Our Nerd Council Expert, Daniélle Neal of Sunbirth talks full-circle nutrition and the 4th Trimester.

How Baby’s Nutrition Mirrors the Mother’s

Introducing Allergens: What You Need to Know

## Colostrum - The First Milk

As soon as the placenta is delivered, your body goes into milk production overdrive. Your hormones shift tremendously, and you begin making colostrum, whether or not you plan on breastfeeding. If you are choosing to nurse, the first 72 hours postpartum are crucial for establishing milk supply. 

Your newborn should be feeding at least 8 times a day. The first milk you make will be colostrum, which is full of protein, nutrient-dense, and highly concentrated. It is also thicker and more yellow than mature milk. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Milk "Coming In"

Most parents start making more milk within 3-7 days postpartum. Your breasts may feel tender, heavy, or even warm to the touch. Your nipples may also leak a little, a lot, or not at all. 

By the end of the first week, your colostrum changes into thinner, whiter milk. The amount of milk typically increases rapidly as your baby's stomach capacity expands. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Milk Production

After a couple days, milk production becomes less about hormones and more about maintenance. To keep producing milk, live by the motto "8 or more in 24". Many newborns are exhausted and need to be woken up for feedings during the first couple of weeks (not fun, we know). If it's been about 3 hours since their last feeding, initiate breastfeeding. 

As your baby gets older, they will wake up independently when hungry. Follow their lead and feed whenever you notice the following hunger cues. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Common Infant Hunger Cues: 

- Smacking or licking lips
- Opening and closing mouth
- Sucking on hands, fingers, toes, toys, or clothing
- Rooting around on parent's chest 
- Hitting you on the arm or chest repeatedly
- Moving head frantically from side to side
- Fussing or crying 

If your baby misses a typical feeding, make sure to still express your milk. This will prevent plugged ducts, infections, and engorgement, which can reduce milk production. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Supply Between Breasts

Most breastfeeding parents have an uneven milk supply, meaning that their supply varies from breast to breast. This is completely normal. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Increasing Production

Many new parents worry that they aren't making enough milk. However, it is important to remember that breastfeeding is all about supply and demand. The only surefire way to increase your milk supply is by nursing more often during a 24-hour period. And, of course, make sure you are staying hydrated. 

Some foods that are thought to boost milk supply include fenugreek, oatmeal, fennel seeds, lean meat, and garlic. Please consult your doctor and your baby's pediatrician before using these foods to boost production. The evidence behind these foods increasing supply is purely anecdotal. There needs to be more high-quality research to fully support any claims. 

It is also sometimes necessary to hand express or pump when…

1. Baby isn't latching properly
2. Baby falls asleep during a feeding
3. Parent has risks of low milk production 
4. Baby and parent are separated due to medical reasons
5. Baby is premature
6. Baby is sick

## Nutrients & Supplements

The breastfeeding diet is similar to the pregnancy one but much more relaxed. Your milk's fat, protein, and carbs do not depend on your diet. However, eating nutrient-dense foods provides much needed energy and exposes your baby to healthy flavors. Focus on protein, calcium, iron-rich foods, vitamin C, and omega 3s. Your body will burn 300-500 extra calories daily, so now is not the time to diet or track calories. However, you should drink around 16 cups of fluid daily and continue to take your prenatal vitamins. 

Like during pregnancy, caffeine and high mercury fish should be minimized. Some herbal teas and supplements should also be avoided completely. Read tea labels carefully to make sure dangerous herbs haven't been added.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Signs Baby is Eating Enough

Below are the signs that your baby is getting enough milk:

__1. Weight Gain:__ Babies tend to lose weight during the first week after birth. However, if baby is still losing weight after 5 days, speak to your pediatrician. After the initial weight loss, your babe should gain weight continuously. 
__2. Wet Diapers:__ A newborn's stool starts out black and sticky, then change to yellowish and loose by day 4-5. Seeing wet and dirty diapers daily is a good sign that your baby is getting enough to eat. 
__3. Swallowing:__ You should be able to hear or see your baby swallowing as they eat. 
__4. Relaxed Hands:__ Your baby may start feeding with their hands clenched in a fist, and as they get full, their hands will become relaxed and open. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Skin-to-Skin

Skin-to-skin contact activates your baby's feeding instincts and stimulates milk flow - so snuggle your little one as much as possible! If you are concerned about baby's latch or your milk supply, make sure to contact a lactation consultant. They can help determine whether or not your babe is getting enough milk. 

Milk Supply 101

In the United States, there are around 3,400 SUIDS-related deaths every year, with 27% of these caused by strangulation or suffocation in a bed. New parents can take steps to prevent SUIDS, with safe sleep being a vital preventive measure.

To make it easier to remember safe sleep guidelines, follow the ABCs of sleep:

- __A - Alone__
- __B - Back__ 
- __C - Crib__

Place your baby on their back to sleep in their own flat sleep space, with no loose items like pillows, blankets, or stuffed animals. Bed-sharing is not recommended.

Keep the room temperature between 68 and 72 degrees. To keep your baby warm, use a wearable blanket or long sleeve footie pajamas, avoiding loose fitting items. Stop swaddling once your baby starts rolling and avoid weighted sleep sacks, as they may pose risks.

Use a crib, bassinet, or portable play yard with a firm, flat mattress and fitted sheet. Avoid letting your baby sleep on couches, armchairs, or seating devices like swings or car seats, except during short car rides.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Known SIDS risk factors:

- Placing baby to sleep on their stomach or side
- Babies born before 37 weeks of pregnancy
- Low birth weight, weighing 5lbs, 8oz or less
- Smoking during pregnancy
- Drug and alcohol use during pregnancy
- Babies sleeping on a soft surface 
- Soft and/or fluffy bedding
- Blankets, bumpers, and stuffed toys, in the sleeping area
- Overbundling or dressing baby in too many layers of clothing
- Sickness with a fever
- Sleeping on an adult bed, couch, or armchair alone, with an adult, with a sibling, or with a pet
- Parent smoking cigarettes, using heavy drugs, and/or vaping
- Baby is younger than 4 months old 

By following safe sleep recommendations, parents and caregivers can reduce the risk of SIDS and other sleep-related infant deaths.

Practicing safe sleep reduces stress for new parents and lessens anxiety about SIDS. Breastfeeding, skin-to-skin, and tummy time are excellent ways to decrease the risk of SIDS for your baby. After the first 6 months, the risk of SIDS lessens, but continue safe sleep practices until your baby turns one.

If sleep becomes a struggle, consider attending a newborn care class, using sleep routines, or hiring nighttime help. It's okay to ask for assistance – raising a baby takes a village.


Safe Sleep: Why It’s Important

Pregnancy can be extremely joyful and exciting. However, it can also be extremely emotionally challenging. Expectant mothers can feel stressed, anxious, and depressed. It may be confusing feeling this way, especially with a planned pregnancy. But don’t feel alone. Many women struggle with their mental health while pregnant. 

There are quite a few assumptions made when it comes to pregnancy. Some of these include:

- Getting pregnant is easy 
- All pregnancies are planned 
- All pregnancies are wanted 
- Pregnancy will result in a healthy baby
- Pregnancy will result in a live baby
- Being pregnant is a joyful time for a woman

These assumptions can have a significant negative impact on your mental health. When you aren’t “glowing”, and your experience doesn’t align with your expectations, it can be disappointing and depressing.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Mental Health’s Importance: 

It is normal to have fears, worries, and negative thoughts during pregnancy. These feelings can be especially distressing if you have experienced a loss in a previous pregnancy.

It can also be stressful thinking about life post-birth. Having a baby causes a monumental shift. While you have nine months to plan, there are a lot of things you can’t control. Having some anxiety about what will happen financially, physically, and emotionally is completely normal. 

Postpartum depression was long believed to be something that set in after childbirth. But studies are showing that it can develop before giving birth to your baby. Make sure to pay attention to your emotions both during pregnancy and after. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Risk Factors:

There are certain factors that put you at greater risk of developing mental health conditions during pregnancy. These include:

- A personal history of mental illness
- Family history of mental health issues
- An inadequate support system
- A history of miscarriage or loss
- A difficult pregnancy 
- Relationship difficulties 
- Domestic violence 

Covid-19 has also made things more difficult for pregnant women. It has heightened anxiety and increased feelings of isolation as women protect themselves from exposure. 

There are also many hormonal changes that occur during pregnancy. You might experience mood swings, feel tearful, and be easily irritable. Once your body gets used to the higher hormone levels, these symptoms usually taper off. However, some women experience hormonal mood shifts throughout their pregnancy. 

Your physical health can also have a direct impact on your mental health. Severe nausea, headaches, heartburn, digestive issues, or general discomfort can lead to prolonged sadness. This is especially true if the pain is disrupting your everyday life and/or ability to function. 

Around 15-21% of pregnant women experience depression or anxiety. This can happen anytime during pregnancy. 

Research shows that mental health issues can affect both the mother’s well-being and the outcome of the pregnancy. A fetus with a depressed mother is at increased risk for excessive fetal activity, low birth weight, effects on early brain development, and preterm delivery. 

The good news is that both depression and anxiety are highly treatable.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Is it Pregnancy or Something Else? 

During pregnancy, you can expect mood swings, sleep disturbances, bladder compression, appetite changes, heartburn, and tiredness. An appropriate amount of worry can also be expected. 

Some common symptoms of mental health struggles are low self-esteem, insomnia, fatigue that doesn’t lessen after ample sleep, excessive worry, intrusive thoughts, and/or a loss of interest in activities you used to enjoy. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Treatment: 

It is important to get help early. The American College of Obstetrics and Gynecology recommends screening for depression and anxiety at least once during pregnancy. But you don’t have to wait for your OBGYN to scan you, you can talk to your primary care provider at any time. You can also reach out to a virtual support group or a licensed counselor. There are many pregnancy safe medications that can help you. 

If you are experiencing thoughts of self-harm, call the toll-free National Suicide Prevention Hotline at 1-800-273-8255. For non-emergency situations, Postpartum Support International is also a great resource: 1-800-944-4773.

If you are struggling with your mental health during pregnancy, you are not alone. Get the help you need and deserve. You can search for a mental health professional [here](https://wearerobyn.co/find-providers?serviceId=ProviderServiceOffered:3decbb8a-6f68-4941-8a35-f381606688da). 

Pregnancy & Mental Health

## 1. NICU Caregivers: 
NICU parents can find solace in knowing that a dedicated team of doctors, nurse practitioners, and nurses are there to provide exceptional care to their baby. These compassionate professionals vigilantly watch over NICU babies and are there to support parents throughout their journey, alleviating fear and uncertainty.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Advocacy for Your Baby: 
As a NICU parent, being your baby's advocate is crucial. Communicate openly with the NICU staff, asking questions until you fully understand your baby's care plan. This clarity will help ease fear and anxiety. Collaborate with the medical team, including doctors and nurses, to ensure the best possible care for your infant(s).

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Understanding NICU Admittance: 
Infants may be admitted to the NICU due to various reasons, such as low APGAR scores, jaundice, respiratory distress, or irregular heartbeats. Preterm deliveries may also lead to NICU stays. Understanding the factors that determine NICU admittance can help you mentally prepare for the situation.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Emotional Preparation: 
Emotionally preparing yourself is crucial. Seeing your baby in the NICU can be overwhelming, but discussing your baby's condition with your partner or loved ones and viewing photos before visiting can help ease the initial shock. Take care of your own postpartum recovery while trusting that your baby is receiving the best possible care.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. NICU Visits:
Visiting your baby in the NICU may involve wearing protective gear, but it offers opportunities to bond and connect with your infant(s). While you might not immediately hold your baby, you can still touch them gently. If breastfeeding is not possible, consult with your baby's nurse about pumping and providing breast milk for your baby.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 6. Support and Mental Health: 
NICU families may find it challenging to share their experiences with others. Choose what feels best for you and consider seeking support from mental health specialists or joining NICU parent support groups.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

While becoming a NICU parent is unexpected and emotionally challenging, staying calm, informed, and connected with your baby and partner can make this journey more manageable. Remember that this difficult road is one you can navigate with the right support. Always consult your healthcare providers and adhere to safety guidelines during your NICU visits.

**Please note that current NICU safety guidelines may vary by hospital, so be sure to inquire about specific requirements during your visit.*

NICU Parent: What to Expect

## Step 1: Making the Decision
Choosing surrogacy as the path to parenthood is a significant and emotional decision. Couples may find it challenging to shift from their original family planning expectations, but with the guidance of mental health professionals, they can find acceptance and embrace the new path to parenthood.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 2: Fertility Options
Do you have embryos on ice? Do you need to do another retrieval (ugh)? Do you need donor gametes (an egg or sperm donor)? Now is the time to figure out how you would like to build your family. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 3: The Matching Process
Couples can either work with a reputable surrogacy agency or find a surrogate independently. Agencies can provide valuable screening and matching services, but make sure you choose a top-rated center. Alternatively, finding a surrogate independently also requires thorough screening and compatibility assessment.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 4: Medical Screening of the Surrogate
Before proceeding with legal arrangements, a medical screening ensures that the surrogate is fit to carry the intended parents' child. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 5: Psychological Evaluation for Surrogate and Intended Parents
Both the surrogate and intended parents undergo psychological evaluations by qualified mental health professionals. Find a credentialed [mental health provider here](https://wearerobyn.co/service/mental-health#mental-health-before-pregnancy). 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 6: Securing Medical Insurance for the Surrogate
Ensuring that the surrogate has adequate insurance coverage is essential. Some surrogates already have surrogacy-friendly health insurance. If you need to purchase insurance for your surrogate or future baby, now is a great time to look into options. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 7: Hiring a Fertility Attorney
A knowledgeable fertility attorney is crucial for creating detailed and legally sound surrogacy contracts. These contracts cover various provisions, including parentage, compensation, insurance, medical expenses, travel restrictions, and more. Each party, including the surrogate, requires independent legal representation.

Surrogacy contracts are incredibly detailed and nuanced. Without an experienced attorney, important provisions could be left out. The code that governs surrogacy is also very detailed and specific. If your contract misses a requirement, you may need to go to court to obtain parentage. This will cause you more time, money, and frustration. 

Only once a contract is agreed upon and notarized can you proceed with the embryo transfer. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 8: Payment
To facilitate the surrogacy arrangement, escrow companies familiar with surrogacy contracts can handle the financial aspects. Most surrogacy agreements require payment within 10 days of signing the contract or before starting injectable medication, whichever is earliest.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 9: Pre-Birth Order, Post-Birth Order, or Adoption

Some state laws will allow you to establish parentage of your child before they are even born. The pre-birth order is usually filed around the seventh month of pregnancy, although the process can start as early as the fourth month (depending on state laws).

__These surrogacy-friendly states permit surrogacies for all parents, grant pre-birth parentage orders statewide and name the intended parents on the birth certificate:__
- California
- Colorado
- Connecticut
- District of Columbia
- Delaware
- Maine
- New Hampshire
- New Jersey
- Nevada 
- Rhode Island 
- Vermont 
- Washington

By completing a pre-birth court order, not only will you protect your legal rights to your child, but it will also help your hospital process move smoothly by:
- Requiring you to be listed on the child’s birth certificate
- Allowing you to make medical decisions for your baby
- Helping to resolve insurance coverage issues
- Allowing your baby to be discharged from the hospital to you

Check your state's laws on surrogacy and pre-birth orders [here](https://www.internationalsurrogacycenter.com/become-a-surrogate/surrogacy-by-state/). 

### Post-Birth Order
Not all states allow you to file a pre-birth order, some require you to wait until after the baby is born. These are known as “post-birth orders,” and they’re usually filed three to five days after the birth of the baby.

### Adoption

In certain situations, some states may not allow pre-birth or post-birth orders for surrogacy, leading to adoption as the legal means to establish parentage. Although everyone recognizes you as the parent of your child, following specific legal steps is necessary to protect your parental rights. There are various adoption options based on your marital status and the use of donated gametes in the surrogacy process. Your lawyer and surrogacy specialist will guide you through the process, ensuring a smooth adoption journey.

- __Stepparent Adoption:__ If you are a married individual, and one biological parent has already been named on the birth certificate, the other partner can complete a stepparent adoption after birth. This type of adoption is commonly used by married same-sex couples or heterosexual couples using donor gametes.
- __Second-Parent Adoption__: Similar to stepparent adoptions, second-parent adoptions apply to unmarried partners, especially when one biological parent's name is already on the child's birth certificate.
- __Single-Parent Adoption:__ Single individuals who have pursued surrogacy may need to complete a single-parent adoption. While single men can typically name themselves on the birth certificate, single women not carrying their child might have to go through this process. However, some steps typically associated with single-parent adoptions might be waived, depending on the situation.

__Surrogacy-Specific Considerations:__ Parentage establishment in surrogacy may differ slightly from non-biologically related adoptions. Requirements like the home study and post-placement assessment may be waived due to the established relationship between you and your child. However, it's essential to consult your lawyer about your specific circumstances and the state laws governing these processes.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Step 10: Enjoy your baby!
After a challenging and emotional journey, you can finally welcome your long-awaited child into your life and savor the joy of parenthood. It's been a long road,  give that little one some sweet snuggles! 

Navigating Surrogacy: A Step-by-Step Guide

## Understanding Postpartum Body Changes:

Weight gain during pregnancy is a natural part of the process, and some women may feel freer and more accepting of their bodies during this time. However, those in larger bodies might face pressure from healthcare providers to avoid gaining weight, leading to complicated feelings surrounding body image. After giving birth, women also encounter societal pressure to "bounce back" to their pre-pregnancy weight, which can contribute to negative body image, low self-esteem, and mental health issues.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Coping Strategies:

__1. Challenge societal messages:__ Recognize that the ideal body image is a social construct, and comparing yourself to others can be detrimental to your well-being. Curate your social media feed by unfollowing accounts that contribute to negative body image and focus on promoting body positivity.

__2. Set realistic expectations:__ Postpartum recovery takes time, and your body may take time to return to something you recognize as your own. Allow yourself the space to heal and embrace the changes that come with motherhood.

__3. Address diastasis recti:__ Diastasis recti is a seperation of your left and right belly muscles. is common in women who are over 35, deliver a high birth weight baby, or have a multiple pregnancy. It's usually most noticeable right after delivery. There may be a bulge in the middle of the belly. It might also be noticeable only when the abdominal muscles are tense, such as during coughing. If you believe you are experiencing diastasis recti, seek guidance from your OB or a physical therapist for exercises that can help.

__4. Find ways to feel good in your new body:__ Wear clothes that fit comfortably and help you feel confident. Appreciate your body's ability to nurture and care for your baby.

__5. Trust your body:__ Instead of following strict diets or external cues, learn to respond to your body's natural signals of hunger and fullness without guilt or shame. Respect your body's needs and give yourself permission to eat as required.

__6. Remember your worth is not defined by your body:__ Embrace the changes that come with motherhood and recognize that you are more than just your physical appearance. Embrace your body's ability to adapt during pregnancy and postpartum. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

Postpartum body image struggles are common, but with self-compassion, realistic expectations, and support, you can embrace and appreciate your new body. Remember that every individual's journey is unique, and healing may take time, but it is a valuable and empowering process. Embrace your postpartum body as a testament to the incredible journey of motherhood.

Your body is amazing, just look at what it created! 


Postpartum Body Image: Understanding & Embracing Changes

Every pregnant person has an idea of how they would like their birth to go. So it can be extremely unsettling when it doesn't go to plan. It's hard to cope when something that is supposed to be so joyous causes such distress. 

We hope this article can bring clarity to the subject while also providing some support in knowing you are not alone. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What is trauma?

Trauma is a distressing or disturbing experience that ultimately affects our ability to cope adequately. Trauma comes in all shapes and sizes; it is not a one size fits all issue. The misconception that trauma has to be an utterly brutal near-death experience is not always the truth – as everyone is different and our perceptions and coping abilities vary between differing live events.  

According to Psychology Today, ‘traumatic events tend to be sudden, unpredictable, and feel beyond a person’s control.’ So, when it comes to birth trauma, more often than not, there are feelings of having little control or say in how things went.

As a perinatal mental health expert, oftentimes there’s an ‘off’ feeling with birth trauma - feeling anxious, on-edge, easily irritated, or just simply fatigued. Trauma lives in our bodies and it will exacerbate itself in a number of ways. Motherhood is hard enough, adding birth trauma to that can be exhaustive in every sense of the word. Dealing with trauma can be scary and upsetting – but there are ways to treat symptoms, learn to cope, and ultimately heal.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Examples of what birth trauma may look like:

- Physical and/or medical complications with pregnancy and/or birth
- Medical complications with newborn or newborn born prematurely
- Assisted delivery (medications, forceps, emergency c-section)
- Birth plan did not go as anticipated
- Feeling unheard, helpless, or unsafe during your birthing experience
- Added stressors (ie: Covid, childcare issues with other children, no birthing partner, etc)
- Stillbirth or neonatal death 
- Previous birth trauma

These are just a few examples. Ultimately, if you are feeling unable to cope after you give birth, birth trauma may be something you are experiencing. 

After we give birth there are lots of fluctuating hormones. So, how can we differentiate birth trauma from baby blues, postpartum depression, or just normal recovery? __Here are some of the symptoms of birth trauma that you can look out for:__ 

- Vivid flashbacks and nightmares (normally about birth)
- Physical symptoms: shaking, sweating, nausea
- Inability to talk about your birthing experience without becoming anxious, upset, angry, or overwhelmed
- Hypervigilance
- Difficulty sleeping
- Avoidance (emotionally numb, blocking out the trauma, feeling detached from your body, etc)
- Feeling like no one understands or would believe you
- Blaming yourself
- Feelings of shame and/or guilt

Sometimes it can be very difficult to identify. At first, it is common to blame symptoms on lack of help or sleep deprivation. But, if what you are experiencing is, in fact, birth trauma, it's important to seek help.  

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What is a trigger?

Unfortunately, trauma does not go away on its own. It will reappear through different triggers that will continue to cause distress. A trigger could be a person, place, scent, a particular song – it is something from the time of your trauma that brings you back to it, causing you to feel overwhelmed or flooded. For some women, the scent of their newborn is a trigger to their traumatic birth.  

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## How do we heal from birth trauma?

The first step is being able to label your birth as traumatic. By being able to accept that your birth experience was traumatic, you are allowing yourself to be open to healing. There are many ways we can heal from our birth trauma. Some people can adopt certain coping mechanisms while others seek out professional support. Ultimately – by learning to cope, heal, and process what happened, you will be able to find the root of the trauma. Once you begin to understand your experience more, telling your story and speaking your truth will help reinforce your ability to be the resilient strong mama you are.  

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Some ways we can heal from birth trauma:

### 1. Support:

Support in all forms. Support yourself by not blaming or judging yourself – you did not cause this or do this to yourself. Seek out support from a friend, partner, family member, and/or community member. 

When seeking outside support make sure it's from someone you trust and feel you can be honest with. If seeking out professional support surrounding birth trauma, look for someone who specializes in trauma or perinatal mental health. Support may also look like taking medications to manage distressing symptoms. This is something you can discuss further with your doctor or mental health professional.

### 2. Learning Triggers

It's important to identify triggers so we can implement coping strategies when/if it comes up. When you are feeling triggered, some ways you can cope are – breathing/relaxation techniques, keep a log/journal for when you are feeling triggered (journal writing can also help identify patterns in your triggers like a certain time of a day or a specific place), and call someone you trust when feeling triggered. If you have identified a trigger – plan ahead! If you know seeing a specific provider will be triggering, ask to see a different provider or bring along a support person to your appointment. There are a ton of ways we can cope with triggers; don’t get discouraged! Everyone has different coping strategies that fit their personalities and experiences. It may take time to find a strategy that works for you. 

### 3. Relaxation techniques

Relaxation techniques can be extremely helpful when dealing with trauma. They help ground us when trauma and triggers make it difficult to remain in the present. Some relaxation techniques are: 

- deep breathing
- guided meditations 
- listening to calming music
- using a diffuser with calming scents (lavender or lemongrass)
- practicing gratitude
- taking a hot shower or warm bath 
- getting out in nature (going for a walk and/or sitting in the park)

It's important to try to de-escalate ourselves emotionally and mentally because after experiencing trauma, we tend to be overstimulated. Finding a technique that works for you may take some trial and error. Start small and try to find one that works best for you. 

Own your story. Own your truth.

Trauma can be silencing. Birth trauma can be deafening. We are often taught to just ‘deal’ or ‘push through,’ but when experiencing trauma – that can become impossible. No one deserves to suffer and constantly relive and struggle with trauma. As mothers, we want to be our best selves for our children, and owning our stories – traumatic or not – is a part of that. There are so many avenues where you can do this; some we discussed above. Owning your truth doesn’t always mean you need to scream it from the mountain tops (but that’s okay too – catharsis). Sometimes just writing your story out with pen and paper or telling someone you trust about your experience can help. The more you can let go of any shame, guilt, and blame the more you can build up your ability to cope and heal. It’s important to also make note that everyone’s birth story and/or experience is unique to them. Don’t let someone else’s experience hinder what you are feeling.

So, when you catch yourself saying “Well Jane had it worse than I did” or “I need to just get over it, it’s been 2 years” – stop yourself right there. Everyone’s perception and experience of birth trauma is different and that does not take away from what you may have felt or experienced. Also, let's give ourselves some grace. There is so much about fertility/infertility, pregnancy, birth, and postpartum that can be traumatic. Experiencing birth trauma and continuing to navigate motherhood is no easy feat. Just by reading this article, maybe (hopefully) something resonated with you. 

And that’s the first step. Just becoming aware. 

As a clinical social worker who specializes in perinatal mental health and a mother myself, I understand how tricky birth trauma can be. Sometimes we find ourselves questioning ‘Can I do this?’ or telling ourselves that we’re not good moms because we yelled or had a bad day. But the fact that you are questioning or worrying – makes you a good mom. 

We want to be the absolute best for our children so that our children can also be their absolute best. And in order to be the best moms, we have to allow ourselves the space to heal. Unfortunately, even after all the healing in the world, we will still have bad days. Don't forget that you are doing an amazing job! 

Lastly, I want to encourage any mama’s out there who are struggling to seek out professional help. Remember how strong you are and how far you’ve come – you’ve gotten yourself this far and it will get better. 

__The 988 Lifeline provides 24/7, free and confidential support for people in distress.__

Coping With Birth Trauma

# Infant Sleep Tips

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 1. Optimize the Sleep Environment

As your baby grows past 8 weeks, their awareness of the environment increases. Ensuring their nursery is dark (like a cave) helps release melatonin, the sleep hormone. Maintain a cool room temperature (68-72 degrees) and consider using a white noise machine. Alternatively, a fan or humidifier can create a similar soothing effect.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Establish a Consistent Bedtime Routine

Babies thrive on routines. Start implementing a simple nap time and bedtime routine from around 6 weeks old. This routine can include feeding, diaper change, swaddling, pacifier, and two soothing songs before placing your baby in their crib or bassinet. Predictability helps your newborn wind down and transition into a deep sleep. To avoid dependency on feeding for sleep, try to feed your baby at the beginning of the bedtime routine.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Follow an Age-Appropriate Sleep Schedule

Often, sleep issues arise when the sleep schedule isn't aligned with your baby's age. Depending on their age, your baby requires a specific number of naps and the right balance of day and night sleep. Missing optimal sleep windows or insufficient overall sleep can lead to problems. Typically, babies take three naps between 4-8 months, two naps between 8-15 months, and one nap between 15 months and three years. Remember, quality naps during the day contribute to a better overall sleep routine.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Encourage Independent Sleep Habits

If you find yourself rocking, feeding, or holding your baby to sleep, you may experience frequent wake-ups during the night. When babies wake up, they often need the same conditions recreated to fall back asleep. By gently teaching your baby to fall asleep without assistance, in their crib, they can learn to self-soothe and sleep for longer stretches. Various methods, from direct to gradual approaches, can help establish independent sleep habits.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. Maintain a Flexible Bedtime

While some parents believe in a fixed bedtime, it's important to be flexible. Adjusting bedtime based on your baby's daytime naps can greatly influence sleep quality. If naps were poor, consider moving bedtime earlier, even as early as 5:30 p.m. On days with good naps, bedtime can be closer to 7:30 p.m. Understanding age-appropriate wake windows is key to effective sleep training.

Infant Sleep Tips

# Top 5 Remedies for Morning Sickness

1. __No Empty Stomachs:__ This one may seem impossible to achieve, but it is important to try to keep something in your stomach. Nausea and queasiness are much worse when your stomach is empty. Keep dry and plain foods, like saltines or cheerios, on your nightstand for a quick snack upon waking up. Eating small meals throughout the day, such as applesauce, pretzels, crackers, popsicles, or smoothies, can also provide relief.
2. __Vitamin B6:__ Load up on Vitamin B6 – In addition to its role in developing the baby's brain and nervous system, Vitamin B6 can help with morning sickness. Foods rich in Vitamin B6, such as seeds, nuts, beans, legumes, fish, and lean meats, may provide relief from morning sickness throughout your pregnancy.
3. __Ginger:__ Research suggests that ginger can reduce signs and symptoms of morning sickness. Sip slowly on ginger ale or ginger tea to settle your stomach during bouts of nausea. Mild-flavored ginger snaps or ginger chews are also great options.
4. __Bone broth:__ Taking small sips of bone broth throughout the day may bring relief. Broth can help keep you hydrated and provides beneficial minerals like calcium and magnesium. This is especially helpful if you struggle to keep a regular meal down. The magnesium found in bone broth can also help reduce stress and anxiety.
5. __Avoid triggers:__ Pregnancy can heighten your sense of smell, so it's important to avoid foods or smells that trigger nausea. Certain foods may now cause adverse reactions that didn't bother you before. Identify problematic smells and try to stay away from them as much as possible. 

Unfortunately, morning sickness has no cure. Hopefully, the above tips help you out a bit. Other remedies such as aromatherapy or sea bands may also help. Keep in mind, that every pregnancy is different, and the severity of morning sickness can vary. If you experience severe morning sickness or significant weight loss during pregnancy, consult your OBGYN.

Top 5 Remedies for Morning Sickness

As you and your baby embark on this journey together, both of you will learn and adapt. It's a process of growth and adjustment. It's absolutely okay to reach the conclusion that breastfeeding may not be the best fit for you, your baby, or both.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

# 10 Breastfeeding Tips:

## 1. Skin-to-Skin ASAP: 
Request skin-to-skin contact as soon as possible after birth. This helps your baby self-attach and improves the likelihood of successful breastfeeding.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Mindset & Patience: 
Prioritize your baby's health and well-being above all else. Breastfeeding may not come naturally to everyone, and that's okay. Be patient and compassionate with yourself and your baby.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. The Set Up: 
Over time, you may notice that your baby prefers a certain position or that they latch on easier when held a specific way. Below is the basic format you can follow to get set up to feed and will help you figure out your little one’s favorite spot. 
- Hold your baby so they are turned toward you with their hips, ears and shoulders are in alignment
- Place baby’s arms / hands are around the breast
- Line up their nose to your nipple
- Baby opens their mouth
- Baby’s head tilts back
- Move them gently onto the breast if necessary 

## 4. Feeding Cues: 
Observe your baby's cues for hunger and feed them when they are calm and ready. Look for signs like eye fluttering, stirring, or sucking on their hands.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. Positions, Positions, Positions:
Familiarize yourself with different breastfeeding positions to find the one that works best for you and your baby. [Here](https://www.medela.com/breastfeeding/mums-journey/breastfeeding-positions) is a great guide from Medela on different positions. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 6. Nutrition: 
A lot of babies lose weight during their first week of life. Talk to your pediatrician about what you can expect. The American Academy of Pediatrics states that babies should stop losing weight by day 5, so if weight loss continues make sure to visit your pediatrician. 

It is also helpful to keep track of what you’re seeing in their diapers. As long as you are seeing at least 4 wet diapers a day, there probably is no cause for concern. If you’re ever worried, call your doctor.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 7. Supply & Demand: 
Breastfeeding is based on supply and demand. Increasing the frequency of feedings throughout the day can help increase milk production.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 8. Help is Available to You: 
Seek breastfeeding support before the baby arrives, whether through your healthcare provider, lactation consultant, or breastfeeding classes/support groups.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 9. It Shouldn’t Hurt: 
If you're experiencing discomfort, it's important to seek help. For instance, nipple pain is not a normal part of breastfeeding, and there's no need for your nipples to "toughen up." To address nipple pain, it may be necessary to focus on achieving a good latch by ensuring your baby deepens their latch to encompass more of the areola. 

Additionally, pain could be related to an oversupply issue, where your baby is receiving an excessive amount of milk, leading to discomfort. Regardless of the specific issue, if you're a nursing mother experiencing pain, please reach out to your doctor or a lactation consultant for assistance.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 10. Fed Is Best: 
No matter how your baby is fed, all that matters is that they are. The health and happiness of new parents is crucial to a little one’s wellbeing. So please take that into account during your breastfeeding journey.


Prepping for Breastfeeding

Understanding what you can and should eat during pregnancy can be overwhelming. There is an abundance of information available, often offering contradictory advice. While certain foods are deemed safe and recommended for one pregnancy, others are cautioned against them due to potential risks. Expectant mothers must navigate through a labyrinth of guidelines, considering factors such as nutritional requirements, potential allergens, foodborne illnesses, and cultural beliefs. 

Sorting through this sea of information can leave one feeling uncertain and anxious about making the right choices. Nonetheless, seeking guidance from healthcare providers and reputable sources can help expectant mothers make informed decisions about their diet, promoting the well-being of both themselves and their unborn child.

Below are the top 5 foods fertility specialist and nutritionist, Tracy Lockwood Beckerman, suggests to support a healthy pregnancy, backed by scientific research.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 1. Farro: Boost Energy & Promote Bowel Regularity

Farro, a nutrient-rich superfood high in iron and fiber, can provide the necessary nutrients for a healthy pregnancy. Enhance bowel regularity by incorporating fiber-rich foods like buckwheat, quinoa, and sorghum.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Hard Cheeses: Build Strong Bones & Provide Vitamin D

Discover the benefits of hard cheeses like parmesan, gruyere, gouda, and jarlsberg. Packed with vitamin D and calcium, these cheeses support fetal skeleton development. Note that not all dairy products are suitable for pregnancy.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Egg Yolks: Essential Nutrients for Central Nervous System Development

Choline, an often overlooked but vital nutrient for central nervous system development, can be obtained from egg yolks. A single yolk provides around 20% of the recommended daily value of choline, along with other essential vitamins and minerals.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Legumes: Boost Iron Intake & Enhance Absorption

Iron plays a crucial role in fetal and placental development, as well as maintaining mom's red blood cell count. Legumes, such as beans, peas, and lentils, offer non-heme iron. Pairing them with vitamin C-rich foods improves iron absorption.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. Hazelnuts: Rich in Folate & Magnesium

Hazelnuts provide dietary fiber, protein, magnesium, and folate. With high folate content, they contribute to reducing the risk of neural tube defects during pregnancy. Additionally, hazelnuts are a great source of copper, aiding in iron absorption.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Other Healthy Foods for a Nourishing Pregnancy Diet
If you're not a fan of the recommended foods, consider incorporating walnuts, sardines, avocado, chia seeds, omega-3 fatty acids, folic acid, olive oil, leafy vegetables, and more into your diet. These choices help maintain blood sugar levels and support a healthy pregnancy.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

Remember, it's crucial to prioritize food safety during pregnancy. Avoid consuming raw or undercooked eggs, meats, seafood, shellfish, or poultry. Choose pasteurized cheese and avoid high-mercury fish. For personalized dietary guidance, consult a registered dietitian or nutritionist.


Pregnancy Nutrition: 5 Essential Foods 

## Reasons for Induction

Labor needs to be induced for a variety of reasons. Some of the most common causes are being past your estimated due date, water breaking without contractions, high blood pressure, pre-eclampsia, concerns around placental function, gestational diabetes, low or high amniotic fluid levels, or other medical issues. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

# Induction Methods

Induction procedures vary depending on the birthing person’s body, age, and health history. Scheduled inductions typically take place in the evening, to allow you to prepare for the birthing process. Having a good meal and a shower beforehand is ideal. Some inductions may be more urgent than others, so make sure to speak with your provider about the best plan for you. 

Once at the hospital, your vitals will be taken, your cervix checked, and an IV port will be placed. A heart rate monitor and contraction monitor will also be wrapped around your belly to check the baby. They will monitor your baby’s heart rate for at least 20 continuous minutes. You may also have a finger pulse oximeter or a cuff to measure your blood pressure. Depending on your wellbeing, these measurements may be taken more often during your labor and delivery. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 1. Membrane Sweep

This is the least invasive “induction” method. In fact, it is less of an “induction” and more of a trigger that can cause labor to begin. Your provider places a finger into your cervix and swirls the finger around to separate the amniotic sac from the neck of the cervix. This procedure can be pretty uncomfortable. If the procedure is successful, contractions will begin within the next couple of hours. Often, the provider will perform the sweep, instruct the mom to walk around, then return for another exam to see if things have progressed. If the sweep isn’t successful, you may have to proceed with one of the most invasive procedures listed below. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Medication

There are three primary medications used to begin induction and make cervical changes. Cervidil (prostaglandin gel), Pitocin (synthetic oxytocin), and Cytotec (misoprostol). 

- __Cervidil:__ softens the cervix but does not cause contractions. The gel is inserted high into the vagina next to the cervix. Typically 1-2 doses are administered before any cervical changes occur. For your baby to exit, the cervix must be 100% softened (effaced) and 10cm open (dilated). This medication should not cause any discomfort after insertion. 
- __Pitocin:__ is used to stimulate contractions. It is administered through an IV at a low dose, then increased in even intervals until contractions are consistent, about 3-4 minutes apart. Contractions caused by Pitocin can be more intense than ones without medication. Because of this, you may want to ask about pain management options such as an epidural or nitrous oxide.

Some providers may prefer Pitocin or Cytotec, and both may not be at every hospital. Cytotec is more widely available because it is less expensive. Some people may be concerned about using Cytotec for induction because the drug’s intended use is to treat stomach ulcers. However, it was discovered to cause uterine contractions and is commonly used. Cytotec is a small pill that is administered orally or vaginally. You may receive multiple doses of Cytotec depending on your body's response. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Foley Balloon:

With the Foley Balloon, a small catheter is inserted into the vagina and placed against the cervix. By filling it with saline water, gentle pressure is applied to the cervix, encouraging effacement and dilation. While some may find the insertion mildly uncomfortable, others experience stronger sensations. Opting for upright positions and utilizing gravity, such as sitting, rocking, or bouncing on a birth ball, can aid in cervical changes and provide comfort.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Water Breaking: 

If the cervix is already effaced and dilated, a provider may perform an artificial rupture of membranes (AROM), also known as water breaking. This procedure involves creating a small puncture in the amniotic sac using a specialized hook. The aim is to lower the baby's head in the pelvis, exerting pressure on the cervix. While you may experience a warm gush of fluid, this procedure is generally not uncomfortable. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. Sex: 

As a natural induction method, engaging in sexual activity can be an enjoyable and natural way to encourage labor progression. Sexual stimulation and orgasm release oxytocin, a hormone that stimulates contractions. Moreover, semen from a male partner contains prostaglandins, which have similar effects to medications like Cervidil in softening the cervix.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 6. Movement: 

In most cases, except for the initial administration of certain medications, you are encouraged to move around during labor. Utilizing gravity and staying active can aid in the birthing process. Whether you have a doula or nurse, they can guide you in using your hospital space effectively. Trust your intuition and listen to your body's needs, as it instinctively knows how to find comfort. Additionally, online resources and childbirth education classes offer positions and techniques to support labor progression and enhance comfort.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Castor Oil Is Not Recommended:

Castor oil is not recommended to induce labor due to its potential risks and limited effectiveness. Using castor oil for labor induction can lead to unpredictable and uncomfortable results. Castor oil stimulates the bowels, which can cause cramping and diarrhea. However, this intestinal stimulation does not always translate into effective contractions.

Moreover, the intense cramping and discomfort associated with castor oil can be distressing and exhausting for a pregnant person. Additionally, there is a risk of dehydration and electrolyte imbalances because of excessive bowel movements caused by castor oil. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Monitoring and Considerations: 

Continuous monitoring of your baby's heart rate is crucial for ensuring their health and wellbeing during any induction. In some cases, babies may not tolerate induction medications well and display signs of distress. 

If fetal distress persists, your provider may recommend a cesarean birth instead of continuing with induction and vaginal delivery.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

Inductions can vary in duration, often taking longer than non-induced labor. Being patient and prepared for a labor process that may last from hours to days is important. If induction methods do not lead to the desired progress or expediting the birth is necessary, a c-section delivery might be the best option. 

Remember, each birth journey is unique, and staying educated and empowered will enable you to actively participate in your birthing experience.

Induction Methods

Lactation begins during pregnancy, with colostrum production, and continues after birth as hormonal shifts and breastfeeding cues play a role in transitioning to mature milk. The varying experiences of individuals, including differences in colostrum visibility and breast changes, further contribute to the confusion. By unraveling the intricacies of lactation and dispelling common misconceptions, parents can better understand this natural process and feel more empowered in their breastfeeding journey.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Phase 1: Pregnancy

During pregnancy, lactation begins as early as 12-18 weeks. Hormones produced by your pituitary gland and your baby's placenta stimulate the growth of milk-making tissue. The first milk you produce is called colostrum, which appears thick, sticky, and varies in color. While some may notice colostrum leaking or can squeeze some out, it's important to note that every experience is different and does not predict future lactation capabilities.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Phase 2: The First 72 Hours

After giving birth, the delivery of the placenta triggers a hormonal shift that stimulates lactation. During the first 72 hours postpartum, frequent breastfeeding or expressing colostrum is crucial for establishing long-term milk production. Your baby's demand for milk plays a vital role in transitioning from colostrum to mature milk.

It's normal for breasts to feel heavy and tender, and nipple lactation or leakage can vary. Over time, colostrum transitions into thinner, whiter mature milk, and volume increases. 

Skin-to-skin contact and feeding cues from your baby are essential during this phase.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Phase 3: The Early Days

After the initial postpartum period, milk production shifts from being hormone-driven to maintenance-driven. In the first two weeks, establishing a breastfeeding routine or expressing milk regularly (at least 8 times in 24 hours) helps maintain milk production. 

As your baby grows, their feeding patterns will change, and you can follow their cues. Adequate weight gain and dirty diapers are signs that your baby is getting enough milk. Remember that milk needs will vary, and as your baby starts solid foods around six months, their milk intake will decrease.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

Seek support from a lactation consultant if you have any concerns or questions about milk production. Remember, every breastfeeding experience is unique, and with the right knowledge and support, you can nourish your baby and enjoy this special bonding time.

Some mothers may experience difficulty with milk production, particularly in cases of medical complications such as postpartum hemorrhage. It's important to recognize that not all moms will have their milk come in immediately and/or may have a low supply. While this can lead to feelings of inadequacy and frustration, combo feeding and formula feeding are perfectly nutritious options. Every parent and baby's journey is unique; the most important thing is that baby receives proper nutrition and care. Fed is best.

When Does Lactation Start? 

# Breastfeeding Diet

To help you navigate this important phase, we have compiled a comprehensive guide to optimize your breastfeeding diet. By incorporating these suggestions into your routine, you can ensure a healthy balance of nutrients while nurturing your little one.

__1. Calories & Protein:__ When breastfeeding, your body requires additional calories and protein to support healing, lactation, and your own energy levels. Aim for an extra 450-500 calories per day, as the National Institute of Health recommends. Additionally, ensure an intake of approximately 65 grams of protein daily, as advised by the Dietary Guidelines for Americans. Opt for protein-rich snacks like boiled eggs or nut butter with fruit.

__2. Choline:__ Choline plays a crucial role in your baby's brain development and is transferred through breast milk. Incorporate choline-rich foods into your diet, such as egg yolks. If needed, consider choline supplements to ensure adequate intake for both you and your baby.

__3. DHA:__ DHA, an omega-3 fatty acid, is essential for your baby's brain and vision development. Aim for 200-300 mg of omega-3 fatty acids daily, as the American Academy of Pediatrics recommends. Opt for low-mercury seafood like salmon or shrimp. Canned tuna can be consumed once a week in moderate amounts.

__4. Selenium:__ Selenium is an antioxidant that aids in thyroid hormone metabolism and immune function. Incorporate selenium-rich foods like low-mercury fish or eat one Brazil nut every other day to boost your selenium levels naturally.

__5. Iodine:__ Iodine is crucial for your baby's thyroid function and brain development. During lactation, your iodine needs are higher than during pregnancy. Choose iodine-fortified salt, seafood, eggs, dairy products, or seaweed to increase your intake.

__6. Vitamin D:__ Vitamin D is essential for preventing conditions like rickets in your baby. Although breastfed babies often require Vitamin D supplementation, ensure you meet your own Vitamin D needs for optimal bone health and well-being. Exposure to sunlight and Vitamin D3 supplements can help bridge the gap if your prenatal multivitamin does not provide adequate levels.

__7. Vitamin A:__ Vitamin A supports your baby's immune system and overall development. Incorporate foods rich in beta-carotene, such as sweet potatoes and cantaloupe, into your breastfeeding diet. A moderate amount of pre-formed Vitamin A from animal and dairy products can also be beneficial.

__8. Healthy Carbohydrates:__ Opt for nutrient-rich carbohydrates like whole-grain bread or oatmeal to meet your increased calorie needs. These choices provide essential nutrients and promote satiety.

__9. Water:__ While drinking more water won't directly boost milk supply, staying hydrated is crucial during breastfeeding. Producing breast milk requires significant water consumption, so stay hydrated throughout the day to maintain energy and overall well-being.

__10. Caffeine:__ Moderate caffeine intake is generally safe while breastfeeding, as only small amounts transfer to breast milk. However, exercise caution and limit excessive consumption. Avoid multiple trips to coffee shops or highly caffeinated beverages.

__11. Alcohol:__ Alcohol can affect your baby through breast milk. It's best to wait a few hours after drinking before breastfeeding. Pumping and discarding milk can be an alternative if needed.

Prioritizing your nutrition during the breastfeeding period is essential for both you and your baby. By following these tips and building a supportive network around you, you can ensure a successful experience while maintaining a healthy diet. Embrace self-care, leverage available resources, and enjoy this beautiful and transformative phase.

Breastfeeding Diet

One key to successful latching and breastfeeding is skin-to-skin contact. Skin-to-skin immediately after birth can significantly improve your breastfeeding journey. It allows your baby to naturally find their way to the breast, guided by their instinctual sense of smell. It also benefits breastfeeding moms by triggering the release of oxytocin, which aids in post-birth recovery and prevents excessive bleeding.

It is even possible to do skin-to-skin after a C-section. Baby is put directly on your upper abdomen. Then your medical team pushes the baby underneath the drape. You can also do cheek-to-cheek bonding if that is what you are more comfortable with. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## The Art of Positioning

Finding the optimal positioning for both you and your baby also encourages latching. Breastfeeding is a unique bond between mother and child, and as you embark on this journey, you may discover specific positions that work best for you and your baby. The cross cradle and football holds are popular positions for newborns, providing excellent support and comfort. However, explore and choose the position that suits you and your baby's needs.

### Cross Cradle Hold: 

1. Use a nursing pillow to support your arms and baby during the feed.
2. Cradle your baby with the arm opposite to the breast you're nursing from.
3. Place your forearm along your baby's back, supporting their spine.
4. Rest your hand on the back of your baby's neck and shoulders for added support.
5. Position your wrist between your baby's shoulder blades, with your thumb behind one ear and fingers behind the other.
6. Cup your breast with your free hand, placing your thumb above the nipple and areola.
7. Lightly compress your breast so the nipple points slightly toward your baby's nose.
8. Your baby may latch if they are ready.

### Football Hold:

1. Position your baby at your side, on the same side you'll be nursing from.
2. Place your baby facing you, with their legs tucked under your arm.
3. Support your baby's head with the same hand, and cup your breast with your free hand.
4. Use a nursing pillow for added support and comfort.

__Feel free to experiment with these popular positions as well:__

- __Cradle Position:__ Similar to the cross cradle hold, but with your baby's head in the bend of your elbow on the nursing side.
- __Laid-Back or Reclining Position:__ Lean back on a well-supported bed or couch, allowing your baby to rest against you in any direction while maintaining body contact.
- __Side-Lying Position:__ Both you and your baby lie on your sides, ensuring tummy-to-tummy contact.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Signs of a Perfect Latch:

- Baby's lips should be pursed out, not tucked in
- Observe movement in your baby's jaw
- Hear or see them swallow
- A pain-free latch is a good latch. Mild discomfort at the beginning is normal, but ongoing pain or discomfort may indicate an issue with the latch.

If you suspect an improper latch, gently break the suction by inserting your finger into the corner of your baby's mouth and try latching again. Remember that babies can breathe while breastfeeding through their nose.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Breastfeeding Letdown

The letdown reflex involves the release of hormones prolactin and oxytocin, which stimulate milk production and trigger the release of breast milk. Recognize the signs of letdown, such as tingling sensations, leaking, and baby gulping, which may occur during breastfeeding or even when your body anticipates a feeding.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Overcoming Challenges

Breastfeeding parents often face sore, tender, cracked, or bleeding nipples. These issues can often be resolved by addressing the latch. If your baby is not latching properly or you experience pain or clicking noises during feeding, gently break the suction by inserting your finger into the corner of your baby's mouth and attempt to re-latch. 

Remember to get in a comfortable position, compress your areola, stimulate the rooting reflex, and ensure that your baby's mouth covers the nipple and areola while their chin and nose touch your breast.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Troubleshooting:

Various factors can hinder a baby's ability to latch properly. Some common reasons include:

- Fussiness
- Sleepiness during feedings
- Large nipples
- Flat or inverted nipples
- Engorgement
- Oversupply
- Premature birth
- Tongue tie
- Cleft lip
- Down Syndrome

Seeking guidance from a lactation consultant can be helpful. They can provide personalized support, suggest techniques like nipple shields or pre-feeding pumping, and help establish a successful latch for both you and your baby.

All About Latching

Approximately 20% of new moms experience postpartum depression. However, this statistic is likely an underrepresentation, as research often overlooks certain demographics, including women of color, low-income women, LGBTQ+ individuals, immigrants, and their family members, who have higher rates of depression and anxiety during the postpartum period.

Unfortunately, the challenges posed by the COVID-19 pandemic have further increased the risk of postpartum depression for new parents. The pandemic has brought financial insecurity, childcare challenges, and varying levels of state and local assistance, making maternal mental health a pressing public health concern. Supporting women and their loved ones during this critical time is essential for the well-being of our society as a whole.

The postpartum period is often the most neglected phase of a woman's healthcare journey. Typically, women receive only one postpartum visit with their healthcare provider at six weeks post-delivery, which is often too late for effective preventive care. This leaves women feeling isolated, uncertain, and overwhelmed during those crucial initial weeks.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Symptoms of Postpartum Depression

Initially, the symptoms of postpartum depression may resemble those of the "baby blues." These common experiences include feeling sad, moody, overwhelmed, having trouble sleeping, frequent crying, and exhaustion. These symptoms typically manifest around the 2-3 day mark after delivery and can last for about two weeks as both the mother and baby adapt to their new routine.

It is worth noting that around 80% of women experience the baby blues to some degree. However, if severe mood swings persist beyond the first few weeks, it is essential to be vigilant for signs of postpartum depression or other mood disorders. __Postpartum depression is just one type of mood or anxiety disorder that can occur during this period. Other conditions include:__

- Postpartum Anxiety
- Postpartum OCD
- Postpartum PTSD
- Postpartum Psychosis
- Postpartum Rage

It is crucial to remember that postpartum depression can persist for up to a year or even 18-24 months after childbirth. 50% of women who experience postpartum depression have no identifiable risk factors. It is, therefore, crucial to incorporate early and frequent screening for perinatal mood and anxiety disorders as a standard part of prenatal and postpartum care.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Recognizing the Symptoms

In the first year postpartum, women and their partners should remain vigilant for __the following symptoms that may indicate postpartum depression:__

- Anger 
- Irritability
- Loss of interest in the baby or self-care
- Decreased enjoyment of previously pleasurable activities, 
- Appetite changes
- Sleep disturbances (either excessive sleep or insomnia)
- Frequent crying
- Feelings of guilt
- Shame
- Worthlessness
- Hopelessness
- New-onset bodily aches and pains
- Thoughts of self-harm
- Intrusive thoughts
- Suicidal ideation

Although these symptoms are common during the postpartum period, the fear and stigma associated with them often leave women feeling isolated and frightened. If you are experiencing thoughts of self-harm or harm to your baby, reach out for immediate support __(call the National Suicide Prevention Hotline at 988).__

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Causes of Postpartum Depression

The causes of postpartum depression are multifaceted and vary from woman to woman. While there is no single cause, certain risk factors contribute to the development of postpartum depression or perinatal mood and anxiety disorders. __These risk factors include:__

- A family or personal history of depression or anxiety
- Inadequate social support 
- Financial stress
- Marital stress
- Complications during pregnancy or previous pregnancies
- Major life events (such as a death, job loss, or relocation)
- Multiples births
- Infants requiring neonatal intensive care
- Infertility struggles
- Gestational diabetes
- Gestational hypertension
- Preeclampsia
- A history of abuse or assault
- Adverse childhood experiences
- Substance abuse
- Systemic racism
- A history of Premenstrual Dysphoric Disorder (PMDD) 
- A history of Premenstrual Syndrome (PMS)

These risk factors highlight the need for a comprehensive and inclusive approach to postpartum care that considers the diverse needs and backgrounds of all women.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Supporting Women with Postpartum Depression

Various tools are available to identify and support women with postpartum mood and anxiety disorders. One such tool is the Edinburgh Postpartum Depression Scale, a 10-question screening tool available in over 65 languages, free of charge. Women should undergo screening during both the prenatal and postpartum periods, with a focus on early and frequent assessments. However, it is important to note that a screening tool is only effective when healthcare providers create a supportive and non-judgmental environment for women to be open and honest in their responses. 

Currently, barriers exist that prevent some women from accessing proper screening, such as providers' lack of familiarity with the tool, discomfort in handling positive results, limited community resources, and a failure to create a safe space for women to share their experiences. While screening is an important part of the diagnostic process and treatment of depression, it is just one piece of the puzzle.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Moving Forward

Understanding the challenges and complexities surrounding postpartum depression can be overwhelming. We need a consistent, inclusive, and non-judgmental system of care that celebrates women's choices and empowers them with knowledge and resources to improve their health. __Remember to call 988 if you feel like you are struggling. You are not alone.__


Postpartum Depression: Causes and Symptoms

## Below are the top five foods for breastfeeding moms: 

### 1. Water:

Of course, this is not technically a food, but its importance still puts it at the top of the list. The recommended fluid intake for nursing mothers is around 16 cups a day. One way to make sure you drink enough is by keeping a large water bottle with you all the time.

### 2. Salmon: 

Salmon is one of the most nutrient-dense proteins for nursing mamas. It is full of DHA and EPA, which are omega-3s that support your baby’s brain and nervous system development. Salmon is also packed with vitamins B12 and D. To avoid consuming too much mercury, stick to around 12oz of salmon a week, or two large filets. 

### 3. Lentils:

Lentils are rich in both protein and fiber. These keep you full and help your digestive system function. They are also a great source of potassium, folate, and B-vitamins. 

### 4. Oats: 

According to anecdotal reports, oatmeal is one of the best foods for boosting milk supply. Oats are also a good source of fiber, folate, and iron - which are important for nursing moms and babies. 

### 5. Bell Peppers: 

Bell peppers are loaded with vitamin C and vitamin A, both of which are in high demand while nursing. These vitamins protect your immune system and help you heal. Eating veggies while breastfeeding also helps expose your baby to the flavor, making them more likely to enjoy them once they start solids. 

### Other great foods: 

- Leafy Greens 
- Fennel
- Sesame Seeds
- Sweet Potatoes
- Chickpeas
- Papaya 
- Lactation Cookies 

### Don’t Forget to Eat: 

While taking care of your newborn, it's easy to forget about taking care of yourself. Make sure to eat something every 3-4 hours. This prevents your blood sugar from crashing. Don’t be embarrassed to set up a meal train for yourself. Getting help during those first couple months is extremely helpful. 


Foods for Lactation

## When Do Babies Sleep Through The Night? 

We wish the answer was more clear cut, but as you know, each baby is different. It really depends on how long your babe can go without a feeding. Whether you breast or bottle feed, consider how long your little one can go in between feedings during the day. If they are eating every 3-4 hours, then they likely can only sleep for that amount of time before raising the hunger alarm. However, some babies can go for longer stretches, depending on their growth and development. 

Consider the types of feedings that your baby is having during the middle of the night. Are they gobbling up milk like they would during the day? Or are they just drinking in order to help them fall back asleep? If it is the latter, then it is time to teach them how to fall back asleep on their own. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Safe Sleep

The most important thing is to make sure your baby’s sleep space is safe. To reduce the risk of SIDS, the AAP recommends:

- Placing your little one on their back to sleep.
- Place for your baby to sleep is on "a firm, flat, non-inclined surface free of soft goods." 
- There shouldn’t be anything else, such as blankets, bedding, pillows, or stuffed animals, in your baby’s crib or bassinet. 
- No sleeping on any included surfaces such as "car seats, strollers, swings, infant carriers, and infant slings”.
- Sleeping in the same room – but not in the same bed as baby, preferably for at least the first six months.
- Avoid parent and infant exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs.
- Pacifier use and breastfeeding are associated with reducing risk.
- Weighted swaddles, weighted clothing or weighted objects on or near the baby are not safe and not recommended.
- discontinue the use of swaddles when baby exhibits signs of rolling.

While waking up frequently during the night is frustrating for exhausted parents, it is normal and healthy for your newborn to wake up every 3-4 hours to feed. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Sleep Pattern Outline

- __0-3 months:__ Newborns are not yet capable of settling on their own and need nighttime feedings every 3-4 hours. They require 10-12 hours of night sleep and 4-6 naps per day, ranging anywhere from 20 minutes to 2 hours each. 
- __4-7 months:__ Baby can learn how to self-settle and may be able to put themselves back to sleep. They need 11-12 hours of nighttime sleep, which can include 1-2 feedings if your pediatrician still recommends them. They also need at least two 1-2 hour naps per day. 
- __8-12 months:__ Almost all babies drop nighttime feedings at this age. They need 11-13 hours of uninterrupted nighttime sleep (unless their pediatrician says otherwise). They also need at least two 1-2 hour naps per day.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Sleep Success

The best way to set your baby up for success is to have a consistent and calming bedtime routine. Following a step-by-step routine helps your babe’s body prepare for sleep. 

An ideal bedtime routine for a 4-18 month old baby would include breast or bottle feeding, a bath, a diaper change, putting on pajamas, story time, turning on a sound machine, and then laying down to sleep. It is the time to wind down, cuddle up, and bond with your little one. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## A Good Night’s Sleep

Independent sleep is a learned skill that requires teaching, support, and practice. There will also be roadblocks such as teething, growth spurts, sleep regressions, illness, and travel. 

If you are having trouble getting your baby that is around a year old to sleep through the night, don’t hesitate to contact a sleep coach. There are many strategies besides letting your child “cry-it-out” that can be used. Your whole family deserves and needs a good night’s rest. 


When Can Babies Sleep All Night?

# What is Preeclampsia? 

Preeclampsia is a condition that can develop over time. Experts aren’t sure of the exact cause yet, but most information shows that it is associated with the formation of the placenta and if it implanted properly onto the uterine wall. A woman and her baby can be perfectly healthy, and still have a diagnosis suddenly appear. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What are the symptoms?

Symptoms can include…

- Very elevated blood pressure (140/90 or above)
- Protein in urine
- Severe swelling in hands, feet, and face
- Persistent headaches
- Blurry vision and dizziness 
- Nausea/Vomiting
- Fatigue
- Shortness of breath
- Stomach pain, specifically in the upper right portion (this may feel like heartburn)
- Sudden atypical weight gain 

Symptoms can start out as mild swelling and elevated blood pressure then increase into severe headaches, blurred vision, vomiting, and shortness of breath. 

Some symptoms, such as fatigue, shortness of breath, and swelling, may seem normal during pregnancy, but they may indicate an underlying issue. __If you experience any of these symptoms, call your doctor and let your OBGYN know during your checkups.__

Preeclampsia can affect any pregnant individual. Those who are at a higher risk of developing it include women with: 

- A history of high blood pressure
- Obesity
- Diabetes 
- First pregnancy 
- Preeclampsia in a prior pregnancy
- Multiples (twins or triplets)
- Over age 40 
- Under age 20 
- History of kidney disease 
- Family history of preeclampsia 
- Autoimmune conditions such as Rheumatoid Arthritis

Preeclampsia is a serious condition, and the severity can vary between cases. It can lead to HELLP syndrome or Eclampsia. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## HELLP Syndrome 

HELLP syndrome is when the liver, red blood cells, and blood clotting systems are not working properly. HELLP stands for Hemolysis (damaged red blood cells), Elevated Liver Enzymes (liver cell damage), and Low Platelet Count (the cells that help blood clot). 10% of preeclampsia cases can develop into this syndrome. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Eclampsia

Those who have severe preeclampsia can develop seizures. Seizures are sudden, uncontrolled disturbances in the brain that can affect movement or behavior. These seizures can occur during pregnancy or shortly after giving birth.

Patients with eclampsia can also have HELLP syndrome. If this is the case, magnesium will be administered to prevent seizures. 

It is vital to receive timely care to avoid serious complications with preeclampsia, HELLP syndrome, and eclampsia. __Make sure to talk to your healthcare provider about any symptoms that occur.__

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Treatment

Preeclampsia can only be cured by delivering your baby and placenta. When diagnosed, your OBYGN will want to deliver the baby as quickly as possible. However, if you are not near your due date, treatment includes: 

- Rest or bed rest 
- More prenatal visits 
- Blood pressure medication 

If you are at high risk of developing preeclampsia, your provider may suggest a low dose aspirin as soon as 12 weeks of pregnancy as a preventative measure. But do not self diagnose, speak to your doctor about any concerns or symptoms. 

If you are near your due date, your provider may determine that it is best for you and your baby to induce birth earlier than expected. Induction techniques can include Pitocin, cesarean section, or intravenous magnesium. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## How dangerous is preeclampsia? 

All of the above conditions are life threatening, which is why it is crucial to talk to your provider about any symptoms you are experiencing. It is important to be closely monitored if you have preeclampsia. It can affect the mother by causing liver failure, renal failure, seizures, or long term cardiovascular dysfunction. The baby can also lack food and oxygen, leading to growth restrictions and needing to be born prematurely. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What now? 

While all this sounds scary, with proper care, most women fully recover and deliver healthy babies. As long as the expectant mother attends all her prenatal visits and follows her doctor’s advice, serious complications are rare. 

As soon as the baby and placenta are delivered, symptoms are typically resolved within one to six weeks postpartum. Your doctor will monitor your blood pressure, kidney function, and liver function to make sure that everything is back to normal. 

If at anytime you feel “odd” or “off”, don’t hesitate to reach out to your provider. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Prevention

Unfortunately, the exact cause of preeclampsia is unknown. However, these habits can increase your chances of a healthy pregnancy: 

- Limit salt intake
- Drink 6-8 glasses of water a day
- Get adequate rest 
- Get regular low-impact exercise
- Avoid processed foods
- Elevate feet 


What is Preeclampsia?

## What is skin-to-skin contact? 

Skin-to-skin contact is when the baby is placed on the mother’s bare chest, breast, or even cheek to cheek after birth and left for at least an hour. Skin-to-skin contact is especially important for preemies, as it improves physical and developmental outcomes. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## When to Start

Research has shown that what happens during the baby’s first hour of life can maximize its bonding experience with their parents. It is ideal to begin skin-to-skin contact as soon as possible, ideally within the first hour of birth. For moms who give birth via c-section, skin-to-skin can still be done immediately as long as your care team is informed. For NICU babies, it is important to ensure their health and stability first. Once you get the go-ahead from your doctor, skin-to-skin can begin. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## The Benefits

Nils Bergman, a perinatal neuroscientist stated that, "the salient stimuli that the newborn timetable requires at birth are the mother’s smell (perhaps reassuring of continuity) and skin-to-skin contact, which will provide touch, warmth, stability, and movement. Essentially, the rich parasympathetic and sympathetic innervation of the skin allows the maternal and newborn autonomic nervous systems to communicate directly." 

In the first hours and days of life, skin-to-skin contact encourages deeper bonding while regulating your baby’s temperature, blood sugar, heart rate, and stress hormones. When a newborn is placed on their mother’s chest, they may even make their way naturally to the breast and latch on without any assistance. Skin-to-skin also helps increase mom’s milk production. 

Babies can benefit from skin to skin contact for months. Experts recommend at least three months for full-term babies, and six months for preemies.Skin-to-skin contact can take place any time a baby needs comforting or calming or when mom’s milk supply needs a boost.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Infant Massage

The western world is becoming more familiar with beneficial practices that ancient cultures have been utilizing for a long time, one of them being skin-to-skin contact, and another being infant massage. 
In a study conducted in 2007, premature babies who were given fifteen minute massages three times a day for five days in a row exhibited fewer stress behaviors. Multiple studies have also illustrated the positive effects of massage on weight gain for preterm infants. One study published in The Journal of Perinatal Education showed that infants in a massaged group gained 47% more weight than those in the control group. The massaged babies spent an average of 6 days less in hospital and were discharged sooner.

Infants who were massaged for 15 minutes before bedtime also fell asleep faster than those that were read bedtime stories.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

We are only beginning to learn about all the benefits of skin-to-skin contact. Science is now showing evidence of what we as a species have long known, that touch is an integral part of the human experience - and it all begins with skin-to-skin contact. 


Skin to Skin Benefits

## What is Gestational Diabetes?

Gestational diabetes is also known as carb intolerance. Normally, the carbs in our food are broken down into sugar. Our insulin then takes the sugar from the blood to the cells for use. However, when you have diabetes, the sugars don't get removed properly and build up in the blood. Pregnancy alone increases blood sugar spikes, to provide fuel to the fetus, but some bodies have a hard time handling this.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Why should I avoid high blood sugar while pregnant? 

The sugars in a pregnant person’s blood enter the placenta, but the insulin doesn’t. This means the fetus will absorb a lot of sugar. To manage this sugar spike, your baby will make high levels of insulin. Once born, the baby will continue to make lots of insulin, which puts them at a higher risk of hypoglycemia (low blood sugar). 

A gestational diabetes baby is also likely to be larger at birth, since insulin turns sugar into fat. This increases the chances of needing a c-section and your baby's shoulders getting stuck during vaginal childbirth. There is also an increased risk of obesity, diabetes, and heart disease for your child. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Are Weight Gain and Gestational Diabetes Related?

Gaining weight does not mean you have gestational diabetes, but there can be a connection between gestational diabetes and gaining more than expected. The correlation isn’t completely understood, though it is likely related to increased insulin resistance. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Gestational Diabetes Risk Factors: 

__It is important to know that gestational diabetes is not your fault.__ Researchers still don’t know exactly why some women get it and others don’t, but they do know that it’s a hormone issue. 

### Risk factors may include:

- Being overweight
- Having prediabetes
- Having had gestational diabetes during a previous pregnancy
- Having polycystic ovary syndrome
- Having an immediate family member with diabetes
- Having previously delivered a baby weighing over 9 pounds

## Treatment: 

Changing the carbs you eat and decreasing the amount reduces the risk of both short and long-term consequences. Each person’s tolerance is different, but these general tips for a healthy pregnancy tend to be effective:

### 1. Focus on Protein:

Protein helps maintain a healthy blood glucose level and supports the growth and development of your baby. __Some good sources of protein include:__

- Chicken 
- Turkey 
- Fish (Stick to 8-12 oz of low mercury options a week)
- Cheese
- Eggs
- Nuts
- Tofu
- Beans

### 2. Choose Complex Carbs:

Not all carbs are created equal. Refined carbs break down to sugar quickly and cause a large sugar spike. White bread, pasta, rice, desserts, and breakfast cereals are all good examples of refined carbohydrates. You will want to avoid refined/processed carbs. Complex carbohydrates contain fiber healthy fats, causing them to break down into sugar slowly. __Some good examples of complex carbs would be:__

- Beans
- Berries 
- Greek yogurt  
- Sweet potatoes 
- Quinoa

### 3. Non-Starchy Vegetables:

You can eat large amounts of non-starchy vegetables without bumping your blood sugar up. These should take up the largest portion of your plate. __Some good choices include:__

- Broccoli
- Cucumbers 
- Green beans 
- Onions
- Peppers 
- Leafy greens

More complex carbohydrates, such as sweet potatoes, peas, beets, squash, and carrots, can also be eaten, just in smaller portions (½ - 1 cup per meal)

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### 4. Reduce Sugar Consumption

Any form of sugar (cane sugar, corn syrup, honey, maple syrup, agave) is released into the bloodstream quickly, leading to blood sugar spikes. 

__What to Avoid:__

- Fruit Juice
- Soda
- Sugary Drinks
- Energy Drinks
- Desserts
- Ice Cream
- Hydration Drinks

### 5. Be Careful with Grains

Whole grains are a controversial topic when it comes to gestational diabetes. While they may contain fiber, they only offer a small amount compared to their carbohydrate content. For example, a piece of whole grain bread can contain 5 grams of fiber but 20 grams of carbs. For this reason, some pregnant women can tolerate whole grains, while others cannot. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### 6. Low Impact Movement

Pregnancy is not the time to start a new intense exercise routine. If you were not exercising before pregnancy or are considered high risk, always talk to your doctor before starting a new movement routine. If you went on walks prior to getting pregnant, a 10-minute walk after eating can help your body absorb carbs.


Gestational Diabetes Diet

# The Four Stages of Labor

When it comes to vaginal birth, there are four distinct stages that the body goes through. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Stage 1: Effacement & Dilation 

This is the longest stage of the labor process. Effacement is when the cervix thins in preparation for birth. Dilation is the opening of the cervix, the entrance to the uterus. Stage 1 can be broken down into three phases. 

__1a. The Early Phase:__ This is the very beginning of labor. Your contractions can be up to 20 minutes apart. The frequency is not consistent and doesn’t have a pattern. Often, the contractions are mild, which makes this the perfect time to rest if you can.. Your cervix will dilate up to 6 centimeters, about the width of a soda can. Your baby begins moving down into position. 

__1b. The Active Phase:__ Your contractions become stronger, longer, and more frequent. At this point, you may need support from a partner, family member, or doula to get through them. Your cervix is dilating up to 8 cm, about the size of a baseball. You should head to the hospital, or call your midwife once your contractions are every 5 minutes, they last 1 minute, and have been following this pattern for at least 1 hour. This is known as the 5-1-1 rule. You can download an app or write in a notebook to keep track. 

__1c. The Transition Phase:__ This phase is short and intense. Contractions last about 90 seconds and come every 2-3 minutes. You will be completely effaced and the cervix will open up to 10 centimeters (About the size of a bagel). Your partner, doula, or nurse can help you find the most comfortable positions, as your body does this hard work. Your team will be closely monitoring both you and your baby’s heart rate. 

  ![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Stage 2: Pushing & Birth

On average, this stage can last a few hours. This is when you work to bring your baby down through the birth canal, out of the vagina, and into the world. Several factors can impact this phase, including:

1. The position of your body while pushing
2. The position and size of your baby
3. Whether or not you are medicated
4. If this is your first birth

Contractions are now every 4-5 minutes, which allows you to rest a bit between each push. The end of this phase is marked by the birth of your baby! Your cord is cut and you get to have skin on skin bonding time with your newborn.  

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Stage 3: Delivery of the Placenta (Afterbirth)

During this stage, your doctor will be watching to see if your body is ready to release the placenta. You might feel some minor contractions again, which are signaling you to push the placenta out. If you don’t feel that urge, let your caretakers know and they will help you. 

Once the placenta is released, your doctor will make sure it has been expelled entirely and check you for any tears that require repair. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Stage 4: Immediate Postpartum

During this time, your provider will be monitoring you for any postpartum complications. They will frequently check your uterus' firmness, massaging it often to encourage it to contract and prevent postpartum hemorrhaging. 

Some people experience tremors or chills in the hours after giving birth, warm blankets and rest can help. Your care team will provide ice packs to help with perineum pain and swelling. They will also offer options for pain relief and monitor your pain levels. Be sure to eat and drink to regain your strength (maybe some of those foods you have been missing so much!)

This is also when you get uninterrupted time to bond with your baby. If possible, start nursing within an hour of your baby’s birth. Babies are typically very alert during the first few hours of life, which makes this a great time to try breastfeeding. Ask for help from a caregiver or lactation consultant to start the first latch. 

Make sure to also get all the freebies you can from the hospital before you leave. There are a bunch of postpartum essentials you’ll need for recovery, and you can likely get a lot of them for free upon discharge. Most hospitals offer a peribottle, heavy duty maxi pads, disposable mesh underwear, skin numbing spray, a sitz bath, donut pillow, breastfeeding supplies, baby wipes, diapers, pacifiers, and baby bottles. Don’t be shy and take everything you can get! 

The 4 Stages of Labor

## DO...

### 1. Take a prenatal multivitamin:

No matter how good your diet is, it is nice to have a “safety net” during pregnancy to help fill any gaps. Folic acid is particularly important, because it prevents neural tube defects of the baby’s brain. Prenatals are especially helpful when you are dealing with nausea. Saltines and ginger ale may be the only thing you can keep down, so having a pill that can meet your baby’s demands is extremely helpful.

If you are vegan or vegetarian, make sure your prenatal vitamins include B12, iodine, and zinc. Omega-3 fatty acids (DHA) are also helpful while building a baby. 

### 2. Get plenty of calcium:

Calcium is crucial for prenatal development (think of all the bones you are building!) You won’t find prenatal vitamins with calcium, because iron and calcium block each other’s absorption when taken together. The best way to get calcium is through your diet. Dairy is one of the richest sources, but you can also get it from dark leafy greens, sardines, tofu, beans, almonds, and figs. 

Taking a calcium supplement may be recommended if you are vegan, dairy-free, or have a history of eating disorders. Talk to your doctor before adding one to your diet. 

### 3. Eat lots of protein: 

You may remember from high school biology that proteins are the “building blocks” of the body - so it makes sense that you need more while pregnant. Protein needs increase about 27% while expecting. Try to include a protein-rich food at each meal and snack. 

Adding protein-rich foods to your diet may reduce nausea as well. Pairing carbs and protein can also help with blood sugar balance, which is especially important for moms with gestational diabetes. 

Some great sources of protein are beans, tofu, nuts, lentils, seeds, quinoa, oats, meat, fish, shellfish, milk, cheese, yogurt, and eggs. Try to include one of these every time you eat. 

Protein powders are not advised during pregnancy due to fear of contamination or additives. Talk to your doctor if you are thinking about adding protein powders or shakes to your diet. 

### 4. Eat small, more frequent meals:

Up to 90% of women experience nausea while in the first trimester. In the second trimester, your symptoms might include indigestion, gas, and constipation. Near the end of pregnancy, your symptoms may change to feeling full too fast, even while still hungry. (Your baby is taking up a lot of real estate.)

You can tackle these side effects by eating small and frequent amounts of food. This is especially helpful with morning sickness, since an empty stomach often makes symptoms worse. Try to also separate drinking fluids and eating. 

### 5. Embrace eating fats: 

Thankfully, fat’s bad rep and the low-fat craze of the 90s is going away. Unfortunately, there are still lingering feelings that fats should be avoided. This couldn’t be further from the truth, especially while pregnant! 

Fat provides energy, aids in digestion, and helps us absorb vitamins and antioxidants. Some great sources of fat include fish, cheese, yogurt, nuts, olives, coconut, and avocados. 

Omega-3 fats are particularly helpful because they support your baby’s brain and eye development. They can be found in chia seeds, flax seeds, salmon, sardines, mackerel, and light tuna. Experts recommend not exceeding 8-12 oz of fish per week during pregnancy, due to mercury content. 

### 6. Seek support with eating: 

Eating disorders affect at least 9% of the population worldwide. If you have struggled with disordered eating, you are not alone. Pregnancy can be a particularly vulnerable time because of body changes and weight gain. 

If you find yourself struggling, share these concerns with your OBGYN or a registered dietitian. It is crucial to make sure that you're getting all the support you need. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## DON’T…

### 1. Don’t count calories

It is understandable to want to make sure you are getting the right amount of food for your baby. However, counting calories is not a helpful way to do so. 

Calorie needs change drastically and dynamically throughout your pregnancy, as your baby’s growth stages shift. Needs also differ from person to person, based on genetics, lifestyle, and a multitude of other factors. 

Counting calories can lead to disordered eating. It creates a deprivation mindset that can disturb your relationship with food, which is definitely not what you or your baby needs right now. 

The healthier and more accurate way to ensure your body is getting what it needs is to listen to your hunger cues. Your body will tell you when it needs food and when it is full. 

### 2. Don’t worry about eating “perfectly” (no such thing!)

Many moms feel guilty that because of nausea, they weren’t able to eat a single vegetable their entire first trimester. Maybe you too are feeling the pressure to eat nutrient-rich home-cooked meals every night of your pregnancy. What is important to remember is that there is no such thing as the “perfect” diet. 

Of course, eating a variety of healthy ingredients, fruits, and veggies is always good. But at the same time, pregnancy is physically and emotionally draining. Most of the time you don’t want to stand over a hot stove for hours, and some nights you may crave a pint of Ben & Jerrys for dinner. 

Rather than striving for perfection, aim for more attainable goals. For example, trying a new vegetable once a week. 

### 3. Don’t completely cut out sweets or treats

Pregnant women who are worried about gaining weight or developing gestational diabetes will often be too strict on themselves when it comes to their diet. By restricting sweets and carbs, you will just end up craving them more. This will lead to you never feeling fully satisfied. 

Keep enjoying your favorite snacks* throughout pregnancy, including chips and dessert. Enjoying them in moderation is completely safe for you and your little one. If you have gestational diabetes, pair sugary foods with protein packed foods, and go for a nice stroll. This will smooth out any blood sugar spikes. 

### 4. Don’t eat undercooked animal products

This is the exception to the above section. If your favorite snack is sushi or a runny egg, they should be avoided. While pregnant, avoid eating raw fish, meat, and eggs to reduce the risk of listeria or food poisoning. Both you and your fetus are more vulnerable to food-borne illnesses right now. Just make sure to cook meat, fish, and eggs to the minimum safe temperature before consuming. You can also eat deli meat if you heat it up to 165°F before eating.

You should also avoid cheese made from unpasteurized milk and high-mercury fish. Fish high in mercury include tilefish, swordfish, shark, marlin, orange roughy, king mackerel, and bigeye tuna. Thankfully, most cheeses sold in grocery store chains are pasteurized, even soft ones. Look for “made with pasteurized milk” on the label. 

### 5. Don’t compare yourself to others

Social media makes it tempting to compare yourself to other parents-to-be out there. Remember, videos can be heavily filtered and photos are likely photoshopped. Social media is never a good representation of real life. Follow people that make you feel good, unfollow accounts that don’t - or take a break from social media entirely! 

What your healthy pregnancy looks like is going to look different than others. Even if every pregnant person ate the same exact diet, their bumps and bodies would still look different. 


Pregnancy Foods: Dos & Don'ts

## Mental Health: 

Many new moms struggle with the baby blues after giving birth, and 1 in 8 moms will suffer from postpartum depression. 

Sometimes getting enough sleep, eating healthy foods, exercising, and drinking water isn’t enough. Don’t feel bad if you need a bit of a break. Find a relative, babysitter, or friend to watch the baby while you get some much needed rest. 

Remember to be kind to yourself and never compare your journey to what you see on social media. What you see is not realistic, and taking a social break may be helpful. Do the best you can and give yourself time to adjust to a new baby. 

Feeling emotional after a baby is normal, but postpartum depression is not. As soon as you realize you’re not thinking clearly, ask for help. Don’t wait until it’s an emergency. __Postpartum Support International__ will call you back within 24 hours to help connect you with resources in your area. There is also a __National Suicide Prevention Lifeline: 9-8-8__

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Symptoms of Postpartum Depression: 
- Feelings of anger or irritability
- Lack of interest in the baby
- Appetite and sleep disturbance (more than expected with new baby; sometimes manifests as insomnia even when baby sleeps)
- Crying and sadness
- Feelings of guilt, shame, or hopelessness
- Loss of interest, joy, or pleasure in things you used to enjoy
- Thoughts of harming the baby or yourself

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Treatment: 

1. Contact your healthcare provider (e.g. OB-GYN, pediatrician, therapist) and get connected with a therapist who specializes in PMADs. Discuss the necessity of breastfeeding-safe medication (if you are feeding your baby from your body).
2. Bolster your support system. Reach out to trusted friends and family, and/or if resources allow, hire someone to help with the baby and/or housekeeping.
3. Find a group for new moms (such as Life After Birth®) for connection, community, and support.
4. Prioritize sleep and rest.
5. Go outside and get fresh air and sunlight daily, even if it’s just to get the mail.
6. Keep a bottle of water near you and drink from it all day and night; refill when empty.
7. Eat every few hours.
8. Keep taking your prenatal vitamins.
9. Go for daily walks (if your recovery allows).
10. Seek out mind-body practice like yoga, meditation, and/or breathwork to help manage stress.
11. __Contact Postpartum Support International or the National Suicide Prevention Lifeline: 9-8-8__

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Physical Health: 

Nutrition is an extremely important part of your postpartum wellbeing, especially if you are breastfeeding. 

Here are the top five best foods for breastfeeding mothers: 

__1. Water__
The recommended fluid intake for nursing moms is around 16 cups/day. Keeping a reusable water bottle with you that has measurements on it is a great way to keep track of your water consumption. You can also have a big glass of water next to you while you nurse or pump. 

__2. Salmon__
Salmon is one of the most nutritious proteins for breastfeeding mommas. It is full of DHA, EPA, omega-3s, vitamin B12 and vitamin D. These vitamins and minerals support both you and your baby's brain health and nervous system. If you eat fish, it is recommended to stick to about 12 oz of salmon a week, or about two filets. 

__3. Lentils__
Lentils are loaded with potassium, folate, B-vitamins, protein, and fiber. Together, these nutrients keep you full and provide much needed energy.

__4. Oatmeal__
Oatmeal is great for breastfeeding moms because it can increase milk production. It is also full of fiber, iron, and folate, crucial nutrients during the postpartum period. 

__5. Bell Peppers__
Bell peppers are loaded with vitamin C, vitamin A, and antioxidants - all of which are in high demand during nursing. These nutrients also protect your immune system. 

### Other Great Options:

- Fennel or fennel seeds
- Sesame seeds
- Sweet Potatoes
- Chickpeas
- Papaya
- Leafy greens
- Lactation cookies

While the breastfeeding diet isn’t nearly as strict as the pregnant one, you should still avoid high mercury fish, alcohol, caffeine, certain herbs (comfrey, coltsfoot, borage, aloe, black cohosh, feverfew, ginseng, licorice root, kava kava) and highly processed foods. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Lactation:

Breastfeeding your newborn can be an exciting, stressful, painful, and anxiety inducing experience. We recommended speaking to a lactation specialist to get all the tips and tricks needed to make the process go as smoothly as possible. Most often, it is not as easy as popping your baby onto your chest. 

A prenatal chestfeeding class can also be extremely helpful. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Recovery: 

Pregnancy and birth is extremely tough on your body. Almost every woman you speak to will say their body was never the same - and why should it be? You grew a human inside of you! 

Growing and birthing a child (whether through vaginal delivery or Cesarean section) comes with its own physical challenges - stretch marks, an enlarged uterus, feet swelling, swollen breasts, hair loss, incontinence, the “mask of pregnancy” (brown marks on the face), back pain, wider hips, and vaginal pain. Any painful symptoms should resolve within a couple months of giving birth. 

While most of the focus is on your newborn after birth, your body just experienced something major. This is why postpartum physical therapy is important. Treatment can help to restore musculoskeletal function to the core and pelvic floor. 

During birth, your baby can apply pressure to your urethra, causing you to temporarily lose some bladder control. Most women regain full control within a year, but some women need physical therapy to aid in their recovery (especially if they had a bigger baby). 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Postpartum Energy: 

“When we become parents, many of us are told: “Sleep when the baby sleeps, because rest is important postpartum.” It certainly is, but sleeping when the baby sleeps can feel nearly impossible,” says Elyse Kupperman Chaifetz, Ph.D. 

As a new parent, exhaustion is at an entirely new level. Trying to sneak in a wink of sleep feels impossible while caring for your new baby. While rest, recovery, and physical therapy are important, it can be difficult to actually make it happen.  

### A couple dietary things you can do to improve your energy: 

1. Eat breakfast within one hour of waking
2. Eat regularly throughout the day
3. Eat nutrient-dense foods
4. Drink tons of water 

### Best foods for energy: 

1. __Vegetables:__ including leafy greens, bell peppers, broccoli, avocados, carrots, kale, sweet potatoes, tomatoes, celery, cabbage, and carrots
2. __Fruits:__ citrus, berries, mangos, melon, apples and bananas
3. __Whole grains:__ oats, quinoa, and whole wheat bread
4. __Proteins:__ fish, poultry, tofu, beans, seeds, nuts, and lentils


Postpartum Preparation

## Tips for Managing Nausea: 

1. __Eat something every 1-2 hours:__ an empty stomach tends to make morning sickness worse. Try to make sure you always have something in your belly - even if it’s just a couple of saltines or a piece of toast. 
2. __Eat something before getting out of bed:__ We recommend keeping a non-perishable snack, like saltines or pretzels, on your nightstand to nibble on in the morning. Your partner can also bring you some oats or toast to eat before you sit up. 
3. __Try to eat proteins:__ Something mild, like a protein-rich smoothie, baked goodie made with bean flour, or soup with beans added may help. 
4. __Avoid high fat foods:__ Fat slows the speed that food empties from the stomach, which may make nausea worse. 
5. __Stay hydrated:__ Aim for drinking small sips of water every 10 minutes. If your body is tolerating it, slowly increase to every five minutes. While plain water can be tough on your stomach, you can try a ginger or camomile tea. If warm or room temperature water isn’t your thing, trying ice water or ice chips might help. You can also freeze coconut water or fruit juice into a popsicle. It is important to rehydrate after throwing up. 
6. __Eat bland foods:__ Bananas, applesauce, and toast are all good options for an upset stomach. Basically, eat whatever you can get down and keep down. 
7. __Have someone else cook:__ If your nausea is triggered by the aroma of food, have a friend or partner take on cooking duties, or get takeout. For soups, smoothies, and purees that can be sipped, try putting plastic wrap over the top of the glass and poke a straw through to sip with less smell.
8. __Try ginger:__ Powdered or freshly grated ginger can be added to oatmeal, yogurt, and smoothies. Ginger chews and ginger tea can also be helpful. 
9. __Try sour flavors:__ According to the American Cancer Society, lemon, cherry, pomegranate, and cranberries can all help reduce nausea. Chemotherapy patients often find these flavors helpful. 

## Lemon-Ginger Cubes Recipe: 
From Healthy, Happy Pregnancy Cookbook

If you love ginger, these cubes are for you! You can take one of these first thing in the morning or whenever nausea peaks its ugly head. You can also place one into a glass of sparkling water for a homemade lemon-ginger drink. 

### Ingredients (makes 16 servings):

- 3/4 cup freshly squeezed lemon juice
- 3/4 cup water
- 2 tablespoons freshly grated ginger
- 1/4 cup honey

### Instructions:
1. Puree all the ingredients in a blender until smooth, about 1 minute. 
2. Strain through a fine-mesh sieve or cheesecloth into an ice-cube tray and freeze until solid, 4 hours or overnight.


Foods for Morning Sickness

Your body goes through many significant changes while pregnant. On top of a growing bump, compressed bladder, and tender breasts, your amount of blood increases by 30-50%. This means you need a lot of iron to make new red blood cells. Red blood cells carry oxygen from our lungs to the rest of our body. They also gather carbon dioxide and bring it back to our lungs to be exhaled. 

As your blood volume increases, it can be difficult for your body to maintain its iron levels. When your body is using more iron than you are consuming, you can become anemic. Mild anemia is common during pregnancy, but more severe anemia is a concern because it can lead to low birth weight, premature births, and maternal mortality. 

In America, 18% of pregnant women get diagnosed with an iron-deficiency. These rates increase each trimester, with 6.9% in the first, 14.3% in the second, and 28.4% in the third. Over the course of your pregnancy, your total blood volume doubles. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Symptoms of an Iron Deficiency: 

Some people don’t experience any symptoms at all, which is why it is good to check in with your OBGYN often. Others start with mild symptoms that worsen throughout pregnancy. Common symptoms to look out for include. 

- Fatigue
- Shortness of breath
- Lightheadedness
- Worsening vision
- Cold hands and feet
- Chest pain
- Weakness
- Difficulty concentrating
- Pale skin, lips, and nails

If you think you may have an iron-deficiency, it is crucial to see a doctor before self-diagnosing. Never take an iron supplement without a prescription from your doctor, because overdosing on iron can be life threatening. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Who is at risk?

Although iron is found in many foods, such as leafy greens, lentils, and red meat, iron absorption is difficult. Some pregnant women are at a higher risk for iron-deficiency including: 

- Having one pregnancy shortly after the other
- Are pregnant with multiple children
- Are vomiting often due to extreme morning sickness
- Are vegetarian or vegan
- Had a heavy pre-pregnancy menstrual flow

During your pregnancy you will take a [CBC](https://www.acog.org/womens-health/faqs/routine-tests-during-pregnancy?utm_source=redirect&utm_medium=web&utm_campaign=otn) (complete blood count) test. The CBC test counts the different types of cells that are in your blood. The amount of red blood cells can show if you have a certain type of anemia. This test is done twice, at the beginning and near the end of your pregnancy. If you feel like you have anemia symptoms, don’t wait until your routine test. Ask your doctor to get tested sooner. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Know the Numbers:

- Your hematocrit (Hct) level is the ratio of red cells to blood in your body. Healthy Hct levels are between 36%-48% for women. 
- Your hemoglobin levels tell you the amount of hemoglobin in your blood. Hemoglobin carries oxygen throughout your body and expels carbon dioxide.The normal volume of hemoglobin for women is 13.8 g/dL. 
- Typically, anemia in pregnancy is when hematocrit levels are 36% or lower, or there is a hemoglobin level less than 12 g/dL. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Preventing Pregnancy Anemia:
1. Eat foods that are rich in iron, folate, and vitamin C. Red meat, chicken, eggs, beans, fortified grains, and fish are rich in iron. Leafy greens, beans, and citrus are high in folate. Citrus fruits, bell peppers, and cantaloupe are high in vitamin C. 
2. Cooking with cast iron pots adds up to 80% more iron to food. 
3. Take a prenatal vitamin that has folate instead of folic acid 

Pregnancy & Iron Deficiency

The day you meet your baby is fast approaching and you have also done a lot of work to get here. Dealing with food aversions, nausea, restless nights, and a finicky bladder was just the tip of the iceberg. But now it is almost over, and with your hospital bag packed and your birth location chosen, it has become a waiting game. 

So what are the signs that you should head to the hospital? When do you contact your provider that labor has started? Below, we will help you gain a deeper understanding of the birthing process and the confidence to have an empowered birth experience.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Signs That Labor Is Soon:

There are a couple clear signs that labor is approaching. You may experience all or none of these. 

- __Lightening:__ your baby’s head drops lower into your pelvis. 
- __Loose Stool:__ your body begins to flush out everything it no longer needs to grow your baby. 
- __More Vaginal Discharge:__ the hormone prostaglandin prepares the cervix to open. This may cause more discharge. 
- __Nesting:__ the urge to prepare your nursery, pack your birth bag, and fold baby clothes.
- __Pelvic Discomfort:__ the hormone relaxin loosens cartilage, ligaments, and muscles around your pelvis to start making room for your baby. This can lead to discomfort. 
- __Strong Emotions:__ your hormones fluctuate towards the end of your pregnancy, which leads to mood swings. 
- __Tiredness:__ your body wants to build up energy stores to prepare for birth. This can cause you to feel extra sleepy. 
- __Weight loss:__ your weight might plateau or lower. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Signs That Labor Has Started:

Movies have led people to believe that labor starts with water breakage and rushing to the hospital. In reality, your water breaking might not be your first sign. 

Labor is typically a slow process that becomes more intense the closer you get to birth. The beginning of labor may feel like mild menstrual-like cramping. The cramping may happen every couple minutes or have no real pattern. 

If you are able to go on a walk, it can be helpful. Being upright and moving helps your cervix dilate and your baby move into position. Make sure to stay hydrated and take breaks if needed. 

If you would rather rest during this time, go for it! Resting can also move your birthing process along. Relaxing now will help your body maintain a good energy level during more active labor. Take a warm bath, lower the lights, listen to soft music, and snuggle with some cozy blankets or with your birth partner. 

Eventually, those mild cramps will become more intense and follow a pattern. These contractions will feel like a tightening of your belly, either the whole thing or just the lower part. As your contractions become more severe, you may need to use breathing techniques and focus inward. Your birth partner can help you by providing massages and counterpressure. Try to stay relaxed, remembering that everything you are feeling is natural. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## When to Contact Your Support Team

As your contractions become stronger and closer together, it is a good idea to start timing them. You can use a pen and paper or a contraction timer app on your phone. Look for an app with an obvious start/stop button and shows the average duration and frequency of your contractions over the last hour. 

It is a good idea to call your provider once your contractions follow the 4-1-1 pattern; contractions are about four minutes apart, last for 1 minute, and the pattern has lasted for an hour. 

Your provider will ask you some questions to check if you should start heading to your birth location. If you are having a home birth, your midwife will discuss if she should come join you. 

Remember, you are in charge of your birthing experience. If you need more support, let your partner, doula, or medical team know. They will do what they can to meet your needs and make you as comfortable as possible. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What to Pack: 

Part of the nesting urge that we mentioned earlier can include packing up your birthing bag. However, thinking of all the things you may need can be overwhelming. If you are giving birth at a hospital or birthing center, call ahead to ask what supplies are available. __Most birthing locations provide:__

- Postpartum underwear 
- Maternity pads 
- Ice packs 
- Perineal spray 
- Perineal bottle 

These supplies will help lessen the load of your bag. Make sure to take whatever freebies your location will give you!

Once you find out the supplies your birthing location will provide, here are some essential items you will want to bring: 

- __Loose Clothing:__ stretchy pants, a loose top, and a soft zip up hoodie should help you feel more comfortable. 
- __Toiletries:__ you may want to do some self-care while you are at your birthing location for hours. A shower, brushing your teeth, or brushing your hair can help you feel better during and after labor. 
- __Chargers:__ to ensure you have a form of entertainment while waiting and so you can take photos of your newborn! 
- __Comfort Items:__ your pillow and favorite blanket can help you feel calm and comfortable during your birthing process. 
- __Baby Clothes:__ since you don’t know how big your baby will be, it’s a good idea to pack a newborn outfit and a 0-3 month outfit. Many parents like to get a fun matching beanie and onesie set for their first photos. 
- __Baby Book:__ this is a good place to store newborn paperwork and keepsakes. 
- __Baby Blanket:__ to snuggle your little one in
- __If you have pets:__ your baby will likely get a beanie after they are born. That beanie will be covered in their scent and can be used to introduce your pets to their new roommate. Let your pets smell the beanie first and then have them meet your newborn.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

Building a supportive birth team that understands your preferences can help you maintain a confident mindset during the labor process. Your support team can inform you of what options are available regarding pain management and comfort. 

Robyn offers a digital doula text-based service to support new and expectant parents through pregnancy, birth, postpartum, and early parenthood. 


Signs of Labor

Low-quality foods, such as highly processed foods, can negatively affect your emotional health. Below are some foods that can help reduce your stress levels while also improving your overall wellbeing.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Salmon:

The average American diet lacks omega-3s while being high in trans and saturated fats. Omega-3 fatty acids help produce brain chemicals responsible for positive moods, such as dopamine and serotonin. Our bodies cannot produce omega-3s on its own, so we have to rely on food to obtain it. Cold-water fish such as salmon or sardines are great sources. If you are a vegetarian, walnuts, cashews, chia seeds, flaxseeds, pumpkin seeds, and sunflower seeds are also rich in Omega-3s.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Complex Carbs: 

Simple carbs, such as white bread, pasta, rice, pretzels, essentially anything made with white flour, can lower your mood. This happens because it causes your blood sugar to spike and then quickly crash down. When blood sugar crashes, it causes anxiety and a bad mood. This is why you should reach for complex carbs instead. 

Complex carbohydrates release blood sugar slowly, which can help produce serotonin. Serotonin acts as a mood stabilizer that can increase your wellbeing and aid in digestion. Oats, [sweet potatoes](https://helloyumi.com/products/1161-purple-sweet-potato/), farro, barley, and [beans](https://helloyumi.com/products/821-black-bean/) are all complex carbohydrates. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Lean Proteins: 

Protein is rich in the amino acid, tryptophan, which is more powerful than you may think. Tryptophan is widely known as the chemical that causes post-thanksgiving dinner naps, but it also produces serotonin. Fish, eggs, and [beans](https://helloyumi.com/products/601-kidney-bean/) are all chock-full of protein, which can help keep serotonin levels up.  

Pairing proteins with complex carbs is a great way to reduce anxiety. Complex carbs help tryptophan reach the brain, which can improve overall cognitive function. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Leafy Greens:

Dark leafy greens are rich in folate, which produces dopamine, the “happy hormone” that is an important part of our brain’s reward system. Folate deficiencies are linked to high rates of depression, insomnia, and fatigue. [Spinach](https://helloyumi.com/products/1521-carrot-spinach-millet-bite/), [broccoli](https://helloyumi.com/products/466-broccoli-mash-bowl/), [kale](https://helloyumi.com/products/2392-kale-peach/), asparagus, and collard greens are all significant sources. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Almonds:

Almonds are loaded with GABA. When GABA attaches to a GABA receptor in your brain, it produces a calming effect. This can help with feelings of anxiety, stress, and fear. Almonds are one of the most convenient sources of GABA, but it is also found in wheat bran, halibut, and [bananas](https://helloyumi.com/products/2413-banana-cream-pie/).

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Superfoods: 

If you aren’t a fan of the foods mentioned above, you can also opt for avocados, [blueberries](https://helloyumi.com/products/479-blueberry-chia-pudding/), dark chocolate (yas!) pistachios, or green tea. All of these are easy to snack on and incorporate into your diet. 

Does all this information make you feel a bit overwhelmed? You can also chat with a [registered dietitian](https://wearerobyn.co/) about how to eat your way to less stress, one bite at a time. 


Stress Reducing Foods

Have you heard through the grapevine that breastfeeding is extremely painful and difficult? Well, it doesn’t have to be. While breastfeeding is no walk in the park, the earlier you get professional help, the easier your journey may be. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## How problems start: 

Unfortunately, breastfeeding isn’t as instinctual as we would like it to be. There are quite a few things that can hinder breastfeeding, including insufficient glandular tissue, PCOS, diabetes, thyroid problems, blood loss, retained placenta, high levels of stress, and certain medications. But even if you have any of the mentioned causes, that doesn’t mean you won’t be able to breastfeed. Taking prenatal breastfeeding classes and getting help right after delivery may be helpful. There are various interventions that can increase your odds of successfully breastfeeding.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Milk supply: 

A pregnant body starts to make breast milk at around 12-18 weeks. Ideally, the breast will grow by at least one cup size throughout pregnancy. The areola can also change color.  

The first breast milk is called Colostrum, which can be yellow and thick or clear and runny. It is rich in protein, antibodies, sugar, and fats. Colostrum builds up a baby’s immune system, coats their intestines, and creates a healthy gut biome. 

When in the hospital, you may not see a lot of colostrum. This leads many patients to believe they have a low milk supply. Your lactation consultant can help you learn how to hand express to help with milk production and flow. Hand expressing is a great way to get colostrum out if baby is not latching. 

Pumping may also be needed, so it is important to have the pump beforehand. Many insurance companies cover the cost of a pump completely. Once you receive the pump, the next step is to make sure you have the right flange size. Bigger breasts do not mean you need a bigger flange, it all depends on your nipple size. Not using the right size can cause damage to the breast and can cause a supply decrease. 

If you have a breast pump with the correct flange size, it would be great to bring it along to the hospital so you can start using it after birth. Hospitals rarely provide a variety of flange sizes, which leads moms to using the wrong size. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Breast Milk Transition:

After 3–4 days of making colostrum, your breasts will start to feel firmer and engorged. This occurs because your milk supply is changing from colostrum to mature milk. This can be very painful and uncomfortable. 

Ideally, the breasts can be expressed every 2-3 hours by feeding baby or pumping. This will decrease the chances of engorgement and any other painful breast infections like mastitis. 

If baby is having trouble latching, doesn’t have a good latch, mom isn’t hand expressing correctly, or the pump flange size is incorrect, the chances of engorgement and infection are greater. This can be anxiety inducing because the mom is in pain and the baby isn’t eating well. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Pain While Feeding: 

Many women have heard through friends, family, or the internet that breastfeeding hurts at the beginning, but if you stick with it, the pain will eventually go away. However, breastfeeding should not hurt. If there is breast or nipple pain, that means the baby’s latch is not good, the breastfeeding position isn’t ideal, or the baby is tongue tied or has thrush. Reach out to a lactation consultant to get an oral assessment if you are experiencing pain. 

5-12% of babies are born with a tongue, lip, or buccal tie. Some signs are a shallow latch, compressed nipple (shaped like lipstick), painful breastfeeding, fussiness, gassiness, a white tongue, clicking while feeding, and open mouth sleeping. If baby’s tongue does not go out past their lower lip or touch their palate when crying, this can also be a sign. 

Your nipples should not be scabbed or bleeding. If you are experiencing pain or soreness, you can find some relief through nipple cream, hydrogel pads, warm or cold compresses, epsom salt soaks, or medihoney. For severe pain please contact your provider to get proper treatment. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Infection:

If your breasts aren’t emptying well, this can lead to clogged milk ducts and mastitis. To help prevent infection, you can massage the breast while baby is feeding or you are pumping. Mastitis can appear suddenly, and symptoms include breast tenderness or warmth to the touch, breast swelling, skin redness, breast thickening or a breast lump, pain or a burning sensation while breast-feeding, flu-like symptoms with a fever. Antibiotics are needed to resolve mastitis. Your provider will also likely encourage you to continue breastfeeding through mastitis.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Mental Health: 

Dysphoric milk ejection reflex, or D-MER, is a condition that affects some lactating women. It causes dysphoria, or a state of feeling unhappy, right before your breasts release milk. It shouldn’t last more than a few minutes. 

D-MER can lead to intense negative feelings while breastfeeding your baby. Feelings such as sadness, irritation, restlessness, anger, panic, depression, or anxiety can occur. Some women have only mild symptoms, but for others, the feelings can be severe enough to make them give up nursing entirely. 

Thankfully, D-MER doesn’t last forever. Most of the time it resolves in a couple of days or weeks. However, for some women, it can last as long as they are nursing. 

Some ways to cope can be surrounding yourself with trusted friends and family, having skin-to-skin contact with baby while breastfeeding, watching a show or eating a snack during those first couple minutes, or practicing mindfulness. If these tactics don’t help, talk to your doctor. Dehydration, too much caffeine, and stress can worsen D-MER. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

Whether you choose to breastfeed, pump, formula, or bottle feed, there is no one way to do it. Every mom has their own journey, and many mothers legitimately cannot breastfeed or choose not to. There is no reason to feel any shame - fed is always best! 


Breastfeeding Problems: What You Might Encounter

Since the COVID-19 pandemic began, product shortages have become commonplace. Supply chain issues and recalls have worsened these shortages. Formula is currently one of the supply categories most affected. As scary as these shortages can be, the American Academy of Pediatrics (AAP) asks families to avoid bulk buying and hoarding in order “to help ease the impact of shortages.” __Below are tips from nutritionist, Kayla Thorngate, on what to do.__

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 1. Pediatric Offices or WIC:

“Some pediatric offices or WIC offices may have some sample cans in stock they can provide to families in a pinch, but it will not be a substantial amount to feed a baby for a long period of time.”

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Do Not Dilute 

“It’s not recommended to dilute formula to make it last longer, use recalled formula, switch to cow’s milk before age 1, or try to make your own (as there are recipes parents can find online).”

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Milk Sharing

“If parents are truly at a loss for formula, they can consider informal milk sharing (donor milk from other mothers) through their state chapter of Human Milk 4 Human Babies.”

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Transition to Another Brand 

“We recommend parents always have at least one can of their current formula on hand when they go searching for more formula. In the event their current formula is no longer available, they can mix and slowly transition from one brand to another. Most healthy babies won’t have issues switching, but it can make it easier on their digestion.”


Formula Shortages: What to Do

## Why so much dairy?

Cow’s milk is a mixture of fat, sugar, protein, and hormones. The components found in milk react with our bodies and brains to release “feel good” chemicals (serotonin and dopamine). Our enjoyment of dairy comes down to fat and sugar. Cheese is very high in fat and ice cream is high in both fat and sugar. We love to consume dairy!

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Why shouldn’t we consume it?

Although dairy has become a staple of the American diet, we may have been tricked into thinking it is better for us than it actually is (Remember the Got Milk campaign?) An article in [The New England Journal of Medicine](https://www.nejm.org/doi/full/10.1056/NEJMra1903547) stated that “the health benefit of a high intake of milk products has not been established and concerns exist about the risk of possible adverse health outcomes. Therefore, the role of dairy consumption in human nutrition and disease prevention warrants careful assessment.”

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## The risks associated with dairy consumption:

- __Saturated Fats:__ Dairy contains high levels of saturated fat, which can elevate blood cholesterol levels and increase the risk of heart disease.
- __Prostate Cancer:__ The risk of [prostate cancer](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683061/#:~:text=Fermented%20dairy%20products%20may%20affect,increased%20risk%20of%20prostate%20cancer.) can be increased by milk consumption.
- __Acne:__ Dairy [worsens acne](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106357/) and irritates skin. This is because of the natural hormones found in milk, as well as the artificial hormones given to cows to increase milk production.
- __Ovarian Cancer:__ Studies have shown a link between dairy consumption and an increased [risk of ovarian cancer](https://www.webmd.com/ovarian-cancer/news/20000505/milk-ovarian-cancer-risk#1). A study published in 2000 warns that, “women who drink two or more glasses of milk a day have a 44% higher risk of getting [ovarian cancer](https://www.webmd.com/ovarian-cancer/guide/what-are-ovarian-cancer-symptoms) than women who rarely drink milk.”
- __Environmental Impacts:__ A 2018 study estimated that dairy milk emits 3x more greenhouse gasses than plant-based milks.
- __Lactose Intolerance:__ Up to 75% of the world’s adult population is lactose intolerant, with some ethnic groups up to 90%. Lactose intolerance can cause bloating, stomach pain, flatulence, diarrhea, constipation, and even vomiting. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Milk

There are currently around 20 different milk substitutes on the market, with the most popular being oat, soy, almond, and coconut. Milks can be created from grains, nuts, seeds, and beans. Plant-based milks have been a rich part of human history. In 8th century Spain, Horchata was made from dried and ground tiger nuts. Almond milk was featured in 13th century Baghdadi and English cookbooks as well as 14th-century Egyptian recipes. Soy milk was also prevalent in China in the 13th century. 

In recipes, you can use plant milk as a substitute for milk in a 1:1 ratio. In baking, oat milk and almond milk typically produce the best result. You can find many different varieties of plant milk in your grocery store, or even [make some yourself](https://minimalistbaker.com/make-oat-milk/)! 

### EASY NUT MILK

- 1 cup raw cashews, sunflower seeds, or hemp seeds (soaked for at least 4 hours)
- 3 cups water (more or less depending on how thin or thick you want it)
- 1 tsp vanilla extract (optional)

__INSTRUCTIONS:__

1. Blend very well until creamy, about 2 minutes.
2. Store in an airtight container and shake before serving.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Cream:

Cream is thick, creamy, and high in fat. It gives a certain decadence to food, both sweet and savory. You can use cashews, coconut cream, silken tofu, chickpeas, potatoes, cauliflower, and aquafaba to replace cow’s cream. These ingredients can be used in different ways and recipes to create a creamy texture. 

### Homemade Cream Recipes:

- [Cashew Cream](https://www.thefullhelping.com/purpose-cashew-cream-recipe/)
- [Coconut Whipped Cream](https://downshiftology.com/recipes/how-to-make-coconut-whipped-cream/)
- [Tofu Sour Cream](https://www.theblendergirl.com/recipe/vegan-sour-cream/)
- [Aquafaba Whip](https://minimalistbaker.com/a-guide-to-aquafaba/)
- [Coffee Creamer](https://ohmyveggies.com/vegan-coffee-creamer/)

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Butter:

We love butter because it is pure fat! To replace the fats found in dairy, oils must be used. A couple of great plant-based butters are currently on the market, including Earth Balance, Country Crock Plant Butter, I Can’t Believe It’s Not Butter, Miyokos, and Simple Truth. Try to make sure that they are non-hydrogenated, as hydrogenated oils contain trans fats and can increase cholesterol. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Yogurt: 

Plant-based yogurts are becoming more and more common on supermarket shelves. Commercial yogurts are made from oat, soy, coconut, almond, cashew, and flax milk. 

### DR. YAMI’S INSTANT POT VEGAN GREEK YOGURT

- 2 cups raw cashews, soaked overnight and drained
- 1 can coconut milk (full fat)
- 1 packet [vegan yogurt starter](https://shop.culturesforhealth.com/products/vegan-yogurt-starter)

__INSTRUCTION:__

1. Blend soaked cashews and coconut milk until smooth.
2. Add the cashew mixture to your instant pot.
3. Add the starter and stir well with a whisk until completely incorporated. 
4. Push the yogurt button on the instant pot and set to 12 hours.
5. Turn the steam valve to “vent” to allow humidity to escape. 
6. Once done, let it cool to room temperature and transfer to sealed containers.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Cheese:

There is an extremely high demand for vegan cheese. Current popular brands include Daiya, Field Roast Chao Cheese, Treeline, So Delicious, Kite Hill, Follow Your Heart, Violife, and Vromage. Miyokos also makes [artisan plant-based cheeses](https://miyokos.com/collections/vegan-cheese-wheel), perfect for a charcuterie board. The Field Roast Chao Cheese Creamy Original is great in sandwiches and melts nicely. 

You can also use nutritional yeast to get a cheesy flavor in [pastas](https://helloyumi.com/blog/mac-and-cheese-recipe/), soups, and [dips](https://helloyumi.com/blog/vegan-cheese-sauce/). Nutritional yeast is an amazing source of B-vitamins and protein, especially B-12 which is important for brain health. It is also a complete protein, meaning it contains all of the amino acids our body needs, but cannot produce itself. Tofu and cashews are also often used to create cheesy textures. 


Replacing Dairy in Your Diet 

4 Ways Nutrition Affects Sleep

## VITAMIN D:

Vitamin D promotes calcium absorption. It is critical for bone growth, immune function, and inflammation reduction. Vitamin D deficiency can lead to rickets in children and osteomalacia in adults. Both of these conditions soften bones, leaving them weak and brittle. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Sources of Vitamin D: 

- Sunlight on bare skin
- Fatty fish (salmon, trout, cod liver oil)
- Mushrooms that have been exposed to sunlight
- Fortified foods (milk, cereal, and orange juice)

Certain factors can prevent us from getting sufficient Vitamin D from sunlight. These include latitude (north of New Mexico, Arizona, and Oklahoma), clothing, sunscreen, shade, windows (UVB cannot go through glass), smog, clouds, the time of day, the season, and your skin’s melanin content. 

### How much is recommended?

- __0-12 months:__ 400 IU (10 mcg)
- __1-18 years:__ 600 IU (15 mcg)
- __19-70 years:__ 600 IU (15 mcg)
- __>70 years:__ 800 IU (20 mcg)

**Recommended dietary allowances for adequate intake from the Food and Nutrition Board committee.*

### Amount of Vitamin D in plant-based foods:

- __Fortified Plant Milks:__ 1 cup = 100-144 IU
- __Mushrooms (exposed to UV light):__ 1/2 cup = 366 IU

### Who is at risk for deficiency? 
- Exclusively breastfed babies
- People with darker skin
- People taking oral steroids, certain weight loss drugs, cholesterol medication, and certain seizure medications. 
- People with Crohn’s and Celiac
- People with fish-free diets 
- People who do not eat fortified foods
- People with increased body fat
- Older adults

### Vitamin D & Sunlight: 

Humans produce Vitamin D when they are exposed to UV-B rays from sunlight. However, the sunlight must come in contact with bare skin. Sunlight exposure can produce 10,000-25,000 IU of Vitamin D. You can never get too much Vitamin D from sunshine. 

In the spring and summer, 15-20 minutes of sun with bare arms and legs, between the hours of 10am-3pm, can produce the daily dose of Vitamin D. Those with darker skin tones may need to stay outside longer. 

Remember that increased sun exposure also comes with the risk for skin cancer. After sunning yourself for 15-30 minutes, make sure to put on sunscreen. 

### Vitamin D Fortification:

Vitamin D concentrate is added directly to cow’s and plant milk. They are often fortified at comparable levels. Check labels for added Vitamin D. Yogurt, tofu, cereal and orange juice also come in fortified varieties.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## VITAMIN B12

Vitamin B12 comes from bacteria, not animals or plants. Many animal products are high in Vitamin B12 because they accumulate the bacteria throughout their lives. With pesticides and antibiotics being used in soil, plants are no longer a reliable source of B12. Thankfully, certain mushrooms and seaweed still contain it. Cereal, plant-based milks, and nutritional yeast are also now fortified with a crystalline version of B12. This crystalline form is actually easier for our bodies to absorb. 

Vitamin B12 is crucial for red blood cell formation, DNA synthesis, metabolism, and neurologic function. Vitamin B12 deficiency can lead to weakness, fatigue, appetite loss, neurological symptoms, depression, and memory problems. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Vitamin B-12 Sources:

- Animal products such as eggs, dairy, and meat
- Fortified plant foods including nutritional yeast and cereal.
- Breast milk 
- Infant formula
- Supplements 

### Who Is at Risk for Deficiency:

- Adults over the age of 50 (because the stomach acid required to absorb B12 decreases)
- People with pernicious anemia
- People with Celiac or Crohn’s
- People who have had weight loss or gastric surgery
- Pregnant and lactating vegan moms
- Vegans and vegetarians

### How Much Is Recommended?

- __0-6 months:__ 0.4 mcg
- __7-12 months:__ 0.5 mcg
- __1-3 years:__ 0.9 mcg
- __4-8 years:__ 1.2 mcg
- __9-13 years:__ 1.8 mcg
- __14+ years:__ 2.4 mcg
- __Pregnancy/lactating:__ 2.8 mcg

### Supplements: 

There is no known intake level that is toxic, but high doses may cause acne or rashes. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## CALCIUM: 

Calcium is the most abundant mineral in our bodies. Calcium levels in our circulatory system stay the same and do not fluctuate with consumption. When blood calcium levels fall too low, our bones release calcium into the blood. 99% of our calcium is stored in our bones.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Why is it important?

Calcium is required for bone formation, muscle contraction, blood vessel contraction, hormone secretion, and nerve signaling. 

Inadequate calcium intake leads to osteoporosis and osteopenia. These cause bone fractures and weak bones.

### Sources:

- Dairy
- Green Beans
- Nuts & Seeds
- Foods fortified with calcium

__Note:__ Infants receive all the calcium they need from breastmilk or formula

### How Much Is Recommended? 

![Calcium table](//images.ctfassets.net/vrwte4peyqq1/5L2BfRbyKpLLEyhIpjsHt6/9c5b8bd616d3e456baea34eeb333f131/Calcium_table_.png)

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Amount in Plant Foods:

- __Fortified Plant Milk (1 cup):__ 300-450 mg
- __Tofu (½ cup):__ 200-400 mg
- __Blackstrap Molasses (2 tbsp):__ 200-400 mg
- __Fortified Orange Juice (1 cup):__ 350 mg
- __Cooked Broccoli Rabe (1 cup):__ 200 mg
- __Cooked Soybeans (1 cup):__ 184 mg
- __Cooked Kale (1 cup):__ 177 mg
- __Sesame Seeds (2 tbsp):__ 176 mg 
- __Cooked Bok Choy (1 cup):__ 168 mg
- __Cooked White Beans (1 cup):__ 161 mg
- __Fortified Breakfast Cereal (1 serving):__ 130 mg
- __Shelled Edamame (1 cup):__ 122 mg
- __Almond Butter (2 tbsp):__ 111 mg
- __Chia Seeds (1 tbsp):__ 76 mg

### What About Supplements?

It is not recommended to take calcium supplements. There are risks associated with excess calcium intake, including kidney stones, constipation, cardiovascular disease, interactions with medications, and decreased iron and zinc absorption. 

The best way to add calcium to your diet is through natural and fortified foods. 

### Absorption Varies: 

- Average calcium absorption from food is about 30%. 
- In infants & young children, absorption can be as high as 60%. 
- In older adults, absorption can drop to 15-25% 
- High sodium consumption leads to increased calcium excretion. 
- High caffeine intake can lead to decreased absorption and increased excretion.

### How Much per Day? 

Despite popular belief, a diet high in calcium is not necessary to protect against bone fractures. Some experts believe that we don’t need as much as the Institute of Medicine suggests. Overall diet and lifestyle can impact calcium and bone metabolism. Cultural, genetic, and geographic differences also play a role. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## ALL ABOUT BONE HEALTH:

Bone health isn’t only about calcium. Bones are dynamic, and are constantly remodeled throughout our lives. In children and teenagers, bone formation exceeds breakdown, but for adults it can be the other way around. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Risk Factors for Osteoporosis: 
- Age (typically affects older adults) 
- Female (lower estrogen post-menopause)
- Low body weight
- Ethnic background (increased in white and asian populations)
- Inactivity/sedentary lifestyle
- Disordered/restrictive eating practices
- Smoking
- Family history
- Long-term use of certain medications such as steroids 
- Certain medical conditions that affect nutrient absorption

### What to Avoid:
- High sodium diet
- Smoking
- Excess Alcohol
- Excess Caffeine

### What to Include: 

- Exercise such as walking, running, climbing, and resistance training. 
- Adequate Calcium intake
- Adequate Vitamin D intake
- Adequate protein intake
- Adequate intake of Magnesium, Manganese, Vitamin K, folate, Vitamin C, Potassium, and Boron
- Lots of fruits and veggies!

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## IRON:

Iron deficiency is the most common nutritional deficiency in the world. Iron is a major component of hemoglobin, a type of protein in red blood cells that carries oxygen through the body. It is also necessary for growth, neurologic development, cellular functioning, muscle metabolism, and the synthesis of some hormones. 

There are two types of iron, heme - derived from animal products, and non-heme - derived from plants. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Where Do You Get It? 

You can find iron in animal, plant, and fortified foods. Vegans can easily obtain sufficient iron from plant-based foods. 

### Iron per Serving: 

- __Fortified Breakfast Cereal:__ 18mg
- __1 Cup White Beans:__ 8mg
- __Dark chocolate (45-69%):__ 7mg
- __½ Cup Lentils:__ 3mg
- __½ Cup Spinach:__ 3mg
- __½ Cup Firm Tofu:__ 3mg
- __½ Cup Kidney Beans:__ 2mg
- __½ Cup Chickpeas:__ 2mg
- __½ Cup Sardines:__ 2mg
- __3 oz. Beef:__ 2mg
- __1 Baked Potato:__ 2mg
- __1 oz. Cashews:__ 2mg
- __½ Cup Green peas:__ 1mg
- __3oz. Chicken:__ 1mg
- __½ Cup Broccoli:__ 1mg
- __1 Hard Boiled Egg:__ 1mg
- __1 Slice White or Wheat Bread:__ 1mg

### How to Improve Iron Absorption:

- Phytates, polyphenols and calcium can inhibit iron absorption
- Avoid taking calcium supplements at meals
- Add a source of Vitamin C to meals (bell peppers, citrus, tomato)
- Avoid coffee and tea at meals (polyphenols)
- Eat more legumes (lentils, peas and beans)
- Soak or sprout beans and whole grains prior to cooking

### How Much Is Recommended? 
![iron-table-fixed](//images.ctfassets.net/vrwte4peyqq1/3R9woLhXaQwwn8u8tFhtQJ/ded938fd9051d0c3de2258c41c5d081b/iron-table-fixed.jpg)

### Who Is at Risk for Iron Inadequacy? 
- Menstruating women
- Pregnant women
- Premature, preterm, and low birthweight babies 
- Exclusively breastfed babies between 4-6 months of age 
- Frequent blood donors
- People with malabsorption from chronic conditions or surgery
- Children consuming excess cow’s milk and dairy

__Be careful!:__ Accidental ingestion of iron supplements can be toxic! Always keep out of reach of children

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## IODINE:

Iodine is an element naturally found in earth’s soil and seas. It is usually in the form of salt. Iodine is necessary for proper thyroid, metabolism, and immune system function. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Iodine Deficiency 

- The earliest sign of deficiency is a goiter (enlarged thyroid gland)
- In pregnancy, deficiency can lead to the baby being born with impaired neurological function, stunted growth, and physical deformities.
- Iodine deficiency is the most common cause of preventable intellectual disability in the world

### Sources of Iodine

- Found in seaweed (nori, kombu, kelp, wakame)
- Breastmilk and infant formula
- Fish and seafood
- Table salt fortified with Iodine
- Fortified enriched bread
- Chicken eggs
- Cow’s milk

__Note:__ specialty salts and salt in processed packaged foods are not typically iodized

### How Much Is Recommended Daily? 

- __0-6 months:__ 110mcg
- __7-12 months:__ 130mcg
- __1-8 years:__ 90mcg
- __9-13 years:__ 120 mcg
- __14+ years:__ 150mcg
- __Pregnancy:__ 220-250mcg
- __Lactation:__ 290mcg

**IOM Food and Nutrition Board 
**WHO, UNICEF and ICCIDD recommend 250 mcg per day for pregnant women*

### Iodine Food Sources:

- __10g Dried Seaweed:__ 232mcg
- __3 oz. Baked Cod:__ 158mcg
- __¼ tsp Iodized Salt:__ 76mcg
- __3 oz. Cooked Shrimp:__ 13mcg

### Absorption Barriers:  

- Levels in soil vary and may lead to insufficient intake in some regions
- Goitrogens are substances that inhibit iodine uptake in the thyroid
- Soy, cassava, sweet potato, millet, and cruciferous vegetables are goitrogens
- Selenium, vitamin A, and iron deficiency can inhibit iodine uptake as well

### Who Is at Risk for Deficiency? 

- People who don’t eat iodized table salt
- Pregnant women
- Vegans (especially if they don’t eat salt or seaweed)
- Residents of areas with iodine-deficient soil.

### Should You Supplement? 

If you do not eat iodized salt, seaweed, or seafood, then it is okay to supplement. The [YUMI multivitamin](https://try.helloyumi.com/whole-food-vitamin/ "YUMI vitamin link") contains a safe amount of iodine. Iodine only supplements and kelp supplements can contain amounts that are too high and should be avoided. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## OMEGA-3 FATTY ACIDS 

Omega-3s are polyunsaturated fatty acids. One type of Omega-3s is alpha-linolenic acid (ALA), which cannot be made by the human body. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Why Do We Need It? 

Omega-3s support the cardiovascular, pulmonary, immune, and endocrine systems. They also provide energy and have anti-inflammatory properties. 

Deficiency can cause rashes and dry skin.  

## Omega-3 Sources 

- ALA is found in flax seeds, chia seeds, hemp seeds, walnuts, and flax, canola and soybean oil
- DHA and EPA are found in fish, seafood, and seaweed

### How Much Is Recommended Daily? 

![omega-intake-table](//images.ctfassets.net/vrwte4peyqq1/1zrWRsP4k7uNKzm1cVEXt6/67bd73f123f4b7b5887aa01e0b10a885/omega-intake-table.jpg)

### ALA Sources:

- 1 tbsp Flaxseed Oil: 7,260mg
- 1 tbsp Chia Seeds: 2,139mg 
- 1 oz. English Walnuts: 2,570mg
- 1 tbsp Ground Flaxseeds: 1,710mg
- 1.5 tsp Soy Oil: 450mg
- 1 tsp Canola Oil: 433mg 
- ½ cup Soybeans: 500mg
- 1 cup Firm Tofu: 400mg
- 1 cup Tempeh: 400mg 

### Supplements for Vegans:  

- Try to obtain adequate ALA from chia seeds, flaxseeds, and walnuts
- Vegan DHA/EPA supplements are made from microalgae. 150-300mg supplements are a good choice. 
- Algal oil supplements
- The American Academy of Pediatrics recommends that pregnant and breast breastfeeding women consume 200-300 mg of DHA per day

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

---

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## FOOD FORTIFICATION: 

If a food is “fortified” that means that vitamins and/or minerals have been added to it. Food fortification began in the 1920’s to combat common nutritional deficiencies. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Nutrients Added to Fortified Foods in the United States 

- 1924 - __Iodine__ - Salt (to prevent goiter)
- 1933 - __Vitamin D__ - Milk (to prevent rickets)
- 1940 - __Thiamin, Niacin, Riboflavin, Iron__ - Wheat Flour
- 1945 - __Fluoride__ - Water supply (to decrease cavities)
- 1988 - __Folic Acid__ - Wheat flour, enriched cereal grain products, other products (to prevent neural tube defects in babies)

__Please consult with YOUR medical provider to determine if supplementation is appropriate for you or your child.__


Important Nutrients

Plant-based diets are rich in veggies, fruits, whole grains and legumes. They also eliminate any animal products (meat, eggs, dairy). 

### What are Whole Foods?

Whole foods are unrefined or unprocessed. They also do not contain any additives or preservatives. They are consumed as close to their natural state as possible. A good example of whole foods would be fresh fruits and vegetables.

In contrast, processed foods are refined, contain preservatives, and additives (such as food dyes). If it comes in a box or bag, it is likely processed. A grape would be a whole food, grape juice is a processed food. 

### Is a vegan diet dangerous for children?

A plant-based diet is not only safe, but it can also prevent many common chronic diseases. “It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence.” - American Dietetic Association (2009)

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

# Plant Based Diet Advantages:

- Plant-based diets tend to be high in Fiber, Complex Carbohydrates, Folic Acid, Vitamin C, Vitamin E, and Carotenoids
- Lower odds of obesity among vegetarian children and adults
- Vegetarians have lower rates of diabetes
- Decreased risk of constipation and acne

## Will they get enough protein?

Protein deficiencies are extremely rare and not something you need to worry about too much with healthy children. Surprisingly, children in America actually tend to consume too much protein. The WHO recommends that healthy children consume around 1 gram per day. Babies need a bit more. Even if your child has a plant-based diet, they will eat well above this. 

As long as you focus on a whole food diet, your child will be good to go. Broccoli actually derives 30% of its calories from protein! A diet full of fruits, vegetables, whole grains, beans, lentils, nuts, and seeds will provide everything your babe needs. Also remember that it doesn’t have to be all-or-nothing, placing less emphasis on meat, dairy, eggs, and processed foods is a good way to start. You can also have your toddler take a daily [multivitamin.](https://try.helloyumi.com/whole-food-vitamin/) 

For infants 0-6 months old, exclusive breastfeeding is recommended if possible. Breast milk only contains 1gram of protein for every 3 ounces, but this provides all the protein your little one needs. Our protein needs are not as high as people may think. 

## Vegan Sources of Protein:

- ½ cup tofu = 6g 
- 1 cup broccoli = 2.6g 
- 1 oz. hemp seeds = 10g 
- ½ cup black beans = 7.5g 
- 1 cup brussel sprouts = 3g
- ½ cup soy beans = 11g
- 1 cup spinach = 5g
- ½ cup quinoa = 4g
- 1 cup sun-dried tomatoes = 8g
- ½ cup oats = 5.5g 

## What about Calcium?

Calcium is not only found in dairy products. It is found in a variety of plant foods. The best vegan sources are greens (collard greens, turnip greens, kale, bok choy, mustard greens, and broccoli), tofu, fortified orange juice, fortified plant milks, beans, nuts, and seeds. 


Plant Based Diet Advantages

## The Five Pillars of Healthy Eating: 
These pillars are your guide on how to navigate healthy eating in this modern world. It introduces healthy habits that are sustainable and fulfilling. Conveniently, you can begin incorporating these pillars into your lifestyle immediately. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### The Goals of the Five Pillars: 
- __Promote Health & Wellbeing:__ Your family deserves health and happiness. This includes having more energy, strong immune systems, and fully experiencing and enjoying life. 
- __Foster Confidence:__ This means confidence in your food choices and yourself. Every single body is a good body. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 1. Honor Hunger & Satiety: 

Essentially, this means eating when hungry and stopping when satisfied. This is known as intuitive eating. Hunger is the body’s cue that it’s time to eat and should not be ignored. You should only stop eating when you feel sufficiently full and avoid overstuffing yourself.

To help children honor their hunger cues, don’t force the “clean plate club”. Trust your little one when they say they are full and allow them to eat when they are hungry. 

If you encourage your babe to eat intuitively, they will be more willing to try different foods. It may be scary at first, but trusting your child’s intuition will help them make better choices when they are older. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Emphasize Whole Plant Foods:

Whole plant foods are unprocessed fruits, vegetables, beans, grains, nuts, and seeds in their original form. They are full of nutrients, vitamins, fiber, and antioxidants. When these ingredients are refined, their fiber gets removed and sugar, salt, preservatives, or dyes can be added. The more whole foods you can add to your child’s diet, the better! 

__Easy meal ideas include:__

- Oatmeal with fruit
- Veggie wraps 
- Fruit salad
- Bean chili 
- Avocado toast
- Smoothies 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Establish Positive Environment: 

Your environment affects your success. As a parent, you can make sure your kitchen is stocked with healthy meals and snacks. Provide a variety of fruits, veggies, nuts, and seeds in accessible spots. Try to keep less healthy foods out of reach and sight. Some ideas include apples, bananas, applesauce, unsweetened peanut butter, and unsalted nuts. 

One of the most important things you can do for your little ones is to avoid dieting and encourage body positivity. Be cautious about the way you talk about your own body as well, especially in front of your children. Home should be a safe space where your tot is safe from body shaming and teasing. You should also monitor any media or popular culture they consume. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Be Flexible 

Try to follow the 80/20 rule. 80% of the time, strive to eat as healthy as possible. 20% of the time, incorporate the foods that you save for special occasions. 

Your diet should never feel like deprivation. There is a huge variety of healthy and delicious plant based foods. Explore different meals and find ones your family loves! If our healthy foods are bland and uninteresting, our children may not want to continue the lifestyle later on. 

But food also doesn’t have to be complex to be yummy. Apples and peanut butter, and hummus and carrots are easy, nourishing, and scrumptious. 

Don’t restrict your family during holidays and special occasions. There is no need to be a purist 24/7.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. Relax and Have Fun

Eating healthy shouldn’t be stressful. Remember to have fun and laugh at your mistakes. As parents, we do the best we can. 

If at first you don’t succeed, then try again. If your children hate the healthy meal you worked hard on, and won't eat anything but their potatoes, relax and regroup! Don’t focus too much on individual meals, but on your overall habits. 

Respect and cherish your body and model self confidence for your children. You will quickly see how the attitude of acceptance spreads to your whole family. 

__Easy Plant-Based Recipes:__

- [Red Risotto](https://helloyumi.com/blog/red-risotto/)
- [Mango & Squash Smoothie ](https://helloyumi.com/blog/mango-squash-smoothie/)
- [Great Greens Smoothie](https://helloyumi.com/blog/great-greens-smoothie-recipe/)
- [Banana Oat Pancakes](https://helloyumi.com/blog/banana-oat-pancakes/)
- [Split Pea Dip](https://helloyumi.com/blog/split-pea-dip/)
- [Instant Pot Veggie Stew](https://helloyumi.com/blog/instant-pot-veggie-stew/)
- [Cinnamon Blueberry Oatmeal](https://helloyumi.com/blog/cinnamon-blueberry-oatmeal/)


Raising Healthy Eaters

Considering all the questions around baby sleep, and the infinite number of opinions on each of them, it’s no surprise that a lot of misinformation gets out into the atmosphere. That misinformation also often becomes accepted as fact. Today, I’d like to set the record straight on a few of the most common misconceptions when it comes to baby’s sleep. Alleviating some of the most common concerns and questions from new parents in the process. 

__Sleep Expert, Dana Obleman, breaks down 6 BIG MYTHS about your baby’s sleep.__ (We hope this helps you sleep better as well.)

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Myth #1 - More awake time during the day means more sleep at night

Babies need sleep. I mean babies need a TON of sleep to compensate for all of the growth and development their bodies are doing. While you might be inclined to think that a really sleepy baby will sleep better at night, overtiredness actually stimulates cortisol production, which stimulates the fight/flight response, making it harder for baby to get to sleep and stay asleep at night. Sticking to a consistent nap schedule and making sure baby’s getting adequate nap time during the day helps to ensure a long, restful night’s sleep.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Myth #2- Babies aren’t supposed to sleep through the night

While it’s true that many babies will need at least one nighttime feed up until they’re around six months, that doesn’t mean that they’re supposed to wake up to feed every hour. More often than not, when a baby wakes up in the night, it’s because they’re coming to the end of a sleep cycle. If they fully wake up during that light stage of sleep, they might have a hard time getting back down on their own if they’re accustomed to being nursed, rocked, or fed to sleep. Breaking the dependency on those “sleep props” and helping baby learn to fall asleep independently will help them string those sleep cycles together. And don’t worry, if they wake up hungry, they’ll let you know.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Myth #3 - Babies can adapt to a flexible schedule

Even though babies can be pretty impressive with their ability to fall asleep in some loud and hectic environments, that doesn’t mean they’ll just fall asleep any time they’re tired. Babies sleep best when they’re on a consistent schedule, supported with a predictable, repetitive bedtime routine. Think of it the same way you would about feeding your baby. You organize your day around baby’s feeding schedule, so try to dedicate that same level of commitment to their sleep schedule as well. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Myth #4- A tired baby will just fall asleep

While it’s true that some babies can recognize when it’s time for bed, the majority will stay awake past their ideal nap or bedtime if there’s anything remotely interesting going on around them. Keeping an eye on baby’s sleep cues and sticking to a consistent schedule is the best way to prevent overtiredness.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Myth #5- Babies need a night light

Contrary to popular belief, babies are not scared of the dark. Up until around the age of 2 years, they haven’t developed the imagination to get themselves worked up about what kinds of things might be lurking in the dark corners of their bedroom. A dark bedroom, and I mean really dark, to the point where you can’t see your hand in front of your face, is a great way to encourage long, restful, uninterrupted sleep. My usual recommendation is not to introduce a nightlight until your toddler starts complaining that they’re afraid of the dark, and if you do intend to use one, make sure it’s warm in color. Blue light mimics sunlight which, in turn, stimulates cortisol production, which can keep baby from getting to sleep. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Myth #6- Teaching self-soothing skills can be harmful to your baby’s development

The topic of self-soothing has been the subject of a fair amount of controversy in the last few years, with some people even going so far as to say that it can be damaging to baby’s development, or that it affects the bond that babies have with their caregivers. 

While I’m always in favor of more research into the science behind infant and baby sleep, the current data shows absolutely no negative effects from teaching your baby the skills to fall asleep independently. It doesn’t harm your bond with each other, it doesn’t teach baby to suppress their crying, and it doesn’t cause any detrimental effects down the road. All it does is help you and your baby get the sleep you need. 

As a group, we parents are never going to agree on everything. Every parent on earth has at least a slightly different approach to parenting, but my hope is that we can all start with the most reliable scientific facts and data to make informed decisions as we develop our strategies. That is the foundation of being the best parents we can be.


6 Big Myths About Your Baby’s Sleep

# Do I Have Postpartum Depression?

“Is this normal?” is the most common question I receive from new parents. Let’s unpack that.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Matrescence

Matrescence is the psychological birth of a mother, similar to adolescence. This involves identity shifting as well as hormonal, emotional, and bodily changes. Therefore, the awkward metamorphosis you feel is normal. Even though matresence and Postpartum Depression (PPD) may have some overlapping symptoms, the symptoms are not clinically significant. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Baby Blues

Baby Blues are caused by the sudden change in hormones after birth, combined with the stress of caring for a new baby, sleep deprivation, and recovering from delivery. You might feel more tearful, irritable, overwhelmed, and emotionally fragile than usual. Generally, this will start a couple days after delivery, peak around week one, then taper off by week two on its own. Up to 80% of birthing people experience the Baby Blues. Since it affects the majority, that makes it pretty normal. However, if your symptoms do not go away after a few weeks or get worse, or if they appear after the first two weeks of giving birth, then you may be suffering from a Perinatal Mood & Anxiety Disorder (PMAD).

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Postpartum Depression (PPD)

Approximately 15% of women experience Postpartum Depression (PPD) following childbirth. It’s likely much more than this (especially with the pandemic) but it is grossly under-reported due to shame, denial, and/or fear of one’s baby being taken away. Percentages are even higher for women dealing with poverty and can be twice as high for teen parents. People of color are also more susceptible to PPD and are less likely to receive treatment. Ten percent of women experience depression in pregnancy. In fact, perinatal depression is the most common complication of childbearing. Symptoms differ for each individual but might include:

- Feelings of anger or irritability
- Lack of interest in the baby
- Appetite and sleep disturbance (more than expected with new baby; sometimes manifests as insomnia even when baby sleeps)
- Crying and sadness
- Feelings of guilt, shame, or hopelessness
- Loss of interest, joy, or pleasure in things you used to enjoy
- Possible thoughts of harming the baby or yourself

Although there may be some shared symptoms with Matrescense and the Baby Blues, what differentes PPD is the level of functioning. 

If you think you or someone you know is experiencing PPD, reach out to a healthcare provider as soon as possible. In addition, __[Postpartum Support International](https://www.postpartum.net/)__ will call you back within 24 hours to help connect you with resources in your area. There is also a __National Suicide Prevention Lifeline: 1-800-273-8255.__

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Postpartum Obsessive Compulsive Disorder (PP OCD) & Postpartum Psychosis (PPP)

If you are having intrusive thoughts, including images of hurting your children that are disturbing to you, then you may have Postpartum Obsessive Compulsive Disorder (PP OCD). A woman experiencing Postpartum Psychosis (PPP) experiences a break from reality. In her psychotic state, she believes she would be protecting the baby by harming it. Although PPP is rare, occurring in only .1-.2% of birthing people, it is a life-threatening emergency that warrants immediate medical attention to safeguard the life of both mother and infant. A postpartum psychotic episode should not be confused with other PMADs.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Treatment

If what you’re experiencing falls out of the range of normal and is not going away on its own, it is imperative that you receive support. It’s not only for you, but for your family as well. There is no need to suffer unnecessarily hoping symptoms will go away. PMADs are treatable and temporary.  Here are some suggestions that you might find supportive for your recovery:

- Contact your healthcare provider (e.g. OB-GYN, pediatrician, therapist) and get connected with a therapist who specializes in PMADs. Discuss the necessity of breastfeeding-safe medication (if you are feeding your baby from your body).
- Bolster your support system. Reach out to trusted friends and family, and/or if resources allow, hire someone to help with the baby and/or housekeeping.
- Find a group for new moms (such as [Life After Birth®](https://www.mollynourmand.com/life-after-birth)) for connection, community, and support.
- Prioritize sleep and rest.
- Go outside and get fresh air and sunlight daily, even if it’s just to get the mail.
- Keep a bottle of water near you and drink from it all day and night; refill when empty.
- Eat every few hours.
- Keep taking your prenatal vitamins.
- Go for daily walks (if your recovery allows).
- Seek out mind-body practice like yoga, meditation, and/or breathwork to help manage stress.

**Statistics and information on PMADs from [Postpartum Support International](https://www.postpartum.net/)*

Do I Have Postpartum Depression?

# Open Cups: Why 6+ Month Olds Should Use Them

The American Academy of Pediatrics (AAP) recommends that babies breast/bottle feed until 12 months. But did you know that you can introduce your baby as young as 6 months old to an open cup?

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What does “open cup” mean?

An open cup is simply a cup with no lid. It may be a little messy, but drinking out of an open cup is crucial for speech development and self feeding. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Why should you introduce your child to an open cup around 6 months of age (or when they start solids)?

Cup drinking requires a different swallow pattern than bottle feeding. It requires moving the tongue front to back, which is essential for eating solid foods and making certain speech sounds. 

Babies that use a bottle for an extended period (after 18 months old) or children that drink from hard spout cups may develop  a forward resting tongue position. This can result in improperly developed oral structures (such as the palate, jaw, and teeth) and may negatively impact speech sounds.  

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## How to teach open cup drinking:

- Start with 1-2 tablespoons of breastmilk, formula, or water.
- Place your hands over your baby’s hands on the cup.
- Help them guide the cup to their mouth and tilt it just enough so the liquid starts to touch their lips.
- Gently tip the cup enough until your baby is able to drink a small amount of the liquid.
- Guide your baby’s hands to show them how to set the cup down!

**As your baby gets older, they will be able to control the motion of drinking from the cup by themselves!*

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### What if my baby refuses to drink from the cup?

Try to keep the experience fun and positive!  If your baby gets frustrated or is uninterested, try again next mealtime!

### Which open cups should I use?

You can use any open cup. However, if you want a break-proof baby-safe cup, small silicone cups are easier to grip. Cups with side handles are also helpful for little hands. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Best Open Cups for Babies:

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

[![Green Sprouts Cup ](//images.ctfassets.net/vrwte4peyqq1/53wJuyMOhvsu5fAUi1OW1i/4e0b840939d2b274e681474d8c8a4088/green-sprouts.jpg)](https://greensproutsbaby.com/products/learning-cup-made-from-silicone?variant=34277521948803)

## 1. [Green Sprouts Learning Cup](https://greensproutsbaby.com/products/learning-cup-made-from-silicone?variant=34277521948803): 
- 100% food-safe, LFGB silicone cup with no harmful chemicals
- Two easy-grip handles
- Slip-resistant, wide base for stability
- Dishwasher & sterilizer safe

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

[![Tiny Cup](//images.ctfassets.net/vrwte4peyqq1/oRlS2YLagag9sSMD56OpC/f3f70d5a77ac4977052b4b1093932381/Tiny-Cup.jpg)](https://ezpzfun.com/products/tiny-cup)

## 2. [EZPZ Tiny Cup](https://ezpzfun.com/products/tiny-cup):
- Designed to fit baby’s mouth and hands
- Interior angle provides even flow for safe drinking
- Weighted base and tactile bumps provide topple resistance
- Heat and cold safe

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

[![Eztotz My First Cup](//images.ctfassets.net/vrwte4peyqq1/1AXtOoQGFFRubsNB0Z2Bi6/101c65fb2ccb05c664f0502f76bd4476/eztots.jpg)](https://eztotz.com/products/eztotz-my-first-cup-100-silicone-baby-toddler-cup-made-in-usa-tiny-open-cup)

## 3. [Eztotz My First Cup:](https://eztotz.com/products/eztotz-my-first-cup-100-silicone-baby-toddler-cup-made-in-usa-tiny-open-cup) 
- Made in the USA
- Soft Food Grade Silicone
- Dishwasher safe
- Weighted at the bottom to prevent spills
- Ridged design helps with grip

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

As parents, we understand that open cups are not always practical for little ones. If you cannot use an open cup, we recommend a straw cup. The swallow pattern used when drinking from a straw is similar to that of an open cup and helps promote a mature swallow pattern as well.  

Have you started cup drinking with your mini? Share your experience in the comments!

**Always refer to your pediatrician for medical needs and guidance!*


Open Cups: Why 6+ Month Olds Should Use Them 

How to Talk to Your Kids About War & Conflict 

### Remind Your Baby of Their Happy Place…the Womb!

Babies calm easily—and sleep best—when we give them an extra trimester, by lavishing them with womb-like rhythms. Babies are born with a special calming reflex that occurs when we precisely mimic the womb using the 5 S’s (swaddling, side/stomach position, shushing, swinging, and sucking).

__Safety Tip:__ The side position is only for calming your baby in your arms. Babies should always sleep on the back, the only safe position.

![50px space](//images.ctfassets.net/vrwte4peyqq1/3QVzFzxbghfK2iNfsNzzT4/cb8ca14940fe175daa6267f547206bd8/transparent-space.png)

## 1. Swaddle — Even If Your Baby Resists at First

Want your baby to sleep well at night and take nice, long naps? Then never skip out on swaddling. It prevents flailing of the arms—a top reason babies accidentally wake themselves. Some babies fight the swaddle at first, but don’t let this fool you into thinking they don’t like it. Swaddling reminds babies of the snug security of the womb. Once your wiggly worm is nicely wrapped, layer in the other S’s and she’ll soon be blissfully calm and ready to sleep.

__Safety Tip:__ Be sure your swaddle is hip-safe. Baby’s legs naturally are in a “frog” position. In the swaddle, your little one's legs should be able to bend up and out at the hips. Baby’s legs should not be tightly wrapped straight down and pressed together. This can increase their risk of hip dysplasia and dislocation. [Click here to view how to safely swaddle your baby. ](https://m.youtube.com/watch?v=QhBBqmuP5jg)

__Safety Tip:__ stop swaddling when your baby is attempting to, or can roll over. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. Side/stomach position

The back is the only safe position for sleeping. Therefore, only do this “S'' while holding your baby. Lay them on their side or stomach in your arms. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Shushing

Believe it or not, babies do not need (or like) to sleep in complete silence. Womb living is noisy, with the sound of a mother’s blood flow being louder than a vacuum cleaner. We recommend getting a sound machine to mimic the sounds they fell asleep to for the first 9 months. Avoid nature sounds or lullabies and just stick to good ol’ white noise. An [actual machine](https://www.potterybarnkids.com/m/products/marpac-dohm-elite-sound-machine/) will work better than an app, and don’t be afraid to turn it up to about shower level loud.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Swinging

While in utero, your baby gently rocked all day and night. They also jiggled around with every step you took. Continuous, rhythmic motion brings on sleep—think about how easy it is to doze off in a car, plane, or hammock. 

__Safety Tip:__ Doctors warn against using swings or rockers for sleep, because a baby’s heavy head can fall forward and cause suffocation. So, only rock your sleeping baby in your arms…or a smart sleeper, like [SNOO](https://www.happiestbaby.com/products/snoo-smart-bassinet?currency=USD&variant=29950972620&utm_medium=cpc&utm_source=google&utm_campaign=Google%20Shopping&utm_source=google&utm_campaign=&gclid=Cj0KCQiA8vSOBhCkARIsAGdp6RSSe3mnc2nHiZ3Kwg_Z-u9KgZw39ptrrwXq1W8ZSbFQfgUydfd7AnsaAhA2EALw_wcB), which provides safe motion on a flat surface.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 5. Sucking 

Giving your baby a pacifier is the “cherry on top” of the 5 S’s. Babies suck on their fingers in the womb because their hands are right next to their mouth. But once they are born, they don’t have the muscle coordination to get their digits near their lips. Therefore, many fussy babies are instantly soothed when given a binkie. 


Better Baby Sleep - The 5 S’s of Sleep with Dr. Harvey Karp

Why Babies Shouldn't Drink Juice

How to Prevent Picky Eaters

How Plant-Based Diets for Kids Can Still be Healthy

Rebecca is a L.A.-based International Board Certified Lactation Consultant. She provides in-home lactation support to new and expecting families. She also studied nutrition at New York University and California State University Northridge. At her practice, Best Milk LA, she fields all sorts of questions from new moms. Below are the top four she receives. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)
## 1. How often should my baby be eating?

During the early days, you’ll want to aim for 8-12 feedings per 24 hours. This breaks down to every 2-3 hours. If your baby shows early signs of hunger before that 2-3 hours mark, be sure to feed him/her on demand. One of the amazing things about breastfeeding is that a baby can’t overfeed at the breast. They simply stop feeding when they’re full.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. How do I know my baby is getting enough to eat, or that I’m making enough milk?

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)
Here are 5 ways to tell that you're making enough milk and your baby is getting enough:

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

1. Your baby nurses at least 8-12 times in 24 hours
2. You feed the baby at the first signs of hunger
3. Your baby is gaining weight
4. Your baby has wet and dirty diapers
5. Your baby seems satisfied at the end of a feeding

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. What are common signs of an infection and when should I see a doctor about breastfeeding problems?

Mastitis and Thrush are two of the most common infections women experience during the breastfeeding journey. If you experience a red wedge-shaped area on the breast, fever, flu-like aches, and/or shivers, you may have mastitis and should contact your doctor and lactation consultant. If you experience itchy or burning nipples that appear pink, red, shiny, or flaky, you may have thrush and should be seen by your doctor right away.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. When should I start pumping? 

It’s always best to wait at least 3-4 weeks to introduce pumping, unless of course there are breastfeeding issues that require a mother to pump before then, or if she has chosen to pump exclusively from the start. 

Waiting at least 3-4 weeks to start pumping helps ensure that a mother’s milk supply and the breastfeeding relationship have been fully established. Pumping earlier can be very overwhelming and lead to uncomfortable engorgement, oversupply, recurring plugged ducts and a bottle flow preference...issues you’ll definitely want to avoid. 

If you’re looking to store some extra milk *after* the first month of life without putting your body into oversupply mode, you can pump after the first morning breastfeed and send that milk straight to the freezer for your stash.

Lactation Pro Rebecca Agi Answers The 4 Questions She's Always Asked

A book that makes you feel more sane– instead of less– is worth its weight in gold. Shira Lenchewski, MS, RD, an L.A.-based dietitians and a national expert on nutrition, delivers that and a side of cauliflower popcorn with her new book, The Food Therapist. In a nutshell, it’s a guide to repairing your relationship with food to help you become more aware of your patterns and the psychological factors driving your behavior. It also provides some pragmatic advice– as well as delicious recipes– to set you up for success.

We’re a busy generation, whizzing from one task to another, and often multi-tasking as we grab our grub on the go. Unfortunately, that leaves little time to thoughtfully examine how and why we eat the way we do. As Shira points out in her book, our complex and often emotionally charged relationship with food has been shaped by a cauldron of personal, cultural, and societal factors that extend as far back as childhood. If you thought you were the only one to Yo-Yo between an extreme desire to eat a chocolate cake for comfort and the feeling of immense guilt after eating said chocolate cake, you are not alone.

The key, argues Shira, is to be honest with yourself. “Accepting our food-related fumbles without the typical shame spiral, allows us to identify and really get to work on overcoming the obstacles holding us back from making solid food choices consistently, day in and day out,” says Shira. Thus the goal is to be conscious about how we eat and remove guilt from the equation.

While the first half of the book gives you the emotional toolkit, the second half is focused on concrete day-to-day tactics. This includes what to pack in your pantry and a slew of mouth-watering recipes like roasted sesame-ginger Brussels sprouts and turmeric tahini sauce. The recipes are fairly simple, making them easy to put on repeat. There’s a lot to love here.

“The most reliable way to create the future you want is to first envision it and then work at it, a little bit at a time, every single day,” says Shira.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

[![food-therapist-book](//images.ctfassets.net/vrwte4peyqq1/1ZOZNEg82aWbp98XKq8CNK/00cb5a9faa6b3b967bcb890836af3371/food-therapist-book.jpg)](https://www.amazon.com/Food-Therapist-Intention-Indulge-Without/dp/1478918160/ref=sr_1_1?ie=UTF8&qid=1522079368&sr=8-1&keywords=the+food+therapist)

To purchase Shira’s book, The Food Therapist, [click here](https://www.amazon.com/Food-Therapist-Intention-Indulge-Without/dp/1478918160/ref=sr_1_1?ie=UTF8&qid=1522079368&sr=8-1&keywords=the+food+therapist).

The Food Therapist by Shira Lenchewski, MS, RD

It may be tempting to go on a drastic diet after your pregnancy to achieve that ever elusive, post-baby celebrity bod. Who hasn’t stared wide-eyed at some starlet who has miraculously snapped back to a size zero in 8 weeks flat? But, instead of limiting calories, you should be focused on filling your body with nutrition — lots of it.

In fact, I tell my clients their body needs 4,000 calories a day — yes, that is a 4 followed by 3 zeros — to make a good supply of breastmilk. Though initial reactions range from “you’ve got to be kidding me” to “how could I possibly consume THAT much,” you need that much food to give your body the raw material to make great breastmilk. Between breastfeeding and the physical marathon that is the first months of motherhood, your body is expending a lot of energy. The reality is after pregnancy you need to think even more about nutrition, despite the temptations to slip into your pre-baby diet.

(This message is especially important, given that many women have told me they estimate that 1,000 to 1,200 calories is all you need to get through the day. In contrast, many medical experts warn breastfeeding women to not dip below 1800 calories per day since it could kick start “starvation mode” and seriously hamper your ability to make milk)

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## How do you hit 4,000?

It’s actually not too hard to get 4,000 in the first 4 weeks. Your body is normally ravenous as breastfeeding and having a new baby at home is exhausting, and your household is still probably in celebration-mode, with family and friends often dropping off lots of good, fatty, calorie-laden food during those first several weeks. Around and after the 6-week mark, you need to really keep an eye on your intake. Most mamas want to start exercising again, lose that pouch, and maybe (MAYBE) even have sex again. So there’s a temptation to ease off the high fatty foods. The days go by fast as a new mum and before you know it, you’re not even eating a complete meal throughout the day, just snacking when you can in between feeding.  

But it doesn’t have to be hard to kick up your calorie intake.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What are the best foods for the 4,000?

Try oatmeal teaming with nuts and dried fruit, rice pudding made with coconut cream, one or two whole avocados every day, and lots of ghee/organic butter/coconut oil. If you don’t have a dairy allergy, amp up to full cream yoghurt and whole milk.

__Another tip:__ Soups, soups, soups. Warm and wet foods are your friends. Keeping things warm and easy to digest makes it easier for new moms to eat more. Eat more chocolate! Enjoy that high fat hot chocolate, add coconut oil to everything (it’s one of the best things for breastmilk due to the high amounts of lauric acid — I mean the coconut almost looks like a breast!).

Enjoy the healthy fats, savor that chocolate. There will always be time to worry about fitting into your old pair of jeans.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

If you focus on eating the right foods, it’s amazing how little you need in terms of extra supplements. New moms are often advised to double their DHA supplementation dosage, or even to take pre-natal supplements for one year after giving birth, but if you’re increasing your fat and caloric intake with wholesome, rich foods, you really don’t need the supplements.

Why This Doula Tells Her Clients to Eat 4,000 Calories

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 1. Keep Healthy on Hand

Make breakfast and lunch extra nutritious, with lots of veggies, protein, and healthy fats. If there is to be a huge family feast, be sure to have healthy balanced food on hand for your littles. The timing of family meals can be difficult for little ones. If the meal begins at 2 pm, but your baby is on a 12pm lunch schedule, make sure there are healthy snack options available.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 2. DIYSS: Do it Your Sweet Self

Make your own sweets! Homemade treats can still be fun, delicious, and sweet. Baking at home avoids the additives, processed oils, and excess sugars found in processed desserts. You can involve the kids in the baking process as well ([try my chocolate peanut butter bon bons](https://www.youtube.com/watch?v=6bAzoMCZmBo)).

In addition to sweets, make some festive savory foods. A quick google search will give you plenty of ideas for pumpkin fries, pumpkin hummus, and more! 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 3. Get Moving

Prior to sitting down for a big meal, try to find time to be active. There’s a reason pre-turkey football games are popular amongst adults. Engage your tot in some afternoon snow play or a living room dance party. The more they move, the better they will feel post-meal. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## 4. Set Boundaries

Thanksgiving ends on Thanksgiving. Same with other seasonal holidays. Your children need boundaries in real life, and the same is true for pre-and-post holiday gatherings. Delicious, nutritious leftovers are wonderful, but there’s no need to have Pumpkin Pie with whipped cream for breakfast.

A Nutritionist's 5 Tips for Avoiding Overly Sugary Holidays

## How long have you been working in this field? 

I have been officially working in maternal health and infant wellness since 2010. I completed the DONA doula training with Ana Paula Markel at BINI Birth. Prior to that, I was exposed to babies, birth, midwifery care, and doulas in 2008, when I worked at the Prenatal Yoga Center in New York City. I worked at the front desk doing administrative work (I was an undergrad student at the time) and it was then that I knew I wanted to work in this field.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What led you to becoming a midwife? 

After completing my doula training, I volunteered at a midwife’s birth center doing administrative work. I was able to sit in on prenatal visits and observe births. Eventually, the midwife told me, “You are meant to do this and you should.” That instilled a lot of confidence in me and encouraged me to go back to school.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What is a common misconception people have about midwives and out-of-hospital births?  

The biggest misconception is about the care that is provided. Most people think midwives are only present during the birth, with towels in hand and nothing else. They often confuse the role of a doula with a midwife. 

A doula is trained to provide emotional and physical support during labor. Their purpose is to help women have a safe, memorable, and empowering birthing experience. They do not perform any medical procedures.

Midwives are licensed medical health care professionals. They are trained and certified to care for and manage low-risk, healthy women during the childbearing year. During the pregnancy, they perform lab work and monitor the baby’s growth and development. They also discuss nutrition, exercise, and stress with the mother. During labor, midwives monitor the baby’s heart rate with a hand-held ultrasound device. They carry medical supplies and medications (IV antibiotics, DeLee suction traps, Amnio-hook, anti-hemorrhagic medications, oxygen tank, suturing materials, Erythromycin, Vitamin K, etc.) for both the mother and baby. Essentially, the midwife carries a mini-clinic in her birth bags.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## In your experience, how common is hospital transfer? 

The national statistic is that 1 in 4 first-time mothers transfer to the hospital. In my experience, it depends on the volume of clientele. I have seen as low as a 7% transfer rate and up to 25%.

However, most of those transfers are non-urgent. They are usually due to maternal exhaustion, need for pain relief, or augmentation of the labor. Both the mother and baby are stable, but intervention is needed (i.e. an epidural). Less than 1% of transfers are true emergencies.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What is the most difficult part of the job? 

The most difficult part is being on call. While the work is extremely fulfilling, you can appear flaky and unreliable to loved ones. There are dinners, celebrations, shows, movies, and gatherings that have to miss because someone is in labor. This can put a strain on personal relationships.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What is the most rewarding part of the job?

Seeing the transformation in a woman’s sense of power and confidence after giving birth. There is so much shock, awe, joy, tears, sweat — it’s a beautiful thing to witness and the greatest high in the world. That sense of accomplishment often has a positive impact on her approach to breastfeeding and bonding. Knowing I was there to help her navigate that journey is such an honor.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What is one of the greatest lessons you’ve learned in this field?

Birth teaches you to be humble and present. It forces you to have intentions but not expectations. It teaches you that it’s not about the setting, the care provider, or the mother. There are so many other factors that are at play. As one of my clients, Sarah, so beautifully put it, birth is ‘so dark and so light and all of it sacred’.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What advice would you give a new mother who wants to have an unmedicated birth? 

Watch birth videos and read positive birth stories. Get to know laboring women’s behaviors and sounds. The more they know about it, the less fear they will have experiencing it. People often say, ‘Women have been giving birth naturally since the beginning of time, so why can’t I do it?’ My response is that those women used to see birth all the time. It was normal. Today, we only see birth in movies, and it is always depicted as a horrific event. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## What are some of the basic health, diet, and lifestyle recommendations you give your clients?

Imagine yourself training for a marathon. You would never show up to the start line having spent the last few months eating loads of sugar and not exercising. One has to train physically and mentally.

Eat a high-protein and low-carb diet. This will help control blood sugars, satisfy pregnancy cravings, and prevent excessive weight gain (which leads to more complications during and after the birth). 

Exercise regularly. Aim for walking 3-6 miles/day or doing an hour of cardio. This allows the baby to find the best position in the mother’s pelvis and prepares the mother for the endurance she will need for labor and birth (which can be up to 12-24 hours long). 

Decrease stress. When there is a constant stream of stress hormones coursing through the mother’s body, this increases the risk of complications for both her and the baby. Have a daily practice of deep breathing, centering/meditating, yoga, and talking to the baby. This naturally lowers your blood pressure, pulse, breathing rate and allows the body to recover from a constant state of being in the ‘fight or flight’ mode. 

Bodywork in the form of chiropractic care and acupuncture are key in preventing and/or treating aches, pains, and other issues. Lastly, take a great childbirth preparation series. Knowledge is power!

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

## Do you have a self-care routine?

I try to eat well and go for a walk every day. I take a lot of supplements: Chinese herbs, probiotics, omegas, vitamin D, vitamin B complex, and ginkgo bilboa. I also drink a lot of wellness shots (turmeric, lemon, garlic, cayenne). I see a chiropractor weekly, not because anything is wrong but just as preventative care. Every other week, I see a therapist to touch base emotionally. Periodically, I will do some journaling, coloring, or water coloring. You can’t beat a good Korean spa day or at-home facial steam and mask. I try to practice what I preach.

A Licensed Midwife on the Transformative Power of Birth

Lily is the health coach and chef behind @cleanfooddirtycity and author of Good Clean Food. Whether she’s making Sweet Potato Toast topped with a Sunny-Side Up Egg or Adaptogenic Lattes, she always finds ways to inspire thousands of people to eat healthier (and prettier) every single day.

Born in Santa Monica, California, Lily now resides in New York City, which serves as inspiration for her blog, Clean Food, Dirty City. Years back, Lily found herself plagued by chronic migraines and vertigo, which led her to make a shift in the way she ate. She started focusing more on health and began a gluten-free lifestyle. She became a Certified Holistic Health Coach and started studying modern functional medicine. Clean Food, Dirty City was born.

The popularity of her blog and Instagram grew quickly— her Instagram has over 100,000 loyal followers. These days, in addition to creating extraordinarily delicious food for her Instagram and promoting her cookbook, you’ll find Lily designing the menu for Clean Market, her new restaurant opening in New York City. Further proof that she’s a true wonder-woman, in and out of the kitchen.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### How do you help new parents get back on track with their own nutrition? What do you tell them? What tips do they tend to find most helpful?

I believe the most important thing is tuning in and listening to your body. Everyone is unique in what their needs are at any point in their life and the nutrition that suits them at that specific moment. In terms of hacks, it’s always good to invest in a stocked pantry for last minute snacks and meals.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### About that pantry— what are the absolute must-haves? 

Olive oil, lemons, avocado, a grain, a bean, coconut water, frozen fruit, gluten-free sourdough, sauerkraut, and tahini.

In terms of snacks to keep on hand, I love seedy crackers, sprouted hummus, apples, almond butter, goat or sheep cheese, smoothie, and matcha latte ingredients.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### What unique ingredient are you experimenting with and/or learning more about right now?

I’m designing the menu for my shop, Clean Market,  right now and experimenting with lots of different adaptogens for our signature latte program. I’m also playing with crispy yucca bread, which is delicious. Stay tuned for the results!

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Design your perfect day of eating for the postpartum mom, who needs a lil’ extra nourishing. 

I always focus on super nourishing foods during my monthly cycle, which would also apply to the postpartum mom. I recently shared these paleo tartines on my blog and they are one of my favorite ways to start the day. I like to enjoy them with some avocado on the side for the perfect balance of protein, healthy fats, and greens.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### When it comes to self care, what is one nutrition strategy and one non-nutrition strategy you practice each week?

Definitely a solid, blood-sugar balancing breakfast like the above. I’m also a huge fan of bone broth and enjoy a cup first thing in the AM with some soft scrambled eggs and avocado.

Beyond nutrition, I aim for 30 minutes of movement a day, even if it’s simply a walk around the block.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### What’s your go-to, on-the-go snack?

Seedy crackers and sprouted hummus or a Health-Ade Kombucha and dried mango and nuts.

For many, detox = deprivation. Why is it important to change that association, and how do you go about changing that?

Your body already has an amazing system in place that detoxifies. Deprivation will only stress your system and leave you feeling worse. For me, detox mode means nourishing my body with real, whole foods that are easily digestible (and lightening up on indulgences like sugars and alcohols that can be taxing on our system).

This means lots of leafy greens, whole grains, lean proteins, cooked vegetables, blended soups, and lots of water! I have a whole section in my book devoted to “detox” and it’s filled with a lot of recipes you may not typically classify as “detox” like my mom’s minestrone, a squash + sprouts salad, and the best guac.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Tell us all about Clean Market! 

I’m excited to share! Clean Market is a space that encompasses innovative wellness services (IV drips, infrared saunas, and cryotherapy), a functional tonic bar and cafe, along with a modern apothecary market.

We hope you come in, enjoy a sweat in the sauna, sip on a tonic, and then recreate the experience at home with some magnesium bath salts or the adaptogenic blends we use in the café. We’re on a mission to connect our community with products and services that elevate their health and overall wellbeing. 

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### What’s your favorite “Comfort” recipe?

The “Nourish” chapter is the ‘comfort’ chapter in my cookbook, Good Clean Food, and it’s filled with so many good recipes like blueberry buckwheat pancakes, zucchini lasagna, and spaghetti squash and mushroom meatballs. I’m a big fan of the sesame noodle bowls with pan-fried tofu.

![20px-space](//images.ctfassets.net/vrwte4peyqq1/3U2pLqHthKu2RgFjYzpWui/a313b5daf52bda69ac08caabb4b077cf/20px-space.png)

### Now what is the best guilty pleasure food?

Crispy French fries with a perfect aioli.


Nutritionist Lily Kunin on Pantry Must Haves & Food Hacks

## Gut Health is Overall Health

The journey to a healthy gut microbiome starts the day a baby is born. As soon as they start breathing, touching, crawling, and eating, they’re bringing all sorts of good (and bad) microorganisms into their body. A gut microbiome that’s filled with good bacteria encourages neurological development and tightens the gut lining, which increases nutrient absorption. It also strengthens immunity – 70% of the immune system exists in the gut. 

An imbalanced gut leaves the door wide open for digestive issues, chronic illness, infection and obesity. It can also lead to common childhood issues like eczema, food intolerances, diarrhea, and colic. When the body starts relying on medicine to treat these problems, the gap between healthy bacteria and bad bacteria widens. 

Studies also show that poor gut health is linked to poor attention span in children. Sick of telling your kids to finish their dinner before tv time? Maybe it’s got something to do with the gut.

## Probiotics and Kids 

So how do you keep your child’s gut microbiome full of good bacteria? One word: Probiotics. Probiotics are beneficial, live yeast and bacteria that naturally exist in the body, and they’re your go-to ticket to gut health.

Foods like kimchi, sauerkraut, and kombucha are naturally probiotic-rich…. But not exactly a kid’s idea of a “snack.” Probiotic supplements, like Jettie, are foolproof ways to get diverse, clinically studied bacteria to the gut.

### C-Section and Formula-Fed Babies are at Risk

Your baby’s intro to bacteria is at birth. Babies delivered vaginally get bacteria from the vaginal canal, which is similar to the mother’s gut microbiome. C-section babies miss this diverse, beneficial dose of bacteria, and instead get whatever exists in the sterile hospital (which isn’t much). Sterile is great for a safe delivery, but not for a newborn gut. 

When it comes to formula vs. breastfeeding – we’re not going to tell you what you should do. But the fact is, if you’re opting for formula, your little one is more susceptible to catching a cold. A recent study compared breastfed babies to formula-fed babies and this is what it found:⁠

- 75% of the babies who got sick were fed formula, as compared to the 25% of those breastfed ⁠
- Of the 28% of babies who didn’t get sick, 86% were breastfed and only 14% were formula-fed⁠⁠
- This is the silver lining: 70% of the immune system lives in the gut, which means poor gut diversity is going to have a direct impact on how often your baby gets sick. Jettie probiotics give your c-section or formula-fed baby the bacterial diversity they’re missing.

These days, you can walk down any supplement aisle and find more probiotic brands than you can count. For Jettie, probiotics are personal. Jettie was created by Kiley Taslitz-Anderson, mother of two boys, both delivered by c-section. When they were born, she knew they needed a probiotic to provide the good bacteria they didn’t receive from vaginal birth, but she wasn’t satisfied with the existing brands. 

Jettie is the only existing seasonal probiotic – which is a non-negotiable because exposing the gut to a rotation of probiotic strains is the only way to achieve optimal gut health. Otherwise, the gut gets bored of seeing the same thing day in and day out, and stops doing its job (sound familiar?) If you’re going to give them a probiotic, you should be positive that it’s working. With Jettie, you’ll never have to wonder. Not only are Jettie’s strains diverse, each one has published studies that point to real results – from reducing sick time, to helping with food sensitivities to decreasing colic.

Life as a parent is chaotic – but using Jettie is simple. Like Yumi, Jettie delivers to your door, and all you have to do is mix a small packet of flavorless powder into your child’s drink. Right now, you can __get 35% OFF your first month of Jettie probiotics with code JETTIE4YUMI.__ Next? Sit back and watch them reap the benefits of a healthy, balanced gut.

Why Your Baby Should Be Taking Probiotics

Babies in utero develop their ability to hear at 32 weeks. Therefore, their capacity to recognize vocal tones and melodies is established before they take their first breath of air. For this reason, I recommend my clients start playing music and singing to their babies in utero. The comforting familiarity of songs becomes a great tool for parents to use to connect with their newborn. Never underestimate the power of a good song! Working with babies as a postpartum doula I have learned to always have a good playlist on hand. Sometimes a tune is all it takes to soothe a crying babe and send them into a slumber. Here is a list of songs that you and your baby will enjoy.

You can also listen to this playlist on Spotify, by [clicking here.](https://open.spotify.com/playlist/5DkkExmVuE7GoCxLwxKhJU)
1. Penguin – Michael Hurley
2. Get Happy – Whispertown
3. Mama You Sweet – Lucinda Williams
4. Lopin’ Along Thru the Cosmos – Judee Sill
5. I’ll Be Here in the Morning – Townes Van Zandt
6. Can’t Stop Cryin’– Whispertown
7. The Moons Detriment – Shannon Lay
8. Here Comes the Sun – The Beatles
9. Who Knows Where the Time Goes – Fairport Convention
10. Beautiful Boy (Darling Boy) – John Lennon
11. From the Morning – Nick Drake
12. Razor Love – Neil Young
13. You are Your Mother’s Child – Conor Oberst
14. Blue Moon – Big Star

*__About Carson Meyer:__ Carson Meyer is a DONA certified Birth Doula from Malibu, California. She attended New York University’s Gallatin School of Individualized Study where she pursued studies in child development, art therapy and alternative medicine. In 2016 Carson returned to Los Angeles and began her journey as a doula with training from BiniBirth founder and DONA President, Ana Paula Markel. She works closely with mentor Lori Bregman and is a member of the Loom Community. Carson is passionate about supporting parents through a healthy and peaceful pregnancy, birth and postpartum period in the environment that best suits their needs.*

The 1000

by

YEAR 0

MOST POPULAR

The 1000

by

The 1000

Year 1

0-4 Months

5 Months

6 Months

7 Months

8 Months

9 Months

10 Months

11 Months

12 Months

Year 2

Year 3+

Heavy Metals

Subscribe

From our Nerd Council

Year One

Year 3+

Our Podcast

Year 3+