Mindful Pregnancy Epilogue: The Fourth Trimester

Equinox Firestorm*

The usual narrative is usually that newborns are helpless. Growing up, I was repeatedly instructed, “Make sure to support her head!” whenever I was trusted to hold a baby. For the first three months they’re still supposed to essentially be fetuses; many people call them blobs. This was not my experience with Equinox Firestorm.

I don’t get ethereal often, so grant me this one paragraph. I’ve always found it a little woo woo when people say they’re “old souls,” but I’m going to say it about Equinox anyway: when she was born there was a wisdom, purposefulness, and fearlessness about her. As I’ve watched her develop from that newborn sage into a cute, pudgy three-month-old baby, it’s seemed as if she had to slowly forget her innate understanding of her place in the universe in order to learn how to smile, babble, and bat at her hanging toys. It’s like she’s doing the eight limbs of yoga backwards: letting go of samadhi (transcendence) so she can learn how to do asana (poses). Before she was born, I bought her a copy of, The Little Soul and The Sun, and this heartwarming children’s parable has come to my mind many times over the last twelve weeks. My hope for Equinox is that one day she will remember who she is; she is an ember with the potential to one day ignite a Firestorm.

During pregnancy, when the baby kicked strangers told me she would be a soccer player, but friends suspected she was actually doing rock-n-roll vinyasa in my belly. Turns out my friends were right: from our first days home she was already doing a perfect locust pose on Daddy’s tummy as he reclined back on the couch, and now she is weirdly comfortable resting in sphinx pose for several minutes at a time. I tried to lovingly support Equinox’s head when she was born, but she wouldn’t have any of it. Although her movements were uncoordinated at first, she’s always had control her head, and resists restraint. From day one, if she was hungry she would repeatedly thrust her gaping mouth against the chest of whomever was holding her making primal “gnar” sounds until she was lined up with a source of milk. All we could do was try to spot her. If I were to get a stick figure family for my Subaru, I’d get a mommy, a daddy, and a little tiny velociraptor.

Baby Locust

Equinox, my little yogini, doing locust pose at two weeks.

Motherly Love

The big feelings of pregnancy have nothing on the big feelings of the postpartum period. I expected to feel warm, fuzzy motherly love the moment my little one was placed on my chest. But, as I mentioned in Equinox’s birth story, that moment was completely overwhelming for me. I don’t think I began to feel a soft, glowy, buttery type of love until six weeks when she started smiling at me; before that I felt an uncomfortable psycho-stalker infatuation type of love. One of the first of many sleeping arrangements Richard and I tried was to take two-hour shifts with the baby. I didn’t sleep during my shifts even though the baby did; I just stared at her, obsessively counting her breaths. Finally I bought a meticulously-researched mesh-walled co-sleeper that sat on the center of the bed, and was finally able to rest lying face-to-face with her.

To keep my epilepsy at bay, in Equinox’s fourth week, Richard began taking the her to the guest room all night long with a bottle of expressed milk on hand so I could get a solid seven hours of sleep. However, I had been feeding the baby on demand for a several weeks and our bodies were so in sync that, despite wearing earplugs and being on the opposite side of the house, I’d wake up at the same time as she did, literally (my breasts were engorged with milk) aching to be near her. Richard made me promise to stay in my bedroom and get some much-needed sleep. I was so drawn to the baby, that most nights it took every calming pranayama and yoga nidra practice I know to keep me in bed. Some nights it took half a tissue box worth of tears. And some nights none of that was enough: before the baby woke up, I’d tiptoe into the guestroom without waking Richard just to check on Equinox. If I was gazing at her with heart-melting motherly love this would have been sweet, but it wasn’t that; I was staring at her with compulsive, overly-obsessed mama bear love.

Overly-Obsessed Mama

Overly-Obsessed Mama

The weirdest thing that happened in that first month was that every time I woke up, I would think I was holding her nestled in my arms. My visual cortex would very clearly morph a fold in the quilt in my peripheral vision into the image of her face. If I didn’t know from studying Cognitive Science that peripheral vision is almost completely fabricated by the brain, I would have thought I was going nuts (most of the rest of the time she was in my arms, so my brain made a reasonable guess). For weeks, I lived out the first verse of You Are My Sunshine every time I woke up.

Thankfully, as the post-pregnancy hormones dissipated and I settled into motherhood the craziness subsided and was replaced by the type of love they portray in Similac commercials. Her smiles bring me endless joy, and I will do the most ridiculous goofball things to get a laugh out of her (she just laughed for the first time this week *melt*).

Mommy Tummy

I thought I would be at least a little upset about my mommy tummy, but I wasn’t. I had realistic expectations, so when I still looked six months pregnant after giving birth it didn’t phase me. For the first couple days postpartum, my belly felt weirdly empty and I felt bizarre shifts as my internal organs began returning to their rightful places. When I laughed, my belly jiggled like one of those jell-o cakes a neighbor would have brought to my door had I given birth in the fifties; the appearance and sensation made me want to laugh harder, but I had to resist for the sake of my stitches down below.

With the industry built around losing baby weight, I thought it would be much harder than it actually was. I gained thirty-seven pounds during pregnancy, which is slightly above the “ideal” range. A big chunk of that was just water, which I sweated, bled, peed, cried, and lactated out quickly. Without doing any exercise, within a few weeks of giving birth, I hovered at eight pounds above my pre-pregnancy weight (which I probably needed for breastfeeding), and by three months I was back down around my pre-pregnancy weight. I don’t have a celebrity-grade, airbrushed flat stomach or anything (I never have), but I really don’t feel like I have much extra fat to lose.

That said, my abdominal muscles became weak and overstretched during pregnancy, so I started going to mommy and baby Pilates when Equinox was six weeks old. Also, my skin is a little worse for wear: I’m now sporting my fair share of stretch marks and the fading remnants of a linea nigra. During adolescence, I got stretch marks on my hips, thighs, and calves, so these new ones are just another addition to the collection, and I know from experience that they will fade. I think now I actually might be more likely to wear a bikini than I was before to make a body-positive statement that I shouldn’t have to hide my normal, healthy mommy tummy.

Postpartum Recovery

(This section may be TMI for some readers. Consider yourself warned, and skip it if you’d rather not know).

I’d always heard Cesarean births were tough to recover from, but I was not prepared for how long and frustrating the recovery from a vaginal birth would be. I think women don’t talk about this because chatting about the recovery process is unglamorous and low-priority; by the time we’re done telling postpartum guests about our unique birth story and about how our precious baby is doing it’s time for them to go home. I had no clue what I was in for.

Between the tear, catheter (I was too swollen to urinate after childbirth, and I needed another dose of fentanyl to stop sobbing, “No, please just let me try to pee on my own one more time! I can do it!” long enough for them to painfully insert a catheter), and painful varicosities (a common aftereffect of pushing), my “bottom,” as the nurses called it, was a disaster. My expectation was that it would kind of hurt to sit down for a couple days after birth, I’d bleed for a week or two, and then I’d feel all better. No. It took six weeks for the lochia (bleeding) to stop and to just be able to imagine that one day I might feel normal again down there. For the first day or two, my crotch was so sore that just getting up out of bed took several excruciating minutes and instead of walking around our hospital room, I shuffled around like an ancient mummy.

Sitting was surprisingly painful for the next two or three weeks, which made breastfeeding uncomfortable. Frustratingly, I couldn’t go from sitting to standing or vice versa while holding the baby, which made me feel helpless and dependent on others (although, why shouldn’t I have been? American culture has weirdly unrealistic expectations of new moms). What used to take two minutes in the bathroom took ten, and involved heavy-duty maxi pads, anesthetic spray, and a squeezable water bottle the hospital gave me to use a poor man’s bidet. They tell us that it’s safe for to have sex after six weeks, but for the record, “safe” doesn’t necessitate that one will be able to fathom attempting it so soon after pushing a human out of one’s body nor that it will feel good.

But, as we tell our postpartum guests if we do mention our discomfort at all, it was all worth it for my beautiful baby. And, as far as newborns go, I really do feel like I won the baby lottery. That’s not to say it’s been easy—we have all the typical newborn challenges (sometimes I can’t fathom baby care is just a normal, natural, no-big-deal thing humans have been doing since the dawn of our species), but that’s the thing: they’re typical. She’s the baby they write the books about. Harvey Karp’s Five S’s worked on her in the early weeks, she went through all the weird skin phases Baby 411 warned me about, and she hit her Wonder Weeks (i.e. the most non-wonderful weeks you can imagine) right on cue. She even speaks the Dunston Baby Language.

Postpartum Bliss

I’ve spoken with two camps of people: those who say, “Stay in the hospital for as long as they’ll let you and enjoy the ’round-the-clock care and free meals,” and those who say, “Get the hell out of that God-awful place as quickly as you can!” It turns out Richard and I fall into the latter camp. Although the midwives were wonderful and the lactation support I got was amazing, we couldn’t wait to escape being disrupted at least every two hours ’round the clock (especially since they inexplicably chose midnight as the ideal time to whisk the baby off to be weighed and measured); the cramped room alive with annoying indicator lights; and the suspiciously geometric food (although, admittedly Stoeffer’s and DiGiorno were staples in our diet for many weeks after the baby was born). Also, to protect their liability, the hospital staff was obligated to overreact to my epilepsy; At 3 a.m., one nurse took it upon herself to coerce me into interventions that I’d previously declined when I was too groggy to stand my ground. However, our first few days home were total bliss.

Throughout pregnancy I’d had debilitating hypermobility issues, but childbirth turned out to be the best chiropractic adjustment ever. I’d worked hard to build the strength to carry thirty-seven extra pounds on my hips, so my pelvic stability was better than ever when I instantly dropped a significant amount of that weight. During pregnancy, I was sure we’d bought a defective mattress for our new bed, but my first night home from the hospital I laid down sans the pile of pillows I’d needed to support my pregnant body, and it felt like I was sleeping on a wonderful, billowy cloud.

When I read stories about women who just loved being pregnant while I was waiting for Equinox, I rolled my eyes so hard because it wasn’t like that at all for me. This part of the story is going to be like that for parents with anything but the easiest of babies. If you had issues with breastfeeding or a sensitive baby (links to blogs by friends who dealt with these experiences), you may want to skip the rest of this section.

I have the type of good problems that they tell you not to confess to other parents: My breast milk fountains out so quickly and easily that it’s embarrassing to breastfeed in public: Equinox pulls off coughing loudly as milk jets uncontrollably all over her face (I did not know this was even possible). Needless to say, my clothes, sheets, furniture, and floors are all spattered with milk and my freezer is overflowing with full medela storage bags. I used to worry Equinox slept for too long of stretches, and I woke her up periodically to eat. I also used to think she was dangerously subdued (she nearly never cries inconsolably); I’ve accepted that she is just a good-natured, soothable baby.

A friend attributed her chill baby to having a chill pregnancy, and I took that to heart during my own pregnancy. So—sample size two—it’s worth taking those warm chamomile-lavender epsom salt baths if you are privileged enough to have the time and means.

My first few days at home with the baby were so joyful it was surreal. We could have been on the cover of a Hallmark card: we would take family naps with the baby in a cosleeper in the middle of the bed, and Richard and I spooning it on either side, our ankles intertwined with each other’s as if our bodies were forming a heart around the baby.

In the first week of breastfeeding, the hormones sent me into a state of euphoria. The day my milk came in, I felt like I was back on the fentanyl. Nowadays, I’ll catch up on the world news, apply filters to the daily baby photo I send to my mom, or even make a phone call while breastfeeding, but in those first couple weeks all of that just felt wrong. All I wanted to do was gaze down lovingly at the baby and marvel, Wow, she’s the most beautiful baby in the whole wide world.

Granted, the extreme highs were complemented by heavy lows. From about halfway through my first week to halfway through my third week postpartum, my “baby blues” (experienced by 70-80% of new moms) were like clockwork: I’d get inexplicably sad from about seven to nine in the evening, and cry over nothing, which was hard on both Richard and me, especially before we recognized what it was, that it was okay, and that it was temporary.

Postpartum Doula

A huge reason the first days went so smoothly was because we hired, Melitta Hoder, a postpartum doula. I cannot recommend her—and postpartum doulas in general—enough; she worked with me for nearly fifty hours over the first six weeks, and it cost less than what I paid my birth doula. She stopped by the hospital while we were there to make sure breastfeeding was going well, came over on our first night home to get us settled, and helped us get out the door with a packed diaper bag for our first pediatrician appointment (which neither Richard nor I would have even thought to bring at all). She taught me how to tie a Moby wrap, use my breast pump, and introduce a bottle without causing nipple confusion. She told me when to expect growth spurts so the all-night feeding frenzies didn’t come as a shock. When I worried about my milk supply (which I did constantly), she brought a scale to weigh Equinox before and after breastfeeding to find out exactly how much milk she was getting.

New parenthood is an incredibly sensitive, challenging, emotional time, and postpartum doulas are trained (and in Melitta’s case, experienced) in supporting this transition. My mom and sister graciously calmed the baby when she was fussy while they were in town during Equinox’s third week (not to mention that they concocted homemade granola bars and cleaned my toilets), but most visitors will thrust a baby back into his or her parents’ arms in horror the moment he or she begins to cry. Melitta let me feed the baby and have some precious bonding time with her while she was contented, then took her when she needed to be burped, soothed, or changed and urged me to go take a nap. When I woke up, the dishes had been washed, the laundry had been done, and there was a plate of apples, almond butter, boiled eggs, oatmeal cookies and cheese for me to snack on next to my breastfeeding spot. I began watching Melitta carefully to learn how she managed to care for the baby and do all of that at the same time.

Melitta was compassionate and supportive of me being where I was in my process of learning how to be a parent, but she gently and constantly lead me toward the next step. For example, while I ate lunch she would talk to the Equinox, saying, “I’m going to hold you for a bit so Mommy can eat lunch. One day, Mommy will learn to breastfeed with one hand, and you’ll both be able to eat at the same time!” I hadn’t been around enough breastfeeding mothers to know this was the next step.

Then Things Got Hard…

One of the things Melitta repeatedly warned me about was that babies get progressively fussier until six to eight weeks, and then they plateau (and maybe get better). It took at least eight weeks. Because I have what I would still consider to be an easy baby, I can say with some authority that when parents of older children tell you, “Cherish this time, you’re going to miss it,” they either think your newborn baby is a joyful, curious three-month-old who smiles and plays or they completely repressed the newborn stage. Once the initial bliss and novelty wore off for us, shit got real.

Although Equinox slept well (a couple four-hour stretches at night), we didn’t. When she was a newborn she had a repertoire of sleep sounds from humming to croaking, which made it nearly impossible to sleep in the same room as her. Then, when she had the odd segment of quiet sleep I compulsively checked her to make sure she hadn’t suffocated. Richard was less paranoid, but he started developing nervous tics from listening to the obnoxiously loud white noise the baby needed to sleep all night long. Every few nights we changed sleeping arrangements, trying to find a configuration in which everyone could sleep. There wasn’t one.

When Equinox was about a month old, she went through a phase in which she would only sleep while we were walking her around in the baby carrier. I don’t know what we would have done without Melitta coming by with knowledge and energy (which we definitely lacked after a few days of this) to teach us how to get her to nap in our Rock N’ Play (a rocking bassinet).

When Richard was heading back to work and Equinox was an alert and awake one-month-old (meaning less nap time for me when sleep deprivation is my main seizure trigger), I listened to some early signals from my body and begrudgingly went on epilepsy medication. I cried the last time I breastfed the baby without traces of the drugs in my milk (even though my doctors and lactation consultant say there’s no evidence that what I’m taking is hazardous to her). I was meticulous about prenatal nutrition, and choose to believe that made her resilient enough to handle a little bit of medicine. Going on medication was heart-wrenching at the time, but it’s improved the quality of my life and relationship with the baby so much that I have let go of much of the guilt I initially felt. Before I was on the medication, I needed the baby to sleep at certain times so I could catch up on my own sleep, and looking back over the commitments I made to my daughter reminded that this was not who I wanted to be as a mother. Months ago, I wrote:

I hold onto no disillusion that I possess you, control you, or am entitled to anything from you.

It feels good to not need anything from my little one.

I still exclusively breastfeed Equinox, and hope to continue breastfeeding her for as long as there are proven benefits. Breast milk advocates will tell you that it is a beautiful, amazing bonding experience with the baby—and it is. It is also one of the most isolating things I’ve ever done. Once the initial novelty and gaga hormones wore off, I realized I was spending a third of my day in a dimly-lit nursery with no other adults to talk to, my only company a tiny human leaching nutrients out of my body. When I started breastfeeding in public, many people avoided looking at me. I was eager to introduce bottle feeding so Richard could give me a break, but for every bottle I have to go back to my lonely glider chair and have a robot leach nutrients from my body (side note: I laughed out loud the first time I used my breast pump. It is so weird).

I am thankful I found the New Moms’ Support Group at Natural Resources in San Francisco around five weeks postpartum. Nursing alongside other mamas brought a social element and a sense of solidarity to the experience. Having a supportive community where I could vent without judgement and be reassured that it would get easier as the baby developed was relieving and helped me recharge. (Sure enough, breastfeeding sessions are now a third as long as they used to be).

A friend of mine had a baby after she’d been with her partner for ten years, and she reported that it hadn’t shaken their relationship because after all those years together they were totally in sync. Richard and I have been together for seven years, and I thought we’d be the same. Nope. Babies are warm, soft, squishy wedges that drive themselves between partners, and we had some pretty brutal fights in the first six weeks. Long before I got pregnant I read Misadventures of a Parenting Yogi by Brian Leaf, and a quote from him came back to me many times in the early days:

I don’t think couples with small children should be allowed to divorce. With no time to connect, lacking sleep, and always feeling overwhelmed parents of very small children, it seems to me, are not of sound mind to make such a life-changing decision.

Things never got that bad, but reflecting on this quote helped me keep the experience we had in perspective. As time went on, the intensity of our arguments dropped off as we relearned how to communicate and were able to spend more alone time together as Equinox’s sleep patterns became more predictable.

…Then Things Got So Much Better

For the first eight weeks I was in survival mode, and I had to really try to be present and cherish the joyful moments. At three months now, we’ve hit a sweet spot in which Equinox constantly draws me into presence, so many moments are unforgettable, and time is starting to move too quickly. Although she has her occasional regressions that have me up every hour all night, her sleep is becoming more manageable and predictable. Every morning when she opens her eyes and sees my face, she breaks into big gummy smile. When I play with her she discovers exciting new skills she integrated overnight. Sometimes she’s energetic and will let out guttural laugh when the dog licks her face. Sometimes she’s mellow and wants nothing more than to cuddle up with me all afternoon, nursing and sleeping.

My biggest challenge lately is giving her the space to explore her independence. For example, she is now learning to soothe herself to sleep, and it takes all my effort to resist swooping in at the first sign of fussiness. I thought empowering her would be my forte, but it is surprisingly hard for me. Lately I’ve found myself drawing strength from one of the commitments I made to her before she was born:

I give you enough structure for you to develop security and trust, and enough freedom to explore, express your creativity, and make your own mistakes. I allow this balance to shift as you grow and develop.

It was worth it to write these commitments down before I moved into the alternate dimension of motherhood.

Equinox is not a newborn any more, and it’s exciting, and overwhelming, and amazing, and terrifying all at the same time. Every day requires me to take another step farther outside my comfort zone, and every day I manage to meet that challenge. All the techniques I learned for childbirth (cleansing breaths, letting go of control, trusting my instincts, integrating with my partner, etc.) have turned out to apply even more to parenthood than it did to the birthing process. I’ve only practiced yoga in a studio once since I gave birth, but somehow I don’t feel like I’m missing out. I’m still practicing the eight limbs of yoga on a daily (or hourly, or minutely) basis but in a different form. If yoga class is the “practice,” then motherhood is the real thing.

13 Weeks

Equinox at thirteen weeks with Foxy. #thatdimple

*Name changed.

37 Weeks Pregnant: An Epileptic Mama’s Postpartum Plan

March 2 – March 8: 37 Weeks 0 Days – 37 Weeks 6 Days.

Belly and Baby Update

Babies are a little more robust when born after 39 weeks, but at 37 weeks they’re considered to be at term. Hitting that milestone this week lit a fire under my buns to finish doing our taxes, add some final items to the hospital bag, and place one last small Amazon order for baby things we were still missing. Okay, maybe it was a large-ish Amazon order that included more than 25 board books, Dr. Seuss books, and Robert Munsch books. I’ll probably need a dolly to get that box inside, but books are an investment worth the effort.

Books for baby

Part of my book order showed up this morning! Some of these books are a little advanced for a newborn, but we want to read to her every day, and I’m hoping having a variety of books will help us stay engaged and committed to this.

I also managed to research makes and models for a reliable second car (chauffeuring Richard to and from his shuttle stop every day is no longer going to work with a baby in tow), find us a suitable car from a private party, set up a test drive, arrange mechanic’s inspection, buy the car, and register it at the DMV all the span of one week. The last time I went to the DMV without an appointment, I swore I’d never do it again, but I couldn’t get an appointment within the allotted title-transfer period, so I had no choice (Richard offered to take time off work to do it, but that seemed silly). I went to the DMV armed with a giant sun hat and sunglasses, a small camping stool, a granola bar, a water bottle, and my Kindle app loaded up with a book my friend recommendedThe Happy Sleeper: The Science-Backed Guide to Helping Your Baby Get a Good Night’s Sleep-Newborn to School Age. So far the advice in the book is resonating with me—it’s a balance between compassion and structure. I looked ridiculous, but I think people were jealous of my seat when, true to form, the DMV’s computer system went down for 45 minutes. By the time the system came back up, the rest was a breeze because so many people in front of me had given up and gone home, but the whole experience still last two-and-a-half hours. My body was pretty committed to being horizontal for the rest of the day.

Family Car

Completing our suburban lifestyle with a second family-oriented car. Having a second vehicle will probably be more fuel efficient than our current schedule of me chauffeuring Richard to and from work (since I go to work in the opposite direction or back home during the day, then go back to pick him up).

My mom has told me about how when she was pregnant it was arduous to roll over in bed, and I’ve empathized, but this is the first week I’ve really known what she meant. When laying on my side, my belly weighs me down so much that I can’t roll over unless I use my hands to bring my belly along for the ride. With my awkward size, certain movements are almost comical now. On the weekend I was out for a picnic with friends, and when it came time for me to laboriously get up off the ground I couldn’t help but feel like a topsy-turvy Winnie the Pooh.

My belly button goes between being flat and inverted, depending on the baby’s position. I think I may have developed a small stretch mark or two on the underside of my belly since the baby descended, but I can’t see anything below my navel without a mirror, so I can’t tell for sure. I don’t know if what I’ve been feeling lately are Braxton-Hicks contractions or just generic pregnancy sensations, but almost every day this week my body has told me, “Go take a nap,” in the language of menstrual-like cramps. I take it as a sign my body is preparing for labor.

37 Weeks Pregnant

37 Weeks Bump Update: Ready to go on a picnic.

Preparing for the Postpartum Period

When people ask me about my fears around childbirth I don’t many to report. This is probably because any worries I have about childbirth are far overshadowed by the uncertainty I have around the postpartum period, and I don’t have the bandwidth to concern myself with both. Caring for a newborn baby makes me nervous because I have a history of sleep-deprivation-induced seizures, and the number one thing people tell expecting parents is about how sleep-deprived they will be.

For the last eight or nine years, my condition has been manageable without medication. I simply do what it takes to get enough sleep every night. (Many of my healthy lifestyle habits like avoiding alcohol and caffeine stem from this). However, control over my lifestyle is going to be completely usurped by the baby. As any parent, I want what’s best for my baby, but I’m going to have to navigate some trade-offs around my condition. Here are three things I desperately want for my baby and me, but it would be a feat to achieve all of them:

  1. I want to breastfeed. There are enough public awareness campaigns out there that by now nearly everyone knows that breastfeeding is the way to go, if possible. Newborn babies need to breastfeed ten to twelve times per day, which works out to be about every two hours (although, some babies cluster feed, so I may get longer stretches to sleep). Sleep deprivation is almost built into that schedule. Before learning more about breastfeeding, I thought I could pump during the day and Richard could bottle feed at night to give me some longer stretches of sleep, but in the first month using bottles may turn the baby off the breast.
  2. I don’t want to expose the baby to unnecessary medication. I choose to control my lifestyle instead of taking medication because I don’t like that stuff in my body, and I’m even more hesitant to expose my baby to it through my breast milk. I’ve consulted with my doctors and lactation consultant, and they agree that the baby getting the drug they have in mind through my breast milk is better than me not breastfeeding at all, but there are still potential side effects for the baby (to which the solution would probably be to reduce or discontinue breastfeeding) and me (including reducing my milk supply).
  3. I don’t want to have a seizure. I don’t even want to think about having seizure while home alone with the baby or while holding the baby. The idea is horrifying. To avoid seizures, I need to get enough sleep (which may not be compatible with breastfeeding) or take medication.

Number three is non-negotiable. Between the other two, and I’d rather take medication than forego breastfeeding. However, I hesitate to jump on a resolution before I meet my baby. Maybe she will be all about cluster feeding, and I’ll be able to take long enough naps to keep seizures at bay without drugs (I’d have to be the luckiest mama ever, but there are “easy babies” out there). Maybe there will be an unrelated reason I can’t breastfeed, so I could take medication without affecting the baby or Richard and I could feed in shifts so I could sleep. Instead of choosing now, I’m choosing to wait and see. My body gives me plenty of warning signs well before escalating to a full out seizure, so I’ll have time to respond in a way that makes sense for my situation.

In the meantime, I’ve been developing a plan to set up my postpartum time so that I have a shot at having my cake and eating it too (breastfeeding off meds and seizure-free). Here’s one epileptic mama’s postpartum plan:

  1. Hire a postpartum doula. Birth doulas (professionals who coach women through childbirth) are getting to be more mainstream, but many people don’t know there are postpartum doulas as well. The idea is that the postpartum doula takes care of and educates the mother so the mother can care for her baby (sometimes this means they take care of the baby so the mother can take a nap). I’m hoping that having a baby expert come in several times a week to teach us how to best care for my baby will help us iron out any kinks that make the baby more fussy than she needs to be, and reduce my stress and anxiety so I can relax. Richard and I chose to work with Melitta Hoder, who has many years of experience and is also a certified lactation consultant. We have her for thirty hours over the first month, which makes me feel much more at ease. I considered hiring a night nurse (someone who stays overnight and cares for the baby), but newborns don’t really have nights and days, and whether I have extra help or not, I’ll still need to wake up to breastfeed every couple hours. If we have a high maintenance baby or I’m still relying heavily on Richard when it’s time for him to go back to work from paternity leave we may reconsider our options.
  2. Visitor blackout period. My only hope at achieving all three of the desires listed above is to follow the old adage and “sleep when the baby sleeps.” Every minute I spend entertaining visitors is a minute I should be napping. As such, Richard and I have chosen to snuggle into a cocoon for the first two weeks of the baby’s life so we can focus completely on coming into our rhythm as a new family. The last thing I’ll want to do is wake the baby up or interrupt her feeding schedule so she can interact with visitors. So, in the first two weeks we won’t be having guests over to see the baby, hold the baby, or gush over the baby. I do want her to be surrounded by loving, supportive people in her life (and all my amazing friends and family fit the bill), but in the first couple weeks what we could really use are people dropping off meals, picking up our laundry to be washed, or taking our dog out for some exercise. When visitors come over I want to want to hand over the baby rather than feeling like people are disrupting our bonding time, and I’m hoping the two-week buffer will foster this.
  3. Try out different sleeping arrangements. We have practice with this from pregnancy. I already wake up every two hours to go to the bathroom, or change position, or stretch, or drink water, or get a snack. A few months ago, neither of us were getting a good sleep: I’d wake up uncomfortable, but try (unsuccessfully) to go back to sleep without changing positions so as not to disrupt Richard. Inevitably I’d end up moving or getting up, which would wake Richard up. We tried a couple different sleeping arrangements and settled on sleeping in separate bedrooms, which has been amazing. Sleep deprivation drives a far bigger wedge into a relationship than sleeping apart. I know I want to sleep with the baby close to one of us when she’s a newborn, but I’m not sure how close (On us? On the bed? Beside the bed? Across the room?) and I’m not sure if all three of us sleeping in the same area will maximize anyone’s sleep. I’ve found advice pointing in all different directions on this topic, so we’re going to have to wait and see what works for us.
  4. Start “shift work” as soon as is sensible. I’ve got my fingers crossed so hard that breastfeeding will be smooth for me. Ideally, parents wait to introduce bottles until the baby is a month old so breastfeeding is firmly established, but my lactation consultant says that if absolutely needed she can help us use techniques introduce the bottle earlier. This will be a game changer, because Richard and I will be able to care for the baby in shifts, which will give us both more sleep. I’m an early bird and he’s a night owl, so I think we’ll be able to work out a schedule that’s appropriate for both of us. I’ve already got my breast pump and milk storage containers, so I’m ready to go when the baby is.
    Update: After reading this post, some friends advised me that there are nipple-free alternatives for feeding newborns. Syringe feeding, spoon feeding, and cup feeding shouldn’t cause nipple confusion. I’m so glad to know we have options!
  5. Visitor welcoming period. After our two weeks of cave time, the baby will start becoming more active, if she’s going to be colicky that will be starting around two or three weeks (I was fussy baby, so I may get my karma), and toward the one month mark she may be starting to take a bottle for some feedings. Needless to say, at this point, there will be much more visitors can do to help out with the baby instead of just doing chores for us (and interacting with the baby is what many people really want to do when they come and visit). If the baby hasn’t let me put her down for two weeks, I will probably happily pass her off to a friend or family member who wants to rock her while I eat, take a shower, or lay down down for a bit. My family is planning to come stay with us during this time to meet the baby and help out, which I’m really looking forward to. We’ll also be excited to start inviting friends over to see us and our little one.

There are so many unknowns that this is just my best guess at what will work for us. Maybe on day three I’ll be eating my words and calling friends begging them to come over and help me out physically, emotionally, or mentally. Even so, it feels good to have a vision and to practice being assertive about what I want for my baby.

28 Weeks Pregnant: 13 Misconceptions I Had About Babies

December 29 – January 4: 28 Weeks 0 Days – 28 Weeks 6 Days.

Update: This post generated a great discussion on Facebook. I concede that this post should actually be named “13 Misconceptions I Had About The Research About Babies.” Real babies can be quite different from theoretical babies. More updates below on individual points.

People say all the time that you can never be ready for pregnancy, childbirth, or parenthood, but reading up on and preparing for these stages at least makes me feel ready. I’m two-thirds done pregnancy, I’ve read several books about it, I’m going to regular prenatal visits at my hospital, I’m enrolled in a birth prep class, my birth and postpartum doulas are hired… I feel that doing much more would be over-preparing for birth. As such, I’ve chosen to move on to reading about newborn care. After poring over online reviews, I chose two baby books to read:

  • Baby 411 by Ari Brown and Denise Fields. This book struck me as one that would contain conventional, mainstream advice on newborn care.
  • The Baby Book by the Doctors Sears. This book struck me as a little more hippy-dippy-touchy-feely (i.e. totally up my alley), as it encourages attachment parenting.

Baby 411These books are both tomes, so Richard and I chose to each tackle one. I decided that since my intuitions would probably gravitate more toward the Baby Book and his toward Baby 411, we should swap to read the book that would give us different perspective. I just finished reading Baby 411, and the chapters on newborn care were informative, non-judgmental, and easy to read. I didn’t enjoy the (many) chapters about everything that can go wrong with the baby, but the conditions were presented in a non-alarming way and I’ll be glad to have all that information for reference when I’m wondering if my baby’s latest rash is anything to worry about. The vaccinations chapter aside (which was strongly pro-vax—I happen to agree so it didn’t bother me), Baby 411 focused on giving the reader straight-up information, rather telling the reader what to do, so parents could draw their own conclusions.

My biggest take-away from reading Baby 411 was that many of the opinions I held about newborn care were kind of ignorant, based mainly on things I’d heard, not on actual science or evidence. I don’t like to think of myself as judgmental—previously, if I saw a baby using a pacifier, I wouldn’t think anything as blatant as, Omg, I can’t bu-lieve those parents are using a pacifier. That is SO bad for the baby. But I might think something more subtly judgmental like, Ah, this must be a fussy baby and the parents need to use a pacifier for their own sanity. I didn’t occur to me that maybe these parents were more educated than me and made a carefully informed choice to use a pacifier to best support their baby’s health (see below for more on pacifiers). Baby 411 certainly put me in my place.

Here are Thirteen Misconceptions I Had About Babies, and what Baby 411 had to say about them. Some of these statements are not categorically false—just much more nuanced than I realized:

Misconception #1: You can train newborns to sleep when you want them to. I didn’t necessarily think this was a good idea (see next my point), but I did think it was possible. According to Baby 411 it’s not: newborns are not developmentally capable of falling asleep on their own. Intense sleep training before five or six months will be futile and detrimental to the baby. In fact, the authors also say that “you can’t spoil a newborn” because bad sleep habits don’t develop until after two months of age. As such, all the “rules” for promoting independent sleep go out window for newborns (e.g. don’t breastfeed the baby to sleep). Parents can unabashedly do whatever it takes (within reason, of course) to get a newborn to sleep.

Misconception #2: Letting a baby “cry it out” will mess her up.

Update: A better statement of my misconception would be “Research strongly suggests that letting a baby ‘cry it out’ will definitely, for sure, mess her up.” This was my misconception, but it doesn’t mean the exact opposite is true (i.e. Letting a baby “cry it out” is definitely, for sure, not going to mess up any child). Reality is something more like, “Research is equivocal about the safety of the ‘cry it out; method.

I’ve heard and read this so many times that I assumed there was hard evidence backing this statement, but it actually stands on shaky ground, scientifically. Proviso: As mentioned above, the baby must be neurologically mature enough to settle on her own (five to six months), and shouldn’t be left to cry it out when she needs a diaper change, is hungry, or there’s an underlying medical reason for her crying. The two main ways to teach a baby to sleep on her own are Rapid extinction/Cry it out (which I’d be too much of a worrywart to handle) and Progressive Waiting/Ferberizing (which I would be more comfortable with). Interestingly, many infant sleep disorders are attributed to excessive parental intervention (e.g. Soothing a baby to sleep then putting her to bed—when she wakes up briefly as part of her natural sleep cycle she’s shocked and upset that the parent has disappeared, and cries to get them back). All of this said, I wouldn’t go so far as to say that the research proves that sleep training is definitely safe either. The authors of Baby 411 did not advocate for independent sleep over co-sleeping (other than to warn of the increase SIDS risk in a shared bed). My pre-parenthood opinion is that at the current state of research, the question of sleep training comes down to individual parents’ instincts, opinions, and individual needs; neither camp has grounds to be on a high horse.

Misconception #3: Breast milk is nutritionally complete.

Update: This isn’t anti-breastfeeding; Baby 411 strongly encourages breastfeeding. Also, this misconception is a bit of an overstatement. Breast milk is nutritionally complete for infants until their iron stores become depleted, at which point parents either add iron-rich solid food (e.g. cereal) or iron supplements. Friends have pointed me to additional resources that say exclusive breastfeeding is fine until six or nine months, so supplementation at four months (as reported below) may be overly-cautious. Please consult with your pediatrician or lactation consultant!

The opinion that breast milk is amazing, perfect, and has magical powers is mainstream and well-supported. When I’d heard the recommendation that babies should be breastfed for a year (or more), I thought that meant exclusive breastfeeding. It turns out this would be unhealthy. When babies are born, they have a plentiful store of iron from their mothers, but by six to nine months these iron stores are completely depleted. Baby 411 recommends that babies who are exclusively breastfed take an iron supplement from four months until they have other dietary sources of iron. The authors say solid foods, such as meat or cereals naturally high in iron, should be introduced into a baby’s diet between four six months (there are risks associated with introducing solid foods earlier or later than that; check out the book for more details).

Misconception #4: Breastfed babies will grow better than their formula-fed counterparts.

Update: As in the previous point, this is not anti-breastfeeding; Baby 411 strongly recommends breastfeeding. This misconception should have been stated “Breastfed babies will grow faster than their formula-fed counterparts” from the get-go. As explained below, faster growth doesn’t necessarily mean better growth.

If “better” means “faster” this is false. Breastfed babies grow slower than formula fed babies for the first four to six months. Baby 411 accents that this slower growth does not mean breastfed babies are less healthy; breastfeeding has been proven to be beneficial for babies’ health and development. However, growth charts produced by the CDC, which some doctors may use, compare a baby’s growth to other children in America—both those who are breastfed and formula-fed—making breastfed children look like they’re growth is lagging. Growth charts produced by the WHO (which the CDC itself recommends for infants) draw on data from several countries and consider breastfed babies’ growth patterns to be the gold standard. The authors recommend asking a baby’s doctor which chart they use to evaluate growth.

Misconception #5: Newborn babies should never be placed on their bellies. To avoid confusion: Putting babies to sleep on their backs is important. There is rock solid evidence that this helps prevent sudden infant death syndrome (SIDS). However, always being on her back can cause the back of a baby’s head to flatten. Also, Baby 411 cited an interesting statistic: back-sleeping infants who end up sleeping on their tummies are 18 times more likely to die from SIDS, eek. This is thought to be due to a dearth of experience coping with being on the belly and a lack of neck muscles development (Side conclusion: if a baby is a back sleeper, make sure all babysitters and other caretakers know to only put the baby to sleep on her back). To help develop experience and neck muscles strength, the recommendation is to have babies spend at least five awake, supervised minutes on their tummies per day for the first eight weeks of life.This is cutely called “Tummy Time.”

Misconception #6: Pacifiers are evil. I’d heard that pacifiers interfere with breastfeeding, mess up teeth, and cause ear infections. Baby 411 added one more: they may disrupt sleep because when the baby’s pacifier falls out during the night she will “call” mom to replace it. However, pacifiers have one significant plus: They have been shown to drastically reduce the risk SIDS. According to this well-written summary of research about pacifiers, pacifiers can reduce SIDS risk by fifteen to fifty percent, depending on use. What about those risks? There’s not much indisputable scientific evidence that pacifiers interfere with breastfeeding, just a lot of anecdotal evidence (which is still worth taking into account). To be safe, Baby 411 recommends waiting until breastfeeding is well-established before introducing a pacifier (usually around two to four weeks). For the other factors, the magic number is six months. SIDS risk is greatest before six months, so this is when pacifiers are most beneficial. Ear infection risk is pretty low until six months. Tooth decay isn’t an issue until the baby actually has teeth, which also often occurs around six months (even then, tooth decay can be circumvented by sterilizing pacifiers before use and not dipping them in honey or sugar). According to the article linked above, pacifier use doesn’t contribute to tooth misalignment until eighteen months. If parents choose to use a pacifier, Baby 411 recommends doing so between two to four weeks and six months of age, and using the Soothie brand (which I got for my baby shower!), because it is designed to closely resemble a human nipple.

28 Weeks Pregnant

28-week bump update from the beach. Compare this to the beach photo in my previous post about week 12 to see how much I’ve grown. (Or look back two posts to see that I’ve maybe shrunk a little since Christmas without all the yummy treats around)

Misconception #7: Babies should be warm and cozy when they sleep. When we bought our new home, we knew it needed to have its ducts insulated, and I made sure we got it done quickly because I worried the baby would get cold in the nursery. Turns out the ideal sleeping temperature for babies is much cooler that I thought: according to Baby 411, the recommended safe room temperature to reduce SIDS risk is only 68 degrees. Interestingly, anything that can cause the ambient temperature of the crib to go up—like the adorable bumper pads that perfectly match my “Forest Friends” nursery theme—increases the risk of SIDS. The authors recommend hanging anything but the bare bones crib bedding on the wall as decoration. After reading this, I also opted to buy a crib that had slats on all sides to promote better ventilation rather one that had one or two stylishly solid sides.

Misconception #8: A fever of 101°F degrees is panic-worthy. The Fever-phobia section of Baby 411 was written for me, because I’ve been wracked with worry every time Richard has had a fever (once, I was up all night Googling “rabies” to rule it out for sure). I thought that 99°F was a fever and 101°F was a worrisome fever. It turns out that body temperature fluctuates quite a bit throughout the day. According to Baby 411, it’s coolest at 7am (as low as 97.6°F) and highest at 7pm (as high at 100°F). The true definition of a fever is a body temperature of 100.4 or higher taken rectally. So, 101°F is a low fever. The authors insisted on using a rectal thermometer, which I begrudgingly added to my baby registry—we’ll see if I actually muster up the nerve to use it (I also added an ear thermometer as a back up).

Misconception #9: Fever-reducing medicine prevents the baby’s brain from getting cooked. Baby 411 says that a fever cause by infection is unlikely to cause brain damage. Body temperatures over 108°F cause brain damage, but attaining that level of heat takes environmental factors (like leaving the baby in a hot car) to push body temperature this high. According to the authors, infections do not cause body temperatures over 106°F. Fever-reducing medicine is just to help the baby feel more comfortable. Thank goodness for one less thing to worry about with regard to both the baby and the husband.

Misconception #10: I’m vaccinating my baby, so she will be safe whether or not other parents vaccinate theirs. Vaccines have a couple legitimate risks (which Baby 411 goes over in great detail), but the rate of death and disability is much higher if a child actually gets one of the diseases we routinely vaccinate against. Some children are medically unable to get vaccinated (e.g. they’re allergic to a component of the vaccine), so I’ve also always felt a sense of social responsibility to get my children vaccinated to protect those that can’t be. However, even though I’m pro-vax, I’ve never felt the need to have advocate to others about it. I didn’t think others’ decisions would directly affect me or my vaccinated children. The authors brought up a couple points I hadn’t previously considered:

  • Newborn babies don’t get all their vaccination on day one, so they depend on herd immunity (i.e. everyone else being vaccinated) to stay healthy. My baby will depend on everyone else being vaccinated.
  • The lifesaving effects of vaccines are astounding, but most vaccines are not 100% effective. There are mutated versions of all those scary diseases that we can still catch. If another child gets sick with a mutated viruses (which is more likely with zero vaccination protection), my child may be at risk, even with a vaccination.
  • If a high enough percentage of the population is unvaccinated, viruses are likely to mutate within their multitude of hosts, making vaccines less effective in those that do get their shots. All children (without medical contraindications) must get vaccinated for my child’s vaccination to be as effective as it should be.

It turns out we are in this together. Part of me wishes I hadn’t read this because it made me more judgmental of others’ decisions and more likely to ask the somewhat offensive question, “Is your child vaccinated?” before scheduling a playdate. Another part of me is grateful to be informed and hopes I’ll actually have the guts to pose that question.

Misconception #11: Kids shouldn’t drink from garden hoses because they contain bacteria. When we moved into our new home, I pondered over the various garden hose options at Lowe’s and forewent spending extra money on the safe-for-drinking hose. Now I wish I had splurged. The problem with garden hoses is not the bacteria, it’s that they contain lead. Yes, lead as in the neurotoxic heavy metal, ugh! Baby 411 recommends running to the hose for a minute to clear lead before filling a kiddie pool (from which children will inevitably drink).

Misconception #12: It’s harmless to share utensils with a baby. I would not have thought twice about this before reading Baby 411. According to the authors, tooth decay is contagious. By swapping saliva with the baby, you also share cavity-causing bacteria that can erode the baby’s new teeth. Who knew?

Misconception #13: TV is never good for kids. I’ve never had the intention of completely preventing my children from watching TV, but that doesn’t mean I thought TV was beneficial—I assumed that I’d need an occasional break from providing entertainment. For the most part, Baby 411 advocates against screen time. Young babies aren’t developmentally capable of understanding what’s on the screen, and that time in front of the TV takes away from time that could spent listening to parents talk or read, or playing with toys they do understand. However, there is evidence that educational programming is beneficial for kids, provided they can understand the content. The authors say “the magic age to understand TV is two years old.” This rules out “Baby Genius.” However, even after two years, the authors recommend limiting screen time (check out the book for more details).

Other interesting factoids from Baby 411:

  • The average baby goes through 2300 diaper changes in the first year alone. Oh my god.
  • Babies lose their hair around four months, and then grow new hair. Good to know ahead of time, that would have freaked me out.
  • The authors say you can expect an infection every other week in the winter. You can also expect to catch many of the infections your child gets. Ick.
  • There are studies that have found “babies conceived less than 12 months after the birth of the first-born child were three times more likely to be diagnosed with autism spectrum disorder. Babies conceived from 12 to 23 months after the birth of the first-born child had almost two times the risk of autism. And, even babies conceived 23-35 months after the firstborn child had a slightly greater risk of autism.” I had never heard this before. I had a sister close to my age, which I loved, but I will definitely balance that priority with this evidence when planning my next pregnancy.

After reading Baby 411 I feel like I know a little more about babies, but friends and family tell me that what sounds good, effective, and easy on paper in baby books often isn’t any of those things in real life. I’m sure after the baby is born I’ll be able to write a much longer “Misconceptions I Had About Babies” blog post than this (maybe even containing opinions that contradict what I wrote here) based on experience.