{new #OutsideTheMomBox post} Book Review: The Vital Touch by Sharon Heller

"This book is about the continuous battle between our genes and our culture," so begins Dr. Sharon Heller in the introduction of _The Vital Touch_. And with that lead-in you can only guess where things go from there! _The Vital Touch_ was required reading for my DONA-approved post-partum doula training so I read it when my daughter was about five months old. While the book spends plenty of time on newborns, it is an appropriate (and I would say, important) read for anyone with a baby under 1 year. Disclaimer: _The Vital Touch_is almost 20 years old and while I would normally steer clear of recommending older resources, I feel very strongly that the knowledge it contains is both relevant and crucial for new parents to access.

As the title would tell you, Heller offers plenty of evidence in support of being physically and emotionally engaged with your baby.  But one of the strongest aspects of the book I think is in her comparison with how the US compares with other countries in terms of how we care and respond to babies. For example: Heller tells us that American babies are among the least held babies in the world. Knowing how the US ranks in terms of infant mortality, I think this statistic, while almost twenty years old, is likely still true, sadly. With stories, facts and figures, Heller gently prompts us to look closely at what is lost when babies needs are ignored or attended to in less a way than they should be. Frankly, it is fascinating. 

And there's no easy answer here. As I've said before here and here, here too is that we need to redirect fault away from mom and toward a society which doesn't set new moms up with the tools that we need for success when our baby is born. That's a problem. I believe that most moms make decisions that they believe are best for their child. So while Heller addresses many of the issues that I've discussed before in terms of the culture of absence that new moms are born into, there isn't the same call to action that Katrina Alcorn offers readers in _Maxed Out_. I'm okay with this, however, because: 1) Heller's strength is really that of an anthropologist and educator and she does such an outstanding job in these areas and 2) in 1997, there just wasn't a concerted effort or public urgency around organizing for societal change for moms that we see today. 

_The Vital Touch_is a truly must-read for any new parent. But it feels especially relevant for new parents who are curious about child development in their baby. Heller is accessible, compassionate and curious...all of which make _The Vital Touch_not only an engaging but a relatively easy one too.

Is there a book that you are curious about that you'd like me to review? Leave me a comment below.

Update: I did email Dr. Heller and ask if she planned to do an updated version of The Vital Touch and she wrote back with this: "no updated version. Publishers don't do this unless books sell volumes and unfortunately this one hasn't. But thanks for reaching out & for your support!" Never hurts to ask. :-)

{New #OutsideTheMomBox post} #Moms H2O 101

Summer is officially here and with it, long days that often feel exhausting, especially if you are pregnant or have a baby attached to you. One way to help curb exhaustion and remain alert is to stay hydrated. 

I'm always surprised how much more awake I feel after I sit down and have a few good gulps of water. Then, again and again. Dehydration can make us feel fatigued, head-achy, and nauseous. Drinking water is kind of like taking deep breathes, for me. It can feel cleansing and mind-clearing...when I'm being mindful of what I am doing!

Pay special attention to your fluids when you're exercising. I had a wicked headache for almost 4 days shortly after I came back from working out harder than I should have, one of my first times back at the gym. I'd drank a little water when I was there but not enough and had been nursing Elisabeth almost non-stop the night before as she battled yet another ear infection. I couldn't figure out why my headache was so bad. It seemed like a migraine but I'd never had one before. Only an 800 mg tab of prescription ibruprophen leftover from oral surgery seemed to knock it back a bit. Weeks later, after sleuthing around on the internet, I guessed that perhaps I had been severely dehydrated. I now make it a practice to drink most of my 16 oz Camelbak of water en route to the gym, while there, and on the way back home. I also keep a full glass of water by my bedside table so I can sip overnight whenever I need to.

Speaking of sipping, make those sips more appealing by adding something to it. I'm a sucker for pretty things so when something is more visually appealing, I'm more drawn to it, even my water bottle! Grab a bundle of mint from the Farmers Market on Saturday mornings for only $1. I add a good 8-9 leaves to my Camelbak and then keep a pitcher of cold water with plenty of mint floating in it, ready to go in the fridge. That bundle should last the whole week. If you aren't a mint fan, add some cubed watermelon, slices of washed, peeled cukes or the old standby: lemon wedges. Even Elisabeth is getting into it, saying "mint" and looking for it at the Farmers Market!

A bib always helps with any water play! (Elisabeth at 7 months.)

Kids, even babies, love water. We bought Elisabeth a water table when she was a little over a year and I have high hopes for her to use it for another two years at least! But for littles closer to the 6 month + mark, you don't need to get that fancy: set them up for some fun water play on their high chair (or outside in the shade on a blanket). Put a few ice cubes on their tray and see how they react. It will likely be too slippery to pick them up easily but of course keep a close eye on them with the cubes. If your baby is teething, wrap the cubes in a scrap of clean, thinnish fabric so baby can then use them to ease their achy gums. This kind of cool distraction might be just the thing you need to remind you to drink your water too!

A few special notes-

If you're breastfeeding, baby will be drinking more which means that YOU need to be drinking more. Breastfeeding is a loss of fluid, after all, so you do need to replace those fluids. Baby doesn't need water. Remember that breastmilk is 89% water so baby doesn't need to be drinking water by herself although a sippy cup full of water can be a fun activity! Water is okay for Baby to drink if she is at least 6 months but just a few ounces a day. Most babies under a year don't seem all that interested in drinking water.

If you're pregnant, it's even more important for you to be drinking plenty of water when the weather turns hot. Dehydration can happen very easily and can be very dangerous. Remember too that a loss of fluid is felt throughout the body (think headaches, nausea, etc.) and that includes the uterus. This piece over at Live Strong details all of this quite nicely. 

Do you have any tips or lessons learned when it come to keeping hydrated? Leave a comment below. Thanks for reading!

{new #OutsideTheMomBox post} Impact of maternal #childhood #sexualabuse on #babies

Childhood sexual assault (CSA) survivors have a different set of challenges than new moms who aren't survivors. [For perspective, about 1 in 7 girls will be sexually abused before her 18th birthday.] These challenges can manifest themselves in different, often unexpected ways, not just in mom, but also in baby. As the first in a new series here dedicated to raising awareness about the realities that survivors face as pregnant women and new moms, I'm going to highlight three ways that a history of CSA in mom can impact a newborn's health and well being:

1. From the strange new feeling of your milk letting down to the realization that your breasts really aren't your own anymore, breastfeeding can be a very triggering act for a survivor. Add in factors like an infant's roving hand, pain of any sort, feedings at all hours and you can start to see why some survivors don't breastfeed. For survivor moms, it's usually less of a "choice" and instead often related to not being able to tolerate breastfeeding or the fact that it just doesn't work for them. And yet, we all know that breastfeeding is ideal for baby. Studies that confirm this are numerous; check out the first paragraph here for details. 
2.  Failure to thrive (FTT) is a state of undernutrition due to inadequate caloric intake, inadequate caloric absorption, or excessive caloric expenditure. There are two types of FTT: non-organic (a non-medical reason the infant isn't thriving) and organic (a medical reason that the baby isn't thriving). With both types, the bottom line is that baby isn't getting fed enough. There are many reasons why FTT can occur: lack of success breastfeeding, emotional overwhelm in mom, misunderstanding or a lack of understanding about basic infant needs in mom/parents, lack of attachment to baby by mom, etc. Each of these above reasons can be by-products of mom's past history of abuse. Dr. Kathleen Kendall-Tackett, IBCLC talks a bit about this here.
3. Not all women bond immediately with their baby.  For survivors, however, that bonding may take even longer, even if the baby is "just" a normal, dependent infant. If the baby is special needs, is "difficult" or has other challenges (colic, etc.) then bonding may be even harder. "Mere" insistent neediness of a baby may stir up past feelings of vulnerability and powerless that mom associates with the perpetrator of her abuse. It's normal: the perpetrator took what he wanted from the survivor and when a new baby enters the survivor's world, dependent and unable to feed or care for herself, the survivor's body is once again at the whim of someone else. This lack of bonding can become problematic though if FTT (see #2) develops and/or if mom begins to have ideas of harming her baby.

What does all of this mean? Well, simply due to their past abuse, survivors carry with them challenges that can complicate their ability to provide the best care for their baby. Add in factors like poverty, a lack of education, an absent or abusive partner, and you have a survivor mom who may barely be hanging on. This is something that should concern all of us. But here's what we can do:

• Keep in mind the challenges of survivors that we discussed above when you hear the ever-present "breast is best" motto. Click here for a bit more on this issue. Not being able to breastfeed a child can be devastating for a new mom's fragile mental health but what is often more detrimental to mom and baby is the societal guilt that moms are made to feel by not doing the "best" they can for their child i.e. breastfeeding.
• Provide support. Support is continually named over and over one of the best resources that you can give a new mom. Good, informed support helps new moms feel less alone, more normal and more accepted. Not to mention provide them with trusted resources that they trust when they need more help or advice. All of this is why I offer free groups. What can you do? Attend a group, help make a group happen for those who need it, or volunteer in a way that feels right to you.
• Rise above the "mommy wars". It can be so hard to sit back and mind your own business. That's true for me too! But we really must. When we accept that we can't ever know someone's whole story and therefore have no place to judge them, then we are removing ourselves from the insidious "us vs. them" battle. It's a battle that neither side will win, even if we "lean in" so let's just opt out of it altogether.

Starting this fall, I'll offer my first virtual program: a childbirth education class specifically for survivors. Open to any survivor, living anywhere, we will meet weekly over a conference call line for seven weeks. First names only. If you'd like more details, head over here to give me a call or message me. Thanks for reading.

April's #NewMoms group conversation: Introducing Solids

The second Saturday of the month is my support group for new moms and babies. Each session starts out with introductions and then goes in our main topic. We leave about 30 minutes for Q&A, then close. With some of regular attendees getting closer to the six month marker, our topic this month was "introducing solids". We talked signs of readiness, dangers of early introduction, purees vs. baby-led weaning and how to tell if baby appears to be sensitive to a certain food. Here's the gist of last Saturday's conversation-

I like to start by asking, "what have you heard?" about whatever our topic is, or a similar question. Moms in last Saturday's group relayed what they had heard from outside sources like their mom or pediatrician's about introducing solids. Some of which was "start with cereal" and "the earlier the better". These answers provided a perfect lead-in to a conversation around signs of readiness. 

Science, evidence-based information, when it comes to information for pregnant women and new moms is very important to me. Anecdotal evidence serves its purpose but when you're seeking real knowledge and not someone's opinion or experience, evidence-based information feels like the only real option in my mind. For the topic of introducing solids, I relied on my breastfeeding bible book (the best book on breastfeeding and beyond that I have found yet) _Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers">Breastfeeding Made Simple_by Kathleen Kendall-Tackett and Nancy Mohrbacher. This dynamic duo recommends the following four signs of readiness before introducing solids:

• Baby can grasp food in hand;
• Baby is interested in food;
• Baby has lost tongue thrust reflex;
• Baby can sit on her own.

Some of these just make sense, right? Giving baby food when he can't sit upright can be a choking hazard. These signs of readiness generally show up around six months. But if they aren't there, don't panic. Tongue thrust is usually gone by four months and baby is usually pretty interested in foods around five months but sitting independently and holding food are trickier. They will come in time. And, yes, do wait for all four signs of readiness. Introducing solids too early can lead to allergies, ear infections and digestive issues. Baby's system is NOT ready for solids earlier than around six months, when each of the previous signs of readiness are apparent.

Once you're ready to go, you just need to decide purees or baby-led weaning. Purees are what you think they are: pureed foods given to baby, just like your parents fed you. BLW is a bit different. The Baby Led Weaning book is a terrific resource. I also wrote a bit here about my early experiences with BLW when I first tackled it with my daughter but some basics are:

Give baby a large enough chunk of food, not tiny bites. Baby will work on as much as they want and leave it when they're done. The result is baby dictates when they have had enough instead of dad or mom trying to guess how many spoonfuls are enough.

• Baby learns to chew, even without teeth!

• BLW believes that early introduction can help eliminate chance of allergies or food sensitivities. There is little evidence to support this but I can say from an anecdotal perspective, I've found this true for my daughter and other babies I know.

• No special meals, no special equipment or longer prep times.
• Anything goes...except honey. Just make sure it is size-appropriate.
• It'll be messy! Pro tip: I use Shout on every.single.piece of clothing that my daughter stains. It works 9 out of 10 times.

Another key point: try and introduce one food at a time, especially early on. If there are reactions like a red bottom (kind of like diaper rash), redness near the mouth other concerning evidence, you will be in a better position to deduce what food might have caused the reaction. And of course always call your trusted pediatrician if you see something that worries you.

Big takeaways from Saturday-

• Solids are just fun for the first year. Think of them as another activity for you and baby to engage in. Your milk or formula is ALL THEY NEED for the first year.
• You're the expert. Do your own homework when it comes to what is best for your baby. 
• Cereal for babies is like cereal for us: filler and yummy tasting. It adds no nutritional value for a baby nor does it teach them how to chew.
• Solids DO NOT help baby sleep better. This is a myth.

I hope this summary is helpful for a new mom who may be interested in attending and as a refresher for those who did attend. Our May (5/10) topic is: summer!

If you liked this post, would you click the heart below?  Thank you!  And if you really liked and want to hear more, I hope you will subscribe here or join us next month.