Tuesday, March 9, 2010

The answer is always "YES!" (Or, how to help a struggling new mom.)

How best to be of service to a new mother often comes up in conversation when you're me, both online and out in the real world. I received this email from a concerned relative of a new mom, so by way of example, I thought I'd share this correspondence, with permission and edited to remove personal information.
I'm hoping you may be able to help me out. My niece just delivered her first child, by C-section, 5 weeks premature. The baby may come home today. My niece is also prone to depression, has been for a long time, and I can hear it creeping back into her. She wants to go back on her meds because she realizes whats happening but of course is worried because she is breastfeeding. Her mother (my sister) is wonderful. She's very practical, almost to a fault. Not that there's anything wrong with practical advice, but I think my niece is going to need more supportive real-time help. I've told her if she needs me just call, I'll take the day off, leave early and if it's the middle of the night, call and we can talk it through together. What else can I do?

First, what a wondeful auntie you are for wanting to help! Assuming you live close enough that visits aren't a HUGE commute, I would offer four basic suggestions (the latter three of which work even if it is a distance). First off:

1. I would consult her about what times of day are best for her to receive visitors, and then I would simply plan to visit her regularly (with notice prior to your arrival, of course). I would not wait for your niece to ask for help - because she may never feel like she can really ask, no matter how sincere your offer of "anytime, day or night" really was. There is a tremendous amount of pressure to become self-sufficient as a new mom, and moms can feel like they're failing if they need to ask for help, no matter how much they need it.

The visits can involve some practical, simple help, like doing the dishes or folding some laundry - things that can make a big difference in a new mama's day (at every visit, I try to always leave the sink free of dishes and the laundry finished or at least in progress). Sometimes just watching the baby while she takes a shower is all she might need to feel renewed. Other days she might have to cry on your shoulder for a while, get some advice on newborn care, then take a long walk while you prepare some food for her (bringing homemade frozen meals is ALWAYS a boon). And some days, just chatting and laughing over tea will make her feel human again.

Point being, the companionship itself is as important as help with tasks , breastfeeding support, etc. Isolation is such a huge factor in postpartum depression, and if she is already prone to depression, you guys (her family) really need to help her watch out for this. Having those regular visits to look forward to, especially in the early days when new moms feel like they're barely treading water, can help her feel like she always has a lifesaver being thrown her way. My friend Patty came over once a week, and though I would have loved help more often, knowing that I had that support to look forward to helped anchor me all week long.

If it's possible for you to visit, let's say, M-W-F (just for example) for a while, and then taper off after you see how she's doing, I think those regular visits would be the best possible thing! I can see how it would also be beneficial to have the visits from you EVEN IF her mom is already there a lot. I am *sure* her mom loves her like nothing else in the world, and vice versa, but sometimes having your mom there can be . . . well, I don't want to say oppressive (though that could be true in some cases), but there might be some extra pressure or other relationship baggage (even minor stuff) that can be hard for a new mom, if that's her only support. I'm not saying her mom isn't helpful, because I'm sure she is, but it can be really refreshing to have someone besides your mom to help. (I hope that made sense.)

2. (You knew this was coming!) One other thing to *consider*, especially if regular visits from you yourself aren't logistically feasible, is, of course, hiring a postpartum doula for her for a while. :o) In addition to being able to provide the above, she does have specialized training, and can sometimes offer a bit more in the way of breastfeeding support, should that become an issue (though very serious problems would be referred to an IBCLC).

To locate a postpartum doula, if you don't know of any, there are a few options - here are a few to get you started:
  • This is DONA's site, the largest of the networks to date
  • And there's this site, though it's relatively new and might not have extensive listings yet: Doulas.com
  • If you're coming up short, just try Googling "postpartum doulas" + "relevant city/area".
3. Just a quick but important note on the meds: There are actually a LOT of medications, including antidepressants, that are perfectly fine with breastfeeding - more than some doctors know unless they specialize in it! The thing to do is find out what her medications are, and then find someone with the Thomas Hale guide to breastfeeding and medication (a.k.a. lactational pharmacology) to look them up - I would try calling local lactation consultants. In the rare cases where the medication IS inadvisable with nursing, alternate medications that may be just as effective are recommended. So if her doctor has told her she can't take her medication while breastfeeding, this might be incorrect - it is worth a look! Plus, you can henceforth impress your friends by saying "lactational pharmacology". It's like flashing a Mensa card.

4. I have one final suggestion. This is something to tell her in response to the inquiries of other friends and relatives who will want to visit. Almost invariably, when people arrange to come calling on a new family, they ask "Is there anything I can bring you? Pick up at the store? Anything?"



This goes back to the learning-to-ask-for-help thing. It is SO HARD for us to get this lesson, and stop trying to prove we are superwomen who can do everything all by ourselves immediately after delivering the placenta, but there's no time like the postpartum period to start feeling comfortable with it.

Have her keep a notepad by the phone, or in a very handy place if she relies on her cell. This notepad would be a great inexpensive gift, especially if a pen is attached so she doesn't have to look for one over and over. She can then keep a running list of things that she and the household need, just jotting them down as she goes. Orange juice, witch hazel, baby wipes, red raspberry leaf tea, onions, sanitary pads, flax meal, Rescue Remedy, dark chocolate, burp cloths, fresh fruit, a new thermometer, WHATEVER. If the list is literally empty, and she can't think of *anything* else - ASK FOR TOILET PAPER. It can always be added to the household stash.

Make her repeat it with you: "The answer is always 'Yes'!"

To help drive the message home, I share with you some "Yes" visuals I found via Google Image search.


  1. Just wanted to suggest LactMed as a source on breastfeeding and medication as well. It's a tad technical, but is freely available online from the National Library of Medicine. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

  2. VERY helpful, thank you!

    The Hale guide is currently languishing on my Amazon Wish List as "highest priority". I'm-a have to suck it up and buy it myself one of these days . . .

  3. Don't forget to pass on the ICAN info to her!

  4. YES!

    Is it a cop out if this is all I say in the comment box? Okay, well then I'll just have to tweet this for some extra brownie points then.


  5. Brownie points hereby awarded! Thanks Melodie!