Author: baileysandbabiesblog

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Oh, hemorrhoids. Those little demons were my constant companions from month six of pregnancy to six months postpartum. And they still like to come for unwelcome visits every now and then. Their specialties are soreness, itchiness, and embarrassment, and they take great pride in being the ultimate pain in the….They range in size from chickpea to grap

So first off, what are they? They are swollen veins in the lowest area of your rectum, or anus. Internal hemorrhoids often go unnoticed, while external hemorrhoids — swollen lumps poking out of the anus — are constantly saying hi. If a blood clot forms in the hemorrhoid (thrombosis), it will likely turn blue or purple. Often, a bit of blood on your poop is caused by hemorrhoids. These beauties can be caused by the following:

• The weight of the baby pressing on the rectum
• Progesterone during pregnancy relaxing the walls of the veins, making them more prone to swelling
• Heavy-duty pushing when pooping (often a result of constipation) or pushing a baby out
• Serious exertion when doing something like lifting a heavy object
• Excess weight

While hemorrhoids usually go away after a few weeks, there will likely be “skin bags” poking out of the anus forevermore. (But they shouldn’t hurt or itch.) And now for some pictures! Just kidding.

What to do

Here’s how to soothe the fury of the hemorrhoid:

Sit on soft surfaces. Soften the impact of sitting by swapping hard surfaces for soft. You can also make a pillow your constant companion.

Ice ’em. Sit on the toilet and hold a piece of ice, or an ice pack, on the hemorrhoids to reduce swelling.

Swap toilet paper for witch hazel wipes. Standard TP usually doesn’t do the trick when trying to wipe away all the poop particles stuck in the crevices of hemorrhoids. So use witch hazel wipes instead. The moisture of these wipes does a better clean-up job, and the witch hazel helps relieve itchiness, pain, and swelling.

Become one with hemorrhoid cream. Many hemorrhoid creams contain lidocaine (Hello, numbness!) and healing ingredients like hydrocortisone, vitamin E, and aloe vera.

Drown them in a warm bath. Soaking in a regular tub or a sitz bath minimizes itchiness, pain, and swelling. You can add Epsom salt or a splash of apple cider vinegar to the water to promote healing.

Load up on fiber, and drink more water. As hemorrhoids can be caused and agitated by constipation, ear fiber-rich foods like avocados, lentils, chickpeas, oats, chia seeds, almonds, pears, raspberries, and of course, prunes. In addition, drink plenty of water, as it helps soften fecal matter and keeps it moving.

Use a footstool when pooping. Propping your feet up on a stool when using the bathroom helps you get into a squatting position, which stimulates the bowels, making it easier to get it all out without too much force.

See your care provider if they’re really bugging you. If the external hemorrhoids seem excessively uncomfortable or are regularly causing rectal bleeding, check in with your care provider.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I’m in a similar community. (Hi, Ojai!) Many moms here have home births, and those who need a C-section, or even an epidural, are often embarrassed to talk about it. But what I’ve discovered is that almost every time someone is brave enough to talk honestly about their birth experience, they’re met with understanding, regardless of the type of birth they had. Often the source of judgment about our birth that we face comes more from within, than from our community. In essence: you don’t need to lie.

I was at a baby shower once where moms sat in a circle sharing their birth stories. Woman after woman told tales of empowering home births (some orgasmic!), until it came to a woman who would not look away from her hands, clenched in her lap. The host asked if she wanted to pass, but she took a deep breath and said no. Then she told us about her C-section. It wasn’t an emergency situation that led her to the C-section, but a series of events that made her feel that a C-section was the best option. “I feel weird saying this,” she said, “but it was actually a pretty positive birth. I had a great doctor who didn’t pressure me into anything, and a surgeon who talked to me in a really encouraging way through the operation.” As she spoke, I scanned the faces of the other women. No one was looking judgy — everyone was smiling and nodding. The woman sharing looked so relieved when she was done. And then, something really cool happened. One of the women who had already told us about her home birth said that her second birth experience had been a C-section, but she had been nervous to talk about it. Then another woman shared a similar story. That one woman having the courage to talk about her C-section in the land of home births made other women feel safe to do the same. I think more often than not this is what happens. Women are afraid they’ll be judged for their cesarean birth story, but instead they’re met with compassion and even relief that someone else is openly talking about it.

But what about that rare person who does pass judgment? Even if the judgment is as subtle as a slight lift of the eyebrows when you tell them about your C-section? Well, that person can go to h-e-double-hockey- sticks. Just kidding. But really, it’s so lame when people are critical about someone else’s very personal journey. If you get stuck in this type of unfortunate encounter, remind yourself that their reaction has so much more to do with them than with you. They likely have a mental catalog of stories, information, and personal experiences that have formed their biased opinion of C-sections. That’s where their reaction is coming from — it’s not an indication that your choice was wrong or that you’re a “bad mom.” Let them feel how they feel about C-sections, and make a mental note to not discuss your birth with them again.

What to do

Here are some ideas to help you not take judgments about your C-section personally and hopefully avoid those condemnatory conversations entirely:

Come to terms with your birth experience before you talk to your community about it. If you’re still processing your C-section, you’ll understandably be much more sensitive to reactions to your birth story. For example, if you’re still trying to decide if the C-section was something you wanted, and you talk to a person who believes pretty much all C-sections are just a money-making scheme, their feedback will likely color how you see your own experience.

To help ensure that your feelings about your birth are built by your beliefs and experiences instead of those of others, spend time reviewing the events that led up to your C-section. How did you feel before, during, and after the surgery? What elements do you feel good about? What do you not feel good about? Do you have questions about the birth? After considering these questions, discuss your findings with the people who were with you during the birth.

Sit with your birth story until you have a solid understanding of what happened, and how you feel about it. Getting to this place before you give the story up for interpretation can make you less vulnerable to judgment, and more capable of sharing the story only with people you believe will be supportive.

Be selective about who you share your story with. First of all, you’re under no obligation to share your story with anyone. If someone asks how your birth went, you can be super general. For example, “It went great. Baby and I are both healthy.” But it can feel good to share your story with certain people, especially if you’re disappointed by the birth and need to vent or mourn. Set yourself up for positive, cathartic encounters by sharing your story only with people you trust, people who won’t pass judgment.

Have a go-to response for the rare time when someone is judgmental. If you unexpectedly find yourself in a conversation with a Fault Finder, have a script ready to get you out of it. For example, if someone starts going on about the dangers of C-sections, how much risk you put yourself in, how you let yourself be manipulated, how difficult it will be to have a vaginal birth now, or one of the other common objections some people have about C-sections, you can simply say, “You know, I’m still trying to figure out how I feel about the experience and would love to press pause on this conversation until I have time to do that.” You’re not required to get sucked into their vortex of opinions.

Be sure you’re not the one passing judgment. As it’s often easier to spot someone else’s judgments than our own, stay aware of your own responses to the birthing decisions of others. Because even when we know how hurtful it is to be on the receiving end of judgment, we can still give in to the impulse to throw around criticism, especially toward the person throwing it at us. But we’re better than that. And while passing judgment can provide initial satisfaction, it often leaves a yucky emotional residue. So let’s make our kindergarten teachers proud and practice that Golden Rule: treat others the way we want to be treated.

Remember that you don’t need to justify your choice. You have every right to choose whatever type of birth feels best to you, regardless of the circumstances. No one has to agree with your choice for that to be true. While it’s obviously fine to justify your decision, you don’t have to. If someone seems judgmental of your C-section, it’s not your job to change their mind — it’s their job to examine their biases and figure out how to be accepting of other people’s choices.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Sister, you’ve just spent nine months abstaining from all the relaxing vices and are now in the thick of motherhood. I don’t blame you for wanting to indulge in some Mary Jane. And now that it’s decriminalized in many states and legalized in others, it’s even more tempting. But like any responsible breastfeeding mama, you want to make sure what you put in your body doesn’t screw with your baby’s body.

The tricky thing with marijuana is that it sticks around in your body longer than something like alcohol, so you can’t “pump and dump.” Various studies have detected small quantities of THC (the psychoactive component of cannabis) in breastmilk from six days to more than six weeks after use. And a study published in Pediatrics found that more than four hundred chemicals in marijuana can transfer into breastmilk. The researchers also reported that typically less THC was detected when the mother used edibles or topicals, instead of smoking. As an added bonus, edibles and topicals don’t expose baby to secondhand smoke. However, all delivery methods expose the baby to THC.

Shedding a less damaging light on marijuana use and breastfeeding is a 2018 study published in Obstetrics & Gynecology that reported the concentration of THC in breastmilk was about 2.5 percent of what the mother received, and of that, only around 1 to 5 percent is absorbed by the baby. So the dose is pretty minimal. In addition, they found that levels of THC in breastmilk were undetectable twenty-four hours after a mother who only occasionally used marijuana ceased use.

But because it’s hard to go twenty-four hours without breastfeeding (at least with an infant), it’s assumed a baby would consume some THC before it was metabolized out of the milk. In the case of chronic marijuana users, the study discovered that it took much longer than twenty-four hours for THC levels to become undetectable — it could potentially take up to four days. This study suggests that risks might be minimal if a mother uses marijuana infrequently and waits twenty-four hours between use and breastfeeding. However, they still urge caution.

Regarding the effects of marijuana — specifically, THC — on the baby, limited research has found that occasional maternal use of marijuana during breastfeeding didn’t have noticeable effects on the infant — but this research did not rule out long-term risks. It’s also believed that THC could alter baby’s brain and motor development, slow weight gain, reduce milk production, and diminish the baby’s ability to suckle.

The bottom line: I don’t have a straight answer for you. Limited research has indicated marijuana can have negative impacts on baby. Continued research might discover a safe amount for a breastfeeding mother to consume, but unfortunately, we don’t currently have that information. So in many ways, the choice of whether to use marijuana when breastfeeding comes down to the level of uncertainty and risk you’re comfortable with.

Make informed decisions by trying the following:

Check with your care provider: With something as little understood as consuming marijuana when breastfeeding, it’s best to check with your care provider before proceeding. While they’ll likely tell you to “just say no,” if you push you may be able to get some information about the amount they think would probably, maybe, possibly be safe. And if you’re hoping to use marijuana for a condition like anxiety and you’d be using it in place of a pharmaceutical, your care provider might determine that the risks of marijuana for the baby are less than the risks of a certain pill. You can also get a second or third opinion to gain a more well-rounded perspective.

Purchase from a dispensary: If you choose to occasionally partake in ganja, know that it’s not all created equal, which is why it’s best to purchase it from a dispensary instead of getting it from a friend. Dispensaries typically have staff trained in the various strains and delivery methods and can help you choose an option best suited to your unique needs. But again, I wouldn’t take this route until you get the go-ahead from your care provider.

Don’t bed-share. If you use marijuana, hold off on bed-sharing the same day, as you might experience heavier sleep.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

It’s safe, so long as you’re drinking only your own breastmilk. Because when you’re drinking milk from your body, you’re not exposed to anything you haven’t already been exposed to. That safety does not extend to the strange trend among bodybuilders of purchasing untested breastmilk at high prices on the internet. I even had an exboyfriend text me after I gave birth, brazenly asking if I would give him my leftover milk. My response: “Uh, no. I don’t have milk to spare, and if I did, I would donate it to a milk bank, not your vanity.” Many milk banks create a safe environment for the exchange of breastmilk, as they ensure that the mother donating milk is free of health conditions, medications, and other substances that could contaminate breastmilk. Milk sold through shady sources online could contain anything from germs found in human waste to Staphylococcus and Streptococcus bacteria (not dinosaurs). Yummy.

Back to your milk. While you can definitely benefit from the proteins and vitamins in it, it’s not nearly as amazing for you as it is for baby. It’s custom made for them, helping ensure they get the exact nutrients and immune-boosting goodies they need during early development. Much of what you get from breastmilk is akin to what you’d get from eating a healthy diet. But if you have enough to spare and are motivated to make your breast milk part of your diet, anecdotal evidence has shown it could…

• Increase energy
• Boost immunity
• Clear up acne when applied to the face
• Soothe Crohn’s disease and rheumatoid arthritis symptoms
• Build muscle
• Help erectile dysfunction (No wonder steroid-filled bodybuilders are all about breastmilk.)

So swigging breastmilk could have some perks, but it might be put to better use by a baby whose mama can’t produce enough. But that’s 100 percent your call — no judgment either way! I have a friend who can’t consume dairy but also can’t stand plant-based milk. She tried her breastmilk in her cereal and coffee and loved it. She now has a massive frozen supply of her milk to use for breakfast.

What to do

You might as well…

Give it a try. If you’re curious about sipping your special sauce, go for it. If you’re primarily interested in it for potential health benefits, try it for a week and notice whether you experience any positive changes. Or if you just like the taste and prefer using it over cow or plant milk, keep on drinkin’.

Consider donating the milk. If you’re not fully committed to drinking your milk but want something to do with your surplus, contact local hospitals to see if they accept donations. You can also reach out to legit milk banks at the following websites:

• hmbana.org
• medolac.com
• prolacta.com
• lactalogics.com

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Dang those little nipple biters. I remember the first time it happened to me. An ungodly pain ripped through my chest, I arched my back, unintentionally chomped the side of my tongue, and held my breath, unable to look down. I was sure my nipple had been beheaded. When I finally peeked, I expected to see a wicked grin on my six-month-old’s face. Instead I saw his perfect, soft, squishy, innocent sleep face. “How can something so adorable do something so evil?” I thought. Thus began the one-month nightmare of living in breastfeeding purgatory.

Hudson had inexplicably developed the habit of chomping on my nipple while falling asleep. As the nipple would start sliding out of his mouth, he would clamp down. It felt personal, and it pissed me off. “How dare you bite me when I’m feeding you my milk.” Sometimes I would actually say that. One time I flicked him so hard on the cheek he started to cry. Then I started to cry. During the few biting encounters when I could hold it together, I’d slide my finger between his gums, break the latch, and refuse to nurse him until the memory of the trauma faded. No one was happy. But after a month, it just stopped and we started liking each other again.

My story is not unique. I’ve had countless women call me, crying that they’d screamed at their baby after being bit. Many said the reaction made their baby hesitant to nurse. And, not surprisingly, the mothers were hesitant to hand over the nipple.

I’ll start to break down the cruel phenomenon of nipple biting by first stating the obvious: your baby is not biting you because they secretly hate you. Here are a few reasons why this oh-so-unfortunate scenario might be occurring:

-The biting is a reflex. Just like the reflex to root, suck, swallow, and gag, babies sometimes have the instinct to bite.

-You baby is teething and wants to chew on everything. Everything.

-Their brain is curious about cause and effect, so they chomp the nip to see what happens.

-They have a cold or an ear infection. If baby has a hard time swallowing because of a stuffy nose or pain in the ear, they might be inclined to bite when nursing. Luckily, that should cease when the cold or infection clears up. In the meantime, get them in a sitting position while nursing and use a humidifier as often as possible. If they’re tugging on their ear, take them to the pediatrician for treatment for a potential ear infection.

What to do

Kindly ask your baby not to bite, as they’re very responsive to logical requests. What’s that you say? Your baby doesn’t acquiesce when you request they sleep through the night, stop puking on your favorite shirt, and not pee on you while changing their diaper? Well in that case, here are a few ideas for surviving the biting phase. Solidarity, my sore-nippled sister.

Be vigilant about positioning. Baby will be less likely to bite when their head is angled back, their tummy is pressed against your upper abdomen, and they have a deep latch. When they have this good latch and are actively nursing, they can’t bite, as their tongue will be covering their lower teeth or gums.

Learn the pre-biting signs. Start paying attention to what your baby is doing right before they bite, as this can help you remove the nipple before it turns into a teething tool. For example, Hudson would bite when he was really drowsy. Some babies bite when they’ve emptied the breast but are still sucking for comfort. Other babies are prone to biting when they’re teething, so if they seem to be extra fussy and are cutting teeth, be wary. I’ve also heard of babies biting when they get distracted and turn their head away from mama’s body. Another big sign of a potential, impending bite is baby pulling their tongue back.

Make sure baby is on a “loaded” breast. As I mentioned before, babies don’t bite when they’re swallowing. So pay attention to how full the breast they’re feeding off is, and switch to the other side when it seems nearly drained. This helps prevent the lull in swallowing that can lead to a bite.

Unlatch baby with your finger. While your first instinct may be to yank baby away from your breast when they bite, this could further damage the offended nipple. Instead, slip your finger between their gums to break the latch. When you feel the release — you might also hear a little pop — remove the nipple tout suite.

Stop nursing, but not forever. After baby bites, stop nursing to inform them that nursing can’t continue after a bite. However, when the bite’s no longer fresh in everyone’s mind (I’m talkin’ around fifteen minutes, not many days), you’re probably safe to recommence nursing.

Offer something else for them to chew on. If you suspect baby is using your nipple as a teether, give them something else to gnaw on. When Hudson went through this, I kept a few teethers by my prime breastfeeding locations and swapped my nipple for a teether as soon as he stopped consistently swallowing.

Don’t beat yourself up for a loud reaction. While we obviously don’t want to respond to a bit nip with a physical action that could hurt the baby, it’s only natural that you yelp, or curse, or let out some other loud noise. I can almost guarantee you didn’t stop to think, “Hmm, what kind of noise can I make that will scare my baby?” No, I’ll bet it just happened, because that’s what happens when a private part (or any part) is bit out of nowhere. Your baby might cry or look offended at your noise-of-not-choice, but you did nothing wrong and don’t need to feel guilty.

Apologize. Not feeling guilty is easier said than done. So if that guilt is sparked after you’ve screamed bloody nipple, just apologize — it’s a classic way to make amends. While baby can’t fully understand your apology, they will be soothed by your calm voice and loving facial expression. And they get over slights shockingly fast.

Don’t wean, unless you were wanting to wean before the biting started. If you love breastfeeding, don’t let the biting scare you away, as it will likely be a short-lived phase.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

One of the causes of those pleasurable sensations is oxytocin. Your body pumps it out when breastfeeding to encourage you to keep doing it and bond with baby. It’s the most natural thing in the world. And the reason it’s messing with your head is likely that our culture oversexualizes breasts. You’ve probably been programmed your entire life to associate breasts with sex. Because of this, breastfeeding can turn you on and even cause sexual fantasies. And there’s nothing wrong with that. You’re not fantasizing about your baby, you’re fantasizing about a tryst with your partner, or Thor, or whomever. And more women than you realize experience this; you just don’t hear about it because society has made the topic super taboo.

Speaking of taboo, some women even report orgasming while breastfeeding. In most of these cases, the woman has her legs crossed, which causes clitoral stimulation. That stimulation, coupled with uterine contractions from the oxytocin and nipple stimulation from the breastfeeding, pushes them over the edge. While many of these women say they’re horrified by this reaction, they don’t need to be. They suddenly had a baby sucking on a part of their body that’s always been an erogenous zone, while other parts of their body that play a part in arousal (the clitoris and uterus) were also being stimulated. They weren’t making a conscious choice to be aroused — biology was doing it for them. It’s understandable to feel resistance to this type of situation, but know that the emotional discomfort will pass. Here’s how it happens . . .

As you continue breastfeeding, your perspective on your breasts will shift from “sexy time trigger” to “feeder of child.” In addition, the prolactin your body is pumping out to produce milk will induce maternal behavior, like a desire to cuddle your baby, fostering the shift in your

relationship with your breasts. While you wait for this change, keep reminding yourself that you’re not a pervert for enjoying the sensations of breastfeeding — that’s just biology rewarding you for giving your baby the gift of mega-nutrients.

In addition to feeling pleasure when breastfeeding, it’s common for your nipples to get hard. This is another phenomenon we usually associate with being turned on (or being cold), and it makes some women uncomfortable. But the nipples are hardening just to meet breastfeeding’s anatomical requirements, as your nipples have to be somewhat erect for baby to latch on. It’s normal for your nipples to harden when stimulated, whether that stimulation is your baby’s mouth, your shirt rubbing against them, or a fondle from your partner. The hardening is sexual only when you give it that label.

It’s also helpful (and maybe a little frustrating) to know that lactating will shift your sexual encounters in a few ways. According to an article published in the Journal of Perinatal Education, during lactation you experience little to no vaginal lubrication when you’re turned on (Oh hi there, lube!), and milk can potentially eject from the breasts during orgasm. In addition, the longer you breastfeed, the more your perspective on your breasts gets embedded in “mom zone,” to the point where you may have little sexual response when they’re touched sexually. The researchers go on to explain that the mix of prolactin and oxytocin that’s released during breastfeeding can also satisfy your need for connection and affection in such a complete way that you don’t seek it as much from your partner. Being aware of all this can help ensure you don’t unintentionally neglect your bond with your honey.

What to do

Here are a few ways to avoid shaming yourself for feeling pleasure when breastfeeding and to maintain a connection with your partner.

Shift your perception of physical pleasure. Many of us associate pleasure in the more sensual areas of our body (e.g., breasts and vagina), and definitely orgasm, with sexual encounters. This is understandable, as sexual encounters (with yourself or someone else) are the primary reason you experience these sensations…until you have a baby. But the “sexual” label we put on these sensations is all in our head. Our body doesn’t care why it’s feeling good, it just likes to feel good. The mind is what gets in the way when we have those warm, tingly feelings while breastfeeding. So give yourself permission to take sexual meaning away from those sensations — at least when breastfeeding. You can start thinking of them as a lovely by-product of feeding your baby — a present for all the hard work you’re putting in. And just like that, you can wipe away shame and guilt.

Find ways to stay connected to your partner. Because breastfeeding can satisfy your need for physical connection, you might find your desire to be affectionate with your partner is weakening. While there’s nothing wrong with this in the short term, it could negatively impact your relationship if it goes on for too long. To fortify that connection, find ways to be intimate with your partner without sacrificing your needs. For example, if you can’t stand being touched after a marathon round of breastfeeding, ask your partner to keep their hands off for at least an hour. When you feel your resistance to touch wearing off, ask them if they want to cuddle while you both play with the baby or watch a movie.

This might feel contrived in the beginning, but the more you commit to reestablishing that physical bond, the more you’ll enjoy it. The key is that the connection be on your terms as you find your way back to intimacy. Feeling forced to be intimate could make you resent your partner, which isn’t good for anyone. Take it slow and steady, and eventually you’ll relish a long hug, or a roll in the sheets.

Create new rules for breast fondling. Once I started breastfeeding, nothing turned me off more than having my boobs touched by my husband. I never told him how I was feeling, and understandably, he took it personally when I swatted him away. Be wiser than me and talk to your special person if you notice yourself cringing when they go for your milk jugs. Explain that it has nothing to do with them, and everything to do with your new relationship with your breasts. You can also reassure them that when baby eventually weans, you’ll probably become more comfortable with boob play.

With that said, you might be cool with certain types of breast touch, but not all. For example, I have a friend who enjoyed her husband gently cupping her breasts, but couldn’t stand him touching her nipples with his hands or mouth. She let him know how she felt, and he honored her guidelines. If you’re not quite sure what you are and aren’t comfortable with, have your partner test out various types of fondling and let them know what feels good.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Solidarity, sister. This largely selfless act takes previously perky boobs and puts them through multiple, daily metamorphoses. During my breastfeeding days, my B-cup tatas would suddenly inflate to DDs in the morning, and after thirty minutes of baby-feeding, they looked like deflated water balloons. Then a couple hours later, they were back in Pamela Anderson territory. As you likely suspect, these size shifts are thanks to the boob-filling and draining that takes place multiple times a day. The constant change does a number on your breast’s skin and tissue — so when a woman weans her baby, she’s often left with a flatter, saggier version of her former chest. But not always! Women with smaller breasts and those with more elastic skin sometimes don’t notice a big change when they’re done breastfeeding. (I get into ways to nurture your bosom buddies in the “What to do” section.)

Now for your nipples. The darkening, which is normal, is caused by pregnancy hormones stimulating pigment-producing cells. The nipples often appear bigger because they’re being drawn out each time baby feeds. These darker, larger nipples can be helpful, as they serve as bull’s-eye “Eat Here” signs for baby. Nipples usually return to their pre-pregnancy size and color (or something close to it) after you wean.

You might also notice those little bumps on your areolas (aka Montgomery glands) plumping up. These bumps secrete sebum, a light yellow, oily substance that keeps your nipples moisturized and clean and emits an odor that attracts baby.

Another thing you can expect from your nipples — for now and forever more — is that they’ll pretty much always be at attention. Months of being sucked train them to stay alert. I enjoy this change, as it gives the illusion that my boobs are perkier than they are.

What to do

While there’s no way to avoid the boob restyling that comes with breastfeeding, there are ways to support your skin and emotional health during the changes:

Become one with organic oil and shea butter. Regularly massaging your breasts with organic oil or shea butter increases suppleness and blood flow. This can minimize stretch marks and help skin bounce back after weaning.

Drink plenty of water. Hydration has a big impact on your skin’s elasticity, which is why you want to drink a minimum of eight glasses of water a day — preferably more.

Eat vitamin-rich foods. The vitamins in healthy foods have a big impact on what’s going on in and under your skin. Here are the vitamins you want to get more of:

-Vitamin A stimulates the growth of new skin cells, which can prevent dryness. It can also curb cell damage and premature skin aging. Foods rich in vitamin A include salmon, eggs, carrots, tomatoes, sweet potatoes, and leafy greens.

-Vitamin C helps your skin bounce back from stretching, promotes collagen production, heals damaged skin, reduces the appearance of wrinkles, and hydrates skin. As an added bonus, it has cancer-fighting properties. Get your vitamin C on by noshing on citrus fruits, strawberries, broccoli, and spinach.

-Vitamin D helps skin stretch, grow, and repair. Get your vitamin D with about ten minutes of sun each day and eating foods like salmon, cod, tuna, and mushrooms. It’s also present in fortified foods like milk, yogurt, cereal, and orange juice.

-Vitamin E is a powerful antioxidant that can reduce wrinkles, inflammation, and dryness, and it might minimize the appearance of scars (aka stretch marks). You can get it from sunflower seeds, almonds, hazelnuts, spinach, mangoes, avocadoes, and butternut squash.

Exfoliate. Once a week, gently rub your breasts with a dry brush or use a sugar scrub in the shower, as exfoliation can promote new skin growth and increase blood circulation, which can regenerate skin and enhance elasticity. Make a homemade sugar scrub by mixing one-half cup of brown sugar with three tablespoons coconut or olive oil and two tablespoons raw honey.

Talk with your partner about your insecurities. If the changes in your breasts make you insecure, tell your partner, as these feelings might impact your willingness to be naked in front of them. It’s also important for them to know so they can be sensitive about how you’re feeling and can maybe even pump up your confidence with compliments about your amazing lactating breasts.

It’s natural to develop insecurities when experiencing rapid changes in various parts of the body, but you don’t have to navigate the emotions these changes trigger alone.

Honor the shifts as a reminder of the gift you’re giving your child. If you get bummed because breastfeeding is almost constantly remodeling your boobs, shift your focus from what they look like to what they can do. They make milk that’s custom designed for your baby! That’s so cool — and something not all boobs can do. Some women would happily give up their breasts’ constant perkiness for the ability to make enough milk for their baby. While you have every right to feel all the feels about your breasts, I encourage you to bring yourself back to gratitude as often as possible.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

My boobs were so leaky the first six months of Hudson’s life that I once dripped onto a woman who was pushing a baby out. Yup. I was her doula and had been away from Hudson for about twelve hours. My boobs were bursting. As I held her leg while she pushed, I wasn’t paying attention to what was happening under my shirt. And then I saw something wet drop onto her arm. It was raining, and the old hospital we were in had some leakage issues, so I looked up. But it wasn’t the ceiling, it was my mammaries. I. Was. Horrified. Thank the birthing gods I was wearing a black shirt; no one seemed to notice, and I flew to the bathroom to change and squeeze milk into the sink. Oy vey.

That’s a long way of saying, I get it. I was constantly embarrassed by my leaky jugs, instead of being thrilled they were producing so much milk. This is something many women experience in early motherhood. I’ll get to how to physically deal with the seepage, but I want to start with the shame you might feel when this happens. As I noted in the previous question, it takes a while to stop sexualizing our breasts, meaning we still think of them in “that way” when they start drawing attention, especially when they’re leaking. I have a friend who had DD-size breasts before pregnancy. They were a G after baby was born. She once said, “I can’t go into public. It’s bad enough that these puppies are so massive, but they start leaking unexpectedly. Obviously, I’m not doing it on purpose, but I feel like people are going to think I’m trying to draw attention to them or something. Leaking from anywhere is embarrassing, but this is next level.” Her words hit on many important points.

First, many women I’ve worked with also think people will judge them for having leaky breasts in public. And maybe some people do, but those aren’t the people we should care about. The people we should care about are the little humans relying on those glorious boobs for sustenance, and your glorious self, who has every right to get out of the house when your body is still trying to figure out the whole milk supply thing. You’re doing nothing wrong when you’re out and all of a sudden you have wetness spreading across your shirt.

While it’s easy for me to write that, I understand it can be tricky to turn off the shame tap we’ve been taught to open at the slightest provocation. I turned off the shame by forcing myself to laugh at the situation. Whenever I was in public and my milk volcanoes erupted, I would shrug my shoulders, laugh, and in my own time, change into the extra shirt I always kept in my bag. I was totally faking this lighthearted attitude in the beginning, but the more I did it, the more I felt genuine humor instead of shame. It also seemed to give others permission to brush it off as no big deal, instead of something to uncomfortably ignore.

The second excellent point my aforementioned buddy made is that we are deeply conditioned to associate a leaking body part with serious humiliation. Peed your pants? Thought you needed to fart, but turned out it was something more? Got boogies coming out your nose? All are situations our society has said should produce mortification. Most people are ashamed even to cry in public. I think that’s all whack. Our bodies don’t stop doing body stuff just because we’re outside the privacy of our home. Leaks happen — to every body. Every single person. I encourage you to remember this when you’re met with seeping boobs in public. Remind yourself that what’s happening is the most natural thing in the world, and if you’re able to give yourself the grace to handle it with amusement instead of humiliation, you’re helping us all take a small step toward being more accepting of our bodies. Hey girl, you can be a leaky boob trailblazer!

What to do

And now for the logistics of that soaked bosom — because while we’ve canceled the Shame Game, it’s still not a fun feeling to have a sticky, wet chest.

Know the leaking triggers. Often hearing a crying baby, seeing a baby, or just thinking about your baby can induce a letdown. Knowing these triggers and any others you notice can give you a heads-up about a milky surge that’s on the way.

Press on your nipples when you feel tingling in your breasts. This preemptive measure can dam the milk flow. If you want to be incognito with this motion, just stretch an arm across your boobs and press it into your chest with your other hand.

Feed baby or pump before you go out. Emptying your breasts before you leave the house can minimize the chance of a leak.

Use breast pads. These absorbent boob buddies can soak up milk before it reaches your shirt. Keep a supply in your car, diaper bag, and purse so you always have replacements on hand. Be sure to change them when they’re wet, as your nipples being in a moist, enclosed space for long periods could lead to a yeast infection. (Aren’t we lucky — we can get yeast infections in the vagina and on our boobs!)

Keep tissues and organic wet wipes handy. I was the worst at remembering breast pads, but I almost always had tissues on hand. I would stuff them in my bra when I sensed an impending leak. And because the stickiness of breastmilk was irritating, I would try to have wet wipes on hand. I recommend organic wipes, as the alternative could leave chemical residue on your breasts.

Keep an extra shirt in your purse and diaper bag. Despite all the pads and tissues, you’ll still have moments where the milk reaches the shirt. So keep a patterned or dark-colored (with the exception of grey) shirt in your going-out bags. Avoid silk. I also recommend a cover-up you can throw on until you’re able to change.

Sleep on a waterproof pad that’s covered by a pillowcase. I had to wash my sheets every single day for the first week of Hudson’s life because I soaked the bed in milk nightly. I then wised up and bought a few waterproof changing pad liners. I would cover the liner with a pillowcase to make it less scratchy, and bam, I only had to change out a small liner and pillowcase instead of all the sheets. If it was chilly, I would sleep in a zip-up sweater so I wouldn’t have to pull the covers over my drippy boobs.

Wear a milk saver while breastfeeding. Many women leak out of one breast while feeding baby from the other. Save those precious drops by popping a “milk saver” onto the boob not being used. These are boob-shaped pieces of plastic and rubber, with a hole in the middle for your nipple and a catchment area below it. Once you’ve finished that side, you can pour the collected milk into a container. It can add up to a lot of extra milk!

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

It’s normal to be nervous about breastfeeding, although this feeling is rarely talked about. Most women hear only about how breastfeeding is the most natural thing in the world, and so great for our babies. While the latter is definitely true, it doesn’t always feel natural.

If you try breastfeeding and find it’s not a fit for your family, you can of course stop. But for many women, there are a slew of “breastfeeding fear sources” that can be unraveled, and often healed, helping them move from fear to gratitude and excitement about breastfeeding. Here are the main concerns:

Shift in the relationship with your breasts: It can be startling when a part of your body that’s probably been sexualized most of your life suddenly becomes a source of food. Some women organically make this shift, while others find it strange to have a little human sucking on a part of their body society has labeled sexual. If you’re in the latter camp, take heart that every woman I’ve worked with who had this block found that once she started, the act felt more natural every day until it finally became second nature. There’s nothing wrong with you if breastfeeding initially feels bizarre. (I dive deep into this topic in the next question.)

Possibility of not producing enough milk: There’s a chance your breasts won’t produce enough milk, because of circumstances like excessive blood loss during birth, limited milk ducts, hormonal imbalances, various medications and herbs, and other factors. While this can be incredibly frustrating and disheartening, a lactation consultant can help you determine why you’re not producing enough milk, and provide effective solutions.

It’s also good to know that the only way to confirm you’re not producing enough milk is baby’s weight. Not being able to get much out while pumping or feeling like baby is not eating enough does not mean your supply is low. Your baby’s pediatrician can help you determine if you need to get your supply up.

Pain from cracked nipples: The first two weeks of Hudson’s life were unreasonable torture for my nipples. I didn’t know he had a shallow latch (because I didn’t call a lactation consultant), so I suffered through bloody, mind-bending pain until my nipples finally toughened up and everything was fine — or maybe he figured out a better latch.

The suffering didn’t need to happen. If I had only asked for support, a lactation consultant could have provided tips to eliminate, or at least lessen, the discomfort. But I didn’t ask because I naively thought it was supposed to be like that — that I had to martyr myself to breastfeed. Don’t follow my lead. Speak up if breastfeeding is confusing or painful.

The newborn being entirely dependent on you for food: It can feel overwhelming to have a tiny, defenseless human dependent on you for protection, booty cleaning, connection, language acquisition, bathing, entertainment, and, well, pretty much everything. But these are all tasks others can help you with. The exception is sustenance — if you choose to breastfeed. This form of feeding is all you. Even if you plan on your partner giving baby bottles of breast milk, you still have to produce that breast milk. It feels like a big responsibility because it is.

I felt buried by this responsibility until I realized it forced me to foster a powerful bond with Hudson. We were together all the time (he was a cluster feeder), which led to us quickly finding a rhythm for our relationship. And because oxytocin was released each time I fed him, I was blissed-out at the end of each feeding. A study published in the International Journal of Psychiatry in Medicine even found that breastfeeding can decrease a woman’s chances of developing postpartum depression during the first four months of the baby’s life. But of course, it’s not a panacea. Some women will still develop postpartum depression no matter how much they breastfeed.

The gist: While I totally get the concern of being the sole source of food for your infant, it’s been my experience that the early demands of breastfeeding could provide innumerable benefits for your transition into motherhood.

Others seeing your breasts: I never thought I’d be okay with my brothers, father, father-in-law, and pretty much everyone I encountered in the first few years of my child’s life seeing my boobs — or at least some side- or under-boob. And yet, I quickly stopped caring. There’s an assortment of breastfeeding covers that allow women to get out the milk jugs without anyone seeing, but I couldn’t be bothered. I just got the fullest boob out, my voracious child latched on, and people looked away. However, I would sometimes breastfeed when Hudson was in the ErgoBaby, my all-time favorite baby carrier, which provided ample coverage.

Luckily, I never encountered comments from breastfeeding-in- public shamers, but even if I had, I’m pretty sure I would have just rolled my eyes. Feeding my baby when he was hungry felt like the most innocent, natural act, and I felt no shame.

With that said, you have every right to want breastfeeding to be a more private experience, and there are ways to achieve that. You can utilize one of the aforementioned covers, pop into one of the pumping stations that are showing up in more public spaces, or do anything else that makes you more comfortable breastfeeding.

Becoming nutritionally depleted: As breastmilk is made from your body, it can deplete you if you don’t stay on top of your food and water intake. Typically, a breastfeeding mother needs an additional five hundred calories a day, ideally from nutrient-rich sources.

Much like in pregnancy, during breastfeeding the body takes what it needs to provide baby with the ideal ingredients for health. If you have a surplus of nutrients and are consistently adding to the supply, you and baby will be fine. But if you’re lacking, you could experience postnatal depletion, which could cause exhaustion, poor concentration and memory, and big emotional shifts.

Maintain your vitality by drinking lots of water and eating breastfeeding superfoods like salmon, eggs, avocado, green leafy veggies, sweet potatoes, legumes, whole fat yogurt, whole grains, nuts and seeds (especially chia and flaxseeds), fenugreek, Ashwagandha, and turmeric. If possible, buy organic.

As you can see, many factors can understandably make you hesitant about breastfeeding. But with the right support and techniques, you can get past these blocks and have a successful journey through this amazing aspect of motherhood.

What to do

Know that breastfeeding is initially a struggle for many women. Needing help with this dynamic undertaking is so normal, and it’s often made much easier with the right support.

Hire a lactation consultant. A great lactation consultant helps you solve logistical issues with breastfeeding, figure out the best ways to make the experience more physically comfortable, and resolve any mental blocks. Because not every lactation consultant will be a good match for you, interview various candidates before your baby is born. This allows you to pick someone you’re comfortable with and have go-to breastfeeding support when baby arrives.

Join a support group. Connecting with women who have similar concerns and struggles can normalize your breastfeeding experience and provide a safe space to share your thoughts and receive supportive feedback.

Soothe pain by expressing milk onto topless breasts. Beyond ensuring that baby has a good latch, one of the best ways to pacify painful nipples is to push a bit of milk out of your breasts and dab it on each nipple, as breastmilk has amazing healing properties. Then, go topless for a while, allowing the milk to soak into the cracked skin.

Make healthy snacks and a big metal water bottle easily accessible. Prevent breastfeeding from draining your vitality by regularly restocking it with nutritious food and lots of water. I would get hungry and thirsty almost the moment I started breastfeeding. If I didn’t have water and food within arm’s reach, I felt trapped. Make sure you’re equipped for the multiple daily feeding sessions by having a bag filled with healthy goodies (that no one but you is allowed to pull from) and an always-filled reusable water bottle (metal is the safest).

Remind yourself how good breastfeeding is for you and baby. When you’re feeling overwhelmed by your breasts and babe, remind yourself that breastfeeding can do the following:

-Lower your baby’s risk of SIDS (sudden infant death syndrome), childhood leukemia, stomach viruses, lower respiratory illnesses, ear infections, and meningitis

-Decrease their chances of developing allergies or becoming obese

-Provide regular helpings of vitamins, nutrients, and other disease-fighting substances that serve as natural immunizations for your baby the first few months of life

-Improve cognitive development

-Save your baby in the case of an emergency, as it protects them from the effects of a contaminated water supply, helps prevent hypothermia, and requires zero supplies

-Reduce your chance of developing ovarian and breast cancer

Making breastmilk even more amazing is the fact that it’s custom made for your baby. Your milk ducts contain sensors that pick up signals in your baby’s saliva, telling your body what your baby’s unique body requires; your body then responds by creating customized milk. Your body also responds to pathogens you’re exposed to by producing customized milk that helps protect your baby from the pathogens’ potentially harmful effects.

Know that there’s no shame in stopping. If after trying all these sources of support, breastfeeding is still causing more stress than solace in your life, you have every right to stop. While I’m all about the benefits of breastfeeding, I’m more about women doing what is best in their unique situation. If the thought of switching to formula fills you with relief, follow that instinct.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Can I start with a rant? Okay, thanks! I think it’s so unfair that after having monthly periods for many years, then growing a baby for nine months, then birthing said baby, we may have to deal with wildly painful periods — sometimes while our vagina or abdominal scar is still healing. Un- fair. And all dudes have to deal with is a slightly lowered testosterone level when they become a dad. Pshh.

Okay, rant over! Thanks for listening.

So what to do about your heavy, painful periods? First off, let’s look at why it’s happening. For many women, a larger postpregnancy uterine cavity is to blame for heavier periods, as it produces more mucous lining that has to be shed each cycle. But we also want to make sure the pain and bleeding aren’t a sign of a health condition. If the bleeding is occurring within the first few weeks after baby is born and is getting heavier instead of lighter, it could be a sign of a partially retained placenta, which prevents your uterus from contracting back down to size. In this case, you’re not having a period, you’re bleeding because open blood vessels in your uterus have not closed properly. Women experiencing excessively heavy, painful bleeding during this early postpartum period should contact their care provider posthaste.  

Other health conditions that can cause heavy, painful bleeding include endometriosis, polyps or fibroids, adenomyosis (thickening of the uterus), or an over- or underactive thyroid.

If you’re not breastfeeding and experience what feels like a period about six to eight weeks after birth (sometimes periods start as early as three weeks after birth), it’s probably a period. If you’re breastfeeding, you could go many months before menstruating, as prolactin can suppress ovulation.

What to do

Don’t suffer in silence. Look into the following to find relief:

Have your iron levels checked. Because heavy periods can screw with your iron levels, and low iron levels can lead to exhaustion and other unpleasant symptoms, have your care provider check for an iron deficiency. If you do have a deficiency, they might recommend iron supplements, IV iron therapy, or diet shifts.

Rule out underlying health issues. In addition to having your iron levels checked, ask your care provider to help you confirm your heavy periods are not being caused by conditions like fibroids or endometriosis. If your care provider is not a specialist in women’s health, ask for a referral.

Consider birth control. As many types of birth control reduce uncomfortable period symptoms or can completely stop periods, you might want to talk to your care provider about getting a prescription for one that’s right for your unique needs. However, make sure birth control doesn’t mask the symptoms of an underlying issue by first having an OB-GYN confirm your reproductive health.

Get some exercise. Exercise is a whiz at helping the body manage hormone imbalances, potentially reducing the heaviness of your next flow. Even going on a thirty-minute walk a few times a week can be helpful.

Know that time may alleviate uncomfortable period symptoms. As your intense periods may be caused by your uterus getting used to life after pregnancy, you can likely expect the heavy flow and pain to somewhat subside after a few months, as your uterus and hormones adapt to their new normal.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

When I was a few months into motherhood, my husband and I had a big fight about sex — and not for the first time. Not surprisingly, he wanted more of it, and I couldn’t get into it. I associated my breasts with breastfeeding, and when I thought of my vagina I could think only of our baby coming out of me. My erogenous zones had turned into mommy zones. This severe shift in perspective suddenly made an act I had always enjoyed feel dirty, and not in the fun way.

To make myself feel better, I started rage journaling (obviously!). During this journaling session I drew what I called my sexuality spectrum. On one end of the spectrum was “using my body to care for a baby” (acts I perceived as requiring 0.01 percent of my sexuality), and on the other end was “using my body to feel sexual pleasure” (acts I thought required 100 percent of my sexuality). I wholly believed the dichotomy of that spectrum was accurate, and it screwed up my sex life for the first year of motherhood. Living by that model meant I had to push through intense mental, physical, and emotional shifts anytime my husband wanted sex, because I’d have to get all the way from one side of the spectrum to the other.

What I failed to realize when I created that spectrum was that the act of breastfeeding and vaginally birthing a baby is a lot more sexual than I realized. After all, my sexuality is what led to me becoming pregnant, birthing consists of the same uterine contractions that happen during orgasms (hence the phenomenon of orgasmic birth), and breastfeeding causes nipple stimulation that releases oxytocin, or “the love hormone.” Some women even have orgasms while breastfeeding.

Sex and motherhood mingle a lot more than we realize. But I think that also puts a lot of women off postpartum sex. For example, I have a client who felt aroused when breastfeeding and experienced a lot of shame around that. She then developed negative connotations about anything that caused arousal because it reminded her of what she called the “wrong feeling” when she fed her baby. This caused issues when it came to sex. She used the techniques in the “What to do” section to restructure her beliefs around motherhood and sexual arousal, and eventually found her way back to enjoying sex.

Something else that can turn a new mom off is the shift in identity that she and her partner experience. Our society often paints “good parents” as virtuous, wholesome, married citizens who never curse and have sex only to procreate. Little room is left for arousal, eroticism, and orgasm. I think that’s a shame. Sexual pleasure is an innate, healthy desire — something to be explored and celebrated instead of suppressed and shamed. But that takes work, because many of us have to reprogram our beliefs on having sex as a parent before we can enjoy having sex as a parent. So how do we start that reprogramming and get to the place where we want and enjoy carnal pleasures as much as our partner does?

What to do

Don’t give up on your sex life. Just because it feels awkward now doesn’t mean you can’t transition into a passionate, deeply pleasing sexual relationship with your partner. These tips can help you start that transition:

Look at where your beliefs about sex and parenthood come from. Many times, our blocks around postpartum sex were implanted long before we became mothers. To remove these blocks, take some time to examine where they came from. You could ask yourself . . .

• What messages did my parents share about sex?
  • How did my parents navigate their own sexuality?
  • What messages have I received about what it means to be a good parent?
  • What societal messages about sex and parenthood have impacted me?
  • Do I associate aspects of sex with traits I’ve been made to feel are inappropriate for a parent to have? (For example, do you think dirty talk, oral sex, or masturbation aren’t appropriate
    for a mother?)

Continue asking these questions until you have a solid idea of the forces that impacted your perception of postpartum sex. From there, you can decide what can be thrown out — for example, outdated ideas passed to you from your parents, the media, or society at large. And then, determine how you would like to perceive postpartum sex. Because that’s the thing, you have the right to create your own definition of what sex after birth looks like, and you don’t need anyone’s permission to live by that new definition. Here’s an example of a new definition, “I perceive postpartum sex as a beautiful dance between me and my partner that allows us to bond and to enjoy pleasure. Being a good parent means honoring my need for pleasure.” Here’s to a shift in perspective that fosters unfettered arousal, rolling orgasms, and a shame-free after glow!

Tell your partner how you feel. I can almost guarantee that you that unless you tell your partner what’s actually going on, you not wanting sex will make them feel rejected, like there’s something about them that’s causing you to not want sex. Fill them in on the blocks you’re having, why they’re coming up, and how you want to navigate them. If you don’t yet know how you want to navigate them, ask your partner if they’re interested in helping you in this process. If so, you can read through these suggestions together or come up with other possible solutions that suit your unique relationship. This communication can foster connection and prevent rifts or resentment that might be caused by changes to your sex life. An added bonus is your partner will probably put less pressure on you to have sex when you’re not feeling it.

Ask to lead the way during sex. When you’re first finding your bearing as a mother who is also a sexual being, ensure that sex moves at your pace by asking to set the pace. Move as fast or slow as you want. Tell your partner how you want to be touched. Let them know when you’re ready to be penetrated or intimately touched on the vagina — of if you’re not ready for that. Teach them what kind of touch on your breasts does and does not feel good. While this instruction might seem strange at first, it can help you feel empowered in your sexuality, and support you and your partner in understanding how to please this new version of you.

Take solo “warm-up” time before sex. For many women, the mind needs to be aroused before the body can get on board. So before you and your partner get frisky, slip away to the bathroom or another private space, and start thinking about things that turn you on. You can also pleasure yourself. Take your time, giving your mind and body time to warm up. Then, when your freshly aroused self is ready, go to your partner.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

After a vaginal birth, your vagina might be a bit wider, which both you and your partner might notice in the first few months after birth. But as you continue to do those Kegels and your vagina settles into its new normal, the changes will be less and less noticeable. In addition, some women experience vaginal dryness as their hormones shift, but this will work itself out after a few months.

Beyond the physical components of sex, you, your partner, or both of you might experience some mental blocks. One of the big ones is feeling comfortable connecting to your sexual side when so much of your identity has suddenly shifted into parent mode. It can be tricky to reconcile these two pieces of yourself. Because of this, it’s normal for your sex life to go through a dry patch in the early months of parenthood. Just take it easy on yourselves, commit to continuing to have sex every now and then — even when it’s awkward — and know that you can find your way back to a steamy sexual connection.

What to do

Go to a vagina spa. I’m kidding. But doesn’t that sound like something that could actually exist in Los Angeles? Until we discover a vagina spa, try these ideas:

Do Kegels. This exercise is a sexual game changer as it strengthens the pelvic floor muscles that surround the vagina, making it tighter. It also increases circulation to the vagina and pelvic floor, which can enhance arousal and lubrication — Kegels are a great way to get you going before sex. To do them . . .

* Identify your pelvic floor muscles by stopping your stream of urine mid-flow. Release after a few seconds.

* Focus on pulling the pelvic floor muscles in and up, hold for the count of ten, and then fully

* Maintain smooth and easy breathing during reps, slowly inhaling with the intake of muscles, and exhaling with the release.

* Do ten sets, three times a day.

Use lube, if needed. Because nothing kills the mood quicker than a dry vagina, purchase an organic lube to utilize until your hormones start providing natural lubrication again.

Get creative with positions. The temporary changes in your vagina could make positions that used to be lovely feel painful; and positions you haven’t tried, the bee’s knees. Go into sex with curiosity, trying out different positions until you find the one (or many) that do the trick. It’s also important to let your partner know you’re going to lead the way with this, as you’re the one who will know when something is working for, or against, your pleasure.

Consider amping up foreplay. If you’ve tried all the positions and none are doing the trick, return to the tried-and-true techniques of oral sex and fondling. Sex will eventually feel good again, but there’s no need to forego pleasure in the meantime.

Love yourself. A transformed vagina, leaking boobs, a shift in identity, fatigue, seriously limited time to get frisky…it can all lead to some bummer thoughts about yourself. Common thoughts I had in the fourth trimester were, “I’m no longer a sexual being, but a bloated baby bottle. I can’t possibly seem sexy to Eric. I feel so gross. Why am I so sticky? My vagina is probably disgusting, but I’m too scared to look.” I was so mean to myself. And needless to say, this meanness didn’t enhance my connection with myself or Eric.

Do as I didn’t, and tell yourself that the mean voice is full of lies. Instead of allowing yourself to fall down the rabbit hole of those damaging thoughts, be gentle with yourself, continually coming back to the knowing that things will settle down, you’ll reclaim your sense of self and sexiness, and your sex life will get back on track. It won’t happen all at once, and that’s okay. Instead of focusing on what’s not working, pay attention to what is — like the fact that you can create, birth, and nurture a new human. And that stretchy pants exist.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

The fact that you want to step away from the negative parenting patterns of your parents is amazing — you’ve already taken a huge leap away from those patterns. Many people grow up in dysfunctional households and never identify what they should try to do differently with their children. You’re in an eyes-wide-open position that’s filled with possibility.

I also invite you to consider that your horrible childhood can be a blessing as well as a curse when it comes to parenting your child. It’s a blessing because you get to start from scratch, and a curse because you have to start from scratch. Regarding the blessing, you have a clean slate you get to fill with your own way of parenting. You get to seek out parenting philosophies that resonate with you, then use pieces of these philosophies to craft your own. It can be an exciting, enlightening process. Regarding the curse, the idea of starting from square one can feel overwhelming. You don’t have positive parenting presets. You don’t have memories filled with happy parenting moments to lean on. You — and your partner, if you have one — are tasked with starting from the beginning. Again, a blessing and a curse.

What to do

Stand firm in the knowing that you’re in no way destined to be a bad parent. You are a wholly unique human who gets to make her own decisions. The dated belief that all women turn into their mothers is ridiculous — you get to choose who you become. You get to choose how you want to parent. The following ideas will help you get on the path that will shape you into the amazing parent you’re destined to be:

Get specific about parenting traits you don’t want to repeat. While you realize you don’t want to parent like your parents, it can be helpful to break down exactly what it is they did or didn’t do that you found damaging. For example, did they ignore you, talk down to you, use corporal punishment, withhold affection, leave you home alone before you were old enough to care for yourself, shame you?

As painful as it might be to dredge this all up, it can be liberating to explore what your parents did and how it impacted you, so you develop a clear picture of how you want to parent. And if you find this difficult to do on your own, seek out the support of a mental health specialist, especially if you experienced abuse.

Determine the type of parent you want to be. Once you pinpoint the parenting methods you don’t want to use, it’ll be easier to determine what methods you want to try. A good place to start is figuring out what the opposite of the negative parenting methods you listed would be. For example, you might list, “actively listening, building up the child’s confidence, using communication instead of physical force to discipline, being openly affectionate, never leaving the child alone (until they’re old enough) or with iffy childcare, supporting the child in navigating failure without shame,” and so on.

Research. The parenting methods you list in the previous step will probably reveal parenting topics you want to learn more about. For example, maybe you’re unsure what nonviolent communication is, are at a loss about compassionate ways to discipline, and want to discover how to be more comfortable with physical affection. Start researching the topics you’re drawn to, and take note of all the ideas and methods you want to try. This will be an ongoing activity, as what works for your family will shift over the years. But every minute of research adds to your base of knowledge and enhances your dedication to being a loving parent.

In addition to this traditional research, you can research parents you respect. For example, if you appreciate the way your partner’s sister parents, you can spend time observing what she does and doesn’t do, and ask questions about her parenting philosophy. The more you’re around parents who show there’s a better way, the more you’ll develop confidence that you can also choose a better way.

Don’t forget about your intuition. While I’m all about that research, I’m also a big believer in your intuition. The fact that you recognize the damaging aspects of your childhood probably means you’re in tune with your emotions and gut instincts about what feels right and wrong to you. Lean on these instincts as you navigate parenting.

For example, when your child is a toddler and they become upset for no apparent reason, you’ll likely have an instinct about how you can support them. And sure, this instinct might be informed by the parenting research you’ve done, but it’s mainly coming from your inner knowing — your ability to tune into your child and support them in the way that works best for both of you. In some ways, the most important thing you can do as a parent is learn to trust your intuition, and take the time to listen to it when parenting decisions arise.

Stay aware of any impulses to emulate unwanted parenting habits passed on by your parents. As strong as your loving intuition is, it’s not perfect and will sometimes give way to subconscious habits learned from your parents. But all is not lost if that happens. It simply means you’re a human who — like every other human — inherited a few of your parent’s habits. The cool thing is, habits can be changed when they’re noticed. So whenever you have a parenting moment that makes you feel icky, analyze it. For example, if your child is being very persistent about their need for attention, and you snap at them in the way your mother used to snap at you, clock that. You might think, “Hmm, it’s interesting that I responded in that way. How can I stay more calm next time, and respond in a way I feel good about?”

The tricky thing is, it can be hard to have this insight when we’re stressed, as stress can automatically push us into ways of being and thinking we learned as a child. However, developing the habit of using stress-relieving tools like breathing or walking away from a situation until you’ve calmed down helps you step out of the responses your parents ingrained in you, and choose something else.

Essentially, managing stress and keeping your eyes open to the negative influences of your parents’ parenting are two of the best ways to prevent your parents’ unwanted influence from bleeding into your parenting experience.

Be wary of your parents’ current influence. If your parents are a regular fixture in your life, stay attuned to whether your parenting habits change when they’re around. For instance, I have a friend who had a painful childhood and spent years working through her issues with her parents. She eventually got to a place where she could have them in her home for visits — her children were four and eight when these visits began.

What she realized was that she changed the way she treated her children when her parents were around. She either reverted to parenting methods they had used, or went overboard with the new methods she’d learned. “It was like I left my rational mind and based my parenting on their reactions to my children,” she said. “I either wanted to please them, or show them I was a better parent than they were. My kids and husband started dreading visits from them because it changed me so much.”

It got so bad she had a sit-down with her parents. She told them how she felt when they were around and explained that if the visits were to continue, they had to hold their judgments and let her parent the way her children were used to. This didn’t immediately solve all the issues, but it set guidelines that helped prevent her parents’ influence from derailing her thoughtful parenting choices.

Know that you won’t be a perfect parent, and that’s okay. No matter how much effort you put into being an amazing parent, you will make mistakes. Your kids will yell at you, you might yell back, some doors will be slammed, and tears will be shed. This is an inevitable part of parenting, and something no one escapes. When this happens, I encourage you to not punish yourself with guilt and shame, but instead to chalk it up to one of those good ole learning moments and move on. The less time you spend lamenting your parenting mistakes, the more time you can spend loving on your children and yourself.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

When I was a new mom, I fantasized about running away to a beachside hotel and sleeping until I no longer felt like I was living underwater. I had it all planned. I would loot my savings so I could pay the hotel in cash and no one could track me through my credit card. I would leave my cell phone under my mattress with a note saying, “I’m alive, but barely, and I’ll return when I’m ready.” The closest I got to this was stopping at the beach parking lot on my way home from Target one day, rolling down the windows, and sleeping for thirty minutes. Most new moms, as well as veteran moms, admit similar fantasies. So we’re not alone.

But just because we’re not alone doesn’t mean it feels good to want to run away from our lives. Something that might help you feel better is knowing most moms that have the running-away fantasy don’t actually want to ditch their families forever; they’re just looking for a few hours (okay, maybe a few days) where they don’t have to take care of anyone’s needs but their own. They want some precious time to screw their head back on. To get so deeply asleep they’re facedown, drooling into a pillow in a pitch-black, airconditioned hotel room. To order room service. To remember what their dreams are. To take a shower, or a poop, without someone crying for them. I think this is a totally normal, valid fantasy.

With that said, if you feel like you want to run away because it seems you’re of no value to your family, you feel too sad or anxious to care for anyone, or you’ve become so obsessed with thoughts of running away it becomes hard to function, you might be experiencing postpartum depression, anxiety, or OCD. In that case, a perinatal mental health specialist is the person to see. They can help you figure out what’s going on and provide specialized support.

What to do

Recognize that this fantasy is a not a sign that you weren’t meant to be a mother; instead it’s trying to guide you toward a life where your needs are honored. Here’s how to listen to that guidance:

Let yourself feel entitled to help and alone time. Some women think they should thank their lucky stars when someone steps in to help with their baby. Or that they need to sing their partner’s praises when they offer to hold the baby while mama sleeps. While it’s fine to feel thankful and express that thanks, you should also expect this support, and even demand it. It shouldn’t be something you stumble upon as often as you find a leprechaun passing out Xanax at the end of a rainbow. You should stumble upon help and time for yourself as often as you throw a load of spit-up-stained shirts into the wash.

What I’m saying is, when you start fantasizing about running away, make a clear plan with your partner or your go-to baby-care person about when you need them to take baby, and for how long. Some women feel that in asking their partner for this support they’re asking for a favor, but no. You’re not asking for a favor. You’re asking your partner to provide something that is your right, not a privilege. So as uncomfortable as this might initially be, I encourage you to clearly let them know what you need, instead of asking if it’s something they’d be willing to do. Claim your right for support.

Fulfill your fantasy. Because the fantasy of playing hooky from your life is usually sparked by a need for alone time, grab it by the horns. When your baby is an infant and incredibly dependent on you, maybe the most you can hope for is a few hours out of the house. But you should take it! Use that time to get a massage; bring a blanket to the beach or a local park, lie down, and sleep in the fresh air; or take your journal or laptop to a coffee shop and write. Do that thing you really want to do but keep thinking, “Nah, I don’t have enough time.”

When baby is a bit older and can survive without you for a night, consider booking a hotel room (and using it). And yes, there will probably be guilt and hesitancy and all that other mom stuff when you prepare to leave, but if you can force yourself to get to that hotel and fully focus on you for twenty-four hours, you’ll return as You 2.0.

Learn from your fantasy. Do me a favor and take a minute to envision what you would do after running away. After you take care of the basics like sleeping, eating, bathing, and maybe having a good cry, what do you see yourself doing? What are the things you would do to make yourself happy if you had no one else to care for? Let yourself go there, then write down what you see.

I did this when Hudson was a newborn, and I saw myself going on sunrise beach runs, taking long showers, sipping coffee while getting absorbed in a writing project, napping, watching some good ole reality television, and eating dessert I didn’t have to share. It was pretty basic stuff. What I realized was that while I wasn’t at a place where I could check off all those activities every day, I could sprinkle them in. So from that point on I committed to doing at least one activity from my fantasy list each day, and it was life changing. I now have a seven-year-old and am thrilled to say I usually do some version of everything on my fantasy list every day. And I didn’t have to run away from my family to do it!

So use your fantasy, mama. Use it to inform how you start blending your fantasy world with your real world.

Let yourself do less. I’ll bet that when you envisioned your fantasy you saw yourself juggling way less than you are now. There’s a reason for that. Moms are taught to stretch ourselves so thin we’re transparent. Cook fresh, organic food. Exercise. Feed baby on demand. Never let them sit in a wet diaper for longer than 3.5 minutes. Maintain a clean, organized home. Call your mom. Keep a foot in your career. Nurture your romantic relationship. Shower. Brush hair. Have a bowel movement. Burp baby. Sleep. (Wait, no, scratch that.) Oy vey. It’s just so much. But here’s a wild idea. What if you let yourself just cross some of the stuff off the list? (At least for now, when baby is such a fresh human and so demanding.) What if you asked someone else to do the cleaning and grocery shopping? What if you let yourself do less and know that it’s not giving up, but getting smart? Try it out for a week and see how it feels.

Tell someone where you’re going. I know a few women who went to the grocery store and ended up at a local hotel. In all cases but one, the women called their partner to let them know where they were. While those were awkward conversations, the partners at least knew they were safe. In one situation, the mom did not inform anyone and turned her phone off. Her sister found her right before her husband called the police. Don’t let that happen to you — it will just cause more stress. Play hooky if you feel you have no other choice, but make sure the person caring for your baby knows what’s up.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I would stop breathing whenever I let myself think about something horrible happening to my baby. Leukemia. A deadly car accident. SIDS. A kitchen accident. The list goes on. The thoughts would slam into me out of nowhere. One time, I was changing Hudson’s diaper and had a vision of him and Eric being in a lethal head-on collision. I froze. Diaper in mid-air. I was there. Feeling all the feelings I assume I would feel if that — the worst — happened. Then Hudson peed on me, and I snapped out of it. These thoughts didn’t come every day, but they came often enough that I had to build walls. I refused to let my mind go there. And if it tried, I would combat it with heavy-duty distraction.

When the distractions got too exhausting and less effective, I saw a therapist. She helped me find a balance between running from the nightmares and letting them swallow me. She also helped me recognize that feeling like something horrible was about to happen didn’t mean anything was actually going to happen. It was just a false thought triggered by the facts that my newborn was so vulnerable and I was almost entirely responsible for keeping him alive. She offered heaps of techniques, and I tried them all. The ones that worked are in the upcoming “What to do” section. But according to the therapist, what I experienced was pretty mild. Some women get so buried in nightmarish thoughts about their baby they can barely function.

One of the most frightening mental phenomena some new parents experience is thoughts of intentionally or accidentally harming, or even killing, their child — a type of something labeled “intrusive thoughts.” Most report that they don’t actually want to harm their baby but still have vivid thoughts of doing so. These thoughts can really become frightening for a parent when they’re doing something like bathing their baby, driving with them, or partaking in other activities that present obvious risks. It can cause an almost constant state of paranoia, and keeping things under control can take debilitating amounts of energy. For obvious reasons, this is a mental state parents rarely tell anyone about, out of fear their baby will be taken away. But what many don’t realize is that these thoughts are more common than you’d expect. A study published in BMC Psychiatry found that between 70 and 100 percent of new mothers report unwanted intrusive thoughts of infant-related harm, and half of all new mothers have intrusive thoughts about harming their infant on purpose. These thoughts don’t make you a monster, they’re just a sign you’re experiencing a very treatable psychological condition. Any mental health specialist worth their salt will not even think of reporting you, as long as you can honestly acknowledge that you find the intrusive thoughts disturbing.

When these intrusive thoughts become consistent and regularly impact your ability to function, they might be a sign of postpartum obsessive compulsive disorder (OCD). This can manifest as obsessive attempts to suppress the intrusive thoughts, partaking in obsessive rituals that you are convinced will prevent harm from befalling your baby (like constantly praying or checking on them), or avoiding triggering situations like bathing the baby or driving with them. Not surprisingly, OCD has been connected to issues with serotonin regulation and elevated levels of oxytocin — both of which are hormones impacted during pregnancy and the postpartum period. Obsessions with intrusive thoughts can also be triggered by stressful situations and a rapid increase in responsibility, which are both major elements of early parenthood. Because of these factors, some mental health specialists believe slight OCD tendencies might be a normal by-product of the postpartum experience.

The rarest but most serious cause of these violent thoughts is postpartum psychosis. This condition usually consists of an inclination to harm the baby, extreme paranoia, hallucinations and delusions, sleep disturbances, and disorientation. It typically presents within a week of the baby’s birth. Unlike moms with conditions like postpartum OCD, those with postpartum psychosis rarely realize that they shouldn’t be having thoughts of harming their baby — they don’t find the thoughts terrifying or appalling. This is a situation that requires immediate intervention.

What to do

If the thoughts you’re experiencing are limiting your ability to function, get support from a perinatal mental health specialist. They will likely recommend cognitive behavioral therapy, and they might recommend medication. Follow their advice before you try any of the other suggestions listed below, as you deserve the support of a mental health specialist who can take the unique circumstances you’re working with and help you craft a customized treatment plan. They can also help you normalize what you’re experiencing, which can be an immense relief.

With that said, I want to acknowledge that summoning the courage to tell someone about your intrusive thoughts can be one of the most challenging things you ever do. The good news is, a condition like postpartum OCD is no longer seen as a “scarlet letter.” Ongoing research is helping us understand that these conditions are not signs that someone is a dangerous miscreant, but rather they’re symptoms exhibited by a perfectly normal human experiencing a treatable psychological phenomenon. There’s no shame in speaking up and accepting help. And in the most extreme cases, speaking up might save the life of you or your baby. From there, consider the following:

Remember that the thoughts aren’t “real.” One of the only good things about horrific thoughts about your baby is that they’re likely a shocking contrast to your other thoughts. This contrast can make it easier to pinpoint when a thought is intrusive — aka, a thought that is produced not by the real you but by the condition you’re navigating (e.g., OCD, anxiety, or depression). This realization can help you separate from the thoughts and remember that they’re not indications of something you will do, or even want to do, and they aren’t markers of how you feel about your baby.

Write down what’s true. If you start getting lost in all the horrible things that could happen, home in on what’s actually real by writing it down. For example, you might write, “I grew and birthed my baby — that wasn’t easy; it took strength and courage. I provide a home and nourishment for my baby. I’m not broken. These thoughts aren’t me. These thoughts aren’t true. I love my baby. That’s true.” Keep writing until you feel firmly planted in your truth.

Bring yourself back to reality with your five senses. Another way to pull your mind out of a swirl of worst-case what-ifs is asking, “What do I see, smell, taste, hear, and feel?” Keep listing things your senses are experiencing until the intrusive thoughts loosen their grip.

Remind yourself that you’re not crazy. When you have intrusive thoughts you’re experiencing a symptom, just like someone with the flu experiences the symptom of a fever. And just as the flu can strike anyone, intrusive thoughts can strike anyone. So when you have the symptom of intrusive thoughts, continually remind yourself that you’re a whole, amazing person having an uncomfortable experience that will pass with the right support. And as long as you recognize that the thoughts are disturbing and are nothing you should act upon, you’re doing fine, as this is an indicator that you’re not experiencing postpartum psychosis. Of course, these thoughts aren’t fun, and they could be a sign of postpartum OCD, an anxiety disorder, or postpartum depression, so get that support, mama.

Find a support group. In addition to seeking support from a perinatal mental health specialist, it can be helpful to find an in-person or online support group composed of women having similar thoughts. This can help you feel less alone, normalize your experience, and help you develop a deeper understanding of what you’re going through. To ensure you find a quality group, ask your therapist for recommendations.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I was so afraid of SIDS, I couldn’t fall asleep the first night of Hudson’s life. When I couldn’t hear him breathing, I placed my hand under his nostrils, waiting for the small puff of warm air that would confirm he was still alive. The fear of SIDS would have kept me from sleeping all through the next few months if the bone-deep exhaustion of motherhood hadn’t pulled me under. While many people talk about how amazing life is when a baby sleeps, my baby sleeping was one of my biggest sources of anxiety. And really, how could we not be terrified of SIDS? Defined as the sudden, unexplained death of an infant under the age of one, SIDS usually occurs when the baby stops breathing during sleep. Understandably, we want to figure out why it happens, and how we can prevent it.

While there’s been significant research on the topic, there’s still not a clear understanding of why it happens. But there are many theories, and these have led to certain safeguards we can implement to minimize the risk of this heartbreak striking our families.

The common SIDS risk factors are listed in the sidebar below. But before we get into that, I want to note that rarely does one factor cause SIDS. Often, the following elements must be present for SIDS to occur — if just one is removed, SIDS is much less likely to occur:

Vulnerability: A defect or brain abnormality that impacts a baby’s heart or lung function (such as the serotonin condition described below) can make them more susceptible to SIDS. Essentially, this vulnerability makes it more difficult for the body of a baby faced with an environmental complication (see below) to trigger a protective response.

Environmental complication: While most babies can manage environmental complications like lying facedown on a mattress or overheating, babies who are vulnerable and are six months old or younger are less able to respond protectively and so are at higher risk for SIDS.

Developmental changes: Infants six months old and younger experience rapid growth and change. These changes could temporarily disrupt internal systems that impact breathing. This is one reason why SIDS is most common in babies between the ages of two and six months.

Common SIDS Risk Factors

Here are many of the most common risk factors for SIDS:

Issue with serotonin-producing neurons: Properly working serotonin neurons are needed to maintain the continued functioning of the heart and lungs. Here’s how it works: The brain facilitates the flow of oxygen to the heart and lungs. If someone has sleep apnea, for example, they stop breathing, and the brain gets alerted that there’s not enough oxygen and too much carbon dioxide. Then the brain triggers a protective process called autoresuscitation, which usually consists of big gasps.

The belief is that in some cases of SIDS this protective mechanism is not triggered. A study done by Harvard Medical School found that when serotonin-producing neurons are inhibited, the brain’s ability to autoresuscitate and save the body from apnea is impeded. Continued research could lead to screening that might help detect infants at higher risk for SIDS.

Sleeping facedown: According to the book SIDS Sudden Infant and Early Childhood Death: The Past, the Present, and the Future, the prone (facedown) position has been found to increase the risk of rebreathing expired gases, overheating, and accidental suffocation. Placing an infant on their side to sleep is also not recommended. In 1994, a campaign called “Back to Sleep” was launched, urging parents to lay babies on their back for sleep. This lowered the rate of SIDS by 50 percent.

Sleeping on a soft surface, or near soft objects: A soft sleep surface or objects that could cover a baby’s face (like blankets, pillows, or stuffed animals) increase the risk for accidental suffocation and overheating.

Rebreathing: This consists of a baby breathing in the air they just exhaled, which causes oxygen levels to drop and carbon dioxide to rise. Putting a baby to sleep on their stomach or having a blanket or other soft material in the crib that can cover their face can result in rebreathing.

Overheating: As overheating could cause respiratory issues or depress a baby’s ability to wake up, it’s been found to be a risk factor for SIDS.

Respiratory infection: An article published in the medical journal Hippokratia found that a mild degree of respiratory viral infection was observed in 80 percent of SIDS cases. In addition, a study published in Immunopharmacology and Immunotoxicology reported that common bacterial toxins found in the respiratory tract, in association with a viral infection, could contribute to SIDS in an infant during a developmentally vulnerable period. An infection can be especially dangerous for a baby sleeping on their stomach, as this prone position could increase airway temperature and stimulate bacterial colonization and bacterial toxin production.

Maternal smoking and secondhand smoke: Maternal smoking during pregnancy is considered one of the greatest risk factors for SIDS, as it can lead to premature birth and low birth weight (both risk factors for SIDS), diminish lung growth, increase the chance of developing respiratory infections, and impair the baby’s ability to wake themselves. And exposure to secondhand smoke after birth could impact the baby’s inflammatory response during an infection and limit their body’s ability to respond to threats to the heart caused by inflammation.

Being born prematurely: A study published in the journal Pediatrics found that many premature babies have impaired blood pressure control, meaning if they have a drop in blood pressure during sleep, their body wouldn’t be able to quickly respond. In addition, premature babies often have a higher risk of developing respiratory distress, do not have strong sucking and swallowing reflexes, and have a higher risk of infection because of an underdeveloped immune system.

Long QT syndrome: This heart rhythm condition can potentially cause fatal arrhythmia — when the heart beats too fast or slow or has an irregular pattern. According to a study in Journal of Biological Research, long QT syndrome accounts for 12 percent of SIDS cases.

Toxins from the mattress: While I want to be super clear that this theory hasn’t been thoroughly tested, I think it’s worth sharing. A New Zealand scientist and chemist, Dr. James Sprott, believes the phosphorous, arsenic, and antimony found in some fire retardants used on crib mattresses can mix with mold created from the baby’s urine, spit-up, and drool to create toxic gas. He believes the inhalation of this gas could contribute to SIDS. An additional theory is that body heat can contribute to the release of volatile organic compounds (VOCs) in mattresses.

Again, this theory hasn’t been conclusively proven, but I think it’s worth it to bypass this potential risk by purchasing an organic crib mattress from a company that’s Global Organic Textile Standard (GOTS) certified. If that’s too pricey, you may be able to prevent the release of these gases with a mattress cover specifically designed to block toxic gases. (If you’re wondering where the information about cosleeping is, go to question 97.)

As research continues, new potential causes of SIDS will likely be revealed. Your care provider can provide information about the most up-to-date SIDS research.

What to do

While there’s no foolproof way to prevent SIDS, the following can help you significantly reduce your baby’s risk:

Practice healthy habits during pregnancy. The American Academy of Pediatrics reports that babies of women who obtain regular prenatal care, do not smoke, and abstain from regular illicit drug and alcohol use during pregnancy have a lower risk for SIDS.

Put baby on their back for sleep. Even if your baby seems to be more soothed on their stomach, always put them to sleep on their back.

Breastfeed. The American Academy of Pediatrics states that babies who are exclusively breastfed have a  percent lower risk of SIDS, as breastfeeding provides the following benefits:

• Supports the baby’s ability to arouse from sleep more easily
  • Decreases incidence of diarrhea, upper and lower respiratory infections, and other infectious diseases
  • Supports the overall immune system
  • Helps the brain systems that control breathing to mature
  • Minimizes allergies that could cause inflammation in air passageways
  • Reduces gastroesophageal reflux
  • Supports the development of the oral cavity and throat muscles, helping to keep the airway open
  • Enhances the mother’s awareness of the baby

Ensure that the crib is empty, and use a sleepsack. Have baby sleep on a firm mattress with a fitted sheet — there should be nothing else in the crib, not even crib bumpers. Regarding clothing, put baby in a breathable sleepsack, which is a “wearable blanket.” This allows them to stay warm without using a blanket that could bunch up around their face. If the weather is so warm that you yourself are using little more than a sheet for coverage, your baby will likely be fine in a onesie or a light sleepsack.

Create a cool environment. As it’s important to prevent overheating, keep the thermostat between sixty-eight and seventy-two degrees Fahrenheit, have a fan on in baby’s sleep area, and clothe them in the aforementioned sleepsack or onesie. In addition, it’s not advised to put them to sleep in a hat, as it can trap heat.

Open windows when weather permits. Fresh air helps keep the air in baby’s sleep environment cool and clean, minimizing SIDS risk factors. If the weather allows and you feel it’s safe, open the windows in your baby’s sleep zone, being sure to insert a window guard when they become mobile.

Cleanse air with plants and an air purifier. Enhance the cleanliness of the air in baby’s room by using an air purifier and placing one or two air-purifying plants in areas of the room they can’t reach. Plants that can cleanse the air of harmful toxins, like trichloroethylene, formaldehyde, benzene, and xylene, include the peace lily, Gerbera daisy, florist’s chrysanthemum, red-edged Dracaena, and English ivy.

Use a firm, GOTS-certified organic crib mattress or a toxin-resistant mattress cover. As the toxins in standard mattresses might increase the risk of SIDS, opt for a GOTS-certified organic crib mattress or wrap the mattress in a cover that’s a “toxic gas shield.”

Make sure baby’s bed adheres to Consumer Product Safety Commission (CPSC) guidelines. A government organization that oversees products sold in the United States, the CPSC provides recommendations for purchasing a safe infant bed; see “Safe Sleep — Cribs and Infant Products Information Center” at cpsc.gov/SafeSleep.

Skip swaddling. While the research is ongoing, a study published in Pediatrics found that swaddling might increase the risk for SIDS, as it could hinder a baby’s ability to wake up during cardiovascular stress.

Have baby sleep in your room for at least the first year of life. A report by the American Academy of Pediatrics recommends that babies sleep in their parents’ room for the first twelve months, as this can reduce SIDS by up to 50 percent. While there’s not a definitive reason for this outcome, it’s believed that a baby will arouse from sleep easier when sleeping in a room with others, and that parents are better able to monitor the baby when they’re in the same room.

Consider a bedside sleeper. These aptly named baby beds are essentially bassinets that can be pushed up next to your bed and readjusted so baby is level with you. Some also have a side that can fold down, allowing you to easily access baby. If you go this route, make sure you select a bed that meets CPSC safety standards. Ideally, it will have a thin and firm mattress that’s no more than an inch thick. In addition, net or mesh walls are preferred, as they increase air flow.

Stay away from cigarette smoke. As breathing in secondhand smoke can be incredibly harmful to infants, remove your baby from any area where someone is smoking. And because smoke can linger on furniture, carpet, and other material, it’s best to not have baby in the home of a smoker, which is why it’s strongly advised that any smoker who lives in the same home as an infant quit smoking. In addition, do not let anyone who smokes hold baby, as smoke can linger in hair and clothes.

Ensure that all babysitters and childcare facilities you utilize follow these safety guidelines. Whenever anyone else will be caring for baby, make sure they adhere to this sleeping protocol. If baby will be at a daycare, have someone there walk you through their protocol. You can also stop in during naptime to see them in action.

The same goes for a babysitter; walk them through your sleepy-time routine, ensuring they understand its importance by having them repeat it back to you. You can also provide a simple written reminder. For example, “Put baby to sleep on their back, in their designated, empty bed, without a blanket and in a sleepsack or onesie, depending on temperature. And turn on the fan.”

If a parent or in-law seems resistant, remind them that this is not a request. While they might have done things differently when their children were infants, it’s up to you how your child is put to sleep.

Contact your pediatrician if baby seems to have respiratory issues. As respiratory issues can be a SIDS risk factor, contact your care provider if baby has a cough, breathing issues, or any symptom that concerns you.

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Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Isn’t it wild how having a baby can change your perspective of almost everyone in your life? Especially your animals. It’s like one minute your pet is a constant companion and best friend, and then, bam, your baby’s born and that pet suddenly feels like a looming threat. This can feel jarring and heartbreaking. While you’re celebrating and savoring the new love that’s come into your life, you’re also mourning the relationship you’re losing. Because even if your pet is able to stay in your home, it’s unlikely your bond will ever be the same, as you now have a new creature to dote on. On the other hand, if you determine it’s safe to keep your pet, their life may become even richer as they develop their own bond with baby. Everyone can win.

Regarding your fear of your pet hurting the baby, there’s no guarantee either way. But there are ways to objectively look at the situation and make a decision that’s best for all involved. And luckily, it’s not very often that a family needs to remove a pet from their home for baby’s safety. In most cases, training, limiting and/or supervising your fur-baby’s contact with your human baby and taking other precautions can ensure your baby’s safety without the need to say goodbye to your pet.

What to do

Here are some ideas to keep your baby safe while also nurturing your pet’s well-being:

Consider whether your pet has ever been violent. One of the best ways to determine if your pet will cause harm to your baby is to review their history. Has your pet been aggressive toward other animals or humans? How do they react to children? Is there anything about their personality or history that would lead you to believe they might cause harm to your baby? Answering these questions honestly can be an important first step in making your final decision about rehoming.

Hire a trainer. A trainer can not only help your pet break bad habits but can also help you determine if they’re a threat to your baby, as animal trainers are often experts in the behaviors of their animal-of-choice and know the signs that indicate an animal could be a danger to others. If the trainer believes your pet is safe to stay in your home, and you agree, you can ask them to help your pet break certain habits to create a safer environment for baby. For example, if you have a dog that jumps on people, is used to sleeping on your bed and getting on other furniture, and normally goes into the room that is now the nursery, the trainer can help you teach them that those habits are no longer allowed. If you’re reading this during pregnancy, I recommend working with a trainer before baby is born.

Introduce your pet to baby’s scent. As most animals have a heightened sense of smell, prepare your pet for the array of new odors baby will supply by having them smell an article of clothing that the baby has worn, before they meet the baby. Pet them as they’re taking a whiff, as this can help them create positive associations with the baby’s scent.

Don’t leave your pet alone with the baby. Make sure you’re always present when your pet and baby are near one another. Both children and animals can be erratic, so you’ll want to monitor all interactions until your baby is much older. In addition, begin teaching your baby that it’s not okay to pull the dog or cat’s tail, for example, by gently removing their hand if such an action occurs.

Stay aware of your pet’s emotions. Keep an eye on how your pet responds when they hear baby cry, for example, or when they’re simply around baby. Is their personality unchanged? Are they acting more aggressive or skittish than usual? Do they seem depressed? Do they shake or show other signs of anxiety when baby cries? Are they indicating stress by averting their eyes or moving away when baby is around? Your observations can inform how you navigate their relationship with your baby. A trainer can also provide invaluable insight into what various behaviors indicate, and what, if anything, should be done.

Tip: You can prepare your pet for your baby’s cries and other noises by playing recordings of baby sounds when you’re pregnant. It can be telling to see how they respond to the recording.

Organize extra care for your pet. Because your pets will likely be dealing with emotions that range from irritation to depression as your attention shifts from them to the baby, ensure they still feel the love by asking friends or family members to spend time with them during the first few weeks postpartum. If you have a dog, find people who can take them for a walk or a romp at the dog park. If you have a cat, ask a fellow cat lover to come over and give them attention. And of course whenever possible, remind your pets they’re still important to you by carving out bits of time throughout the day to spend with them. In addition, when your pet is with you and baby, be sure to also pay attention to them so they don’t feel jealous of the baby.

Ease into baby-pet interactions. When you’ve determined it’s safe to allow your pet to meet your baby, take it slow. Start by having someone hold your pet while you hold the baby, and allow the pet to slowly move toward the baby. They’ll likely sniff them, and maybe give a little lick. During this initial interaction (and all the following) stay as calm as possible, as pets and babies are sensitive to our energy and will react accordingly. A tense mood makes everyone else tense. So take deep breaths, and trust that the meeting will go great.

Read Good Dog, Happy Baby. This excellent book by dog trainer Michael Wombacher provides an effective twelve-step process for preparing your dog and family for a new baby.

Know that you’re not a horrible person if you need to find your fur-baby a new home. As heartbreaking as it is to determine your baby really isn’t safe around your pet, the decision to find them a new home will be best for all involved. Not only will you be keeping your baby safe, but you’ll also be ensuring your pet doesn’t spend the rest of their life being scolded and shut off from the family, and you won’t have to suffer the distress of being the one to hand out that punishment. While it’s devastating to say goodbye, you’re ultimately doing right by all involved.

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