As a new mom, I am struggling to make time for myself, help! 

Creating personal time for yourself as a mama is both challenging and necessary. Just the fact that you know you need it and are reaching out for support tells me that you are committed to caring for yourself! 
You might find this interview helpful:
Watch this video of Savannah Mayfield, Personal Coachas she shares about the importance of self-care for moms and shares some tips for creating the time.

Savannah Mayfield, CEC
http://www.nurturelifecoaching.com

I am pregnant and have recently learned that I have many risk factors for postpartum depression or anxiety (i.e. I am over 35, have a history of depression in my family, am isolated from extended family, and have had problems conceiving and had to use fertility assistance). What steps can I take to reduce the chance that I will suffer with this?

It is a great idea to take steps now to help prevent perinatal mood disorder both during your pregnancy and after you deliver your baby. In the US it is estimated that 10-30% of women experience mood disorders during pregnancy and after birth.  Here are some measures that many mothers say are helpful:

Set up some support for yourself as you transition into early motherhood. This can be the contact information of a great lactation consultant, a free mom’s group at your local hospital, a nurturing postpartum doula, a housekeeper coming a couple times per month, a relative or neighbor checking in on you regularly and bringing meals, or a therapist who specializes in pregnancy and postpartum issues
Having support lined up before you need it makes it easier to utilize the resources when or if you do need help.  You might ask for meals as a shower gift to reduce the stress of those often fussy evening hours when everything hits the fan (and dinner gets neglected). If friends or family offer to help, say yes and think about what you need most.  It might be walking your dog, making you lunch, mowing the yard so you can enjoy sitting in outside.
If you don’t have volunteer helpers, gather names of businesses that attend to the things you very likely will not have time to do in the early months but that are very important to you. Think of the tasks you used to do in your home hours and remember that you will not be available for many of them during early postpartum, so prepare to let go of them or fill in the gaps with other services or friends.
You will also benefit by having attentive care providers that listen to your needs and are watching for signs of any mood disorders. If you do not have full trust in the nurturing care of your healthcare provider, research options, and consider alternative care providers such as acupuncturists or naturopaths that often offer longer visits and give very attentive care with their many healing modalities.

Identify activities that nurture your soul and make time for them during your pregnancy and after the baby arrives.  Whether it is yoga or another fitness class, playing an instrument or dancing, reading great books, or engaging in a creative passion, set aside the time to pursue something that replenishes you. This might mean asking your partner to help you create the time or making childcare arrangements. Making time for yourself in this way provides an outlet for you to care for yourself and maintain a sense of yourself in the midst of the transition to motherhood.  There will be days or weeks when pregnancy, childbirth and caring for a new infant make it difficult or impossible to do what you love, but remind yourself that you will get back to it soon and look for opportunities to do so.

Consider joining a mommy group where you can be free to discuss new mommy trials and joys with others who are thinking and feeling the same things. Most of the hospital systems and birth centers now have free or low cost mama and baby groups, and there are many other groups that offer them as well. You can find a great list at http://www.metro-parent.com, or ask around for feedback on groups that others like. There is nothing like being able to ask a question about baby poop or spit up with other moms who aren’t sleeping much or interested in sex with their partners either!  If you would like to talk with other mamas who have experienced perinatal mood disorders, consider checking out http://www.babybluesconnection.org and getting involved with their wonderful group of moms and well-trained volunteers. Baby Blues provides a safe place for moms to share strategies to cope with really hard days and the intense rollercoaster of feelings that can come during pregnancy and postpartum.

You can also take steps to stay connected to your partner, which takes more planning once children arrive! Set aside time to do things you enjoy together and communicate about your experiences of the pregnancy and your ideas about parenting and sharing household chores and care of your child. Pregnant moms can feel alone in the experience of pregnancy when their partner does not connect with the intense changes pregnancy brings in their body and psyche.  Each of you will experience the transition differently and it is important to stay in touch and communicate your needs.  The research is clear that our satisfaction with our partner typically goes down in the first year of our child’s life (over 67% in one study) as the demands of caring for a new infant become real.  Plan ways to reconnect now, some that involve the baby, and some that are just for the two of you. Reassuring each other of your love and recognizing the challenges you are facing in making this transition can reduce feelings of missing each other. If you and your partner have difficulties communicating, this is a good time to visit a couples’ counselor, take a couple’s communication class (offered by local hospitals and health plans), or read a book for couples with exercises to strengthen communication.  The addition of a baby increases stressors and makes it more difficult to schedule time away, so working out problems before the baby comes can ease the transition for everyone. 

When you are far from your extended family, it is helpful to create your own support system in your neighborhood. Raising a baby takes the support of a whole community so that everyone can thrive. Start setting up this community now by getting to know neighbors and co-workers with children of similar ages.  There are many resources in Portland for new families and momma web sites like urbanmamas.com can provide helpful information to help mothers connect.  (There is a reason PDX keeps getting voted the #1 city to have a baby!)

Remember that just because a chart says you are in a risk category does not mean you will have a perinatal mood disorder and by taking the steps to insure that you have the support and information you need, you are doing what you can to lessen some of the common challenges new mamas face. And we at MotherSource.org applaud your efforts to be the best mama you can be!

Kimberly Bepler of ABC Doula Service
with editorial support from Laurie Cox and Gaby Donnell of Motheroots Counseling

I am 20 weeks 4 days pregnant. I am scheduled for further testing due to blood test coming back abnormal. The test were to test for Down Syndrome.  We will have the ultrasound and further blood work and possibly an amnio. How accurate is the blood test? I was 20 weeks when tested. Any advise is appreciated.

Follow up response:

Ms. Mayfield,

You were correct about the false-positve results. It is a shame that news is given in manners it is at times. Everything worked out fine for us. There really should be more information out there for mothers and fathers faced with the same results. These parents should also not be made to feel quilty over starting a family at a mature age. Thank you for your help! I really appreciate it.

Preliminary Answer:

I can only imagine how worried you must feel right now as you make some important choices about the health of your baby. Thank you for reaching out to us with your question about testing. I have posed your question to a Midwife and will get back to you with the answer.  Just remember that while tests can show possibilities for abnormality, many times false positives come back. I have heard countless stories from mothers of scary test results that end up being benign.
Continue to do your research, stay positive and reach out for support. I hope you have some good friends with whom to share your concerns and fears.

In support,
Savannah Mayfield
Editor of Mothersource.org

Answer from Guest Expert:

The quad marker screen can be offered to pregnant women between 15 and 18 weeks from their last menstrual period. It can be done as late as 22 weeks, but the level of accuracy falls after 18 weeks .This test is done by taking a sample of mom’s blood and measuring the amount of four different substances that pass from the baby’s blood into the mother’s blood. They also look at age, weight, race, and other factors and use a mathmatecal calculation to give parents a risk ratio like 1/1000. Of the mothers who take this test, 5-7% will have an abnormal result for Down Syndrome (trisomy 21). Of these abnormal results only 1-2% of babies actually have Down Syndrome.

The key point to remember is that the quad marker screen has a very high rate of false positives cause by many factors, the most common of which being an incorrect gestational age at the time of calculation. Very few babies end up being diagnosed with trisomy 21, 18, or an open neural tube defect after further testing has been completed. If you get an abnormal result you will be offered an amnio and or a targeted ultrasound to diagnose a problem. I hope this is helpful!

Renee Beninger, CNM

I use cloth diapers but would like to use cloth wipes as well. How do you make them and keep them from getting moldy? 

It’s so easy! Here’s how we did it!

Needs:
Water resistant container (sealing)
Wipes (can be flannel squares, thin infant wash cloths, we’ve even used washed “disposable” wipes!)
Jug of distilled water (plain tap water doesn’t cut it…eventually gets moldy…trust me)
Tea tree oil (antibacterial properties…nice!)
Lavender essential oil (mmmm…pretty…)

Place the wipes in whichever container you will use for storing. In a separate container mix the distilled water with the oils (a few drops to each cup of water you will be using). Pour over your wipes and you are set! You can even take some in a resealable plastic bag for trips away from home. This has worked well for us, and we use the container that some disposable wipes came in. Thin washcloths fold up nicely into it and our wipe solution just needs two cups of water.
Jennifer Fuentes
http://www.milagrosboutique.com

I am traveling with my ten-month old infant across country in a few weeks and am nervous about the flight. Anything you can share with me about making it easier? 

As a prenatal/postpartum yoga teacher and childbirth educator, one of my favorite aspects of my work is the opportunity to connect mamas to the wonderful wisdom and resources we have available to us.  Recently I was fortunate enough to have one of my birthing workshop attendees create the following list, outlining several hints and tips with regard to traveling with little ones.  (It has been slightly condensed from the original).  Amy Jackson is an experienced flight attendant in addition to being a fantastic and creative mama—thanks Amy!

1. “Lap Child” or paid seat?
Most airlines will allow a parent to carry children under 24 months without having to purchase a separate seat. Please keep in mind that it is ALWAYS safer for your child to travel in an approved restraint device (car seat). However, cost is certainly a factor, so here is a tip: Bring your car seat with you to the airport. If there is space on the flight, airlines will almost always allow you to use one of the vacant seats for your infant seat free of charge. If it turns out the plane is full, you can always gate check your seat at the last minute. The Customer Service Agent at the boarding gate can help you with this.

Explaining your situation and asking politely will go a long way when dealing with airline employees. Especially since most of the customer interaction they get is from unhappy passengers. The best way to guarantee that you won’t get accommodated is to be rude and demanding – this goes for dealing with Flight Attendants as well. I can guarantee you there is not a Flight Attendant out there who wants to worry about an unsecured infant during an emergency landing – so if we can help you out, rest assured we will do so!

If it turns out that there is an available seat, chances are it is not next to you. There is something you can do about this if you are traveling on a larger aircraft. When you book your seats (most websites will allow you to do this, or you can request it at check-in) select an aisle and a window seat with an empty middle seat - of course, this only works if you are traveling with another person. Middle seats are the last to get booked, so odds are the middle seat will either be empty, or occupied by a solo traveler. Solo travelers are much more likely to move when asked than someone traveling with a larger party. Plus, who wants to be “stuck” between two parents with a small child? If you need to ask someone to move, get a Flight Attendant to help facilitate. That way, you don’t accidentally start a chain reaction of people seated in the wrong place, which may delay the flight.

One last thing, there is only one lap child permitted per adult, so you won’t be able to travel with two lap children (twins, close siblings) by yourself unless at least one of them is in a car seat.

Approved Child Restraint Devices
The CRS (Child Restraint System) must bear two labels, although typically the text for these two required labels is merged onto one label. The labeling must include the text “This child restraint system conforms to all applicable Federal Motor Vehicle Safety Standards” and “THIS RESTRAINT IS CERTIFIED FOR USE IN MOTOR VEHICLES AND AIRCRAFT”, in red lettering.

It is imperative that your infant/child seat is FAA approved for use in aircraft. If it is not, or the sticker (printed in red) is partially torn off or missing, you will not be able to use the seat on the aircraft. Nearly all infant seats are approved. It is helpful if you know where the sticker is on your seat so that you can direct the Flight Attendant right to it. He or she is required by law to check for the label before allowing the seat on board.

2. Installing your seat on the aircraft
Your infant seat should be positioned on the aircraft as it would be in your car - rear facing for smaller infants and forward facing for larger infants. Regulations require that the seat is secured next to a window. It is not allowed in the center seat or in an aisle (to prevent possible obstruction during an evacuation).

If you have a seat that can be used without a base, select that option when traveling by air. It can be difficult to remove the base once you have arrived at your destination because of the difference between airplane and automotive seatbelts – there often is not enough room to get your fingers under the base to release the seatbelt by pulling up on the metal flap if it has been tightened appropriately. If your seat requires the use of the base, by all means use it, but plan for a little hassle when you get ready to deplane.

If you are using an infant seat (even if you didn’t pay for the child’s ticket) it is required for the baby to be placed in the seat and buckled in for taxi, take-off, landing and whenever the seatbelt sign is illuminated. This means you cannot hold/nurse your baby during these phases of flight. The Flight Attendants may choose not to notice that you are holding your baby during cruise when the seatbelt sign is on, unless there is turbulence, but the take-off and landing rule should be strictly adhered to. Eighty-five percent of aircraft accidents happen during these phases of flight, often with no warning, so the rule is for your child’s safety.

3. Unapproved devices
Many booster seats are NOT approved for use on aircraft. Check for a label before you haul it through airport security. This will save you a lot of headache! There will usually be a label that states the seat is not approved for use on aircraft, so read carefully. Only seats with an independent harness system (not relying on the aircraft seatbelt to secure the child to the device) are approved.

You may not secure your child in a sling, front carrier, or any other type of device that binds your child to your body for taxi, take-off or landing. It is also NEVER safe to secure yourself and your child using the same seatbelt. In the event of a crash, or even a short stop or hard landing, your body weight would be thrown against your child, possibly causing severe internal injuries. Belly belts and vest harnesses are also prohibited.

4. Ear pain on take-off and/or landing
Hopefully, your baby will be in her car seat during take-off and landing. This is the safest spot, but it means you can’t nurse during these phases of flight. Keep a pacifier handy, or if you aren’t using pacifiers, make a paste with a little sugar and water (or spit J) and put it on your baby’s lower lip. This will encourage her to suck and hopefully allow her ears to equalize without pain. You can always ask a Flight Attendant for a sugar packet if you don’t have one. Any kind of sweet/sticky substance would have the same effect.

5. Airsickness
You won’t often know if your child will be airsick until you fly. Always assume that he will be and pack accordingly.  Parents often forget to pack a change of clothes for themselves in their carry-on bag, but doing so (even just a spare shirt) can save you a lot of grief later. Having lots of wipes with you can also be a big asset in this situation.

Don’t hesitate to use your call button and ask for help – even if it is just to request a garbage bag to but soiled wipes and napkins in. Flight Attendants are trained to don gloves whenever they assist in cleaning up body fluids, so don’t be offended when he/she puts on a pair. At many carriers, it is the Flight Attendants who are responsible for cleaning the aircraft between flights, so however yucky and embarrassing it seems, you are doing them a favor by helping dispose of the mess properly instead of hiding the evidence in a seat pocket.

6. In-flight entertainment
Bring a few toys with you for the flight. It is extra helpful to mix old favorites with toys that are new to the child and more likely to grab their attention. For the sanity of yourself and your fellow passengers, please don’t bring toys that make loud or incessant noises. In a pinch, unused airsick bags make great hand puppets.

Above all, check your seating area carefully when you land. You don’t want to create a crisis later because a favorite toy or security blanket was left on board the aircraft.

7. Changing baby / using the lavatory
Very few aircraft lavatories have changing tables, but some do, so be sure and ask or check it out for yourself. Often Flight Attendants can direct you to the best spot on the aircraft to use for changing (there is almost always a better spot than at your seat). Don’t use the airplane blankets for a changing pad – they are used on many, many flights and rarely (if ever!) washed.

For older kids, don’t ever let them go to the lavatory without their shoes on. That nastiness on the floor is NOT all water, despite what we would like to believe.

8. Snacks and meals
Be sure to bring your own snacks on the plane. It is basically a given that anything you get on the flight (if anything) will be unhealthy. Don’t be shy about asking a Flight Attendant to cut your child’s apple juice with water or to ask for warm water to mix formula with. Depending on the Flight Attendant’s experience with children, you may have to be very specific about the water. Asking for a quarter cup of hot water for “tea” and then topping off with regular bottled water should do the trick. I would advise you to just get the water and mix the formula yourself – that way you don’t waste formula with water that is far too hot. Forget about getting food micro-waved, very few airplanes have this capability (airplane meals are loaded already hot into insulated carts). NEVER, EVER use water from a lavatory sink for a bottle, to mix cereal or even to brush your teeth with, it is not safe to drink and is meant for washing hands only.

Happy Travels!
Camille Mülchi RYT, CCE
http://www.motherwiseyoga.com/

I really want to use cloth diapers but don’t even know where to begin with washing them. Help! 

Families new to the world of cloth diapering often ask one simple question: how do you wash diapers? I must admit that for much of Mila’s diapering days we were spoiled by the services of Tidee Didee and just needed to wash soiled covers. Shortly before Mila was out of diapers, I began the laundering on my own and was surprised at how easy it can be.

But how to actually wash? It is tricky to decide how to wash diapers and covers when there are so many different recommendations by the various makers and a common belief that the natural detergents should be avoided (due to natural oils that may leave residue), yet we also want to be friendly to the earth…aaaarrrr! So, I’ll share what has worked for us.
Before you begin: No need to dunk the diapers of babies who aren’t yet eating solids. But once they are eating solid foods, shake those poopy diapers out over the toilet to get the solid poop off, or consider using biodegradable flushable liners ( http://www.bummis.com/en/Products/covers/BioLiner.html ), or attach a sprayer to your toilet.

Now to begin!

Step 1: Cold rinse and spin with Bac-out (about a cup, or two). This will do wonders to prevent stains. The only time I did encounter stains after washing was the time I didn’t rinse! Folks who rinse (as opposed to using a wet pail) often have their own methods. Some use baking soda, others prefer vinegar, or Bi-O-Kleen’s Bac-out (stain & odor eliminator), and others use just plain old water.
Step 2: Warm-warm wash (would choose hot but my machine lacks that option…) with the Bi-O-Kleen detergent (tip: use less soap then you think you need). Through two kids I have never had negative results from using this detergent on either the diapers or covers. Occasionally I will do an extra rinse. Too much soap can linger.
Step 3: Dry diapers and all in ones in the dryer, or once summer has decided to stay, air dry! The sun really does remove lingering stains!_Dry covers per manufacturer’s instructions. If it says I can dry them, I do, but I often just air dry the covers since they are generally made with quick drying fabrics. I also have a general feeling that it will prolong the life of the cover.

Note: Pocket diapers can conceivably get a build up of the natural detergent over time, suddenly making them seem leaky. Now, I haven’t had this happen from washing, but did indeed experience a leaky pocket a couple of times after needing to use rash ointment on my son. I followed “stripping” suggestions on the Happy Heinys’ website and then they worked fine.

And Another Note: If you have a front loading washer, remember to really use less soap than you think you need (sort of the general rule for diapers anyway, but especially so with front loaders). Be sure not to overload the washer because the diapers need to move in the water. And if you can do a second rinse you can ensure that any extra detergent is gone.

You may find some more tips on http://www.diaperpin.com.
Happy Diapering!
Jennifer
http://www.milagrosboutique.com

What is overnight doula care and what can I expect?

Overnight care is popular during those early weeks of sleep deprivation, and can involve help with breast or bottle feeding and maximizing your sleep so that you are refreshed for another full day of parenting. At ABC Doula Service we work overnights with about 40% of our clients. Currently I have my team members and I (we are a company of 12 women, 6 of whom do nights) doing the overnights. We have all had experience with overnight care and love helping families during this vulnerable and precious time. Having a peaceful and confident caregiver at night makes the recovery time go faster, and parents gain the understanding and energy to manage their families better. It is wonderful to have someone nurturing to care for baby, wash bottles/pump parts, prepare snacks for the breastfeeding/pumping mom, fold laundry (or other quiet tasks) and even cook a hot breakfast for the family (if time allows). Not every family needs overnight care, but just knowing it is available can be reassuring for a sleepless new family.

How long does a family need a doula and what kind of care is offered?

ABC Doula Service cares for families in the first several weeks postpartum (up to 12 weeks) and we teach them new skills around feeding, soothing, bathing, and adjusting to new family life. This can take one or two visits, a couple weeks, or a variable schedule for the entire 12 weeks. Many families use our service more intensely for the first few weeks, and then taper off until we are there only once a week or so. I would say that an average family would have the doula there 3-4 times a week for the first week, 2-3 times a week for the next, and end up having us serve them 1-2 per week for the remaining weeks we are needed.

Ultimately, how much service we providce depends on each family’s needs, the level of extended family/friends and neighbors support, and how their recovery time is going. For those with a lot of other support, we offer expertise on feeding and sleep issues, and teaching parents a lot of new baby care for just the first few days. For those who have minimal support, we also add practical help like meal preparation, laundry, nursery organization and errand running for a longer time. Each family determines their needs, and we are flexible to adjust to your needs specifically.

Currently we charge $25 per hour with a 3 or 4 hr min depending on the family’s location and the doula’s travel time to them. We also offer overnight support if desired, for the same rate but with an 8 hr min. We have had the pleasure of working with over 400 families with singletons, twins, or triplets, providing both daytime and overnight care, and feel it is a priviledge to care for families during this sacred time.

I’m 34 weeks and just found out my baby is breech. Are there any yoga poses, or other suggestions that might help?

Your little one must be enjoying being so close to mama’s heart! But yes—we do certainly have some tools to encourage baby to turn (if indeed they are willing.) From a yogic perspective, spending time in the following asanas can be beneficial in encouraging baby to shift into a more optimal position for birth:

CAT / COW (pelvic tilts)

DOWNWARD FACING DOG (or ‘half-dog’ on the forearms)

LEGS-UP-THE-WALL pose, with a bolster or a few blankets under the hips. Limit holding in this pose to 5 minutes or less at a time, and always come out of it (by rolling to the left side) anytime it ceases feeling good.

SUPPORTED BRIDGE pose, with a block under the sacrum. (From here, mama can bring one hand to baby’s head, one to their bottom and GENTLY and intuitively massage in the direction that feels right to her.)

In addition, acupuncture / moxabustion can be a powerful ally in helping to turn a breech baby. I recommend Beth Yohalem-Ilsley at Mississippi Health Center.
Also, many mamas have reported babies turning following gentle chiropractic adjustments. I recommend Dr. Amy Watson at Whole Mama, Whole Child.

Swimming the breaststroke has been known to help as well. Lastly, a procedure called external version can be attempted by your provider if they feel you are a good candidate for this, and it is something you feel comfortable with.

Finally, it never hurts to talk it over with your baby! And in the end, honor their decision. Babies sometimes either have a strong will (which will serve them well in life) or they simply have a wisdom about just how they need to come into the world. (Some babies have cord issues that dictate they not turn head down). Know that they love their mama, and are happy being close to her heart.

Camille Mülchi RYT, CCE of MotherWise Yoga

“I recently was laid off from a job and I am noticing that while I am searching for a new job, I feel needy and like I am not respected. How will anyone hire me if I am not confident? What can I do?”

I am so glad you shared with me this experience that you are having. First, know that you are not alone. Feeling challenged by your confidence levels during a time of transition is NORMAL. Your identity is shifting and you are noticing that much of your confidence was connected to your credibility at your previous job. What a perfect opportunity to work on your confidence APART from a company identity.

Some ideas:
1. Your feelings of “less than” might be coming from your inner critic. During times of change, this mind voice can be particularly strong and often makes us question our abilities. Recognizing this voice is not absolute truth and replacing the message with a positive one (even if you are still trying to believe the statement) can be empowering. For example, if your inner critic says:” You are never going to get that job; they won’t want you,” remind yourself of the skills you have that would benefit the company and create a statement like: “It is possible that I have the skills to create the ideal job for me. ”

2. Then, take action based on your new statement. What would you do differently if you truly believed you had the skills to land the perfect job for you?

2. You said that you “feel less respected”. Know that you are making an assumption (unless someone actually tells you they don’t respect you) and the person who is not doing the respecting is yourself.

3. Observe your feelings that you are calling “needy”. What is it that you are really needing? How can you fill these needs for yourself?

Many blessings to you as you create the ideal work environment for yourself!
Savannah Mayfield http://www.nurturelifecoaching.com