The Parenting Life -- Ann Douglas -- 10/21/2003

By Ann Douglas
WebMD Live Events Transcript

Your new identity as a parent: going back to work or staying home, childcare, reconnecting with your partner, or going it alone. And what is happening with your body now that baby is here? Whatever your situation, parenting is a whole new life, and our "Bootie Camp" instructor, Ann Douglas, helped us answer these new parent questions on Oct. 21, 2003.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD University: "Bootie Camp: A 4-Week Guide to Baby's First Year." Your instructor today is Ann Douglas, author of The Mother of All Baby Books. Today she will answer your questions about your new life as a parent.

Support for this WebMD University course provided by Blue Cross Blue Shield of Massachusetts.

Welcome back to WebMD University, Ann. What was the biggest surprise for you when you were a new parent?

Douglas: I had no idea how exhausted a person could get. I mean, I think we've all had the experience during our college days of pulling the odd all-nighter during exams, but after you have a new baby, you end up pulling what amounts to maybe a week's worth of all-nighters in a row with sometimes as little as three hours of sleep a night, or at least that's how it was for me during the postpartum period with some of my babies.

In fact, I remember when my first baby was born, my husband was building a deck in our backyard, and I remember worrying that I wasn't going to be able to take an afternoon nap with all that hammering going on. Well, the baby and I lay down on the bed to nurse and we both fell asleep. I swear if they had been using jackhammers we wouldn't have heard a sound. That's how exhausted you can be during those early weeks after having a baby.

Moderator: Do you ever catch up that sleep?

Douglas: Eventually you do start to catch up on your sleep, thankfully. I mean, if you had to look forward to being that exhausted for the next 18 years, you would be in a perpetual zombie state! You would have to kiss your sex life, your work life, and most other parts of your life goodbye, because chronic exhaustion can really take its toll on most areas of your life.

Most parents describe the postpartum period as being like walking in a fog. In fact, they often have few memories of this time in their life. They remember that they had a baby, that they changed a lot of diapers, that they had some visitors, went to some doctor visits, but that's about it. The rest is a blur. When you're not getting enough sleep everything starts to blur together and you really start to lose track of time.

It's not surprising that new parents find these early weeks to be both exhausting and stressful. And, if you've been working outside the home up until now it can be a real culture shock as well. You can find yourself going from being a high achiever who can easily whip through a 10-item to-do list in a day, to someone who can't even manage to get the breakfast dishes in the dishwasher before noon, because the demands of caring for a newborn baby can be so all encompassing.

So if you feel like you've suddenly stepped into a parallel universe, you're not alone. A lot of new parents feel this way, and you will, over time, regain your equilibrium. It's all part of adjusting to life with a new baby and getting used to the new rhythms of parenthood.

Member question: I've always heard "sleep when the baby sleeps" but isn't that when you take a shower, do a load of laundry, make a sandwich, etc? It's hard to do those things with an infant in one arm.

Douglas: You really have to learn to set priorities at this point in your life. Some day you may decide that the dirty dishes on the counter are driving you so crazy that it's worth sacrificing your afternoon nap just this once. Other days you may decide that nothing, and I mean nothing, is going to stand between you and the couch while your baby is taking her afternoon snooze. It's a matter of deciding what will leave you feeling the most rested and/or rejuvenated at the end of the day. And your needs will, invariably, shift from one day to the next.

Don't forget that you can download some of those chores to other people, but what you can't download is sleep. Wouldn't it be great if we could hire someone else to take a nap for us when we're feeling exhausted? If only that were possible, but it's not. So keep that in mind. If you get totally behind in your sleep it can take a very long time to catch up. That's one debt that can really weight heavily on your shoulders -- your sleep debt.

Moderator: Can you talk about the changes your body goes through after giving birth and how those changes affect you?

Douglas: Your body goes through some truly dramatic changes after you give birth. I think sometimes we have rather unrealistic expectations about how we're supposed to look and feel after the delivery. Perhaps it's because moms today are getting out of the hospital so much more quickly that we maybe think that it's supposed to be business as usual within a couple of days of the birth, but I can tell you it's anything but for most women.

Your body has spent the previous nine months undergoing the most dramatic physical changes that a woman's body can ever experience, so you can't realistically expect your body to reverse these changes over night. It takes time for your body to move from a pregnant to a non-pregnant state.

Let's talk about the heavy vaginal bleeding that you can expect to experience, for example. Traditionally women have been told to expect very heavy bleeding for about 10 to 14 days following the delivery. Well, a few years back some researchers did a study and found it's actually common for the majority of women to experience this heavy post birth bleeding (lochia) for at least a month, and possibly as long as six weeks after the birth.

Of course, for most women, the lochia won't remain bright red and very heavy for the entire time. It typically tapers off to a lighter pinkish discharge from about the 10th day postpartum onwards. But some women do experience heavier bleeding for a number of weeks. It just goes to show that it does take our bodies quite some time to get back to normal. And of course, that is only one of the changes we can expect to experience.

If you experience an episiotomy (an incision to allow the baby's head to be born more easily during the delivery) or a tear during the delivery, you may find it extremely uncomfortable to sit down during the first few weeks following the delivery. Some women find it works really well to get in the habit of squeezing their buttocks together before they sit down. This helps to reduce a bit of the wear and tear on the perineum. Other women swear by those hemorrhoid cushions that are typically used for other purposes and are available in medical supply stores.

You can also expect to experience a few other complaints during those early weeks after the delivery, such as after pains. After pains are uterine contractions that can either be mildly uncomfortable or downright excruciating. They tend to be more uncomfortable in women who have previously given birth. Fortunately they only last a few days after the delivery and they only tend to be a problem during breastfeeding. However that's small solace, because they really can be extremely uncomfortable. You may want to ask your doctor to prescribe a pain medication that's safe to take while you're breastfeeding, if you find that the after pains are extremely uncomfortable for you.

Finally, let's talk about your belly. If you've been waiting for the past few months to see your belly return to its pre-pregnancy shape, you may have been a little shocked the first time you caught a glimpse of yourself in the mirror after you gave birth. If you were expecting to see a totally flat belly you may have been disappointed to note that you still looked about five months pregnant right after the delivery. It takes a few weeks for the uterus to completely shrink down to its pre-pregnancy size, and depending on how much weight you gained during your pregnancy, it may take months for you to regain your prepregnancy shape.

Try not to put too much pressure on yourself at this point in your life. While it's important to try to be physically active for the good of your own health, no one needs the pressure to look like one of the supermodel celebrity mums within days of giving birth. Instead, focus on being active as a means of relieving some of the stress of new motherhood and of giving yourself an energy burst. That will encourage you to get outdoors and to get active with your baby in tow.

Who knows, when you're pushing that stroller around the block maybe you'll be lucky enough to run into some other new mums on the block and you'll manage to strike up some new friendships -- something that can be a real lifesaver if you're feeling lonely and isolated while you're at home with a new baby.

So as you can see, you can expect a whole new you after you give birth, and let me tell you, the physical changes are just the beginning. Motherhood is a totally transforming experience and the process has just begun.

Member question: Is it OK to try to lose pregnancy weight while breastfeeding, or will it diminish the milk supply?

Douglas: A study that came out a year or two ago indicated that it is safe to lose weight during breastfeeding, provided that the weight loss is very gradual. I don't have the study at my fingertips right now, but I know that the rate of weight loss was something in the neighborhood of half a pound to one pound a week -- a very slow and gradual rate of weight loss.

If you were to speak to a dietician, she would be able to advise you on a safe weight loss plan that would take into account your baby's age and caloric needs and your own caloric needs, and that would therefore ensure that both you and your baby would be having your nutritional needs met while you were starting to work on achieving your weight loss goals.

Something else to consider is the other side of the equation: The exercise piece. Some mums find that it's actually easier to focus on being physically active as opposed to cutting back on their food intake while they are breastfeeding. This is because many women find that their appetite increases while they are breastfeeding. You may find that you have a natural inclination to eat more while your are nursing -- Mother Nature's way of ensuring you're getting enough food for both you and baby. If this is the case, it may be easier for you to try to lose weight by increasing the amount of physical activity you squeeze into your day, perhaps popping baby into the stroller for a brisk after-dinner walk, for example.

Member question: Given all of the body changes, when can we become sexually active again? And do I have to use birth control if I am breastfeeding?

Douglas: You certainly can't count on breastfeeding as a birth control method, although a lot of people believe this. There is some ovulation suppression mechanism associated with breastfeeding, but not enough to provide reliable contraception to most couples. So unless you would be utterly delighted to be headed back to labor and delivery in another nine months' time, you will want to give serious thought to an alternative birth control method.

In terms of when it's OK to start having sex again, most women choose to wait until they get the official thumbs up at their postpartum checkup, just so they can be sure they are healing OK and that there isn't any sort of postpartum infection that they need to be concerned about.

Statistically, we know that most couples wait even longer than the six-week checkup. A study conducted at the University of Wisconsin found that bottle-feeding couples typically wait seven weeks, and breastfeeding couples typically wait eight weeks before resuming sexual intercourse after the birth of the baby. So don't assume that everyone else at your prenatal class reunion is enjoying tons of bedroom action. Chances are, everyone else is stumbling into bed exhausted at the end of the night, too. After all, you're all newbies at this parenting thing.

Member question: What's the nicest thing one can offer to do for a new single parent without implying that she can't go it alone?

Douglas: I think you are being incredibly wonderful and sensitive to want to show your support to your friend without undercutting her confidence in her parenting abilities. You are so wise to realize what a careful tightrope act that can be.

What I would be inclined to do is to compliment her on all the things she is doing right and to find little ways to support her in some of the more mundane tasks, such as folding laundry, running errands, and doing some of the day-to-day "joe" jobs that will therefore free her up to devote as much of her time and energy as possible to caring for and enjoying her new baby.

She is so lucky to have a friend like you in her life. Not every single parent is so blessed.

Member question: There will be eight years difference between our two children. I can barely remember what it was like having a baby around, and we're eight years older and not as able to be sleep deprived as we once were. Please tell me it's like riding a bike and all that baby care stuff will come back to us!

Douglas: We had a six-year gap between our youngest two children, and I'm happy to report that it does come back to you very quickly. You open the newborn diaper bag and you remember in a flash exactly what's involved in getting the diaper on just tightly enough that it doesn't leak, but not so tightly that it pinches the tops of your baby's legs. And all those other newborn handling skills, like how to sneak a sleeping baby into and out of a car seat without waking her: Let me reassure you, you haven't lost your golden touch!

As for the sleep deprivation issue, alas, that does get a little tougher as you get older. I swear it seems to be easier to do without sleep when you're a little younger. But fortunately, caffeine is widely available in our society and that help us tired parents to get through these times in our lives, so I'm sure you and your partner will get over this little hump called postpartum.

Your older children or child will also prove to be a huge blessing in helping to care for their little brother or sister. The last time around you may not have had someone who could run to the other room and grab the extra sleeper you had forgotten to bring over to the changing table. So you will find there are perks to having that eight-year gap. And of course, you will probably find that the eight-year-old acts like a third parent at times, often taking huge delight and pride in "his new baby."

That's not to say that you're likely to sidestep the sibling issues entirely. Most parents find that even the most enthusiastic older brother or sister has times when they find the new baby to be at least mildly annoying or inconvenient to have around. But it's generally easier to sell an 8year old on the merits of sharing mum and dad with a new baby than it is to make the same sales pitch to a fiercely jealous 18-month-old older brother or sister, or at least that's been my experience. Hope these insights help.

Member question: How do I deal with my mom and his mom -- they are driving me nuts with advice. I love them but things have changed since they had babies. I want them to have a good relationship with all of us, but grandparenting is new for them too. Any advice?

Douglas: I think it's really neat that in the past few years a growing number of parent education centers have started to offer grandparenting courses, either courses aimed exclusively at grandparents, or courses that are designed to be taken by grandparents and parents together. Perhaps this might make a great "congratulations, you're a grandparent" present for all the enthusiastic grandparents in your life. Maybe you could send them off to grandparent boot camp for the weekend with or without you and your husband in tow. It might prove to be the ultimate family bonding experience (or not).

Sometimes having an outside expert explain to your mother or mother-in-law that car seats are not an unnecessary frill, and that health authorities no longer recommend putting pabulum in bottles helps to get these relatives off your back. If they hear it from a neutral third party they're less likely to be in your face about these issues.

If these programs aren't available in your area you might think of ordering a grandparent video or book instead, since these types of materials are available no matter where you live. Hope this helps.

Member question: We are thinking about hiring a nanny, part time. This person would not live with us. Do you know any good resources for advertising, interviewing, and hiring in-house day care? We have so many questions about the process, from what our expectations should be to whether we pay taxes on what we pay this person.

Douglas: I have just finished writing a book on this subject. It will be coming out in a few weeks' time. The book is called, Choosing Child Care for Dummies. In the meantime, you may wish to go to the zerotothree.org web site for information on what constitutes quality childcare in general, and do a web search on nanny agencies to get some tips on the dos and don'ts of conducting a nanny search in particular.

You are very wise to do your homework on this particular issue and to research the tax implications carefully, because you don't want any unexpected tax liability down the road as a result of getting on the wrong side of the dreaded nanny tax. There's a lot to think about when it comes to hiring a nanny.

Something else to consider is talking to other parents in your area who have gone this route, both because they can help you to identify some of the potential pitfalls, and because they may be able to help you to find a nanny in your area who is looking for work. It is quite possible that their nanny may have other friends who are in the process of changing jobs and who are currently seeking new employment situations.

Member question: I loved my job and had planned to go back after having my baby. However, now I'm not so sure. I love my little girl and am having a hard time imagining being away from her all day. I want to have my cake and eat it too! Help!

Douglas: It is very normal to feel torn between family and career. Most mums I know who return to work after baby express the same feelings of ambivalence that you are expressing. On the one hand they're very eager to get back to careers they enjoy. On the other hand they feel this overwhelming desire not to miss any of the baby's precious firsts.

Some women are fortunate enough to be able to carve out flex time arrangements or telecommuting arrangements with their employers that allows them the maximum amount of time they are able to spend with their children. Others decide to either work from home or work part time, but not everyone is able to take advantage of these types of opportunities. Some women decide to drop out of the work force for a period of time because they find it too difficult to juggle the conflicting demands of work and family.

All I can say, as a mum who has tried all of these options at various times, is that there is no easy solution to the work/family tug of war, nor is there any one-size-fits-all solution that works for every family. You have to find the solution that will work best for you. Good luck.

Member question: I've read that a new baby can put a real strain on a marriage. Any advice on how to make the best of this time?

Douglas: I remember those days, and you are right, a new baby can be extremely tough on a marriage, because you're both adjusting to your new roles as parents. I found that my husband often felt that he had completely fallen off my radar screen because I was so preoccupied with the new baby, and I, in turn, used to feel that he was being a big baby by not understanding my need to bond with my newborn. This inevitably would lead to a lot of friction and hurt feelings at a time when we both needed one another's support and love tremendously. We got through it each time by talking things through, but only after a lot of exhaustion and unpleasantness.

I wish we could have remembered, in our sleep-deprived haze, to take the time to be a little more proactive about the situation. Perhaps asking one of our well-meaning relatives to come over and take care of the baby for an afternoon so we could go for a walk in the park on our own, but it's hard to come up with those types of solutions when you're feeling totally exhausted and uncreative.

So I would simply encourage you to try to do a little brainstorming and think what you could do to try to stay connected with your partner during what is, for most couples, a hugely challenging period in your relationship. Don't assume, by the way, that you're the only couple experiencing conflict in your relationship; most couples do. It's very, very normal.

Moderator: Before we wrap up, do you have any final comments for us, Ann?

Douglas: I just want to say how much I always enjoy coming to WebMD, because the parents who come to these courses are so committed to learning about the art and science of parenting. Your questions challenge and inspire me, and it is a privilege to be part of WebMD. Thank you.

Moderator: Thanks for joining us, members, and thanks to Ann Douglas for sharing her expertise and experience with us. For more information, please read her book, The Mother of All Baby Books.



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