Working Mothers: The Balancing Act

Here at the Human Lactation Center (HLC) we understand how hard it is to balance work life and home life, and we’re not alone. In 2001, over 60% of mothers with at least one child under 3-years-old were working. That’s up from about 34% in 1975. (Source: Bureau of Labor Statistics.) Personally, I was not prepared for the amount of guilt and angst I would feel trying to balance the passion I have for my work with the love and devotion I feel for my child. However, I believe you can strike a balance between the pulls of work and the duties of parenting, though it won’t be perfect all the time. There will still be the occasional feelings of guilt and loneliness, and the days you feel like you can’t do anything right. Here are some tips that we hope will help you keep all of your roles in perspective.

~3 Tips from Blogs Past~

Feelings of guilt are normal!
You may feel guilty, especially during separation times, or when you say goodbye for the day. Talk about these normal feelings with other working parents. Also, realize that your child may adapt more quickly to goodbyes than you think. Right before you leave, talk through the reason for the separation with her and reassure her that you will be back and be with her again. Click here to learn more about separation anxiety (your child’s, not yours).

Take care of yourself first
I know, this feels counterintuitive, but if you aren’t healthy, you can’t care for anybody well!Take a little quiet time for yourself. Yes, I said quiet time. I take mine at the gym or during a walk at lunchtime. That way my quiet time does double duty! If you’re still in the throws of sleep deprivation, please sleep when you can (like during your child’s naps when you’re home on the weekends) or just rest while your child naps on the days you’re both home. Either one will leave you feeling more energetic. To read more about my own trials with sleep deprivation, click here.

It takes a village to raise a child
My daughter was cared for by some amazing moms while I was at work. My sister-in-law was the first mom to watch my daughter. When she moved away, a good friend of mine who was staying at home with her son watched Lily. When Lily was about 18 months old, she started going to another very good friend of ours’ home while I worked. Our good friend’s daughter was born only 1 week after Lily, and they are best friends to this day. Complicated? Yes, but she has been loved and well cared for her entire life. It takes a village. You can’t do it alone (at least while keeping your sanity).

~3 Tips from Moms at the HLC~

Routines make everything easier
By: Jen G, mom of Lily, 3 1/2
Arrange your morning routines to spend a little time with your child before you leave for work. This may sound impossible, but it can work! What I do is try to wake up before my daughter so that I can get myself ready. Then, when she wakes up, we cuddle and watch a cartoon together or read a book while I sip my caffeine requirement for the morning. Even 20-30 minutes in your morning routine can make a big difference toward connecting with your child before you leave for the day. If time is tight, just eating breakfast together will help you both feel better throughout the day. We also have a great bedtime routine that includes one-on-one time with each other during bath time, story time and cuddles. The day goes much more smoothly when we start and end it the same way.

Set aside special playtime each day with your child
By: Jen B, mom of Olivia (2) and Charlotte (EDD December 2010)
Set aside a block of time each day that is devoted to playing with your child (no checking email allowed!) I know it sounds hard to add anything else to your already busy schedule, but even 30 minutes of one-on-one time with your child will benefit you both greatly. If you make the play physical, you’ll both get a workout at the same time too!

Make family meals a priority
By: Kerri, mom of Elisabeth, 4
No matter how busy you get, plan to have family dinner together. Just sitting down at the table (with the television off) creates a sense of stability for children. Family meals are important to keep communication open and to strengthen relationships among family members. It is also a great way to enhance language development in young children.


As working moms, we are not by any means saying that striking a balance between career and motherhood is easy! However, it is possible, most days, to carve out a little quality time with your family. Precious time with you is the best gift you can give to your child. Whether it’s during a family meal, reading books together, or spending a half hour on the floor playing with your child before bath time, every moment counts. It doesn’t have to be perfect, and many days it won’t be, but rest assured that these small changes can make a big difference. Jane recently gave me a magnet that reads “Worry is like a rocking chair. It will give you something to do, but it won’t get you anywhere.” (Proverb) For now I’m trying not to worry so much about the time I’m not spending with my daughter while I’m at work. Instead, I’m making the time we do have together more meaningful.

Next time: Another Guest Blog Post!

Update - Where in the World are our Readers?

A few weeks ago, we posted a story about a chance meeting with one of our readers in an aiport. We asked you to tell us where you are from and how you learned about this blog. Today, we'd like to thank everyone who submitted comments and give you a little summary of what we learned!

We received comments from 22 readers! While most of the comments were posted by readers residing in the United States, we also heard from readers in Italy, Canada, Ireland, Scotland, England, and South Africa. Some readers learned about the blog by doing an internet search, some received recommendations from friends, family members, or lactation consultants, and a few couldn't remember how they stumbled across the blog. (To those of you who can't remember, don't worry, sometimes I can't remember what I had for breakfast!)

We were so excited by all of your responses (this post received the most comments of anything we've posted so far!) that we did a little more research using Google's website analytics feature and got even more information about where are readers are from! Since our first post in June 2009, we've had 29,867 readers from 6 continents (do you know anyone in Antartica? If so, spread the word!), 161 countries/territories, and 6,551 cities worldwide!

So, once again, we'd like to express our gratitude to all of our readers. For 4 moms in a small town in California, knowing that our work is reaching so many parents from so many different places brings us great joy! We hope that the information we provide on this site is useful and look forward to hearing from you in the future!

Next Time: Balancing work life and parenting

Separation Anxiety Part II: Tips to Help Smooth Separation from Your Baby

Last time, we shared some basics about separation anxiety, a common behavior in infants and toddlers. In a nutshell, after the first few months babies will seek to be close to those they know best and will let their parents know (the best way they know how) that they are not happy when they go away. In this post, we’ll share a few tips to help you get through the tough transitions.

1. Avoidance is not the answer.
I know exactly how tough it is to walk away from your baby, especially if she is reaching out to you with a frantic look, tear stained cheeks, and a quivering lower lip. You just want to sweep your baby into your arms and promise you’ll stay. While that might be a short term solution, in the long term, it actually sends your baby the message that validates her fear and tells her that she won’t be safe with anyone else. That’s not good for either of you.

2. “Talk it over” with your baby.
Even if you don’t think that your baby understands your words, you should let your baby know where you are going, how long you will be gone, who she’ll be staying with and what you’ll do together when you get back. An older baby can be reassured by your words while a younger baby will benefit from seeing that you are calm and happy. Keep your explanation short and simple and don’t offer it until right before you leave.

3. Provide something familiar for your baby to keep with her.
Many babies will pick toys, blankets, and other soft objects that they like to keep near them when they are tired or stressed. Maybe your baby has a favorite blanket that she sleeps with. Making sure that your baby has her favorite snuggly along can ease the transition away from you.

4. Prepare your baby’s caregiver.
Make sure that your caregiver understands why your baby may be upset when you leave. Help him or her to see that your baby is likely to need a few minutes of comfort and/or distraction after you leave. With a few soothing repetitive words and actions, your baby will be ready to play in no time!

5. Be ready for a stormy or silent reunion.
While many babies will be excited and happy when their parents come back, don’t be surprised if your baby does not seem to be overjoyed right away, particularly if your separation has been a relatively long one (like overnight). By giving you “the silent treatment” or crying for a few moments, your baby is expressing how much she missed you. By reassuring her that you missed her too and telling her about what you’ve been doing, she’ll get the message that you understand her feelings and that you want to share your experiences with her. When she’s old enough to use words, she’ll be happy to do the same.

Next time: “Secrets” Readers Around the Globe!

References
Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton; Barry Lester and Joshua Sparrow (Eds). Wiley Blackwell, 2010.

Social and Personality Development, David R. Shaffter, Wadsworth, 2005.

Separation Anxiety Part I: Behavior and Biology

Recently, we’ve had a couple of readers ask questions about babies and separation anxiety. In this post, we’ll share the basics about separation anxiety and next time, we’ll offer tips to help you deal with those inevitable separations, including traveling away from your baby.

The Basics

By the time infants are about 6 to 8 months of age, they start to have a much tougher time when their parents leave them. They may fuss, cry, and cling frantically to their parents even when they just look like they might be leaving. This “separation anxiety” peaks when children are between 14 and 18 months of age and is much less noticeable in most kids by the time they are 2 or 3 years old. Typically, anxious babies will cry out for their parents when they are leaving, letting them know how unhappy they are and "calling" them to come back. For many babies, this doesn’t last very long after the parent has left but of course, the parent doesn’t know that, since he or she is no longer there to see the baby calm down. Once the child realizes that the parent is not coming back right away, she will be less frantic but sad and less active for awhile until she recovers and rests, gets distracted, or starts to play again. While the response is likely to be similar at all ages, anxiety reactions in older infants tend to be louder and longer than those in younger infants. For parents, the tear stained cheeks, the outstretched arms, and obvious fear they see in their babies’ eyes are heart wrenching. And nearly every mother has a story about how horrible she felt walking away from her screaming baby, even when she was leaving the baby with someone they both loved and trusted.

The Theories

There are a lot of theories about why babies develop separation anxiety. Some researchers think it is a natural response to the biological need for babies to stay near caregivers, especially as they gain the ability to move away from them by crawling, walking, or running. Other researchers think that babies become afraid when they can’t explain why someone who is usually close to them is not there or when they can't predict when their parents are coming back. Others believe it is a physical reaction to the potential removal of the things that make parenting so calming for the infant (like touch, warmth, and food). Still others see the baby’s reaction to separation as a confirmation of different types of parent-baby attachment.

Differences in Babies’ Reactions

For most parents, why a child becomes anxious when they leave is less important than what to do about it. Unfortunately, nearly all parents must face their babies’ anxiety at some point, especially in families with parents who must return to work or school. Some babies react in extreme ways to separation, while others don’t seem to mind very much. How much babies fuss and cry depends a lot on their temperament and also on their earlier experiences with separation. Understanding that babies' anxiety when parents leave is a natural part of being human can help the caregiver who remains with the baby to feel a little more confident and in control. Clearly, the anxious baby needs comfort. Calm understanding and repetition can go a long way to easing the worst of the fears. A consistent caring response will help the baby learn that he will be quite safe until mom or dad comes back.

Next time: Tips to Help Smooth Separation Anxiety

References
Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton; Barry Lester and Joshua Sparrow (Eds). Wiley Blackwell, 2010.

Social and Personality Development, David R. Shaffer, Wadsworth, 2005.

Let's Talk About Twins (Triplets, Quads, etc.) Part 2: Bonding with Multiples

My mom grew up as a twin and has shared fond memories (and the usual stories of sibling rivalry) with me as I grew up. Though my mom is a fraternal (not identical) twin, she has many similarities with her sister and shares a special closeness with her to this day. Growing up, each sister knew when the other one was in trouble or hurt. When my aunt married and left the house before my mom did, my mom’s heart broke over the separation. There is no doubt that twins and multiples share a special bond, and that this connection begins in the womb. In this post, we will talk about the unique bond between twins and multiples as well as the bond between caregivers and multiples. We’ll also share some ideas to help parents of multiples bond when their attention is divided among multiple babies.

The “Womb-Mate” Bond
After being “womb-mates” for approximately 9 months and coming into the world together, multiples have forged a strong attachment to each other. Several studies have shown that multiple’s have the ability to comfort each other. In one study, researchers observed the interaction of twins in utero. They found the twins’ movements and behaviors to be in synchrony 94.7% of the time! Ultrasounds have also shown that womb mates touch each others’ faces and even suck on each other’s hands in utero. When multiples are born, and leave the safe confines of the womb, they are sometimes separated. This separation can be stressful because they are so used to each other’s presence. Keeping twins or multiples close to each other after birth can also help regulate their breathing and heart rhythm. (Robin 1996)

Development of the Parent-Infant Bond in Families with Multiples
While multiples develop a distinct bond with each other, they also develop a special bond with their caregivers. For primary caregivers of multiples, this bond can be more challenging to develop simply because of the time and work it takes to care for multiple babies. External factors, such as each baby’s health status, can also affect the development of the mother-baby or caregiver-baby bond. Oftentimes multiples will come home from the hospital at different times based on their health and feeding status. This can be challenging for parents because they have a baby (or babies) at home to care for and a baby (or babies) at the hospital to visit and care for as well. Thus, it makes perfect sense that parents would forge a bond with each baby at a different pace. (Robin 1996) Be patient, the bond will form, it just may take longer than you planned it to.

Forming an individual bond with each of your multiples can be challenging. Before you can form individual bonds with each baby, you must recognize them as individual children. “Collective Mothering” occurs when a mom responds to the infants as a group rather than as individuals. In a study of mothers of multiples, researchers found that when mothers were fatigued they were less likely to provide individualized care for their babies. (Robin 1996)

Caring for Multiples
To cope with the overwhelming burden of caring for multiples, caregivers develop patterns or routines to curb the chaos. While we recognize that routines are important , this study showed that sleeping and feeding routines were carried out uniformly in 80% of the families by one year after birth, without consideration of the children's individual needs or patterns. (Robin 1996)

There are several ways for parents to individualize the care of their multiples and create a special bond with each baby. Here are some tips to do just that:

Allow yourself time with each baby one-on-one
After delivery, allow other close family members or friends to spend one-on-one time with each child. This will not only allow them to create a special bond with each baby, but it will allow you to spend time with each baby individually as well. (LaMar 2004)

Accept help from others
I know this is a common recommendation on our blog, but help is essential when caring for multiples. In one study, almost ¼ of mothers of twins refused help after their babies’ birth. (Robin 1996) Coping with different sleep, feeding and crying patterns in 2 or more infants can be overwhelming and exhaustion is common. We know sometimes it’s hard to ask for help, but keep in mind that levels of depression and fatigue are higher in caregivers of multiples. (Thorpe 1991) Developing a support network will be invaluable.

Watch for each baby’s individual cues
Recognizing and responding to each baby’s individual cues will help your babies feel safe and happy. Remember, babies get better at communicating their needs to caregivers when they get practice giving cues and having their caregivers respond appropriately. For more details about responding to infant cues, click here.

We hope this series on twins and multiples has been helpful to those of you out there parenting (or preparing to parent) these special little ones. For the rest of you, let us know what other topics would be useful to you in your own parenting journey!

Next Time: We’ll share a short series on easing the stress of separation from your baby.

References

Robin, M, Corroyer, D, Casati, I. Childcare Patterns of Mothers of Twins during the First Year. J. Child Psychol. Psychiat. 1996; 37(4): 453-460.

LaMar KL, and Taylor CR. Share and share alike: incidence of infection for cobedded preterm infants. Journal of Neonatal Nursing. 2004;10(6): 6–9.

Thorpe, K. Golding, J, MacGillivray, I. & Greenwood, R. (1991). Comparison of prevalence of depression in mothers of twins and mothers of singletons. British Medical Journal. 1991; 302: 875-878.

Slight Detour - Does Nighttime Waking Make Babies Fat?

We interrupt our blog posts on multiples to give you this special post.... Ok, maybe I'm being a little silly but I have had several people send me links to press coverage on an article that was published recently in the Archives of Pediatrics and Adolescent Medicine. Because the misinterpretation of the article could result in parents being confused or concerned, I thought we would provide our readers with our own take on this article.

The Article: Shortened Nighttime Sleep Duration in Early Life and Subsequent Childhood Obesity by Drs. Janice Bell (University of WA, Seattle) and Frederick Zimmerman (UCLA). Arch Pediatr Adolesc Med 2010; 164: 84-845.

Summary: The authors conducted a secondary analysis (meaning they used data already made public to look at something they were interested in) of a US government funded study that, in part, asked families in 1997 and again in 2002 to use time-diaries to record their children's sleep habits. Infants and children in the study were also measured (weight and height) at follow up. The final sample included 822 children who were between 0-59 months and 1108 between 60 to 154 months of age in 1997. They found that children in the younger group (0- 59 mo) with a short duration of nighttime sleep (in the bottom 25%) at baseline had a greater chance of becoming overweight or obese by 2002. This was not found in the older group. Daytime napping did not seem to make a difference.

The Media "Take": I've seen the press coverage from more than 2 dozen news agencies and blogs; most seem to give the impression that infants and children should be sleeping 13 to 14 hours at night in order to reduce the risk for obesity. They don't account for differences in sleep patterns in infancy vs. preschool children.

The Problem: The researchers grouped the children into the 2 groups for statistical and practical purposes (we don't know how many children in the study group were less than 1 year of age) but doing so was not clinically appropriate. I'm sure that the researchers would not say that parents should worry if their newborns sleep less than 10 hours at night. As all of our readers know, newborns and young infants need to wake for many reasons and that while they will sleep a total of 13 or 14 hours, it won't be all at once.

The Reality: The researchers put a whole bunch of kids (from newborns to 4-year-olds) in a big group and found that sleeping more than 10 hours at night was associated with a reduced odds of being overweight later on. Having this "association" does not mean that less sleep causes kids to become heavier. The authors were not able to control for a lot of things that might have made a difference in the children's weight status. More importantly, putting kids with such different expectations for sleep in one big group isn't useful, especially when it confuses parents and reporters. It would have been better to put the infants in a separate group. But of course, the researchers didn't ask me.

I hope this helps you understand this study a little better.

Next time: Back to Twins!

Where in the World are Our Readers?

Over the last 6 months, we have been busy traveling and spreading the word about Baby Behavior. We've been to nearly every county in California (there are 58) as well as several other states, including Arizona, Maryland, Tennessee, Nevada, and Texas. With all the time we spend in airports, hotels, and restaurants, we have had great opportunities to see parents and babies interacting in a variety of situations.

Just last week, while sitting in an airport, Jane noticed a couple with 2 young children, one of whom was a little fussy. She watched the father walk patiently back and forth with the drowsy and irritable baby while the mom played with the older child. Like she always does, Jane smiled at the family to show that she understood what they were going through and soon after, she started a conversation with the parents. As they talked, Jane found out that the parents had read our blog! She was so excited to meet parents who have been reading the blog and benefiting from the information!

When Jane got back to the office and told me this story, I began to think about how easy it would be for people, from almost anywhere in the world, to stumble across our blog posts. So, to satisfy my curiosity and give us a better idea about who our readers are, we'd like to ask you where you're from and how you heard about Secretsofbabybehavior.com. We'd also love to hear your ideas for future posts! To post a comment, just click the comment link at the end of this entry. Thanks!

Next time: Back to Twins!

Let's Talk About Twins (Triplets, Quads, etc.) Part 1: Getting Ready for Multiples

With multiple births on the rise, we thought we would share a short 2-part series on parenting twins, triplets, and higher order multiples. While multiple births represent only 3% of all deliveries in the United States, they account for 15% of preterm births (babies born before 37 weeks gestation), 20% of low-birth-weight births (less than 5.5 lbs.) and 19 to 24% of very-low-birth-weight births (less than 3.3 lbs.) (Goodnight 2009). Although each multiple birth experience is unique, one thing is universal: there is a lot of preparation needed to get ready for this wonderful yet challenging experience. Part one of this series will provide tips for families pregnant with multiples. Part 2 will provide insights into both the mother-infant bond and the twin-to-twin bond. Let’s start with some tips for getting ready for a multiple birth in your family.

Tip 1: Form your support group early

Having a support system in place is important for any pregnancy, but it’s essential for parents of multiples. Having two or more infants to care for will be overwhelming. Recruiting your family and friends to help you during this time will take some stress off of you and give you more time to focus on your new babies.

With this new experience it may also help to enlist the support of others who have parented multiples. Signing up for a local Mothers of Twins Club (http://www.nomotc.org/) or another similar organization could prove to be an invaluable resource for you. They offer support group meetings, newsletters and opportunities for education and networking.

Tip 2: Make nutrition a priority

Eating a well-balanced diet and getting enough calories can have an impact on the outcome of your pregnancy. Although there is a higher risk of preterm deliveries and low birth weights with multiples, the likelihood can be reduced by eating a well-balanced diet while you are pregnant. In one study, mothers eating a well-balanced diet with enough calories to support appropriate weight gain for a twin pregnancy were more likely to gain the proper amount of weight at 20 and 28 weeks gestation. They also experienced fewer complications with their pregnancies, including lower rates of low birth weight, very low birth weight, preterm births, and NICU (Neonatal Intensive Care Unit) admissions. (Goodnight 2009) Talk to your doctor or a registered dietitian to make sure you are eating what you and your growing babies need. Pregnancy weight gain goals vary depending on your pre-pregnancy weight and the number of fetuses you are carrying.

Tip 3: Prepare for your hospital experience early

Keep in mind that twins and multiples often deliver early (on average 35-36 weeks gestation for twins and a few weeks earlier for higher order multiples). (Goodnight 2009, Evans 1993) While you can’t entirely plan ahead for your birth experience, there are a few things you can do to prepare for the big day:

• Take a tour of the hospital where you are planning to deliver. Check out both the regular labor and delivery floor and the NICU for high risk babies.


• Talk to your doctor about what to expect when you go into labor. It is also possible that your babies will come home at different times as one baby may need to spend more time in the NICU.


• Talk to other parents of multiples to learn about their birth experiences. Even though every birth is a unique experience, you can ask them to share any tools that they found useful or helpful.


• Do your research: Reading books and articles (and this blog!) to learn more about what you can expect and how you can prepare for your babies will be valuable.

Tip 4: Prepare siblings & close family members too

Older siblings and other family members need to prepare for the new babies too! If you have other children, talk to them about what to expect when their new siblings arrive. Helping siblings feel connected to their new babies can make the transition easier for them. One idea is to let the older brother or sister pick out or make little gifts for the babies or make something for them. You can also give something to the older sibling from the new babies to foster a positive relationship between them (Bryan 2002). For more information about helping older children deal with your growing family, click here.

Tip 5: Give yourself time to adjust to the news

Finding out you are pregnant is big news, but hearing you are pregnant with twins or multiples can be quite an unexpected surprise and overwhelming. Take some time to mentally prepare for the new additions to your family. Talking to someone (whether it be your spouse/partner, your doctor, a friend or a counselor) can help you deal with the emotions you feel or concerns you have as they arise.

We hope this post was helpful for those of you out there who are parenting (or preparing to parent) multiples. Many of the topics we discuss in our posts, including this one, are based on comments from readers like you. Continue to let us know what you think and what questions you have! We also encourage you to share this post with any new parents of multiples in your life! Then, stay tuned next week for part 2 where we’ll discuss the art of bonding with multiples.

Next time: Multiple Births Part 2: The Art of Bonding

References:

Bryan E. Educating families, before, during and after a multiple birth. Semin Neonatol 2002; 7: 241–246.
Evans, M. I., et al. Efficacy of transabdominal multifetal pregnancy reduction: Collaborative experience among the world's largest centers. Obstetrics and Gynecology 1993; 82: 61-66.
Goodnight W, Newman R. Optimal Nutrition for Improved Twin Pregnancy Outcome. Obstetrics and Gynecology 2009; 114, 5: 1121-1134.
The American Congress of Obstetricians and Gynecologists: http://www.acog.org/publications/patient_education/bp092.cfm (accessed 8/31/10)
The National Organization of Mothers of Twins Club: http://www.nomotc.org/ (accessed 8/31/10)

*Special thanks to Kassandra Harding for her hard work on the research that allowed us to write this post!*