Life & Littles Podcast!

Exciting news!!!

Our own Dr. Annie is on this week’s episode of Doctor Mommy, MD’s podcast talking about second trimester of pregnancy. The Life & Littles podcast may just be your new favorite listen, friends!

Photo credit Fiona Margo Photography

“Imagine your best friend is a doctor and a mom, what questions would you want to ask her over a glass of wine? What questions would you text her in the middle of the night?” Sound helpful?

Grab a coffee or glass of wine and tune in on iTunes and subscribe to get all the upcoming fun times!

https://itunes.apple.com/us/podcast/life-littles-with-doctor-mommy-md/id1451847392?mt=2&i=1000429939961

You can also find Shelly on Instagram and Facebook @doctormommymd and should check out her gorgeous blog while you’re at it!

Xoxo!

Sexy as a M*ther

There’s a new sexy in town friends, and I would argue, it’s even better than before. It’s mom-sexy. We may not have the bouncy bounty of hair and bikini top filling of yesteryear, but we have some new moves that can light the 🔥🔥🔥 of romance like none other. (Literally. Because no one who’s not a mom would do this stuff…)

Wardrobe

Those young folks are all rocking flowy, low-cut tanks and dresses that show a hint of side or underboob here and there. The sexy implication being a nipple could be exposed at any moment. Enter: nursing tanks. This garment has the significant advantage of being able to actually whip out a titty in 1 second flat. Hey-yo!!!!

Shock Value

Sure Victoria would have you think your partner wants you in lacy little get ups 365 days a year. Let me tell ya, when all they’ve seen you in for months is spit-up stained sweats and then you slip on a real nighty? Firecrackers!!!

Naughty Naughty

Remember those teenage trysts making out when you knew your parents might walk in and bust you any minute -so hot, right? Well, as a parent, you get to turn the tables! You never know when a kid might wake up with a need for an escort to the bathroom and discover you and your partner “practicing stretching” or “having a tickle fight” 😳

Exploration

Another level of kink factor is available for all you cosleepers. Kid is in your bed so that’s off limits (at least I hope, because, wow! Boundaries, people). Hello, laundry room! Or take it to the bathroom counter. Nothing makes for creative sexcapades like having a literal cockblocker in your bed.

You said it!

New Turn Ons

Totally aging myself here, but… Remember when Devin Sawa’s bowl cut was the hottest thing (or were you a JTT gal?)? And then a few years later, it was boy band moves, then Abercrombie store dudes in barely-not-showing-pubic-hair-low cut shorts? What turns you on changes with time. And let me tell ya, once you’re a parent, there is basically nothing sexier than your partner going above and beyond with home & childcare.

Tell Me What You Want

What you really really want…. I’ll tell you what I want, what I really Really want. Because I’m a mom. And ain’t nobody got time for that Oh-let’s-pretend-this-is-fun-because-I’m-too-shy-to-be-honest sh*t. We know what works (hopefully!!) and we know how to get it and THAT, my friends is sexy.

Pregnant Sex

Ok, this one is transient, but can be ahhhhhmazing!! Increased blood flow? Yes please! Embracing your new curves? Oh yeah! Those pregnant boobs? 🙌🏻🙌🏻! If comfort allows, this can be one of the biggest perks of gestation. Get. After. It. There is a big ol’ dry spell (literally, so dry down there) coming up after baby. Store up some good times to last you through!

As always, keepin it Real

Real Talk

In all honesty though, it can be hard to feel like your former sexy self as a mom. Your body is different. It might feel better, it might feel squishier, it might feel completely foreign – no matter what, it changes. You may not have time for basic self care, much less a “beauty routine”. But instead of beating ourselves up about it and missing out on the fun, why not embrace it?! Your body can LITERALLY grow human beings. It’s miraculous. This is a special season in life and won’t last forever. Get out there and have a spicy Valentine’s Day, mamas! I, for one, think you’re SMOKIN!!! 😘

Dr. Annie is newly a mom of 3, a family doctor and finding new ways to be sexy all the time 😜

 

 

Pregnant MD: Third Trimester Woes

As always, this post is meant as information and a personal account only and does not replace the advice of your personal healthcare provider. This post contains affiliate links to help you find the products I personally recommend which may provide small compensation for me.

Rounding out this pregnancy-blogging adventure, I have had a rodeo of all the discomforts of third trimester to remind me what to warn other mamas is coming for them. I had forgotten a few of them, so it’s lucky for you all I decided to go for #3 to be truly up to date on all of this (jk). Every woman’s experience of pregnancy is different – you may get none of these, all of them, and then some more – but I’ve tried to hit the most common highlights here for reference.

Braxton-Hicks

These fun semi-contractions may have started earlier for you than 28 weeks, the official kick-off of third trimester. However, if they didn’t, most women will start to get them more noticeably now. You might start to wonder if these are “the real deal” and whether you should worry. In general, the main difference is BH contractions are a tightening not a pushing down sensation. Think a fist squeezing closed around something rather than trying to push down. It’s hard to know the difference until you’ve had the real thing sometimes, but trust me when I say – you’ll know the real ones when they come.

They can range from barely noticeable to quite strong, stopping you in your tracks. Talk with your provider about when to go get checked, but in general if you’re having more than 4 per hour despite resting and being hydrated with an empty bladder (I do realize those last 2 are hard to balance….), you should check in with your person.

Snissing

I learned this fun term in my first pregnancy and have been giggling about it ever since. Snissing is pissing when you sneeze. As that baby pushes more on your bladder and your pelvic floor loosens up more, you may start to lose control with episodes of pressure – aka sneezing, coughing, laughing, having a toddler jump on you…. Doing Kegels regularly through the pregnancy can help avoid this, but for some it’s your anatomy and you’ll just have to make do with wearing pads and prioritizing emptying your bladder very regularly. Hooray!

Hemorrhoids & Constipation

Everyone’s least favorite body part to talk about – your butthole. These are 2 separate issues but very related, so I’ll address together. Some lucky people (ahem, me included) struggle with constipation at baseline and pregnancy hormones make that so much worse. The worse the constipation, the more you might be straining to get that BM out. I mean this 100% literally: I have had multiple poops that were harder to push out than my actual babies. The more you strain the more pressure you put on the veins around your anus and at some point, they can start to bulge out – this, my friends is a hemorrhoid.

Image result for hemorrhoid illustration

What’s a preggo girl to do?? Stay aggressive about constipation management. Aim for 1-2 easy bowel movements per day. Talk to your provider about a regimen you can use, for me it’s been high-fiber diet, hydration with at least 2 liters water a day, Smooth Move tea most days and high-quality pre/probiotics. The best I’ve found are these Prolistic ones by Nerium, not just saying that because I work with the company, they are superior (link is not even for my own business to keep this separate).

Heartburn and Reflux and Vurping, Oh My!

Me after drinking orange juice

Downward pressure has it’s problems as above, but at some point the upward pressure gets to most people as well. Fun fact – the old wives’ tale that babies with more hair cause worse heartburn is for completely unknown reasons statistically true. The safest methods for managing this are natural:

  • Avoid large meals, don’t eat anything more than a few bites of a snack for 2 hours before bed.
  • Avoid acidic foods: coffee, tomato, citrus…
  • Manage constipation (backing up the whole system)
  • Avoid carbonation

Some people also do well with Papaya Enzyme after meals. And up to 6 Tums regular strength tablets a day are safe – but beware!! These can worsen constipation turning into a self-perpetuating issue. If it’s bad beyond that, talk to your provider about other antacids.

Aches and Pains

You can get upper back pain from the weight of belly and breasts, round ligament pain from your growing uterus, and low back pain from basically doing dead-lifts all day long with a 20lb plyo-ball. I read in residency that 80% of women experience back pain in pregnancy. That seems unreasonably low. I have never, ever talked to a woman who didn’t have some degree of back pain by the end of pregnancy. If you’re out there… what’s that like? What are you made of? Are you descended from Amazons? For the rest of us, a few things can help…

  1. Prenatal yoga. Exercise in general is helpful, but prenatal yoga in particular is INCREDIBLY important for the health and comfort of your back.
  2. Prenatal massage. Make sure you’re seeing someone trained in this specifically and with a table set up to accommodate a growing belly.
  3. Topical creams. Distracting the nerves with something tingly can help temporarily. My go-to is BioFreeze because it’s the tingliest (is that a word?).
  4. Belly and hip supports. See if you can get one through your insurance first, if not, the most popular ones are in This NY Magazine Review
  5. Warm showers or baths or heating pad. I say warm, I mean VERY warm. There is no exact temperature cut-off – just stop as soon as you feel “Hey, I’m hot”.
  6. Tylenol. Yep. That’s all you get. Plain tylenol. Always good to double check with your own provider if this is ok for you, but most pregnant women can take this for bad pain.

If your pain goes beyond what can be managed with the above, talk to your health care provider. Some will have you see a specially trained chiropractor who knows Webster technique, work with a physical therapist or use other medication to manage it.

PN1A8617

Labor Scares

We will do a whole post on ‘How to Tell When to Go To The Hospital”, but in short, many women experience bouts of ‘Prodromal labor’ or ‘False labor’ prior to the real deal.

  • Contractions: The Braxton Hicks can get pretty strong and somewhat regular towards the end and as prenatal providers, we get a lot of “When are they labor?”. The general rule is 5-1-1: if you have contractions that stop you from doing what you’re doing every 5 minutes, lasting 1 minute for 1 hour and getting stronger despite resting and hydrating, you should check in with your person.
  • Breaking Water: This seems like it would be straight forward, however, as explained above with Snissing, plus how much vaginal discharge you might have, it can be tricky. It is often not the Hollywood gush of a gallon of fluid that is obvious, but a slower trickle when your water breaks. If you’re not sure, go empty your bladder, put on a clean, dry pad and walk around a bit. If your water is broken, you’ll keep leaking. Still not sure – go get checked.

Cankles and Varicose Veins

It’s a cruel joke of the universe that just when it becomes super awkward to try to put on any socks, much less super tight compression hose, you start getting ankle swelling that is treated by exactly those socks. Do your best to wear them if you know you’ll be on your feet a lot and certainly if you’re traveling where you’ll be stationary in a car or plane for more than an hour at a time. There are lots of options with better breathability and cuter designs these days, these are affordable and the appropriate 20-30mm pressure rating.

Screen Shot 2018-12-14 at 11.23.38 AM

If you are able, also take 20-30 minutes a few times a day to put your feet up at heart level and let gravity help you out here. If you get the ankle, or in particular hand or face swelling that comes on suddenly, go see your provider right away as this can be a sign of pre-eclampsia.

I would be remiss if I didn’t also warn you that you can get swelling and varicose veins everywhere south of your uterus – including your lady parts. Some women have the special experience of these throbbing, painful veins or swelling in the vagina and labia at the end of pregnancy. While there are also some interesting medieval-looking support contraptions that can help with this, the main thing that will make it less-bad is resting on your side or in puppy-dog pose type position for 10-15 minutes throughout the day.

Image result for puppy dog yoga pose

Lightning Crotch and Sciatica

Ever get a reallllly good zinger plugging something in that the wires were a bit stripped or your finger was on the plug? Imaging that in your labia. Welcome to lightning crotch, the fun pregnancy-version of good ol sciatica. Both of these can happen as baby moves lower in your pelvis toward the end of pregnancy. The same things that help with back pain described above can help with these particular issues as well. Some people also find acupuncture very helpful – but again – check with your provider about if and with whom that would be safe to do.

Pregnancy Brain

Yes, you’ve probably had this all along. Scientists have actually figured out that part of this is due to the hormones circulating around. However, with third trimester, your sleep starts to be very disrupted – most people wake 3-6 times a night to change positions and go pee. This makes the fog worse, of course. My own theory though, is that it’s also due to the now much stronger little being inside your squirming around. I told my husband to try to imagine concentrating with a little elf riding around poking you, elbowing you, going, “Hey! Hi! It’s me! Hey-yo!! Yoohoo!! Hi!” allllllll day long. Now… What was I writing about here…? Oh yeah. Help yourself and write things down! Consider a tracking device for keys, make sure “Find My iPhone” is on and maybe slap some GPS watches on your other kids while you’re at it.

When To Get Help

There are 6 main things we never want you sitting at home with:

  1. Bleeding that is any more than spotting
  2. Concern your water has broken (see above)
  3. Persistent contractions (see above)
  4. Feeling less baby movement – there’s no perfect rule for this, if you’re worried, we are worried.
  5. Signs of pre-eclampsia: Persistent pain in the belly or back, headache, blurred vision, sudden increase in swelling of feet/hands/face, or difficulty breathing.
  6. Depressed mood or bad anxiety, or any threatening or abusive behavior from your partner. These all, sadly, go up in pregnancy – don’t stay silent! We can help!

The bottom line on this one is any time something is beyond a minor discomfort, we want to hear about it. Have a low threshold for asking for advice from your healthcare provider – we VERY much would rather you come in for something small than miss something big.

PN1A8818

Now, then… Who’s ready to have a baby??

 Dr. Annie is a family physician and 3 time mama in California.

 

Bringing Home Siblings

This post contains affiliate links to help you find the products we have found helpful. We may get a tiny reward if you use our links but the recommendations are our own. Pretty Photo above credited to Jordan Marie Photography

All of us Real Mothers have gone through the fun adventure of bringing home a second or third baby to the family and I think we’ve collectively had just about everything go wrong that the rest of you could expect. The inspiration for this post was a friend’s recent experience of her 2-year-old trying to help “calm” a fussy 1-week old brother by very silently and sneakily feeding him an almond <cue full mom panic by proxy>. Luckily she was watching and everyone is ok.

We thought we’d put together a rundown on what will help avert disaster in sibling-land and make the transition as smooth as possible. Most of this is directed toward families bringing home a new baby with a first child (or multiple children) between the ages of 1-5 years old. Older kids are generally a bit easier to explain about baby safety, mom’s recovery, etc… hopefully.

Talk early and often

IMG_3444Being pregnant while managing a tiny terrorist is hectic in and of itself. If this is baby #3 or more for you on the way, that craziness is compounding. It’s easy to forget to talk to your kids about what to expect with a new baby ahead of time because frankly, you’re just in survival mode 90% of the time as it is. However, it makes a HUGE difference and it is much easier to manage baby’s arrival at home if you have had a few convos ahead of time and set realistic expectations for big brother(s) and/or sister(s). Some strategies include using books (see suggestions below), children’s shows (also below), incorporating a little Q&A or “talking to baby” session into bedtime, or talking about it for a bit when you see other people with small babies.

Don’t Miss Topics:

32191833_10100214056795406_9005781614885601280_n
Photo credit: Fiona Margo Photography
  • Where Babies Come From: This is bound to come up in one form or another. Rather than just avoiding the conversation, do yourself a favor and have these books: What Makes A Baby and Hello in There!, for a low-level detail, kid-targeted, but medically accurate way to explain how the baby got in there and how it gets back out. Some other great books are in This Fatherly Blog Post.

 

  • Shows: This is a parent and sibling win-win situation. Your kid feels like they are being treated to TV time, and you get help explaining the sibling transition from familiar children’s characters. Some of our favorites include “We Can’t Wait to meet the Baby” and “The Baby is Here!” (also books!) from Daniel Tiger. You can also view some great short videos about welcoming baby on  PBSKids.org.

screen shot 2019-01-10 at 13.37.10

  • Baby Safety: As reviewed above, kids love to “help” mom with baby and are often distressed by the baby’s distress. Go over specifically:
    • Never put anything in baby’s mouth (including pacifiers because you don’t know where that thing’s been when the toddler finds it). If your kid is older the rule could be “without asking a parent”, but err on the side of never. Since younger kids understand positive “DO” commands better than negative “DON’T” commands – you can frame this as always bring things to a parent BEFORE giving to baby.” This also is important because younger kids may want to share small (CHOKING HAZARD) toys that they may not understand are dangerous to baby even if they are not put near the baby’s mouth. More than one sibling in our crew has tried to share a lego or two to cheer up their new baby, and they need to understand that sharing with a baby is ONLY okay when a parent approves the toy.
    • Never put anything over the baby’s face. Kids also love to “play peekaboo” or give stuffed animals to the baby which can smother tiny nostrils easily. Again, the positive spin on this is that blankets/toys/etc always go on the legs, NOT the face. Include not putting things in the crib/basinet with baby – little kids are remarkably good at “sharing” when you least want them to.adorable baby beanie bonnet
    • Never pick up the baby without a parent’s help. If your kiddo is much older, you can adjust this to their ability. But again, err on the side of caution when baby is tiny and needs head support. A positive way to frame this is “always ask for a parent to help you pick up or hold baby.”
    • We also find it helpful to have a “no-touching-on-the-face or hands” rule to manage germ transition. Point out they can kiss the toes or top of the baby’s head. And keep antibacterial spray such as this kid-safe one from CleanWell ALLLLL over the house.close up of baby feet
  • Mom’s Body: As a second (or third or fourth)-time moms’ belly grows larger, it somehow becomes an irresistible target for kids’ boisterous jumping, bouncing and otherwise projectile launching. You can be reassured, the baby is very well protected in there – but of course if a direct hit results in ongoing pain or bleeding, go get checked! Talk a lot about ways to be gentle with mom’s belly each time this happens.

    christiana-6297
    Photo Credit: Kimberlin Gray Photography
  • Birth and Recovery: Also take the opportunity to talk about what the plan will be while mom is at the hospital or birth center. Go over how mom will be very tired and have some “ouchies” after the baby comes out and talk about ways the kids can help out – getting ice packs for you, rubbing feet, making faces or telling stories to the baby, helping to fetch diapers, etc…. Most kids love being able to help. Emphasizing their “big kid-ness” helps them feel special. If your kid is reward-motivated, you can even set up a points-chart that they earn a sticker for each helpful act to earn a new toy or privilege.

Gift From Baby

Picking up a special time-occupying gift for big kid “from the baby” goes a long way to establishing the baby-is-your-friend status we all want. Some good ideas can be found in this post: Plane Travel with Littles: Carry-On Packing List. Do yourself a favor and DO NOT buy toys that make noise. Boys and girls alike usually like to have their own babydoll of some kind to “mirror” what the parents are doing with the real baby, here are a few other options by age.

1-2 year old: Buckle Toys, Latch Board or Latch Barn

 

 

2-5 Years Old: Magnatiles, Dollhouse and Green Toys Cars + Track

Also consider a tablet loaded with educational games, see Fave Fridays: Smart Screen Time for ideas!

 

Of course, you know your kid best, get them something you know they’ll be excited about and will play with relatively independently for a while. Avoid toys with choking-sized parts even for bigger kids until you know they’re on board with the “nothing-in-baby’s-mouth” rule.

Lower Your Expectations

Most kids go through some form of regression when a new baby comes home. That can take a lot of forms. Potty-trained kids might have accidents again. Kids who have no trouble sleeping alone at night might suddenly be getting up. They will want to play in the baby’s bouncer, ride in the stroller, suck the pacifier. It’s a normal phase and will pass if you don’t overreact. Acknowledge it, talk about it briefly and move on.

Also lower your expectations for getting stuff done. Enlist more help. You will not get those luxurious “nap when the baby naps” moments as easily as when there was just one little being taking your time. (Did those really ever happen anyway?!) Set yourself up for success with a decluttered house, easy food in the freezer and loved ones on board to help as much as possible. If you have trouble asking for help, make a list ahead of time of things that would be helpful or set up a MealTrain or other chore-registry to delegate.

love sweet face portraitThis post is about preparing the kiddos, but part of that also involves preparing your coparent and other family/friends who will be helping. Make sure they know the priority is helping with the housework and the big kid(s). Your job is the new baby. They’re NOT there to hold the new baby while you ‘get stuff done’. I repeat: THEY ARE THERE TO GET STUFF DONE and only as much of the new baby stuff as you want to delegate. Liberally use the phrase, “My doctor/midwife said I need to be holding the baby as much as possible for bonding, immunity and milk production, so can you please <do the dishes, fold the laundry, go to the store, make dinner, take Jimmy to the park, etc…> while we go take a nap together?”

IF and only if you desire a moment away from new baby to shower, snuggle your big kid or whatever else, then others get to hold new baby. No one has a “right” to new baby time except YOU.

539881_667477218286_2026859594_n
Photo credit: Stacey Petersen Photography

If you don’t have family or a community to help, look at neighborhood list serves like NextDoor to hire a middle or high school aged “mommy’s helper” – cheaper than a nanny or babysitter, literally they just come over and do chores or play with your big kid while you’re home taking care of baby.

Enjoy the Before

PN1A8393.jpg
Photo credit: Jordan Marie Photography

The one guarantee with bringing another little life into the family is that things will be different. Better in many ways, harder in many ways, and just altered in many, many ways.

Watching siblings grow together and love one another is one of the greatest joys of parenthood.

Try not to worry too much about how you’ll manage it, because you just will. Do your best to try to soak in the remaining time while the newest addition is still easily portable, fed and clean on the inside of your body. Plan special outings that will be harder with a new baby like going to a movie or kids’ museum. Take a moment every day to pay attention to the little life on the inside as you did with the first baby without even realizing you were doing it.

Good luck multiples parents-to-be, enjoy the ride!

Anne is a mom to three (including one beautiful brand new baby) and family physician in California. Christiana is a mom to three, military spouse, attorney, and currently a stay-at-home mom in New England.

Postpartum Prepping

This post contains affiliate links to make it easier to find the products mentioned, we may get a small payment when you use our links.

Basically since I became a doctor-mama, my go-to baby shower gift has been a big-ol-bag of all the things you’re gonna want to have around after you give birth that no one else will gift you. It’s not the kind of gift that gets a round of, “AWWWWW!!”, and I usually advise the moms to open in in private later so as not to embarrass the grandmas and/or husbands in the crowd. But, after going through the birth aftermath myself, I realized it was the best thing I could do for friends to save them or their loved ones that trip to the grocery store/pharmacy after birth.

close up of pink baby booties
Photo by Pixabay on Pexels.com

Of course, I realize most other people don’t do this for baby showers. So here’s a list of all the things you maybe don’t know you will need. Try to have all this on-hand by about 36 weeks gestation just in case things happen early. I went to get mine at *ahem* 36 weeks exactly and posted about it on Instagram stories (follow us @asamotherblog if you don’t already!). At that point in pregnancy, most women and their babes still go home in the normal 1-4 day postpartum interval so you won’t have extra time to prep.

Diapers & wipes

You probably got some of these at the shower, but make sure you have the right start-up stash before baby is there. You’ll want 1 or 2 boxes of newborn sized diapers. Don’t get much more than that at first because many babies grow out of the N-size fairly quickly. Get 2-3 boxes, minimum, of the size 1’s. Which diapers? That’s up for a whole separate blog-post debate… However! For the N’s, make sure it’s a sensitive skin or natural diaper option to avoid early diaper rash and the ones with the blue stripe to tell when it’s wet are wonderful for your addled post-partum brain. For the wipes, just buy the biggest possible box of SCENT-FREE, sensitive skin wipes. You’ll use them.

Kirkland - ibqh Baby Wipes - Ultra Soft - 900 Count Box rcuzj

Maxi pads

Speaking of diapers, you’ll be wearing your own as well. In the hospital, they provide lovely, actual adult-diaper sized pads and mesh underwear to house them. Grab a few extras for the trip home if you can. After that, though you’ll want a box of heavy-flow, overnight, extra-large pads to wear. You will bleed much heavier than a regular period for at least one week, sometimes 2-4 weeks post-partum and you canNOT use tampons. Get another box of lighter ones for spotting after which can be another few weeks. Get unscented, sensitive ones – your lady parts will be, well…. fragile, to say the least.

Pro-tip: Take ~6 of these heavy duty pads, soak them in witch hazel (see below) and freeze for your own soothing stash of ‘padsicles’, this tip brought to you by my fave pregnancy/post-partum book, The Girlfriends’ Guide to Surviving the First Year Of Motherhood.

Clothes

You might already be set here depending how you shopped in pregnancy. The basic wardrobe of your first 2 months postpartum is as follows:

  • Nursing tank top or bra + boob accessible shirt
  • Kimono or sweatery-type thing
  • Stretchy pants
  • Slippers or comfy socks
  • Granny panties

Nursing tanks have 3 varieties: comfy, sporty, supportive. I would get yourself MINIMUM of one of each if you’re planning to breastfeed for a while. Here are a few of my faves:

The bras also have comfy and supportive options. Get at least 1 of each. Do not, I repeat, DO NOT get nursing bras with underwire. This is a HUGE risk factor for getting clogged ducts which hurt like a mofo. You won’t need that kind of support anyway once your milk plumps those puppies up.

I am super excited that the drapey-cover-up trend is still happening because there are SO many cute options to turn your nursing tank into an actual outfit these days! I mean, you basically get to wear a robe in public and are insta-stylish. For your stretchy pants, you will continue to rock your maternity pants for a while – fold the over-belly ones down if needed. Also, have some high-rise leggings around. NO low-rise, if you have a c-section, those will push on your incision and hurt and if you don’t it will not support your recently vacated tummy enough.

Buy at least a 5-pack of large underwear you don’t care about. The underwear should fit you at 3rd trimester pregnancy because (hopefully you already know this), you will look 5-6 months pregnant for the first several weeks after birth, minimum. When in doubt, size-up. You need ones that are soft, big enough to hold those overnight maxi-pads and that are cheap enough you feel fine throwing them away after they’re stained. Black is a good color choice. Again, avoid low-rise, get at least mid-rise. And add on whatever slippers/socks you like if someone didn’t gift you.

Food

Moving on! In recovery from birth and when starting up nursing, you will need LOTS of easy food. If you’re getting hungry a lot, your body will have a harder time making milk. Stock up on protein and healthy-fat rich snacks that are easy to grab and eat one-handed. My go-to’s are protein bars like RxBars, cheeses, nuts and nut-butters plus something to slather them on. If you like it, lunch meat is also a great option (you get to have it again, yay!).

Stock the freezer with ready-to-heat meals and the pantry with easy sides. I keep around bags of frozen vegetables (much better nutrition than canned), a supply of ground grass-fed meats to throw into the crockpot for marinara or chili, microwavable brown rice and quinoa, sweet potato fries and other easy meals you can throw together 1 handed.

Drinks

Yes, get yourself some celebratory wine/beer/liquor. This should go without saying, but… Should you get drunk while you’re sleep deprived and breastfeeding a tiny human? NO. If you have a history of alcohol or addiction issues, should you jump off the wagon? NO. Can the rest of you have a glass of champagne to celebrate being an actual superhero-miracle-maker? Heck yes!

What I’m really talking about here though is hydration. You’ll need to drink 3-4 Liters of water daily, aka a GALLON A DAY, while recovering and nursing. If plain water isn’t your thing, stock up on what will help you get that in. Herbal teas with fenugreek are a great nursing support. These Upspring berry-flavor or chocolate options are also great. Fruit juices are cool if you’re not diabetic. Sparkling water counts. Just get. it. in. Avoid soda, please, for me?? It’s not good for your recovering body.

Baby First Aid

I strongly recommend getting the Fridababy Baby Basics set that has a snotsucker (much more gentle and effective than a bulb), a Windi (can be a miracle for colicky babies), the Dermafrida for your skin and nail clippers. This is great to put on the registry! Get some plain baby nasal saline drops for stubborn boogers. Have a good diaper cream on hand – Resinol has been our family go-to since I was a baby, but anything basic is fine. You also should have a rectal thermometer in the house in case you need to check a temperature accurately.

For your lady-parts

For you ladies who know you’re having a cesarean section for whatever reason, you don’t necessarily need this. For everyone else planning for a vaginal delivery, also get a large bottle of witch hazel or witch hazel flushable hemorrhoid wipes or pads. You will be far too tender to wipe at all at first and will just use the handy spray-bottle while you go then pat dry oh-so-gently. After that, though, you’ll want to use these gentle wipes, not dry TP for about 6 weeks. Also pick up a bottle of Miralax and some docusate stool softener if you’re not already using them. You’ll want your poo’s SOFT. Trust me on this.

Nursing supplies

If you can get a double-electric breast pump from insurance, definitely do that. If not, or I would say even if you do, I also recommend getting a manual pump as back up and for travel. It’s super helpful even if you’re not planning to bottle feed at all, just to have on hand if you’re engorged or have a clog. Also pick up a jar of organic coconut oil. This is by far the best nipple lubricant and safe for baby, no need to wipe clean before feeding. Put it on after EVERY feed and before EVERY pumping session until your nips have toughened up. You’ll usually be given some lanolin – this is usually WAY too sticky for sensitive nipples. Use it on baby’s bum instead. If it’s your first baby or you’re sensitive, you might need something stronger at first like this Motherlove Organic Nipple Cream.

Motherlove Nipple Cream Certified Organic Salve for Sore Cracked Nursing Nipples, 1 Oz.

Also grab yourself a pack of either washable or disposable (judgement free zone here) boob pads for leakage. I have hoarded all the removable pads from every swimsuit and athletic top I’ve ever bought and use those because they’re washable, but if you aren’t a weirdo like me, buy some 🙂

Last but not least, vitamins

You’ll need to stay on vitamins the whole time you’re recovering from birth (3 months) and longer if you’re nursing. You can keep taking your same prenatals if that works for you or transition to a post-partum vitamin. Two options that are good are Healthy Mama Postnatal and Naturemade Postnatal Support.

Be Well Rounded! Perfect Postnatal Multi-Vitamin +DHA Softgels. Once Daily to Optimize Nutrition While Breastfeeding. 1 Month

Nature Made Postnatal Multi-Vitamin Plus DHA Softgels, 60 Count

 

I’ll be adding Nerium’s Youth Factor vitamin and superfood drink because it can help prevent post-partum hair loss and might boost milk supply as well. Taking all the help I can get!

Here’s the list in-brief for printing:

  • Sensitive skin diapers: 1 box newborn, 2 boxes size 1
  • Sensitive, scent free wipes: largest possible box
  • Maxi-pads: 1 box overnights, 1 pack regular, unscented
  • Nursing tanks x3, Nursing bras x2, stretchy high rise pants
  • Pack of large, mid-rise underwear, dark colors
  • Slippers/socks if needed
  • Snack foods, pantry foods, freezer foods
  • Large water bottle (about 1 liter size), other hydration options
  • Fridababy Snot-sucker, nasal saline drops, Fridababy Windi, tiny nail clippers, rectal thermometer
  • Bottle of witch hazel or witch hazel wipes
  • Stool softeners (miralax and docusate)
  • Organic coconut oil
  • Other nipple cream if needed
  • Breast pads for milk leakage
  • Vitamins

Ok, I’ve got pregnancy brain and that’s all I can think of… all you experienced mamas out there, what else would you recommend?? Comment below!

46495258_10100252467754536_3587221999186870272_n.jpg

Annie Ray is a mom of 2 due any time now with baby #3, a family doctor and Target-lover in Sacramento, CA.

The Silver Lining To My PUPPS Nightmare

Everything happens for a reason

….or so people say.

I had always longed to be a mother. I dreamed of pregnancy, a little baby bump, and a group of like-minded women to with whom to hang out and help raise our little ones in friendship, unicorns, and rainbows.

grayscale photo of two woman showing tummies

What a wonderful portrait of “what to expect when you are expecting”… am I right? In fact, we even joked amongst the four of us here at Real As A M*ther that I would be the one with half a dozen kids and a goofy husband that made me endlessly laugh until I cried and doted on me daily. Perfection.

DSC01327So when my wonderfully hilarious, awesome, doting husband and I got married, it was natural for me to not want to wait to start this family I’d been craving. By the blessed powers that be, within 6 months I had the exciting news to tell my friends and family…..

I experienced the normal first pregnancy woes in the beginning. Morning sickness, nausea, food aversions, being super tired, and reallllllly missing wine. But overall, things were looking great. We relocated to a town outside of the city, and my husband hand-made the baby’s crib and dresser.

DSC01689
I mean, the man is hilarious, awesome, and talented. What can I say?

When I was about four months along, we went to visit Christiana, who was living in Japan! It was an amazing, globe-trotting, babymoon trip where my tiny baby belly began to show while posing for picturesque photos overlooking Japanese pagodas. Pregnancy dreams, on. track.

When we got home, however, life threw my dream a giant curveball. I was on a walk around town, when my calves began to itch. I sat down at our quaint town hall fountain and saw that it looked as though I had been bitten by 30 mosquitos simultaneously. I just chalked it up to summer, and maybe… heat rash?  But the itching persisted.

Within two weeks, it had spread. My inner thighs, underarms, and belly had broken out in a rash. It felt as though I had just slept in a den of mosquitos and chiggers. After calling my midwife, I started taking some liver cleansing teas/supplements. I got some special soaps to help calm it down, and tried oatmeal baths. Nothing helped. Not. A. Thing.

DSC01659
Post Biopsy

I was about 20 weeks along when I saw a specialist that, along with my midwife, decided after bloodwork and a biopsy and although it rarely occurs this early, that I had PUPPPS.

Like many of you right now, I had this reaction.

139615-140075
‘da heck d’you just say?

According to Healthline.com, “Pruritic urticarial papules and plaques of pregnancy (PUPPP) rash is an itchy rash that appears in stretch marks of the stomach during late pregnancy.”

Stretch marks, you say? I was 18 weeks! I hadn’t barely even begun to show, much less stretch. And this was systemic, not on my belly! But, at least I had some sort of explanation that calmed me down. Thinking, ok now let’s get rid of this mess, I said,

“Ok, doc, what can I do?”

“Well, the only cure, is delivery” <heart sinks>

So basically, what I was being told was this: I was going to itch like this for 20 more weeks. 

DSC01660
20 Weeks: just the beginning

4 more weeks went by, which felt like an eternity. The rash got so bad that I could not sleep, eat, or even wear clothes. I had to take cool/cold showers because the heat would spread the rash to a new area, which I kept finding out the hard way as it spread all over my body. It was on the soles of my feet, palms of my hands, even in my nail beds and on my eyelids. The longest I went without solid sleep was 7 whole days. I don’t even remember if I was hungry.

I, did, however, hold tightly onto the fact that I needed to drink water. I remember having thoughts of “I don’t want the amniotic fluid to get low, and that be the reason I have to get a C-Section,” which was a huge fear for me. That was the only coherent thought I remember having during this time.

DSC01661

It was when my mom found me naked on my kitchen floor at 24 weeks (I was lying there because it was cool and clothes made the itching turn to burning pain) that she scooped me up and into the car. I have no recollection of this event, but she took me to the doctor and demanded an appointment right then and there. I had lost 20 pounds, the baby wasn’t gaining any weight, and I was put under the care of a neonatal specialist. I was delusional, depressed, suicidal, and covered in what looked like oozing poison ivy.

At this point, desperation kicked in, (mostly from my husband and parents because I had checked out) and a steroid regimen was put into place. I was on Prednisone until my 30th week and experienced so much relief. The rash was kept at bay and the baby was monitored regularly to make sure the medicine didn’t cause any problems.

Thinking I was in the clear, I weaned off my medication because I was so worried about steroids affecting the baby. Around Thanksgiving, however, it came back with a vengeance. At it’s worst, I could literally peel the layers of my skin off with a tissue. I immediately started the steroids again, and the rash was mostly cleared up in about two weeks.

DSC01804
Belly scarring at 37 weeks

When I went into labor at 37 weeks and 6 days, I had such relief. Where most women are fearful of the unknown, I was prepared and ready for the natural pain and hormone release I had learned about through my teacher of The Bradley Method.

Most of me has forgotten about just how incredibly difficult that pregnancy was. In fact, I am only reminded when I have bad cycles now, because the rash creeps back up under my upper arms and on my legs, raised and irritated ghost shadows of such a dark time in my life.

We still don’t know what causes it. But, some risk factors for developing PUPPPS are:

  1. Carrying a boy: we didn’t know at the time but…check
  2. Being Caucasian: check
  3. First pregnancy: check
  4. Maternal hypertension: undiagnosed but with no sleep…check
  5. Multiples
  6. Rapid or higher than usual weight gain

While I did not fit into the category of the last two risk factors, my mind got to thinking about why my personal case was so different. The only reason I came up with, ties back to the beginning of this post. Because… everything happens for a reason.

It was through this tough and terrible time that I learned about prenatal herbal supplements, and how and why they work. I learned a valuable lesson in the blend of a cooperative maternal care team, and their strategies for helping. I learned the importance of relying on medical intervention, because it saved my life, my son’s life, and my sanity. But the most important gift this experience gave me was the fact that I knew I wanted to help support other women through pregnancy and birth.

I tell this story because it is important to look back and find gratitude in the lessons we are given in this lifetime. Even though I did not know this going through it, I am certain that this time of suffering gave birth to the compassion for women in their childbearing years that I had never known was inside of me. It gave me the tools for empathy that one can only develop while in the depths of great personal struggle.

DSC01829.jpgNow, I feel healing each time I help a woman accept and trust in her body through the pregnancy process. I am energized by watching her awaken to the power within her, and I am both blissfully honored and overwhelmed each time I watch her hold her baby. Because no matter what type of pregnancy, what kind of prenatal education we choose, how or where we labor and birth, or what the birth outcome is, I am reminded in that moment, women are bound together as one. And that is my most ultimate, and ever-present, silver lining.

004 (1 of 1).jpg

Kristy is a certified massage therapist, doula, homesteader and mother to 2 kids in Virginia.

Pregnant, MD: Second Trimester

This post is not meant to be personal medical advice, you should always seek medical advice from your own healthcare provider. 

I love, love LOVED getting all your insights about second trimester experiences on Instagram and Facebook. I also had the great pleasure of being a guest on my good friend Shelly aka Doctor Mommy, MD’s podcast to discuss it – check her blog for even more info and hilarity!

Second trimester is for *most* women the best time in pregnancy. Good riddance, first trimester (if you’re still wallowing in that misery and want more info on managing the issues, see my first trimester post)!

DSC_4743
16 weeks, photo credit: Fiona Margo Photography 

Generally, you can expect decreased pregnancy-related nausea and fatigue. You’ll start feeling baby kicking more and more starting at about 18 weeks, which is the. most. magical. thing!! (IMHO). Mamas usually get to go to that fun 18-20 week ultrasound and see baby including finding out the sex if you so choose. And you get to look actually pregnant and fill out those maternity clothes! Woot! And you’re usually not starting the third trimester discomforts quite yet. However, it’s not all bliss and ice-cream sundaes…

Reflux

That cute belly that’s starting to look more unmistakably like a pregnant bump rather than like you just ate a huge breakfast burrito also puts more pressure on your stomach. Notice the loss of space in image above… This can lead to heartburn or acid reflux that can range from annoying to stop-you-in-your-tracks painful. You should ALWAYS get checked out for bad chest pain that is new. If you’re checked out and know it’s heartburn, you can try to minimize with a few strategies.

  1. Eat smaller, more frequent meals and not for 1 hour before bed. I know, you’ve probably got the appetite of a teenage boy on steroids right now, but pace yo’self!
  2. Make sure you’re managing that pregnancy-related constipation – the more you’re backed up, the worse this will get (again see first tri post for info on this)
  3. Avoid acidic food & drink: citrus, tomato, soda, black coffee, and spicy foods are the worst for most, but you might find your own special fire-starters you’ll need to avoid.
  4. Use Tums as needed if it’s been ok’ed by your provider. Never more than 6 doses daily, and honestly, if you’re taking 4 or more, you should be discussing other treatment with your healthcare provider. WORD OF CAUTION: The more of these you take, the worse constipation you may get, so beware.
  5. If all else fails – ask your provider about starting another antacid medicine daily

Back pain

Relaxin hormone (yep that’s actually what it’s called) is well at work loosening up your pelvic ligaments in preparation for birth. That along with your new weight up front can often start up some low or upper back pain towards the end of second trimester. Some women also start to get shooting nerve pains including sciatica or the infamous “crotch lightning“.

If you haven’t had the latter, praise Jesus for a minute because it’s awful. Basically, that’s one of your pelvic nerves getting pushed on and leads to a sudden sensation of being electrically shocked in the labia. Yowza! Here’s what you can do to help the back:

  1. YOGA!!! Prenatal yoga is a fantastic way to ward this off and stay balanced. That slight decrease in fatigue should help you make it to those classes. No prenatal classes near you? That’s ok – head for an easier flow class that’s not a “hot yoga” class and ask the teacher to show you how to modify poses.
  2. Heat it up. Choose your flavor – a daily heating pad session, steamy shower or very warm bath can work wonders for the soreness. IMPORTANT NOTE: You must stop as soon as you feel “hot” in your body. Getting overheated while pregnant is dangerous.
  3. Massage: I can’t say enough for the benefits of a regular prenatal massage. This is a GREAT thing to put on your baby registry – some places even offer a prenatal “membership” package. Do check that the person you see is trained in prenatal massage – certain positions and pressure points should be avoided.
  4. Still not better? Ask your healthcare provider if its ok for you to take medicine, see a physical therapist or consult with a Pregnancy and Webster trained chiropractor that they can recommend. Chiropractors trained in Webster & pregnancy techniques can be a great help, BUT there are some out there who have questionable training since it’s a less well-regulated field. Make sure you’re going somewhere safe!!

Peeing

You thought you were peeing more in first trimester, didn’t you?

Get ready ladies – more bladder pressure + tiny human karate chopping = soooo many potty breaks. Advantage of this is you can get your 10,000 steps in daily just walking back and forth. Don’t let this deter you from drinking enough water – that can lead to pregnancy complications. Accept it. Don’t fight it. It’s only going to get worse. Go with the flow (see what I did there?? #PunIntended).

You might also get the fun experience of snissing at this point too: sneezing that makes you piss yourself. Great reminder to get busy on your Kegel program!

Contractions

Anybody heard of Braxton-Hicks? Named after the random dude who decided to name the phenomenon back in 1872, these are contractions that are NOT part of labor. They can start as early as 16 weeks for some sensitive mamas, more commonly toward the end of second trimester or beginning of third. However, some women don’t get them at all – and that’s ok too!

The thought is that these are little “preparatory” contractions, the uterus is working on it’s squeezing abilities, but they are not coordinated in a way that leads to any change in your cervix. Some women feel them as a slight tightening, like your pants all the sudden downsized on you but for others, they are quite uncomfortable with pressure-like sensation.

They are by definition irregular. They can be triggered by being dehydrated, pushing yourself too much in exercise, having a full bladder or completely at random.

No need to worry about them UNLESS: Of course if you have known risks for premature labor (talk about this with your provider). OR you have 3-4 in one hour, they persist even though you hydrate, rest and empty your bladder, the discomfort lasts longer than a couple minutes for each one, you are otherwise ill or have vaginal bleeding with them. When in doubt, ask YOUR healthcare provider.

Round ligament pain

You probably have never heard of or known you had a round ligament until pregnancy. It’s essentially a tether for the uterus to keep it where it’s meant to be. It stretches as the uterus expands in pregnancy and can be tweaked with a sharp sneeze or cough or even just standing up. It causes a pinching or sharp pain in the side of your lower belly or groin that lasts for a few seconds to a minute then goes away on it’s own. Unless the pain doesn’t go away – no need to worry about these either.

Image result for round ligament uterus family

Not always the “Golden Trimester”

 

If you’re not the pregnant person yourself, don’t assume ANYTHING. Some of us have pregnancies where none of the first trimester misery gets any better and then second trimester just adds to it. Some still don’t look pregnant. Some are still puking. Some are still so tired they want to take 3 naps a day.  Ask how they’re doing. Ask how you can help. Restrain yourself from commenting on the size of a woman’s belly unless it’s to tell her she’s beautiful. Period. Hard stop. No one needs to hear they’re soooo small or sooo huge. In fact, a simple, “you’re beautiful” is a good comment for all 3 trimesters – because you are, mamas!!

What are your favorite parts of second tri? Any other weird symptoms you have/had?? Comment below for the other mamas!

42356565_261001701423039_6714978253997604864_n.jpg

Dr. Annie is a family doctor, mama of 2 with 1 more on the way in the Sacramento area who has experienced all of the above.