Questions & Answers From Expert Panelists

By Expert Panelists 6/3/2020

I’m curious about when I should start pelvic floor PT after having significant tearing (3rd degree) and stitches. My OB said to wait 6+ weeks to not disrupt healing.

Ideally we are considered “back to normal” at four to six weeks postpartum including return to exercise. Typically I recommend you follow your OB’s instructions. However it is helpful to know that science tells us that the scar from the repair is forming at three weeks and can continue to mature months later, up to two years. Realistically, simply having a BM could offer more force to the wound than a kegel squeeze. Plus, we can do gentle squeezes versus a rock star squeeze. This will help to improve healing.

How long should daytime naps last in month two?

Great question! Naps at this age can range from 45 minutes to two hours. If you notice your baby waking up after 45 minutes wait a few moments before going to get him/her because he/she might transition into another sleep cycle and go back to sleep. They usually have at least one long restorative nap of about one and a half to two hours per day.

What are your opinions on babies sleeping in your bed or in the same room for the first few months?

Sleeping in the same room is great if that is what works for you. I usually encourage parents to move their baby into his/her own room sometime around four months because it helps the baby and caregiver sleep better. I do not recommend having babies sleep in their parents’ bed because that is usually not safe – too many blankets, pillows, bodies – must be mindful of suffocation risks.

I’m planning on having my baby sleep across the hall from my room in their nursery right off the bat. Should I have the baby sleep in my room for a while? I do plan on breastfeeding.

There is no right answer to this, and you are more than welcome to have your newborn in the nursery from the start. I would say that most parents do have their newborn in their room for the first month or so just because they are physically closer when you are constantly feeding them overnight in the beginning. Try what works for you – good luck!

Is there a way to tell whether you are just experiencing baby blues/sleep deprivation effects as compared to postpartum depression?

Great question. Baby blues are normal and up to 85% of moms will experience bouts of anxiety, tearfulness, sensitivity (i.e. cry at the drop of a hat), feeling overwhelmed. The baby blues usually resolve within the first two to three weeks of delivery. Depression distinguishes itself from the baby blues in that it is characterized by inability to sleep even when the baby sleeps, profound sadness, inability to experience pleasure or interest in previously pleasurable or interesting activities, appetite loss, feelings of worthlessness, guilt, poor concentration and at its worst, feeling that life isn’t worth living. If you are experiencing any of these more severe and persistent symptoms, please let your doctor know or you can always call us at Women’s Behavioral Health and schedule an initial evaluation (virtual). 401-453-7955.

My daughter (almost five months old now) sleeps very well at night most of the time (10+ hours with a couple interruptions). However, her daytime naps are usually very short (40 minutes tops), and she usually takes three - four per day. Are there any tips on getting her to extend the length of her naps during the day?

It sounds like your baby is a great sleeper so far so that is awesome! I would say having longer naps tend to be more restorative so I agree that that is a great goal for you two. There are a few things you can try when she wakes up: soothe her back to sleep to try to extend the nap, replace the pacifier if she uses it for sleep, keep a naptime routine to set your baby up for sleeptime, try using black out curtains (light is stimulating), limit cat naps between actual nap time… so many things to consider! I hope that answers your question!

When is a good time to start pumping and when should I introduce bottle feeding?

I usually suggest pumping once you have set up a solid breastfeeding relationship and are confident breastfeeding. This is unless you have a baby who is not latching or you are struggling to breastfeed then you absolutely want to pump when needing to give your baby a bottle. Usually around four weeks you can start pumping. The best time to pump is first thing in the morning as you have the highest amount of the milk making hormone! Although there is not such thing as nipple confusion, you wouldn’t want to introduce a bottle to a baby who is still trying to perfect breastfeeding!

If there is a clicking noise does that always mean there is a bad latch? Can there be some clicking with a good latch? When I have a strong let down the baby sounds like they are getting too much and sounds like choking, grunting and milk leaking out of mouth. Baby adjusts latch to just get nipple and maybe lessen flow (not sure), I’m concerned this might turn into a bad habit and cause pain when teeth come in. Is there such thing as latch “bad habits”?

So clicking is a sign that something is not right in terms of the latch. It may not be painful on your end but something is definitely compromised in terms of the latch. Sometimes babies can have a great latch but at some point while feeding they can move their tongue a different way or maybe their lip rolls in and it can cause the clicking. I do recommend reaching out to a lactation consultant to get down to the bottom of why the clicking is happening.

I really want to breastfeed. I also want my husband to help and bond with the baby when feeding. I plan to pump and also give the baby a bottle. Should this be started right away or should I wait a certain amount of time before giving bottle and breast. I hear a lot about confusing the baby and I don’t want to do that. I will have to pump and give the baby a bottle when I return to work so I don’t want to wait too long before I get the baby used to both breast and bottle.

The desire of partners to be able to help and bond with the baby is something families often discuss while at our center, and often times there is the perception that the way to do that is feeding the baby.

It is often helpful to first get to a point of confidence and ease with breastfeeding before introducing the bottle, but this need not prevent the partner from helping and bonding with your little sweetie!

The whole family benefits when partners participate in all the other ongoing newborn care needs — diapers, soothing, bathing, etc. The beauty of this is that it meets many needs within the family:
  • Supporting deep bonding between partner and baby
  • Increasing partner parenting confidence
  • Helping mother heal and rest
  • Supporting lower stress hormones and higher “love” or connection hormones for the whole family!
I am having trouble weaning my 19 month old and I’m in my first trimester. I breastfed my last three children into toddlerhood but should I continue to push weaning even though she doesn’t seem ready at the moment?

If there is no medical reason to stop weaning then I say keep at it!

I would have a conversation with your OB or Midwife about the risks specifically for you about breastfeeding through pregnancy and as long as they are okay with it and your are as well then I would say keep on breastfeeding!

I read an article that says over 40% of women over 30 or are overweight will have delayed lactation, so their milk won’t come in within 72 hours. What do you do if you still want to breastfeed but have delayed lactation? Can you still try to breastfeed while using formula as you wait for your milk to come in? The article mentioned that in some cases it took up to almost a week for the milk to come in. I really want to breastfeed, but I am worried that I will have difficulties due to being over 40. Is it possible to still breastfeed if your milk is delayed for a long time and you have to use formula?

There are so many factors that play into when a breastfeeding persons milk “comes in”. So in the beginning you will have what is called colostrum which will not look like milk or be in large volumes. This is all and exactly what your baby needs. I usually say most will see the milk transition around day three to five but if it doesn’t, don’t panic! It can take up to a week for the milk to transition. The most important thing is to bring that baby to breast often!

If your milk is delayed and there is some concern for babies weight you can absolutely hand express or begin pumping and supplement or even use formula! As long as you continue to bring the baby to breast and also pump when offering a bottle of either expressed milk or formula. You can absolutely still breastfeed even if your baby is offered formula. Here is a wonderful resource in addition: firstdroplets.com

It can be wonderful to set up a relationship with a lactation consultant or counselor before the baby has arrived, and to plan to receive regular support for the first few weeks after baby is born. This can be a significant help to creating a successful breastfeeding relationship!

I recently had a “clash” with my temporary pediatrician (out of the country at the moment) about prolonged breastfeeding. I think this is a myth but she claimed that ‘I have no milk’ and that my milk is not nutritious anymore. I am still nursing my 14-month old. Truth? Myth? Thank you!

I’m sorry that you had that experience. I would really try to listen to your child’s hunger cues. It might be true that you don’t have as much milk as before, but I imagine your child is eating and drinking lots of other things too which is great! Continue to breastfeed as long as you want while also encouraging a well rounded diet with lots of nutritious foods. If offering other things for your child to drink I would recommend whole milk, soy milk (unsweetened) or pea protein milk - whichever works for your family… and also water!

I’m due in September. When should I get a pediatrician for my baby? I already know what doctor I want, but when do I contact them about it?

Great question! Some parents like to do a prenatal “meet and greet” with a pediatrician (especially if they aren’t sure what practice they want to go to). I do those all the time and love them! Here at Women & Infants Hospital if you already know what practice/provider you will choose then you just tell the labor team after you give birth! They will contact your pediatrician to come to the hospital and see the newborn within 24 hours (if that is something your pediatrician does). Hope that helps!

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Expert Panelists

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