Milk Maid: Are the Benefits of Breastfeeding Bogus or a True Bonus for Your Baby?

Ah, breastfeeding. What can we say? Just the word, the thought, and the image can engender emotions as variable as night and day, north and south, love and hate. People are very passionate (on both sides of the aisle) about this topic. Remember how much flak that lady took who was breastfeeding her 3-year-old son on the cover of Time magazine? She almost got as much press as Caitlyn Jenner!

For those who have danced the dance before, some recall the experience with fondness and affection, while others remember it with frustration and fury. For those who have not yet even tried, the thought can create both anxiety and excitement, nervousness, and anticipation. Wherever you fall on the breastfeeding spectrum, it is worth a discussion. Why is there so much buzz around this subject, including if you do it, where you do it (who knew a woman breastfeeding her baby would make its way to the floor of Congress!), and how long you do it?

The tides on breastfeeding have changed more than the Atlantic Ocean in hurricane season. In the 1950s, women were given medications that put them in a twilight state for delivery (no memory of the pain, the pushing, and the other glories of childbirth) and given formula to feed their babies when they woke up.

Today, hospitals are jockeying to receive the prestigious “Baby Friendly” recognition where Baby and Mom are never separated (the newborn nursery no longer exists). Lactation consultants occupy the hallway. Breastfeeding classes happen twice daily, and formula is hardly even mentioned. In 1971 only, about 25% of mothers left the hospital breastfeeding. In 2005, this number had risen to 72%. The change has come on the heels of extensive research, which has demonstrated the numerous benefits of breastfeeding for both Mom and Baby.

So what is so magical about that milk? Why is it liquid gold? Breast milk offers numerous benefits for both babies and mothers. The list is long, and at the top is the protection it offers against infection. Buried within the milk are antibodies that strengthen your baby’s immune system. While women are breastfeeding, their babies have a lower chance of infections, including stomach bugs, respiratory illnesses (colds and coughs), ear infections, and urinary tract infections. Additionally, breast milk has been shown to help stimulate the growth and motility of a baby’s GI tract.

And as if the carats of this gold were not high enough, breastfeeding does not just offer short-term gains but also major long-term benefits for your child. The pluses seem to persist for years after the last drop is released; a mother’s milk provides protection against illnesses for the first several years of a child’s life. Fast-forward into your child’s adolescent and adult years, and there is evidence that suggests breastfed babies have a lower incidence of chronic diseases, including obesity, cancers, allergies, diabetes, and even adult cardiovascular disease.

And if you think that’s it, think again. Select studies have shown that breastfed babies may have better vision, hearing, cognitive development, childhood behavior, and stress reduction. But while the list is long, some points deserve more press than others. While the early benefits are clear, the later ones are controversial. Don’t let the fear of what might happen to your child ten years into their life if you put the pump away after six months keep you going. Whatever you have done or will do is better than nothing! And remember, many of us have gotten to the top of the professional ladder and never consumed even one ounce of breast milk. Your child’s success is not solely based on their first diet.

Breastmilk doesn’t just do a baby’s body good; it also does your body good! Breastfeeding hastens your recovery post-delivery (the hormone that produces milk also helps the uterus to shrink back down to its normal size). It helps the weight come off faster (a magic diet pill—we’ll take that!), and it can serve as a form of birth control (at least in the first few months after your delivery).

Some data suggest that women who breastfed have a lower incidence of breast and ovarian cancer as well as a lower risk of heart disease. Lastly, it’s basically free! Formula is not cheap, and babies drink a lot of it! Take the money you saved, and buy yourself something special. You deserve it. Breastfeeding is hard work!

But while breastfeeding may not be right for every woman, it is medically not advised for some women. These include women who are HIV+, HTLV type I or type II, have active untreated tuberculosis or varicella (chicken pox), or have active herpes with breast lesions. Women who are advised to take certain chronic medications that they briefly stop during the pregnancy may also be advised to resume postpartum and not breastfeed. Additionally, women who use illicit drugs or consume excessive alcohol should not breastfeed. Lastly, babies with a condition called galactosemia (inability to break down a milk byproduct) should not be breastfed.

Let’s face it, even the best milk producers amongst us need a break every now and again. An afternoon to pamper yourself or an evening out with friends is important for your mental state and can actually help with your milk production. Making milk is hard work. You need to eat well, drink lots of fluid, take your vitamins, and try your best to get some rest (we understand how hard this is!) Continue to watch your fish intake (like you did during pregnancy), as some are loaded with mercury  (Link: A Fishy Situation). Bottom line: in order to keep the milk flowing, you need to maintain your health.

You’re not a machine, but even machines don’t work without maintenance! In fact, it is estimated that you need an extra 500kcal per day when breastfeeding. And although infant demand (how much your baby wants and needs) is the major factor determining how much milk you produce (some women breastfeed twins, triplets, plus!), maternal stress, anxiety, fatigue, illness, and smoking can all lead to a tapping out of your supply. A little pumping and dumping now and again never hurt anyone or left any baby hungry.

While we are not here to tell you not to try or to stop prematurely, we are here to say, cut yourself some slack. You are not a failure if you didn’t make milk, if you couldn’t get your baby to latch, or if you simply could not do it. Breastfeeding does offer many benefits, but it’s not right, easy, or appropriate for every mother. And that’s ok. No baby was rejected from Harvard because his or her mother did not breastfeed, quit after a few months, or didn’t make the recommended six-month mark.

In an ideal world, we would have an extended paid maternity leave—this time together would be more conducive to continued breastfeeding. But most women don’t get this; shortly after delivery, they must return to work. So we recommend you use all the resources available to you: lactation consultants, breast feeding organizations/stores, websites, and your friends. Many of them will have walked in your footsteps only months before and can be your cheering squad pushing you forward. Their knowledge can benefit you and offer you solutions to a problem that, despite the loneliness you feel, millions of women before you have faced.

It’s likely not a day will go by that you don’t blame yourself for something, feel guilty about something, or think that someone else would have done it better. It’s par for the course. Parenting is a big responsibility. We get it; the thought is overwhelming. But on this journey of motherhood, you will bogey, you will eagle, and sometimes you will even par. We all do. Breastfeeding is only the first putt on the course. Do your best, and the rest will likely take care of itself.

Got the All Clear, But Can I Really Re-Consummate This Relationship? Sex after Baby

The first six weeks after your baby is born are a major blur. Let’s be real: while there are magical moments, most of your days are filled with spit up, dirty diapers, milk stains, and sweats (don’t think we changed out of our workout clothes once!). Your home becomes a welcoming ground for friends, family, and all of those well-wishers who can’t wait to meet your little one.

And while you welcome a break from the routine (feed, burp, diaper, sleep), their presence can be beyond overwhelming. It’s not only the germs you see them bringing into your Purel-ed place or the gift that now requires a thank-you note (you could write a thank-you note for that cute onesie in your sleep!), but your energy level for entertaining is at an all-time low. It is not easy.

And to top it all off, your body still does not feel like your own. You’re still bleeding, your boobs are now enormous, and your belly still looks pregnant. (We have all been there. It is not fun one month after delivering, when that friendly neighbor says, “Any day now: you must be so excited!”). Additionally, you are now on pelvic rest—a.k.a. nothing in the vagina for six weeks post-delivery (whether or not your kid came out from below or through your belly). That includes no tampons and no sex.

So you make it through the first six weeks sleepless and sexless and go to your OB for the famous post-partum visit. She or he chats about life, how you are feeling, and how you are adjusting. They weigh you (ugh, still have 15 pounds to go) and examine your incisions (both abdominally and/or vaginally). Then they begin the discussion about birth control—pills versus patch, condoms versus IUD, or for those at the end of the baby line, tying your tubes versus tying his tubes (a.k.a. a vasectomy).

This subject transitions into “YOU are all good to go”; basically, you have the green light to have sex again. At this moment, you are probably thinking, Am I really ready to turn in my postpartum hospital-grade underwear? (Gotta admit, those are the best!) for my Hanky Pankys? Given your current state, sleepless and shaveless, it’s hard to imagine being intimate again.

Let us give you a quick preview… It’s as dry as the desert in summer down there, and no matter how much lubricant you use, you will still feel like you are being set on fire. We are here to say not to worry; while completely unpleasant, it is totally normal. In a large study of post-partum women, nearly 85% of women reported sexual problems at three months’ postpartum (See, you are not alone).

Your mind and body have gone through some pretty serious changes, and it will take time for things to go back to normal. And the good news is that for most it will go back to normal. Research shows that about 50% of women reported dyspareunia (medical way to say pain with sex) at two months post-partum. By 18 months postpartum, this number decreased to 24% (See, time does heal all wounds!).

Post-delivery, your estrogen levels plummet. This drop is not only caused by the delivery of your baby and placenta, but also by the rise in prolactin (the hormone that produces breast milk). Prolactin levels remain elevated post-partum to allow for the continued production of milk. With this high comes the persistent low of estrogen.

In addition to the mood changes, the hair changes, the skin changes, and the headaches that come with low estrogen, you can also welcome vaginal dryness. And not just the mild “Oh, KY Jelly or Astroglide can fix that” vaginal dryness…it’s a dryness that requires an army of products. Medically, we call it “atrophy” or “friable.” Due to “atrophy,” you can often see bleeding post-sex. Again, we are here to say that this is not uncommon.

In addition to the discomfort experienced with sex post-partum, a significant number of women report decreased libido. Nearly 60% of women reported a decreased libido at three months post-partum. Not surprisingly, they cited fatigue, discomfort, and fear of making a bad situation worse. Women who breastfeed were even more likely to report a decrease in libido than non-breastfeeding women; this is likely because those who don’t breastfeed have a faster return of their hormones to baseline. However, the difference did not persist for the long term (again, nothing lasts forever!).

Ways to combat this problem include lubricants and vaginal estrogen creams. So even without a major makeover, in most cases, things will get better. Now, if you sustained a serious tear or had a complication with your laceration or episiotomy, the situation might be a bit more complex. It may require you to sit out on the bench for a bit longer and apply a more comprehensive armamentarium of medications and products. But don’t worry. Even in the most serious cases, with the help of an OB/GYN, a pelvic surgeon, and in most cases, physical therapists, this team can help restore the situation back to normal (although you may need to consider having a C Section for your next child to avoid a repeat event if the situation was really bad).

Bottom line is that your bottom will heal—it just takes time. If you don’t feel like you, physically and emotionally, it is totally normal. Don’t be afraid to give your body and your brain time to rest; the postpartum period is no joke! But rest assured, with a little rest and assurance, you will be back in the game in no time.

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.”