4 BABY ITEMS I LOVE

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Baby items are changing all the time, and I think there is just no way to keep up with it all. So needless to say that with a 6 year gap between my second son and my most recent, there have been lots of changes. I think most mothers would agree, that as you continue to have babies, you start to realize how little you actually need. But there have been a handful of (new to me) items that have really changed the game for me this time around. All of these were shared with me by other moms and I am so grateful for that. So if there is something you’re loving as a mom, be sure to share with your tribe, we all need to help one another out.

At four months postpartum, here are 4 items that I have absolutely loved, have made my life easier and I would recommend wholeheartedly.

  1. Haakaa Silicone Breast Pump: This is a no brainer if you’re breastfeeding. You put it on the breast you’re not nursing from and it collects all the milk from your letdown that is usually just absorbed in the breast pad. This has been such an easy way for me to stash some milk in the freezer.

  2. Baby Shusher: Most of us either automatically “shush” our babies when they cry, or have been trained to do so after reading Dr. Harvey Karp’s book, The Happiest Baby on the Block. But this little machine does the shushing for you! It’s different than an ambient sound machine and actually calms your baby. I tend to use it most in the car, where I feel the most helpless, and it has been a lifesaver.

  3. Askr Embla Sleepod: I am a huge advocate for floor time, and actually shy away from any sort of baby contraption in order to promote babies development. So this sleepod has been a really useful tool for me to place little Anders down in a safe place and not have to run around grabbing blankets for him. He feels cozy and could lay their cooing for long stretches of time. Not to mention it is completely organic and beautifully designed.

  4. Willow Breast Pump: This was gifted to me and I couldn’t be more grateful! Completely wireless, this breast pump allows me to pump in the car, while helping the older kids get dressed and even while I get ready for the day myself. Pumping has never been a favorite past time for me, but with the Willow I can’t complain.

INSPIRING MOTHER SERIES | DR. REBECCA NELKEN

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Women come to me in the postpartum period (which is already so complex), and because no one talks about it, they assume that they are the only one suffering with urinary incontinence, prolapse, or even fecal or flatal incontinence.  I always encourage my patients to share their experiences- when women open up about common experiences we can support each other. 
— Dr. Rebecca Nelken, OB/GYN, Urogynocyologist

I have always been so grateful for other practitioners in the Women’s Health field. Not only because their work can also benefit my patients but because they inspire me through their work in teaching and showing women alternate ways in taking care of their bodies, mentally, physically, emotionally and spiritually.

For this series, I am excited to introduce you to Dr. Rebecca Nelken. Dr. Rebecca Nelken is a double board certified OB/GYN and Urogynocologist. I have had the chance to experience Dr. Rebecca Nelken’s treatment and I am excited to announce that we will be having her as a guest speaker for our first #aconversation series this Friday, May 10 at 10am at Plumb Line Studio. This specific conversation series with Dr. Nelken will bring to light the topic of pelvic floor health postpartum, painful sex, incontinence and prolapse. To sign up for this free event, you can RSVP here.

I know that I truly enjoyed learning from Dr. Nelken and have found her work to be so beneficial not only for my patients, but also for myself and I hope that this will be beneficial to you too.

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AO: What's one thing you have had access to before, during or after pregnancy that has positively influenced your experience? (product/professional service or treatment/class/book etc...)

RN: Vaginal estrogen cream! Sex was so painful after pregnancy.  Even though I had a C-section, my vagina was so dry because I was breastfeeding which suppresses estrogen.  Vaginal estrogen cream allowed me to have sex again without pain!

AO: What are you surprised by (that no one ever talks about) that happens to your mind or body during or after pregnancy?

RN: Unfortunately most women are embarrassed to discuss the pelvic floor symptoms that are so common after pregnancy.

Women come to me in the postpartum period (which is already so complex), and because no one talks about it, they assume that they are the only one suffering with urinary incontinence, prolapse, or even fecal or flatal incontinence.  I always encourage my patients to share their experiences- when women open up about common experiences we can support each other. 

I’ve seen women who are unable to return to exercising because of their incontinence.  This in turn can contribute to depression at a time when women want to get back to their normal routines and bodies, and need those great endorphins.

The good news is that there are many treatment options available (see below).

AO: With your experience, what knowledge would you share with a new mother?

RN: Make the time for self care.  We all feel guilty taking time for ourselves, but it’s so important to model this for our children.  And we are better moms when we are happy!

AO: How has your body amazed you on this journey of pregnancy and/or motherhood?

RN: The magic of the human body is what originally drew me to the field of medicine.  As an OB/GYN initially, and then later as a Urogynecologist I have supported women through their pregnancies, deliveries and postpartum period, all based on my extensive studying.  But living through it myself really took my appreciation to another level. I was blown away by the experience of my body growing a baby, delivering it, and then being able to nourish that baby.

AO: Fill in the blank: My current self care must do/have: _______________

RN: Meditation.

AO: Fill in the blank: Motherhood means: __________________

RN: Letting go & accepting that everything will not go according to script, but that it will end up even more beautiful than you imagined

Additional Questions Related To Your Practice

As a urogynecologist we have a few bonus questions for you since your knowledge and expertise is so pertinent to our audience. 

AO: Prolapse after baby is a common issue I see in my practice.  When do you consider surgery as the best option?  And if that is the case, do you still recommend pelvic floor PT to prepare for surgery?

RN: I always recommend Pelvic floor PT as first line therapy for prolapse.  Especially in the postpartum period, when the tissues are still healing and hormone levels have not returned to baseline.  I try to avoid surgery in this time unless absolutely necessary. 

I encourage women to start with PT, and vaginal estrogen, and possibly a pessary.  It takes about 3 months after completing breastfeeding for hormone levels to return to baseline.  If prolapse symptoms are still present at that time, then we discuss surgery. 

I always recommend pelvic floor PT both before and after surgery, as we have good data that this improves surgical outcomes!

AO: I know that you fit women for pessaries if they have a prolapse.  Do you ever use a pessary temporarily for women postpartum as they heal?  If so, for how long and is it accompanied with other therapies?

RN: A pessary is a plastic device (similar in size to a diaphragm) which can be placed in the vagina to help lift up a prolapse.  These are a great option for postpartum women who are very uncomfortable from their prolapse.  As I mentioned before, most postpartum prolapse will resolve with time and PT, so a pessary is often just the thing to alleviate discomfort in the interim. 

I always teach my patients to insert and remove it themselves, so they can be in control of when they use it.  Some women say their prolapse only really bothers them during a workout, so they can simply use the pessary when they need it.  Other women want to wear it all day, but like to remove it at night so they can have sex.

AO: I am always reminding my patients that incontinence is common post pregnancy, but not normal.  Obviously I am a huge advocate for pelvic floor and core rehab, but are there other treatment options that you perform/prescribe in your office? (ie. laser, estrogen?)

RN: I think the distinction between common and normal is so important!  Both prolapse and urinary incontinence are common postpartum, as the pelvic floor heals from the trauma of pregnancy and childbirth.  But just because it’s common doesn’t mean that women need to live with it.  We have a lot of treatment options to improve these symptoms.  I offer a radiofrequency treatment called ThermiVa.  This is an in-office, pain free treatment that accelerates the body’s natural healing by tightening existing collagen and stimulating deposition of new collagen.  This can improve symptoms of prolapse, urinary incontinence as well as vaginal laxity (looseness), which are all common postpartum.


Name: Dr. Rebecca Nelken

Occupation: OB/GYN & Urogynecologist

Website: www.rebeccanelkenmd.com

IG: @rebeccanelkenmd

ABDOMINAL BINDERS POSTPARTUM

Abdominal binding postpartum has been around for a long time, but with a resurgence of more modern designs and easy to use garments, questions pop up often from women about what is best for them postpartum.

The history of belly binding is rooted in honoring the 40 days of rest “the sitting moon” for mother’s after delivery.  A time that is honored slightly differently in various cultures.  But the idea is for the mother to be taken care of both physically, emotionally and spiritually.  The mother does very little activity other than t give her self rest and nourish her new baby.

When a mother is honoring this time and limiting activity, belly binding or wraps can be a beautiful way to reconnect to the core and feel supported where there is now a void with the delivery of baby.  When the binder or wrap is applied early on, not doing too much physically is crucial.  And this is due to the fact that anytime there is a force through the core, the pressure from it must go somewhere.  And in most cases that is pressed downward into the pelvic floor, which is often healing and/or stretched from pregnancy and/or delivery.  

Therefore if a mother is walking around a lot, lifting and using the binding to allow her to do more physically, the goal is lost and the risks could begin to outweigh the benefits.  I often use a toothpaste bottle as a visual example.  If you were to squeeze the center of the tube (the binder) and place the tube upright, the toothpaste would be pushed down and out the opening, just like your pelvic floor.  And unless your pelvic floor has had an adequate time to heal and recover, the lid (pelvic floor) would not have the stamina to stay on and prevent leaking (incontinence, prolapse, pain).

Overall, I am neither for it or against it.  I just believe firmly that women need education on its proper application and what is feasible for them in their situation.  Every woman is different, so every solution can’t be the same!

Personally, I have chosen to wear the BaoBei maternity bloomers and absolutely love them.  The compression is mild and most importantly they give support to the pelvic floor as well.  I would recommend these wholeheartedly.  Check them out for yourself here!

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LABOR AND DELIVERY PREP

As I now sit with my new baby boy, most likely in the midst of nursing or changing a diaper while you read this, I thought I'd start to fill you in on parts of my pregnancy journey.  Many of you have asked how I prepared for the labor and delivery,  and though I won't yet get into the exact details of my birth experience quite yet, I will say it was an incredibly amazing experience.  

Preparing for labor and delivery takes a holistic approach, but I'll start first with the physical aspect, since this is so much of what I cover with women in the studio.  

Around 35 weeks of pregnancy is when I began consciously preparing on the physical level to meet my baby.  I did certain stretches, movements, breathing, and massage techniques to get ready for the big day.  Here is my go to list of what I did to physically prepare my body.  I hope you find them useful too, and remember only do what feels right for you.

  • Diaphragmatic Breathing (focusing on letting go of the pelvic floor): Sitting on the large exercise ball.  Breathing in as the ribcage expands laterally and the pelvic floor drops down into the ball.  On the exhale (instead of getting the sensation of the pelvic floor lifting), keep the pelvic floor relaxed and dropped down.  Do this for 3-5 minutes daily.

  • Hip Circles on the Ball:  Sitting on the large exercise ball, spread your butt cheeks so the pelvic floor is on the ball more directly.  With breathing, do hip circles 15 times in each direction.  Do this 1-2 times per day.

  • Hip Circles on Hands and Knees:  Go down to your hands and knees, knees wider than your ankles.  Push yourself back and around, making circles in one direction, then repeat going the other direction.  Do 10-15 in each direction daily.

  • Kneeling Lunges:  Kneeling on one knee with the other foot in front, and both knees turned out.  Shift your weight forward and back to open the pelvis and inner thighs.  Use support as needed for balance.  Do 10-15 on each side daily.

  • Deep Squat with Support:  Place a few pillows or a meditation pillow on the ground.  Take a wide stance and lower yourself down into a squat onto the pillow.  Make sure the pillow(s) are high enough so you can maintain a slight arch in your back.  You can place your elbows inside your knees if it feels comfortable.  Hold this position for 3-5 minutes daily while breathing and letting go of the pelvic floor.  Come out of this squat slowly and carefully, use assistance if needed. 

  • Perineal Massage:  A couple days a week in the last few weeks of pregnancy, use a lubricant that you know works for your body, I used coconut oil, to gently massage the perineal tissue.  This is the area at the back side of the vaginal opening, between the vagina and rectum.  You can do this sitting with knees bent, or standing with one foot up on a stool, and easiest to do in the shower.  Apply a gently pressure towards the rectum and sweep back and forth in a "U" shape to begin to stretch the tissue that will be stretched during a vaginal delivery.  (If uncertain about this one, please check with your doctor first and seek out a pelvic PT to teach you)  

  • Overall Sense of Letting go of the Pelvic Floor (relaxing to use the bathroom, not crossing my legs, letting go of any tension in the pelvis)

hip circles on the ball

hip circles on the ball

deep squat with support

deep squat with support

Links for my favorite L&D props:

Exercise Ball

Meditation Pillow

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