Wednesday 2 October 2013

Gratitude: A Small, Cheap and Quick Thing that Apparently Makes a Huge Difference



A while ago I read that someone who actually claimed to be an “expert” on happiness said that one thing that can make you feel happier is acknowledging the things you are grateful for. As my 4-month old was going through a sleep regression, I really needed a boost in morale, so I thought: why not give this a try? It’s free, it’s quick. So I opened a notepad on my iPhone and promised that every day I will write down at least one thing I was grateful for. For instance:

“I am grateful that the 4-month-old sleep regression is just a phase that will pass.”
“I am grateful that we can afford a nanny.”

You get the idea.

I must say: This. Stuff. Really. Works.  

The effect on my morale, on my perceived level of happiness was tremendous! I wonder if this will last or if the effect will wear off. We will have to see. But for now this “gratitude game” has become a part of my daily routine. Whenever I feel down, or when I am brushing my teeth or taking a shower, I just think of the little (and big) things I am grateful for:

“I am grateful for being able to take a hot shower”.
“I am grateful that I do not live under the Stalin regime”.
Etc.

I will definitely keep doing this exercise and I will teach it to my baby once she grows old enough to talk. We’ll make it a part of her bedtime routine.

What are you grateful for?

Friday 6 September 2013

How I became a fan of sleep schedules and bedtime routines

We used to have a baby that cried a lot. We couldn't quite understand why. Every time she cried we kept on distracting or comforting her hoping she'd grow out of it, as books on baby care promised. 

Then one fine day we went on a vacation. Naomi was almost 4 month old by then, so in theory she should've been outgrowing  her fussiness. Instead, the opposite happened.  We started hearing cries like never before. How bad was this? Let me just tell you this: this was the time when I truly understood what people meant by infant colic. Oh, and I was very glad there weren't any neighbors close by. 

Stressed but unrelenting, I was determined to find a solution. Article after article, book after book I found the roots of our problem: our baby was extremely overtired. 

From all the research I've done I learned three  important things: (1) a 4-month-old needs to sleep 14-15 hours a day. (2) a 4-month-old cannot stay awake for more than 1.5-2 hours. (2) A 4-month-old  needs to go to sleep for the night at 7pm! Having read four books on infant sleep I realized this was the three things they all agreed on. Understanding this made a huge difference for us and our baby. 

The cause of our crying was very clearly explained in the book by Marc Weissbluth Healthy Sleep Habits, Happy Child. What often happens is when the baby wants to sleep, the parents interfere. The baby starts crying because she wants to sleep. What do the parents do? They try to distract her with toys or by taking her to a different room, or some other type of stimulation. My mother-in-law, for instance, was convinced that the baby wants a bath, while the bath, being a very stimulating experience for my baby, was the last thing she needed.  As a result of our misreading of her cues, our baby grew more and more tired and her cries escalated into desperate screams. Our baby was a lot smarter than we were. She needed to sleep and she kept on trying to tell this to us. We were ignoring her pleas, what else could she do other than scream? Instead of trying to distract her, we should have respected her need to sleep. At the first signs of drowsiness we should have put her to bed. 

Ok, we figured out that our baby needed to sleep. But bedtime has always been associated with crying. This is where the bedtime routine came in. (BTW, this is another one of those things that all baby-sleep books as well as scientific papers agree on).  As soon as our baby showed signs of tiredness, I decided that we should put her into her sleeping back and into the crib, so she'd have a chance to rest and fall asleep. Of course she doesn't fall asleep by herself yet (wishful thinking), but hopefully one day she'll learn. We let her stay in her crib by herself until she starts crying. Then we come in and comfort her, and when that is not enough, we pick her up and rock her to sleep.

The result? We have a contended baby that does not cry. Plus, she goes to sleep at 7pm, so I have a whole evening to myself. Sure, she wakes up a lot at night. And she mostly sleeps in someone's arms for her daytime naps -- that's something we still have to work on. But she never cries anymore, unless we fail to put her to sleep when she wants to. I used to be jealous at my friends who said: "My baby only cries when there is a reason". Now I can proudly say: "MY baby only cries when she wants to sleep".

Wednesday 31 July 2013

How caring for a newborn is like getting a PhD. An on loneliness...

When I finished my PhD I thought that this was the hardest thing I have ever done. Now that I am caring for a newborn I realize that *this* is the hardest thing. This is where similarities begin. Just like with PhD, this is a process of never-ending research and experimentation. Why did my baby sleep well this night, but then slept horribly the following night? What has changed? What variables were involved? Can I reproduce this experiment? Except the experiments are not reproducible, because babies grow and change every day… Just like with PhD, you often feel like you are poking in the dark, like a blind person, not knowing what you are doing, operating for months without feedback or positive outcome. And just like with PhD, when your efforts pay off, you finally get your paper accepted, or, in case of babies, your baby finally smiles at you, you are elated with joy. Except the joy is much more meaningful and deep with the baby…

Besides those trivial similarities there is another one, unexpected and striking: loneliness. Your friends who have not worked on a PhD will never understand what you are going through. Likewise, your friends who never cared for a newborn will never understand. So you simply cannot expect lots of empathy. Don’t be angry at them, just accept that will never never never understand how you feel. They’ll never understand how it feels to live for months on a sleep schedule consisting of 1-3 hour stretches. They’ll never understand how it feels to “live on a timer” – where you can’t sit down for a relaxed meal, knowing that the baby may wake up anytime. As a result, caring for a newborn can feel very very lonely.

Bouncing on an exercise ball with the baby, trying to calm her down. Hungry.  Alone. While everyone else is having drinks on the patio.  Rocking the baby to sleep in the middle of the night for hours.  You lose control of your  head as your body drifts to sleep, not having slept for more than two hours straight since before you gave birth.  Alone. While everyone else is snoozing peacefully in their beds. Pacing the streets at 5am with the baby in the baby carrier, because she decided the night ends at 4am. Realizing that coffee shops do not open that early. Alone. And when you call your friends and they tell you: "We'll MY baby only cries when there is a reason and she always sleeps through the night!". Now that make you feel really lonely. 

But just like with PhD, if you have a supportive family who are helping you to care for the baby, instead of being a lonely affair, this can be an extremely fun collaborative project that brings the family together and helps you form new deeper ties with the members of your family. I am blessed to have such a family…

If your loved one is caring for a newborn, never ever leave her alone.


Monday 3 June 2013

All the things you learn to do with one hand



There are two kinds of mothers: martyrs and champions. Martyr-mothers complain about how hard their life is, how they sacrifice everything for their baby, how they gave up a sense of fashion, self-respect, personal hygiene and the relationship with their partner all in the name of their little bald selfish devil. They keep saying this while having their second, third, and fourth kid. Champion-mothers talk about how precious their kids are, how time flies and how you need to enjoy every moment. They find creative solutions to balancing caring for their child with everything else they need to do. 

I probably sound a bit harsh here: there are situations where a child is sick or extremely difficult (colicky) or a mother is in a poor health or in a very bad relationship or under financial duress or gets absolutely no help caring for her child. In this case, all the complaints are perfectly justified. I really feel for those women and bow to them. When speaking about martyr-mothers, I wasn’t referring to them. I was talking about mothers seem to have exactly the same experience as champion-mothers, but just choose to portray themselves as victims, rather than conquerors.

Before my daughter was born I made a resolution that I would try to be like one of those champion-mothers. I don’t know if I will succeed, but I try. Not all credit goes to me: I am in a very fortunate situation. I have eight months of maternity leave from my university, a great husband who is physically unable to not care about our baby (it’s in his DNA) and who helps a great deal, a mother-in-law who is like her son, and my own mother who will come to visit for a couple of months to help. I do have to keep running my research lab even while I am on leave, but I can do this at my own pace and from the comfort of my home (thanks to Google hangout!). So at this point many of you are thinking: “Of course it’s easy to be a champion-mother with all this help!”. You could be right. Nevertheless, I’d like to write down a few solutions that I found useful in my effort to remain a champion.

A win-win sleeping arrangement

While Naomi is waking up to feed at night, my husband Anton and I decided that we will sleep separately. I room in with Naomi, so he can get a good night’s sleep, because unlike me he has to get up to work every morning. This arrangement has many other advantages. Because Anton gets enough sleep, he is always very cheerful, and that is super helpful for keeping everyone calm and hopeful. Because he is well rested, he is able to take Naomi for a few hours (during the week-end) or a few minutes on work days, so I can catch up on sleep, take a shower, eat or get out of my pajamas. He also feeds me my favourite brunch – his famous creation of a French omelette with goat brie and dill. I am able to get enough sleep as well. I go to bed at midnight, get out of bed at noon. In that time-stretch I accumulate enough short stretches of sleep to keep me rested. After the birth of Naomi I acquired this ability to fall asleep instantaneously and go into a profound sleep even if I have 20 minutes. Even if Naomi is fussing in the next room – as long as I know she is safe with Anton. Smart Body – thank you for that.

Moby wrap

Moby wrap is a long piece of fabric that you tie around your body creating a contraption in which you can insert your baby and carry her with you wherever you go. It’s the answer to the fashionable trend of baby-wearing. Moby wrap, as almost all other infant products, was too big for my tiny 2.5-kg-at-birth girl (most baby-wearing products are rated for kids weighing 8lbs (=3.6kg) and higher). So I had to be creative. I put on the wrap as recommended, inserted in it a rolled towel, creating a horizontal platform, and on it put Naomi, who can peacefully sleep or breast-feed while I walk around, eat, check email or blog. With this arrangement, Naomi often ends up with bread crumbs or salad dressing on her swaddling blanket, but we make do. The only thing I have not yet figured out how to do with Naomi in a wrap is to take a shower. I suppose I could if I didn’t mind getting it (and Naomi) wet.
It is still a mystery to me why Naomi can sleep for hours (forgetting even to eat) when she is  in the wrap next to my body, while she gets unhappy the minute I put her down into her crib (well, not always, but often).

Moby wrap lets you have at least one hand free (two, if you get good at it). So eventually I learned how to cook salad and make my own omelette while wearing Naomi on my chest.

Medela

I am an exercise fanatic. I need my exercise. I confess that I am addicted. I went to ballet classes up to a week before birth and biked up to a day before birth. The only reason why I did not bike on the day Naomi was born was because my water broke and I figured there is not enough protection for the baby in case I fell or bumped into the steering wheel.  So three weeks post-partum, when the stitches healed and I could sit on my bum again (well, sort-of), I started itching to go to a ballet class. In order to do this, I had to pump milk. This way I could ask my mother-in-law to watch Naomi while I go to class and leave milk in case our little vulture gets hungry.

Lactation experts warn you to not introduce the bottle until the breast-feeding is “well established”. I didn’t know quite what that meant, but I wanted to go dancing so much that at three weeks post-partum I decided that we are well established and began expressing milk.
Medela breast pump is a God-send. I use the Pump-in-style model and a hands-free bra, so I can hook myself up to the apparatus, attach the bottles to my nipples and go around my business while the milk is being expressed. I am so glad I can escape the fate of my mother, whom I remember expressing the milk by hand 24/7.

The little one loves the bottle. Drinking from the bottle requires less work than sucking the breast. But we avoided the “nipple confusion” so far. She gladly takes the breast as well.  Expressing milk is liberating. I now go to a ballet class twice a week. Last week-end (4 weeks pp) Anton and I went up to Grouse Grind (a hike) while the mother-in-law watched our little vulture.  I can also leave the house with Naomi in a stroller for the whole day, take a bunch of bottles with me, and she’ll happily sleep and entertain herself in a stroller as long as I periodically give her food.

If you do get a Medela pump, do get the hands-free pumping bra as well. It makes the world of difference.

Shower and make-up

Before Naomi was born I was terrified to hear the stories of martyr-mothers who say they gave up style and personal hygiene when their baby was born.  So I make it a point to shower and put on make-up every day. Even if I don’t succeed to do this until 2pm, and even though this takes 30 minutes out of my day, I still think it’s useful. Gives me a feeling that I got everything under control.

Exercise ball

My birth doula suggested that I buy an exercise ball to use during labour. Apparently it helps relax through contractions. I did not use it during labour (I preferred a bath tub), but the ball ended up being a very useful tool for soothing Naomi. Anton or I can calm her almost instantaneously if we bounce on the exercise ball with her in our arms. Sometimes this has to be accompanied with a loud “shhh” in her ear. I hope ball-bouncing burns calories and builds leg muscles. I do have to have Naomi in a Moby wrap while I bounce on the ball, otherwise my back gets sore.

Delegation

I am a control freak. For some reason I often get this idea that I can do something better than others, even when this is completely untrue. Well, this attitude is completely not useful when you are caring for a newborn (and in many other life situations as well!). So when my mother-in-law or my husband take over Naomi, I don’t micromanage. I just go sleep or do what I need to do and let them use their intuition. Same with work. Delegated managing major publications to my students. Control – just give it up!

The 5 “S”s.

This is a soothing technique described by a renowned pediatrician Bradley Karp in his book “The Happiest Baby on the Block”.  The 5 “S”s stand for Swaddling, Swinging, Shh-ing and Sucking. It’s what you have to do to calm your baby. Works like a charm, but the devil is in the details. For Naomi, swinging only works on an exercise ball, and the “shhh” has to be very loud!

Trash bags and scotch tape 

Blacking out the room by taping huge black trash bags to windows made my baby sleep in the morning until 7-ish as opposed to when the sun rises, which could be as early as 4:30am.



Naomi

The Birth.  
It’s 3:13am and my water breaks. It’s unmistakable: I feel water streaming from my body. I am not surprised: my mom’s water also broke before labour with her first child, though on average this happens only in 10% of the women. After that, 90% of the women go in labour within 24 hours. I pray that I’ll be the one; otherwise the OBs will be even more insistent on an induction. The fluid is clear, so I am not worried and go back to bed. At 4am I feel something that I recognize as mild contractions. They are like menstrual cramps that come and go every 10-15 minutes. I sleep through them until the morning.


In the morning I call my doula Lolli. I ask her if I should still go to the acupuncture. I heard that some women go into a “false labour” – a labour that begins but then goes away. I want to make sure my labour kicks in. Lolli encourages me to go. This time I don’t bike – I decide it’s not safe with the leaking waters. Anton drives me. He meets me after the accupuncture with a bouquet of roses and a bunch of our favorite food he got at Whole Foods. We are going to have a feast.


Back from the acupuncture, Lolli calls. She is in the area and proposes to stop by. We all have lunch. Contraction are getting a bit stronger. Every time one comes, I excuse myself and run to the bathroom. Sitting on the toilet feels good. Lolli teaches me how to breathe and relax through contractions. They are not comfortable at this point, but once a contraction passes, I forget it ever happened. Lolli asks me if I had called my midwife. I haven’t. According to the protocol I am not supposed to call if my water runs clear. So I am not in a rush to call them – what if they begin looking for reasons to induce me? Lolli encourages me to call anyway. At this very moment Tamar from the midwifery office calls to tell me about my ultrasound appointment at BC Women’s for the following day. I ask her to cancel it, because I am in labour. She sounds incredulous and says that she’ll keep the appointment for now. She probably thinks that I am a newbie and can’t really know whether I am having a real or false labour. I ask her to tell my midwife Jill that I am having contractions. Jill calls me immediately and decides to stop by.


Jill comes over and we are all chatting. I breathe and relax through contractions. Jill brings verbena oil for a labour cocktail – a natural way to induce labour. I am to take it I don’t go into full-blown labour this evening. I am hoping I won’t need it. Jill and Lolli predict that my labour will start late in the night, so they encourage me to get some sleep. At around 2pm I go take a nap. Anton naps with me. Then he goes upstairs to arrange time off work for the following week.


Contractions are still coming about 10 minutes apart. I can no longer sleep through them, but I can sleep in-between. For each contraction, I get up on all fours and breathe and relax through them.


4:14pm: I get too annoyed having to get up on my hands and knees between contractions, so I arrange a stack of pillows for me to lean on. This way I can stay on all fours and nap between contractions. But napping no longer happens. I begin thinking: “Why was I so much against an epidural?”. C-section didn’t seem such a bad alternative either. Thinking back, these thoughts probably meant that I am having active labour. But at that point I did not know. So I did not call anyone. After all, my contractions were still about 10 minutes apart (or so it felt, because I wasn’t really timing), and I was asked to not call anyone or go to the hospital until they are 3-4 minutes apart.


I remember my cousin Anya who had given birth recently said that staying in the bathtub really helped her hope with contractions. I ask Anton to fill the bathtub.


I continue breathing through contractions in the tub. There is a lot of bloody show. Jill had told me that bright red blood could indicate that my cervix is fully dilated. I see bright red blood. Good. At this point I am pretty sure this is the real thing. Although I don’t time contractions, to me it still feels like they are coming 10 minutes apart. Plus, I expect the first labour phase to be long for a first-time mom. So I don’t bother calling anyone. Just sitting in the tub, keep adding hot water as the water cools. At this point I am mostly quiet. Sometimes I quietly vocalize a contraction to help me cope. But I try to not be too loud. At this point I
still care how I look or sound to the rest of the world.


Thank God, Lolli happens to be in the area. She calls Anton suggesting to pop by. Anton asks me what I think. I say “sure, why not”. Wise decision!


6:50pm: Lolli says she is on her way. I begin vocalizing my contractions. Sort of like tennis players when they give a good serve, but not as loud. Before Lolli gets here, I am surprised to realize that I am feeling the urge to push.  I thought this should only be during the second phase of labour, according to what I’ve read. And contractions should be 3-4 minutes apart to get to that phase. Mine feel like they are 10 minutes apart. But I don’t really know, because I wasn’t timing them. There is no clock in the bathroom. Plus, how could the second phase come so quickly? I thought this was supposed to be many hours! Apparently my labour is not going by the books. I am thinking to myself that I cannot imagine getting out of that bathtub and going anywhere. We should just have that baby at home.


Lolli comes and joins me in the bathroom. She hears a grunt – a sign that I am ready to push. She tells Anton to call my midwife right away. We can’t find the phone number, Lolli is frustrated. Lolli is asking me if I would consider having this baby at home. I say, “Yes, let’s do it here, I am not going anywhere”. Inside, I feel confident that this is the right thing to do and that everything is going to be fine. The midwives are equipped to deliver babies at home and they have a protocol to get me to the hospital quickly if things go wrong. That evening at BC Women’s was on diversion -- they were full and were redirecting labouring women to other hospitals. How fitting.


In the meantime, I am ready to push. But I am not allowed to. I can’t deliver the baby before the midwives are here with all the safety equipment. Thank God Lolli is here. She teaches me how to resist pushing by panting like a dog. She pants with me through a few contractions. This is very helpful, because between one contraction and the next I forget how to do this.
 
7:28pm: Anton pages Jill.
7:33pm: Jill calls – she is on her way. I hear Lolli tell Anton to get a stack of towels. Anton wonders whether birthing at home is a good idea. Lolli says that given the state where I am it is safer to stay home. Lolli tells me that I should get out of the bathtub, because it’s small and obstructed by glass doors. I consent.


7:50pm: Jill is here. She checks what’s going on inside. I hear her say: “The baby’s head is right here”. She reassures Anton that it is safer to stay home than go to the hospital and risk delivering the baby in the car. To complete our unplanned labour party, she calls a second midwife, Lorri: this is mandated by the protocol. Lorri arrives at 8:05. Jill or Lolli explain to me that they need to call the paramedics. Not because anything is going wrong, but because they need to be on standby according to the rules. I am totally fine with that. I feel I am in a trans: focused on what’s inside and very calm.


In the meantime, all I feel is a very strong urge to push. There are no longer crampy sensations of first phase contractions. Lolli strictly forbids me to push – we need to wait until the paramedics arrive and until Jill and Lorri set camp in our bedroom. They protect the bed with plastic sheets and towels and set up their equipment. I pant like a dog. I have to pant very quickly to suppress the urge to push.


8:10pm: Paramedics arrive. I am still not allowed to push. The urge is overwhelming. It’s like a train inside your body that moves at full speed, an overpowering force. Lolli is still not allowing me to push. I pant faster and faster. But sometimes I can’t resist the urge and let out a grunt. This is not painful, but intense and overwhelming. I am no longer thinking about an epidural. In the meantime, Jill and Lorri are listening to the baby’s heart beat and measuring my blood pressure.


In-between contractions I feel totally normal. I ask how Anton is doing. We had agreed that he won’t be in the birthing room during the birth, so he is outside. I wonder how he is feeling – this must be so crazy and overwhelming for him! Lorri tells me that he is talking with the paramedics. I hear voices downstairs. He later told me it felt very good that he could talk to anyone. All this time I am on all fours, in the “frog” position.


8:25pm: The infant transport unit arrives. Both paramedic teams are on standby downstairs. Jill and Lorri are all set up. Finally Lolli allows me to push. The urge to push is so strong that I am unsure if I should give in. It really feels like there is a full-speed train thrusting inside my body. So it is really helpful that Lolli’s tells me: “Push this baby out, with all your might”. And I push with all my might. I vocalize. I think I am quite loud now – probably as loud as Sharapova when she hits a good ball. I wonder if Anton can hear. A couple of more pushing contractions. Jill says: “Do you want to feel your baby’s head”? I shake my head. I’d rather concentrate on my job: pushing. More measurements of the baby’s heart rate and my blood pressure.


As I push, there are things besides the baby coming out of my body. Whatever was inside, in my bowels. Lorri wipes me off. This is annoying and I wish she didn’t. I don’t feel a bit embarrassed.


Another push. Lolli keeps reminding me to push with all my might. I really need this reminder. Pushing feels so overwhelming, I would feel afraid to succumb to this force without reassurance. I feel that my body begin tearing apart. I remember Anya saying that the tears that she got during the labour neither hurt nor bothered her after delivery. So I am not worried about that. Lolli explains that after each push, the baby goes back in for a little bit. I figure I better let her out in as few pushes as possible. I want to be done.


Jill tells me to get higher up on my knees, otherwise the baby would bump her head against the mattress as she comes out. Next contraction. I see the head crowning. I realize that it’s time to get this over with.  Next contraction. I give it all my might. The baby is not out yet, but I want this over. So even as the contraction is gone, I give it my own push, and out she comes – head and body at the same time.


It is 8:46pm and Naomi is born.


She is vigorous -- intently looking around with her bright eyes, exploring the world into which she was brought, begins crying right away. When given breast, she attacks it like a little baby-condor: she knows what to do. A little human cub.


Anton brings me food and a long-awaited glass of wine.


Post birth:
Having seen birth videos where babies come out of the womb ashen-coloured and slimy, I am glad to see that Naomi is perfectly pink (rather red), surprisingly mucus-free and begins using her voice right away. She opens her eyes and looks around – such an inquisitive and lively little creature! She is tiny – only 2.475 kg, but that’s normal for her gestational age (between 10th and 50th percentile). Her Apgar score is 9.


I am put on my back and covered with blankets. Naomi is given to me, the embillical cord still reaching from her navel into my uterus, which still contains the placenta. I am told to breastfeed immediately. I am surprised that Naomi knows what to do – she opens her mouth wide and ravenously sucks from the breast. She is hungry!


After labour there is no pain. Just memories of it. So when the midwife suggests to stitch me up (I have a couple of small tears) I try to convince her to let me go unstitched. My legs are shaking – the midwife says it’s because of the adrenaline. I am totally alert and instruct Anton to take pictures of our home birth setup.
Anton cuts the cord.


The midwife offers a shot of oxytocin to encourage the birth of the placenta. Because the labour happened so quickly, she is concerned that I might bleed. Normally very anti-drug, at this point I don’t care and consent to a shot.  The placenta comes out shortly. A few minutes later I Skype my mom and show her our home birth quarters.


My baby Naomi is divine. I’ll never forget how she looked: a tiny, but vigorous, alert and confident human cub. I love you, Naomi.