non-judgemental that doesn't come across as "just suck it up alread?"

[forestrymom]

Can you point them in the direction of LLL? That's really what saved me. I do think it should be more clearly stated that formula is worse for baby and that choosing second best is less of an option. My dd was very high needs, and I was a career woman, and I was only going to nurse for 6 months or so. But I had a very supportive family type doctor who was pro nursing and discouraged formula. He pointed out that its really pretty unlikely that there was anything wrong with my milk--women have been breastfeeding for centuries. I just think we (especially doctors) put too much emphasis on formula being an "okay" second choice, and its not.

Good for you for encouraging it. There aren't many docs out there who do, unfortunately!

[franklinmarxmom]

Wow! I wish you could be my doctor! If only the ped had been so thoughtful! (Are you within 50 miles of me?????)

The best advice I heard (and took seriously) was "sleep when baby sleeps." Most moms say they never really do that, but I did. I ignored the clock and the sun and did it--it really helped. It was the joy of maternity leave--baby's best sleep was from 5-10 a.m., and I could snooze away then. (This doesn't work if you have older kids, but it sounds like the women you describe are dealing with their first.)

Just knowing you care, and knowing it will end, and being told by "a professional" that you are doing a good job--that would have strengthened me immeasurably.

[readytobedone]

i think it's great you're concerned about this! what a great doctor you are; will you be mine?

my thing is, i can so clearly remember thinking i would end up weaning early because of the comfort nursing. she comfort nursed ALL. THE. TIME. and the 6 week growth spurt drove me to the very limits of my sanity.

but it was true what all the mamas here said; it passed, and quickly, and though i can still remember it, it seems so absurd that i worried she would comfort nurse for 4 hours every night (and 2 hours in the middle of the night!) for months. in reality, it was just a few weeks of being stranded on the couch or bed, which really helped me to rest and heal after my c/s anyway.

maybe if you could spin it to these really driven, go-go-go women that being a new mom is about doing a whole lot of sitting and lying down. tell them to get netflix. set up a nursing corner. read magazines. and just give themselves permission to nurse and rest and feel unproductive (because in reality, the whole way to be productive at mothering in the beginning is to slow your pace waaaaay down).

for me, it felt much better once i realized, i can be totally "lazy" and still be doing my job! for the first time in my life, i can just SIT here and seem to be doing nothing, and it's actually nurturing another person!!!

also, for me, seeing the numbers going up on the scale at 10 days, 3 weeks, etc. made all the difference. once i realized DD was thriving like mad off of my being stranded on the couch, i felt a whole lot more purposeful!!!

[HarperRose]

Oh my! Poor moms.

It will pass. They are NOT going to be up 47 times a night for much longer!

My oldest was 3 wks when he was sleeping through the night. MY 2nd didn't sleep through till I cold-turkey weaned her at 2y 9m and she STILL woke a few times a night. The baby was up every couple of hours when he was newborn and around 6 weeks or so he started to change and sleep longer. Now he wakes once, sometimes twice a night.

Let these mothers know that it's a short phase. Relax. Your body will make the amount of milk the baby demands. Take it a week at a time (a day at a time if they need to!) and before long it'll be 3 or 4 hrs between feedings. Maybe more! Be patient.

[miche28]

It's so tough - I remember being there with DD, thinking "I am a competent, intelligent woman, I am doing all the right things and yet this child is wearing me out day by day."

LLL can really help if she finds the right group - it might be helpful for you to get to know some of the leaders so you can match them a bit.

A couple things that were supremely helpful to me:

- an LLL pamphlet that talked about the adjustment to a new baby and in particular how many professionals had to make a massive adjustment when confronting motherhood: they had to go from a goal/outcome-based measure of success to a process-based measure ('cause we all know that changing one diaper isn't a solution )

- the permission to say to myself I will only do this for X more days, hours, minutes. Invariably when I reached that point, the exaperation had faded or I could convince myself to go one more little bit (I think that came from the Baby Book)

- hearing that she is doing a great job and how rich and plentiful her milk must be for such great gain will boost her confidence and give her a sense of achievement and control when she feels she has none

- if dad is around, make sure that he is being supportive by not having any expectations and encouraging mom to sleep during the day, get snacks at night and be the rock he needs to be right now.

And, oh, are you taking new patients?

[DreamsInDigital]

I am so glad that there is at least one doctor in the world that cares so much about her patients.

[mommyddeville]

For me, the biggest help was a breastfeeding moms' group. It helped so much to have other moms say, "I know it's so hard when you're exhausted and your baby is always hungry. But it gets better." Really, that's the only idea I have. It helped to have a lactation consultant call me and make sure everything was ok, too.

[beru]

I love this article and I have given it to two women who really loved it. One said it really shifted her perspective:
http://breastfeed.com/resources/arti...xpectation.htm

Also, I think there are some women who will just not get it. I work with a researcher/doctor who "failed" at breastfeeding. She was completely unable to listen to the advice and counsel of the lactation consultant and LLL leaders.

They said, "you have a sleepy baby, you have to wake her up to feed her. She'll get better at breastfeeding and you will build your supply." She says "that's cruel" and "you don't wake a sleeping baby"

They said "babies sometimes cluster feed". She said "there has got to be something wrong if she nurses this often".

They said "encourage baby to nurse skin to skin". She said "that's freaky".

Basically she had completely unrealistic expectations of what nursing a newborn would be like and she was unable to let those expectations go after the fact. And this is a very good researcher. But it is odd that if it is not her field, she doesn't heed evidence based guidelines at all. I find it so strange.

[turtlewomyn]

I agree with previous posters, send them to LLL or another mother to mother support group. Or, host one in your office if possible! It is so valuable to see other mothers going through the exact same thing (even today, I love seeing other toddlers act like my DD, knowing that she is just a normal toddler, it is reassuring). I also liked having moms who were a few weeks or months ahead of me, so I could see what the future held in store.
And eventually I got to reassure moms with babies that were younger than mine, or give them advice on what worked for me. This really helped to develop my confidence in my mothering.

Finally, don't forget to tell them they are doing a good job, and to listen to their instincts. A LC told me this once, and it makes a world of difference.

[possum]

What a great dr you sound like!
Don't underestimate the power of kind words. "Great job!" means a lot even if our society doesn't allow us to graciously accept complements well.
I remember feeling like I was going to go insane with a grumpy baby and all alone during the day after the first week. My husband had to be back at work, and we lived 10 hours from family and 1 hour from all my work friends. It would have done me good to have some company, but I wasn't comfortable asking for it.
I would definitely encourage them to do stuff with folks - such as LLL meetings - but not all areas have active groups. Mine doesn't. If they have partners who could help, enlist them to facilitate meetings or having company.
It's a big step to go from working with folks all day at a job you're good at to working round the clock that you only wish you were good at with someone you can't hold a conversation with.

[chemer]

I just volunteered to help out with new moms in my area, just offering moral support in the first weeks. The midwives are going to offer my phone number to mothers that they feel could use the company of another who is successfully nursing and I will be willing to go over to their house to visit (or meet in public) if they give me a call. The midwives think that having people willing to visit new moms at home is going to be a big help since so many people don't really leave the house much for the first couple of weeks and those are the hardest. Plus, the new moms will have my number, not the other way around, so there isn't really any pressure on them to call. Maybe you could ask some of your patients if they'd be willing to do this for you.

Convincing them to sleep during the day would also be great, but some people just don't want to listen to that advice.

[birdie22]

For the first two weeks of ds's life, I cried non-stop, had panic attacks, nightmares, feelings that I had made a horrible mistake, feelings that my baby hated me... and worst of all I believed nobody else I knew ever felt this way. I had bought the mainstream image of the glowing mom and cooing baby, and my reality was so different. I was also recovering from a c/s, and I think the pain meds had me befuddled more than I realized. My mother (I found out later) had warned my dh that she thought I was "rejecting" my baby because I was so upset, and that he needed to watch me. I was never going to hurt the baby or myself, but I could tell they thought I had lost it, and that was scary in itself.

I called my OB, and at first the nurse said she was going to send someone to the house to show me how to care for my baby. I was highly offended, as I knew exactly what I was doing; it was my emotional state that was intolerable. I insisted she have my dr. who I trusted call me.

That was the best thing for me, because my doctor shared her own story about how overwhelmed she had been with her first baby. She reassured me that it was a common reaction, partly caused by hormones, and that it would get better. She said to give it a few more days (until 2 weeks pp), and if I was still depressed, then we would look at our options for treatment. Just talking to her made me feel so much better, and she was right; at 14 days pp I felt noticeably better. The fog didn't lift for quite a while, but I really turned a corner after those first two weeks.

I think just talking about it with someone who's been there is so powerful. And ditto everything PPs said about clearing your schedule, let your expectations go and just get through the day for the first few weeks. My dh and I called it "battle stations," and it helped out many times in the first year for growth spurts, illnesses, and other intrusions of chaos on our ordered life.

Sorry to ramble. We're prepping for battle stations around here again, so I guess it's all coming back to me.

I think it's wonderful that you're asking the question.

[RachelGS]

A referral to a breastfeeding support group for new mothers! The new mothers' tea at the birth center where I had my first child was so critical in my realizing that my baby was normal, my experience was normal, nursing nonstop was normal, and that my instincts were sound. But for a nursing mom, the community really needs to be with other nursing moms. And then it can make a huge, huge difference.

Sigh. Wanna come practice in Massachusetts? We need a new family doc.

[kalynnsmom]

I agree about attending LLL or a breastfeeding support group. I attend a breastfeeding support group and it has made all the difference. It's nice to know that she's not alone and things will get better.

[sonrisaa29]

I'd would of loved to have a doctor who knew other women to suggest talking to besides LLL. LLL refused to help me because I was going to be mixing breastmilk/ formula together and doing the whole pump and dump thing because of my meds.

LLL was the only group my doctor was familiar with and I wish she had had a list of more experienced mom's who would of helped with my situation without being judgemental.

[TattoMomK]

I think you just described me in your patient. Me with my first -- that is. It did NOT help that I had family members: my mom, grandma and aunt just convinced my baby must NOT be getting enough to eat since she wanted to nurse ALL THE TIME. They pushed formula supplementation, etc.

Luckily, I had a GREAT doctor too. (You rock by the way!)

He told me "NO, your baby is doing so well on breastmilk, she is PERFECT, she is thriving. I am really begging you not to give her formula, it's not nearly as good for her as your milk. I know you are tired, so maybe offer some water in between feedings. You know it's unnecessary, but I know you must need a break sometimes. As far as her crying, have you considered cutting dairy out of YOUR diet, it may make her go longer between feedings. Also check out Dr. Sears book about High Needs Children."

So those three things:

1) The baby WAS thriving, in fact perfect, gaining extra well, and he told me I was doing a GREAT JOB nursing. Coupled with formula being a bad idea, period.

2) He UNDERSTOOD I was in shock by the amount of time and work it was taking to nurse this high needs baby. He said I could give water (she never did take it) as it might help, but it isn't necessary. Suggesting more resources to understand how to deal with the intensity, like Dr. Sears book also meant he understood. Understanding, not UNDERMINING is exactly what I needed to hear.

3) The dairy thing was dead on. She did cluster feed less when I cut dairy out of my diet. I didn't trust him at first on that advice, but offered it out to other nursing mom's for advice, and they also said it was a good idea. Sure enough....

So I think encouragement, ideas and most of ALL understanding, coupled with the benefits of breastfeeding will help your patients.

A support group in the area for breastfeeding -- not only LLL -- is a fabulous idea. Have you thought of starting one yourself? Have one successful nursing mommy of a patient facilitate, and have a meeting place arranged for these new moms. My midwife has done this and it's lovely. Not just breastfeeding but natural mothering as well. I go every Thursday!

[MaryJaneLouise]

Especially for first time career minded moms, tell them that they have been temporarily reassigned a new career. For the next X weeks, they are to be FULL TIME 24/7 NURSING MOMS. They have no other responsibilities. They are to worry about nothing else. All other chores fall to DH and/of other helpers.

If they are "quantitative" types and have to have some project, tell them to chart number of diapers or something in a daily grid / diary. Or take a picture of their baby every day with a digital camera. Something that at they can look forward to at the end of the X weeks as a "product." Otherwise it WILL seem like a forever, slow as molasses project.

Keep up the encouragement that they are doing great, and you would tell them if they were not. Seriously, that would help if you tell them that if you had real concerns about their babe's weight gain, you would tell them.

to you and your concern for the new moms!

[elanorh]

Quickly - while I have an online moment!

I think that telling her how well her baby is doing, and what a good job she's doing (and acknowledging that the first few weeks are difficult but that things get better) is a huge part of it. For mothers who are used to being in control, the feeling of being out of control and at the 'mercy' of an infant (and yet responsible in every way for its survival) can be really overwhelming I think.

Ditto the pps who suggest bf support groups or LLL - although having been a professional woman, and spending quite a bit of time with other professional women, I do think sometimes there is a real pressure to appear to have it "all together" and therefore, sometimes attending support groups is a very threatening idea (maybe people will discover that I'm human!!) .... So read the body language closely while suggesting this I think, don't make it your only suggestion.

The thing I love most about our Ped (who is very pro-bf) is that she is very collaborative with me; she doesn't treat me like I'm less intelligent or less informed than she is (although obviously she does have an MD!) - have you tried telling the moms, "You know, this is the most difficult part of becoming a mother, and this is what got me through it [insert suggestions - things like having dh do more housework, accepting offers of meals/assistance from family and friends, etc."].

I think the hardest thing for me was (and IS) accepting help from others. I know with a newborn I can't keep a clean house presentable for guests; I can't fix all the meals, tend to the potty-training toddler, etc. Yet I feel like I ought to. So acknowledging that there are some very unrealistic expectations for mothers in our culture; that there are other cultures where the mother is not allowed to do anything but be with babe, while MIL and etc. are busy doing the housework, caring for older children, etc. - while here we think that a new mom should be polishing the silverware by 2 months post-partum. Tell them this is unrealistic, unhealthy for them and their baby.

It helps if their dh is on the same page, if you can get him to the appointment (or dp). SIL's dh crabbed about her not getting enough done around the house during her maternity leave and she kept the house up quite well I thought ....

"Sleep when baby sleeps. If you need to DO something while baby nurses or sleeps, read the baby books you didn't get through before baby was born, and do thank-you's, and call family. The first two weeks are the most difficult, and it doesn't matter whether you're bf or ff, they're still awful. But the time put into bf in the first few weeks, will make the rest of infancy much MORE manageable for you, and you're doing so well now ....!"

Also - compare the first few days of parenting a newborn to their professional careers. Ask them whether, in the first few days of their professional life, did they have doubts, concerns, feel overwhelmed - did they know how to do their job as well as they do it now? Motherhood is the same situation - you're learning as you go, it's new territory with each mother and her baby; you can't go from intern to head executive in a day. The hard work in these early days, lays the foundation for your hopes/plans for the future with this child [play this carefully so that if they're already putting unrealistic expectations on themselves, this doesn't put it over the top].

I know another board I post on, we had a mother who was worrying that she wasn't giving her baby enough developmental play time, because of breastfeeding issues they were having. Her baby was 2 weeks old -- we all reassured her that her baby's "developmental play" right then should be simply being held LOTS and nursed LOTS and good eye contact with mom and dad and that was it, but I don't think she believed us.

[Jane]

A midwife I know suggests that new moms put an "X" on day 10 and a Heart on day 14 - b/c day 10 is really hard and most people love nursing on day 14.
I don't think there's any evidence for that, but just the thought that it's hard now, but easier later, and your feelings can change in just 4 days, somehow is helpful.