Little Known Ways to Surviving The Newborn Stage

February 22, 2022August 17, 2022 kshanmuk

If you are in your first few days of parenting, congratulations! Welcome to the club! 🙂 The newborn stage is exciting and petrifying. If you are a first time parent, you may be tested in ways that you’ve never dealt with previously. I hope the following tips will help you during these early days.

The 5 S’s.

A fussy baby is one of the hardest part of the newborn stage. It’s not like they can communicate through words, and chances are you’re starting to feel frustrated when you can’t figure out how to settle your little one. If you have heard of Harvey Karp and the Happiest Baby on the Block, this tip will seem familiar for you. Dr. Karp encourages a method that helps calm a fussy baby very quickly, which he refers to as the Five S’s:

Step 1. Swaddle:

Yes, it may seem that your baby hates being swaddled. Your baby may kick up a storm or try and escape those tight confines. However, the swaddle resembles the safe and snug cocoon of the womb, which will feel comforting and familiar. Keeping your little one swaddled also prevents him from accidentally waking himself up due to the Moro reflex. Rather than give up right at this stage, get your baby swaddled and move forward to the next step. (TIP: Using swaddles with a velcro attachment will make life much easier because it reduces the likelihood of babies wriggling out).

Step 2. Side/Stomach position:

When babies are lying on their back, it often feels like they are falling. They are likely to display the Moro reflex when this occurs. While sleeping on their back is necessary, holding them on their side or stomach is a fast way to help soothe a fussy baby.

Another influencing factor is that your little one is watching you trying to comfort her. Although you are using a soft and soothing approach, you may end up stimulating her by maintaining eye contact. The next time you are trying to settle your little one, try holding her in this hold, and see how she responds.

Step 3. Shushing:

Your current strategy may involve ensuring the house is completely silent when it’s time for baby’s nap. After all, having a quiet and dark environment is the ideal way for you to go to sleep. Ironically, a silent environment is not as helpful for babies. When babies are in the womb, things are loud. They can hear all sorts of noises coming from inside of you (e.g. blood flow) and from your external environments (e.g. conversations). Rather than keeping a quiet space, it’s best to include white noise to mimic these familiar rumbling and indistinct sounds. Try setting up a white noise machine (or using a free app on your phone) to help introduce some sound to their sleep environment.

Step 4. Swing

The fourth step: Swing

While gentle rocking or swinging motion will be helpful, what is most effective in calming a fussy baby is using a bobblehead-type movement. The womb is not a smooth, gentle place. Instead, it’s quite jiggly. Take a look at the following video to demonstrate how to create the right swinging movement.

Step 5. Suck/Soother

The soother is either your best friend or your nemesis at this point in time. Many parents find that their baby takes the soother right away and it is a fast way to stop the tears. There is an equal number of parents who have bought 14 different soothers and feel frustrated that their baby continues to gag or spit them out. I find this video really helpful for introducing a pacifier.

Seeing it all in action

The following video shows Harvey Karp incorporating all of these tips together. Again, the newborn stage involves a lot of tears. Putting the 5 S’s together is a fast and effective option to help your little one settle.

The 5 S’s in action

Beware of the Google Trap

google trap. anxious parents. Surviving the newborn stage.

It’s easy to keep researching things. If you are anything like me during my first postpartum experience, you will have diagnosed your baby with 20 medical issues (none of which were actually the case). This is super common, and everyone is aware of the vulnerability of searching on WebMD when anxieties are high. Rather than getting into this spiral, reach out to your health care team (e.g. lactation consultant, family doctor, nurses, social workers). You may worry about “bothering” your health team, but I promise you, they are used to parents reaching out. It is common to have questions , especially if this is your first baby. Whether you are struggling with breastfeeding, worried about baby’s health, questioning your relationship, you don’t have to figure it all out by yourself.

Stay Connected

Whether it’s an online forum or with your fellow friends and neighbours, it’s important to have others to talk to. Getting through the newborn stage is tough. There are a lot of questions and anxieties as the baby does new things (or doesn’t do new things). Please know that with every worry you have had, another parent has dealt with the same fear. Anxiety is normal.

Online communities (e.g. What to Expect) are especially helpful for addressing fears that occur in the middle of the night. There is almost always someone available to support you irrespective of the time of day. Speak to your friends, family, and partner. Sometimes our anxieties can escalate. In these moments, it’s helpful to talk them through with a grounded and non-judgemental person.

Get some sleep

In the beginning, when you are on a two-hour feeding cycle, it may seem that sleep is impossible. The idea of sleeping when baby sleeps feels like a joke. This baby never rests unless being held. Whatever the circumstances are with your baby’s sleep patterns (or lack thereof), you still need some rest. I encourage all parents to find opportunities for shift sleeping. Decide among yourselves who is a night owl and who prefers early mornings. Have a bottle ready and let your partner be in charge for those hours. Ideally, you are trying to get a 4-hour chunk of sleep so that you have the opportunity to enter REM sleep. Remind yourself that this is not permanent. While, it’s hard and challenging, your little one will eventually sleep through the night.

Know when your baby is in Active Sleep

I remember that I used to rush in whenever my kids made the slightest noise during the night. I’d assume they were awake, needing another feed, and that I would have to help them settle in some way or form. Unfortunately, my attempts to intervene only frustrated them. This is because I was actually interrupting their active sleep.

Active sleep is noisy! It involves grunting, squirming and even crying. Of course, in my sleep deprived and anxious state as a first time parent, I would see these cues and rush over to “soothe” my eldest, not knowing he was still resting. This tip involves identifying active sleep, and learning to stay out of the way when baby is resting. This video is a great resource to help you identify active sleep:

Attachment can take time

Some parents feel enamoured with their baby from day one. However, many parents do not feel this way. Building an attachment with your baby can take time. It is perfectly normal to feel scared, overwhelmed, confused, nervous or a variety of other emotions when you first meet your child. The newborn stage is meant to be a time where you develop a relationship. You get to know your child, and like any other relationships, you build trust and communication.

Will this tiny person ever stop crying?

There is a hormonal surge that kicks into full gear as soon as we hear the baby cry. You may be among the few who dash from one end of the house, leaping through obstacles in order to stop the tears ASAP. Alternatively, you may feel a rush of anger coursing through your body when you hear your baby wailing. Both responses are common. Our lovely friend, oxytocin has turned things up a notch making parents incredibly sensitive to a newborn crying.

When you hear someone in distress, it triggers you to respond. You will reach for your baby and start to sing, rock, or nurse. You will use any old tricks to help her calm down. However, if you have found this experience tiring or unsuccessful, those tears can make you feel plagued by helplessness and anger.

What to do if you feel anxious or angry about your baby’s tears:

Pause for 15 seconds. Yes, your natural instinct is to rush and rescue, but give yourself a moment to regulate. Give your baby a chance to settle.
Remind yourself it’s not personal. Your baby is not mad at you. You are not a bad parent. Babies cry. All. The. Time. It’s their only way of communicating. Sure, it makes your blood pressure skyrocket, but it’s the only way they can let you know something is up. Trying to decipher those tears will take time and practice, but you and your baby are doing your very best in figuring it out.
Write a plan for yourself. When your baby is fussy, what will you do? Perhaps you will follow the 5 S’s listed above. You may choose to sit in a rocking chair. You might whip out a bottle to nurse him back to calmness. Whatever option you decide, it’s helpful for you to feel confident and aware of your next step.
Ask to switch out. If you’ve already been taking care of a fussy infant all day, you may feel at your wit’s end. Tap out. Have your partner, friend, family member take over for an hour. Try and get out of the house during this time if you’re fighting the urge to run in and fix, correct, or offer suggestions. Take this time for self-care.
Shower yourself with positive affirmations. Ideally you’re saying these positive thoughts to yourself. However, if that is too hard, have a loved one reassure you. Get your daily reminder that you are doing your best. These difficult moments do not make you a bad parent.

Reach out

Postpartum anxiety and depression are common and difficult struggles. They go beyond the stressors of the newborn stage. You may find that you are constantly irritable, overwhelmed, unable to sleep, feeling miserable, or disinterested. If you are struggling, please do not stay silent. Your moods can get better. Reach out to find out more.

Kasi

Book a free Consult

Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum

The pressures of breastfeeding

November 15, 2021July 20, 2022 kshanmuk2 Comments

That first year with a baby is all about feeding, feeding and more feeding. For every parent, there is a time when he or she decides whether to breastfeed, exclusively pump, stick to formula, or use a combination approach. There are a variety of factors that push a parent towards one choice over the other. There is no “right” choice outside of what works best for a caregiver and baby.

pressures of breastfeeding. support for parents who are struggling to breastfeed

Unfortunately, there is a push in our society to breastfeed. We see signs of it right from the day we deliver. There are subtle cues from healthcare staff as they share latching tips before inquiring whether formula is preferred. We are provided pamphlets of breastfeeding support in our care packages before bringing our newborns home. There are posters for breastfeeding help at our midwives’ office.

This blog post is not to push formula feeds. I have no right to claim whether formula is better than breastfeeding, or vice versa. Ultimately, I am true believer that fed is best. As long as your baby is getting the nutrients he or she needs to develop, I consider it a win. Instead, this post is for the parents who are struggling to breastfeed. Whether by choice or by capacity, they are stuck in that internal battle of guilt, frustration and helplessness as they face yet another feed.

The pressures of breastfeeding:

We live in a culture where breastfeeding is encouraged and subtly (or sometimes, not so subtly) pushed as the best option for our baby. New mothers face an onslaught of judgemental messages about breastfeeding, and these comments are made in permanent and absolute terms: “breastfed babies have higher IQs”, “breastfeeding will prevent illness, infections and chronic conditions,” “breast is best,” “you won’t have a good bond if you formula feed,” etc, etc.

struggling with breastfeeding. postpartum support. new mother.

I agree that there are a lot of values to breastfeeding. However, I also work with parents who are driven to the point of exhaustion and anxiety in trying to produce enough supply for their baby. These parents are so angry at their bodies for failing them and not doing enough to support their baby’s growth. If the option of working with a lactation consultant or consuming fenugreek daily is working, then please keep it up! In fact, I encourage you to start here if you truly want to breastfeed. However, if your baby is losing weight, you are feeling stressed out, or are experiencing any number of production difficulties, I want you to take a moment and consider why you are trying to keep up with this expectation.

The “Mommy Wars”

New parents would love to have the ideal postpartum experience. We see images of celebrities looking beach-wear ready a few days after delivery. We see influencers posting feeds of their babes sleeping through the night. There are endless tweets and posts about the “right ways to parent”.

pressures of parenting. super mom. mommy wars.

With all of these messages of ideal parenthood, it makes sense that we are self-conscious about our own parenting. The Times wrote a beautiful article in reference to the Goddess Myth: “Like millions of other American moms, [mothers have] been bombarded by a powerful message: that she is built to build a human, that she will feel all the more empowered for doing so as nature supposedly intended and that the baby’s future depends on it. ” With this constant push for doing things “naturally”, moms carry the stress of parenting a certain way. There is a need to delivery vaginally, breastfeed on command, only feed your body the “right” foods, and of course, look stunning throughout the process. Of course, mothers then bear the burden of immense guilt when they are unable to meet these pressures.

This push to parent in a specific way also comes from mom-shaming experiences. These experiences can include rude comments and glances from others as a new mother orders a second cup of coffee, buys a drink, and of course, pulls out some formula. It’s as if there is a moral obligation that has been violated by not following the rules others deem best for our children. It’s no wonder that new parents are surrounded by a sense of failure and dread as they step into parenting.

Know that you’re not alone

The American Pediatric Society encourages breastfeeding for the first six months of your baby’s life. While 80% of mothers start off with this intention, the Center for Disease Control and Prevention state that only about 58% make it to the six months.

Why is this? Breastfeeding is described as natural and easy; however, any parent who struggles with breastfeeding can vouch that this is not the case. From poor latches, supply issues, mastitis, and other complications, many women start to experience a sense of dread when it comes closer to feeding times. These parents may undergo a period of grief as they cope with the disappointment of needing to put aside their hopes for breastfeeding.

Other parents prefer to not breastfeed. This decision could be based on a variety of reasons: struggles with hormonal shifts while breastfeeding, managing the demands of other children, returning to work, wanting support with nighttime feeds, sexual abuse histories, or simply not wanting to feed in this way. These are not selfish or bad parents. They care deeply for their children while also respecting their own boundaries. At the end of the day, a happy parent is better able to support their baby. If formula feeds provide a calmer structure for the parent, then this is the right decision for this family.

Worries about attachment

Sometimes we push ourselves because we think it’s what’s best for the baby. Sure there are physical benefits to breastmilk, but there are significant benefits to having a grounded and calm parent. If you are overwhelmed everytime you start nursing, that bond is going to feel so much more difficult. You have years to build and nurture the relationship with your child. It does not have to be perfect from day one. Listening to your mental, emotional and physical limits will set you up for success.

For those who feel that nursing creates a better attachment, I encourage you to consider your attachment with your own parents. Are you truly better connected with your mother because she chose to breastfeed versus formula feed? Is your IQ significantly higher than a peer who was formula-fed? Who even asks these questions today of other adults?

You are doing your best for your child

cheerful young multiethnic parents admiring sleeping baby on bed — Photo by William Fortunato on Pexels.com

A hungry baby is a cantankerous baby. A guilty mother is an unhappy mother. Pressures that come from strangers, the internet, and sometimes our own friends and family are perhaps meant with good intentions. However, you are this child’s parent. And if you are feeling stressed and guilty about breastfeeding, you are allowed to stop. You will always be this child’s caregiver, and your bond can be secure irrespective of how you feed this little one. Your baby will grow up and eventually eat food, and this pressure to breastfeed will no longer be the central focus of conversations. So for now, go and enjoy your child. Focus on getting those baby snuggles. Spend time playing, singing, talking, and teaching him or her. And when your little one gets hungry, feed them in whatever way is feasible for you.

All the best,

Kasi

Schedule a free consult

Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum

What is happening with my mood?! D-MER and Breastfeeding

August 16, 2021August 17, 2022 kshanmuk

What is your experience with breastfeeding? Do you feel angry or tearful as soon as you start? Is there a sense of dread when you begin another pumping session? How intense is your anxiety during these moments? When it comes to nursing, there are many parents who enjoy the experience and feel it’s an opportunity to connect with their infants. However, there are also many parents who are frustrated and distraught by the same encounter. Before we assume that the reason we are struggling with nursing is due to postpartum mental health, we want to rule out a physiological illness called D-MER.

Signs of D-MER:

Dysphoric Milk Ejection Reflex (a.k.a. D-MER) is a breastfeeding struggle that occurs during letdown of milk. This includes nursing, pumping, or manual expression to release milk. Normally when lactating, parents experience the warm and loving feelings that come with an increase in oxytocin. However, with D-MER, a caregiver has a sudden drop in mood, and can experience any of the following difficulties:

Breastfeeding and D-MER. Anxiety, sadness or distress during pumping

dysphoria, or a state of unhappiness
panic
restlessness
hopelessness
anger
anxiety
sense of dread/doom
paranoia
thoughts/urges about suicide or self-harm

D-MER most commonly shows up as anxiety, agitation or sadness. The intensity of these experiences can vary from mild to moderate to severe. These symptoms can last anywhere from a few seconds to 2-3 minutes. It typically shows up about 30 seconds prior to milk release. D-MER struggles subside as you continue to nurse, but reoccurs as soon as another let down happens. Typically, parents start to feel better after 3 to 6 months once milk production regulates. Unfortunately, there are no specific tests or assessments to confirm you have D-MER. If you notice an abrupt shift in mood when you are pumping or nursing, it warrants considering whether D-MER is a factor for you.

D-MER versus Postpartum Mental Health

D-MER is a physiological issue. It happens because of hormonal and chemical changes in the brain during breastfeeding. This is not a psychological issue, although it certainly feels like one. Folks who have a history of mental health struggles are not more vulnerable to experiencing D-MER. It is completely by chance. Parents who have experienced D-MER with their first child have a higher likelihood of experiencing it again with future children.

D-MER is not the same as postpartum mental health. While an episode of postpartum anxiety can last for hours or days, D-MER lasts a few minutes and only occurs during the release of milk. Once breastfeeding is completed, parents moods regulate and they are able to re-engage in their daily activities. Unlike any prenatal or postpartum disorder which involves a combination of biological, psychological and social influences, D-MER is caused solely by hormonal shifts.

This does not mean that the two are mutually exclusive. Parents with perinatal mood and anxiety disorders can also struggle with D-MER. If this is the case, then a combination of treatment is useful in order to address both needs.

Why it happens:

D-MER has only recently been identified as a breastfeeding struggle, and research has started in the past 10 years. However, dopamine has been identified as the primary influencer to experiences of D-MER. Dopamine (a hormone connected to feelings of pleasure) must drop in order for prolactin (the hormone which helps produce milk) to increase. What research has found with D-MER is that the drop in dopamine is too significant during milk letdown, which triggers an abrupt drop in moods.

What you can do if you have D-MER:

The first and most important thing to remember about D-MER is that it is not your fault. You are not doing breastfeeding or parenting incorrectly. This is truly a chemical change that is happening outside of your will power. It is not a psychological issue, and there is absolutely nothing “wrong with you.” It’s an automatic reaction, and the emotions and thoughts that come with D-MER are not based on facts, reality, or any truth to your capacity as a parent.

Approximately half of nursing parents stop breastfeeding by 6 months. This can happen for a variety of reasons, and only you are the judge of what is right for your body. If D-MER is one of the reasons to stop breastfeeding, it may be helpful to know that most parents struggling with this issue feel an improvement of symptoms in 3 months once milk production regulates.

Connecting with your health care team:

Lactation struggles. Perinatal mental health. Speaking to physician

Knowing that this ailment is a chemical imbalance, it’s best to speak with your physician or lactation consultant about your experience. In moderate to severe cases of D-MER, treatment options will likely involve medication or herbal supplements to support adequate dopamine production.

Behavioural Strategies

With milder versions of D-MER, there are several behavioural strategies that can be used to support your nursing experience. Firstly, it is helpful to keep track of your symptoms. What varies on days when your D-MER symptoms are worse? Common factors that can improve or exacerbate D-MER include: stress, rest, caffeine intake, hydration, and exercise.

Changing the Pattern:

Using distractions to help during breastfeeding.

Secondly, we want to create a more positive experience when nursing or pumping. When we know we are walking into a stressful event, our system braces in anticipation. With enough occurrences of D-MER, parents are typically anxious about lactation. To break this pattern, we want to pair positive experiences with breastfeeding. While nursing or pumping, add in a pleasurable activity that you can use as a distraction. Options can include: listening to your favourite podcast, reading a novel, playing a game on your phone, watching your favourite TV show, eating a delicious piece of cake. Use this activity only when you are breastfeeding to help your system create positive anticipation.

Mindfulness

Thirdly, mindfulness practices can be used to help during this time. When our system anticipates threat, we are hypervigilant of all signs and symptoms related to the threat. Unfortunately, this can make things worse because we are fixated on every nuance that can go wrong. We can also get caught in a negative spiral after breastfeeding is done because we continue to think about the experience and fret about what did not go well.

Mindfulness involves choosing a neutral anchor to focus our attention. For example, you can focus on the sensation of holding your baby, or keep count of baby’s gulps during a feed. You can pay attention to your own body or breath. You may also focus on external anchors like listen to music or noticing what is outside in your backyard. Your mind may wander, and mindfulness involves re-directing your attention to the safe and neutral anchor whenever this occurs.

Breastfeeding is Tough

There are a lot of factors that can influence our postpartum year, including breastfeeding struggles and D-MER. At the end of the day, no one can or should make the decision to start or end breastfeeding other than you, the lactating parent. If you find your mental health is influenced by your breastfeeding experience, please reach out. You do not have to struggle in isolation.

Take care,

Kasi

Schedule a free consult

Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.