Mamamia has recently launched a new Podcast series called “Year One” which is all about how to help you as a new parent, survive and enjoy, the first year of your child’s life. The Podcast series gives you practical, expert advice from an in house “dream team” of baby experts and I was delighted to be invited to join this team. It’s also a relatable, often hilarious journey of real life stories from the hosts, Holly and Christie, who are mums and share four children under seven between them.

I recorded two episodes and the first is titled “Getting Sleep Sorted”.

Let’s face it, it doesn’t really matter how many baby “how to” books you devoured or how often you researched Dr Google, the first year of your child’s life is still a very steep learning curve for any new parent. And the subject of sleep seems to be the hottest topic.

Prior to having a baby you may never have understood this obsession with sleep. Now you do. The nearest good coffee hub takes on an almost religious significance.

There will be days when you think you’re losing it. Sleep deprivation, an unsettled baby, well meant but unwanted advice, and often minimal trusted support. The hardest job of all is parenting and lots of your friends just won’t get that.

My first bit of advice based on 20 years experience as a Mothercraft Nurse is don’t be afraid to put your hand up if you’re not coping and you need professional support. No one can do a new job without help, any job. You haven’t failed and it shows real courage to ask for help.

The topics and advice we cover in this episode “Getting Sleep Sorted” include;

  • The first 6 – 8 weeks and helping you understand what’s normal sleep patterns and what’s not.
  • The 24/7 intense new role for mum, how often should baby be feeding, unsettled periods and how to cope.
  • How to establish healthy sleeping patterns after 6-8 weeks
  • Do parents sabotage their baby’s sleep, common mistakes.
  • When and how to start a day/night time routine.
  • Where should baby sleep? Safe sleeping guidelines, first with parents and when does baby graduate to their own room? Do baby monitors help?
  • How to avoid/assist “flat head”.
  • Should you use sleep aids like white noise, dummy?
  • Settling techniques and coping strategies for those tricky times like “witching hour”.
  • Baby starts to roll, what then? Transitioning from swaddle to sleeping bag.
  • What does “sleeping through the night” actually mean and when does it happen, if ever?

Click here to listen to the podcast now >

In Episode 5 of this Podcast Series from Mamamia, Holly and Christie ask me for my best tips on venturing out of the house for the first time with your new baby.

This is going to take some serious planning for two! Breastfeeding in public, best coffee hub with a pram in tow, change facilities and how to keep strangers from coughing all over your new baby before vaccinations. You’re probably going to overdo the packing of the baby bag in the beginning. You won’t need a pillow, first aid kit, blanket, breast pump, a stash of snacks, the entire stock of Toys’R’Us, a spare set of clothes for yourself and five onesies for your baby.

We will also cover;

  • How to deal with public transport
  • The best places to go with a new baby and pram
  • What you can stash in the car
  • How to best manage exposing baby to the world of everyday germs/immunisation benefits
  • How do you keep strangers from touching your new baby?
  • How to deal with inclement weather
  • Breastfeeding in public, how do you best manage this to alleviate any pre anxiety or stress?
  • Changing facilities, where are they?
  • What can go wrong?

Click here to listen to the podcast now >

A Mothercraft nurse has specialist qualifications, knowledge and a depth of experience in Postnatal and Early Parenting care for newborns through to preschoolers.

Our knowledge and training includes lactation and breastfeeding, responsive sleep and settle strategies, feeding issues, routine management, growth and development assessment, toddler behavioural management and maternal health. We have been trained to have a holistic and “big picture” approach in order to provide the best, most practical solutions to suit each individual family and their needs.

So when one of our Nurses comes to your home, you can trust our advice and the welfare of your baby or toddler under our care.

The nursing qualification of Mothercraft Nursing was historically obtained from an intensive, 18 month live-in course at Tresillian or Karitane (in NSW).  Like all other health professionals we work in  a regulated industry and must be registered with AHPRA (Australian Health Practitioner Regulation Agency) under the national Nurses and Midwifery Board.

We have the medical training and knowledge to be able to assess and identify the causes behind babies and toddlers who are not thriving, developing or sleeping within normal developmental expectations. This may include some medical conditions such as reflux or other gastroenterological  issues, food allergies or intolerances, common early childhood illnesses and any breast or formula feeding problems.

We also have a depth of knowledge and experience to assess mums presenting with symptoms of perinatal anxiety or depression that may be contributing to feelings of being unable to cope within normal expectations. It is so important to seek the right professional support to help you through this period.

In these and other instances we would refer you to your own or other Maternal Health Specialists we work with so that you have qualified, professional support to help support you and your partner.

The really hot days are upon us, so if you don’t have air-conditioning these suggestions will help keep you and baby more comfortable.

  1. An effective way to manage the temperature at home is to open all the suitable windows and balcony doors overnight to allow the cooler night air in. Then close same at the beginning of day to keep the heat out.
  2. Invest in some fans for the living areas and a small floor fan for your baby or toddlers bedroom facing away from the cot. It keeps the air moving and does lower the temperature a little to make it more comfortable to sleep in.
  3. Cotton singlets and wraps, cotton bed-linen, lots of fluids/breast feeds and regular light snacks are all hot weather essentials.
  4. ‘Just’ warm bath or shower may help (not cold please)
  5. And mums, same sort of care and attention for you too!

To find out more about Mothercraft for Babies services and support, please click here or call Beth on 02 8221 8877.

Most babies from around 2-3 months old start to respond to a more predictable rhythm or pattern to their day/night that reflects their developing needs for number of milk feeds, wake time and sleep cycles. Routines or rhythms that work have some flexibility that allows for the usual intrusions of daily life such as holidays, illness and busy schedules of working parents.

The arrival of siblings creates a greater need for flexibility and adaptation. For mum or dad you still only have one pair of hands!

Here are 3 things to keep in mind;

  1. Establishing an age appropriate rhythm or routine somewhere around 10 – 14 weeks becomes important for baby’s sense of expectation of the feed/play/sleep or feed/sleep cycles. Their circadian rhythms are developing (internal body clock) so distinguishing between night and day will evolve.
  2. Guiding this rhythm can be particularly helpful when the primary caregiver/parent returns to the workforce and having a flexible structure to the day can help you continue to breastfeed for example.
  3. When the inevitable disruptions in life appear such as sickness, holidays, moving house, starting day care, then it’s important to “park” the routine and meet your baby’s increased need for feeding, your comfort and reassurance.
  4. Your baby is a little individual, genetically blessed with a unique temperament, so their sleep needs and wake times will vary. Some days will go smoothly and others won’t. Generally if your baby is happy, relaxed and alert during their wake time then that’s your evidence that they are probably getting enough sleep.
  5. And what worked for your first child may not necessarily work for the next, different temperaments and different kids. Just when you thought you had it nailed!

We are only a phone call away if you need one one one advice and guidance. Call us on (02) 8221 8877 or click here to contact us online.

For those mums who are using bottles for breast/formula feeding…did you know that if you warm the milk a little more (feels warm, not hot please when it touches your skin, inside wrist) the milk flow will quicken through the teat? And conversely if you need to slow the flow down due to gulping/wind then just cool the milk to room temperature (test on inside of wrist and will neither feel warm or cool).

It’s really important to wash and clean those teats and bottles thoroughly before sterilisation as the milk curds can clog the teats and create havoc!

Finally, I am a staunch advocate of the Pigeon teats and their BPA free bottles, they have been on the market for a very long time and still do the best job.

Interview by Brooke Hunter – Originally published Femail Magazine

Beth Barclay, a registered Mothercraft nurse with over 20 years of experience supports the long held belief that baby massage has many benefits. It enhances baby and parent bonding through touch and skin to skin contact and helps reduce stress hormones while improving baby’s sleep patterns. To help incorporate massage into baby’s routine Cetaphil has launched its new Baby Massage Oil with shea butter.

‘Massaging baby helps parents to get to know their baby’s sensitivities to touch, what particular parts of their body responds to a soothing touch more than others. It is even known to reduce colic symptoms and improve digestion,” says Beth.

Cetaphil Baby Massage Oil is specially formulated to protect and nourish newborn and infant skin with botanical extracts including natural calendula, shea butter and sunflower seed oil. It also includes Vitamin E to gently moisturise and protect baby’s delicate skin.

Baby massage tips by Beth Barclay:

  • Choose a time when you are both calm and baby is alert
  • Ensure the room is a comfortable temperature
  • Start on the legs as it’s the least sensitive area
  • Start with long slow strokes to baby’s arms and legs and use soothing tones in your voice
  • Soft music can be played to help relax the parent and baby
  • Talking to baby and explaining in simple terms what you are doing will help baby be reassured by your voice
  • If baby shows signs of discomfort, then stop and try again another time
  • If baby is comfortable on the tummy, then apply long smooth movements from head to toes (great opportunity for tummy time too!)

Interview with Beth Barclay, Mothercraft Nurse

Question: Can you talk us through the benefits of baby massage?

Beth Barclay: There is a long held belief that baby massage has many benefits. It enhances the parent and infant relationship and allow parents get to know their baby’s sensitivities to touch, what particular parts of their body responds to a soothing touch more than others. It can reduce the stress hormones and help relax and settle your baby, improve sleep patterns and sometimes reduce the severity of colic symptoms.

Question: How does baby massage aid in bonding?

Beth Barclay: It helps parent and baby bond through eye contact, verbal soothing and skin to skin contact. And this is the way babies and children experience the feeling of love, through touch. It’s a good ‘wind down” time for both parent and baby, an opportunity to just be with your baby and connect. Some babies may respond quite quickly to the enjoyment of a gentle massage and they are more comfortable with being undressed. Other babies may take some time, so go slowly and patiently, small steps.

It is important to be mindful of your baby’s comfort and willingness to be massaged. If baby is becoming visibly uncomfortable or showing signs of disengagement by losing eye contact and looking away then you should stop. This is a good way for parents to understand their baby’s subtle cues when the enjoyment and relaxation of the experience has finished for them.

Question: What techniques are required for baby massage?

Beth Barclay: Always wash your hands before you start and make sure the room is suitably warm with no draughts so your baby won’t lose any body heat. On a safe surface, rub the massage oil between your palms to warm your hands and you can start with slow smooth strokes to baby’s arms and legs, quietly talking to him and explaining in simple terms what you are doing. Soft music may help relax both of you, particularly if you already use music as a ‘cue” for him to wind down for sleep.

When you decide to introduce massage to your baby choose a time when you are both calm and baby is alert. You may need to leave some clothes on as some babies do not like being undressed. Ensure that the room is a comfortable temperature away from any drafts so that your baby does not lose any body heat. The change table or suitable play mat on the floor maybe practical considerations.

It is important that you are both enjoying this time. If your baby is showing you signs that he is not comfortable then stop and try again another time.

The goal is a relaxed and happy baby and an important bonding time for parent and baby.

Question: How can massage be used to improve sleeping in babies?

Beth Barclay: You may decide to give baby a massage after the evening bath to help prepare and relax your baby for bedtime. This may help with the wind down and calming baby and give a suitable sleep ‘cue” that it is nearly time for bed.

Otherwise it is important that your baby is calm yet alert and feels part of the soothing bonding experience of a massage, having one on one time with the parent or caregiver.

Question: What parts of a baby’s body should we massage?

Beth Barclay: You can start with slow long strokes to his arms and legs, talking to him and explaining in simple terms what you are doing. Baby’s chest and tummy are sensitive areas so be very gentle using circular strokes avoiding the belly button if this has not completely healed.

You can massage their scalps with small gentle circles using your fingertips and similarly the same movements around their forehead and sides of their face. If all is proceeding calmly then roll baby onto their tummy and apply long smooth strokes from head to toes.

Question: Can you talk us through the importance of tummy time?

Beth Barclay: A massage provides a good opportunity to include some practise for tummy time which should be included in baby’s daily routine. Regular tummy time encouraging babies to lift their head helps build their strength in their neck, shoulders and back. This increased muscle strength helps with future milestones such as rolling, sitting up and good head control for starting solids.

Practicing tummy time on a daily basis can also assist and support with torticollis (favouring turning head to one side), (plagiocephaly) ‘flat head” spots. Keeping both sides of their neck strong and flexible can also aid breastfeeding and attachment so baby is just as comfortable feeding on both breasts.

Since 2010 our Mothercraft nursing team has helped hundreds of families overcome the parenting challenges that can arise from time to time. From this experience we know how much a “hands on” home consultation can almost instantly change your life showing you real results and positive change.

To add more value to your home visit package we have introduced a new personalised “Care Plan” for your baby or toddler. Your nurse will put this flexible plan together based on her assessment and recommendations so you can easily refer to it for guidance, support and peace of mind. It will include advice on milk feeds, wake and sleep time, settling methods, diet and solids and any specific advice relevant to the wellbeing of your child. There will also be a recommended Action Plan for you to refer to as we know sleep deprivation can mess with your short term memory!

The Care Plan can be attached to your fridge ( the best notice board in the house!) by our fun fridge magnet with all our contact details should you need our support again.

This past month I have been talking to many mums who are struggling to cope with caring for their newborns. It’s a pretty intense learning curve in the first few months, particularly if it is your first baby.

During pregnancy there is lots of accessible, valuable support and advice available from health professionals and your planning will include where you will deliver your baby and your chosen birth plan. A common theme in the feedback from mums is that the birth plan can be the part of the journey that doesn’t quite go to “plan” and may result in some intervention to ensure a healthy baby and mum. If this is the case it can change your physical ability to manage a new baby when you go home. Speaking with many mums the feedback has a common theme. It can be the start of an unfamiliar feeling of loss of control and free fall in this new role and journey as a parent.

Maternity wards are not conducive to sleep. If you are breastfeeding then you will be feeding every few hours or more around the clock and this may normally take up to an hour each time as your newborn will be sleepy and you are both learning the ropes. Breastfeeding teamwork and getting to know each other takes time and practice. And you may receive different advice from the nurses with each new shift, confusing to know which advice suits you.

Time for hospital discharge and taking baby home.

This is when you and the the real world meet face to face and the intensity of caring for a new baby starts. And maybe this precious baby has been planned for some time and the enormity of her anticipated arrival can be overwhelming. It’s exciting and exhausting, a rollercoaster ride like no other. Emotional support and understanding is so important but not always readily available in today’s busy and high achieving world. Family support is not always nearby.

Dads are often expected back to work within a week. Guilt is a debilitating feeling for both parents. Dads (also sleep deprived and unsure what their parental “task” list involves) feel guilty for leaving their wife and baby at home on their own. Mum may need to touch base with dad at work for reassurance/support. Dad needs to sleep at night if possible so that he can function and be “present” at work. Understandably mum needs some respite or support with the overnight feeds and settling baby. This new routine is a lot to contend with and teamwork becomes really important so you can allow each other some respite.

It is normal for your baby to feed often day and night for the first 6-10 weeks, particularly if your baby has been born early or the birth has been complicated. And I mean every few hours…and it is normal that it can take up to an hour from beginning to end of the feed. Your newborn will be sleepy and regularly fall asleep at the breast, their most favourite place on earth. And it can be really challenging to keep them feeding through the fore and hind milk which will help them settle whilst stimulating your supply. And they need frequent and small amounts to begin with as breast milk is meant to digest easily.

And if you feel you could benefit from some “one on one’ professional guidance and help to establish breastfeeding then don’t hesitate to call on a breastfeeding specialist to help you. The “drop in” times for breastfeeding clinics at your Early Childhood Clinic can be hard to navigate with a newborn, parking and sleep deprivation!

Developmentally your baby can find a feed/sleep rhythm rather than a “routine” for the first few months. After 6-8 weeks research shows that your baby’s circadian rhythm is developed enough to enable an ability to distinguish between night and day. So you can begin to establish some daily consistent rhythm to the end of “day” bath and feed to sleep.

It is well within normal expectations that your newborn will have unsettled periods every day. And those unsettled periods will often shift to different parts of the day and night. Their only way of communicating or signalling their high level of basic needs to you is crying. And it takes time, practice and confidence to understand and read their “cues” so you may successfully respond to their needs. If your baby is crying and distressed then hold them close to soothe and calm them. Leaving babies in their cot to cry without responding serves no purpose other than unnecessarily distressing you both. Your little baby is crying for a reason, it is not behavioural. The skill and experience is identifying the cause of your baby’s distress and needs.

There may be loads of well meaning advice from the internet/mother’s forums/ friends and family that may have worked for them and their babies very well. But this may not suit you, your parenting beliefs and your newborn’s temperament.

If needs be choose one or two trusted advisers combined with your wonderful maternal instincts and enjoy your baby. When you can take a breath, take stock of your changing priorities and let some “stuff” go. Accept any food deliveries, offers of shopping or support and short home visits from vaccinated family and friends in good health!

Love, patience and emotional and physical resilience are the foundations for this wonderful and unique relationship.

 

Recently I was fortunate to be on a safari observing a lioness stalk a water buffalo and its one-day old calf. Here in the wild, the calf’s life was completely in her mother’s hands. It was clear what a huge sense of responsibility it was for the mother buffalo and the importance of her never dropping her guard. It reminded me that humans are also primed to be protective, alert and ready to face any threat in this postnatal period.

Sometimes this biological and necessary hyper vigilance can present as overwhelming, all consuming and distressing when in fact there is really no imminent danger. There is no lioness lurking around the corner. This is what we call Postnatal Anxiety, which is under the umbrella of Perinatal Mood Disorder, occurring in at least 10 percent of women. In my experience in my clinical practice such a presentation seems more common than the mum who is depressed, although these symptoms can go hand in hand.

The anxiety can take many forms. The worry can be predominant, preoccupying and often accompanying difficulty with sleep. Physical symptoms of anxiety can be so intense, sometimes leading to panic. There can be obsessive-compulsive behaviour and thoughts, which can be intrusive and frightening. For example being afraid one might harm one’s baby, or repeatedly checking if the baby is breathing. The baby’s sleep can be a fixation for the mum with mums describing a knot in their stomach when baby goes down. There could also be avoidance as the fear of going out or being alone with baby gets in the way.

In addition to the previously mentioned bias to anxiety at this time, we know that there are certain risk factors that would make a mother more vulnerable. (We mustn’t forget fathers can be anxious and depressed too). These influences include being someone who tends to worry, perhaps being accustomed to replaying conversations, imagining the worst-case scenario, or being up at night ruminating before a big work deadline.

Perfectionism can also be problematic, as when one has rigid expectations about how things should be, these are likely not to be met. This relates to not only how the baby would be, but also even the birth experience, the success of breastfeeding or the way one’s life is going to be when the baby comes. The tendency to believe there is only one way that things should be is likely to feed into anxiety. If the baby isn’t doing what the books say or as suggested by others, it can often lead to spiralling worry.

In addition, having a difficult and stressful pregnancy can contribute to anxiety. In fact often the anxiety begins prenatally. A traumatic labour or a baby having health issues can also make it a shaky start to motherhood. Let’s not forget the relevance of that phrase it “takes a village to raise a child”. Without much support the task of raising a baby is huge and not as nature intended. A woman is not supposed to be with her baby 24/7 and a break is often beneficial for the mother and baby. It is also important to consider if one has a family member, especially a parent who struggles with anxiety in some form. There may be a genetic vulnerability, with some clear messages about the world being a dangerous place having been heard growing up.

So the good news is that in the midst of this stressful experience, is an opportunity to change and recovery is very likely. There is indeed a place at times for antidepressants, which can improve functioning especially when sleep disturbances and elevated anxiety symptoms occur. They are in fact not addictive and need to be seen as part of a 6 month to one-year plan. Psychological input is extremely effective in addressing the anxiety.

Having an opportunity to manage these anxieties in an individual or group context with an experienced clinician can be most helpful. Exercise and nutrition also have a part to play, as ways of reducing anxiety.

Reaching out and not feeling shame around some often frightening thoughts, feelings and symptoms can be a turning point in putting a plan in place. Reminding oneself that although this is a time of vulnerability and unpredictability, it is not necessary to feel that
danger is around the corner. Oh, and the water buffalo was fine, his mum scared the lioness away.

Helpful websites:

www.panda.org.au
www.beyondblue.org.au