Calling all moms who were overwhelmed with a newborn! - Page 2

[sapphire_chan]

As a future new mama, I'd be reassured by the doctor telling me that reversed sleep cycles like that are normal for new babies--with a reminder of how the baby would kick more when I was still and how walking around put it to sleep-- and giving me a time frame when babies usually start switching to sleeping more at night.
Not just "that's normal, you're doing great", but "that's normal" details of how it's normal, "you're doing great, your baby is gaining really well and eating frequently is the best way for your baby to keep growing well" and such.

(Sigh, I wish I lived someplace where I could be your patient.)

[guestmama9904]

1. So glad to hear that there are MDs out there really promoting breastfeeding. yay!
2. regarding the sleep cycle at 6 days old; I was better able to deal with this when I understood it logically, the newborn is used to being joseled to sleep during the day while mom was pregnant and working. when i was pregnant i was in a managment position and worked 50 hours a week. my son was up inside my womb at night, he was most active and rarely kicked during the day. this is then how he was after birth. it does pass within the first few weeks, usually by 6 weeks babies have day/night figured out.

3. I think really emphasizing the dangers of NOT breastfeeding is important. I am sure this can be done compassionately and without judgement of the mother. The biggest dangers that would really sink in to me as a mom are that breastfeeding protects from common childhood diseases and that even if baby goes into daycare our bodies as moms are uniquely able to create antibodies in our milk to the diseases that baby comes into contact with. also skin prolems and asthma increase in children who are not breastfed. I also have hear, not sure if this is still proven medically, that breastfed babies are less likely to die from SIDS.

And of course emphasizing the benefits to the mother of breastfeeding- ie. burning extra calories through breastfeeding, missing fewer days of work when baby gets older as baby hopefully will get sick less often if breastfed, economical advantages of breastfeeding in the cost of formula and bottles and the potential costs of extra healthcare services if baby is not breastfed.

[eepster]

What would have helped me?

If the Dr had called DH and said to him "to get off his and change a diaper and put on a load of laundry, and take your wife a glass of juice."

He would not do any of these things b/c I asked him but had an authority ordered him to he might have.

[Ann-Marita]

When DD was 19 days old, I went to a LLL meeting, desperate for support. I remember what one of the leaders did that night.

She and the other leader held up a chain of paperclips. I think it was something like 70 paperclips, all attached in a line. She said that the chain represented your baby's lifespan, each clip was a year. And these difficult times (the first few days or weeks or even months), were just this small part of a clip over here on the end. It seemed like such a tiny fraction of the whole thing. And yet, giving your baby the best - breastmilk - would effect his health in a positive manner for the rest of his life.

[doctorjen]

The current mama I'm dealing with has great support. A few opinionated relations, but not the ones who really matter (her mom and her dh)
Grandma told me today last night was much better - they took baby to bed and mama didn't get out of bed all night. so let's hope that's the start of feeling better.
We have LLL, but it's not a very big group and the next meeting is almost 3 weeks away. I called my LLL leader today, but couldn't reach her, but also gave the mama her phone number.
One of my dear L&D nurses gave her her home phone and offered that she can call anytime day or night - and reminded her that L&D is open all night long if she just wants to call and talk to someone.

Something I struggle with is wanting to speak the truth (it's the middle of winter for pete's sake, and every day I see sick kids with ear infections, flu, RSV, etc, and of course also there is SIDS and allergies and etc. etc.) and not making someone who is obviously struggling and hurting feel even worse. I don't want to be the doc a mama talks about in 10 years who told her it was fine to go to formula, and I also don't want to be the straw that breaks the camel's back of negativity to a struggling sad mama.

[Hippie Mama in MI]

Originally Posted by 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."

Yes! I went through ppd without help for months before I found a wonderful bf support group through my hospital. It really saved me... The other mommies were honest about their own bf trials and triumphs, and I discovered I was NOT all alone on Planet Poopie. They also introduced me to babywearing, which turned out to be the key to my freedom. We even klatched about husbands. I don't know what I would have done without my group.

: And kudos to you, doc, for caring!!

[APmomto3boys]

We had (until she moved!) a GREAT ap friendly doctor who always told me what a great job I was doing. That made me feel great and I left the appointment very happy! She always pointed out how great my milk must be.. etc, etc, This really helped me. Too bad she moved and my new dr has displays of bf'ing "support" kits everywhere made by enfamil.

Any advice from you on how to get those out of the office?!

[mishka77]

I was in that place of having a baby that stayed up from 11pm to 6am for several nights, nursing non-stop, but sleeping and eating at regular intervals during the day. I didn't ever think that I didn't have enough milk though. I think what helped me was reassurances that as long as baby is eating at regular intervals and giving good output, that she is OK. My hospital had me record when and how long I fed her and how many wet/dirty diapers she had for the first week (on my own I continued doing this for the first 2.5 weeks, put it in a spreadsheet and made some nice graphs, 'cause I'm a science nerd like that!).

It also helped that my Dr, who is also my DD's Dr, reassured me that since she was gaining weight she was doing great; my OGBYN assured me that the mixed up days wouldn't last forever; reading the stories of mamas on this board, the Dr. Sears books, finally giving in to cosleeping (though I was discouraged of doing this by family who were concerned I'd roll over on DD). Cosleeping turned out to be the only way DD will sleep at night. I learned that my maternity leave was NOT a time to get the house clean, it was time to sleep when baby sleeps, learn how to breastfeed, and learn how to listen to and interpret DD's cries! After I let go of trying to be productive in the work sense, and ignore any calls from people at work (and work emails), my life improved significantly!

[Carlyle]

Originally Posted by doctorjen

Something I struggle with is wanting to speak the truth (it's the middle of winter for pete's sake, and every day I see sick kids with ear infections, flu, RSV, etc, and of course also there is SIDS and allergies and etc. etc.) and not making someone who is obviously struggling and hurting feel even worse. I don't want to be the doc a mama talks about in 10 years who told her it was fine to go to formula, and I also don't want to be the straw that breaks the camel's back of negativity to a struggling sad mama.

Can you phrase it in a positive way? Listen to their feelings, and then say something like "it's wonderful that you are still nursing through this trouble because it can really help your dc avoid ear infections/flu/etc/etc/etc"

[Emmeline II]

• I would encourage them to keep two goals in mind: tomorrow and 6-8 weeks. The latter is usually when nursing starts to get easier.
• Hand out business cards with local LLL contacts; try to meet them/go to a meeting so you know what they are like. I'd stick the kellymom address on there too,
• Point out that a high needs baby won't cease to be so when they are on formula, and that introducing formula may not get better results they are hoping for (like sleep).
• Talk about the "No-Cry Sleep Solution" video. Maybe you could leave it running continuously in the waiting room with captions.
• Swaddling can be an effective method of soothing babies. The "Swaddle Me Blanket" is the best for this.
• Nursing Nest! Nursing laying down can be hard but is often the best hope for mom getting sleep.
• Wraps!!!!!!!!!!!!!! A Moby Wrap is great for high needs babies that want to eat and be held all the time. You can position a baby for nursing and have your hands Free! Maybe keep a wrap and a baby weight doll in your office to demonstrate.
• Maybe make a book of bf experiences where the difficulties were overcome.

I thought my fussy baby wasn't getting enough also but every doc said that wasn't the case and we bf for 3yrs.

[Emmeline II]

Originally Posted by eepster

What would have helped me?

If the Dr had called DH and said to him "to get off his and change a diaper and put on a load of laundry, and take your wife a glass of juice."

He would not do any of these things b/c I asked him but had an authority ordered him to he might have.

:

[Breathless Wonder]

The best advice and MD/IBCLC ever gave me was to co-sleep. And honestly, in the early days a side lying nursing position was easiest for me, and encouraged me to rest.

[doctorjen]

Originally Posted by Carlyle

Can you phrase it in a positive way? Listen to their feelings, and then say something like "it's wonderful that you are still nursing through this trouble because it can really help your dc avoid ear infections/flu/etc/etc/etc"

Ooh, good phrasing! I'm writing that down.

I went to LLL myself for quite a while, but have tapered off since my baby weaned. I know the leader here well and we are friends. I have a client/friend also who I keep encouraging to think about becoming a leader herself, but she has been busy with her own growing family and a family business. The LLL group, sadly, is not very big. I live in a town of 14,000 and there are usually less than 5 people at LLL. I post the meeting notices in every exam room in my office and constantly encourage new moms to check them out - but for some reason there is a mis-understanding of what LLL is like. I think women somehow think there will be a bunch of topless women lecturing them or something. LLL was so great even for me, a very experienced mom nursing my 4th most recently - that mother to mother support is so helpful and it's so nice when you are struggling to have several other women saying "Oh yeah, it was just like that for me!"

As a society, we seem to value so little the work that new mothers do. And we live in such isolated times that new mothers have often had no contact with other new mothers before they have their own babies. I know it's a shock for most of us when we start off with a new baby - but it seems like the combination of having no idea what it's going to be like and feeling so inadequate and unsuccessful once the baby is here is just so hard for so many women - especially if they were successful in other areas of life first.

Sometimes, I'm really glad I had my own first child while still "young and stupid" and hadn't formed any opinion of what it was supposed to be like! When my baby fussed, I did whatever he seemed to need, and if it worked, I didn't worry about whether it was right. Hence, by night 2 I had a full-time co-sleeping baby who I carried around all day also and was able to make it through those early weeks relatively well rested and feeling like a success as a mother.

[sonrisaa29]

Originally Posted by doctorjen

Ooh, good phrasing! I'm writing that down.

I went to LLL myself for quite a while, but have tapered off since my baby weaned. I know the leader here well and we are friends. I have a client/friend also who I keep encouraging to think about becoming a leader herself, but she has been busy with her own growing family and a family business. The LLL group, sadly, is not very big. I live in a town of 14,000 and there are usually less than 5 people at LLL. I post the meeting notices in every exam room in my office and constantly encourage new moms to check them out - but for some reason there is a mis-understanding of what LLL is like. I think women somehow think there will be a bunch of topless women lecturing them or something. LLL was so great even for me, a very experienced mom nursing my 4th most recently - that mother to mother support is so helpful and it's so nice when you are struggling to have several other women saying "Oh yeah, it was just like that for me!"

As a society, we seem to value so little the work that new mothers do. And we live in such isolated times that new mothers have often had no contact with other new mothers before they have their own babies. I know it's a shock for most of us when we start off with a new baby - but it seems like the combination of having no idea what it's going to be like and feeling so inadequate and unsuccessful once the baby is here is just so hard for so many women - especially if they were successful in other areas of life first.

Sometimes, I'm really glad I had my own first child while still "young and stupid" and hadn't formed any opinion of what it was supposed to be like! When my baby fussed, I did whatever he seemed to need, and if it worked, I didn't worry about whether it was right. Hence, by night 2 I had a full-time co-sleeping baby who I carried around all day also and was able to make it through those early weeks relatively well rested and feeling like a success as a mother.

I would also like to add that I think its important that doctors also tell new moms that just because a child hates to cosleep or doesn't like to be worn or the mom can't breastfeed doesn't mean that you're a failure as a mother. You can still bond with the baby in hundreds of other ways.

I think its important to realize (as I am sure you know since you see hundreds of babies) that each baby is different and what works for one doesn't always work for others.

Again I also can not stress the importance of having a bf group that is supportive of mixing formula and breastfeeding (which LLL is not).

[MilkTrance]

You know, I think this was one blessing of having a C-section -- I was in the hospital for a week, so for the first 5 or so days of my baby's life, I had 24/7 support available to me at the push of a button.

So if you have knowledge about community resources/nurses, support groups or recommendations on how to include family for support, that is how I would suggest you counsel your patients.

[PatioGardener]

Originally Posted by doctorjen

Something I struggle with is wanting to speak the truth (it's the middle of winter for pete's sake, and every day I see sick kids with ear infections, flu, RSV, etc, and of course also there is SIDS and allergies and etc. etc.) and not making someone who is obviously struggling and hurting feel even worse. I don't want to be the doc a mama talks about in 10 years who told her it was fine to go to formula, and I also don't want to be the straw that breaks the camel's back of negativity to a struggling sad mama.

Have you read "Provider Encouragement of Breastfeeding: Efficacy and Ethics" by D.J. Miracle and V. Fredland? I really like how they present the information. Here is the reference: Journal of Midwifery & Women’s Health. 2007. 52(6): 545-548.

[Turkish Kate]

You're such a great doc to be so concerned over this issue. Wish I could find someone just like you on this side of the earth. Only one suggestion that I haven't seen yet: Do you have experienced BTDT mothers in your practice who would be willing and able to act as mentors to new moms? Too sleep deprived myself to think on it any further . . . .

[pookel]

Originally Posted by doctorjen

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.

This is me exactly, except it was the same thing all over again with my SECOND baby, when I was expecting it to be easier.

Things I would have wanted to hear:
1. It gets easier - the first two weeks are the worst.
2. If you're going to give up breastfeeding so you can sleep, try pumping and having your partner give a bottle at night.
3. If you're giving your baby formula, you don't have to quit breastfeeding. Do it as much as you can handle. You can work on building your supply up again later if you need to. It may not be as good as exclusive breastfeeding, but it's a lot better than quitting entirely.
4. You're not a bad mom for not bonding immediately and being happy with your baby. It's normal to feel that way. Your only goal should be to make it through the first few weeks.
5. Zoloft is compatible with breastfeeding.

I would also push the idea that they need to be getting support anywhere they can find it - husbands, family, friends, other moms. They shouldn't feel like they have to just sit around with the baby all day long. If it makes them feel better, let grandma hold the baby while mom gets some time to herself.

In my case, I had flat nipples and a very hard time breastfeeding both babies, and it just killed me that I was failing at something that was supposed to be natural and right. The first time, I supplemented and ended up going to just formula at 9 months. The second time, I supplemented for a couple weeks, and when I was feeling stronger, I started taking fenugreek and mother's milk tea and just nursing whenever I could. I got my supply back up and ditched the formula within a week. With Corbin, I didn't know that was possible - I thought once I started giving him formula, it was a slippery slope to weaning.

I think too many moms believe it's black and white, one or the other - they see exclusive breastfeeding 24/7 as too overwhelming, and so they give it up entirely. I wish they knew there were options to try before giving up.

[bobandjess99]

The problem, especially withthe combo you describe (prof mom, higher needs baby) is this

**UNREALISTIC EXPECTATIONS**


honestly, if you have contact with these moms before hand, I think just better preparation is what is needeed. Women, especialy those who might not have been around babies as much, or who have friends who only FF and CIO, etc, simply have NO IDEA how much WORK it can be to have a "normal" newborn. The needs ARE constant. They ARE exhausting. And frankly, even some of the better AP books, like Dr. Sears or LLL/womanly art, simply don't delve into the realities of what it is like....frankly, unless a BFing mom is blessed with a unique baby, she is NOT going to be feeding him 8-12 times a day, and it wont be every 2-3 hours, etc. It's going to be 10-40 times a day, some feedings might be 10 minutes after the last one,...and yes, most of that might be at night, etc.

no, you don't get 2 15-minute breaks and a 30 minute lunch, and no you don't get to clock out at 5 pm. It's an around teh clock job, and your "job expectations" are to do WHATEVER the baby needs...even if NONE of the books described YOUR baby......

I think most moms struggle, because they feel they are not doing it "right" because their baby isn't the "avergae" baby described in books....let them know the REALITIES of what it measn to be a mom...not sounding negative, but just honest.....and let them know they are doing GREAT!

[Black Orchid]

Well... can you make a house-call? Seriously, the situation you describe is EXACTLY like DD1... we just couldn't handle it and were so lost and alone with no family. What really turned thigns around was a house call from LC-RN who came and showed us some tricks by handling DD (not in a teaching way at all, but just had that magic touch and demonstrated it). She watched us nurse and gave me tons of praise... she was just like a confident, granny-figure that we needed at that moment. She also showed me how to nurse lying down. It was really nice to have someone come into our home to help us. It was so much more meaningful than in a clinical situation (no matter how homey).

And she told us to make sure DD was awake between 8-10pm. She actualyl told us to go somewhere stimulating between 8-10 pm and DD would sleep a good stretch at the beginning of the night.

DD was still a bad sleeper, but it really helped to get out of the house. Thank you for being such a caring and compassionate care provider to these women. Your patients sound so lucky!