Postpartum

What to Pack in Your Birth Bag

birth bag.jpg

As your guess date approaches, packing a birth bag is essential. Around 36 weeks is a good time to start collecting things to have ready. We have put together a list of favorites for you.

Labor

  • Snacks: Bring your favorite snacks for you and your partner. Think of things that are mild and easy to eat. Some good ideas are trail mix, protein bars, dried fruit, honey sticks, nut butter, instant oatmeal, and yogurt.
  • Fluids: Bring a water bottle to keep near you at all times. Your partner can help remind you to hydrate through labor. It is also ideal to bring a few alternatives to water for both of you such as, coconut water, emergency-c, juices and natural popsicles.
  • Clothing: For laboring, bring comfortable nightgowns, a robe, t-shirts or pajama tops. If you plan to labor in the tub and/or shower, you may wish to bring a sports bra or swimsuit top. If your partner would like to support you in the tub or shower, bring a swimsuit. Bring a pair of slippers and cozy socks.
  • Lip Balm: In labor your lips tend to get very dry, especially during pushing. Have it ready to use and easily accessible. 
  • Hot Pack: Heat can be a wonderful comfort measure. You can use an electric heating pad, microwavable rice pack or hot water bottle.
  • Music: Think about making a labor and birth playlist. This may be soft, slow songs, spiritual songs or even fun upbeat music. If your place of birth does not have speakers, pack your own.
  • Essential Oils / Lotion: Bring your favorite oils and a plain lotion with you. Some recommended oils are peppermint (for nausea), clary sage (to help strengthen contractions), lavender (for relaxation). The lotion can help with massage. 
  • Hair Accessories: If you have long hair, you may want to put it up at some point during labor to get it out of your face. It can be nice to bring a headband too. 
  • Chargers: Be sure to pack phone chargers. If you are bringing a camera, bring a charger and extra batteries just in case.

Postpartum

  • Clothing: Bring comfortable clothes to wear home. Something loose and easy to get on and off. Be sure to pack a change of clothes for your partner as well. If you are breastfeeding, bring a nursing bra.
  • Baby Clothing / Blankets: For the ride home you will want an outfit for baby (onesie, footie pajamas, socks and a hat). Also bring at least 2 blankets.
  • Toiletries: Pack a small toiletry bag for you and your partner. Just the basics is fine, toothbrush, toothpaste, face wipes and a hair brush.
  • Car Seat: You will want to have your baby's carseat installed in your car at around 37 weeks so you are prepared to bring him/her home. You want to make sure that it is installed properly so give yourself plenty of time.

Pregnancy and Postpartum Uncensored

Let's be honest ladies, there are many things that happen during pregnancy and postpartum that no one ever told you about. In the moment they are far from funny but looking back all you can do is laugh!

Pregnancy Uncensored

No Control Over Gas: Starting in early pregnancy our digestive system does all kinds of strange things we are not used to. Gas being one of them. And it only gets worse as pregnancy progresses! This can happen in the most inopportune times...

Hiccups and Belching: Ladies with manners goes out the window. There is no stopping it. It doesn't matter what you eat or drink, it is happening! Thank your lovely digestive system once again.

Unpredictable Emotions: You'll laugh, you'll cry, you'll probably yell. Emotions are up and down throughout pregnancy. They can change on a dime any time of day. Commercials alone can get the tears flowing. Hunger can cause an angry outburst. The next minute you may find yourself dying of laughter. 

Wetting Your Pants: It could be a sneeze, a cough or a good belly laugh that causes it. It could be a trickle or a gush. The pressure on your bladder is no joke mamas! You may want to keep a pair of clean undies in your purse.

Nipple Changes and Pain: It is amazing how your body changes during pregnancy. Women's nipples and areoles become quite dark and large. The reason for this is for breastfeeding. It makes it easier for the baby to see them. But it can be quite alarming! Side note: if you are pregnant in winter, watch out! Cold temps can cause a stabbing pain in your already sensitive nipples!

Postpartum Uncensored

Bleeding and Mesh Underwear: Most of us are not prepared for the month long bleeding that comes after birth. Fun times. No period for 9 months and then BAM! 3-6 weeks of bleeding. To accommodate this you will be given mesh underwear with a pad that is more like a diaper. Victoria's Unkept Secret.

Hair Falling Out: A few months after your bundle of joy has arrived, your glorious pregnancy hair may fall out at an alarming rate. Don't worry- Although it may seem like you'll lose it all, you won't. Your body is just readjusting. During pregnancy you don't lose much hair at all so it is just making up for lost time!

First Postpartum Poop: This is definitely not discussed ahead of time and there should be a forewarning! After giving birth, which might feel like a huge bowel movement, the last thing you want to do is actually have a bowel movement! The pressure can feel kind of scary, but I promise your insides will not fall out even though it feels like they might!

Labial Swelling: Whether you push for 15 min or 2 hours, there will be swelling- probably lots of it. You may not recognize yourself down there. Stick with ice packs and 3-4 sitz baths per day. The swelling goes down! 

Hemorrhoids: This little cluster of grapes on your backside can happen in pregnancy, labor, birth AND postpartum. It is part of why the first postpartum poop is so uncomfortable. Have no fear, they do get better. Those lovely sitz baths will help immensely!

Pregnancy and postpartum is a very special time in a woman's life. It is beautiful and messy all at the same time. All laughs aside, if you are struggling during your postpartum time or something just doesn't seem right, please reach out. There are many resources in the Twin Cities such as, Postpartum Support Minnesota http://www.ppsupportmn.org, WildTree Psychotherapy http://wildtreewellness.com and Iris Reproductive Psychiatric Clinic http://www.irisreproductivepsychiatry.com

 

 

Super Purple Lactation Smoothie

Screen Shot 2017-01-20 at 1.28.00 PM.png

Start your day with this yummy Lactation Smoothie! The ingredients chosen for this recipe are great for boosting your milk supply! If you are dairy free, you can add some almond milk or coconut milk instead of greek yogurt. 

1 Large Banana

1 Cup of Blueberries

1 Cup of Strawberries

1 Tsp of Flax Meal

1 Tsp of Brewer's Yeast

Drizzle of Honey

Handful of Spinach

1 Heaping Tablespoon of Plain Greek Yogurt

Combine all ingredients in your favorite blender, blend until smooth and ENJOY!

Boobs, Breastfeeding & Lactation

Breastfeeding a newborn is a beautiful way to bond, connect and nourish your baby. There are many benefits of breastfeeding. What aren’t often talked about are the struggles that can happen during the first few weeks postpartum. As you learn about your baby and your baby learns about you, there are some things that can ease the difficulties that may arise. Collecting these items and organizing support before your baby arrives is ideal.

Create a Breastfeeding Station

There are things we have found helpful for the breastfeeding mama to easily have on hand. This can be a basket that has the following items available and easy to access when you nurse your baby.

Good Nipple Cream: A good nipple cream is essential to help relieve discomfort of sore, cracked nursing nipples. This can be applied before and after breastfeeding and anytime in between. We love Motherlove Nipple Cream.  

Nursing Pads: No nursing mom wants to face the embarrassment of wet spots on her shirt from milk leakage, but it can happen to even the most prepared woman. The chances are reduced if you use breast pads, which when used properly can prevent uncomfortably soaked clothing. Choose from washable or disposable types, both of which can keep you comfortable and dry. 

Gel Pads: Medela makes a wonderful product called Tender Care Hydrogel Pads. They quickly soothe sore nipples and act as a barrier between your clothes and your skin so they don't rub and irritate further.

Water Bottle: Staying hydrated is important while breastfeeding.  Keeping water nearby during breastfeeding is a must! Becoming dehydrated can decrease your milk supply and also make you feel tired. It is estimated that over 75% of Americans are chronically dehydrated. 

Easy Snacks: While breastfeeding you need about an additional 400 to 500 calories a day — to keep up your energy.

To get these extra calories, opt for nutrient-rich choices, such as a slice of whole-grain bread with a tablespoon of peanut butter, a medium banana or apple, and 8 ounces of greek yogurt. Try to have protein with each snack to help balance your blood sugar which in turn will help maintain your energy and mood.

Cloth or Small Towel: Have this handy for when your baby spits up or you need to catch milk leaking.

A Good Book: Reading is one of my favorite things to do while nursing. With my first baby, I finished many books in our marathon nursing sessions from the rocking chair. Clever pillow arrangement allows your hands to be free, or think about a book holder. Set up a little table right next to your rocking chair, have a basket of snacks on hand, set the book in a book holder, and you only need one hand to turn the page! You can also read in the side-lying nursing position – just prop the book on a pillow behind baby.

Support System – Good Support is Essential

Educate Your Partner: It is important for your partner to be educated about the ins and outs of breastfeeding so that he or she can help you in your breastfeeding journry.

Breastfeeding Friends: If you have friends that are breastfeeding, surround yourself with them. Keep their phone numbers handy for questions and encouragement.

Your Mom: Sometimes mothers can be a great support during breastfeeding, especially if they breastfed themselves. However, don’t feel guilty if you need to tell your mom that you would rather not talk about the subject if you find it stressful. 

At Health Foundations, our lactation consultants and postpartum nurses are here to assist you with any and all questions you have related to breastfeeding your new baby. We also have a group called Mama’s Milk Hour that meets every Thursday at 2:30. Our group is led by a lactation consultant and is a wonderful way to connect with other moms. This group is free and open to the public. 

If you are pregnant and just beginning your search for prenatal care, contact Health Foundations to schedule a free consultation with a midwife and a tour of our beautiful Birth Center. We are here to serve you at every stage.

Boost Your Milk Supply With No-Bake Lactation Oatmeal Bites

No oven required for this delicious unbaked treat. Full of galactagogues, which are known for increasing milk supply, these yummy No-Bake Lactation bites are sure to be a quick and easy snack that the whole family will enjoy. 

Ingredients:

  • 1 cup of oats (old fashioned or instant)
  • ½ cup of peanut butter or other nut butter of choice
  • ½ cup of honey
  • 1 cup of coconut flakes
  • ½ cup of ground flax seed
  • ½ cup of mini chocolate chips
  • 3 tablespoons of brewer’s yeast
  • 1 teaspoon of vanilla

Directions:

  1. Mix all ingredients together
  2. Refrigerate for one half hour
  3. Roll into bite-sized balls
  4. Roll balls in coconut flakes 
  5. Enjoy!
  6. (Store leftovers in an airtight container in the refrigerator)

Recipe transcribed from: TeenToddlerNewborn.com

Managing Visitors After Baby

Newborn Visitors

Nothing attracts well-meaning visitors like a brand new, adorable baby. Once the little one arrives, friends and family will be eager to meet your little one. Being prepared ahead of time for how you and your partner want to handle visitors once baby arrives will save you a great deal of stress and spare you some potentially uncomfortable conversations.  Here are 5 tips for managing doting friends and family once you bring your baby home.  

  1. Come up with a plan with your partner: These days/weeks following the birth of your baby are all about you, your baby, and your new family. You will not only be adjusting to caring for a newborn but also dealing with your own recovery and rapidly fluctuating postpartum hormones. It is important to be mindful of rest and nourishment. This is also a special time of bonding for you and your baby. Set those boundaries ahead of time and stick to them. There will be plenty of time for everyone to meet baby when the time is right!
  2. Accept help: When baby arrives, it is perfectly fine to ask for/accept help. Most people will offer- say yes! People often like to bring a meal, but don’t be afraid to ask for help with things like walking the dog, looking after your other children, or even holding the baby while you shower. Knowing that some of your daily chores are being taken care of allows you to focus on important things like resting and bonding with your new babe.
  3. Have your partner protect your space: Agree ahead of time that your partner will be the person to greet visitors and also gently nudge them once they have been there for a little while. A good amount of visiting time is about 15 minutes. Your partner can tactfully send people along their way when you need your rest, gently step in if your parents or in-laws are overstepping their bounds, and/or make suggestions as to how people can make themselves useful during their visit.
  4. Shamelessly ban sick visitors: There are few things as susceptible to germs and illness as a vulnerable newborn. There is no excuse for visitors showing up with a cough, the sniffles, a sore throat or even recovering from “food poisoning.” Let those mama bear instincts take hold and politely suggest that anyone who is not feeling 100 percent save their visit for a later date. It’s also okay to require that visitors wash their hands and use hand sanitizer before holding your baby. 
  5. Allow for plenty of alone time: A steady stream of visitors can be exhausting. You will likely already be feeling the effects of sleep deprivation, working to establish your breastfeeding relationship and will be navigating life with your newest family member. Try to space your visitors out and limit the time they spend in order to allow plenty of time for you and your little family to bond. True friends and family will understand how sacred this special time is for you and your new family.

You should never feel the need to apologize for prioritizing and taking care of yourself and your new baby in the days and weeks following your delivery. Your baby. Your family. Your way.

For questions regarding prenatal or postpartum care, natural delivery or other women’s services, contact Health Foundations for a free consultation with a midwife or for a tour of our Birth Center.

Five Things to Expect During Your Postpartum Recovery

As mothers and mothers to be, we typically spend a great deal of time planning and preparing for our child’s birth. We read books, take prenatal classes, write birth plans, pack bags, wash, fold and organize baby laundry and so much more in preparation for the big day. Very few of us however, give much thought to what the postpartum period will be like for OUR bodies. Consumed with the excitement of our baby to be, we may forget that once we bring home our bundle of joy we too will need care, rest and healing as we recover from the amazing feat of giving birth. Here are 5 things to expect from your postpartum recovery.

  1. Heavy bleeding: As your body sheds the uterine lining and also bleeds from where the placenta was attached, you will experience heavy bleeding known as lochia. You may see blood clots in this bleeding and it will likely appear bright red at first. The intensity of the bleeding should subside with time and gradually turn to spotting before it stops. Typically, this should last approximately 2-6 weeks after you give birth. To prepare, stock up on heavy duty overnight strength sanitary pads, mesh panties and even adult diapers can be a great option. This applies whether you had a vaginal delivery or a C-section.
  2. Some pain and discomfort: Take a moment to consider what an incredible thing it is that your body is going to birth a 6-10 pound baby. With this incredible miracle comes hard work and its fair share of aches and pains. Whether you have a natural birth or a C-section, you can expect to experience some cramping, soreness, muscle aches and joint pains. With a vaginal delivery you may also experience some burning and soreness of the perineum and with a C-section, pain at the incision site and abdominal pain as you recover from major surgery.
  3. Hormonal side effects: As your body seeks to adjust hormonally after giving birth, you will likely experience a few unpleasant side effects. These may include fluctuating emotions and weepiness, hot flashes, night sweats and chills, and continued feelings of clumsiness from the production of the hormone relaxin. Give yourself some grace during this period as you may not feel like yourself despite your excitement over your new baby. If you are concerned that the baby blues may be developing into something more serious like postpartum depression, contact your midwife, doctor or a counselor for support. There are many wonderful resources available for women suffering from postpartum depression. Don’t be afraid to ask for help. 
  4. Breast changes: As your milk comes in after baby is born, you may experience some engorgement and sore nipples and breasts as your supply adjusts to meet baby’s needs. You may also notice that your nipples appear darker. If you are recovering from a C-section, breastfeeding can initially be more challenging due to pain from your surgery and having to find a position that is comfortable for you and your newborn while you heal. Fear not though, it will get easier with time and your milk supply will adjust as you and your baby find your rhythm. Consider having nipple pads on hand for leaking breasts, cooling pads or ice packs for sore breasts and a nipple cream for aching and cracking nipples. Be sure to signup for our next Pumptalk 101 class if you have extra questions or would like some more suggestions.
  5. Constipation, incontinence, and frequent trips to the bathroom: Depending on how you delivered and your own personal recovery, you may experience a period of constipation following giving birth and/or urinary or fecal incontinence. A vaginal delivery can cause temporary nerve damage around the bladder making it more difficult to sense when you need to go to the bathroom. You may also have weakened bladder muscles, hemorrhoids and though less common, tears to the anal sphincter causing fecal leakage. Conversely, you may also experience constipation due to the slowing of your metabolism and digestive tract. Talk to your doctor or midwife for effective ways to manage these various side effects.

It’s not uncommon for the postpartum period to be filled with excitement, exhaustion, trepidation and feeling a bit overwhelmed. Make sure that amidst all the emotions and adjustments, you allow time for your own care and recovery. Your body has just undergone the incredible journey of childbirth and needs time to rest and heal so that you can focus on caring for your new, beautiful baby. 

What to Expect from Your First Postpartum Period

Photo by Piotr Marcinski/iStock / Getty Images

One of the many great perks of pregnancy is that you get a minimum of nine months sans menstrual cycle. No pads, tampons, monthly cramping or moodiness (okay, so those last two can happen in pregnancy too). At some point however, after your little one is born and your hormones settle back into a rhythm, your monthly visitor shall return. Many women wonder when this will happen and if it will be the same, worse or better than their pre-pregnancy periods. Here’s all you need to know about your first postpartum period and the factors that may impact how long it stays away.

If you are not breastfeeding your baby, you can anticipate the return of your cycle sometime around two months postpartum. There is a wide range of normal for that first postpartum period that can range from light to heavy, more or less cramping than you previously had, small blood clots and a consistent or inconsistent flow. Your period may be totally different than your pre-pregnancy period or exactly the same and it can differ after each child birth, as well. Whether breastfeeding or not, if your period returns soon after your delivery, avoid using tampons while your body is healing.

Breastfeeding your baby can be a game changer in the return of your menstrual cycle and fertility. Breastfeeding releases the hormone prolactin into the body which is necessary to produce breastmilk but consequently suppresses your reproductive hormones. The effect that breastfeeding has on the body will vary from woman to woman with some getting their cycle back a few months postpartum and others needing to ween entirely before their period returns. For women who practice ecological breastfeeding and natural child spacing, the average return of menses is 14.6 months.

Because breastfeeding suppresses fertility hormones and the return of your menstrual cycle, it can be used as a form of birth control for the first six months of baby’s life and possibly beyond. Learn more about maximizing your period of infertility following your baby’s birth and how to use breastfeeding as an effective means of contraception.

Although you can get pregnant before your first period because ovulation may occur, the chances are slim—about 6 percent. Because of this, some women who are eager to grow their family start to feel concerned about when their period will return. If you are breastfeeding around the clock and your body is continuously releasing prolactin and suppressing fertility hormones, it may begin to feel like your fertility will never return. If you are concerned about the return of your fertility because of age or your child spacing plans, there are usually ways to continue breastfeeding and still get your period back. Here are a few tips if your baby is over six months of age and you are concerned that breastfeeding is suppressing your cycle:

  • Start introducing solids: Once your baby is eating more solids, he may not need to nurse as often. Learn more about starting solids with baby.
  • Try cutting out a session and offering a bottle: Sometimes making abrupt changes to your pattern of breastfeeding can bring back your cycle.
  • Work on night weening: Research suggests that reducing time spent suckling at the breast between the hours of 12 and 6 AM may be most effective for bringing back fertility.
  • Be patient. Lactational amenorrhea may be your body’s way of telling you that it’s not ready for the next pregnancy yet and your child’s nursing habits may be indicating the same. In MOST cases, your period and fertility will return eventually despite continuing to breastfeed.

You may feel as though you have PMS symptoms for months preceding the return of your period as your body gears up for ovulation. It’s not uncommon to have some cramping, cervical mucus and other menstrual cycle indicators well before you get your actual period. Then once your cycle returns, it may take a few months for it to regulate back to a reliable schedule (if you’re lucky enough to have one). Although most women will begin to ovulate after their first period, it’s not uncommon to have one or more anovulatory cycle before returning to full fertility.

Whether you are welcoming the extended vacation from your monthly visitor or are anxious for its return, your period will return when your body is ready. If you have not had your first period due to breastfeeding and have concerns about the return of your fertility, talk to your midwife or OB to come up with a plan that works for you and your baby to aid in the return of your cycle. For questions about pregnancy, natural birth or your postpartum period, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Boost Your Milk Supply With No-Bake Lactation Oatmeal Bites

No Bake Lactation Bites

No oven required for this delicious unbaked treat. Full of galactagogues, which are known for increasing milk supply, these yummy No-Bake Lactation bites are sure to be a quick and easy snack that the whole family will enjoy. 

Ingredients:

  • 1 cup of oats (old fashioned or instant)
  • ½ cup of peanut butter or other nut butter of choice
  • ½ cup of honey
  • 1 cup of coconut flakes
  • ½ cup of ground flax seed
  • ½ cup of mini chocolate chips
  • 3 tablespoons of brewer’s yeast
  • 1 teaspoon of vanilla

Directions:

  1. Mix all ingredients together
  2. Refrigerate for one half hour
  3. Roll into bite-sized balls
  4. Roll balls in coconut flakes 
  5. Enjoy!
  6. (Store leftovers in an airtight container in the refrigerator)

Recipe transcribed from: TeenToddlerNewborn.com

 

Tips for Hiring Your First Caregiver

Hiring First Caregiver

You have a new baby. Suddenly, your life revolves around this tiny perfect human and you feel as though you are wearing your heart on the outside of your body. Whether you are returning to work or have decided you just need a few hours to yourself each week, hiring a caregiver for your child can be a very scary and overwhelming prospect. Here are 10 tips to help you find the best caregiver for your family.

  1. Decide what you need and want in a caregiver: Are you looking for someone who can work in your home full-time when you return to work or just for a few hours each week? Do you expect your caregiver to help out with household tasks like laundry and tidying or will their sole focus be caring for your baby? Is it necessary that your caregiver has a car and a clean driving record or is it okay if they arrive via bus or need to be picked up? These are all important factors to consider when determining your caregiving needs. Take the time to write a thorough job description identifying all your needs and wants for a caregiver and don’t forget to include what you are willing and able to pay. Indicate the type and length of relevant childcare experience you require and any other criteria that is important to you like a college degree, CPR and First Aid certification or previous child development coursework. Being specific with your needs up front will help potential caregivers know if they are qualified for the position before applying.
  2. Allow time for the search: Hiring a caregiver for your baby is not a process you want to rush. Allow plenty of time for interviewing multiple candidates, calling references, conducting trial periods and deciding who will be the best fit for your family. You should start your childcare search at least two months prior to when you will need the caregiver to begin. Deciding who you will entrust with your most precious child is not something you want to do in haste.
  3. Connect with friends and family members for referrals: What better reference than one that comes from someone you already know and trust. When you begin your search for a caregiver, reach out to other parents you know and ask them who they would recommend. Ask family members whom you trust and who know your family well, who they would suggest you contact. You may even be lucky enough to have a family member who volunteers to help with the caregiving of your baby.
  4. Consider using a reputable nanny agency: If your personal connections aren’t rendering any great referrals, consider using a professional agency with a good reputation to help you with your search. Using a childcare agency has the added benefit of providing you with candidates who have already been vetted, gone through a background check and determined to be qualified for caring for babies and children. While you may pay a fee up front for this type of service, the peace of mind in the long run will be worth it.
  5. Don’t cut corners on the interview process: While it can be helpful to begin the process with a phone interview, make sure that you meet all serious potential candidates in person. Prepare your questions for the interview ahead of time and allow up to an hour to spend with each applicant. During your time together, you will want to ask questions about experience, child rearing beliefs, what they plan to do with your baby during their time together and any other areas of importance to you. It’s a good idea to ask how the caregiver might approach certain scenarios and how they have handled challenging situations in the past. If possible, have the potential caregiver interact with your child during her visit so that you can see her degree of comfort caring for an infant and how your baby responds.
  6. Call their references: Ask for at least three references from each potential caregiver and actually call them all personally. Make sure they provide you with references that can speak to their professional experience caring for babies and children and not just personal friends or family members. Ask each candidate’s references to share strengths and weaknesses they noticed while working with them and be sure to ask about any reservations they may have in recommending them for future positions.
  7. Ask for a background check: Unless you are hiring a friend or family member for the position, you are essentially hiring a stranger to work in your home and care for your baby. A background check is an important step to ensure that you are hiring the person you think you are hiring and to rule out the possibility of any criminal background. If you find your caregiver via an agency or online nanny website, they may already have a background check on file. If not, you can easily find back ground check services online to conduct varying degrees of searches. Do not skip this step before employing someone in your home with your child.
  8. Make sure they respect your parenting beliefs: If you are adamantly against letting your baby, “cry it out”, and your nanny thinks it’s okay to do, we can guarantee this will not be a good fit. It’s important that your caregiver has a good understanding of your parenting style and beliefs and is comfortable following them while in your home. You will want your child to ultimately feel that it is a seamless transition from parent to nanny in terms of the type of care that is provided. Your nanny should be working with you, not against you, to raise your baby the way you have decided you want him raised.
  9. Conduct a trial period: Decide upon your top candidates after the interview process and do a trial period with each of them. You can do a trial day or week depending on how much time you would like to assess the fit. During this time, stay home and observe how they interact with your baby and their degree of comfort and ease caring for your little one. Do short excursions away to see how your baby adapts to being left with another caregiver. This will also give you and your caregiver the opportunity to get to know one another better and for her to ask any questions she may have about your baby or home. 
  10. Create a contract: Once you have decided on a good fit for your family, put all your expectations, agreements, and terms of employment on paper, review it with your new nanny, and have both parties sign and date the document. Make a copy for your new caregiver and keep one for yourself. This way, if issues arise in the future about expectations or care provided, there is a contract to reference. 

With the proper preparation and thought, finding the right caregiver for your child can be a rewarding and beneficial experience for all involved. Needless to say, this person will be one of the most important people you will hire in your life as they will be responsible for love and care of your baby in your absence. Take the time to do it right—it’s worth the peace of mind.

Diastasis Recti: Everything You Need To Know

Diastis Recti

If you are pregnant or postpartum and your stomach seems to be protruding more than normal, you may have diastasis recti. Diastasis Recti is a common condition in pregnancy, affecting approximately 30 percent of women, in which the abdominal muscles widen causing the stomach to stick out or create a bulge. Although in many cases the abdominal separation will resolve on its own, it is important to identify the condition so that you do not engage in any activities or exercises that may worsen the separation. Here’s everything you need to know about Diastasis Recti and pregnancy and what you can do to heal it.

What causes Diastasis Recti?

Diastasis Recti is the result of a combination of the uterus growing and putting pressure on the abdominal wall and pregnancy hormones that cause softening of the connective tissue. When the abdominal muscles are stretched, the uterus, bowels and other organs are left with only a thin layer of tissue to hold them in place. This results in the stomach bulging out. You are more likely to suffer from Diastasis Recti if you have had multiple children, have large babies or are having multiples. It is also more common over the age of 35. 

How does Diastasis Recti affect pregnancy?

While you may not be bothered by a protruding stomach during pregnancy, the symptoms of Diastasis Recti can be uncomfortable. Common symptoms include back pain, difficulty breathing, pelvic floor problems, urine leakage and constipation. Diastasis Recti can also make a vaginal delivery more difficult as you will not have the same muscle support. In rare cases, Diastasis Recti can lead to a hernia. 

How do I know if I have Diastasis Recti? 

To determine if you have Diastasis Recti, you can conduct a self-abdominal separation test. To do this:

  1. Lay on your back with your feet flat on the floor and knees bent.
  2. Place one hand behind your head and the other on your abdomen. Your fingers should be parallel to your waistline at belly button level.
  3. Gently press your fingers into your abdomen.
  4. Roll your upper body off the floor into a crunch sit-up.
  5. Feeling across your midline, find the right and left side of your abdominal muscles and test for separation at, above and below your belly button.

You may have Diastasis Recti if:

  1. You detect a gap that is more than 2.5 inches when your abdominal muscles are contracted.
  2. The gap does not shrink as you contract the abdominal muscles.
  3. There is a protrusion along the length of the midline of your abdomen.

What should I do if I have Diastasis Recti?

You may not recognize the presence of Diastasis Recti until after you deliver when your stomach seems to still protrude several months postpartum. At this point, what you do NOT do is as important as what you do do in healing your abdominal separation. 

  • Do NOT strain your stomach muscles by lifting heavy objects or when constipated.
  • Do NOT do exercises that utilize your stomach muscles such as sit-ups, crunches, push-ups or planks.
  • Do NOT engage in any exercises on your hands and knees.

Although it may seem like a good way to restore your stomach strength after pregnancy, all of the above exercises and movements can actually worsen the degree of separation between the abdominal muscles. 

While minor Diastasis Recti will likely resolve on its own over time, if you are concerned or are considering becoming pregnant again, seek the help of a physical therapist. A physical therapist can guide you through exercises that are safe for the condition and will aim to strengthen your traverse stomach muscles without further separating the outer abdominal wall. Exercises may involve a belly splint or Pilates and can be effective at reducing the separation. If the separation is too great and rehabilitation is ineffective, you can undergo abdominoplasty surgery to correct the problem. 

Although Diastasis Recti may be unavoidable for many women, the best way to reduce your chances of it happening is to strengthen your abdominal muscles before becoming pregnant. Strong core muscles going into pregnancy will be less likely to separate due to the pressure of the growing uterus. It should be noted though that ALL women will experience some degree of diastasis in their third trimester as the baby grows. For questions about Diastasis Recti, pregnancy or natural childbirth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Postpartum Core Training:

Brio Fitness for Woman leads a postpartum core training class at Health Foundations to help with Diastasis Recti. This is a gentle and informative series of classes that will walk you through the foundation of re-training your core after a pregnancy. Yoga, strength training, light cardio, and deep core work will be included in every class. You will also be given "homework" that you can do throughout each week. This series is for new and veteran mamas alike and is designed especially for women who have diastasis recti.

Chicken Barley Soup for Lactation

Chicken Barley Soup For Lactation

After giving birth and amidst the exhaustion of caring for a newborn, comfort foods may be all you want. Try this delicious chicken soup recipe that is not only healthy and rich in protein and vitamins, but will also give your lactation a boost!

Ingredients:

  • 1 tablespoon of olive oil
  • 1 onion, chopped
  • 1 cup of button mushrooms
  • 2 carrots, peeled and diced
  • 2 cups of baby potatoes, cut into small pieces
  • 2 cloves of garlic, minced
  • 2 cups of vegetable broth
  • 1 cup of water
  • ½ cup of pearl barley, rinsed under cold water
  • 2 boneless, skinless chicken breasts, cut into cubes
  • 1 cup of frozen peas

Directions:

  1. Heat a large pot over medium heat and add oil and onion. Cook until onion softens, approximately 3 minutes.
  2. Add mushrooms, carrots, potatoes and garlic. Cook until mushrooms are soft, approximately 3 minutes.
  3. Add broth, water and barley. Boil and then reduce heat to medium-low.
  4. Simmer covered until barley is tender for approximately 25 minutes.
  5. Stir in chicken and peas until chicken is cooked through, approximately 10 minutes.
  6. Enjoy!

Recipe transcribed from: Today's Parent

When Your Birth Doesn’t Go As Planned

Woman Contemplating Feelings

Whether you had hoped for a home or birth center delivery and needed to transfer to the hospital, or had prepared for a natural birth and ended up having a C-section, births that do not go according to plan can be disappointing. Many mothers spend their pregnancies preparing for and creating a detailed birth plan in the hopes of having the experience they’ve always envisioned for themselves and their baby. Despite the best laid plans, birthing classes, and providers, sometimes our bodies and our babies have other plans in mind. When your birth doesn’t go as planned, it’s not uncommon to experience some negative emotions along with the excitement you’re feeling about the new baby. Many women who have experienced some form  of birth trauma  or unexpected intervention report feeling disappointed, angry, guilty, frustrated, indifferent and sometimes even resentful towards their baby or their body. These feelings usually follow birth experiences that felt out of their control, traumatic or unexpected such as having an episiotomy or emergency C-section. If your birth experience has left you feeling as though your body failed to do what you had hoped it would do, here are some ways to cope with those negative emotions and acknowledge the strength and courage in your journey.

Writing Birth Story
  1. Acknowledge your feelings: This can be difficult to do when everyone is expecting you to be overjoyed by the arrival of your new baby. However, if you are experiencing disappointment, sadness, guilt or anger about the way your delivery unfolded, it’s important to take the time to allow yourself to experience those feelings without judgment. Giving birth may be the single most important event in your life thus far and it is okay to feel sadness about any part of the labor or delivery that was traumatic or upsetting to you. If you try to push away your negative feelings about the experience, they will likely resurface at a later date as unresolved issues. 
  2. Take steps to process your grief: It is perfectly normal to experience grief following a traumatic or upsetting birth experience. It is important to allow yourself to experience the grief so that you can move forward feeling as though you have processed your feelings. Talking to your midwife or doctor and asking questions so that you can better understand and process your experience is one way to work through what you may be feeling. Two cathartic ways to process grief following birth are: telling your birth story to a trusted friend or family member or writing down your birth story. Writing or telling a detailed account of your experience can help you process your feelings of disappointment or guilt and also help you identify  all of the moments (there are so many!) of great courage and strength.
  3. Surround yourself with loving and supportive people: Limit visitors in the early weeks following your delivery to people who can be sensitive to your feelings and your experience. While not intending to be unsupportive, people may make comments suggesting that the only thing that is important is that you have a healthy baby. You can gently remind them that the experience was important to you and you are not ready to discuss it further at this time. You can also ask your partner to help play gatekeeper in the early days staving off unnecessary visitors and unsavory comments.
  4. Acknowledge the strength and courage in your story: Even if your birth didn’t end the way you had hoped, do your best to remember the amazing work that your body did. Whether you labored for 18 hours before ultimately having a C-section, endured hours of natural labor before electing to have an epidural, or had to undergo any number of interventions that were frightening or upsetting to you, your body has done an amazing thing. There is also an incredible amount of strength and courage in having to let go of your birth plan and have a birth experience that feels completely out of your control. Whatever your story is, whatever the intervention or unplanned turn your birth took, your body has done a miraculous thing.
  5. Ask for help: Whether you would like extra support from your partner, your provider, a friend to listen or to seek out a new moms’ group in your area, make the effort to reach out for help and comfort. The postpartum period, despite the awe and excitement of a newborn, can be an isolating and overwhelming experience. Adding grief from your birth experience to this mix may be too much to handle on your own. If at any point your grief begins to impact your ability to function throughout the day or seems to overwhelm the joy you have for your new baby, see your doctor or a therapist for an assessment for Postpartum Depression. Although the baby blues are a normal experience in the weeks following delivery, moms who have experienced a traumatic birth experience are more likely to develop Postpartum Depression. Ask for help right away if you feel like you might be experiencing Postpartum Depression. Click here to learn more about Postpartum Depression

If you’ve experienced a traumatic or disappointing birth experience, don’t suffer in silence. There are many women out there whose birth plans have not gone according to plan and who are left feeling guilty, angry and even depressed. There is no shame in a birth that does not go as planned and no shame in grieving the experience you did not have. Remember that you gave it your all and that is enough; that you are just as strong, powerful and amazing as all of the other mamas before you. At Health Foundations, we are here to support you throughout your pregnancy, delivery and postpartum period, regardless of whether or not your delivery took place with us, in the hospital or in the operating room. We are here for you. Contact Health Foundations to schedule a free consultation with a midwife or to find support.

 

Your Six-Week Postpartum Visit - What to Expect

Midwife Postpartum Visit

Whether you give birth at a birth center with midwives or at the hospital with your OBGYN, you will likely have a postpartum follow up appointment about six weeks after you deliver. The purpose of the visit is to check on your physical and emotional well-being as you recover and adjust to your new life post childbirth. Here’s what you can expect to happen at your six-week postpartum check-up. 

NOTE: Health Foundations also provides a postpartum visit at 2 weeks for our families

A thorough assessment of how your body is recovering from childbirth: 

Your midwife or doctor will likely check the size of your uterus to see if it has returned to its pre-pregnancy size. She or he will also want to ensure that any vaginal tearing or C-section incisions are healing well, and assess for any post-birth physical problems like hemorrhoids, incontinence or constipation. Now’s the time to mention any other aches and pains you are experiencing. Your care provider will likely also clear you for sex and exercise at this visit should everything check out okay.

A check-in on your mental health: 

Your care provider may give you a written assessment for postpartum depression or she may just evaluate how you are feeling in discussion. Postpartum mood disorders affect approximately 10-15 percent of all new moms though many feel ashamed or afraid to seek the necessary help. If you are experiencing symptoms of depression such as hopelessness, sadness, anger or thoughts of harming yourself or your baby, please tell your care provider right away so they can support you in finding the appropriate help. There are many options for moms experiencing postpartum depression or anxiety including counseling, support groups and even medication. Your postpartum visit is a great opportunity to share any concerns about your mental well-being with your care provider.

A discussion about birth control:

Since you’ll most likely be cleared to resume having sexual intercourse with your partner at this visit, your care provider will probably want to discuss options for birth control. While exclusive breastfeeding can provide effective protection for the first six months postpartum and sometimes beyond, you may want to consider a back-up plan such as the mini-pill or an IUD if you don’t want to risk your kids being too close in age. Your midwife or OBGYN can discuss the various options for birth control with you and help you come up with a plan that works for you.

Your annual gynecological exam:

Many practitioners will go ahead and perform your annual exam at your six-week postpartum visit. She may conduct a pelvic exam, Pap smear and breast exam in addition to the usual physical exam measures such as weight and blood pressure. It’s a good time to discuss any other health concerns you have so be sure to bring a list of questions with you to the appointment. 

A breastfeeding consultation:

Your midwife or OBGYN will check in with you to see how breastfeeding is going with your new babe. They can help you troubleshoot any difficulties, address issues with engorgement or clogged ducts and refer you to a lactation consultant if you need additional guidance or support. 

Your postpartum visit is a great time to address any questions or concerns that you are having about your recovery, physical or mental health or adjustment to caring for a newborn. Be sure to come prepared with your questions written down so that you can make the most of the time with your care provider. At Health Foundations, our care doesn’t end in the birthing room. We are here for you during your postpartum period and beyond to support you and your new family as you adjust to motherhood. For questions about natural birth or postpartum care, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Is Breastfeeding An Effective Form of Birth Control?

Breastfeeding Baby

If you’re a new mommy and have passed your postpartum period of pelvic rest, you may be wondering how effective breastfeeding is as birth control. While you and your partner may be eager to be intimate once again, you are likely not looking to add another baby to the family anytime soon. Fortunately, exclusive breastfeeding is actually a highly effective method of birth control during the first six months postpartum and sometimes even beyond. Here’s how to make the most of your lactational amenorrhea.

What is the Lactational Amenorrhea Method?

Lactational amenorrhea is the term used to refer to the natural period of infertility that occurs after giving birth when a woman is breastfeeding her baby and is not menstruating. This period of infertility occurs because the hormones necessary for milk production actually suppress the hormones necessary for ovulation. Consequently, the Lactational Amenorrhea Method refers to when a couple uses exclusive breastfeeding as a form of birth control. You may be wondering just how effective simply breastfeeding your baby can possibly be at preventing pregnancy. The answer to that question is very effective, if a few important criteria are met. 

In order for the Lactational Amenorrhea Method to be as much as 98-99.5 percent effective, the following factors must be present:

  • Your baby must be 6 months or younger
  • You must be breastfeeding on demand during both day and nighttime
  • Your menstrual cycle has not yet returned
  • Your baby must be exclusively breastfed with no formula supplementation or introduction of solid foods to his diet

Even after six months of age, moms who frequently breastfeed their babies and who have not had the return of their menstrual cycle are only 6 percent likely to become pregnant.

What Factors will Affect the Return of My Fertility?

Although the average time for nursing mothers to experience a return of their menses is 14.6 months, there are a number of factors that may cause you to become fertile before then. These factors known to impact fertility include:

  • The introduction of solids to baby’s diet
  • A reduction in the number or duration of nursing sessions per day
  • Your baby beginning to sleep through the night
  • Regularly pumping in lieu of breastfeeding

Every woman is different and experiences sensitivity to hormones to varying degrees. Overall, the amount of time your baby spends at the breast each day will be the biggest factor contributing to the duration of your lactational amenorrhea. If your period has returned, breastfeeding is no longer impacting your fertility and you should not rely on this method for birth control. 

Can I Increase the Length of my Lactational Amenorrhea to Prevent Pregnancy?

Yes! There are several simple ways that you can attempt to maximize your lactational amenorrhea while breastfeeding. These include:

  • Continuing to breastfeed on demand past six months. Aim to put your baby to the breast at least every 4-6 hours, day and night.
  • Cosleeping to increase night nursing. Fertility hormone production is highest during the nighttime hours making night nursing a primary factor in preventing the return of fertility.
  • Delaying solids until 6 months and offering the breast before each meal.
  • Using nursing to comfort your baby.
  • Offering breastmilk exclusively. Do not supplement with formula.
  • Skipping pacifiers and postponing the introduction of bottles until necessary.
  • Keeping your baby close to encourage frequent nursing by babywearing.
  • Nursing lying down for naps and at night.

Using breastfeeding as birth control is a safe and effective way to prevent pregnancy during the first six months postpartum and even beyond under certain circumstances. Most importantly, your baby will enjoy the limitless health and emotional benefits of exclusive breastfeeding during this critical time in her development. For questions about lactational amenorrhea or for anything related to pregnancy and natural birth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.