Thursday, October 28, 2010

And Baby Makes Three - Part 5: The Rocky Road to Becoming A Mother

In this extended series of posts, we've looked closely at the importance of parents' relationships in babies lives. We've talked about the changes that new babies bring to couples' lives and how dads experience the transition. To end this series, we'll take a look at women's experiences in becoming mothers. Given that there are literally hundreds of studies about moms, we can't possibly do a good job in covering them all. Instead, we'll focus on some of the most common key findings.

The Realities of Recovery

While many mothers in the studies learned about childbirth by taking classes or asking questions, few moms were ready for those first few days home from the hospital. Muscles ache, stitches hurt, exhaustion sets in, and going to the bathroom becomes something to dread. Some moms are also dealing with nausea, incision pain, nasty headaches, and wild mood swings. Don't be surprised if you feel very emotional during those first few days, it is common for new moms to feel that way, but if you feel out of control of those emotions, you should talk to your doctor.

Feeling the Weight of Responsibility

Many new moms feel that they are responsible for the bulk of the baby care and still expected to meet everyone else's needs too - partners, other kids, friends, family and pets! The weight of all that responsibility can be overwhelming. It is interesting that many of the moms in the studies asked their health care providers how to manage all the responsibility rather than how to get more support. Secrets readers know that we think all moms should ask for help from family and friends so that they can get the time they need for their own physical recovery and to connect with their babies. Even the most independent and organized mom can't multitask enough to make those exhausting first few weeks easy; moms need help. It would be better for moms to use their organizational abilities to make a nice chore chart to share with helpful friends and family. These days, so many moms think they'll be able to go back to their regular routines in a short time - unfortunately, babies can't cooperate with any of moms' plans until they are older.

Dealing with the Fear

Babies are so tiny and they look so fragile, many mothers are worried that they'll make a mistake and somehow hurt their babies. They worry that they won't know if they don't have enough milk, or what to do if their baby gets sick, or if anything else is wrong. Since most new moms find themselves on an emotional roller coaster, the fear that they feel can be extreme. Some mothers question their ability to cope with it all and aren't reassured by their partners telling them "You'll be fine." Anxiety can be a tough thing; new mothers may need to talk about their fears with professionals they trust. Moms in the studies felt better if they knew they could call their health care providers or the one of the hospital nurses whenever they had questions.

A New Normal

I really don't know if anyone can be prepared adequately for life with a newborn. Routines, relationships, and day-to-day activities will need to be replaced with a "new normal" that won't ever be the same as before the baby came along. Many of the moms in the studies wanted to get back to their "normal" lives but they realized fairly soon that wasn't going to happen. Part of their transition to motherhood involved their acceptance of the "new normal."

The idea that you will never go back to what life was like before baby may sound intimidating to those of you still awaiting your special day but we can reassure you that the "new normal" will (eventually)be even better than the old one. Even though both my children are adults, my life is not like it was before they were born and I am thankful for that everyday. While I don't miss the fatigue or the scarier moments, I have thousands of precious memories that I wouldn't trade for anything. We hope that this series has helped shed some light on the challenges of the transition to parenthood. The transition is a rough and rocky road but the rewards are worth the ride. Be sure get some help at home! Help won't make it easy but support from family and friends will make a huge difference, to mom, to dad, and to baby.

Next time: Back to Basics!


Barnes et al. Learning about babies: what new mothers want to know. J Perinatal Educ. 2008; 17:3:33-41.

Forster et al. The early postpartum period:Exploring women's views, expectations, and experiences of care using focus groups in Victoria, Australia. BMC Pregnancy and Childbirth. 2008; 8:27.

Tuesday, October 26, 2010

And Baby Makes Three - Part 4: The Realities of Becoming a Dad

In the first 3 installments of this series, we talked about the joys and challenges of couples’ transition to parenthood. We’ll finish this series with two posts about how this transition differs for men versus women. While most of the studies of early parenthood are focused on moms, recent studies have explored parenting from the dads' perspective. We realize that each father enters parenthood in his own way, but there do seem to be some generalities that come up again and again. In this post, we’ll share a few these findings with you.

Lost in the Shuffle

Many fathers reported feeling left out of the picture during their partners’ pregnancies. Visits to the doctor or midwife were centered on the mother’s condition and feelings and many dads felt there wasn’t time to get their own questions answered. Prenatal and childbirth classes weren’t much help either because very little time was spent on topics directly related to being a father. Support from friends and family tended to be focused on the mom's needs as if she would be the only one affected by the birth of the baby. While dads wanted to support their partners, they felt that little useful information or advice was offered to them.

Dealing with Reality

Just as many mothers anticipate what their babies will be like, fathers spend much of pregnancy imagining their new lives with a newborn. The babies in parents' dreams are often nothing like the real thing. Many men have little experience caring for babies and some new fathers know almost nothing about newborns or how to care for them. Fathers in the studies reported feeling frustrated because they wanted their babies and partners to be happy yet they didn't have the skills to be much help. Dads were overwhelmed by the work needed to take care of babies and the sudden radical changes in their relationships with their partners. They relied on trial and error, friends, and their partners to help them build their confidence as new dads. Over time, they learned how to recognize and address their babies' needs. Despite their new abilities, many of the dads found that their efforts weren't recognized by friends, family, or professionals. They were still seen as the "second string" when it came to parenting and the lack of recognition of their importance in their babies' lives was a big source of frustration.

Building a Bond

In the 1960s (of Mad Men fame), the stereotypical man went back to work the day after his baby was born and accordingly, he had very little to do with his child until he bought him/her a basketball as an 8th birthday present. Those days are long gone. Most of today’s fathers want to play an active role in their children’s lives. Dads in the studies enjoyed spending time with their newborns and feeling that they were providing the care their babies needed, especially when their babies were able to respond by calming down or smiling back at them. Dads sometimes thought that feeding was the only way to bond with babies and some fathers of breastfeeding babies reported being disappointed that they had to “wait” to bond with their babies until breastfeeding was over. Of course, Secrets readers know that feeding is only part of parents’ connections with babies. Dads who understand baby behavior can play a powerful role (no matter how their babies are fed) as the “translator” of their babies' “language” (especially for sleepy and sore new moms) while providing a consistent source of love and comfort to their babies.

Building baby care skills helped fathers in the studies feel more confident, connected, and in control. They learned how to support and protect their new families through trial and error, from other dads, and reading. We know we have dad-readers out there and we hope that you’ll share your questions with us. Let us know what’s confusing you; we’re here to help.

Next time: And Baby Makes Three - Part 5: The Rocky Road to Becoming a Mother

Goodman JH. Becoming an involved father of an infant. JOGNN 2005; 34: 190-200.
Deave T, et al. Transition to parenthood: the needs of parents in pregnancy and early childhood. BMC Pregnancy and Childbirth 2008; 8:30.

Thursday, October 21, 2010

Baby Behavior is on the Road!

Our baby behavior bloggers are on the road this week training and teaching. We'll be continuing our series on parents next week. Have a great weekend!

Tuesday, October 19, 2010

And Baby Makes Three Part 3- The Challenge of Change

In the first 2 installments of this series on parents' relationships, we talked about how having a baby can change couples' relationships and then we explained how one research study describes how couples become a family. In this installment, we'll talk about how these charming little beings can wreak such havoc on their parents. In what specific ways must couples change when their newborn comes along?

A New Orbit

When two people are at the start of their relationship with each other, they tend to feel as if they are the center of their own universe. They sneak away to their own special places, develop inside jokes, and smile secretly to each other among friends about shared experiences. Even during pregnancy, couples plan, fret, and dream together. Then, quite suddenly, the couple finds that their universe has shifted, they have a new orbit and this one, revolves around the baby. This reorientation can be tough at first but it doesn't take long before new routines fall into place. Children are an incredible source of inside jokes and shared experience - your new orbit will feel just as comfortable as the old one. You just need to give it some time.

No Solid Ground

Even if pre-baby couples felt confident in every other aspect of their lives, they often feel lost when it comes to the new baby. They recognize that the baby is so vulnerable but sometimes feel unsure about how to help when the baby is unhappy. We hope that our "secrets" are helping you feel confident that you understand what your baby needs, even if we can't help you catch up on all that lost sleep!

So Much to Do and So Little Time

Caring for tiny new babies takes an enormous amount of work. Feedings, diaper changes, baths, dressing, calming, and playing all take time. Using some very unscientific methods, we estimated that the average couple spends about 9 hours a day (24 hours) caring for their newborn - 300 minutes feeding, 45 minutes with diaper changes and cord care, 160 minutes calming (only at the peak of fussiness in the first 6 weeks), and 40 minutes playing and interacting. These activities don't include household chores, eating, showers, visiting, doctors' appointments, being with each other, and oh yes, sleeping. The baby will sleep 13-14 hours per day (in spurts of course). Let's say you manage to sleep 12 hours in bits and pieces, that leaves you about 3 hours per day for everything you did before you had the baby. So, when you feel like you have no time to get anything done, you're right! Things do get better as parents get more efficient and as babies get older and easier to care for, but those first few weeks are overwhelming.

Moving at Snails' Pace

Just when couples have more to do than they ever had in their lives, they find that even the smallest things, like going to the grocery store, takes forever. Going anywhere with the baby means packing and repacking, and checking and rechecking, using the unfamiliar car seat, the ever-jamming stroller, and everyone who knows you will want to stop and say hello (and tell you crazy stories about their own birth and newborn experiences). Unfortunately, it takes a long time before you feel like you can go anywhere quickly. With toddlers, the whole world slows even more (I used to like that!). But you can reduce your stress if you just plan for the time, including the time needed to deal with the big diaper blow out just as you get everyone settled in the car.

New Parents Need New Ways to Communicate

New parents may not believe me, but all the knowing smiles, the laughter, and the fun will come back, but while you're struggling through the early weeks, you need to be very careful with each other. When it was just the two of you, you may have thought that you could read each others' minds but don't assume that you can do that when the baby is young. You're both going to feel unsure, tired, and overwhelmed so you need to find new and direct ways to communicate your needs.

For those of you who have "been there" - we'd love to hear from you about your big changes and especially what you think of our 9 hour workload estimate! Let us know by leaving a comment.

Next time: And Baby Makes Three Part 4: How the Adjustment to Parenthood Differs for Women vs. Men

Fowles ER, Horowitz JA. Clinical Assessment of Mothering During Infancy. JOGNN 2006; 35: 662-670.

Deave T et al. Transition to Parenthood: The Needs of Parents in Pregnancy and Early Parenthood. BMC Pregnancy and Childbirth 2008; 8:30.

Friday, October 15, 2010

Answers to Our Parents Quiz

1. Which of the following countries has the highest average age among moms having their first child? a. Denmark b. France c. Switzerland d. United States

C. Switzerland where the average is 29.4 years.

For the others - Denmark = 28.4 years, France = 27.8 years, US = 25.0 years (all of these averages come from 2006).

2. Who pays more per year for childcare, parents in the United States or parents in the United Kingdom?

United States (but not by much!)
Of course, costs vary based on location, time, and age of the baby, but average cost (in 2009) for full-time infant care in the UK is (converted) US$13,350 vs. US$14,591 in the US.

3. Which state in the US has the lowest number of births per year?

Vermont with 6513 births (2007 data). The highest is California with 566,352 births!

4. Kids clothes are expensive. How old are kids when parents spend the most money on their clothes? a. 6-8 years b. 9-11 years c. 12-14 years d. 15-17 years

c. 12-14 years (I was sure it was 15-17 years!)

5. In which of the following countries do parents tend to have the most children? a. Japan b. Australia c. Germany

b. Australia.
The average number of children per mom in Australia is 1.78. Japan has the most children per household.

Next time: Back to Posts about Parents!

Monday, October 11, 2010

Time for a Parents Quiz!

Since we are spending so much time talking about parents, we thought we would have a quiz about them. We'll post the answers on Friday. Feel free to share your guesses by posting a comment.

1. Which of the following countries has the highest average age among moms having their first child?
a. Denmark
b. France
c. Switzerland
d. United States

2. Who pays more per year for childcare, parents in the United States or parents in the United Kingdom?

3. Which state in the US has the lowest number of births per year?

4. Kids clothes are expensive. How old are kids when parents spend the most money on their clothes?
a. 6-8 years
b. 9-11 years
c. 12-14 years
d. 15-17 years

5. In which of the following countries do parents tend to have the most children?
a. Japan
b. Australia
c. Germany

Thursday, October 7, 2010

And Baby Makes Three Part 2- Parents' Early Relationships: Chaos, Retreat, and Reorganization

In the last post, we talked about how parents' relationships with each other can influence their babies' behavior. When parents are frustrated and angry with each other, babies can be affected both by the stressful environment and by their parents' lack of attention to their early cues. We also described how easy it is for new parents to be frustrated, given how hard it is to care for a child, especially those first few unrelenting weeks. In this post, we're going to share a study we found that we think will interest you. We each decided that it described our own experience very well. We'd love to hear what you think.

The Evolution of Parents' Interdependence
In a study published in the Journal of Family Nursing (2007), Linda Bell and colleagues at the Universite de Sherbrooke in Montreal studied family relationships in the first 4 months after the birth of the couples' first child. While the study was small (18 low-risk families), all of the parents consented to detailed interviews (60-90 minutes long) when their babies were 1 week, 6, weeks, and 16 weeks old. Mothers and fathers were interviewed separately. We think having these interviews take place at such pivotal ages was brilliant and the story told by the researchers hit home for all of us. Their findings describe how family relationships evolve, focusing on parents' experiences and perspectives at each time point.

Week 1: Chaos
In the first week, parents were confused, stressed, trying to understand and relate to their babies. They ended up in survival-mode, trying to find ways to get through each day. The mothers talked about struggling to figure out how to keep baby happy and dads talked more about being fascinated with their babies' physical appearance ("he looks like us") and abilities. Because both parents were so confused about what to do with the baby, they relied on each other to help them guess what was best. They tried as best they could to "be on the same page" and work together to make sense of things. Neither parent had a set "role" or job.

Week 6: Retreat and Regroup
By the time the baby was 6 weeks old, parents had "figured out" their roles. Each parent could describe how they separately related to the baby. Parents (through negotiations or established routines) had developed "jobs" that belonged to them. Interestingly, moms tended to take on more jobs that involved direct infant care (not just feeding) and dads tended to have jobs that were more supportive or protective. Most of the dads in the study worked outside the home and it is likely that this separation made a difference in the outcomes. When discussing family relationships, the parents talked a lot about their new relationships with the baby but very little about their own relationship - as if the baby's needs had pulled them apart.

Week 16: Family Reorganization
As the babies reached 4 months of age, the parents were far more likely to see their family as a "unit" working together. The "couple" had reformed and parents realized that their relationships with the baby were different, but complementary. Out of all the chaos and struggle, they discovered common goals and ways to reassure each other. Since their babies were old enough to interact and play with both parents, moms and dads were able to develop individual relationships with their babies while building a sense of themselves as a family unit. The parents also rediscovered each other.

Happy ending, eh? While we know that this kind of harmony doesn't come quickly to every couple, we all remembered this evolution exactly as the authors described it. We hope that this study (and our perspective) offers hope to all of you who are still in those first few weeks wondering how you'll ever be able to manage it all. You will. You'll be pros in no time. Remember, talk things over, keep your sense of humor, ask for and accept help.

For those of you beyond those early months, let us know if your experience was like ours. We'd love to hear from you.

Next time: And Baby Makes Three Part 3- The Challenge of Change

Reference: Bell, L. et al. Mother' and Fathers' Views of the Interdependence of Their Relationships with their Infant: A Systems Perspective on Early Family Relationships. Journal of Family Nursing 2007; 13: 179-200.

Sunday, October 3, 2010

And Baby Makes Three, How Couples Become Parents Part 1

For those of you living through those exhausting first days and weeks of parenting a newborn, it must be unimaginable to think of yourselves 20 years from now reminiscing about the magic of that first year. “Magic?” you say aloud, “you’ve got to be kidding.” You wonder how I can think that the excruciating fog of unrelenting sleep deprivation, the confusion, the stress, and the overwhelming weight of responsibility can be “magic” for new parents. But I can, and not just because those days are so far behind me. That same first year is filled with exquisite moments that enrich, thrill, strengthen, and change you forever. That first year also has a powerful influence on the “couple” that now must become “parents.” So far, we haven’t talked much about relationships between parents, but we need to, because the relationship that parents have with each other has a strong influence on baby behavior. In this series, we’ll take a closer look at the evolution of couples into their new roles. In this installment, we’ll talk about the influence of parents’ relationship on babies’ lives. Next time, we’ll talk about how parents’ relationships tend to reorganize in the first few weeks and months. After that, we’ll share what’s known about the challenges couples face during the transition to parenthood, and we’ll finish up with what is known about how the process affects men and women differently. In a future series, we’ll take a look at the transition for single parents.

Three’s a Crowd
These days, it is not uncommon for couples to have lived together several years before they have a baby together. This early "pre-baby" time together can help each partner to mature and to grow more secure in themselves and in each other. With or without "pre-baby" time, most couples build routines and expectations based on what they’ve learned about each other and many become set in their ways. And then baby comes along with overwhelming needs and built-in stress inducers such as their ability to cry and their lack of ability to sleep very long. Few first-time parents are prepared for the effort required in those first few weeks and many parents feel that their partner just isn't doing enough to help. Communication breaks down, stress and exhaustion take over; intimacy flies out the window. Any relationship will be tested under such a strain. It is not surprising that many couples find themselves feeling out of control, isolated, misunderstood, and angry (at least some of the time) at each other.

Unfortunately, these feelings may play out in each parent's relationship with the new baby. Without a sense of support, parents may find that they can’t keep up with the baby’s demands and they may even withdraw. Without careful attention to early cues, parents won’t pick up on what the baby is trying to tell them and the baby will escalate the cues or give confusing signals, further frustrating parents. Babies become increasingly stressed, cry more, are unable to maintain their moods or control their response to their environment, and the cycle continues. While this scenario is a bit extreme, something like this happens to many families, even if only once in awhile.

Taking Care of Number One (and Two)
So what can be done to prevent this cycle from starting in the first place? Preparation is an important way to keep “the couple” from imploding. Keep in mind that no matter what anyone else says, you both are likely dealing with the greatest stress in your lives. Neither of you will be at your best or as sensitive as you may have been to each others' needs for at least a few months. Setting up and taking advantage of a support group can have a huge effect on the biggest stressors (lack of sleep, feeling overwhelmed, and social isolation). Friends and family can share the load, do the dishes, let you nap, let you go out together, reassure and nurture you. You can always “pay it forward” for other families or share your expertise in baby behavior to return the favors – favors that you should accept quickly and with gratitude! Parenting is not one of those things in life that should be done without support. One last piece of advice, talk to each other, right from the start. Don’t let anything fester. If you think you change more diapers, or get less sleep, forgive first, get the facts, and plan to work together to find solutions. Keeping peace between you will keep all 3 of you calmer and more secure and will help your baby grow and learn in a positive and nurturing environment.

Next time: And Baby Makes Three Part 2- Parents' Early Relationships: Chaos, Retreat, and Reorganization
Deave T, et al. Transition to parenthood: the needs of parents in pregnancy and early parenthood. BMC Preg Child 2008; 8:30.

Lutz KF, et al. Furthering the understanding of parent-child relationships: A nursing scholarship series. Part 2. Grasping the early parenting experience - the insider view. J Spec Pediatr Nurs 2009; 14: 262-283.

Gunnar MR, et al. Brain and behavior interface: stress and the developing brain. Inf Ment Health J 24: 195-211.

Friday, October 1, 2010

Music to Moms’ Ears

A Guest Post by Taryn Barrette, RD

In past posts we’ve written about various ways to use repetitive movements or sounds to soothe an upset or crying infant. Today we’ll focus on one more tool for soothing a crying baby: music!

Babies are exposed to regular beats even before they are born. The beat of your heart and theirs’ combined with the rush of blood surging through arteries and veins provide a veritable anatomical symphony - one which is rudely interrupted by the onslaught of noises, smells, sights, and interactions that distract a newborn once out of the womb. In the same fashion that rocking and speaking softly to your baby provides a constant repetition of the same stimuli, musical beats can supply the same soothing repetition to help your baby calm down. Whether you play music or sing to your baby, researchers have demonstrated that just 30 minutes of music per day can help babies cry less often and help mothers become calmer.

Researchers have shown that preemie babies who have been diagnosed as ‘inconsolable criers’ respond with decreased frequency and duration of crying when exposed to recorded music. Not only does crying decrease, another team of researchers found that music elicited a physiological response. In those babies who listened to music, their stress hormones, heart rate, respiration rate and energy expenditure all decreased. Premature infants listening to music had increased catch-up growth and shorter hospital stays too. It is thought that the soothing sensation of music decreases the energy spent on crying and allows more for growth and development!

But what about moms? Mothers who practiced skin-to-skin contact with their babies while listening to music experienced a significant decrease in anxiety compared to moms who used skin-to-skin contact alone. Infants of these calmer moms experienced more quiet sleep, less crying, and reduced stress. This makes a lot of sense. A stressed out mother may not be very responsive to her baby’s cues which could lead to escalation of the cues and eventually crying from the infant.

Rhythmic music has also been shown to increase rhythmic movement which is positively correlated with an infant’s good mood. This makes sense too! I'm never in a bad mood when I’m dancing! Music is also used in “Music Play Therapy” to help at-risk mothers safely and positively interact with their quiet alert babies. Moms and babies can move, dance and communicate through music to provide a fabulous learning environment for both mom and baby.

To sum things up: when your baby is upset and you are looking for safe, effective ways to help soothe your baby – soft, rhythmic music can be another option for you. Alternatively, when your baby is happy, you can use music to help your baby learn and have fun. Rock on!

Next time: We introduce a new series!


Cevasco, AM. “The effects of mothers' singing on full-term and preterm infants and maternal emotional responses.” J Music Ther. 2008 Fall;45(3):273-306.
Kaminski, J, Hall, W. “The effect of soothing music on neonatal behavioral states in the hospital newborn nursery.” Neonatal Netw. 1996 Feb;15(1):45-5.
Keith, DR, Russel, K, Weaver, BS. “The effects of music listening on inconsolable crying in premature infants.” J Music Ther. 2009 Fall; 46(3): 191-203.
Lai, HL, et al. “Randomized controlled trial of music during kangaroo care on maternal state anxiety and preterm infants’ responses.” Int J Nurs Stud. 2006 Feb;43(2):139-46.
Lubetzky R, et al. “Effect of music by Mozart on energy expenditure in growing preterm infants.” Pediatrics. 2010 Jan;125(1):e24-8. Epub 2009 Dec 7.
Stumptner, K, Thomsen, C. “MusicPlayTherapy—a parent-child psychotherapy for children 0-4 years old.” Prax Kinderpsychol Kinderpsychiatr. 2005 Oct;54(8):684-99.
Zentner, M, Erola, T. “Rhythmic engagement with music in infancy.” Proc Natl Acad Sci U S A. 2010 Mar 30;107(13):5768-73.