car life
we don’t use the iPad in the car but I included the one we do own and love. There is also a compartment on the car organizer for the iPad.
what we pack the car with for Roadtrips with kids
outdoor kids gear for comfortable play
back to school for outdoor play
I know many of the more traditional preschools are moving more towards outdoor play because of the current COVID situation. Knowing my boys go to nature-based preschool definitely made me feel at ease about sending them back this fall. Last year they probably spent 50/60 percent of their day outdoors, and this year that is moving to 80/90 percent. Yes, that includes pouring rain and snow. The only time they will not be able to be outdoors is if there is thunder/lightning. I’m sure more of the traditional based programs might not go from 10 percent to 80 percent of time outdoors, but I know many will spend significantly more time outdoors. Whether it’s 10 percent or 70 percent, your child needs the right gear to feel comfortable and have fun. After researching what the Finland, Sweden brands and parents are doing, I picked up on things American parents might not know. Some might include layering is essential, but with the RIGHT materials, the fit is so important to make sure their gear is not restrictive, and rain gear is key! It’s not all about the snow. I will be doing a post on winter gear in a few weeks when the new lines are released, but let's start with fall gear. When I pick Charlie up from school many times, he is covered in mud head to toe. Making sure he can explore but still stay dry and be comfortable is critical.
This is the typical list all Scandinavian parents get when signing their kids up for pre-school:
Base layer (merino wool) (Base layer)
Tubes leggings (mid-layer)
Fleece Jacket or a thick wool sweater (mid-layer)
Polyester wind pants or rain suit (rain jacket + rain paints w/straps) (top layer)
Wind jacket (top/shell layer)
Down jacket (top/shell layer)
Snow pants or snowsuit (top/shell layer)
Balaclava/or neck warmer
Hat
Mittens
Rain mittens
For base layers I love Ella’s wool. I’ll share more in my next post but the boys wore Ella’s wool base layers and tube leggings last year. They will fit for a few years, are great quality, and are great for mobility. Here is a link to the base layers and tube knit leggings, HERE . You can use code MrsNipple for 10 percent off through Dec.
FALL GEAR PICKS for kids
For everything rain gear + snow we are going with Reima, HERE. (Also love their base layers) MRSNIPPLE20
Reima has been around for 75 years. “Having an active, happy childhood isn´t about sport or achievement, but the simple joy of movement, of exploring, discovering and asking, where next? This is why, for 75 years, we’ve had our hearts set on one thing: to create clothes for that let kids live curiously, whatever the weather.”
I wanted a company that understood what kids need for gear when it comes to outdoor play and Reima had it ALL from rain to snow gear and everything in-between. Reima is that brand!! I will share more in stories but here is what I am using for the boys for the fall from Reima in bold but any of the below are perfect.
raingear:
Layering guide for babies
winter update
WINTER GEAR PICKS for kids
I've been so impressed with the Reima Fall gear that I also ordered the boys their winter gear from Reima. Last year we ordered from a US-based company, and I was not impressed. I think the countries where outdoor schools have been the way of life forever really know what kids gear should offer.
Here are my picks for winter gear from:
Reima code: MRSNIPPLE20 for 20 percent off. Click HERE to shop
Ellas Wool: MRSNIPPLE for 10 percent off. Click HERE to shop
Widgeon fleece jackets: MRSNSP25 for 25 percent off. expires 10/25 Click HERE to shop
ONE PIECE SNOW SUIT: I ordered the Stavanger snowsuit (CLICK HERE) for the boy's snowsuits in Cinnamon Brown. Not only do I love the look of this suit, but I did research around five mom's opinions on winter gear for kids, and this was the fan-favorite. These moms all lived in cold weather climates, and their children were very active outdoors. They pointed out quality, movement, but most importantly, warmth without ever sweating or becoming wet. If this was the pick for super adventurous families from Alaska and Colorado, I know it will work for us too!
GLOVES/ MITTENS : I love the Otte mittens; click HERE. They come in multiple colors and are warm, breathable, and stretchy. If you want the gloves version, click HERE.
WINTER JACKET & SNOW PANTS: I prefer the one-piece for kids. Yes, even during potty training. That being said, there will be times you need a winter jacket. For those times, I prefer THIS Sydkap jacket. It is a 3 in 1 jacket which I love for kids. It gives you the option for versatility and not spending on multiple jackets. They also have matching snow pants HERE.
MY ACCESSORY PICKS
BALACLAVA FOR VERY COLD DAYS: HERE and HERE
DON’T FORGET THE SOCKS!: I have all of these HERE
BASE LAYERS & FLEECE JACKETS: I have not tried the Reima Fleece jackets, but we do have THIS base layer and THIS base layer and love both. For all base layers, click HERE, and for all fleece jackets, click HERE.
I also love Ellas Wool base layers, but they are all sold out at this time. We layer our base layers with the Ellas Wool Tube knit leggings HERE. They offer warmth and movement!!! For a discount at Ellas Wool, use MRSNIPPLE for 10 percent off. This is a small Scandinavian born Brooklyn run brand by a mom!
For fleece jackets, we have always LOVED THIS brand. From the newborn stage, HERE and HERE and on to the toddler age with the jackets. For a fleece 2nd layer, I prefer THIS Fleece turtleneck or THIS fleece crewneck sweater (vellow fleece).
OTHERS: Some other picks I love, but I could not order it all :( was THIS super cute snow suit (full piece in the grayish green or warm yellow) , THIS puffer jacket, THIS super sharp jacket (navy or bubble gum pink), THIS really cute girls jacket, THIS sharp full snow suit or THIS retro kids suit.
Reima also has big kids gear as well!
Some Examples of how my kids dress
Rainy cold fall day : Base layer, tube leggings, fleece jacket, rain jacket, rain hat, rain mittens with liners, rain boots , wool socks.
Mild rainy fall day: Base layer, tube leggings, fleece sweater, rain jacket, rain hat, rain mittens, rain boots, wool socks.
Warm rainy fall day: Regular pants, t-shirt, long sleeve t-shirt, rain pants, rain jacket, rain hat, rain boots, wool socks.
Dry cold fall day:(no moisture on ground): Base layer, tube leggings, fleece or wool sweater, fleece jacket, mittens, winter boots, wool socks.
Dry warm fall day (no moisture on ground): Sneakers, pants, t-shirt, long sleeve t-shirt, wool socks.
Dry Mild fall day: (no moisture on ground): Base layer, tube leggings, fleece sweater, rain boots or sneakers, wool socks.
Dry Cold winter day: base layer, tube leggings, fleece sweater or fleece jacket, snow suit, snow mittens, hat, winter boots, neck warmer, wool socks.
Snowy cold winter day: base layer, tube leggings, fleece sweater or fleece jacket, snow suit, snow mittens, hat, winter boots, neck warmer,wool socks.
rainy cold winter day: base layer, tube leggings, fleece or wool sweater, fleece jacket, rain jacket, hat, rain hat, neck warmer, liners and rain mittens, winter boots,wool socks.
Freezing cold winter day: Base layer, tube leggings, fleece or wool sweater, fleece jacket, neck warmer or wool balaclava, snow suit, snow mittens, hat, winter boots,wool socks.
RUN DOWN ON THE LAYERS
How to Dress for Winter BASE LAYER STARTS NEXT TO THE SKIN VIA Christina Boucot
In cold weather, your body still sweats. And sweaty clothing in cold weather is not a good thing. Sweaty, wet clothes will make you cold. The job of your next-to-skin or base layer is to wick moisture. Look for labels that wick moisture, natural fabrics are wool and silk. Polypropylene & Polyester are the most affordable material. Try to avoid 100% cotton as a base layer which absorbs sweat but holds it close to your skin.
INSULATION IS THE NEXT LAYER
The function of your mid-layer is to insulate you from the cold, and continue to move moisture outward. This layer could consist of a wool, down or fleece. Merino wool provides the same benefits as regular wool, without the scratchy, itchy feeling. Merino wool garments make excellent base layers and mid layers. Down offers warmth, but is best for dry climates (since it loses its insulating abilities when wet). Nylon is a lightweight, breathable, quick-drying material. Nylon is more durable than polyester and is sometimes blended with other materials to enhance durability.
OUTER LAYER IS YOUR PROTECTION FROM THE ELEMENTS
There are winter jackets and winter shells that serve all types of snow sports; skiing, riding, hiking, and all- around winter fun. Today, your typical shell is often non-insulated (or very lightly insulated). The shell's main function is to repel water, while remaining breathable. Without breathability, sweat builds up and your clothing loses its insulating ability.
As mentioned above, all of your layers need to be breathable, allowing your perspiration to escape and your body to regulate its temperature. Many shells also feature zippered vents (such as underarm "pit zips"). With vents, you can let out the heat you have built up - while working hard at having fun.
WATER-RESISTANT, BREATHABLE
Jackets and pants labeled water-resistant and breathable provide good protection in mild to moderate weather. Most have a DWR (durable water repellent) coating to shed light rain and snow. Soft shells and waterproof jackets that are not fully seam-sealed fall into this category.
WATERPROOF BREATHABLE
In order to qualify as waterproof, a shell must have a membrane and be fully seam-sealed. However, no waterproof breathable shell is going to be “completely waterproof.” With enough water pressure, even the best jacket will leak eventually. For more info on our waterproofing standards, check out the Waterproof Guide.
Warm winter socks are important in keeping warm dry feet. Wool is best, although good synthetic "fleece" socks are often quite good. One pair of good quality socks is all you need. Layering of socks is not recommended, this could make your feet sweat making them wet and cold.
Gloves or mittens, hats, scarfs and eye wear are also a must in cold weather.
FOLLOW UP Q&A AROUND BIRTH
QUESTION FROM READER: This is great and totally echoed everything we learned from our childbirth class this past weekend!! One thing I would like to know more about is post-partum care and the best tips/tricks for making it through those first few weeks of uncomfort.
ANSWER, DR. GILMORE: The best way to approach postpartum is to do everything gradually. Let your body be your guide. Here are some random things that come to mind for common discomforts during pregnancy and postpartum. Please know that these are things people don’t like to acknowledge no less talk about. However, they are essentially for postpartum recovery:
Hemorrhoid care: The majority of women who decide to have babies deal with hemorrhoids at some point in time. This is my little magic solution- witch hazel. It is the major ingredient in the costly “tucks pads”. You can by a bottle of witch hazel solution for a couple of dollars in any pharmacy by the rubbing alcohol. Use the witch hazel to clean yourself after “#2”. You can also make cold compresses by soaking the little disposable make up pads in the witch hazel solution and keeping them in the refrigerator. Witch hazel is astringent. It is soothing and can actually help keep hemorrhoids from enlarging or getting inflamed. A simple but life-saving remedy. Remember hemorrhoids are basically varicose veins of the hiney. They can recede but they really don’t ever go away, sorry.
Stitches/ incision: Follow your providers instructions carefully in regards to incision care and have it checked when they ask. Prevention is key. If there is a problem they know what they are looking for and they can put up things quickly. For the perineum the squirt bottle or “peri- bottle” is your friend. Use it with nice warm water for cleaning and healing.
Kegel exercises:
Whether you have a vaginal or a surgical birth your perineal muscles have been over taxed with pregnancy. They need a little exercise. Kegel exercise can be initiated right after birth. Kegel exercises are basically when you isolate and tighten your perineal muscles. The perineal muscles are the group of muscles that support your urethra, vagina and rectum. By strengthening the perineal muscles you improve muscle tone and blood flow to the perineal and vaginal area. When doing Kegels exercises start with an empty bladder and try to incorporate all of the perineal muscles including the vaginal and rectal muscles. If you are not sure what Kegel exercises are this website gives the best description from the resources I looked at:
https://www.babycenter.com/kegel-exercises.
You can do Kegels whenever you want because nobody knows you are doing them. If you get into a routine Kegels can improve perineal, bowel, and bladder function throughout the life span.
Pain management:
Unless you have an aspirin allergy non-steroidal anti-inflammatory (NSAIDs) like Motrin or Aleve are your best bet. They help with pain caused by uterine cramping, they help with perineal inflammation, and they help with incisional pain as well. Narcotic pain agents are not necessary if you have had a vaginal birth and they are only used in limited quantities after a surgical birth. They can cause sedation, constipation and GI upset with prolonged use. Work closely with your provider to determine what the best plan is for your situation.
COMMENT FROM A READER: As an experienced labor and delivery nurse, I wish more of my moms would read this and come in with realistic expectations- especially the "go with the flow" attitude!!! The only thing I want to piggy-back on is the birth plan. If you choose to have a birth plan, PLEASE PLEASE PLEASE go through it with your provider to see what they agree with and disagree with, etc., before you come to the hospital. It is soooo frustrating to be the nurse that gets this well thought out birth plan from a patient who has a provider who you know will not follow any of it, and have to let the patient down. It's not usually our fault you can't have intermittent monitoring, etc.- some providers just aren't comfortable with it. By discussing it before going into labor, you can know that your birth plan will be able to be followed, or not. A lot of patients think it's because of hospital restrictions that we cannot follow your birth plan, but 9 times out of 10, it's because of your provider.
Thank you again for such a wonderful post!!!!!!!
PREGNANCY & BIRTH
If you didn't read the original spotlight post with Meg Hall & her Mother Brenda M Gilmore DNP, CNM, FNP, CNE, you can find it HERE. I would recommend reading that post first. Below you will find a compiled list of questions that readers had after reading the post above and the follow up answers from Dr. Gilmore.
Q&A
QUESTION FROM READER: Great post, so informative! I have 10 weeks left. Thoughts on cord banking? I know it’s personal and expensive but haven’t seen a lot of studies or news on it.
ANSWER, DR. GILMORE: Cord blood banking is kind of like an insurance policy using stem cells. Almost every day there is more and information on how stem cells are used to treat many types of immunologic disorders, blood disorders, and other medical conditions. The cord blood is a treasure trove of stem cells. There multiple companies throughout the country who will help you collect and store your babies cord blood (stem cells) for a fee of course. Usually there is a fairly large fee for the cord blood collection and processing (1-3 thousand dollars) based on the services you buy then you pay an annual fee for storage (1-3 hundred dollars). The premise is that if you don’t collect the cord blood/ stem cells they will be tossed and lost forever. The thing is you don’t know if your child may need these cells decades later. This process is a way to preserve that option. Actually, I am pretty neutral on this subject. I think if the parents or the parent’s family has a long history of medical problems then it definitely should be considered. But it really is a very personal decision. Some parents just want the peace of mind that the stems cells have been saved and they will be available in the future. Now, when choosing a company be sure you look at their reviews and check out their reputation. The biggest indicator of their effectiveness is if they have had successful stem cell transfers in the past and how many. Below are 2 companies that I worked with in the past. I am not advocating for either of them and there are other reputable companies not listed here. But this is a good place to start for comparison and information. Also know that some states give you the opportunity to donate your stem cells to a public bank as well. https://parentsguidecordblood.org/en/donate-cord-blood
https://www.cordblood.com/cord-blood-banking-cost/cord-blood-stem-cells
https://www.cryo-cell.com/cord-blood-banking-costs
QUESTION FROM READER: what are your thoughts on laughing gas as an option for pain relief during labor? I’ve read a bit about it and how they use it in other countries. Do you believe this is a safe option? If I were to ask for this option, am I likely to get a negative response from my physician? Thank you for your time!! :)
ANSWER, DR. GILMORE: What you are talking about is nitrous oxide. It is a gas that the mother can self-administer during labor for pain management. I have not personally used this mode of pain management but it is used here in the US. About 2 years ago at the American College of Nurse Midwives conference a group of Air Force midwives did an education session on this. They use the nitrous oxide quite a bit. It was quite interesting. It is a gas (nitrous oxide) that is mixed with oxygen and delivered through a mask. The gas makes the woman relax, feel sleepy, and reduces her perception of pain. Just like IV pain medication it is short acting and does not take all the pain away. The laboring woman can use the gas during contractions to manage the pain. The key to this therapy is that only the woman in labor manages the mask. If there is someone else applying the mask then there is risk of the woman receiving too much of the gas. I do think it’s great to have many tools in the pain management toolbox. However, there is limited availability for this so check your particular area to see what your options are. http://americanpregnancy.org/labor-and-birth/nitrous-oxide-labor/
QUESTION FROM READER: Super silly question....What are your views on the old wives tale about full moons and labor. I've heard nurses swear by it, but that there is absolutely no concrete evidence. I'm due in a week and a half and there's a full moon on Wednesday, so just asking for fun!
ANSWER, DR. GILMORE: Yes, today is super, blue, blood moon etc. etc. Unfortunately, we won’t get see it on the east coast but I hope to see pictures because I’m sure it will be spectacular! I wish I could tell you
that there is some truth to the old wives’ tales. There are plenty of experienced nurses that feel there is a correlation. However, this has been studied quite a bit over the years and there really
isn’t evidence to support it. But you know what things happen. I think babies come when they are supposed to. They are the really the only ones who know the plan and they aren’t telling
anyone. Here’s to your little one and my granddaughter coming sooner than later! -
QUESTION FROM READER: This is probably a total noob question, but re: cord clamping...historically was the thought that the cord would have to be cut for babies to...live? (Not sure the best way to word that.) Your mom mentioned she’s seen a baby “pink up” while still attached, so I’m wondering if that in the past it was thought that wouldn’t happen, enter immediate cord cutting?
ANSWER, DR. GILMORE: Delayed cord cutting allows continued flow of oxygen and nutrients through the umbilical cord for a short time after birth. In the case I described the baby received a little extra oxygen boost right after birth while remaining skin to skin with mom and it eased the transition to life outside of the uterus. If the baby's umbilical cord had been cut early we would not have had this opportunity. The baby may been separated from mom to provide the needed support.
QUESTION FROM READER: Thank you for the great blog post! Could you also cover c-sections? I’ve had one so I don’t have questions but I’d still love to read your views - how to prepare (physically and mentally!), recovery etc. Also related to delayed cord clamping, feeding right away (particularly if the section is under anaesthesia) etc.
ANSWER, DR. GILMORE: We are very fortunate to have surgical options for birth when a vaginal birth is not feasible. I have assisted with c-section deliveries throughout my midwifery career. Birth is amazing in any shape or form. However, the transition to life outside the uterus is different after a c-section for a newborn. They tend to need a little more respiratory support and that has to take priority over delayed cord cutting. Honestly, if there are emergent issues after a vaginal birth that would have to take precedent over delayed cord cutting also. If possible spinal anesthesia is preferred over general to avoid neonatal sedation. Yes, there is potential for delay maternal newborn bonding after c-section but hospitals are really working on this. There is a definite movement to facilitate skin to skin contact and early breastfeeding after surgery. And remember skin to skin contact is not limited to just after birth. It should be done as much as possible with babies. It feels so good to both moms and babies. Moms after c-section may need some additional support initially but successful breastfeeding is definitely an attainable goal. Lastly, I continue to be amazed at how quickly mothers recover for surgical birth. At our hospital women after vaginal birth go home in 1-2 days. Women after c-section go home after 3 days (sometimes 4). That's not a huge difference in the hospital stay for major abdominal surgery. It just shows hows strong a woman's body is. The ultimate goal is healthy mom and healthy baby. We are so blessed to have so many options to reach that goal.
COMMENT FROM READER: Thank you for this post! For someone who has recently had their first baby (3.5 weeks ago), I really relate to a lot of what your mom has said and can’t recommend her advice enough! Labor, delivery and post partum should be as relaxing and stress free as possible, and her advice really helps guide new moms in that direction. One thing I would reiterate is get breast feeding help if you want to breast feed! When it comes to breast feeding, the best advice I’ve gotten, and your mom touches on this as well, is to solicit the help of a Lactation consultant. Almost all hospitals have them and they can be a huge help if you really want to breast feed but have no clue what you’re doing. My son had jaundice and had to be on phototherapy for a few days after birth. He was having a really hard time latching to my breast (which I later found out is fairly common with jaundice as the newborns can have a weak suck) and he wasn’t getting enough colostrum and breast milk. I had to ask multiple times for a lactation consultant to come and assist, and it wasn’t until I started crying to my husband and nurse that I was concerned about the lack of nutrients my son was getting, that the consultant finally came. We talked through different options and ended up using donor milk through an SNS (supplemental nutrition system) until my milk came in and we were able to get my son to latch. We still have to use a nipple shield off and on to help with the latch, but if it weren’t for the help of the lactation consultant, we probably would have switched to formula, which was not an ideal option for us.
Apologies for the long winded comment, but I’d just tell all new moms to be your own advocate. Don’t be afraid to ask for help, even if you have to ask multiple times. Be adamant about it, because once you’re home, you don’t want to feel helpless.
Thanks again for this post! It’s great advice!
TO SUMMER at home OR TO SUMMER away
time, space, people, place
As you know, I'm not an infectious disease physician or an epidemiologist, but I'm just a mom that has done her research and has made a decision around what works best for our family. My favorite articles/interviews have been with infectious disease physicians and epidemiologists where they are not afraid to give you their real opinion with a YES or NO or a LOW - MEDIUM - HIGH risk. One of my favorite articles, which was released at the end of May, is this one, HERE,
"From Camping To Dining Out: Here's How Experts Rate The Risks Of 14 Summer Activities".
For 14 different activities, the experts give a low-medium-or high-risk outcome, including details around how to make it more or less safe. For example, they shared that staying at a hotel can actually be a lower risk than getting your hair cut! I've totally adapted to the phrase from this article, "time, space, people, place." Dr. Miller stated, "The more time you spend and the closer in space you are to any infected people, the higher your risk. Interacting with more people raises your risk, and indoor places are riskier than outdoors."
I think the decision around how to spend this summer/come out of quarantine is SUCH a personal one. I also don't think there is a clear right and wrong way of doing things right now (as long as your sticking to the guidelines), which actually makes some decisions even harder. For us, we feel like we are taking the necessary precautions in our day to day life, including how we travel. We are comfortable with our decision to go on vacation, but if your COVID anxiety is going to be soaring the entire time you are away, it's probably not worth the trip. Here is my take on camp, playdates, get-togethers, dinning, travel, and accommodations.
CAMP
We decided not to do camp with the boys this summer, which I'm actually still torn over. The reason I'm torn is that the boys' socialization is at the top of my list in importance right now. The last few months have been so isolating for all of us, and our mental health is a significant priority, including theirs. I'm torn because if schools end of being canceled this fall, I will regret not getting all that socialization during camp into their system. Numbers are looking great in our town, and the camps are outdoors, which were two critical things for me. I just wasn't 100 percent sure about the choice, so we decided to skip camp this year.
playdates + get-togethers
For us, the main concern here is, are the families we are around taking similar precautions as we are. Again mental health is so important, and that means seeing people, both for adult and kid time. A few weeks ago, I tried to have a "social distance" playdate with a friend that was social distancing similarly to how we were, and I immediately realized it's not going to happen with kids. At the toddler age, my mindset is your either comfortable with your kids playing together or maybe it's best to wait. Once I quickly realized this, it was refreshing to see the kids playing with their friends, like the kids they are supposed to be. We only have two families the kids have been around in addition to their cousins. We are starting small, but it has been a major breath of fresh air. We think it's just as important where you play as it is which families you choose to be around. We are trying to keep all playdates outdoors! Adult dates as well. We know it's not only safer to socialize outdoors, but it's also so nice to start taking advantage of this weather before winter hits.
Dinning
One thing Ray and I LOVE is dinning out and supporting local businesses. As the state opens up indoor dinning at restaurants, we will still opt for outdoor seating. We had a date night at Gray Barns on Saturday, and it was glorious. We immediately recognized that we need to prioritize businesses that have tight protocols / are taking COVID seriously. We noticed so many small things, like even having to turn over our water glass to have the waiter fill it up and paperless checkout. We felt completely comfortable dinning out at Gray Barns and are excited to continue to dine out at places we know are cleaning, masking, and following all protocols. As you will see throughout this post, being outdoors vs. indoors with others is important to us.
TRAVEL
Traveling with kids is very different for us than traveling alone. Flying is just something we are not comfortable with, especially with our kids. Ford puts his hands in his mouth, non-stop. Being indoors with others for more than a short period is something we are trying to avoid, which includes flying. Even though airplanes have excellent air filtration systems, we ultimately know we have less control over the situation while flying. There are so many factors you can not control; how full the flight will be, is someone sneezing around us, will we be stuck on the runway etc. We also have nothing too urgent to fly to and knew we could have a great vacation somewhere close by, so we decided to drive/go on a ferry over flying. We are traveling to Martha's Vineyard / Nantucket at the end of June. To get there, we will drive and then either take our car on the ferry or take the ferry (there's an area you can sit where you are still outdoors). We feel comfortable with these ways of transportation. Just to note, there is no right or wrong answer here. No one knows for sure if driving is safer than air travel. Ultimately the reason we are not going with air travel is that we have way less control over the situation. Click, HERE for an article about flying.
ACCOMMODATIONS
I know many of you are going back and forth between rental homes and hotels, and I actually don't think it's that simple. I don't have an answer backed by data, but my gut says it's more important what the overall situation is and what the cleaning protocol between guests is at both places.
Here are some questions you might ask yourself…..
Does your hotel room have a kitchenette? (you can always eat in)
What is the COVID protocol at the hotel?
Do they have cottages with private entrances?
Can you opt-out of daily hotel room services (less chance for exposure)?
Is there a stairwell or room on the first floor so you can skip the elevator?
How crowded does the beach near the hotel get? ( Something important for me was if the hotel has a private beach and we can stay there vs. rental and going to a crowded beach it might be worth it)
How big is the hotel (How long does it take you to get to your room)?
What is the dining situation?
FOR RENTALS, the biggest thing for me would be how well they are cleaning between guests and are they using approved disinfectants. Remember, at both hotel rooms and rentals; you can go in yourself with a mask and alcohol wipes to clean before you bring the in the fam. You can also ask rentals to remove toys, books, or any accessories from the rental before your arrival. If you really want to be as safe as possible, try to request rooms unoccupied for several days.
OUR summer plans
We usually spend almost every weekend out East and then one full week away each summer. Ray grew up at the beach so the Hamptons has been our happy place as a couple and now as a family for the last nine years. Unfortunately because of COVID it’s not possible to spend time at Ray’s family home.
We’e been trying to come up with some weekend trips we could take as a family (stay tuned) Our full week summer vacation is not until August, and that's still up in the air. If you have any recommendations for something in driving distance please share on the instagram post! In two week we are taking a much needed little vacation. We are going away for five nights (Ray for three) at the end of June/beginning of July. I have my own plans Ray doesn’t know about to try and extend when we get there :) For that trip, we are staying in two hotels, both owned by the same brand; both have the same protocols, which I trust. Both villas have kitchens, have outdoor areas, and are under strict cleaning protocols. We have never been to Martha’s Vineyard so I’m really excited. We have a bunch of fun things planned while we are there. In Martha’s Vineyard we are staying at The Winnetu and in Nantucket were staying at The Nantucket Hotel. We rented a house in Nantucket two summers ago while I was pregnant with Ford. It was at the beginning of the first trimester so I slept…a lot.
Other trips we are thinking about is a weekend camping in Maine or a trip to NH possibly on a lake.
This summer is going to look very different but we are exited to be making new memories in new places.
Remember this is super personal for all of us and we are all trying to do our best.
xx
Data is changing by the day. These are the decisions we've made as a family as of 6/16. Tomorrow is a new day.
how to establish emotional connection with your family
written by couples + family therapist Amanda Craig, PhD, LMFT
One of the hardest commodities to come by in life has now been mandated...
TIME
As hard as it is to slow down and change habits, this is our present reality. To support the health and wellness of our communities we must make changes to our "business as usual". One change we can make is the way we spend time with our families. Many who work in the city, travel a lot for work or have long hours are being asked to stay home. Schools are closed, activities are canceled, restaurants are empty. Our daily routine has been turned upside down.
How can you embrace this "opportunity" through emotional connection?
Emotional Connection is essential for optimal health and wellness. Now is a good time to reconnect with our children and partner. When we are in emotionally connected relationships we know the other person will support us, is part of our team, and will have our back in times of trials and tribulations. Emotional connection soothes our nervous system and makes us feel healthier and happier. We feel calm, have more energy, have a more optimistic outlook and are better able to deal with the tough stuff, like the uncertainty we are all experiencing.
For kids emotional connection centers around being understood, spending time together and feeling safe and secure with their parents and caregivers. Kids build a stronger sense of self, are more confident to go out into the world, and are more resilient in times of trial.
If we are depleted and exhausted we cannot be emotionally present for our partner and/or our children. Self-care and self-compassion are essential. Know you matter, you're doing a great job even in your worst hour, and you're not in it alone. It's okay to take time and make sure your own needs are met.
So how can we establish emotional connection?
1. Find time to sit, smile, make eye contact, or give a hug. All these actions show our family members that we care and we are in this together. Our brain actually interprets the experience and feels happier when someone makes eye contact with us, uses a pleasant voice tone, or is near us.
2. Have fun, play, and laugh. We get so caught up in the "have to" we lose sight of the "want to". Take time to do things together that are fun. Things you haven't done in a really long time. Play board games, charades, or cards. Paint or draw. Watch a comedy. Play dress up. Listen to music. Dance a jig, or tell jokes.
3. Set a basic consistent schedule each day. Start with a daily morning check-in that the family can count on and Talk about the expectations for the day. Keep as many school day and workday rituals the same including bedtime for kids.
4. Teach and learn. When kids teach adults something their self worth grows exponentially. They get to be the leader, the knower, and the teacher. Bake and cook together, deep clean your garage, start spring yard clean up, think about spring flower planting, create a woodworking project, write short stories together, code, or play video games together. Ask your kids what they want to do by asking open-ended questions or giving multiple-choice options.
5. Be aware of your emotions. Express them and regulate them. We all have fear and anxiety right now, it’s just a matter of how much we are experiencing. Our kids can feel how nervous we are based on our energy. Instead of being impatient or distant or trying to do business as usual talk to your kids about your feelings. Let them know this is an uncertain situation and although we are nervous your family is safe and will get through this together.
6. Ask your kids how they feel? Help them scale their feelings from 1-10. Naming and scaling our feelings shows our kids that feelings are okay. It also opens the door for our kids to express themselves.
7. Make time for you and your partner to hang. Kids can take all of our time and energy. Parents need time to talk, laugh, hang, and make love. If you are both home carve out some time to be together. If you find you don't want to spend time together talk about why. Where has the joy of being together gone and how do we find it again?
8. Leave some time and space for you. Sit down, delegate, read, write, stretch, or sleep in. Listen for those nudges that are important to you, that always seem to take second fiddle to your family's needs. Take some time. You will feel better and have more to give your family.
Hopefully, we will never see something like this again, where we are asked to socially distance from the people and places where we usually find support, friendship, compassion, generosity, and connection. Use this as an opportunity to reconnect with your family. You will look back and be so thankful you did!
Written by Amanda Craig, PhD, LMFT
info@manhattanMFT.com
couples and family therapy
Telehealth options available
anxiety + COVID-19
anxiety in the face of COVID-19
Emily is part of Team Nipple! She is from Long Island and once sold ad space, taught kindergarten and now spends her days raising her kids Bobby (1 years old), and Mary Clare (2 years old) and then writing about it. She will tell you she is both wildly obsessed with her children and overwhelmed by them every day. She was diagnosed with postpartum depression and anxiety 6 weeks after her daughter’s birth. “It brought me strength and passion I didn’t know I had.” - Emily
Emily will take it from here —
The evolving COVID-19 situation is causing worry and anxiety for even the most laidback person. For someone like me, who is managing generalized anxiety, the current global pandemic is a very real trigger.
The biggest challenge is not knowing how it will all play out. There is no way to know what will happen and that feels scary. Accepting that no good comes from worrying about the unknown is the first step to coping with anxiety. If you’re scared or worried and feeling anxious I’ve included several different techniques you can try right now!
5 Techniques to try right now for Coping with COVID-19 Anxiety:
Shifting “What if” to “What is” - A mindfulness technique that has really been helping me create less suffering for myself is remembering the distinction between “what if” and “what is”. We cannot control or predict the “what if’s”, but they create the worry, anxiety and suffering. Try to bring yourself back to the “what is’s”. What is happening right now-I am safe and my family is in no immediate danger. Watch Cory Muscara’s short video explaining the “what if and what is” technique.
Cold Water Immersion - This is just what it sounds like. When you feel anxious, immerse your body in cold water. When anxiety strikes, it is typically not possible to fully submerge your body so do the next best thing. I splash the coldest water possible on my face and run my wrists under the coldest water. It creates a very similar effect. I am willing to try just about anything for reducing anxiety but when my therapist recommended this it was met with a heavy dose of skepticism. I thought, “really? Cold water on my face is going to make my anxiety go away?” But I figured, “what’s the harm in trying?” A shock of cold water increases the release of norepinephrine (the hormone that calms you down) to the bloodstream which has a positive influence on mood, attention and focus. Don’t knock it till you try it.
Put Down Your Phone - This not a formal mindfulness exercise, it is more just really good advice. The limitless amount of information we have at our fingertips via our smartphones undoubtedly causes us anxiety and suffering, particularly during the current situation. Take a moment to consciously put your phone away, in another room, maybe even turn it off. Then try one of the coping techniques above or just take a get outside and look up at the sky.
5-4-3-2-1 Grounding Technique - This technique forces you into the moment! You use your 5 senses to come back to the present moment. There is no wrong way to do this and I think you will find it forces you back into the moment very quickly.
5 – SEE – name five things you see
4 – FEEL – identify four things you can touch around you
3 – HEAR – acknowledge three things you can hear
2 – SMELL – find two things you can smell
1 – TASTE – identify one thing you can taste
5. Take 5 Breathing - Stretch your left hand out, palm up, fingers spread. Take your right pointer finger and point it at the base of your palm, this is the starting point. Begin to trace each finger from the starting point and back down again. When tracing up, deeply breath in through your nose, when tracing back down, breath out through your mouth. Repeat on all 5 fingers. The breathing slows the heart rate, the tracing provides sensory input to your brain. The technique gives you something to focus on rather than your current worry. Great for kids and adults alike!
I have learned so much about mindfulness and coping with my anxiety from Cory Muscara. Cory is the founder of the Long Island Center for Mindfulness. He serves as faculty at Columbia Teachers College and the University of Pennsylvania, where he teaches mindfulness and positive psychology, and in 2012 spent six months in silence living as a monk in Asia. He regularly appears on the Dr. Oz show as a guest expert in the topic of mindfulness. He offers a wealth of information on his YouTube channel, check him out! https://www.youtube.com/channel/UCUPP3b6x2a1FcUMTrsdAR2g/featured
Come say hi! You con fine me over at @Emilykasel
Emily
dual income families working from home with kids
Working parents home with their kids
Caroline Birman is full-time working mother of two young children: Annabelle (3) and Finn (8 months). She and her husband Todd have ample experience balancing their demanding careers with unforeseen gaps in childcare, mainly due to the ever-germy Chicago winters.
We have a 3.5 year old and an 8 month old and do 3 days of daycare and 2 days at my mom’s house each week. January was a rough month for us health-wise (stomach bug for both kids, two rounds of colds, a random fever, and Influenza B for my mom) and we perpetually had at least one kid home with us for the first 5 weeks of 2020. My husband and I have the ability to work from home and used this sick stretch to get a great system down while making sure the kids are getting the attention they need.
1. The minute we have an inkling that one or both kids will be home we start preparing our work schedules. We pull up our Outlook calendars, color code the calls that cannot be rescheduled in red, and cross check to see if there is any overlap. If there is overlap we decide together which call is more important to keep. We try to be as objective as possible but sometimes we have to play Rock Paper Scissors for it :)
2. Once we have the “red” calls identified, we block out the day in shifts. We try to do an “hour on, hour off” schedule. For example, I’ll take the 9-10 kid shift while my husband takes the 9-10 work shift and then we switch. We both work during naptime but have an “on call” shift instead of the “kids” shift, meaning if one of the kids wakes up we know who is on duty. The parent on the kid shift or on call shift acts as it the parent on the work shift is 100% unavailable unless there is a medical emergency.
3. We move the flexible calls and tasks to our assigned work shifts and mark our kid shifts as “busy” in Outlook so people don’t try to put things on our calendars.
4. If there are any tedious administrative tasks that don’t require human interaction (example: expense reports) we either do them during the kids’ TV time or at night after they go to bed.
Also worth noting: If we have a little time to prepare, one of us runs errands (groceries, supplies, etc.) and the other preps the house (prints coloring pages, rotates toys, catches up on laundry).
Hope this helps!
Caroline (@carolinebirman)
The Motherhood Journey of finding the right Au Pair
TO AU PAIR OR NOT TO AU PAIR…THAT IS THE QUESTION
Every family is unique in its needs. When it comes to childcare for parents who
work outside the home, the options can seem endless and cause some analysis
paralysis. Nannies, daycare, part-time babysitter, family help, or au pair – these
are just a handful of options available to parents. Here’s how one mom, Cooper
McManus, chose to bring an au pair into her home, and the experience she’s had
since. Cooper sheds some light on what can often seem to be a very confusing
setup, and offers some perspective for other parents deciding on childcare!
Cooper McManus is a Connecticut mom who lives with her three little girls and husband. Cooper runs one of my favorite brands, Hat Attack, and she is the head of all design and product development. Like many of us, she found herself rethinking her current childcare situation, and ended up transitioning from daycare to using an Au Pair. You can find her journey below.
We decided to transition to an au pair when we had two children in full-time daycare and the cost was out of control. My husband asked me to look into other options and after some research, the au pair route seemed like the most practical solution for our family—flexible hours and a standard rate (no additional cost for additional children). Our house is a great setup for an au pair (lower level with access to the guest room through garage, separate living space, and bathroom), so we decided to give it a shot. We were nervous about having someone live in our house but figured it was worth a try! Worst case, we would go back to the daycare situation. The selection process was pretty simple, Skype interviews, emails, etc. and we selected a 26-year-old from Columbia. There are many schools of thought around the age of an au pair (I have friends who prefer younger au pairs) but we really wanted someone mature and independent, so we put a minimum age of 23 on our search.
The first month was definitely a transition period. This likely varies depending on the country the au pair comes from, but ours had no experience with “American” things such as using a washer and dryer. It was a lot of training, explaining (and re-explaining) how to do things, around the house and otherwise. We definitely had a language barrier as well but our au pair was very open and willing to learn. From day one we totally trusted her with our girls. She met great friends/nannies/other au pairs and kept the kids busy every single day. We were SO happy to no longer have to pack up every morning and get the kids out the door (dressed, packed lunches/millions of snacks) before work for daycare. We simply woke up and left for work, kids still in PJs and playing. The end of the day was also AMAZING. The kids used to be exhausted, sitting on 95 in traffic, eating leftover snacks at 5:30 pm because they were starving for dinner. Now, when I arrived home at 5:15 pm every day, they were fed, bathed, and ready to relax for the evening. Changing to an au pair was a serious life-changer for us. This au pair stayed with us for two years until her time with the program ended. This is the worst part, that they have to leave; but at the same time, change is good. There were certain things I wanted to change in the way our au pair worked, so we were excited about getting a new au pair.
It was not as easy selecting the second au pair. I felt a lot more pressure to pick someone “perfect” because we had such a good experience the first time. We decided to focus on Columbian au pairs again, because our youngest (now we have three girls) did start to pick up on some Spanish and I planned on asking the new au pair to speak to the girls in Spanish a lot more this time around. I found a great girl, 25 years old who was very sweet and checked off all the boxes for us. When she arrived and went on her first “test drive” with my husband, it was clear that the driving skills she promised to have were not accurate. It was scary. My husband came home from that drive and was in shock. We decided she was possibly nervous and unclear of the roads in the US, so we gave it a few more tries but she showed the same lack of skill each time. After about 10 days of living with us, and five lessons with a driving school, she backed into a gate at a friend’s house and that was when we decided we needed to let her go and enter the “rematch” process. She was able to rematch quickly with a family who lived close to a town that didn’t need driving.
Rematch was pretty much the worst experience of my life. We have never been more stressed in a situation than we were during this process. How it works is you are given a pool of au pairs who are also in “rematch” for various reasons (not connecting with families, families changed their mind about needing au pairs, families who move and no longer have room for them, etc.). Many of them are in rematch because they can’t drive! It was awful. Every day I would refresh the page of available au pairs like a maniac to see if anyone else popped up to interview. We were desperate, lowered our standards completely, willing to accept ANYONE who would come help us! I was borrowing other people’s nannies, leaving work constantly to get home to be with the kids, spending my ENTIRE workday searching for au pairs. Our only other option was to select an au pair who was out of the country, which meant a minimum wait time of six weeks before they could complete the steps to come to the US. Aside from six weeks being too long to be without childcare, we also didn’t want to risk another out-of-country au pair who potentially couldn’t drive. We loved a lot of the girls we interviewed, but every single au pair we interviewed did not select us (you have to mutually agree to “match”). Because we had an “infant” who was 19 months old at the time, we were required to select from only infant-qualified au pairs (CT state law). The infant-qualified au pairs do NOT have to select a family with infants. The girls in rematch seem to know the system (as they have been in the country for a bit of time) and the girls we interviewed were selecting families where they had “breaks” in the day, or the kids who were old enough to be in school and they just had morning/afternoon hours. It felt like nobody wanted a family with three kids five years old and under.
I will be 100% honest in saying that we chose our current au pair in rematch because she was literally our only option. We were left with no choice. It had been weeks without childcare, I could barely get any work done (I have a much more flexible work situation than my husband, who could never be doing all of this research while at the office), and we needed someone immediately. We matched with a 25-year-old from Brazil, who had been in an awful family situation—verbally abused and had already left the house to stay with the au pair counselor because her living situation was so bad. The counselor took her out driving and promised us she was a great, confident driver, so we decided to give her a try. Our transition was SO easy. Having someone who had been living in the country for a few months already was completely different than having someone arrive off an airplane to the US for the first time. She knew exactly what to do, the right questions to ask, and got the hang of the girl’s schedules very quickly. My girls love her, she’s made great friends, which means fun playdates and adventures with the kids.
We hope that our current au pair wants to do a second year with us so that we can avoid starting over. But regardless, we will get an au pair again. While the rematch experience was honestly terrible, we are willing to take the risk because the rest of the program works for us. I think next time around we will try to get an au pair who is in the country already, looking for placement for year two, or in rematch—because I learned how much different it is! We’ll also be out of the “infant” pool and hopefully, have more options to select from.
The question I get the most about having an au pair is about the living situation. We never thought we’d be the people to have a live-in babysitter. I think as a host family, the situations vary and it all depends on how you set it up. I have friends who include their au pairs in all family activities, dinners, etc. They spend off-hours together and consider them friends. When we are interviewing for au pairs, we make it clear that we are not one of those families. We love our au pairs! The girls DO consider them a part of our family (school stories, pictures, etc. always include the au pair’s names in the list of who lives with you), but as full-time working parents, we explain to our au pairs that our time off is our family time, and that we also want them to have their own lives. They are with the girls 45 hours a week and from our experience, they appreciate their time off. People are usually shocked to hear this but when our au pair isn’t working, we NEVER see her. At the end of the day she typically goes out with friends to eat or meet up for coffee or she spends time in her room talking/video chatting with friends and family at home. On weekends she volunteers, goes to church, explores NYC, and even takes weekend trips to travel the east coast.
Here are a few tips to help you during your process:
1) Do your research and read ALL of the documents in the application. You'd be surprised what you may find!
2) Be upfront with your expectations and house rules
3) Communication is key
4) Utilize the community counselors, they are supportive and experts in how to manage every situation
5) Go with your gut! If something ever feels wrong or off, you are probably right!
Tips to help with coping, and reducing trauma in infants and toddlers during medical procedures
I’m a Certified Child Life Specialist, which I’m sure many of you have never heard of, so let me tell you a little bit more about what I do every day. Child Life Specialists are educated and clinically trained in the developmental impact of illness within the hospital and outside in the community. Our role is to help improve patient and family care, satisfaction, and overall experience to aid in coping, and reducing trauma. We help infants to adolescents cope with the uncertainty of illness, and provide information in a developmentally appropriate way, so the child has an appropriate understanding. We provide opportunities for therapeutic play, preparation for procedures and education. It is through these avenues that we help aid in reducing fear, anxiety, and pain.
While our job is beyond fun, it is also much more than that. I am not only the play lady, but I am also the educator, the advocate, the developmental expert. Some call me the keeper of bubbles, light spinners, and all things to help children cope! I thought it would be helpful to have some tips and tricks on supporting children through doctors’ appointments and making it easier for all the moms/caregivers out there having to support their child, I know it’s not easy watching your child have to get poked, so hopefully this will make it easier on you and your child!
Infants:
Allow the infant to become familiar with medical materials, even doctor play kits prior to going to the doctor. Familiarization can make the medical materials less threatening.
Bring their transitional object i.e. pacifier or blanket to make them feel supported
Advocate for position for comfort! Allowing your child to feel comforted during a poke (lab draw or shot) can help with reducing trauma. See position for comfort poster – back to chest or chest to chest.
Keep the environment as low stim as possible and use a calm soothing voice
Try to keep as normal a routine that day as possible even if going to the doctor
If your baby benefits and is comforted by singing, then sing to your child during the lab draw or poke
Buzzy bee – you can buy it on Amazon. It may be overstimulating for some infants. The premise is that it tricks your brain into thinking about the vibrations versus the poke. Videos on the website
Toddlers:
Be honest and prepare your child! Let them know they are going to the doctor. Use simple concreate language to explain what is happening. For instance an injection. Ex. They are going to give you a poke to help give your body medicine that it needs to stay strong, help you stay healthy, etc. Also just like infants, any familiarization with medical supplies aids in making it less threatening.
Be sensitive to the language you are using:
Instead of saying “it will hurt” or “it won’t hurt” say “it may feel uncomfortable” or explain what it feels like.
Give concrete cues to when it will be done
Instead of saying “don’t move during the poke”, give the toddler a role, “your job is to stay really still like a statue” or “you are doing such a good jobs staying still”
Coping tips:
Crying is ok, it’s a way of coping
Some kids like to be distracted
Some kids like to focus on the procedure and watch to help them cope
Follow their lead. Don’t say Don’t – phrase instructions positively
Position for comfort!
Give choices when possible
Just like infants, try to keep a routine as much that day as possible
Buzzy bee
Don’t make it a reward unless it is something sustainable, like a sticker chart. Kids will have to get pokes and injections the rest of their life for multiple reasons, so we don’t want to make it a reward if it’s something that they need.
Bring transitional item for comfort
Coping kit items to bring for your child if they benefit from distraction:
Light spinner
Bubbles – distracting as well as promoting relaxation
I-Spy Book
iPad (a game they can play with one hand or a movie)
A pinwheel they can blow. Helps with breathing and aids in relaxing their body without their knowledge
Feel free to reach out to kelly.stewart710@gmail.com for any other questions!
More on Buzzy Bee: https://buzzyhelps.com/
BRUSH, BRUSH, BRUSH
KIDS & TEETH
After high school I had zero clue of what I wanted to do in life. I mean I wanted to get married and have babies, but in order for that I needed to find my future spouse and I hadn’t yet. I was a typical teenager working a minimum wage job, somewhat attending classes at community college, and trying to figure out my next step. Then, one day I decided to just get out of my comfort bubble and go to career college to be a registered dental assistant! I was so proud of myself for making it through school, graduating with honors, passing all three tests-one being hands on and terrifying for me, and then finding a job as a pediatric assistant!
I had no idea what was all involved in the pediatric field, but I learned quickly and even became the back office supervisor and lead assistant. Pediatric dentistry involves infants and children, children with special needs, and adults with special needs. I saw everything from a hospital setting for special needs, toddlers being put under general anesthesia for full mouth dental work, and parents that just did not care. It became too emotional for me and I needed to do something else in life. It was such a good learning step in life for me though.
In my almost 4 years working in the field I learned so much about dentistry. I have tried my best to take what I learned and put it to use with my own sons. I haven’t found a local pediatric dentist yet, but that’s next on my list. I wanted to share tips with other mamas because without working in the field I wouldn’t know any of this either. Diet and hygiene are huge in taking care of teeth!
Finding a dentist:
Find a pediatric dentist through the American dental association, not just a dentist that says they see kids too. A play area does not mean they are trained in pediatric dentistry.
Never leave your child. I’ve heard stories of children being strapped down, luckily I worked in an office that didn’t believe in this.
Hygiene:
Brushing– 2 times a day, if you want to battle just once, pick night to remove everything from the day! Start when they get their first tooth, you can use a cloth to wipe teeth, a finger toothbrush, or a soft toothbrush.
What to use: ” For children younger than 3 years, parents and caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice.” ADA
For children 3 to 6 years of age, parents and caregivers should dispense no more than a pea-sized amount of fluoride toothpaste.
Teeth should be brushed thoroughly twice a day (morning and night) or as directed by a dentist or physician. Children’s brushing should be supervised to ensure that they use the appropriate amount of toothpaste.
How to brush: toddlers are hard! I battle my 17 month old every night! Make it as fun as possible! Stand behind them and brush that way. Make sure to brush in circle type motion, not just back and forth. The top teeth are more sensitive! Eventually they will get use to it if you do it daily!
Flossing– only worry about this if their teeth touch. If they have gaps, no need yet!
What to use: any floss, the pickers will be the easiest!
Diet: Diet plays a HUGE role in cavities!
What causes the most cavities:
Apple juice should never be given! It has SO much sugar, and it’s what caused a lot of problems. I saw it daily.
Never give anything Gummie- even vitamins!
Soda as we all know has a lot of sugar-the lighter in color the more sugar!
Of course, on occasional anything is okay. These should never be consumed daily.
A few good snack ideas:
String cheese
Fruit
Yogurt- although check the sugar, Greek yogurt is most likely the best option.
Peanut butter- natural
Water or milk to drink only, and make sure brush after final milk at night.
“It’s genetic, our family just has bad teeth!”
I heard this SO much. Sure, your family may have bad teeth, but it’s not genetic. Children do however get their mothers bacteria, meaning without good hygiene or diet, their chance is higher from cavities. Once again mom is to blame, not dad. Orthodontic wise is a totally different story!
I am in no way an expert, but this is what I learned from working in the pediatric dental field. Hope these tips can help more mamas out there! Tickle those sugar monsters away, their health depends on you.
Check out The Brushies Finger Puppet Brush and Book ! So fun for kids!
PARENTING WITH ANXIETY: COMING ALONG FOR THE RIDE
PARENTING WITH ANXIETY BY CAROLYN STACK MATERNAL WELLNESS RN
I am so excited to share this piece today for so many reasons.
It will 100 percent help every mom dealing with anxiety that will read this
It will help those be better support systems to those who are living with anxiety
It’s written by my sisters best friend who is basically my older sister because being four years younger than your sister makes all her BFFS your sisters as well. Carolyn seriously makes every person around her laugh and smile. She has a larger than life personality that makes you just simply want to be near her at all times. When you read Carolyn’s story below you will find that she lives with anxiety but it does not define her. She has dedicated her life to help those around her.
Carolyn is a Maternal Wellness Nurse at The Center for Perinatal Mood and Anxiety Disorders at Monmouth Medical Center in Long Branch, NJ. One of only 10 comprehensive programs in the entire country for PMADS. She is a two time survivor of Postpartum Anxiety, Intrusive Thoughts and Birth Trauma. She is a maternal mental health advocate and a peer group facilitator for The Bloom Foundation for Maternal Wellness. She lives at the Jersey Shore with her 2 little boys and amazing unicorn of a husband who helped her out of the dark.
Parenting with Anxiety: Coming Along for the Ride.
You know that meme about anxiety that goes something like, “Hold on. I’ve gotta overthink about it.” ? That’s pretty much me. The majority of the time. In some form, anxiety has always accompanied me on my journeys. Sometimes in the back seat quietly peaking its head up over my shoulder every once in while, and other times, like when I suffered from severe postpartum anxiety and intrusive thoughts, it has been the pilot of this ship. For the most part, I had a pretty good handle on my anxiety in my early 30’s. Life was moving along nicely. That was until I had kids. There’s nothing like babies and kids and pregnancy and childbirth and PARENTHOOD to wake up that backseat driver and push you right out of the front seat. But if you have anxiety as a parent it doesn't mean you have to always be teetering on the edge - holding on for dear life from that shriveled up fossilized french fry you've found lodge into the carseat. Postpartum goddess and guru, Karen Kleinman, author of Dropping the Baby and Other Scary Thoughts, says it best: “Recognizing and understanding your anxiety might mean the difference between unnecessary suffering and healthy coping.”
So what does parenting with anxiety mean for me? It means a lot of self care. And I don't mean in the form of manicures and massages and GNO’s (although don't get me wrong - these are important much needed time outs that can FEED your soul). I’m talking about the type of self care that involves doing the hard work, the heavy lifting. For me it means still going to therapy every other Monday to make myself accountable for my anxiety and to figure out what I can do to make it better. It means that I do a lot of checking in, grounding and mindfulness when I feel my brain going to that place. Stoping. Taking a deep breath. Fact checking what my brain is telling me vs what is really going on. ANXIETY IS A LIAR, and when we take the power away from our thoughts, they become that, just thoughts.
If I feel my heart starting to race or a tightness in my chest, it means pressing pause on whatever I'm doing and (if possible) splashing some water on my face, sticking my head in the freezer ( silly sounding but totally effective), or using some yummy smelling hand cream to get in touch with my five senses and to ground myself back to the present.
Sometimes doing my best also means taking medication. There is SO MUCH stigma around medication - everyone, everywhere wants to be the one who “doesn’t need it” - myself included for a long time. I would advocate for everyone else, but when it was my turn to take that little white pill I’d come up with every excuse in the book. My favorite analogy for taking medication for anxiety goes something like this: “I wear glasses. Can I manage without glasses? Well, yes, probably. I could squint a lot, constantly move up close to anything I want to see…I could just accept that I’ll never be able to see eagles flying in the sky or whales jumping out of the ocean.But why? Why try so hard to manage life when I could just put on a pair of glasses? No one would ever suggest a near-sighted person should just work harder. No one would say ‘Maybe that’s just your normal’ to someone that needs glasses. They would say ‘Let’s go to the eye doctor and get you a prescription so you’re able to see again.’ So, I’m here to tell you its ok. Its ok to take medication. Its one tool in your toolbox. It doesn't make you weak. It makes you strong, mama.
Sleep. I know that sleep is huge for me, so making sure that I get at least seven hours a night is a must. No screen time right before bed (easier said than done) so my mind can relax. I found checking Insta or FB right before I went to bed made my mind race with all sorts of thoughts. Find a little nighttime ritual that sets your body up for a deep sleep. We play ambient sounds thru Alexa and use some lavender spray on the sheets before bed. You could always put on your essential oils diffuser or do a quick mindful meditation thru one of many free apps available. I LOVE Insight Timer and Calm!
Lets go back to social media for a second, I know that this can be a huge trigger for me and a lot of other parents. Social media can be amazing and give us a support system and help us connect with other parents - just like in this platform. I find personally and professionally, that social media can also be fuel for the fire. I refuse to read sad or upsetting stories about babies and children. It doesn't make you a bad person to not read it - you must protect yourself - JUST KEEP ON SCROLLING! It’s like a social media version of ear muffs.
Exercise and clean eating is also a must to keep my anxiety at bay. It’s no secret that exercise helps improve our mood thru the release of endorphins. This was a major hurdle for me, but something that I had to commit to because I knew how important it was to my over all mental health. Doing some moderate to light exercise 3 x week makes me feel more level headed and clear. It makes me feel like a good mom! I’m not talking about anything crazy (but if that’s your thing by all means go for it). For me, it is 20 mins on the bike or a 30 min jog in the park. Just pushing your stroller around the block or getting out in the fresh air and running around with your kids at the park can be invigorating. And it’s a win/win for everyone involved.
Here’s another tough one: learning how to say NO and then doing it! If you’re anything like me you're a people pleaser and you want to do all of the things, all of the time. There would be some weekends we’d look at the calendar and see that we had committed ourselves to too many things, and that would send me into a complete tailspin and my anxiety would go into overdrive. I had to learn to under schedule. CRINGE. To say no to that second birthday party in 1 day or that playdate when your kid had a crappy night sleep, or your husband’s brother’s girlfriend’s BBQ that interferes with bedtime. Its OK to say NO!
And the big finale - the concept of radical acceptance. For years, I fought the fact that I was an anxious person. If someone mentioned that I was anxious, I’d almost physically wince. I’d get defensive and angry. When I was struggling with severe Postpartum Anxiety after my first was born, it took me OVER A YEAR to accept help. When I finally completely and totally accepted that anxiety was a part of my life and probably always would be— I stopped letting it define me. I was no longer an “anxious parent”. I was a parent who had anxiety - along with a long list of other wonderful traits.
So what am I saying? - I’m saying OWN IT. Talk about it - speak its name. Call yourself out. Tell your family and friends whats going on - they can’t begin to understand if they are left in the dark. I also started finding the humor in it. “Anxious mom, over here!” I’d say if the after school playground banter turned to something that would start to make my heart race. And you know what? I realized when I let my guard down - that I wasn't alone. That there are plenty of other parents out there having the same struggles, and we are all just doing our best and TRYING to do our best for our kids. At the end of the day, healthy moms equal healthy families and we owe it to ourselves and our children to be present and available.
Carolyn is a Maternal Wellness Nurse at The Center for Perinatal Mood and Anxiety Disorders at Monmouth Medical Center in Long Branch, NJ. One of only 10 comprehensive programs in the entire country for PMADS. She is a two time survivor of Postpartum Anxiety, Intrusive Thoughts and Birth Trauma. She is a maternal mental health advocate and a peer group facilitator for The Bloom Foundation for Maternal Wellness. She lives at the Jersey Shore with her 2 little boys and amazing unicorn of a husband who helped her out of the dark.
MARRIAGE + BABIES
After our engagement, my good friend sent Ray a list of questions she asked Ray to answer so she could share them at my bachelorette. They were pretty simple questions. She read the question out loud and I had to guess what his answer were. Hearing his answers was one of the most special moments of my wedding season. Reading them this afternoon brought a smile to my face, that time in my life feels like decades ago. It seemed to be just what I needed.
I want to start out by saying, if you are struggling in your marriage you are not alone. Many women can relate and have been there. I can confidently say both new moms and seasoned moms have as well. Sometimes it can feel like you are all alone, you might often wonder if the distance you feel between yourself and someone you once called your best friend is normal, or if you have bigger issues to tackle.
If you are feeling like you don't know how you can get through this week or month or year.....I'm here to tell you that you can. Having babies is a wonderful thing but it can also flip your world upside down. We deal with crazy hormonal changes, grow an actual human, birth that human and then pretty much don't sleep for ten or so years. It's normal in my opinion to go through some serious growing pains in the relationship department. Don't be too hard on yourself and take one day at a time, it's NEVER to EARLY to reach out for help.
I'm no expert but I spoke with one and here are some tips she wanted me to share:
-Plan a date night with just the two of you once a month and leave your phones at home. If there are triggers that create conflict in your relationship agree not to talk about them during date night.
-Double date. Sometimes being around others will make you realize, "Hey, my spouse is fun :)” and you will naturally avoid most triggers mentioned above. Go out with other couples!
-Put the kids down and have a meal together once a week while sitting across from one another, no phones or television. Eye contact is key so make sure you are sitting across from one another, not next to each other.
-Focus on physical touch....holding hands, cuddling, kissing, sex (I know your exhausted but physical connection is so important)
-Plan an activity together once a quarter or twice a year without the kids that will incorporate some sort of team building. Cooking class, workout class, hike, wine tasting. Think 'something fun' where you will work together.
-If you can get away for a weekend or longer once a year without the kids, do it.
-If you have older memories of when you were in a better place, revisit them…what did you love about your spouse at that time?
I will be having a mom and a professional both share in-depth articles in the near future that will really get into marital issues after kids. For now, I wanted to give you some takeaways and let you know you are not alone.
I also want to share the question + answer game I briefly discussed above. I encourage you to try and get your husbands to play along. Send them the questions below. Have them answer them but don't have them show you. Then when you are together at date night have them ask you the questions and try and guess what they typed out. I know it sounds super corny but I promise it will get you laughing + connecting. If that’s something you haven't done in a while it could be a nice activity. Remind your husband that this is important to you. It might take some negotiating :)
Below you can find the list of questions to share with your spouse and here are Ray's answers ….from 2014:
What date did you meet Liz? March 17th, 2011
Where did Liz and you go on your first date? Well technically we went to Morimoto, but you can’t really count that, back then she wouldn’t go out with me alone for about two months (group dates only), so our first "real" date was at Locanda Verde, the same place we went after we got engaged
Where was your first kiss? On the lips. Just kidding. It was at Morimoto, about 30 minutes before we got kicked out
Describe your first impression of Liz in one word. Stunning (it’s Liz chiming in real quick…. I remembered this and I answered funny and then I also answered funny for the next one. Then I soon realized Ray doesn’t actually think I’m funny) lol
What's your favorite quality of Liz's personality? (ie - funny, trustworthy, kind, hardworking...) if I had to choose just one, I would say her loyalty/trustworthiness
What's your favorite body part of Liz? I’ll keep this PG and say her eyes...but I really love her butt. Don't say this in front of my 100-year-old grandmother, please.
What thing does Liz do that annoys you the most? when she doesn’t clean up after herself/leaves dirty pans on the stove
If you could get rid of one item of Liz's clothing what would it be? Sports bras. All of them.
What item of clothing would Liz throw away for you? That already happened. Nothing was left behind and she dresses me now. But prob her ex-boyfriend's t-shirt that I am actually wearing as I type this
What's Liz's most embarrassing moment? (if you can think of it) When she accidentally walked out of her apartment naked and locked herself out. I'd like to note that this was before she met me
Who is the one celebrity you would be worried Liz would leave you for? Prob Ronaldo Christiano, the soccer player
How many kids will you and Liz have? I say two, she says at LEAST 4. We will prob meet in the middle.
If you and Liz had a perfect day in NYC, what one place would you have had to visit? I actually think this is your hardest question and I am going to give you a very indirect answer. Before I met Liz, I was a lazy person not really living my life. I would get generally drunk on weekend nights and sit in my apartment all day watching TV. She taught me how to embrace this city and explore every corner of it. My favorite times with Liz are when we start out going for a walk and end up discovering the city for the next 6 hours, and I love that we have taken that zest for life and exploring to so many other parts of the world together. So there really isn’t one place, but I credit her with not only changing the way I appreciate this city but the way that I live my life. She will prob say Five Points for brunch...
If you could live anywhere in the world with Liz where would it be? California. Cheesy answer, but we both want to do it
What moment did you know Liz was your main squeeze for life? After our relationship continued to persevere through a lot of challenges early on (you guys remember Liz when she was a single 25-year-old right? juuussttt kidding), I knew it was for a reason, and we continued to grow closer. I’m not sure when it exactly happened for me, but the deciding factor was that I simply never wanted to do anything without her, and it was the first time in my life that I have ever felt this way. Whether it was happy hour, watching a movie, or going to watch football with friends at a bar, I always wanted her by my side no matter what, and I had NEVER been like that before, that is how I knew. My life is simply better when she is alongside me.
Reading that brought me back to the us before kids. I wonder how it would sound now :) You can find the questions below to send to your significant other xx Keep a lookout for the in-depth relationship post from both a mom & an expert coming soon.
QUESTIONS TO SEND TO SIGNIFICANT OTHER
What date did you meet?
Where did you go on your first date with your wife?
Where was your first kiss?
Describe your first impression of your wife in one word
What's your favorite quality of your wife’s personality?
What's your favorite body part of your wife?
What thing does your wife do that annoys you the most?
if you could get rid of one item of your wife’s clothing what would it be?
What item of clothing would she throw away of yours?
What's your wife’s most embarrassing moment? (if you can think of it)
Who is the one celebrity you would be worried your wife would leave you for?
How many kids will you and your wife have?
If you and your wife had a perfect day, what one place would you have had visited?
If you could live anywhere in the world where would it be?
What moment did you know your wife was your main squeeze for life?
BABIES & RELATIONSHIPS
MAMA FRIENDLY ANTI-AGING TREATMENTS & NO SHAME IN THE BOTOX GAME
MY THOUGHTS ON BEAUTY & SOME ANTI-AGING TREATMENTS WITH MODERN DERMATOLOGY
SKIN JOURNEY
If you just started following along on my skin journey I ended up in Dr. Robinson’s office when I noticed an extreme jump in aging. It was for obvious reasons. Two under two, babies will do it to you. I was taking care of everyone in my life except myself and it was starting to show. I always told myself to be proactive with skincare but at this point I felt like if I didn’t act soon the proactive thing was going to be a lost cause. My issues were wrinkles (deep ones between my eyes a.k.a. the 11 lines), texture, redness, and uneven skin tone. Dr. Robinson put together a series of treatments to try and combat my concerns. Aging can mean different things to different people. For me my main concern was the lack of a natural glow. I miss that youthful glow I had back in the day and honestly if I had to pick the thing that is the most important to me it’s not the wrinkles, it’s that glow. Though, yes, the 11 lines do drive me crazy as well. I just want smooth glowing skin. Is that too much for a mama to ask for!? I think not.
I decided to do three treatments to help battle my issues. Picosure treatments, Vampire facials and a small amount of botox on my forehead.
PICOSURE
Dr. Robinson’s summary of the Picosure treatment: “This laser treatment is highly customizable to each patient's skin and goals. It's a great option for patients who don't want downtime but are looking to improve their skin and reduce signs of aging. The laser uses highly targeted energy delivered in a trillionth of a second to break up areas of pigment (freckles, sunspots) while causing minimal injury to the skin, which triggers the body's natural response to produce new collagen. It is a great treatment for fine lines, wrinkles, acne scars, and can also be used for tattoo removal.”
Mrs. Nipples summary: This is a great treatment not only for the many benefits but it’s a very quick treatment for those busy moms that need to be in and out. I was just a little pink post procedure so there’s virtually no downtime. I do recommend making sure you use numbing cream before each treatment so I head in about 30 minutes before my session. After I’m nice and numb it’s then a quick 15 minute session followed by 5-10 minutes with an ice pack. I haven’t finished my package of treatments but I will be sharing the results when I do. Bonus: It’s breastfeeding friendly!
VAMPIRE FACIAL
Dr. Robinson’s summary of the Vampire facial: “The Vampire Facial refers to the process of micro needling the face (creating small holes in the skin) and then applying a patent PRP (platelet-rich-plasma) overtop to sink in. To create the PRP, we draw the patient's blood, spin it down in a centrifuge to isolate the platelets. This treatment is most effective when done in a series and is great for overall skin rejuvenation, treatment of texture, and fine lines.”
Mrs. Nipples summary: I’m loving the immediate results I see with my vampire facial also known as the PRP facial. I also think it’s a super interesting treatment. The doctor draws blood for the facial, hence the name. They then spin the blood to separate the platelets and plasma from the red blood cells. The liquid that is then applied to your face is the platelet-rich plasma. The dated way of performing the facial is to put the blood on the patients face as well. New studies show the benefits lay in the platelet-rich plasma and that is why it is now separated. The platelet-rich plasma is applied onto your face during microneedling so it can penetrate your skin. I did not find this treatment painful at all. The microneedling basically permeates the skin with platelet-rich plasma (PRP) and in turn it stimulates collagen and elastin fibers to promote cell turnover. This is also a great treatment for moms as it is packed with benefits with no downtime and is all done during a short office visit. I’m still mid package with this one but I already can highly recommend it. Bonus: It’s breastfeeding friendly!
BOTOX
Dr. Robinson’s summary of Botox: “Botox is a neuromodulator (Dysport and Xeomin are other options in this same category). Botox can be used for lines, wrinkles and facial sculpting. It can be used preventatively in light doses to prevent deep wrinkles from developing. It can be used for people who have already developed wrinkles to smooth the area and prevent them from worsening. The treatment works by blocking nerve impulses to the muscles that create these movements, causing them to relax which will soften your expressions and reduce your wrinkles. They can also work to soften and sculpt the face and neck by decreasing unwanted muscle mass. It can also be used for medical conditions like Migraines and Excessive Sweating.”
Dr. Robinson’s summary around the safety of Botox: “Botox is safe when injected by a qualified and experienced board certified dermatologist. Botox is a drug made from a neurotoxin produced by the bacterium Clostridium botulinum called botulinum toxin. What we inject is a highly diluted version of this toxin, it stays where it is injected, but even if it entered your bloodstream, the cosmetic doses (typically less than 100 units) used are significantly lower than the toxic dose that would be harmful systemically (2,500-3,000 units).”
Mrs. Nipple’s summary: I know there are many of us that might hide their love for botox. I don’t really see the big deal. I feel by women not being honest and open with other women about the work they have done can set unrealistic expectation for other women. There should be no shame in the botox game.
Though yes I used to be one of the women that was like whaaattttttttt???? Never!
I had two treatments of botox before Charlie was conceived, both used as preventative measures. The first time I had a small amount injected into my forehead and loved it. No one noticed, not even my own mother. I think the secret is putting just enough for preventative measures but not too much that it looks like you had work done. I went in 6 months later and had a little more injected along with a small injection around my eyes. I honestly did not like the results when I had it done to my eyes. I would smile and feel like my eyes looked hallow. I felt like I couldn’t smile with my eyes….if that makes sense. (This was most likely due to the Doctor that injected it, which was before I found Modern Dermatology) I really loved the results I saw by having it done to my forehead. It was quick and it really wasn’t that painful at all. There is also basically minimal downtime, I just had slight bumps where the injection site was and they went down soon after.
I was planning on doing a small amount of botox on my forehead after Charlie was done breastfeeding but I found out I was pregnant when I was just 10 months postpartum. That plan was put on hold and my lines between my eyes have only continued to get deeper. So here I am again a few years later counting down the days. I breastfeed my babies until they turn one so I will wait until Ford is one for my treatment. I think some people, especially men think of the completely frozen plastic look when they think of botox or the overfilled over botoxed look you might see on a Bravo reality show. This is not what I’m referring to here. I think botox can go undetected when it is used correctly by an expert to keep the natural look of a persons face or when it is used as a preventative measure.
I also would like to point out there is so much beauty in aging and I’m in no way telling you that you need botox if you have wrinkles. My mom has never done anything to her skin and has such a beautiful complexion. It is such a personal decision. I’m just giving you what is some useful information so you can make your own choice.
ICE QUEEN: disclaimer
IMPORTANT: Remember, just don’t over do it. I don’t like the frozen look for many reasons, one it looks so unnatural, two the more important one…human connection. Human connection is so important and without being able to make facial expressions based on how you are feeling when speaking to your children or others in many ways can change the way you process emotions. Studies suggest, that when you can’t physically express your emotions, you feel less emotion. Again along with that it also just looks unnatural and processed. What are your feelings towards botox? Go comment on my latest post and share!
Q & A
HAVE YOU EVER DONE FILLERS OR ANY OTHER COSMETIC PROCEDURES: I have not had fillers and it’s not something I plan to do. I also have never had any other cosmetic procedures.
DO YOU STILL HAVE BOTOX IN YOUR FACE: Nope, I don’t. I have not had it in over three years. Botox only lasts around 3 months and I had it done 4 years ago.
WOULD YOU RECOMMEND BOTOX: Honestly I wouldn’t get it done if you are very young. I got it done too early in my opinion. I only had a few very very fine lines and I didn’t really need it. I was 29 years old and thought I was getting it as a preventative measure. The problem with that is Botox only lasts a few months so 4 years later, two babies, pronounced 11 lines and no botox left in my face, I kind of felt like I flushed that money down the toilet.
BOTOX & other tales from aging during mommyhood... everything skin!
Q&A WITH MODERN DERMATOLOGY
I’m beyond excited to announce I’ve partnered with Modern Dermatology on a quest to reverse my skin to my pre-mama/pre 30s days.
I wanted to find an office that had the latest technology, were very up to date with current trends and studies, and something else that was important to me was that my doctor was a mom! Trusting someone with your skin is a big deal. I wanted to not only be able to express my concerns but I really wanted to feel like I was seeing someone who really “got” the changes I felt I was going through due to #momlife. Both women that founded Modern Dermatology are moms of…….wait for it…..FOUR KIDS EACH. What are the chances that I find an office that exceeds all of my concerns and between both of the dermatologists they have eight children.
Dr. Robinson pictured above. How are you a mom of four?!
Dr. Klein and Dr. Robinson first met during their residency at Yale, where they received top-tier training from leaders in medicine. They each went on to gain experience in medical, surgical and cosmetic dermatology, while participating in cutting edge research, and presentations locally and around the world….YUP! I knew I found the right spot! You can check out their website, HERE.
Soon after the birth of my second baby I noticed an extreme jump in aging when it came to my skin. It wasn’t gradual by any stretch of the imagination. I felt as though I went to bed one night and woke up the next with large pores, some acne scars, wrinkles, and an extreme lack of any glow. Maybe I’ve been too busy to notice but it felt like an overnight change. It’s been three years and counting that have been full of pregnancies and breastfeeding with no break in between and I was left with skin I didn’t recognize.
Now that I’m 33 years old I’ve decided this year was the year to really focus on restoring my skin. I’ll be sharing more about the specific treatments I will be doing but they include multiple treatments of the PicoSure laser and vampire facials. Dr. Robinson took a look at my skin and told me exactly what I needed to reverse the signs of aging that I was concerned with. I realized the average facial at the spa was not cutting it. I needed something that had longterm benefits but was also breastfeeding friendly.
After sharing my my feelings around my mama skin I had such a huge response online. So many of you agreed and had so many questions. It can get confusing around what you can & can’t do pre baby, during pregnancy and post baby. Here were the most common questions. Dr. Robinson answers all of them below. The most popular being BOTOX.
Is botox safe while pregnant and/or breastfeeding?
It is not safe to treat while pregnant or nursing as the toxin does enter our blood stream, albeit briefly, and has not been tested on pregnancy/nursing women.
What are your thoughts around light therapy? Low frequency stimulation...
Laser and light therapies are great options for needle-shy patients who are looking for skin rejuvenation. The light therapies available in our office are stronger versions of the “at home” devices on the market, which offer low-level stimulation. These devices activate receptors in your skin, and stimulate cells to regenerate – and when we increase the cadence of cell turnover it can help calm existing issues like acne, while boosting collagen production, which will lead to a decrease in visible fine lines and wrinkles.
What can you do to treat wrinkles while breastfeeding?
I recommend HydraFacials for patients looking to treat their skin while nursing. Just be sure to tell your aesthetician you are nursing so they can customize which products are used during the treatment.
What should our daily skincare routine consist of? Serums, toners, collagen...
1) Cleanse with a gentle cleanser like Alastin Gentle Cleanser
2) Toner (if you use one, but they really aren’t necessary and I generally advice against them)
3) SPF if you’re using a chemical blocker. Chemical sunscreens work by absorbing the UV energy into the skin, so for it to work it needs to be on top of clean skin so it can be absorbed and do its job.
4) Prescription or Topical if you have one (e.g. an Rx Acne topical)
5) Antioxidant Serum
6) Oil Free Moisturizer
7) SPF if you’re using a physical sunscreen. Physical sunscreens work by reflecting the UV rays off of the skin, so it should be the last thing on your skin.
If you start botox what happens if you stop? Do you have to keep getting treatments forever?
Botox generally wears off in 3-4 months. Nothing “happens” it just wears off and your muscle movement returns. You can choose whether or not to re-treat, it’s not an “all-in” commitment.
I am pregnant with my third and I really want to get the broken/ruptured blood vessels on my face removed. How do I go about doing this and can I do it while pregnant?
During pregnancy blood volume in your body increases, which can worsen this issue and can lead to new broken blood vessels (along with other conditions like varicose veins). I would suggest treating after delivery with a series of Vbeam Pulsed-Dye-Laser treatments.
What is the injection procedure for smile creases?
It always depends on the anatomy of the specific patient’s concerns, but in general a combination of light toxin and a small amount of filler. The toxin would help prevent the wrinkles from worsening, especially lines above the upper lip, while the filler provides instant plumping of the sunken area where the wrinkle currently sits.
Are there any retinol products (like a daily serum) that are pregnancy safe?
Retinols and retinoids are NOT safe during pregnancy. Alternatives to retinols to build collagen such as petpides, can be used safelty.
Should you wait until you are done having babies to start getting botox?
You certainly don’t have to. Many of my patients like to treat between pregnancies.
What negative side effects does botox have?
If you’re treated by an inexperienced injector you may be over-treated and left looking “frozen.” While botulinum toxin injections are easy in terms of comfort time for the patient, the treatment still needs to be done by a trained and experienced medical professional. If the injections are too deep, too low, or in the wrong spot, you could have negative side effects, like a droopy eyelid or forehead or asymmetry. It’s important to see an experienced, board-certified dermatologist or plastic surgeon for botulinum toxin injections .
What can I use to help the 11 lines between my eye brows?
botulinum toxin, as it stops the muscles from contracting. Stopping or softening the muscle contractions in the glabella ( muscles between the eyebrows) leads to a softening of the 11 lines. ]
Best skincare products that are breastfeeding safe AND effective?
I love peptides based products as they are retinol/retinoid free but can have a great effect on collagen and elastin production. My favorite is Alastin Restorative Complex. I also find that a great morning antioxidant with vitamin C complexed with safe but effective topicals acids is imperative. My favorite is Pure BioDerm Super Antioxidant
Is botox safe to get in between pregnancies? (If you are planning on having another baby but you are not pregnant yet)
YES!
Can you really get rid of stretch marks via laser treatments?
Stretch marks come in two varieties, red and white. Red stretch marks can be treated with a series of PDL or VBeam laser which helps dimish the redness. In addition, white stretch marks can be lessened with a series of fractional resurfacing, such as the Fraxel Dual, as it helps to build collagen and reduce the depth of the stretch marks.
Any easy ways to help Melasama spots?
There are a few options including laser treatments, as well as peels. The Cosmelan peel is a great option for most patients. The peel targets hyperpigmentation by reducing melanin production. The mask stays on for 6-8 hours, is rinsed off with a gentle cleanser and within 1-2 days the skin becomes red and swollen, then 3-5 days later peeling begins. In addition, as series or lasers such as the Pico and Revlite can be helpful for reducing melasma. Just remember though, when exposed to the sun, the melasma can return, so great sun protection is the key.
What safe treatments (pregnant) should we be doing to help keep our skin looking youthful (Since botox is out)?
During pregnancy a series of light treatments can help reduce inflammation, redness, and the occasional breakout. This paired with gentle peels and facials can keep your skin glowing and looking great while waiting for baby
What's the best treatment for post pregnancy melasma that can be used during a new pregnancy?
Many chemicals and treatments for melasma can’t be used during pregnancy. Also, as melasma is the “mask of pregnancy” and is linkled to the pregnancy hormone status, it makes sense to wait to treat until after delivery. But again, sun protection and topical antioxidants are key.
My skin is so loose on my face and neck after my baby. What is this happening?
What can I do thats natural and safe? (34 years old) Sounds like part of your issue might be dehydration – which is common for new moms, especially if you’re nursing – so start with some water and try a hydrating treatment like HydraFacial.
What in office treatments result in that youthful glow I feel like this tired mom is lacking?
There are SO many options – the best first step is a consult to evaluate what is the best for your concerns. We can customize a treatment plan based on your skin and your comfort level with needles, lasers, pain…etc.
I've been working out non stop and feel like I have pockets of fat I just can't get rid of. What can I do?
We have a few options…Kybella is an injectable solution for the pouch of fat under the chin, other options include SculpSure (heating fat) and CoolSculpting (freezing fat). These are all permanent fat reduction treatments.
I'm still struggling with diastasis recti 12 months post-delivery. Did you struggle with this at all? Any advice?
Diastasis recti can be really tough. Targeted therapy can help to rebuild the abdominal wall muscles. Somestimes, surgery is needed to put the muscles back together and it is best to consult with a plastic surgeon for more information.
What are the best ways to age well?
At the core it’s all about prevention. That starts with daily use of sunscreen SPF 30+. The sun – specifically UVA rays – is the biggest “bad guy” when it comes to aging. Second to that are our lifestyle choices – eating a healthy diet and getting exercise. From there we are fortunate to have many advances in cosmetic medicine from injectables and laser treatments to skincare products and body sculpting.
Deanne Mraz Robinson, M.D., FAAD
President, Modern Dermatology
I found Modern Dermatology through my friend and fellow blogger Lindsay Blackinton. We will be teaming up together for a great giveaway with Modern Dermatology! stay tuned.
TOILET TALK..POTTY TRAINING
MAMA SERIES X TOILET TIME
Toilet Talk
Toilet Training in 3 Days or Less
Hello Mama’s! My name is Nancy Hake and I am a certified Special Education teacher in both Connecticut and North Carolina. I have over 20 years of experience in the education field working with children ranging from 3 years-21+. My most extensive work has been with preschool and elementary aged children with special needs. I also have a background in applied behavior analysis, management and techniques. I am currently a SAHM to my 18 month old son, Charlie.
Aside from sleep training our little ones, one of the next dreaded questions is how do I toilet train my toddler? How do I know that they are ready?
There are a few simple questions you should ask yourself before getting started:
Does your child have the motor skills necessary for independent toileting; Can the walk to the toilet, sit independently, pull their pants up and down?
Can your child follow basic 1-2 step directions?
Does your child have a means of communicating the need to go? This does not mean they have to be able to verbalize the need. Other forms of communication can be used such as a picture icon or sign language.
Are there any medical reasons which may inhibit your child to feel the urge to go?
I will encourage you to wait to begin this 3 day process if you can rule out any of the above.
It is important to note that there are many methods to toilet training. I am not going to say that this way is the end all be all version, but I have successfully used these methods with non-verbal children, children with behavioral challenges etc..
Before starting, model to your child the toileting process (when appropriate). Invite them into the bathroom when you have to go. Verbally tell them, “I have to go to the bathroom” and go. Toddlers are sponges, they pick up on our routines. When we make it a part of the day, they will most likely want to make it a part of thiers.
Getting Started:
You will need to set aside 2-3 days to stay at home. Do not begin this procedure if you are heading out of town or have lots of weekend activities planned. Many choose to start in the summer when their child can be free of clothing. With this plan you can begin at any time as long as you can guarantee being home for a majority of the day.
Identify a highly motivating item for your child. For many this may be an “M&M” for others it may be a few minutes of screen time. Regardless of what it is, it is CRITICAL that there is no access to the item at any other time other than toileting. The reinforcer will lose its value if offered at other times.
Create a bin to keep within reach of your child with extra pull ups, wipes, underwear, changes of clothes. This is necessary for your child to become a team member in the toileting process.
Stock up on juices, popsicles, salty foods. Why? Salty foods create thirst, thirst creates the urge to drink which creates the need to go!
Create a busy box for the bathroom (small toys, books, etc.) You want to pair the bathroom as a motivating place to be. Keep the isolated reinforcer in there as well.
*Avoid the use of a kindle or IPad because this can become very distracting and your child may just end up sitting on the toilet all day.
Find a timer to use. You will need this to monitor your last bathroom trip.
Be prepared! Are you sure you are ready to begin? There’s no turning back.
Start by allowing your child access to drinks and popsicles. If they do not appear to be thirsty, allow them to eat some salty foods. Keep the drinks within their reach throughout the day.
Set the timer for 30 minutes (this time will increase when success is met).
When the timer goes off simply state “It’s time for the bathroom”.
Take your child directly to the bathroom. Ask them to notice whether or not they are wet or dry. If they are dry sit them directly on the toilet. Keep them there until they void (pee).
When your child does meet success and pees, make it the biggest celebration!! YAY!! You peed on the potty!! Immediately reinforce them with the item you have chosen. Complete the toileting process of wiping, pants up, flushing, washing hands.
Reset the timer and start the above process again.
When your child has an accident… Immediately state in a disappointed tone (not yelling) “You have wet pants, we pee on the potty”. Take them quickly to the bathroom (allowing them to walk) and have them take off the wet clothes. Sit them directly on the toilet. This is where the busy box comes in handy. Keep them occupied in the bathroom until they are able to pee on the toilet (even if it’s just a little bit). Once they pee on the potty provide tons of praise and reinforce with your pre-determined item right away.
Once they complete the toileting routine, have them go to the basket with the extra clothes to help get dressed. Ask them to give you the pull up or underwear and a clean pair of pants since the old set is now wet from the accident. Have them put the wet clothes in the sink. You want to make having an accident inconvenient for not only you, but them.
If your child is successful with the 30 minute intervals you can increase in 15 minute increments. Increase after 2-3 consecutively successful trips to the bathroom. Toddlers will need reminders at times to use the bathroom, especially if they are busy playing, so don’t expect them to independently request every single time in the beginning.
Once you are successful for a few days at home you can take your training on the road!
Take your child to the bathroom right before you leave the house.
Keep a portable toilet in the car. Toddlers will need the bathroom at the most inconvenient times and we don’t want to reinforce having accidents because a bathroom isnt nearby.
Introduce them to the bathrooms in the public places you visit so they know where they are and that they can ask to go.
Keep extra changes of clothes in your diaper bag because we can assume a few accidents will occur on the road.
Key points to remember:
Reinforcement is the key! The more motivating the reward, the more likely your child will want to be successful.
Remain consistent in your methods, reactions and rewards.
Don’t give up. Toileting is a huge milestone for children.
Expect that peeing on the toilet will come easier than poop. (That’s a whole other blog post).
Most important: Stock up on the wine! It’s going to be a long couple days, but well worth it in the end.
Good luck to you all! I’ll be taking this adventure very soon with my son.
Please feel free to reach out with any questions, comments, successes and failures.
Happy Toileting!
Nancy
DOULA Q&A
MOM LIFE & COFFEE WITH A DOULA
Meet Margot!
My name is Margot Lowenstein Simmons and I was born to mother. I work to redefine the scope of doula. I am a trained postpartum doula, a certified breastfeeding counselor and a Sleep Savvy Gentle Sleep Coach. I bring my own personal humor and joy for family to my work. I provide truly nonjudgemental support and specialize in offering practical tips and tricks, coaching to ensure a happy, relaxed family unit, transitioning to and from work, as well as the special experience of having toddlers! Because - I think we could all use a little less judgement and little more doula.
Margot answered a few of YOUR questions.
I have a 16 month old and I'm due with my second next week. Any and all advice with routines for two babies would be great!
Congratulations!! Having been a mom to 2 under 2, myself, I totally can say that while hard, this is also an amazing dynamic!
The best advice I have on the managing of two babies - and really multiple children of any kind - is just to take stock and realize that sometimes it’s gonna work and sometimes it’s gonna fail. And when it works - it works brilliantly. And when it fails, it fails hard. Having realistic expectations and taking “failures” in stride and with perspective is imperative.
Related to perspective, remember to find the time out for yourself. When you’re managing two babies, it’s easy to get lost in the ups and downs of the crazy. Taking moments away - real moments - from the start - where you can learn to rely on someone else to manage the logistics is invaluable. Not only will it allow you to feel sane - investing in teaching someone else “the way” will allow you to step away with much more ease when it’s getting to be too much.
Finally, remember that there are moments when both kids will be synced up and moments when it’ll feel like they couldn’t be more out of tune with their needs. In the very beginning, it’s easier. Throwing new baby in the carrier and tending to toddler with two hands can be the norm - for bath time, for dinner, for naps on the go. As baby gets older and demands more of a schedule - look for efficiencies. Can baby be bathed at the same time as toddler? Can you give baby a bottle or a boob while toddler eats dinner? Finding the synergies within your routines is clutch. Then, one day, you’ll look up and realize both kids are napping at the same time - and you’ll say to yourself - “holy $#*! - I have 30 mins to myself! What should I do?!”
Any advice on deciding for a RCS or VBAC? Any advice on how to have a successful VBAC?
Do your research and make your own choices within the context of your circumstances. Decide what feels right to you and advocate for it before and during your delivery. Remember…this is YOUR experience. It is unique to you and to this baby. It’s routine for your doctor. So, speak up. Even in an “emergency,” you can always ask for a couple of minutes to process and assess your feelings. Making your own choices is incredibly powerful.
Don’t wait to speak up until you’re in the moment. Talk to your practitioner in the many weeks leading up to your delivery. Ask how many of his or her patients have successful VBAC attempts. Talk about what he or she sees as the likelihood of your being successful. Make him or her hear your wishes but also understand your practitioner’s POV. You need to go in eyes wide open to what your practitioner thinks and feels so there aren’t surprises about decisions that get made. If you don’t like what you’re hearing – consider a change. There are lots of women who late-term transfer and plenty of practitioners who accept them.
Get support. If you really want the VBAC, consider whether you will feel strong enough – whether your partner will feel strong enough – to speak up in the face of nurses and doctors who may be saying scary things. If you even think you might feel intimidated – get the support of a doula or someone who can be your advocate – who has see successful VBACs – who has experience and who is in tune with your emotional and physical well-being.
Most of all – go with your gut. It’s the surest way to no regrets. And regardless of how you deliver your baby – remember that it will be special for you and for that baby forever.
Any tips on getting back to work life balance would be awesome. We had a great balance pre baby but we obviously have way more responsibility now.
Work/life balance is a funny thing – sort of a holy grail! First, own that it’s not going to look like it was before. Mourn the loss – it’s okay! Sometimes we beat ourselves up for feeling sad that we yearn for our pre-baby lives – but it’s normal. We just don’t talk about it. So, go ahead and say it out loud. Having a baby isn’t all fun – it’s amazing – but it’s hard!
Then, consider what were the most “good-feeling” parts of that balance before baby. Was it that you never had to race out before your work was done to get home to relieve a nanny or pick up a baby from day care? Was it that you didn’t have to choose between the gym and work and seeing your baby? Isolate the biggest points of frustration – then you can go about resolving the biggest pain points.
Make a plan. Don’t look at singular days – look at weeks – and chunk them out on your Google or Outlook calendar. Don’t exist in the tyranny of the urgent; you’ll never feel like you have balance. Block off your “work” time, your family bonding time, your YOU time (don’t forget this one!!), your friend time, etc. Consider each category important and treat it like you’d treat meetings with your boss. If you have to move a family thing because something at work came up – you don’t LOSE that family thing – you move it somewhere else.
And, partner with your partner. Talk things out and make sure you are clear on what each of you is responsible for. Maybe one night per week is your “stay however late I need to” night and your partner is on baby duty. Maybe he is the baby supply Amazon order captain and you’re the fridge is stocked boss lady. Sharing the “wealth” is important so resentments don’t build up. I’m a HUGE advocate of talking this out before your baby even arrives. Ask me more about that!
SLEEP. My baby is 3 months old. Great naps, falls asleep on his own for naps but not bed time. Sleeps thru the night but getting him down at night is a struggle. Any advice?
First of all – your three month old sleeps through the night!!! Pat on the back, mama! This is the exception – not the rule! So celebrate small victories. Sometimes it seems like everyone else has sleep “easy” but I assure you the dirty little secret is that EVERYONE tackles a sleep challenge.
The struggle you’re experiencing could be caused by a range of things. But, for anyone struggling with some issue with their nighttime sleep routine, my biggest suggestion is to go back to basics.
Examine how much sleep your baby is getting in 24 hours. Are they getting too little or too much? There is a range!
Make sure your babe isn’t getting over-stimulated before bedtime. I’m a HUGE advocate of circadian rhythms. Make sure your baby gets exposed to daylight during the day and darkness at night. In the hours between dusk and bedtime, take your baby outside and let them experience the sun setting and darkness arriving (even for 10 minutes). When you come back in – turn your screens off and your lights low.
Consider a really good “getting ready for bed” routine and keep it consistent every night. Maybe a walk, a bottle or nurse, a bath, a song or book and then into bed. Keep it consistent.
PREPARING FOR BIRTH, BABY, AND BEYOND
PREGNANCY & PREPERATION
Mrs. Nipple: So I met a friend on the internet :) That sounds as funny as I thought it would, but she's pretty awesome. Her name is Meg Hall and she has a great blog called, For The Long Hall. When I read her mom's post about preparing for birth & labor, I just knew it was too good not to share. Meg's mom has quite the track record. Family Nurse Practitioner, Certified Nurse Midwife, and most recently, a Doctor of Nursing Practice and Certified Nurse Educator.
Meg Hall: Arguably the greatest benefit I've had at my disposal throughout my pregnancy is my mom! While she's a rockstar mama in general, she also happens to be an extremely talented women's health provider (and now professor). My mom has a passion for learning and caring for women and has worked for many years as a Family Nurse Practitioner, Certified Nurse Midwife, and most recently, a Doctor of Nursing Practice and Certified Nurse Educator. She's not only a super smart cookie, but also a very level-headed, non-judgmental and rational healthcare provider that immediately puts her patients at ease (you can ask my friends - who have been asking her 'embarrassing' questions my entire life ;)
Disclaimer: any and all advice below should not replace or override the recommendations of your healthcare provider. Please ask your doctor for recommendations specific to you or your pregnancy.
Brenda M Gilmore DNP, CNM, FNP, CNE (Meg's mom) will take over for the remainder of the blog post
Introduction
First, we’ll start with preparation for birth including the choice of the birth attendant and then we will talk about some common practices during labor and birth. We end with some thoughts about going home with the new baby. I am not including my resources for this post. However, I did consult the literature while writing this and I am including links with supportive information as I go along.
Preparing for Labor and Birth
Remember, women have been having babies for centuries. Our bodies are made for this amazing job. Have confidence that your body will know what to do when the time comes to give birth. We are extremely fortunate to have so many ways to support you in the birth process. Embrace this new journey you are about to take. Be thoughtful and informed about the birth process and the multitude of options you have in this country. Do some research and consider your expectations and beliefs surrounding labor and birth. This will facilitate your choice of a provider and your decisions regarding pregnancy, labor and birth. Be an active participant in your pregnancy and birth experience.
Choosing a Provider
When choosing a provider first you have to consider where you would like to have your baby. Are you planning a home birth? If so a licensed midwife may be the choice for you. Licensed midwives or direct-entry midwives who are non-nurses and they are trained to do home birth. Be aware that they are not available in all states. https://mana.org
If you are still looking for a more holistic midwifery approach but not necessarily a home birth then certified nurse midwives (CNMs) may be the answer. Certified nurse midwives are advanced practice nurses who can attend birth at home, in birth centers, or in the hospital setting. Overall, CNMs have a close relationship with the medical community for collaboration. They can also provide women’s health across the lifespan and not only during pregnancy. http://www.midwife.org
If you have medical conditions or other circumstances that may put you at higher risk then you may be more comfortable with a physician overseeing your care. Or some women just prefer care by a physician. There are many options for board certified OB/GYN physicians throughout the country. https://www.acog.org/Patients
Today, many OB/GYN practices have both physicians and CNMs who work together collaboratively so you can have the best of both worlds. Regardless of your choice you should verify your provider’s credentials and reputation.
Labor and Birth Expectations
What do you know about labor and birth? Have you done this before? Is this your first baby? Have you read up on the process? Have you taken any childbirth classes? Do you know what your options are regarding care? Who’s going to be with you? Have you discussed this with your provider? Have you thought about a birth plan? I know I’m asking more questions than providing answers but really knowing about the birth process and considering what you expect and want will lessen the fear of the unknown and help you prepare in a thoughtful way and reduce your anxiety while awaiting the birth of your baby.
Birth Plans
A birth plan is not a contract or a concrete expectation of what should happen during labor and birth. It is a thoughtful list of choices surrounding birth and labor that you would prefer. There should always be room for contingency plans in case emergencies arise and care for you and the has to be changed. By working through a birth plan it assist you in considering aspects of labor and birth that you may not have thought of before you became more educated and inform on this subject. The birth plan can also prompt conversation with your provider as specific questions arise. Here is a very comprehensive birth plan template.
Labor Support
Labor and Birth Coaches
So this is a big question for “the big day.” Who do you want to support you during labor?” Please notice did I did not say, “Who do you want in the room with you?” A birth is not a “show or circus” to watch. Labor and birth are hard work and you need people around you who can help you do that. Labor coaches should only include people you trust and don’t mind being naked or doing bodily functions in front of. That probably narrows the list down a little bit. Labor coaches should know your birth plan and/or expectations. They should be able to advocate for you and work with you through the process of labor and birth.
Doulas
There are also professional trained labor coaches available. For a fee, doulas provide individualized, continuous, and comprehensive support before, during and shortly after birth. I have worked with doulas throughout my career as a CNM and I have seen them make a huge difference for laboring women and their families. An effective doula is worth their weight in gold. If you are considering a doula make sure you meet with a few to insure they will meet your needs, include your other labor support in their approach, and be available when you need them. https://www.dona.org/what-is-a-doula/
Preparing for your hospital stay
A big step for preparing for birth is packing the hospital bag. My advice is to be thoughtful and brief. For an uncomplicated vaginal or c-section birth the hospital stay is usually only 2-3 days so leave the big suitcase at home.
Don’t:
Buy fancy PJs. You’re only going to get body fluids all over them. Use the provided hospital gowns and underwear for at least the first 24 hours after birth.
Bring a full complement of toiletries. Leave the majority of your morning preparations (make-up, curlers, etc) at home. You will be in the recovery phase for a few weeks so allow yourself some down time.
Bring your skinny jeans to wear home. You will not fit into them. Bring loose comfortable clothing. Your maternity clothing will still work well.
Bring a mini nursery for the baby. The hospital will supply basic supplies for the baby while in the hospital. Use those and leave yours at home. You really only need one weather appropriate outfit to bring the baby home in and one back-up outfit (for unplanned messes). Extra blankets, toys, little shoes, bows, etc. just get soiled or lost.
Do:
Bring your own basic toiletries including your toothbrush, travel size shampoo, soap, etc. Bring just enough to make you feel comfortable and normal.
Bring your own pillow(s). Hospitals NEVER have enough. Be sure to bring ones that you can part with if they are lost or soiled beyond salvation.
Make sure you have a safe and properly installed car seat for the baby. Hospital staff will not let the baby go home in anything else. Have a stocked diaper bag in the car for baby’s trip home
What every woman know should before labor/birth.
Labor and birth is EXTREMELY individual and unpredictable. My biggest pet peeve is every well-meaning friend and family member who must tell every newly pregnant woman their absolutely horrific birth story. DON’T LISTEN!!! This is your labor and birth and yours alone. Be informed and keep an open mind. Collect information and facts but don’t get caught up in others drama stories. Be flexible and know that labor may be tougher than you think so be ready to consider all of your options. Communicate, communicate, communicate with your provider and your labor support team.
Care and Coping during Labor
So now you are in labor. How long will this take? How much worse is it going to get? Unfortunately, there are really no answers to these questions. That’s what makes labor so intriguing. We know so much but labor really continues to mystify us. That’s why “going with the flow” is so important. Since I could write a book about coping with labor (and many have) I’m going to focus on the specific questions that were asked.
Eating in labor
Traditionally, in the hospital setting, woman have not been fed during labor. The biggest concern is complications of anesthesia administration (if needed) with a full stomach. However, there are randomized controlled trials that do not show any increase in adverse effects on maternal or neonatal outcomes with food consumption in labor. In my experience starving a patient does not facilitate labor and can make women pretty uncomfortable. Some birthing units will allow light meals during early labor and then limit intake as the labor progresses. Honestly, women in active labor are much less interested in food and if there are complications they are more apparent as labor progresses. The bottom line is that food intake during labor should be considered on a case by case basis and definitely not automatically ruled out.
Pain management
There is a multitude of pain management options available to cope with labor. Each setting or facility will have their own options for patients. The hospital setting will have the most options available. Intravenous pain medication and the epidural are the two most common options. There are pros and cons for both options. Informed decision-making is paramount in choosing what option is right for you. I have provided a comparison table to summarize the information.
Breech Birth
After many decades of breech birth the evidence is pretty undeniable that overall neonatal outcomes are better with c-section delivery. Vaginal breech deliveries are still performed but there are very few providers adept at vaginal breech birth. If a woman has a primary (first delivery) c-section for breech position there are still many providers that would consider a vaginal birth after c-section (VBAC) in this circumstance.
http://americanpregnancy.org/labor-and-birth/vbac/
After Birth
So now the baby’s out. What’s next? Believe it or not things that occur right after birth are EXTREMELY important.
Skin to Skin
I cannot say enough about skin to skin contact right after birth. There is so much new research that supports early skin to skin contact for mother and baby. The skin to skin not only facilitates closeness and bonding but it actually initiates the process of the breast milk composition to be tailored specifically to the baby’s immunologic needs. It’s called the “microbiome.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686345/
Really interesting stuff!
Delayed cord clamping
This when the umbilical cord is not cut or clamped for several minutes (or when pulsation stops) after birth. I have actually given a mother oxygen and watched a newborn pink up with the umbilical cord still attached directly after birth. In general, delayed cord clamping is recommended if feasible. http://americanpregnancy.org/labor-and-birth/delayed-cord-clamping-risks-benefits/
Breastfeeding
Initiation and maintenance of breastfeeding can be a challenge, especially in the first few weeks. Make sure you have the support you need during your hospital stay and beyond. Most facilities provide lactation services to their new mothers. Know what your options are in your community. https://www.babyfriendlyusa.org/about-us/10-steps-and-international-code
http://www.ilca.org/why-ibclc/falc
Breast pump recommendations
It’s funny that this is one of the questions. Meg and I just went through this process. I work in an academic setting and I am surrounded by maternal child experts. Two of which are experience lactation consultants. Four experienced nurses (including the 2 lactation consultants) recommended the Medela portable double pump for general use. However, they also recommended a hospital grade (you can rent them) double breast pump for the first month after birth to establish a solid milk supply. Please note that I have no relationship with any company that sells breast pumps. Medela is widely available and parts/supplies are easy to obtain. It is also recommended to maintain individual use (meaning only you use your pump) and follow the pump instructions to maintain sanitization and cleanliness of the pump and supplies.
(Meg note: I was deciding between the Medela vs. the Spectra S1. All of my mom's LC friends/academic colleagues recommended the Medela and all of the working moms I spoke to recommended the Spectra (mostly because it is apparently much more quiet, it is hospital grade (stronger), kept its suction longer and is a 'closed' vs. open system). I am still undecided but found this review to be very helpful!
If you cannot or decide not to breastfeed
Your breasts do not know you are not going to use them for feeding. The natural process of preparing to feed a newborn will still occur to some extent. To decrease discomfort related to milk production and engorgement avoid breast stimulation. Wear a snug fitting sports bra most of the time and use icepacks and take Tylenol/ Motrin for comfort measures. Do not express milk or pump as this will continue to stimulate milk production. Over time your breasts will get the message that their services will not be needed. It may a few days to a week to get them on board with your plan.
Going Home
Everyone feels overwhelmed when they go home with this tiny being they are now responsible for. You are new parents and it is normal to feel unprepared. Give it time for you and your baby to get to know each other. Again, know your resources and accept any help that’s available… on your terms.
Rest and Recovery
As a new mother your primary responsibilities should be to care for and get to know your baby and to recover from birth. The majority of other tasks like sibling care, house work, errands, and cooking should be delegated to others as much as possible for the first few weeks. This will sound cliché but SLEEP WHEN THE BABY SLEEPS if you can. It does help when you are up several times a night with feedings.
Visitors
Well-meaning friends and family may just pop over to “help you take care of the baby” or just stand around not quite knowing what to do. This is what I tell all mothers going home from the hospital. Schedule your visitors! Figure out when you and the baby are at your best and have visitors come at that time. AND if they want to know what to do to help tell them to bring food (especially if that is their expertise). This really helps minimize this job for you and your visitors truly feel like they are helping you. It’s a win-win!
In summary...
I believe I have incorporated all of your questions in this extensive blog post. I will be glad to do a follow up post to address any additional questions that this information may bring to light!
Brenda M Gilmore DNP, CNM, FNP, CNE