Feeling More Than Blue: The Reality of Postpartum Depression

There is no easy way to say this…the postpartum period can suck. It can be awesome and awful, exhilarating and exhausting, and precious and painful all at the same time. You will find strength you never knew you had to get through those long days and even longer nights. But while nearly 40 to 80% of women feel postpartum blues, about 10 to 15% actually suffer from postpartum depression. It is a serious illness that requires serious attention. We want to address it with all the gravity that it deserves.

The emotions following the birth of a baby are as labile as the weather in the tropics. In minutes, you can go from elated to dejected. While it is quite common for women to experience what is called postpartum blues (a.k.a. the baby blues), the symptoms of depression are usually mild and short lived. Why it happens is not clear; most of the research points towards those crazy hormones that are flooding your system post-delivery. Women report sadness, tearfulness, irritability, anxiety, insomnia, and decreased concentration.

In the first two to three days following delivery, about 40 to 80% of women report feeling blue. In most cases, the symptoms of being “blah” (medical term = dysphoria) will peak over the next few days and then resolve within two weeks, basically, like a blip on the radar. So while some moments—and days—will be harder than others, all in all your mood and emotions should be stable.

Postpartum depression is in many ways the baby blues magnified by 100. Unfortunately, because the symptoms often overlap with the typical postpartum pleasantries, many women are misdiagnosed or undiagnosed and suffer in silence. Fatigue, difficulty sleeping, change in appetite/weight, and low libido (to name a few) are often seen in both processes. Again, what fuels postpartum depression is largely unknown; however, much like the blues, hormonal changes are thought to be the culprit (although here genetics is also thought to play a role).

While we are all at risk, there are specific risk factors that make us more likely to develop this disease: a history of depression, history of abuse, stressful life events, lack of a partner or social/financial support, family history of psychiatric illness, and childcare stressors (inconsolable infant crying). If postpartum depression is left untreated, it can often develop into chronic depression. It can also have a major impact on our ability to bond with the baby and can impact the development and mental health of infants and children.

To minimize the negative domino effect for both mother and baby, we as OBs need to ask the right questions and encourage you as moms to share your emotions. While we can’t definitively prevent who develops postpartum depression and how it affects them, we can identify women who are at significant risk and start treatment early. For example, if you have a history of major depression and were successfully treated with antidepressants in the past, you may be a candidate for immediate medical treatment postpartum. Bottom line, don’t be afraid to share your past history (physical and mental) with your doctor; this sort of information may make a big difference on how you weather the postpartum storm.

The “fourth trimester” (aka the postpartum period) is largely dominated by breastfeeding. Therefore, taking medications for both depression and anxiety while breastfeeding has become a hot topic. As moms we don’t want to take anything or do anything that could affect the health or development of our baby. We martyr ourselves to the umpteenth degree for our children; what we ingest, be it food or medicine, while breastfeeding is no different. But the reality is an unhappy mom makes for an unhappy baby. While medications may not be the first or only step (cognitive behavioral therapy is recommended initially) they are a close second. And in cases of severe major depression or mild/moderate depression that is not treated with psychotherapy alone, medication should be initiated. In general, for women who are breastfeeding SSRIs (selective serotonin-norepinephrine reuptake inhibitor) are the preferred class of medications as they present the lowest risk to your baby.

Everything in medicine (and in life) has a risk-benefit ratio. It’s like a seesaw; sometimes you are up, and sometimes you are down. Our goal when prescribing treatment is to find a balance. For example, while breastfeeding on an antidepressant may pose a small risk to your baby, the benefits of breastfeeding appear to outweigh the small risk of the antidepressant on the baby. All medications will make their way into your breast milk, but the amount can vary.

Here are some pointers to reduce the exposure:

  • Select medications that are in your system for a shorter amount of time.
  • Take medications immediately after you nurse (so that the levels in your milk are the lowest).
  • Work with your OB, your mental health provider, and your pediatrician and see what is best for you and your baby. You wouldn’t stop taking medicine for your blood pressure if it was high. Your brain is no different!

The problem with post-partum blues, depression, and the feelings of being down and out is that we are afraid to admit things are not perfect and that maybe motherhood is not all that we imagined. We feel guilty for wanting to scream when the baby won’t stop screaming or drink a bottle of wine when the baby won’t take the bottle. We feel guilty about not loving every second of what is supposed to be the most precious moments of our lives.

But the reality is, we all feel like this. For some of us, they are transient, and we quickly return to our baseline. But for others, the feelings remain and can worsen. Don’t be afraid to share your feelings; help is available. You are not a bad mother for feeling this way. In fact, admitting there is a problem and getting help makes you bold, courageous, and actually a pretty badass mom!

Wine = Whine

We’ve all been there. The incessant instances of “No,” “I don’t wanna go,” and “Mama…,” whether it’s at the 5 o’clock witching hour or the 1 o’clock I don’t want to take a nap, these sounds are less than pleasant. Like nails on a chalkboard, the longer it goes on, the more it drives you insane. It drives your blood pressure up and takes you to a place that can only be made better by some time alone and a sizeable glass of rosé! Let’s face it: they whine, you want wine.

Motherhood isn’t easy. It’s non-stop, 24-hours-a-day, seven-days-a-week work. And unlike any other job, you can’t clock out, you don’t get paid, and there’s no such thing as overtime. And no matter how badly you wanted this “job” or how long you took to perfect your “resume” (a.k.a. did whatever it took to have a baby), there are many times when you want to quit. We know…we feel it too.

Although we can’t offer you a break room, we can offer you a few words of advice. When you’re all whined out, take a moment and step away. Whether it’s for some deep breaths, a quick workout, or a glass of wine, do something that will help you reset. Stepping out of the moment rather than stepping into the drama will let you come back to the scene in a whole different headspace.  

But when all else fails and your self-inflicted time out doesn’t do the trick, pick up the phone. Call your BFF, and let it all out. The more you share, the less isolated you’ll feel. Community and camaraderie can be more powerful than any cocktail you concoct. Verbalizing your feelings to a peer can prevent you from loudly vocalizing (a.k.a. yelling) your frustration to your kids. So, while a phone call may seem second best to a glass of wine, “pouring” out your emotions can be pretty powerful.

Cheers!

Big Girls Do Cry

Showing emotion has too long been viewed as a sign of weakness. “Tough” and “strong” meant holding in how you were really feeling, especially as a mom trying to juggle it all. Fear of being judged or being seen as weak or imperfect prevented us from sharing our emotions. No one wanted to be the odd woman or mom out. But unlike the lyrics of the song most of us know from the Dirty Dancing soundtrack, big girls do cry. Shedding a tear doesn’t make you a wimp or pathetic; it makes you real.

Whether you are the mother of a newborn, a toddler, or a teenager, parenting is hard. And although the problems may change (getting your little one to sleep through the night to getting your teenager to come home at night), tackling them is equally as challenging. It can drive the sanest of us insane! Add to that another child or two, and the tasks don’t double, they quadruple: your head is spinning. Without your Google calendar attached to your hip telling you whom to pick up and when, you would be lost. But sometimes, even the most organized planner, the best parenting books, and the cleanest diaper bag can’t replace how lost you really feel.

Fear of being seen as lesser, imperfect, or subpar makes most of us hold our feelings in. And as the emotions build, so do the walls we put up to hide how we are really feeling. But the walls not only keep our feelings hidden, but they also keep the support of others out. They prevent us from making contact, from building relationships, and from seeking help.

When we share how we feel, our failures, and our fears, we create community. We create connections. We work together. And together, as a unit of women, moms, partners, sisters, and friends, we can stand stronger. Start a movement of honesty and truth by being honest and true with who you are and your fallibilities. You never know whom your words will reach and whom you will inspire.

So, take it from two big girls who frequently cry: crying is not a bad thing. In fact, it’s a pretty good thing. Just find the shoulder of someone you trust when you do. It will make the whole process a whole lot easier!

7 Tips for Picking a Nanny: Advice from Expert Tammy Gold

Whether you are a new mom or a seasoned mom, searching for a nanny can be a challenge, to say the least! From where to find someone to what questions you should ask at that first meeting to when is the best time to start, the search can be overwhelming. Let’s face it: there is nothing or no one more important than your child. Finding the right person to help you care for your little one can seem nearly impossible.

To help soothe your nanny nerves, we sat down with Certified Parenting Coach, Licensed Therapist, and Founder of Gold Parent Coaching Tammy Gold (www.tammygold.com) to get the seven best tips on how to find a nanny. Here’s what she had to say….

Rule #1: Don’t rush the process of looking for a nanny.

When you’re worried about childcare, it’s extremely hard not to rush, especially if you need coverage immediately. But you must force yourself to fight the initial panicked instinct to hire the first remotely qualified nanny and put her to work right away. To make a good decision, you need data. You want to allow yourself plenty of time and ideally be under as little pressure as possible so that you can go through the entire process carefully, complete the necessary due diligence, and feel great about the person you hire.

Rule #2: Do the work to figure out what you need.

Your nanny will be intimately involved in raising your child, so you want to really hone in on the quirks and nuances of your family, as well as the nanny personality and skill set that you need. You’re the employer, so you get to create the job, and it can be whatever you want it to be. But you need to be absolutely clear about the requirements and expectations from the get-go. Things get complicated when a nanny feels misled, you feel like you’re not getting what you pay for, or you try to change the job and modify the nanny’s responsibilities along the way.

Rule #3: Have realistic expectations.

There will be pros and cons to every candidate, and every nanny will occasionally make mistakes. But that doesn’t mean that she can’t be a wonderful caregiver or that she isn’t the right fit for your family.

Rule #4: Don’t project too far into the future.

When you sit down with a nanny, try not to think, “Is this the person who’s going to care for my child for the next ten years?” Don’t worry about whether this is a life-long match or whether you can see her being at your child’s wedding someday. Most nannies don’t stay forever; they typically stay for a few years and then move on as the family’s needs or their needs change. So, all you have to decide is whether this person is the right caregiver for your child right now and whether she will still be able to meet your needs one to two years down the line.

Rule #5: Remember that, during the nanny interview, your nanny is also interviewing YOU.

Yes, you are choosing to hire a nanny, and yes, as the employer, you are in the driver’s seat. But in the nanny’s mind, she is also deciding whether she should work for you, and any really good nanny will have her pick of jobs. Be aware that, at any given point in the process, she will be asking herself, “How do I feel about this family? Do I like how they handle things? Do they make me feel respected and understood?” You are two equal parties in every sense of the word, and you want to think about it as an equal relationship from the start.

Rule #6: If you like someone, keep the process moving.

Remember that, when nannies are interviewing with you, they are also interviewing with other families. If you like someone, make sure she knows that you’d like to move on to the next step, and give a specific timeframe so she knows what to expect. You want to keep the nanny in the loop so she knows you’re serious and hopefully will not jump to accept another offer.

Rule #7: Keep the faith!

Nanny searches require stamina, and just like job searches or dating, they can have ups and downs. There will be setbacks. A nanny may do everything right and then be terrible in the trial, or your frontrunner may get another offer that you can’t afford to match. You will sometimes feel like you are getting nowhere—and then suddenly, you’ll meet the right nanny and feel that “click.” The key is to be patient and continue with the process. If you stay the course, it does work!

Even Moms Need a Day Off!

As moms, we often think we can do things one-handed, backwards, and in the dark. You know how it is. You use any extremity (even teeth) to hold bags, babies, and BIG cups of coffee. Your day starts with the roosters and ends with the owls. The responsibilities are endless, the needs of others limitless, and the workload large. Motherhood is the most rewarding job—but it’s also the most exhausting. On a daily (more like hourly) basis, you want to quit. You wonder how can things get any harder or any more harried, and then your toddler empties your jewelry box into the toilet bowl—and you think, I guess it can get worse!

The only way to survive the disaster days is to allow yourself time to recharge. Even the fanciest cars need to refuel (nobody can run on empty forever). You are not a horrible person for thinking that time with your kids can be terrific and terrible all at the same time. They can push your buttons, make you want to pull all your hair out, and force you to ask yourself, Why did I ever do this? Let us remind you that you did this because even on the temper-tantrum, drama-filled, never-ending-tears days when they are finally sleeping and you stand at the door watching them breathe, you think, I never knew a love like this existed.

That’s why.

However, when you are worked to the bone, appreciating even the most precious moments of motherhood can be difficult. If you’re feeling like you can’t take another minute of the crying, you’re not alone. You are not a bad person or a bad mother. It is because of the enormity of it all, the all-consuming, all-in and all-on, that we beg you to take a break. We ask you to give yourself a rest—even if only for a few hours. Ask your partner, your parents, your friends, or a sitter to come over and relieve you for a few minutes, a few hours, or even a few days. It’s okay to need time off; we all do! You shouldn’t feel guilty because you want a day to sleep past 5 a.m., not change a dirty diaper, or not have an argument about why you can’t eat dessert before dinner.

We get that guilty feeling too when we clock out, but you gotta do it. Time away from any job is needed, especially one that’s all day and all night. Don’t beat yourself up because you can’t be on ALL the time. Nobody can (and anyone that says they can is lying to you). We moms can sort of do it all, carry a kid, a bag, a stroller, and pay for groceries all at one time. You do whatever you have to do to keep them safe, smiling, and healthy, in body and spirit.

Just because you can do it all doesn’t mean you don’t need some time to just do nothing. You’re not a machine; you’re just an awesome mom.

Making the Most Out of Your Minutes

We are certainly not all knowing. We aren’t even half-knowing. But what we do know from years of trying to do it all (which, p.s., is a total impossibility) is that you can’t do it all. Admitting it early in your career as a mother will make your evaluation of yourself a whole lot easier to take. Cutting yourself some slack before you start the day will soften the blow when you can’t work out, clean your house, do the laundry, go to work, take your kids to gym class, do some homework, make dinner, and oh yeah, get yourself dressed.

The list of never-ending responsibilities goes on and on. Being a mom is no joke. While the actual number of people who need you, want you, and can’t function without you can be small (for most of us, this is a low single-digit number), their demands are high. As a result, the days are long, and the nights are short, unless your little one is still not sleeping. Then the nights are even longer! We are here to offer a few pointers from a couple of girls in the know who are still trying to know how to make the most of our days and the most of our time.

First things first, plan. Plan, plan, and then plan again (preferably in pencil so you can erase). Make a road map of what you want and what you need your day to look like. If it seems unrealistic or nearly impossible, then move some of your stops to another day. With less on your plate, it will make you less anxious about satisfying a long list of activities.

Anticipate what you might need and whose help you may need. While a crystal ball showing you what may go wrong and what will go right does not exist (although if you find one, please share!), knowing what you can and cannot accomplish alone is helpful. Things like extra milk, extra diapers, and extra clothes don’t take up a whole lot of room, but they do make a whole lot of difference in your day. Think about everything that could go wrong, and plan for that. Taking a little extra may make your bag a touch heavier, but it will make the potential downsides much lighter.

Be Efficient. The best athletes, surgeons, and technicians are efficient. Whether they are efficient in their footwork out on the court or efficient in their hand movements in the operating room, their lack of wasted movements moves them to their destination faster. Now, while we don’t expect you to be Serena Williams, try and mirror this in your day-to-day routine. Doing a couple of things at once (although texting and driving is NOT on this list) will help you bang out more than one task at one time. That’s why they made hands-free breast pumps!

Shut off, and tune in (to your family). We as mothers have definitely learned this lesson the hard way. Hearing your child ask if your Apple product is more important than their newfound ability to ride a bike is pretty awful. They are the apples of your eye, and trying to make the most of your time together is key. When it comes to the end, you won’t ask yourself if you sent enough texts, but you will ask yourself if you spent enough time together. Staying present with your plus one and plus ones will alleviate a lot of the guilt you feel when you are gone and ensures that your time together is more meaningful. Remember, it’s about quality not quantity.

Don’t worry about how you look, how they look, and how it looks! Although your desire for things to look just right is right on in our appearance-obsessed culture, we are all filled with flaws. Real life is not as glossy as your Instagram feed would make it seem. Filters will filter out the bad days (who posts the bad hair days on Facebook?), but they don’t represent the truth. Be mindful of what you take away from images on social media; they aren’t always reality. Bottom line: if your 2-year-old wants to wear her PJs to the park, sometimes it’s better just to go  with it. While you will have to put your foot down on some things (she is not wearing Minnie Mouse PJs in your family pictures), you have to pick your battles. Feeling good is way better than looking good.

Take time for yourself. An exhausted, frustrated, and spent mother, like a muscle that has been utterly fatigued, is not going to function as well without a break. We all need a day, or at least a few minutes off. Don’t be ashamed to ask for a break, a mini time out, or a breather. It doesn’t make you a bad mother it makes you a smart woman. Knowing when you have hit your breaking point will help avoid a way bigger problem.

Let the little things go. For fear of sounding trite or clichéd, we can’t stress this one enough. As doctors, we have seen a lot of bad stuff, to say the least. The kind of stuff that takes your breath away, brings you to tears, and makes you thank your lucky stars that you are still alive. And while many things in medicine bring us sadness, they have also helped bring us a lot of perspective. Appreciate what you have and who you have. You never know what could happen tomorrow. The small stuff will work itself out, trust us…doctor’s orders.

The Waiting Game

As parents, we have all been there—the endless, time-stands-still, clock-barely-ticking waiting game. Whether you are waiting for the arrival of your baby or the arrival of your teenager (who is clearly late for curfew!), we have all stood by the door waiting for it to open. The anticipation and the anxiety can be debilitating. Not knowing what is happening and what could happen to your child can be incapacitating. And while we certainly don’t have any ways of making the clock move faster, we do have ways of dealing with the unknown. It’s called limits. We put limits on the situation, our surroundings, and ourselves to limit the negative emotions that can take over your mind and limit your ability to function.

  1. Limit the negative energy: The waiting game is not a solo sport. When you are waiting for news, be it good or bad, it’s nice not to be alone. It’s also nice not to be with people that drive you crazy. Find someone (or someones) who have good juju and can stay by your side as you are standing on the sidelines.
  1. Limit your idle time: When not occupied, your brain can go farther than a trans-Atlantic flight, especially when you are thinking about your children’s health. Your mind can concoct some pretty crazy stories. And while we are not recommending that you do algebra or geometry in your idle time, we are suggesting that you listen to music, read a book, consider meditation, and hop on the phone with one of your friends. Although these modalities won’t change the outcome, they can help speed up the clock and maybe even reset your psyche.
  1. Limit your Google search: On the heels of #2, be skeptical about what your searches reveal. While we too have many degrees from Dr. Google, the Internet can be a scary and sketchy place for advice (minus Truly, MD!). You can take any myriad of symptoms and make them into the Plague. Speak to a professional, and get their educated opinion before you make a diagnosis that is dubious, to say the least.
  1. Set limits for what you can and cannot do: So often, we try and do it all. It’s hard to find one woman who doesn’t want to be Cameron Diaz in There’s Something About Mary. But the reality is that there is no She-Woman (or He-Man, for that matter). We all need help. And we are all limited. Your limitations don’t make you less of a woman, a partner, or a mother. They make you real.
  1. Limit the what-ifs, the should-haves and the could-haves: Life is not lived in reverse. Unlike that car sitting in your driveway, it can only go forward. No matter how hard you want to turn back time, you can’t. At some point, you have to stop beating yourself up for what you “should have” recognized and what you “could have” done. It won’t change what happened; it will only change how you move forward.

Unfortunately, in this game there is no official time clock. There are no periods, no quarters, and no halves. To make it to the end takes fortitude and strength. Parenthood is a challenge. And while we may not be there on the field to cheer you on, we hope that just knowing how many other people have played the same game brings you comfort. You are not playing this game alone!

Goodbye, Diapers!

I think one of the greatest mom moments might be when you say goodbye to diapers: the moment when you realize you no longer need to carry a diaper bag, no longer need to search out bathrooms with changing tables, and no longer need to keep the Diapers.com app open at all times. For all of you moms of toddlers, both who are on the cusp or who have recently completed potty training, you get what we are talking about. It’s a goodbye moment that you never thought would come. And unlike the many places, events, and people you have waved goodbye to, this one evokes intensely polarized feelings: relief and reminiscing, escape and longing, and happiness and sadness (whoever thought they would miss a diaper!). But while most of us are not bummed about saying goodbye to cleaning someone’s bum, we feel a twinge of sadness for the mommying chapter that is closing.

In many ways, the early days of mommying are like running the hurdles. And even if you are not a track star, you get the reference. But it’s not only the ups and downs that those infant and toddler days bring, but also the major events that need to be tackled, one after another: feeding, sleeping, crawling, walking, talking, peeing, and pooping. You clear one, and it’s on to the next. And these hurdles, unlike that track and field event you watched on TV, are not all the same height. Some are super, super high.

Potty training is one of those skyscraper-like hurdles. And whether you decide to follow the “Child-Oriented/Brazelton Approach” or the “Toilet Training in Two Days or Less Approach,” it can be a bear or a major pain in the behind. And trust us, we are not here to tell you one approach is better than another or criticize what you have done. You do what works for you and your little one. But we are here to say that, whichever you chose, bear with your baby (and yourself) as you tackle this giant milestone. Don’t let the pressure of those around you, an impending trip, or a summer camp requirement stress you out. It will happen. As moms who have jumped this hurdle twice, we promise you it will.

We are pretty confident that you won’t find a mother who will miss those poop explosions or trying to wipe, change, and hold their little one down with one hand while searching for a clean place to change their diaper with the other. But you will find many moms (us included) who will mourn the passage of time. Saying goodbye to diapers symbolizes that next phase. It symbolizes their growth and ours, both as mothers and as individuals. In many ways, no matter how dirty it is, it is the end of an era.

While that era may have been soiled and smelly, there was also something special about it. So, while we eagerly wave goodbye to diapers, don’t rush what’s to come. As a wise mother once said, “No one ever goes to college in diapers, so don’t stress about potty training.”

The Ultimate Snow Day: What It Really Feels Like to Have a Newborn

A couple of weeks ago, we were chatting with a friend who recently had a baby. After the routine pleasantries—“He is so adorable,” “You look amazing,” and “How magical is motherhood?”—the conversation got real. We started to dish on the unbelievable fatigue, the shower drain-clogging hair loss, and the daily outfit dilemma (nothing fits my top or my bottom!).

Let’s face it: those first few weeks can be pretty blustery. To quote a fellow member of the new mom club: “That first month is like one long snow day. You hang out in your PJs, you eat lots of comfort food, and you lay around on the couch.” Your days snowball into nights and avalanche into the next day. It’s one big mental blizzard.

And although many of you will bring your little ones home during a heat wave in August, when snow days are far from your mind, you get the concept. It’s that never-ending feeling of being in a daze. Not only are you utterly exhausted, but you are also completely confused: nipple pads, Diaper Genies, and breast pumps. It’s like speaking a foreign language. It makes you want to bury your head in your pillow, pull up the covers, and take a long nap. But you can’t. Motherhood calls.

At some point, you will have to put on regular clothes, you will have to cook yourself a meal, and you will have to leave your apartment. You will have to go back to normal. And finding out how to adapt to that new normal can be tough—it’s hard for even the most seasoned mothers. It’s important to remember that things will be “chilly” when getting your cadence down, but with time, help, and patience, things will get easier.

Take it from us, former members of the new mom “snow day club.” Motherhood, particularly those first few months, will throw you lots of snowballs. Some will land softly, and some will hit you smack in the face. But wherever they hit, you can brush them off and get back up.
The sun is on its way out!

Bad Moms

The other night, amidst packing and paying bills, I stumbled upon the movie Bad Moms. And while I never had a strong desire to watch it, for a combination of comic relief and some much-needed mental respite, I decided to put it on. I was immediately hooked. As a mom who struggles with work and kids, family and career, there was something to this movie. And while I don’t think it will win an Oscar, the movie not only made me laugh, but I also came pretty darn close to crying (and not because I was laughing so hard).

My emotions went south because, from the title to the struggles that Mila K and her besties faced, I could relate. The being late to everything, the never having everything under control, and the constant feeling like you are doing a C job as a mom, a wife, and a professional resonated with me. Add to that the constant feeling that people are watching and judging you, and you really have yourself in a tailspin. It’s a wonder any of us can get out of bed in the morning! It seems that no matter how hard you try, crossing the threshold from “bad” to “good” feels impossible.

Unfortunately, this piece won’t offer you much in terms of advice. It doesn’t come with “10 Tips on How to Feel Better about Yourself as a Mom” or “5 Ways to Feel Good Rather Than Bad.” And that’s not because we wouldn’t share it if we knew (trust us, we give you all that we’ve got!), but because we also don’t really have the answers. We, too, just like many of you, struggle with the “bad mom” feelings on a daily basis. No matter how big our smiles are on Instagram or how color-coordinated our outfits are, we are far from perfect.

We are sharing these emotions, as well as our flaws, to bring unity amongst women. To help us all recognize our similarities rather than dissect our differences. At the end of the day, we pretty much all want the same things—health, happiness, and love. So, let’s promise each other that the next time you think about uttering the words “I am such a bad mom,” you stop yourself. Take a deep breath, and think about all that you have already accomplished today and all that you will do, both for yourself and for others.

Cut yourself some slack. Cut out the negative thoughts. And cut out the negative people who perpetuate those emotions. Although we didn’t learn it in medical school, we are pretty confident that a processed lunch with non-organic bread or an extra 30 minutes on the iPad is not the end of the world.

Give yourself a break: doctors’ orders!