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The thought of sudden infant death syndrome (SIDS) keeps me up at night. Why does it happen, and how can I prevent it?

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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My pet used to feel like my child, but now that I have a human child I never want my pet around because I’m nervous they’ll hurt the baby. Should I find my pet a new home?

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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Since giving birth to my second baby, I’ve been finding my first child kind of irritating. Am I a bad mom for not feeling equal favor for my children?

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

While most parents swear they feel the same about all their children, that’s usually not true. A study published in the Journal of Family Psychology found that 74 percent of mothers and 70 percent of fathers reported preferential treatment toward one child. This isn’t surprising, as personalities, shifting life circumstances, and a slew of other factors impact how we feel about the people in our life, meaning there will be seasons when we enjoy spending time with some people more than others — and our children aren’t immune to this.

While you probably love all your children so much you’d die for them, that doesn’t mean you equally enjoy spending time with all of them. For example, you might have an adorable baby who can’t talk back, a four- year-old who worships the ground you walk on, and a teenager who primarily communicates with eye rolls. Not surprisingly, you’d probably prefer to hang with the little ones. Even if your children are close in age, you’ll likely still have your “favorite.” Like if the two-year-old has intense emotions that trigger you, and your baby is super mellow, you’ll probably favor the baby. There is nothing wrong with any of this. You can love all your children unconditionally while not liking them equally.

Something else to consider is that your older child might be feeling especially “needy” right now. They can sense that your focus has shifted, and they want your attention. Many children, even older ones, often seek this attention by acting out of character or creating disturbances. Essentially, they create circumstances that force you to pay attention to them. And because sleep deprivation and the endless needs of a newborn make it hard to recognize the deeper meaning of these outbursts, it’s easy to lash out and create even more of a divide between you and your child. This will probably resolve itself as your family settles into its new structure, but in the meantime, you can call on your partner or other adults close to your older child to spend more time with them. You can also ask these adults to take the baby for short stints so you can spend one-on-one time with your firstborn, even if it’s the last thing you want to do. (No judgment!)

It’s also important to remember that your favor may shift as you and your children change. As life continues molding your family, you might find that one child’s irritating traits are dissolving, while your “favorite” child begins getting under your skin. And remember, that preverbal baby will eventually find their voice, and it’s anyone’s guess how you’ll respond to what they have to say. Isn’t parenthood exciting?!

What to do

Keep reminding yourself that while it’s totally normal to like one child more than the other, it’s still important to not engage in differential treatment (aka treating one child better than the other) and to continually ensure that all your children know how loved they are. These activities can help you do that:

Examine what bugs you about the child you don’t like as much. It can feel really icky to not know why you don’t like one of your children as much as the other. This not-knowing can lead you to believe you’re a bad mom, cold hearted, or just destined to have a tumultuous relationship with that child. I don’t think any of that is true. I’ll bet there are specific reasons why certain things about your child trigger you. Let’s figure out what they are.

When you find yourself inwardly (or outwardly) rolling your eyes at this child or gritting your teeth, notice that. Press pause and objectively look at what’s happening. What about this moment is irritating you? Is your child responding to something in the same way your partner does, a way that you wish they didn’t? Are they responding in the opposite way that you would, and that’s triggering? Does their behavior remind you of someone you don’t like, and that dislike is being reflected onto your child? Does their behavior remind you of flaws in yourself you want to avoid? Is your child acting needy in a moment where you feel stretched thin? Unravel the situation until you figure out what the core source of your annoyance is.

Developing this deeper understanding about your child and how you respond to them will support you with the upcoming activities, and help you realize that neither of you have a fatal flaw or are intentionally trying to irritate one another. You’re both just doing your best to feel loved, seen, and heard as your family adapts to the big changes brought on by a new baby.

Create intentional opportunities to bond with your not-the-favorite child. Now that you’ve started pinpointing why your child irks you, brainstorm activities you can do together that have the lowest potential for irritation. For example, snuggling on the couch and watching a movie, making a smoothie, or building a LEGO tower might be situations that allow you to be together without getting peeved with each other. When it’s time to do activities like cleaning up, brushing teeth, getting dressed, or other tasks that typically find you and your child clashing, you could tap out and call in your partner, at least while you have a newborn. While this won’t always be possible, being aware of situations that typically cause you to get frustrated with your child, having another adult take on these situations, and investing time in the activities that are usually harmonious can begin shifting your parent- child relationship.

Talk with your partner. If you have a partner in this parenting thing, they can help you see your relationships with your children more clearly. They likely witness your interactions with the kids more than any other adult and can support you in identifying dynamics you’re not aware of, or easing up when you’re too hard on yourself. For example, they can let you know if your actions make your favoritism clear, and if you’re overly harsh with the child that’s bugging you. They can also help you make a plan for how the two of you can provide all the children equal care and attention, which might look like them picking up the slack with the child who’s frustrating you, making sure they don’t feel neglected.


Help your kids feel emotionally safe. If you sense the child you don’t favor as much is picking up on your energy, remind them how much you love them and let them know what’s going on — in an age- appropriate way. For example, my friend Amy has an eleven-year-old son who really irritates her. “He is me in a little boy’s body,” she said. “He’s constantly showing me all the things I don’t like about myself, and I have no patience for it.” Her daughter, on the other hand, has a temperament similar to Amy’s husband’s. “She’s so easy to be with,” Amy said. “Sometimes when I’m spending time with her in the morning and her brother wakes up, I feel angry. I feel like he’s going to ruin my mood before he even does anything.”

Needless to say, Amy was wracked with guilt about this, especially when her son straight up asked, “Mom, why don’t you like me?” Amy was inclined to tell him all the things that would make him feel better, but she decided that would only mask the problem. Instead, she told him that because he was so much like her, he sometimes reminded her of things in herself she wanted to change. She told him it wasn’t fair to take this out on him, and asked him to let her know when she was being unkind. He now says, “Mom, are you seeing you in me?” when he senses that he’s bugging her.

If Amy’s son had been younger, she probably wouldn’t have gone into the whole “You remind me of me” thing, as he might not have been able to process that. Instead, she could have acknowledged his feelings, asked questions to get more insight into what was making him feel unliked, and then assured him that things would change.

Above all, stay aware of how you’re treating each child so you can avoid hurting anyone, glean insights into how to improve these relationships, and tune into your children so you can tell when they are in need of reassurance that you love them deeply.

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I know there’s a whole movement about not judging mothers, but I’m still afraid I’ll be judged. How can I feel secure in my parenting decisions and manage the judgment when it comes?

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

There sure is a movement to stop judging mothers. And for good reason! Us poor mamas have everything from side-eye to full-on trolling thrown at us for putting even a finger out of line. But where to put “the line” is the biggest problem. What’s the definition of that line? Where the heck does it live? Each parenting camp (and there are many) will give you a different answer to those questions. And all of those camps are certain their way of parenting is The Way to parent. It’s a dangerous recipe for excessive judgment that sadly causes mothers to feel unsure and shamed about their parenting choices.

I wish I could tell you the movement to let moms be has resulted in a rosy world where all parenting trolls say, “You know what, I don’t agree with you, but that’s okay! I’m sure you have your reasons.” But it hasn’t. The judgment still exists, and not just on the internet. Family gatherings, mommy-and-me groups, preschools, parks, and all the other places where mothers and offspring congregate can be ground zero for judgment, even from people who know better and mean well. And it will probably always be that way.

So what to do? Luckily, I’ve developed this fairy dust that you blow in the face of anyone who starts judging your parenting, and they suddenly understand where you’re coming from. Or no…maybe I haven’t. But wouldn’t that be cool?

What’s actually cooler is the realization that the only person we need to convince to stop judging us is ourselves. When we figure out how to be solid in our unique parenting choices and realize it’s not the right way, or the wrong way, but our way, we’re free to stop caring (at least as much) about the judgments that come from external sources. It’s like my mom said for the entirety of my teen years and was annoyingly right about, “What other people think and say about you has nothing to do with you.” You just need to get right with you.

The main reason people judge another’s parenting decision is because that decision is different from what they’re doing, and they process it as that person implying that they’re doing it wrong. Their judgments are essentially saying, “Nah-ah, I’m not doing it wrong, you’re doing it wrong.” So ultimately, the judgment comes down to that person’s own stuff. I know this because I used to be a big-time judger. I wouldn’t do it openly; I would do it behind people’s backs like a civilized person. When I finally started looking at why I did that, I realized that every time I judged someone’s parenting choice it was because that choice ignited my own insecurity. For example, I had a friend who shared how they no longer let their toddler have screen time because he got too obsessed with it. I was so triggered by this. I immediately went to my husband and was like, “There’s no way they’re actually doing that. They have to be lying. And if they’re not lying, they’re just going to make their kid obsessed with screens when they’re older because they were deprived as a child.” My judgments completely came from the fact that I was feeling guilty about how much screen time I let our son have. But I didn’t want to give it up because it made life so much easier. I was fighting hard to feel okay about my choice, even though I didn’t. As you can see, those harsh judgments were all about me and my stuff.

What to do

Keep reminding yourself that judgments aren’t personal and that you can trust yourself — then try the following:

Above all, listen to feedback from your intuition. You already know the best way to parent your unique child, in the unique circumstances you live in. Deep down, it’s all there. But the opinions of others, books by the experts, how we were parented, and various other factors muddy the waters, making us second guess our decisions.

To step out of that muddiness and make decisions that feel intuitively right, get into a quiet space and ask yourself about the parenting decision you’ve been conflicted about. For example, “Where should my baby sleep?” When the voice of your mother or that expert or whomever starts babbling, push them away. Seek the answer that makes your insides happy. When you find the right answer for you, your stomach will unclench, your chest will feel light, and your heart will say, “Yes! That feels right!” And you don’t have to ask permission to listen to these feelings. You can just do what feels right.

And the cool thing with decisions is, you can always change them. If you decide cosleeping is right for your family, but then circumstances change and it no longer seems like the best option, you can edit what you’re doing. And while many parenting decisions might have to be made with a partner, you’ll be able to discuss the options with more clarity when you first determine what decision makes your insides happy.

Caveat: Some of your decisions will come more from that place in your brain that’s craving ease than your deep wells of wisdom — and that’s okay. We will never be perfect parents. We will sometimes be like, “Yeah, I know I shouldn’t let my kid watch so much SpongeBob, but it’s saving my sanity right now, so oh well.” We’ve all been there. Heck, I’m there while I type this.

If someone’s disapproval triggers you, explore that. When my mom gently insinuates that I might try something different with Hudson, I. Get. So. Angry. Irrationally angry. When I started looking at where that came from, I noticed that the angrier I got over a suggestion, the more my insides (those traitors!) thought she was right. She knows me so well. She knows when I’m not honoring my instincts. And I hate when she’s right, because obviously we all hate when our moms are right, right?

So if someone’s judgment really ticks you off, explore whether you’re being triggered because what they’re suggesting is what you actually feel is best deep down, or because it just doesn’t feel good to be judged. If it’s the latter, remember that their response to your choices has way more to do with them than you, and go on your merry way.

Find soothing tools for when you’re triggered. When I feel judged I immediately get defensive. I want to lash out. Sometimes I do lash out. But when I catch myself, I keep my ego from raging by saying, “I hear you, but I really have to pee. Let’s press pause on this, and I’ll be right back.” It sounds ridiculous, but it works like a charm. This protocol gives me the opportunity to be alone and get hold of my emotions. I’m able to step away from what was said and figure out if the person was being hostile, trying to be helpful, or just making an offhand comment they didn’t intend as a judgment. Usually, I’m able to come back to the conversation with some perspective and more self-control. You certainly don’t have to use my “I gotta pee” trick, but I encourage you to make a plan for how you’ll respond when judgment causes an ego flare-up.

Feel free to not share your parenting philosophy. If you’re with someone you know won’t understand your parenting choices, you have every right to not discuss them. For example, if your judgy in-laws are constantly asking why you do this or that with your child, you don’t have to explain yourself. You can simply say, “It’s just something that works for our family. We’re not saying it’s the way everyone needs to parent, but it’s the way we’re choosing to parent.” If they harp on about what they think you should do or how kids were parented “in their day,” feel free to just smile and nod while using your brain power to figure out which Netflix show to watch tonight, or tell them your tampon is leaking and walk away.

Steer clear of toxic parenting spaces, online and IRL. Certain Facebook groups, some parenting forums, get-togethers with parents you know you aren’t aligned with . . . these are all environments where toxic judgments run amok. While of course there are exceptions, you’d be wise to avoid gatherings you believe will be saturated with strong, maybe even hurtful opinions, especially when you’re still trying to figure out how you want to mother. There’s nothing wrong with guarding your heart.

Broaden your perspective on judgment from loved ones. The potential exception to my “stay away from toxic environments” spiel is family gatherings. While certain familial situations are definitely toxic and should be avoided, there are others that are uncomfortable just because a family member is having an awkward time being involved in your child’s life.

For example, let’s say one of your child’s grandparents gets to see them only twice a year. Every time you see that grandparent, they might be full of suggestions for how to parent. You would be within your right to be incredibly irritated by this. But riddle me this — what if the unsolicited advice was the family member’s misguided way of feeling more connected to your child? What if they feel that sharing their “wisdom” is a gift that will enhance your family’s life? If you suspect this is where a judgy family member is coming from, you might help them find other ways of feeling connected — for example, taking on some feedings or diaper changes or, in the case of older kids, having a few one-on-one outings. If this doesn’t stop the “Maybe you should try. . .” comments, feel free to straight-up tell them that while you respect their insight, you’ll let them know if it’s needed.

Resist the urge to make your own judgments. While placing judgment can feel so juicy in the moment, the “high” never lasts. Moral of the story: If we don’t want others to judge us, we shouldn’t judge them. We’re all doing the best we can, and we all deserve more understanding and “you do you” from our fellow parents.

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I get really defensive when I receive unsolicited parenting advice. It’s so bad I’ve been snapping at strangers and find it hard to be around friends and family members who have kids. How can I navigate this advice without creating tension?

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

Unsolicited advice is composed of an interesting mix of motivations and emotions, as the advice-giver is usually trying to make themselves feel important and helpful, while the advice-receiver often feels like they’re being told they don’t know what they’re doing. For the most part, the only kind of advice that doesn’t cause tension is the solicited kind. So yup, it’s perfectly natural for your hackles to rise when someone starts preaching

about sleep training, insists you’ll kill the planet if you use disposable diapers, or shares some other opinion that primarily serves to pump up their ego. And while you have every right to be annoyed or defensive, remember that you and the advice-giver likely have two completely different perceptions of the conversation. They think the two of you are bonding over their knowledge and helpfulness, while you feel like they’re judging your parenting and putting their opinions where they don’t belong. Keeping that in mind can significantly reduce your defensiveness.

Something else that could be happening is that you’re feeling insecure about your parenting knowledge and choices, and need space to figure out what feels best for you. People telling you what you should do can make you feel rushed to make decisions and even more insecure about your base of knowledge. If you’re feeling this way, I encourage you to remember that you’re the expert on your child. You’re the guru of your family, even if you haven’t consumed as much parenting literature as the other person or haven’t found all the answers. (And spoiler alert: no one ever finds all the answers.) So instead of letting the advice get to you, take it as a sign that it might feel good to take some alone time to meditate on what’s going on with your baby, yourself, or your family and what solution intuitively feels right. If you don’t know where to start, use that alone time to research the issue and make a list of potential solutions that resonate with you.

It’s also common to feel the urge to tell the advice-giver why certain advice wouldn’t work for your family and, in the case of something like corporal punishment, why you think it’s wrong. But the fact is, they don’t want to hear it, and you don’t want to waste your breath. You don’t have to convince them their advice is misguided, or the way you’re doing something is working fine, or you’re confident you can come up with a solution on your own. You don’t owe them any explanation, and you don’t have to get sucked into a parenting debate — save your energy for something enjoyable.

What to do

Here are some tips for slipping away from advice sessions with minimal effort and emotion.

Scream “No!” when someone tries to give you advice. Just kidding. Try this:

Keep parenting challenges to yourself when you’re with chronic advice-givers. Minimize the chance of receiving advice that might activate your defensiveness and anger by dodging parenting conversations with people prone to offering advice.

Compose go-to responses. When most people give advice, the response they want is an unsarcastic version of, “Oh my gosh, thank you! I never would have thought of that. You’re a genius! What would I do without your superior insights?” But you don’t have to give them that. You get to think of a response that allows you to shut down the outpouring of advice without getting into an argument. I usually say something like, “Hmm. That’s interesting. I’ll think about it.” If they continue with the advice, I’ll interrupt with an, “I’m so sorry but I think my baby just pooped. I’ll be right back.” And then I’m not right back.

Here are additional responses you can tinker with:

  • “[Insert the parenting choice here] is working just fine for us. No need to fix what isn’t broken.”
  • “It sounds like that worked great for your family. I love how there’s so many unique ways to raise a child, and that every family gets to make their own decisions.”
  • “I’m sure that’s an ideal option for some families. We’re going to keep doing what feels right for us.”
  • “We tried that, but it didn’t work for us. Just shows that each child is different!”
  • “I’m doing what the pediatrician advised.” And it doesn’t matter if this is a lie — it will likely shut down the advice or judgment, as people are often loath to go against the word of an expert.
  • “Luckily, we don’t have to agree on the right way to [insert parenting topic here]. We can each do it our own way.”
  • “Thanks for your concern.”
  • “I’ll keep that in mind. Anyways, tell me about that book club you joined.”

Check in with yourself after receiving advice. After you’ve gotten out of an unwanted-advice conversation, take a pause and look objectively at the advice. Do you instinctually know it won’t work for your family? Does it go against your parenting philosophy? If so, fuggedaboutit. But if the advice sparked some interest, file it away for later use.

Remember that the advice-giver is (probably) coming from a good place. Most people aren’t trying to insult or annoy when they give advice — usually, they’re genuinely trying to help. Hold on to this belief when they blast you with their counsel. While you don’t have to agree, or even listen to it, remembering that they’re probably not intending to insult you can help you stay calm enough to gently extract yourself from the conversation, instead of raging.

Avoid being the advice-giver. I like to preach about how annoying unsolicited advice is, but I myself give it all the time. And I’m working on this. Be better than me and swallow your advice when it tiptoes to the tip of your tongue. I can almost guarantee that people would prefer your empathy or your questions about what they think they should do over your wisdom (as wise as it might be). And of course, if they ask for your opinion, you can let it rip.

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I don’t feel connected to my baby. I don’t even like to look at them. Am I a monster?

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

You’re not a monster. Not even a little bit. You’re one of the many women facing postpartum blues or postpartum depression. According to a study published in Morbidity and Mortality Weekly Report, one in nine women experience symptoms of postpartum depression. But some believe the number is actually much higher, as many mothers don’t feel comfortable talking about their depressive symptoms.

While it’s easy to convince yourself that the lack of connection with your baby is a sign you’re lacking some essential “good mother” chip, it probably just means that wonky hormones, plus the ingredients of exhaustion and extreme change, are impacting your ability to bond. However, just because the causes of what you’re experiencing aren’t dark and sinister doesn’t mean you’re not feeling like this is the end of the world. Many of us are given the consistent message — especially during pregnancy — that the bond between a mother and child is unbreakable. That it’s the greatest love story we’ll ever experience. When that’s not our reality, it can feel life shattering.

Something important to remember as you navigate this likely heartbreaking experience is that it’s temporary. While any form of anxiety or depression can easily trick us into thinking we’ll never feel better, that’s rarely the case.

If you’re sad and unable to develop a bond in the two weeks following baby’s birth, you might be facing the common phenomenon of postpartum blues, which is believed to be caused by a combination of your hormone levels plunging and a struggle to adapt to the abrupt changes of motherhood. If the feelings of sadness and disconnection don’t lift after two weeks, you might be experiencing postpartum depression.

It’s also important to realize that you’re not scarring your child, or your future bond with them, by not feeling connected now. The mother-child bond develops over a lifetime, and it will happen for you, even if you first have to navigate medical and emotional support. And it’s wise to seek that support. Sadly, about 60 percent of women with symptoms of depression do not receive a clinical diagnosis, and 50 percent of women with a diagnosis do not receive treatment. As added incentive to seek support, consider this: studies have shown that while postpartum depression can have short-term impacts on infants, there are rarely long-term emotional effects if the mother receives treatment early-on.

What to do

Get help, as you should not have to navigate this pain alone. While I totally get the resistance to being open about your depression (I waited two years before I asked for help!), I can almost guarantee that your care provider won’t judge you. They’ll probably be relieved you were brave enough to speak up. And I want to remind you again that postpartum blues or depression is not a fatal character flaw, it’s a very common by-product of going through the intense physical and mental shifts of pregnancy, childbirth, and early motherhood. It doesn’t mean you’re a bad mother, or that you’ll never bond with your baby. Asking for help is actually one of the best things you can do for your baby.

Here are a few support-steps you’ll likely need to take:

See your primary care provider. The first stop on the path to moving past postpartum blues or depression is your care provider. They can help evaluate what’s going on and refer you to a mental health specialist. They might also prescribe medication, like an antidepressant. For many women, medication is a key player in getting out of the grips of postpartum depression.

Be consistent with counseling. After you find a mental health specialist you resonate with, commit to showing up. When I was depressed, I cancelled on my therapist all the time because I felt too listless to leave the house. Needless to say, I didn’t get much out of the relationship. Years later I faced another bout of depression and forced myself to see my therapist once a week. If I couldn’t get out of bed, I would FaceTime her. I always felt lighter after our sessions and gleaned serious benefits from our time together — and I also needed medication.

As hard as it can be to keep showing up for counseling, it’s one of the most potent ways you can nurture yourself through depression. Even if some days you’re sure you have nothing to say to your therapist, you’ll benefit from simply arriving at the appointment.
Find quality care for baby. As you navigate this challenging time, it will be essential to ask trusted loved ones for help with your baby. Being their sole caregiver while trying to get through depression might feel impossible, which is why calling in reinforcements can ensure that you and baby get the care you deserve.

You might resist this because you don’t want to tell people about your depression. This is normal, but you’ll probably be amazed by how supportive friends and family are when you trust them with your vulnerability. (And you might also be surprised to learn that some of your loved ones have been through the same thing.)


Continue to spend time with baby. While being with your baby might be a painful reminder of how disconnected you feel, it’s important to continue being with them, even if you have to fake affection. Because “faking it ‘til you make it” might just help you develop an authentic bond with baby, and it will definitely support them in feeling bonded to you. If you don’t trust yourself to adequately care for your baby on your own, ask an adult to be with you when you’re spending time together.

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I find it really boring to take care of a baby all day. Does that make me a bad mom? Is there a way to make it more entertaining?

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

Girl, I feel you. When Hudson was a baby I felt like I was on a hamster wheel of feeding, butt cleaning, spit-up dodging, cooking, not showering, and walking around in circles saying, “Shh.” I felt like my life had been drained of creative, thought-provoking stimulation. I was mega-bored hanging with a person who didn’t talk and cared only about my boobs. And I was pretty sure I was missing crucial mothering pieces.

It’s no wonder we feel like there’s something wrong with our boredom when we’re constantly told how magical it should be to interact, bond, and help baby learn about the world. These are all essential tasks that plant seeds for the emergence of independent, vibrant humans. So shouldn’t we feel inspired and excited by them? I suppose some women are, but I wasn’t.

If you relate, let me start by saying how super-duper normal you are for feeling this way. You’re not an evil Grinch incapable of connecting with your child. You’re an adult who craves activities that challenge your mind and awaken your creativity. At first glance, caring for a baby does none of these things, and often it just makes us feel incompetent and frustrated. But when we dive deeper into the nuances of baby care, there is something to be done about baby-care boredom.

What to do

Toy around with these ideas:

Incorporate your interests into baby care. For example, it’s important to talk to baby so they’re exposed to language, but who said you have to talk to them about mundane topics or read to them from cardboard books? Give your babe language exposure by reading aloud from a magazine or that book you’ve wanted to read. And music — scrap the Mozart (unless that’s your jam!), strap baby to your chest, and get a workout by shaking your butt to nineties hip-hop while making funny faces at baby.

Think of innovative ways to make baby tasks more interesting. Do this by listing your daily baby-care activities on one side of a sheet of paper and writing your interests and talents on the other half. Then, start brainstorming how you can fuse the lists, mixing and matching your interests and talents with baby-care obligations.

For me, diaper changes became more compelling when I used the time to challenge my writer’s brain to come up with new lyrics to favorite songs. Breastfeeding was made way less boring by putting a TV tray and my laptop by my nursing chair and writing weird poetry while Hudson ate. And I made sure I still interacted with him by asking questions about how I should get around tricky prose.

Remember that you don’t have to parent the way others do. Bringing your unique self into motherhood is one of the best ways you can quell boredom and foster an authentic bond with your baby — it will help them get to know the real you. And if your way doesn’t look anything like the way of your sister or the ladies in your mom group, that’s okay. We all get to forge our own path.

While life with baby will eventually become less boring, regardless of what you do, liven up your mama-baby relationship now by injecting motherhood with the stuff that makes your mind do a happy dance.

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I resent my baby for getting all the attention, and I feel invisible. How can I start feeling like I matter?

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 a wild emotional shift to go from getting ample help and compliments when the baby is inside you, to suddenly being seen as their leaky accessory after going through all the work of getting them out? And sure, there are folks who ask about the birth and tell you how great you look (bless them), but really, most people are all about the baby. This can be nice at times, as you may score much-needed down time while others coo and ooh over the baby, but then there are the times when you crave to be seen as more than a mother — as more than the lady carrying around that adorable creation everyone wants to hold. You crave conversation about that book you’re writing, or that cat-grooming workshop you went to… or whatever your thing is. You want to be honored for being the powerhouse who grew and birthed a baby while also having all of these other amazing qualities. You’re not selfish for feeling this way.

For the first six months of Hudson’s life I felt completely invisible. When people came up to us, their eyes would immediately lock onto him. If they engaged me in conversation, their eyes would stay on him, and the topic would almost always be his eating, pooping, or weight-gaining habits. I felt like I was his personal assistant. Or PR rep.

A big part of my frustration was that these interactions were a physical manifestation of what was going on in my own head. Almost every thought I had, every action I took, involved Hudson. I could barely remember what made me an individual. While I loved him deeply, I also felt twinges of resentment that he had robbed me of my individuality. Luckily, these feelings began to fade as he grew and became less dependent on me. And of course, because motherhood is crazy like this, him needing me less made me have moments where I missed him needing me all the time. Geesh.

What to do

Remember that in the early days of motherhood it’s so normal for your life and identity to feel fully wrapped up in baby. However, you can create a lifeline to your unique self by making a list:

1. Create a list of all the things that make you feel like you. This list can contain anything, from something as simple as taking a shower or organizing the closet to tasks as complex as creating a graphic novel or starting that business you’ve been dreaming of.

2. Put the items on the list into three categories. The first category will contain the actions that are absolute essentials and should be prioritized immediately (for example, taking a shower every day, and going on a walk three times a week). These are the things you’ll bring to your support system and say, “Let’s figure out who can watch baby during these times so I can do these things.”

The second category will consist of actions that are incredibly important to you but can be put on hold for six months, as month six is often when baby is a tad less dependent and able to be with others for longer periods. My top two items in this category were meditating for fifteen minutes and writing for one hour, every day.

Finally, move the remaining actions on your list into category three, which consists of the things that will come back into your life after baby’s first birthday. By this time, you’ll likely be in your groove with motherhood, sleeping fairly regularly, and feeling comfortable setting up consistent childcare. This is around the time I started teaching HypnoBirthing classes and amped up my writing career.


3. Use the list. Pull out your categorized list whenever you’re forgetting who you are or wondering if you’ll ever get back to that person. After a day of feeling invisible, this list helps you breathe and remember that there will come a time when life settles back into a more balanced rhythm. And no, life will never go back to feeling exactly like it did before baby was born, but it will start being more layered and consisting of people seeing you as a unique woman, not just the person that baby is clinging to. Things will get better.

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I feel pleasurable sensations when I breastfeed, and it’s messing with my head. I can’t reconcile having what I can only describe as a sexual feeling while doing something that’s far from sexual. It’s making me resist breastfeeding. What should I do?

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 byproduct 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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Why are my milk-producing boobs constantly changing size? Why have my nipples changed color? And what can I do to ensure they don’t look defeated when I’m done breastfeeding?

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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I feel self-conscious about my massive leaking boobs. How do I make them stop leaking? And how do I stop feeling ashamed of my body? Especially when I’m in public.

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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I feel like I should want to breastfeed, but I’m totally freaked out by the idea. Why do I feel like this? What should I do?

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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I’ve been having the heaviest, most insanely painful periods since having my baby. Is this normal?

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. (For more on this, see question 65.)

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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I’ve been avoiding sex because I now associate my vagina and breasts with my baby, and I can’t reconcile motherhood with arousal. Is there a way to shift my mind and body out of mom mode so I can enjoy sex again?

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, see question 56), 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 . . .

  1. What messages did my parents share about sex?
  2. How did my parents navigate their own sexuality?
  3. What messages have I received about what it means to be a good parent?
  4. What societal messages about sex and parenthood have impacted me?
  5. 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. For 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 it 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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Will my vagina feel the same to my partner after a vaginal birth? Will sex feel the same for me?

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 midflow. Release after a few seconds.

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

* 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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Until my baby is vaccinated, I don’t feel comfortable taking them out of the house or exposing them to anyone but my partner and me. Am I being paranoid?

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

I don’t think you’re being paranoid. But let’s peel back the surface of your feelings by considering a few things. First, if your baby has a compromised immune system, it’s wise to be cautious about being around too many people until they’re less vulnerable. And if you’re in the thick of flu season or have family members who have been battling a “bug,” it’s best to avoid exposure for you and baby.

If you have a healthy baby, you’re likely fine to go out. This is especially true if you’re breastfeeding, as breastmilk fills your baby with antibodies and other goodies that work wonders at protecting them from harm, at least for a few months. The one “going out” caveat is that you might want to avoid incredibly crowded areas, like theme parks, malls, and cruise ships, for example, as these are the types of environments that can breed the spread of infection.

With that said, consider whether your hesitancy to leave the house or have people over also has to do with your need to integrate with all the changes you’re going through. Becoming a parent is one of the most massive, sudden transformations a human can go through, which makes it natural to want to pause interaction with the outside world until you get your bearings.

Whatever your reasoning, I recommend following your instincts. If you’re yearning to leave the house but guilt over exposing baby to a virus is holding you back, get creative about safe ways to go out. For example, you could go on walks, so long as you have a hard line with strangers trying to touch baby, which strangely happens more than you’d expect — people see something cute and want to touch. You could also meet friends for a picnic at the park or go to an uncrowded restaurant and sit on the patio. Essentially, choose activities that allow you to be outside, without having close contact with others.

If you want people to come over but worry about invisible dangers they might carry into your home, be strict about them washing their hands as soon as they arrive and holding off on coming over if they’re sick. Your pediatrician can also let you know if there are vaccinations you should confirm that others have before coming over. For example, whooping cough was a big problem when Hudson was born, so I and everyone who would be frequenting our house were vaccinated with Tdap before he was born. In addition to all that, you have every right to not allow anyone to hold the baby.


That’s my long way of saying that what you’re feeling is your maternal instincts giving you a strong signal that you should explore.

What to do

After contemplating where your hesitation to go out with baby or have people over is coming from, consider the following actions, as they can provide a welcome sense of security:

Get a recommendation from your pediatrician. If you’re raring to get out but fear keeps popping up, ask your baby’s pediatrician for their suggestion. They can guide you based on your baby’s unique health circumstances and any public health concerns you should be aware of.

For example, I’m writing this during the Covid-19 outbreak; for obvious reasons, this pandemic makes it easy to decide whether to go out or not. But even when we’re not in the midst of a pandemic, flu season and a flare-up of other viruses could cause the pediatrician to advise you to stay close to home for awhile. Regardless of their recommendation, you’ll likely have more clarity after the chat.

Breastfeed. While breastfeeding isn’t a substitute for vaccinations, the milk does give baby an extra layer of protection for about six months after birth. Breast milk does this by providing antibodies that support the immune system and protect against diseases you have had or have been vaccinated for. These antibodies can bind to potential pathogens and prevent their attachment to the baby’s cells. In addition, breastfeeding can enhance the baby’s response to certain vaccines.

Get vaccinated. Protecting yourself is one of the best ways to protect your baby. So confirm with your care provider that you’re up to date on vaccinations, and ask if they recommend any new ones. Many advise pregnant women to get a Tdap vaccine and a flu shot during pregnancy.

Don’t let others touch baby until they’ve washed their hands. Because close contact, touch in particular, is one of the main ways viruses spread, require anyone who wants to hold baby, or even just touch them, to wash their hands for at least twenty seconds first. And remember, you have every right to not allow others to hold or touch baby if you’re uncomfortable with it.

Verify the health standards of the day care facility you use. If your baby will need day care before they’re vaccinated, confirm the health standards of your preferred center by reading their health and safety inspection report. Many centers post these online, and you can also ask them for a copy. In addition, ask them about their hand-washing policy, vaccination requirements and records for those old enough to receive shots, guidelines for keeping a sick child home, and anything else you feel is important. The Child Care Aware website offers excellent resources for finding quality childcare: childcareaware.org/families /choosing-quality-child-care/starting-child-care-search/.

Avoid crowded spaces. As I mentioned before, crowded areas increase baby’s risk for contracting a virus. While the risk is probably pretty low when an outbreak isn’t occurring, if you’re feeling anxious you can enhance your peace of mind by avoiding crowded spaces until baby is vaccinated. For unavoidable sites like airports, minimize baby’s exposure by washing your hands as often as possible, not letting anyone touch them, and minimizing their contact with public surfaces.

Know that it’s okay to want to stay in. If baby’s health is only a portion of your hesitancy to interact with others, and all parts of you resist the idea of going out or socializing, trust that. Honor your need for time and space.

Create a loose script for when people hassle you about your need for space. Because it can be hard for others to understand your request for space — especially when they’re yearning to meet that adorable baby — come up with a go-to response for when you’re questioned. For example, “The pediatrician recommends we keep baby home and away from others for [insert your desired period of time here], and for baby’s safety we’re going to honor that.” Even if the pediatrician didn’t recommend this, I’m all about blaming it on them, as others are often loath to go against the word of a medical expert.

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I had a horrible childhood and am afraid I’ll replicate that with my child, as I have no good parenting role models. Am I destined to be a bad parent?

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. There’s a list of helpful parenting classes and books in the “Recommended Resources” section on page xx to get you started.

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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Sometimes I fantasize about running away. Do I need help?

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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I have horrific thoughts about awful things happening to my baby. Sometimes I imagine being the person inflicting harm. Am I crazy? Am I a danger to my baby?

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 byproduct 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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The thought of sudden infant death syndrome (SIDS) keeps me up at night. Why does it happen, and how can I prevent it?

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.

There’s not much you can do about baby’s vulnerability or age, but the “What to do” section (pages 224–26) helps you cancel out most environmental complications.

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.

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 50 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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