Gravida: Helping New Moms Do Pregnancy & Postpartum Like a Pro

By Morgan Michalowski, CNM, WHNP, IBCLC #Gravida The number of times a woman has been pregnant A program to help new moms heal from postpartum and return to their lives stronger than ever Table of Contents:

Section 1: Preparing For Birth (1-13)

Hospital Bag Checklist Should I Get an Epidural? The Pros and Cons How to Create Your Birth Wish List What You Need to Know- Signs of labor! How to Handle a C-section Like a Pro

Section 2: Postpartum Recovery (14-37)

Create a Postpartum Oasis- Here’s How! It’s Ok to Ask for Help: A Letter for Friends and Family How to Heal Your Vagina After Birth How to Heal a Depleted Body Motherhood Manifesto

Section 3: Mental Health (38-45)

Is it Baby Blues or Postpartum Depression? Stronger Together: 36 Questions that Lead to Connection Top 10 Questions to Ask Parents

Section 4: Feeding Baby (46-59)

Signs Your Baby is Hungry! Milk storage Guidelines and Power Pumping How to Increase Your Milk Supply How to Select the Best Pump (for you) How to Get Privacy While Pumping

Section 5: 6 Weeks and Beyond (60-79)

Will My Baby Ever Sleep? Here’s What to Expect Hacks Every New Mom Needs Science Says Do This to Raise Healthy Kids Workout Like a Mom Healing Postpartum - 6 Weeks and Beyond

Section 6: Parental Leave (80-85)

How to Rock Your Maternity Leave Nesting at Work: How to Prepare for Leave How to Talk to Your Boss About Your New Life Leaning in Work Day

Feel free to email [email protected] if you have questions about postpartum. If you’d like more support, check out our video course at www.gravidamom.com Preparing For Birth: Hospital Bag Checklist Gravida Guide “There is a secret in our culture, and it’s not that birth is painful. It’s that women are strong.” —Laura Stavoe Harm Hospital Bag Checklist:

Birthing Parent Anticipate spending 24-72 hours in the hospital. Here’s what to bring:

– 1-3 comfortable outfits

Bring pants that are loose enough to fit giant maxi pads, comfortable enough to sit in for hours, and easy to wash because they will get dirty.

Bring shirts that open in the f ront for easy skin-to-skin time or to breastfeed.

– The right bra:

If you’re not breastfeeding, pack a supportive sports bra.

If you’re breastfeeding, bring 1-2 nursing bras.

– A belly binder

Be extra: – Things for your hair:

Shampoo, conditioner, hair bands, wet brush (post-birth hair is messy- tangles).

– Things to keep you hydrated because hospitals are dry:

Water bottle, coconut water, bone broth, herbal tea, chapstick, face and body lotion, eye drops

– Diffuser with your favorite essential oils:

Pro tip: Lavender or Rose essential oil to balance mood and reduce symptoms of postpartum depression.

Remember the small things: – Phone charger

– Glasses, contacts, contact solution and case

– Camera

– Gum/mints

– ID/Insurance card Support Person – 1-3 sets of clothes – Charger – Deodorant

– Glasses – Contact solution – Contact case

– Contacts – Shower sandals – Shaving cream/razor

Baby:

– Car seat

– Going home outfit

– 1 blanket

Hospital Checklist Gravida Guide 1 Giving birth at home or at a birth center? Talk to your midwives about what to bring!

Hospital Bag Checklist: What will the hospital provide?

Answer: The essentials!

For comfort: For hygiene:

– Pillows, blankets, hospital gown – Toothbrush and toothpaste

– Mesh underwear, pads, ice packs, peri-bottle – Soap

– Sitz bath – Hand sanitizer

For pain: For baby:

– Over the counter or prescription pain medication – Diapers and wipes

– Stool softener – Onesie

– Witch hazel pads – Baby blankets

– Dermoplast spray – Baby shampoo and comb

– Nipple cream and hydrogel pads

“Let choice whisper in your ear and love murmur in your heart. Be ready. Here comes life.” —Maya Angelou

Hospital Bag Checklist Gravida Guide 2 Preparing For Birth: Should I Get an Epidural? The Pros and Cons Gravida Guide #epidural An epidural anesthetic:

Used in labor to produce the loss of sensation below the waist. A needle is used to thread a catheter into the epidural space. Side effects include: shaking, low blood pressure, itchy skin, fever, Epidural Use: headache, and, best of all, pain relief. The Pros and Cons of Epidurals in Labor:

If you’re on the fence about an epidural in labor, here’s what you need to know: – Pros: – Excellent pain relief.

– Give you time to sleep if you’ve had a long labor.

– Great if you are high-risk for needing a c-section; eliminates the need for general anesthesia for surgery.

– Effective pain management can lower stress and improve blood flow to your baby.

– No difference in NICU admission compared to mother’s who don’t get epidurals.

– No difference in baby’s APGAR score, a measure of the baby’s well-being 1 and 5 minutes after birth.

Cons:

– Greater use of forceps or vacuum in delivery, which can lead to 3rd or 4th degree tears or damage/ trauma to the infant’s head.

– Greater use of pitocin, a medication that causes uterine contractions, which can cause frequent contractions or fetal distress. Pitocin has a short-half life and the effects can be reversed quickly.

– Decreased blood pressure which can lead to dizziness or nausea. You may need more IV fluids or medication to keep the baby’s heart rate up.

– Increased length of time pushing, more likely to have excessive bleeding. Postpartum Pitocin can reduce the risk of postparum hemorrhage.

– Maternal fever: fever is a side effect of epidurals & a sign of infection. Because we don’t know if the fever is a side effect or sign of infection, we treat mom and baby with antibiotics.

Here’s how to keep labor rocking and rolling if your epidural slows down labor:

– To offset the side effects of an epidural, master the rotisserie chicken!

– Rotate positions every 30-60 minutes to keep your body and labor moving!

– Start on your back, rotate to your side, then to hands and knees, to your other side, and repeat!

– Your nurse will help you into these positions and provide you with pillows or a peanut ball to keep you comfortable.

– Heads up: It’s never too late to get an epidural (unless you’re pushing out a baby). However, if you think you might want one, consider getting it in active labor around 5-7 cm dilated.

– When anesthesiologists place epidurals, in order to stay focused and give you that sweet relief, they typically do not allow family or friends to be in the room with you.

Should I Get an Epidural Gravida Guide 4 Preparing For Birth:

How to Create Your Birth Wish List Gravida Guide #informedconsent Your moral right to body autonomy and integrity

A comprehensive, ongoing, and client-centered discussion on the Birth Wish List: pros, cons, and consequences of medical interventions or procedures. Your Birth, Your Way

You might be a “natural” mama going for an epidural or a lover of medicine planning an unmedicated birth, here’s how to give birth, your way:

1. Identify your big picture goals:

Over the course of my pregnancy, I’d like:

- As much information as possible to inform my decision-making.

- To avoid too much information. Tell me what I need to know and nothing more.

I’d like to have a birth that is:

- Unmedicated

- Medicated

I’d like to have a:

- Vaginal birth

- C-section birth

I’d like to push:

- In any position that feels comfortable to me.

- In positions you suggest, but please respect my decision if I decline your ideas.

- As long as possible before considering other options if my baby and I are stable.

When my baby is born, I’d like:

- To catch the baby/have my partner catch the baby/OB provider catch the baby.

- Skin-to-skin as soon as possible in any environment (labor room or OR).

- A quiet room. This is a very special moment for us! I know you see it every day, but please refrain from talking until after our baby is born. Thank you!

2. I plan to achieve my goals by:

Laboring at home as long as possible:

- Is there anything in my medical history preventing me from doing this?

Moving as much as possible in early and active labor. To support movement, I’d like:

- Intermittent fetal monitoring

- A portable continuous fetal monitor, so I can move if I have to have continuous fetal monitoring.

- A peanut ball to keep labor moving if I’m stuck in bed from a complication or epidural.

- To avoid having an IV, or, if medically necessary, a capped IV so I can move with ease.

Avoiding induction or augmentation:

- Please discuss natural options to stimulate labor if my baby and I are stable.

Birth Wish List Gravida Guide 6 “A birth plan not going according to plan is an apt

introduction to motherhood because the reality of raising a family includes surprises and ultimately letting go of control.” Birth Wish List: -Ryan Tanner Your Birth, Your Way

2. I plan to achieve my goals by (continued):

Working with a doula. Their name is: ______.

- We plan to use the following techniques:

- Hydrotherapy (shower/tub/warm compresses) - Aromatherapy - Breathing techniques - Music - Massage - Other:______Scheduling a c-section:

-My support person is: ______

- I do/don't have music I to listen to during surgery.

- Give me the details (I want to be a part of the process as much as possible.)

- Spare me the details (I don’t want to see or hear anything. Please distract me during delivery!)

3. If things do not go as planned, I'd like:

To make an informed decision. - Please explain and ask for consent prior to any intervention, including vaginal exams.

To be supported.

- If it's medically necessary to change paths, please be gentle and supportive of me if I find it hard to adjust. Remind me that we are doing everything we can to have a healthy parent and a healthy baby.

To see my baby as soon as possible.

- If my baby has to go to the NICU, I’d like to have the phone number to contact my baby’s nurse. If I am stable, I’d like to go to the NICU right away. If I can’t go right away, please explain why so I have a clear understanding.

Birth Wish List Gravida Guide 7 Preparing For Birth:

What You Need to Know - Signs of labor! Gravida Guide #pregnancylife When the last few weeks of pregnancy feel like 100 years. How you look on the outside doesn’t determine the shape of your pelvis. Women of all sizes can push out babies! Myth vs. Fact: What You Need to Know- Signs of Labor!

1. Myth: If my water breaks it means my baby is coming right now!

Heads up:

Water breaking also be a slow trickle. The big gush is more Hollywood than reality.

You might not even know that you broke your water. It's hard to tell what's what in the 3rd trimester.

If you're not sure if your water broke, contact your OB provider and tell them what you felt (a pop, slow trickle?), see (consistency, color?), and smell (urine-like or sweet?). If your water breaks, even if you’re not contracting, the countdown to delivery is on!

Pro tip: While waiting to hear back f rom your OB provider, walk around the house in a skirt without underwear to see if you continue to leak fluid. If you do continue to leak, it’s likely amniotic fluid!

2. Myth: Timeable contractions = active labor!

Heads up:

Active labor = contractions every 3 minutes that last 1 minute and the pattern lasts an hour. We call it 3-1-1

But you can tell it’s active labor when the contractions are strong, intense, and require focus! During a contraction, your belly will be as firm as your forehead, and you might feel pressure in your pelvis or a dull ache in your back.

Signs of active labor: can't stand to have clothes on your body, contractions continue with both movement and rest (even in the shower), trance-like state & don't hear what others say, you might poop, throw up, or get very sweaty.

It’s possible contractions start and stop and increase and decrease in intensity before settling into a regular pattern. If you can talk and move during a contraction, it’s probably not active labor!

Pro tip:

You can keep a contraction log in your phone or use a contraction timer app, like Bloomlife. Start the clock when your contraction begins and tap it again when it ends. That’s how long your contraction is! Is it 3-1-1?

3. Myth: I’ve never done this before so I don’t know what I’m doing!

Heads up:

If you feel like labor is moving too quickly or not quickly enough; if you are concerned at any point about you or your baby’s health, or if you have a gut instinct you need to head to the hospital, trust yourself and check in with your OB provider!

Pro tip:

A pregnant mama knows her body and baby better than anyone!

Labor Signs Gravida Guide 9 Preparing For Birth: How to Handle a C-Section Like a Pro Gravida Guide Ready for your c-section? To prepare for the big day, ask your OB these questions:

– How many hours before my c-section should I stop eating and drinking?

– Do I need to discontinue or avoid any medications prior to surgery?

– Do I need to shower before coming to the hospital? Or use a special antiseptic soap or wash?

– Do I need to shave my bikini line?

It’s baby time! These things need to happen before you meet your baby:

– Be admitted to the hospital where your care team will explain what to expect and obtain signed consent. You can expect a physical exam, blood drawn, IV, and IV fluids. Your baby’s heart rate will be monitored before and during the c-section.

– Go back to the OR (alone) for regional anesthetic with either a spinal or epidural. After you’re numb, a catheter is placed in your bladder where it will stay for approximately 24 hours.

Heads up: If you have an emergency c-section and don’t have an epidural in place, you may need general anesthesia.

– Have your support person join you in the OR once you and the team are ready to get the show on the road!

Pro tip: bring some tunes to help you relax during the c-section! You can also request a gentle c-birth, where you have a clear drape to see your baby born, immediate skin to skin if you and baby are stable, and first latch with the support of a nurse while your team gets you ready for PACU.

Your baby is here! What happens next?

– Spend your first few hours as a family in PACU (the recovery room) where a nurse will monitor your vital signs, heart rhythm, bleeding, and pain.

Heads up: To ensure you don't bleed too much f rom your uterus postpartum, your nurse will need to do something called a fundal check. A fundal check is when someone presses on top of your uterus, or fundus, to confirm it's firm and center. To get through this experience, take pain meds, use ice packs, and have your nurse count to 3 before they start. – Bond with your baby while you recover, if you both are stable.

Pro tip: Get some skin-to-skin time with the help of your nurse or support person! You can get a nesting shirt to keep baby safe in your arms while the pain medication wears off.

– Be cleared by the anesthesiologist and transfer to the postpartum unit where you will stay for 48-72 hours.

How to Handle a C-Section like a Pro 11 Here’s how to do PACU Like a Pro:

– Have a support person with you during your PACU recovery. You will be drowsy and have health devices attached to your body, making it difficult to move or lift your baby! Here are all the annoying (but totally necessary) devices keeping you healthy and safe:

Blood pressure cuff on your arm.

Pulse oximetry probe on your finger.

ECG leads on your chest to monitor your heart rhythm.

Compression socks and sequential compression device (or leg pump machine!) on your legs to prevent blood clots.

Fluid and pain medication running through your IV.

A catheter in your bladder.

Pad and mesh panties.

Heads up: you will still have postpartum bleeding f rom your vagina.

– Give your family and f riends a heads up that only 1-2 support people are allowed in PACU. If family members wish to see the baby right away, they will have to rotate one at a time or wait until you are moved to the postpartum unit.

– Stay hydrated! Bring your own coconut water, bone broth, or herbal tea.

– Prepare for a longer PACU recovery if you had an emergency c-section with general anesthesia.

Mom’s First 24 hours:

Expect to swell, particularly in your hands, feet, and legs, f rom all the IV fluids. It goes away in a few days!

Feel better faster by walking within 24 hours to reduce pain, get your bowels moving, and eliminate gas.

Pro tip: Take pain medication and put on a belly binder before you get up for the first time.

Protect your belly and reduce pain by holding a pillow directly over your incision for support when you cough or laugh. Use the same technique during the car ride home to soften the impact of a bumpy road.

Keep your lungs healthy and prevent the build-up of fluid or mucus by using an incentive spirometer to practice deep breathing. It’s only natural to take shallow breaths when you’re in pain!

Prevent nausea and vomiting by slowly introducing food because abdominal surgery makes your bowels sluggish.

Pro tip: Start with broth, soup, rice, or toast. If you feel nauseous, ask your care team about IV anti-nausea meds!

Ask your OB provider for clear instructions on how and when to take pain medication. To prevent unnecessary nausea or vomiting is it better to take medication:

With or without food?

In the morning or at night?

Mom’s First 2 Weeks Postpartum:

– Load up on snacks, like yogurt, crackers or toast, to coat your stomach if you were prescribed pain meds.

How to Handle a C-Section like a Pro 12 Mom’s First 2 Weeks Postpartum:

– Load up on snacks, like yogurt, crackers or toast, to coat your stomach if you were prescribed pain meds.

– Use an app or set a reminder on your phone to take your pain meds at the right time! Or place medication(s) near something you use daily, like a toothbrush.

– Take Healthy Mama ‘Move It Along’ stool softener once or twice a day with a full glass of water.

Pro tip: Stop taking if you develop diarrhea or haven’t had a bowel movement within 1-3 days of starting medication. Discontinue after 1 week.

– Protect your back by wearing a belly binder for support, you can find midwife- approved ones at www.gravidamom/productplaylist

Mom’s New Life:

– Have scar tissue pain? Try soft tissue mobilization. C-section pain can be relieved by massaging the scar and other things we call "soft tissue mobilization." Here’s how to know whether you might benefit f rom massaging the scar:

Pain/sensitivity at and around the scar.

Reduced mobility and elasticity; making bending forward and lifting uncomfortable, or they feel like that area is being pulled/tugged on when standing up straight and reaching overhead, which can affect posture.

Low back pain f rom compromised/weakened abdominal muscles.

Trigger points in abdominal muscles that refer pain to the urethra and clitoris.

Superficial nerve irritation surrounding the area of the scar.

– Ask you OB provider, once your scar heals, around 6 weeks postpartum, if you’re clear to start the massage process.

– Work with a physical therapist or body worker to learn advanced techniques. Here’s how to gently start the process at home:

Step 1: Place fingertips so the pads of your fingers are just above the scar line. Use Vitamin E oil to reduce scarring. It’s also safe to use coconut oil or olive oil for massage. You can add essential oils, like chamomile, lavender, or f rankincense, to coconut oil for a little self-love during a time that’s not ideal. You can use 10-12 drops of essential oil for every 2 tbsp of oil.

Step 2: Lightly put your fingers on your skin and feel how mobile it is- move your fingers up, down, side to side, and in little circles.

Step 3: Can you move your skin in all directions? If not, notice where you feel resistance, work your fingers in the direction of resistance and gently hold until you feel it release.

How to Handle a C-Section like a Pro 13 Postpartum Recovery: Create a Postpartum Oasis- Here’s how! Gravida Guide Heads up: Don’t do it all! We know it inspires cringes to ask for help. But growing a baby, birthing it and taking care of it while healing and getting ready to go back to work is too much for one family to take on. It takes a village!

Part 1: First 6 weeks postpartum:

Avoid house chores. Delegate, boss lady!

Request gift cards for grocery services: – Shipt for same day grocery delivery.

– Instacart, select the following no cook, fast meal prep, easy-to-eat one-handed food items:

Costco (Pro tip: The Fooducate App gives the following foods an A- to A+ on their organic, real ingredients rating scale)

Breakfast:

Rader Farms Organic Fresh Start Smoothie Blend

Mamma Chia Squeeze Blackberry Bliss

Snacks:

Made in Nature Goji Berries

Manitoba Organic Hemp Hearts

Kirkland Signature Eggs Hard Boiled

Perfect Foods Organic Protein Bars

Love Organic Beets

Wholly Organic Guacamole

Lunch/Dinner:

Maya Kaimal Simmer SCE Vindaloo & Coconut Curry

Tropicland Organic Cauliflower Rice

Mass River Farms Organic Butternut Squash

Don Lee Farms Veggie Bowl

Golden Ladle Chicken Broth for Sipping

Beverages:

Spindrift Sparkling Water

Kirkland Organic Coconut Water

Request gift cards for meal kits: – Peachdish:

From award-winning chefs and a highly-qualified nutrition team comes an extremely flexible meal kit delivery service with locally and sustainably sourced ingredients.

Subscription, skip or cancel anytime, or place a one-time order.

Approximately $25/meal

Create a Postpartum Oasis- Here’s how! 15 – Sun Basket:

From top farms enjoy responsibly sourced, organic, non-GMO, hand-selected, seasonal ingredients with grass-fed, antibiotic-f ree pastured meat all packaged together in a 100% recyclable box.Subscription, skip or cancel anytime, or place a one-time order.

Subscription, skip or cancel any time.

Approximately $11.99/meal

– Green Chef:

An exclusively environmentally-conscious meal kit, all materials are recyclable or compostable, and all ingredients are GMO-f ree and organic. Choose f rom vegan, vegetarian, paleo, keto, gluten-f ree, and omnivore meal plans.

Subscription, skip or cancel any time.

Approximately $10-15/meal

– Blue Apron:

Locally sourced, pre-measured ingredients, not all meals are organic or GMO-f ree. They support regenerative farming practices and base their menus around crop rotations.

Subscription, skip or cancel any time.

Approximately $9.99/meal

– Home Chef:

With ten dinner options, breakfasts, a f ruit basket, and a f resh smoothie per week, they have a gluten-f ree, low carb, vegetarian, soy-f ree and nut-f ree meals options.

Subscription, skip or cancel any time.

Approximately $7.99/meal

Request gift cards for laundry services – DRYV:

Schedule flexible pickup and drop-off in seconds.

Serves most major cities.

$20 minimum

– Rinse:

Have dry cleaning or laundry delivered at home or work.

Available in Chicago, SF, Washington D. C., Northern Virginia, Boston.

Price per pound: $1.75, $30 minimum.

– Cleanly:

Subscribe and have laundry day done in no time.

Available in NYC, Brooklyn, Washington D.C.

Pricing per item available on their website, no minimum.

Request gift cards for task services: – Hello Alfred:

If Hello Alf red is available in your building, you can set it up to deliver and put away your groceries, do your laundry, or drop off prescriptions.

Available in most major cities for apartment dwellers but not direct to consumer.

– TaskRabbit:

Use TaskRabbit if putting away the dishes, running errands, folding laundry, assembling the crib or walking the dog feels like more than just a chore.

Available in most major cities.

Create a Postpartum Oasis- Here’s how! 16 Use a caregiving app to communicate and coordinate with family and f riends: – Lotsa Helping Hands:

This is your (f ree) one-stop-shop to organize the help everyone is offering you. Post requests for support, to set up tasks or send invites to those in your network to manage, organize, and coordinate meals, rides, and whatever else you need through their care calendar. Your care team will receive automatic reminders, so nothing is forgotten.

– CareZone:

A simple way to organize your health! Scan medications and share with family or your provider, set automatic reminders for when to take your medication or track your blood pressure, or get your medicine delivered for f ree.

Invite family members, f riends, or providers to share vital health information with them safely and privately.

– Give InKind:

Communicate your wishlist, fundraise, or coordinate meals to get the exact support you need f rom f riends and family! Request gift cards for NatureBox, Bambino Childcare, Talkspace, Amazon Prime, or Zeel.

Request a Meal Train: – To organize meals for your family.

– Use Nourish Gravida Guide for ideas.

– Request 1-2 meals per day for 6 weeks.

– Use a cooler + sign for meal drop offs.

- “We can’t wait to see you when we know up f rom down!”

- “While we feed our baby, we can’t thank you enough for feeding us!”

- “With full hearts and hungry bellies, you’re the best for filling both!”

Part 2: Mental health.

Get mental stimulation and rest to feel like a sane human!

Activate the buddy system:

– Look for a new moms group hosted at a local hospital.

– Check out apps like Peanuts, Mom Life, or Hello Mama to meet new parents.

– Join We Are Gravida; it’s our passion to create an inclusive community where you share the mundane and life-altering moments of parenthood, to learn from and support each other along the way and together raise healthy, engaged, and kind humans.

Create a list of professional support services:

– Find a mental health therapist through Psychology Today. And did you know that you can narrow your search with terms like postpartum or Internal Family Systems to find the right fit?

– Use Talkspace, Headspace, Mindshift, Expectful for on-demand virtual therapy or meditation.

– Use Postpartum Support International in case of emergency to get direct peer support or connect with local resources.

Create a Postpartum Oasis- Here’s how! 17 Make space for self-care:

– Get an at-home massage with Zeel or Soothe.

– Create a 5-minute self-care ritual:

- Wash your face and hold a warm washcloth to your face for a few seconds, apply a totally indulgent moisturizer.

- Take a special beverage to enjoy in the shower.

- Add a few drops of Tea Tree, Eucalyptus, Lavender, Bergamot, or Lemon oil to the floor of the tub during the shower for a relaxing or mood-boosting effect.

- Apply exfoliating body polish followed by hydrating body oil to connect with your body.

- Read a few pages f rom a favorite book right when your partner comes home or during lunch at work.

- Massage your feet with a foot massage ball while you get ready in the morning.

- Hop in bed and gently massage your face with a jade roller before falling asleep.

- Set a timer for two minutes (or use an electric toothbrush) and deep breathe while you brush your teeth. If you want to remove cosmetic stains to brighten your smile, add a charcoal toothpaste 2-3 times a week.

Part 3: 6 weeks and beyond.

You’re not failing if you need help longer tha n 6 weeks. Postpartum ‘ends’ when you feel you have some semblance of balance!

Create a list of your childcare, babysitter, and daycare options:

– Main caregiver:

– Back up:

– Safe community spaces:

– Pro tip: To gain a stronger level of comfort with the person or people taking care of baby, spend time with childcare providers in one- or two-hour chunks with baby and/or older children.

List Plan A, B, C options for housekeeping and chores so, no matter what, things get done!

– Option A:

– Option B:

– Options C:

Make a list of what is/are mom’s concern(s) about this transition and what will we do about it?

– Concern: - What we’ll do about it:

– Concern: - What we’ll do about it:

– Concern: - What we’ll do about it:

What is/are partner’s greatest concern(s) about this transition in our family and what will we do about it?

– Concern: - What we’ll do about it:

– Concern: - What we’ll do about it:

– Concern: - What we’ll do about it:

Create a Postpartum Oasis- Here’s how! 18 Postpartum Recovery: It’s Ok to Ask for Help: A Letter for Family and Friends Gravida Guide It’s Ok to Ask for Help: A letter for family and friends

Asking for help is so hard!!

We all need it, new parents survive off it, yet asking for help can make you feel physically ill. It’s easier to give support than it is to ask for it and you know that if someone asked you for help, you’d be glad to give it. So go on, ask for it!

A letter to family and friends:

This new family is learning how to do life with a baby in their arms!

Here’s where they could probably use a bit of Pro tip: When you offer help, define the kind of help help: you’re offering. Be clear with how you want to help, confirm the offer works for them, and follow-up. Go that Clean! extra mile! Clean the house while they’re at the hospital (once you have their approval, of course). Coming home from the hospital to a clean, organized space is one of the BEST gifts you can give a new family. “Hey, you had a baby! I’d love to Food! Stock their fridge and freezer. Fill it with nutritious, (clean/organize/prep meals) next week. easy-to-eat food (heads up, new moms thrive on How does that sound? If that sounds foods eaten with one hand). Snack plates are a great idea, think Whole Foods Hot Bar: roasted veggies, good, which day works best?” an assortment of whole-grain or vegetable salads. Batch frozen fruit for easy-to-make smoothies. (Now the only thing they have to do is say yes/no and give a Healthy frozen meals to heat up. date. Boom!)

Lighten the load! Consider a gift card for meal delivery service, massage, pedicure/manicure, house cleaning, postpartum doula, or night nurse. Any gift card to lighten their load as they adjust to parenthood goes a long, long way.

Sleep! Ask if the family wants to sleep while you hang with the baby or sleep with the baby while you clean. Either way, help them prioritize rest in a way that feels good to them.

It’s Ok to Ask for Help: A letter for family and friends 20 Postpartum Recovery: How to Heal Your Vagina After Birth Gravida Guide #vaginalove

Reduce risk of tearing with perineal massage:

Step 1: Start perineal massage around 34 weeks pregnant.

Step 2: Practice daily for 1-5 minutes to gently stretch the perineum, the tissue between the vagina and anus, to prevent tearing during childbirth. You can practice perineal massage on your own or have your partner help.

Step 3: Wash hands, trim nails, get into a comfortable position, lying down or standing/squatting in the shower. Use a warm compress during the massage to increase circulation and flexibility of tissue.

Step 4: Use a massage gel (see our product playlist for ideas!).

Step 5: Reach your hands in front of you or behind you to begin massage. You can massage with one hand or both.

Step 6: Insert both thumbs (or thumb and index finger from the same hand) about an inch inside the vagina (up to the first knuckle), rest your palms against the inside of your leg.

Step 7: Gently press down with your thumbs or fingers toward the anus, and then pull them apart from each other and out to the sides. Hold this stretched position a few times, consciously relax your muscles in this region. You might feel a slight burning or stretching sensation.

How to Heal Your Vagina After Birth 22 #poorvagina

Step by step guide to healing your vagina:

Step 1: Ice packs.

– Immediately after delivery, use an ice pack to reduce vaginal bruising and swelling.

– Switch ice pack every 30 minutes.

– Ask your nurse for ice packs take home with you or buy a reusable ice pad online. See our postpartum essentials product playlist!

Step 2: Get clean.

– Take a bath or shower a few hours after delivery, so you feel refreshed!

– Be aware of dizziness in a warm shower! Have someone near you to help if you feel lightheaded.

– Gently pat your vagina dry when you do a shower for the first time after delivery.

Step 3: Sitz bath.

– Use a sitz bath three to four times a day for the first 2-4 weeks. Sit in it for 10-20 minutes for best results to heal a sore vagina or hemorrhoids.

– Don’t add soap to your sitz bath as it can dry out or irritate already sensitive skin.

– Add herbs to make your sitz bath more soothing. You can add witch hazel, make an herb bath, or purchase premade sitz bath herbs. See our postpartum essentials product playlist for safe and healing herbs!

– You can store your sitz bath in the shower/tub or in a plastic bag.

– Rinse and clean your sitz bath after each use. You can clean it with traditional cleaners, like bleach, or create an antiseptic cleaning solution by mixing 1/2 cup organic white distilled vinegar or lemon with 1/4 cup baking soda into 1/2 gallon 2 liters of water.

– If you don’t like the sitz bath, you can take a regular bath instead.

Step 4: Wear pads or incontinence underwear.

– Change pads every four to six hours.

– If bulky pads feel uncomfortable, try incontinence underwear!

Step 5: Pat dry.

– Always pat the perineal area dry from the front to the back after washing to avoid introducing germs from the rectum into the vaginal area.

How to Heal Your Vagina After Birth 23 Step 6: Numb it up!

– Use witch hazel, Dermoplast spray, and stool softeners to reduce pain and irritation to the perineum.

– Use witch hazel wipes and dermoplast spray every 2-4 hours as needed. Use these products right before or after you pee to reduce stinging.

– Take a stool softener once or twice a day for the first week.

Step 7: Spray it down:

– Use a peri-bottle for 1-2 weeks, or longer if needed, when urinating.

– Fill the peri-bottle with warm water or a healing herb mix. Then, squeeze the bottle in the direction of your urethra and vagina. Spray while you urinate to reduce pain and irritation.

#vaginabouncesback

Ongoing comfort:

Ice packs to reduce swelling and provide pain relief.

– You can make a ‘padsicle’ at home: Take a dry pad, soak it in witch hazel or an herb mix, and place in freezer. To prevent water from leaking, wear incontinence underwear or the hospital mesh panties while the padiscle is in place. Wear for 20-30 minutes or until you feel numb.

– Fill a condom with ice for a no leak solution!

– Purchase reusable ice packs.

Take over the counter pain-relieving medications, like Acetaminophen or Ibuprofen.

– Most over the counter pain medications are safe to take while breastfeeding. Check out LactMed app for more information on breastfeeding and medications. Always talk to your provider about options that are safe for you.

If you have a 3rd or 4th-degree tear, talk to your OB provider about prescription pain medication to use the first few weeks postpartum.

Don’t stand or sit for long periods. Alternate positions to reduce pressure on your perineum.

How to Heal Your Vagina After Birth 24 Brace your perineum! To (discreetly) support your perineum try:

– Sitting off to your side with legs tucked underneath your butt.

– Cover your lap with a pillow while you use your hand to support your perineum.

– Place a rolled towel underneath you while sitting for natural support.

– Reflexively and openly hold your vagina when you laugh or cough because (ouch!) you can’t help it and that’s ok!

When feeding your baby, sit on:

– A donut seat cushion.

– A breastfeeding cushion: use it as a seat (if you’re not using it for baby!) like you would the donut seat cushion.

– 2 towels- roll them and place them next to each other for a boost.

– Lie down to reduce the pain. Try feeding in the side-lying position.

– Lie down to rest for 20–40 minutes every hour for the first two to four days to reduce pressure on the perineum so the stitches can heal. Lie in a position that’s comfortable to you. However, you might consider lying on your side with one pillow between your legs, one behind your back, and two under your head for a supported and comfortable position.

#howtopoop

How to poop after childbirth!

Step 1: Keep your poop soft:

– Eat a high fiber diet + drinking 2L of water/day. To do this easily, place 3 tablespoons (or more) of chia seeds in a 2L water bottle. Add fruit for extra flavor.

– Take a stool softener 1-2 times a day.

Step 2: How to poop:

– Do not strain when pooping.

– Sit with your bottom to the back of the toilet seat, legs apart, up on toes (or feet flat on a footstool)

– Keep a straight back and lean forward with your stomach and pelvic floor muscles relaxed.

– Keep breathing! Don’t hold your breath.

– Have a support person with you when you poop for the first time. Having someone with you makes the moment less scary and even a little funny.

How to Heal Your Vagina After Birth 25 Step 3: Support is everything:

– Support the perineum with your hand while emptying your bowels, laughing, coughing, or sneezing.

Step 4: Prevention:

– If you are prone to constipation, use bulking or softening agents up to six weeks after repair. Discuss this with your OB provider first.

#pelvicfloorgoals

Step 1: Patience:

– Avoid pelvic floor strengthening exercises for six weeks after the birth of your baby to prevent straining the wound.

Step 2: Start slow:

– After six weeks:

Work with a pelvic floor physical therapist to learn gentle pelvic floor exercises, to improve circulation and decrease swelling and pain.

Kegel!

Practice Kegels several times during the day.

Tighten your pelvic floor muscles by squeezing around the birth canal, vagina and butt all at once, lifting up and towards your pubic bone ('squeeze and lift!'). Hold each contraction for 2-3 seconds and then release and relax - you feel a definite 'letting go' of the muscles.

Repeat ('squeeze and lift!') and relax, resting for about 5 seconds between each contraction.

Repeat this as many times as you can, up to a maximum of 8-10 squeezes.

Step 3: Work the core:

– Try pelvic tilts, belly breathing, and yoga to work your core and pelvic floor.

How to Heal Your Vagina After Birth 26 #omg

Contact your OB/CNM if you:

– Have not had a bowel movement in 48 hours.

– Feel like you have an infection (fever, worsening pain, body aches, pain with urination)

– Bad smelling lochia (the normal discharge from the uterus after childbirth)

#dontwannaknow

Tearing:

1st-degree tear: superficial tear, may or may not require stitches.

2nd-degree tear: tear of the skin and muscle, stitches are usually needed; it can take two months to feel comfortable again.

3rd-degree tear: is a tear through the muscles and the muscle layer that surrounds the anal canal, requires stitches; can take two months or longer to heal. It’s recommended to have pelvic floor therapy to heal muscles.

4th-degree tear: goes through the anal sphincter into the anal canal or rectum. Only 2% of the population experience a 3rd or 4th-degree tear! It’s recommended to have pelvic floor therapy to heal muscles.

Periurethral: A tear near the urethra, may or may not require stitches; might have pain or irritation when urinating.

An episiotomy is a cut made into your perineum to enlarge your vaginal opening. An episiotomy involves the same muscle and tissue as a 2nd-degree tear. However, some episiotomies can extend further. Episiotomies are not routinely done.

How to Heal Your Vagina After Birth 27 Postpartum Recovery: How to Heal a Depleted Body Gravida Guide Gravida Guide Step-by-step guide to healing your body after pregnancy and birth with delicious and healthy noms.

Step 1: Replenish Your Brain. Key nutrients: Omega 3s, healthy fats, vitamin D and B.

– Help fuel brain function and keep depression at bay by fueling up with Omega-3s, like wild salmon, organic eggs, sardines, walnuts and flaxseeds.

Make this recipe when need to cook something one-handed.

Roasted Asparagus with Walnut-Flaxseed Crumble: Gluten-Free, Vegan; prep time: 15 minutes. Recipe

Make this recipe 3 days ahead of time when you need a hearty breakfast or lunch.

Mushroom and Spinach Frittata: Purchase pre-sliced mushrooms and baby spinach for easy preparation. Prep time: 20 min. Recipe

– Help combat constipation, headaches and insomnia by chowing down on hemp, chia, pumpkin and flax; these magnesium-rich seeds are superstars for pre- and postnatal health.

Make this recipe ahead of time and store in the f reezer to beat a sugar craving.

Delicious Chocolate Covered Apricot Ginger Energy Balls: Gluten-Free, Vegan; prep time: 20 minutes. Recipe

Make this recipe when you want your quick snack to double as a ref reshing drink.

Invigorating Wild Blueberry Chia Fresca Drink: Gluten-Free, Vegan; prep time: 5 minutes. Recipe

– Support baby’s organ and brain development and jumpstart your metabolism, your milk supply and the quality of your milk by going for healthy high-fat foods! It seems counter-intuitive when you’re trying to get your pre-baby body back but increasing fats intake is good for your heart, cholesterol, and overall health. It’s the type of fat consumed, rather than the percentage of calories consumed f rom fat, that is linked to chronic disease. If you just try to limit the amount of trans fats, saturated fats, and triglycerides and go with fats like polyunsaturated and monounsaturated, you’ll be good to go.

Load up on healthy fats and satisfy your sweet tooth with one of these smoothies!

Creamy Chocolate Blueberry Recipe: Gluten-Free, Vegan; prep time: 5 minutes. Recipe

Banana Avocado Cacao Acai Bowl: Gluten-Free, Vegan; prep time: 5 minutes. Recipe

Pro tip: When possible, switch out butter for olive oil.

How to Heal a Depleted Body Gravida Guide 29 – Get a boost of energy f rom eating oats, brown rice, whole-wheat pasta, or whole-grain foods. They are linked to increased levels of serotonin, a natural mood stabilizer, and keep your blood sugar, energy, and mood stable.

Make this recipe 4 days ahead of time or modify when need you need a quick and satisfying salad.

Crunchy Thai Peanut and Quinoa Salad: Modify: Save time + buy pre-shredded cabbage and carrots, use ground ginger instead of f resh ( tsp of ground ginger for 1 tablespoon of f resh), and chop cilantro or peanuts in a mini-blender or food processor. Gluten-Free; prep time: 20 minutes. Recipe

Make this recipe when you need energy but have none.

Simple overnight Cinnamon Buckwheat Groats: Gluten-Free, Dairy-Free; Prep time: 5 minutes. Recipe

Make this recipe ahead of time when you need fuel for an extra-long day.

No Bake Peanut Butter Chocolate Chip Oatmeal Energy Bars: Store in f reezer. Dairy-Free; prep time 5 minutes. Recipe

– The power of dessert is in cacao! Chocolate with cacao content of 80 percent or hig her is rich in a powerful antioxidant known to reduce the risk of heart disease and insulin resistance.

Make this recipe ahead of time when you want to stay fuller (and happier) longer.

No-Bake Salted Chocolate Fudge Protein Bars: Gluten-Free, Dairy-Free; Prep time: 5 minutes. Recipe

Make this recipe when you need to feel superhuman.

Blueberry Cacao Power Smoothie: Gluten-Free, Dairy-Free; Prep time: 5 minutes. Recipe

Step 2: Replenish Your Bones and Joints! Key nutrients: Calcium, magnesium, phosphorus.

– Delicious and comforting, bone broth builds strong bones, boosts the immune system, improves digestion and supports joints, hair, skin, and nails. An excellent source of minerals to protect your bones and teeth, amino acids to protect your joints, gut and your immune system.

Certified Humane Bone Broth! Link

– Support bone health by adding sesame seeds or tahini to your diet to get more phosphorus and magnesium.

Make this recipe when you don’t know what to eat!

Tahini Dip: A multifunctional dip that pairs well with f resh or roasted veggies, pita, and as a dressing. Gluten-Free, Dairy-Free; Prep time: 5 minutes if you use a food processor. Recipe

Make this recipe when you need to pack a lunch and hit the road.

Simple Tahini Chicken Salad: Buy a rotisserie chicken to simplify Prep time: 10 minutes. Recipe

Make this recipe when you’re craving a tasty dip for a snack plate.

Smoky Chipotle Hummus: Gluten-Free, Dairy-Free; Prep time: 15 minutes. Recipe

How to Heal a Depleted Body Gravida Guide 30 – Load up on calcium with leafy greens like collards, mustard and turnip greens, kale, and bok choy.

Make this recipe when you need to cook with one hand or trick yourself into eating greens.

Arugula hummus: Gluten-Free, Dairy-Free; Prep time: 10 minutes. Recipe

Make this recipe when you don’t (or can’t) chop anything.

Kale chips: Gluten-Free, Dairy-Free; Prep time: 15 minutes, tear kale by hand. Recipe

Make this recipe when you need to eat the rainbow with minimal effort!

Baked Sweet Potato with Mustard Greens: To get THE best sweet potato texture, heat in microwave for 10 minutes before baking at 425 for 1 hour. Gluten-Free, Dairy-Free; Prep time: 25 minutes. Recipe

Make this recipe when you want the benefit of a salad but don’t want to eat one.

Mixed Leafy Green Soup: Minimize chopping by placing onion in food processor to dice. Gluten-Free, Dairy-Free; Prep time: 20 minutes. Recipe

Make this recipe when you’re over smoothies and green juice.

Super Simply, Very Green Soup: Store in f reezer for 2-3 weeks. (Gluten-Free, Dairy-Free; Prep time: 10 minutes). Recipe

Make this recipe when you forgot you need to make dinner.

Curried Butternut Squash Soup: Freezer f riendly (1 month) or simplify recipe by purchasing precut butternut squash and chopping shallots in food processor. Gluten-Free, Vegan, Prep time: 10 minutes. Recipe

Step 3: Replenish Your Iron! Key nutrients: iron, protein, fiber.

– Fight fatigue by eating lentils and beans that are rich in fiber, protein, and iron, selenium, zinc, and magnesium.

Make this recipe ahead of time and store in the f reezer for 1 month.

Simple French Lentil Soup: Add greens for extra credit. Gluten-Free; Prep time: 10 minutes. Recipe

Make this recipe when you need a meal that’s as comforting as a hug.

Hearty Lentil, Kale & Potato Soup: Gluten-Free, Dairy-Free; Prep time: 10 minutes. Recipe

Make this recipe when you need a cheap treat! No chopping necessary.

Fudgy Black Bean Zucchini Cookies: Gluten-Free, Dairy-Free; Prep time: 10 minutes. Recipe

How to Heal a Depleted Body Gravida Guide 31 – Make life easy with pre-cooked grains. Quinoa is particularly high in fiber, protein and iron. Make quinoa ahead of time and mix into salads throughout the week.

Make this recipe when you need to up your f ruit game or spice up breakfast!

Quinoa Porridge: Gluten-Free, Dairy-Free; Prep time: 10 minutes. Recipe

Make this recipe when need to take breakfast on the go!

Roasted tomatoes with Eggs and Quinoa: Make cheesy quinoa and roasted tomatoes ahead of time. Prep time: 10 minutes. Recipe

Make this recipe when you’re craving pizza.

Easy Quinoa Pizza: Prep time: 15 minutes. Recipe

– Replenish iron stores and red blood cells postpartum by increasing dietary iron. Here are two ways to do it:

Type 1: Heme Iron, found in animal products, is more easily absorbed and you don't need to do anything special to get that iron goodness. Enjoy the following iron rich foods:

Clams: trace amount of mercury, 23 mg iron per 3 oz, safe to eat 2-3x/week

Make this recipe when you need to triple stack iron.

- Anything Goes Donabe: Prep time 20 minutes. Recipe

Chicken liver: 8mg of iron per 3 oz

Make this recipe if eating chicken liver makes you squeamish.

- Jen’s Improved Chicken Liver Ragu: Make ahead and store in f reezer. Prep time: 15 minutes. Recipe

Sardines: 2.4 mg of iron per 3 oz

Make this recipe when you only have time to mash a few ingredients with a fork!

- Cilantro-Lime Sardine Salad in Avocado Halves: Switch out mayonnaise for vegan mayonnaise. Prep time: 5 minutes. Recipe

Chicken: 0.6mg of iron per 3 oz

Make this recipe when you need a super simple sizzling recipe.

- Everyday Roasted Chicken Breasts: Prep time: 5 minutes. Recipe

Type 2: Non-heme, found in plant-based options is less easily absorbed. That means that if you're not eating meat and are going for these options, to optimize iron absorption, pair legumes, veggies, f ruits, grains, and nuts with Vitamin C-rich foods. Stay away f rom pairing non-heme iron with tannins found in tea, wine, calcium.

Pair:

Spinach + quinoa

- Make this recipe when you need that vitamin C boost built into your salad.

· Sun-Dried Tomato, Spinach, Quinoa Salad: Cook spinach to unlock even more iron! Gluten-Free, Vegan. Prep time 10 minutes. Recipe

Spinach + tofu

- Make this recipe when you’re craving a hearty meal that packs a nutritious punch.

· The Best Vegan Lasagna: Save time and buy no-cook noodles. Vegan. Prep time: 15 minutes. Recipe

How to Heal a Depleted Body Gravida Guide 32 Potato + turnip greens

- Make this recipe when you need a dash of comfort.

· Mashed Turnips and Potatoes with Turnip Greens: Gluten-Free, Nut-Free. Prep time: 10 minutes. Recipe

Tempeh + bulgur

- Make this recipe when you’re up for a tasty challenge.

· Hearty Vegan Mushroom, Bulgur, and Bean Chili: Top with tempeh bacon bits. Gluten-Free, Vegan. Prep time: 10 minutes. Recipe · Tempeh Bacon Bits: Gluten-Free, Vegan, Prep time: 5 minutes. Recipe

Chickpeas + quinoa

- Make this recipe when you want all components to the food pyramid in a single bowl.

· Chickpea Broccoli Buddha Bowl: Buy pre-chopped broccoli and carrots to save time. Vegan, Prep time: 15 minutes. Recipe

Edamame + bok choy

- Make this when you need a ref reshing and lite meal.

· Edamame, Bok Choy, Mango Salad: Buy mango spears to save time. Gluten-Free, Prep time: 15 minutes. Recipe

Lentils + quinoa

- Make this when you need a solid base to inspire your creative genius. Easy to make with one hand.

· Lentil Quinoa Salad: Make it Mediterrean by adding cucumbers, red pepper, or salmon. Gluten- Free, Vegan. Prep time: 15 minutes. Recipe

Blackstrap molasses + cashews

- Make this when you’re craving that salty bacon goodness

· Bacon Cashews: Eat as a snack or chop and add to salads. Gluten-Free, Vegan. Prep time: 5 minutes. Recipe

Pumpkin seeds + dried f ruit

- Make this when you need snack options (stat!).

· Granola Bars with Dried Fruit and Seeds: Use raisins for an iron-rich option. Keep as bars or use as yogurt topping. Gluten-Free, Prep time: 15 minutes. Recipe

Step 4: Replenish Your Gut! Key bacteria: lactobacilli.

– Absorb more nutrients, improve digestion, and boost gut health with probiotic-rich foods. Here are a few to get started:

Kefir: Some experience constipation and abdominal cramping when they start Kefir. Ease into by consuming 2- 4 oz, increase to 8 oz per day.

Make this when you need a tangy treat.

Coconut Milk Kefir: Add to smoothies to vary the flavor. Vegan. Prep time: 5 minutes. Recipe

How to Heal a Depleted Body Gravida Guide 33 Fermented vegetables: One of the least consumed foods but so important to gut health (bonus: it might help you lose weight)

Make this when you need a quick foodie adventure. Gingered Carrots: Make ahead of time and store for 3-4 weeks in the ref rigerator. Gluten-Free, Vegan. Prep time: 5 minutes. Recipe

Tempeh: Reduces bloating and aids in digestion.

Make this recipe when you need to need to clean out your f ridge. 30-minute Tempeh Stir-Fry: Make ahead of time and store in the f reezer for 1 month. Gluten-Free, Vegan. Prep time: 20 minutes. Recipe

Kimchi:

Try Sunja’s Medium Spicy Kimchi if you’re new to Kimchi. Not too hot, not too sour!

Miso: Get a hit of that umami flavor while replenishing your gut.

Make this when you need a warm and savory 6 ingredient meal.

Classic Miso Soup: Gluten-Free, Vegan. Prep time: 5 minutes. Recipe Step 5:

Replenish Your Milk Supply! Key hormone: phytoestrogens are a natural compound found in plant-based foods. They balance your estrogen and boost your milk supply

– One of the best known ways to increase milk supply is by eating garlic! Most infants tolerate garlic in the breast milk quite well, however, if you notice increased fussiness in your infant dial it back.

Make this when you want a taste of heaven with zero effort.

Garlic confit magic elixir: Buy f resh peeled garlic to save all the time. Gluten-f ree, Dairy- f ree; Prep time: 20 minutes. Recipe

– Increase prolactin, a milk-producing hormone, by eating oats. They are rich in plant estrogens and beta-glucan.

Make this when you need a high protein smoothie.

The Breakfast Smoothie: Prep a smoothie bag and buy 5 more minutes of sleep. Gluten- f ree, Dairy-Free. Prep time: 5 minutes. Recipe

You can prep smoothies ahead of time by placing all ingredients, except liquid or any ones that won’t blend well when f rozen, in a sandwich-size plastic baggie. Add liquid in the morning.

Pro tip: Protein powder is safe to consume while breastfeeding! You may want to avoid protein powders with fillers! Milk Drunk Protein Powder is an excellent option if you’re looking to boost your supply, too.

– Stimulate lactation with foods rich in phytoestrogens. Try:

Fennel: Make this when you need comfort food for any mood.

Roasted Fennel with Parmesan: Gluten-Free; Prep time 10 minutes. Recipe

You can eat fennel raw or cooked, add fennel seeds to a recipe, or drink it as a tea. Pro tip: Fennel is a traditional remedy to reduce colic in infants.

How to Heal a Depleted Body Gravida Guide 34 Dark Leafy greens (spinach, kale, collard greens, broccoli): Make this when you need dish served with a side of tang.

Collards Greens and Kale: Gluten-Free, Dairy-Free. Prep time: 15 minutes). Recipe

Sesame seeds: Make this when you want the perfect energy bar.

Chewy Sesame Bars: Store in f ridge or f reezer. Dairy-Free; Prep time: 5 minutes. Recipe

– Add the milk-producing, immune-boosting powerhouse super seed, Flaxseed, to any meal and get a bonus bump in Omega-3/DHA!

Make this when you’re in a pinch and need a sandwich wrap ASAP.

Flaxseed Wraps: Gluten-Free, Vegan. Prep time: 10 minutes. Recipe

– One of the oldest milk boosting foods, and a great addition to your diet for being high in proteins and fatty acids, are Almonds!

Make this when you believe it’s impossible to be healthy and decadent at the same time.

The Best Vegan Broccoli Salad Ever: Put broccoli, onion, almonds in a food processor to avoid chopping. Gluten-f ree, Dairy Free; Prep time: 15 minutes. Recipe

How to Heal a Depleted Body Gravida Guide 35 Postpartum Recovery: Motherhood Manifesto Gravida Guide Place this sign on your front door to remind others of the love and support you need!

Surprise! We gave birth… twice! Welcome to the world baby! Welcome to the world mama!

With the new baby, a mama was born too and both need support just the same. Both baby and mom are learning how to eat, sleep, and be in the world.

To give them time to heal, text______for ways to support our new family.

Motherhood Manifesto Gravida Guide 37 Mental Health:

Is it Baby Blues or Postpartum Depression? Gravida Guide #matrescence The process of becoming a mother, but feels like being an awkward teenager. What’s Normal? Is It Baby Blues or Postpartum Depression?

Baby Blues?

80% of mothers will experience baby blues, which occurs 4-5 days after the birth of the baby and resolves within a few weeks. Baby blues may be a natural way to grieve your old lifestyle and body image.

– You might be experiencing the baby blues if you:

– Cry (Even if it’s a positive experience, having a baby is shocking, isn’t it?!)

– Have mood swings, irritability, anxiousness (Hello, bonding hormones.)

– Feel overwhelmed (You’re sore, your baby needs you. It’s a lot.)

– Have a change in eating and sleeping patterns (when do you eat or sleep- When your newborn is eating while you should be sleeping? Or sleeping on your chest when you need to eat?)

– You know all of this. But literally do this in the next 24 hours if you can:

– Take naps. For a refreshing nap, sleep alone while someone watches your baby so your brain settles into a deep sleep. Otherwise, it’s in baby mode!

– Cry if you need to! Like really cry. Let it all out and try not to judge the emotion. Just feel it and let it pass. Shedding tears releases stress, increases oxytocin and endorphins so you’re ready to be present.

– Talk to family or f riends about your feelings. If you don’t know where to start, refer to “Top Questions to Ask New Parents” Gravida Guide for ideas.

– Take 5 minutes for yourself. Lie on the ground, place your hands on your chest, and slow your breathing.

– Don’t judge what you’re feeling. You’re not a bad parent if you wonder what the heck you just signed up for.

Perinatal Mood and Anxiety Disorders (PMAD):

– If you find yourself wondering: “I think these emotions are getting in the way of living my life” but…

“I’m educated on signs, symptoms and risk factors for a mood disorder. If I have it, I’ll know!” “I’ve handled difficult life events before. Why would having a baby be any different?”

– If that sounds like you, let’s talk about perinatal mood and anxiety disorders. Symptoms of PMAD can begin in pregnancy or up to a year postpartum.

– Depression: similar to baby blues but are present every day for at least 2 weeks. Symptoms look like:

– Fatigue (“I don’t sleep well and naps don’t make me feel better.”)

– Feeling sad (“I have a heavy feeling of dread that something isn’t right.”)

– Hopeless (“I can’t get in control of my feelings no matter what I try.”)

– Overwhelmed (“Even when people tell me I’m doing a great job, I can’t beat the feeling that it’s too much and I won’t get the hang of it.”)

– Trouble sleeping and eating (“Every time I try to sleep I wonder when my baby is going to wake.”)

– Feelings of guilt and worthlessness (“My family might be better off without me.”)

– Losing interest in things they used to enjoy (“I do what I need to take care of my child, but there’s no point in finding time for me.”)

– Withdrawing f rom family and f riends (“I don’t want anyone to know something is going on.”)

– No interest in baby (“I make sure my baby is fed and cuddled, but I feel like I’m watching someone else’s kid.”)

– Thoughts of self-harm or harm to others

Is It Baby Blues or Postpartum Depression Gravida Guide 39 “Postpartum depression takes certain truths and turns them into the worst version of the truth. The truth is, your life is changed forever when you have a child, but what you don’t factor in is that it might be better and it might be more enriched.” What’s Normal? - Brooke Shields Is It Baby Blues or Postpartum Depression?

Perinatal Mood and Anxiety Disorders (PMAD):

– Anxiety: can come on rapidly, within a week of giving birth. Thoughts can get in the way of caring for your baby or living your life. symptoms look like:

– Restless, irritable, or on edge (“There’s always energy coursing through my body.”)

– Excessive worry or concern (“”How often do most people check to see if their baby is breathing?”)

– Being easily fatigued or difficulty sleeping (“It’s the kind of tired where my body is asleep but my mind can’t stop.”)

– Difficulty focusing (“If there’s a problem I’m trying to solve, I can’t figure it out. I feel confused, foggy, and numb.”)

– Muscle tension (“How sore should a new mom actually be?”)

Things to watch out for:

– Create a postpartum mental health plan if:

– You experienced:

Depression at puberty, a reaction to birth control or fertility treatments, abuse of any type (current or past) recent loss or change in jobs, a recent move or immigration, separation f rom a parent in childhood, the recent death of a close family member.

– You have a history of:

Pregnancy or postpartum mood disorders, family history of mood disorders, an eating disorder, thyroid disorder, diabetes or gestational diabetes, infertility, birth trauma, miscarriage, neonatal, loss or terminations, substance abuse.

– Currently have:

Limited social support, family members with medical problems, an unplanned or unwanted pregnancy, baby with a challenging temperament, relationship difficulties with your partner or are a single parent, a negative or challenging relationship with your mother or father.

– Seek outside professional support to ease the transition into parenthood if you:

– Consider yourself: A pessimist, people-pleaser, task-oriented, perfectionist.

– Find yourself:

Having negative or high expectations of birth or parenting, experiencing your infant’s temperament as a failure on your part, with limited coping skills, seeking external control.

When nothing sounds good, here’s how to find the time and energy to heal:

Self-care: Medication:

– Need a sounding board but don’t want to go anywhere? – Talk to your OB provier about anti-depressants that Try Talkspace. are safe to take while breastfeeding.

– Feeling the need to clear your head? – Incorporate daily mood-elevating herbs, like Try Expectful, a meditation and sleep app for pregnancy ashwagandha, rose, damiana, or lemon balm, in and postpartum or on-demand postpartum yoga with a tincture or tea form. subscription to OneOeight. Social: – Looking to balance your mood? Try lavender or rose oil (take it with you on-the-go in a – Use a virtual new moms group, like We Are Gravida, car diffuser) or increase exposure to mood-boosting when you don’t feel like going anywhere. light with bright light therapy while you’re inside feeding a baby. Check out Circadian Optics Lumos. – Hire a postpartum doula or night nurse to get sleep.

Is It Baby Blues or Postpartum Depression Gravida Guide 40 Mental Health: Stronger Together: 36 Questions that Lead to Connection Gravida Guide #parentingburnout Self-care isn’t selfish, it’s strategic. Signs of parenting burnout: angry, critical, loss of humor, low energy, mood swings Stronger Together: 36 Questions that Lead to Connection

Are you ready to be parents?

Nearly everyone says that they aren’t! But there are some things that you can do to strengthen your bond with your co-parent. It’s often hard to put language to the fundamental shift that happens when you go from thinking about “you” as a couple to thinking about “you” as a family.

Here are some questions to help you stay connected to your partner and prepare for your postpartum journey.

Questions to Bond as a Couple:

Pregnancy

1. What has been your favorite and least favorite parts of pregnancy?

2. What has been your most embarrassing moment in pregnancy?

3. How have I (and we) changed since becoming pregnant? Becoming parents?

4. What’s taken you by surprise in pregnancy? Postpartum?

5. Do you miss our pre-pregnancy life? If so, what parts?

6. What food or activity are you most excited to enjoy post-pregnancy?

7. What do you imagine birth being like? Feeling like?

8. How do you feel about the blood, fluid, and poop of childbirth?

Parenthood

9. What did you like and dislike about how your parents raised you?

10. If you could change anything about the way you were raised, what would it be? What does that mean for raising our child?

11. What part of parenting makes you the most excited? The most nervous?

12. What do you think will be the hardest adjustment we will have to make as new parents?

13. What do you need each week to feel like “you”? What do we need each week to feel like “us”?

14. What will you do if you need alone time but feel like there’s not enough space?

15. How will you feel and what will you do if the baby only calms down with me?

16. How comfortable do you feel talking to each other about the parts of parenthood we dislike?

17. What’s one simple and short activity we can do together to stay connected during our child’s first year of life?

18. We might only ever talk about the baby once they’re here! What kind of questions should we keep asking each other that aren’t baby related?

36 Questions that Lead to Connection Gravida Guide 42 #thecure Beat parenting burnout (because it also benefits your kids) by working out, going on adventures, dating your spouse, sparking your creative juices. Stronger Together: 36 Questions that Lead to Connection

Questions to Plan as a Family:

Labor

19. Who will be the designated notetaker or question collector for the birth, postpartum, and baby?

20. What do you want to take on and research or learn in pregnancy, birth, postpartum, and baby care?

21. Who do we want with us when I’m in labor? Doula? Family members? Who will watch out other children?

22. Will we tell family and friends right away that the baby was born?

23. What kind of help (and from whom)do we want immediately after birth?

24. What kind of help do we want from family and friends the first two weeks postpartum?

Baby Care

25. Let’s talk sleep! How should we divide nighttime duties?

26. Babies cry a lot! How much crying are you comfortable with? Will we implement a “cry it out” method, or will we always immediately respond?

27. Tell me 3 things about the imaginary baby you created in your mind. How do they live up to our real baby?

28. How do you want to bond with our baby? Skin-to-skin time? Bottle-feeding? Walks?

29. When was the last time you changed a diaper or bathed a baby? Are you nervous about performing these tasks, especially with a newborn?

30. Can we agree that we will share the joy and burden of dressing our child and weeding through the clothes they outgrow? What other tasks can we do together?

Life Together

31. Have you thought about how and where to have sex when there’s a baby in the house? What are you comfortable with?

32. What type of family activities can we do together?

33. What small things can I do to remind you I’m with you in all of this?

34. What life activities will we prioritize as essential? What will we “let go” of during our baby’s first year of life?

35. Which one of us strongly prefers a clean house? A stocked fridge? Homemade meals? How can we divide those chores so we each feel supported?

36. What are your top 3 concerns on returning to work? How can I help make the transition easier?

36 Questions that Lead to Connection Gravida Guide 43 Mental Health: Top 10 Questions To Ask Parents Gravida Guide #Parentlife People who raise and care for small humans. Parent priority #1: keep baby alive. Parent Priority #2: hande the pressure of caring for a baby. Let’s Do This… Top 10 Questions to Ask Parents Share with friends and family for a little love along the way! (Or post on your front door for people to read before entering the house)

Healing From Birth:

1. Is your birth something you’d like to talk about or process?

What was the hardest part? Do you have a favorite moment? How do you feel about the way you were treated during labor?

2. Do you have any questions about what happened during your birth?

Do you know what interventions were utilized during labor and birth? Or why specific interventions or decisions were made?Make a list and contact your OB provider to get more information if you’re unsure of what happened during birth!

Bonding with Baby:

3. What physical or emotional surprises have you encountered since having the baby?

4. What was it like meeting your baby for the first time? Love at first sight or slow growing (both are normal)?

5. What’s the craziest day-to-day adjustment you’ve made since having the baby? 6. What’s been the best and hardest physical change you’ve experienced in pregnancy or postpartum?

7. What did you imagine parenthood would be like? How is it similar or different from your experience?

Taking Care of Mama:

8. Would you like someone to take the baby so you can have time for yourself?

9. Do you want us to clean up so you can rest with your baby?

10. What’s one thing that makes you feel like ‘you’? How can we help you do that?

P.S. You can safely assume all new mothers need something to drink, eat, or a million pillows.

P.P.S Enhance a moment of rest by turning on music or offering a foot massage while she’s feeding the baby.

Pro tip: Check out Product Playlist for Nurse Midwife-approved products for new families. "The Mommy Self-Care Must-Haves That No One Tells You About" was created for this very moment!

Top 10 Questions to Ask Parents Gravida Guide 45 Feeding Baby: Signs Your Baby Is Hungry! Gravida Guide A breastfed baby is like, “what do you mean I shouldn’t be hungry. I ate over 10 whole minutes ago!” Is My Baby Hungry? Let’s look at the whole picture!

Age: Birth - 6 weeks

Your baby is going to eat VERY frequently!

– Expect very frequent nursing the first 6 weeks of life (or beyond)!

How f requent? At minimum 8-12 feedings in 24 hours. How long should a feeding last? At least 10 minutes per feeding per breast.

Pro tip: Some babies feed 4-7 times in one hour, and yes, there’s milk!

– Your breasts are never empty. Better yet, the emptier they are, the higher the fat content.

Longer or more frequent feedings move fat out of your breast and into your baby’s mouth where it belongs! Fat globules like to stick to everything and need force to move. With longer or more frequent feedings there is less milk to move making it easier to push fat globules out of your milk ducts.

Don’t worry if your baby slightly drops in weight.

– Most babies lose 5-7% of their body weight and are back to birth weight by day 14.

– On average, babies double their birth weight by 3-4 months.

Pro tip: Without a pre-feeding and post-weight, you won’t know how much breast milk your baby transfers, but by day 4, if your baby is frequently feeding without frequently pooping, check in with your pediatrician!

Get ready for those mini-marathons of diaper changes.

– Day 1 to 7: one wet diaper per day of life.

Hydrated urine is light yellow. If you notice a few diaper changes in a row with urine that is consistently dark, concentrated, or smelly your baby is likely in need of more milk. If more frequent breastfeeding doesn’t change the color of urine, notify your pediatrician.

– One dirty diaper per day until day 4. Some babies have anywhere from 3-12 dirty diapers per day!

Pro tip: Dirty diapers are a great indicator your baby is getting enough to eat. If by day 5 your baby has fewer than 4 dirty diapers or hasn’t transitioned f rom meconium to yellow stool, notify your pediatrician.

– 24-48 hours after birth: expect meconium (dark and tarry stool)

– 2 - 4 days: Green-yellow stool (non-breastfed babies). Mustard yellow stool (breastfed babies)

Signs you’re doing it right: Visuals.

– Actively feeds: at least 10 minutes and takes herself off the breast.

– Content: a hungry baby makes tight fists, but a content baby’s hands are open and relaxed. That’s your fuel gauge! Listen for audible swallows and look for circular motion of the jaw. Age: 6 weeks - 6 months

Baby gains:

– 3.25-4.5oz of weight gain per week. Continue to take in the whole picture:

– After day 14, expect 6-8 wet diapers and 1 or more dirty diapers per day , positive weight gain and visual cues.

Signs Your Baby Is Hungry Gravida Guide 47 WHO and UNICEF recommend responsive feeding (RF), or feeding on cue.

Benefits of RF (based on research): development of healthy eating, skills for self-regulation, self-control of food intake, associated with ideal growth standards, nutrient intake, and long-term regulation of weight. Signs Your Fussy Baby Isn’t Underfed!

Underfed or just plain fussy?

Answer: If you have a fussy baby and they have adequate weight gain and output, following athree not signs they are underfed:

– Fussiness in the first several weeks of life (baby is adjusting to life outside the womb)

– Babies who want to nurse often (every 1.5 to 2 hours is standard for breastfed babies. Watch your baby, not the clock)

– Breasts don’t leak any milk, or they suddenly stop leaking (doesn’t have to do with milk supply. If you were leaking, your body adjusted. If you barely leaked, some boobs just leak less)

– Breasts feel softer than they used to (this is pretty common once mature milk supply comes in)

– You get very little milk when pumping after a feeding (babies are more efficient at extracting milk than a pump, and your leftover milk amount isn’t a good indication of milk supply)

– Your baby suddenly increases their frequency of nursing (likely will line up with a growth spurt)

Yes! I can confidently say my baby got plenty to eat: Step 1: Once baby is latched, let them take the lead. They will pull themselves off when done.

Here’s what an active feeding looks like:

Rapid suckles at the beginning of the feed to stimulate your let-down.

Slow, long suckles in the middle and end to extract milk. Audible swallows every few suckles.

Pro tip: If your baby transitions into a half-hearted feeding pattern (think: light, inconsistent sucking) and you aren’t sure if they are done eating, gently blow on their face or tickle their feet to find out. They will:

Pop off asleep (done)

Keep going (needed a little reminder)

Fuss, re-latch, continue to half-heartedly suckle (you can keep them at the breast. They still get milk!)

Step 2: You don’t need to feed baby on both breasts with each feeding.

If they are too sleepy to take the other breast, let them sleep. If they wake up 10 minutes later ready to eat, offer the other breast first.

Pro tip: You can’t overfeed a breastfed baby. If they’re fussy, feed them first before you try other methods of soothing!

Step 3: Between 1-6 months, intake of breast milk stays the same.

On average, a baby will take 19-30 oz of milk per day or 2.5oz per feeding.

Pro tip: Check out our breast milk expression calculator to figure out how much your baby eats!

Signs Your Baby Is Hungry Gravida Guide 48 Feeding Baby: Milk Storage Guidelines and Power Pumping Gravida Guide #terminfant A baby born after 37 weeks. Heads up: The live cells and antibodies that fight the growth of harmful bacteria in your baby’s intestines also protect against Breast Milk Storage: bacterial growth in your breast milk when it’s stored! Guidelines for Healthy Term Infants:

Heads up: Milk storage guidelines are based on ever-evolving imperfect clinical research. Follow the rules but use your senses (like you do when detecting spoiled cow’s milk) for when you think your breast milk has gone bad! Keep your breast milk in tip-top condition:

– Wash your hands (not your breasts) before expressing breast milk.

– Hand expression or expressing with a pump are equally safe.

– Wash your hands and clean your pump parts per the pump manufacturer’s instructions.

– Check the taste and smell of your breast milk 1-2 hours after pumping.

– Did you know that frozen breast milk can have a different odor than freshly pumped milk? Have no fear! Smell or taste fresh and frozen breastmilk under clean conditions to develop a baseline to prevent the "did my breastmilk go bad?!" moment. Lipase, an enzyme found in breast milk, breaks down fats causing breast milk to smell or taste soapy or sour.

– If your baby isn’t a fan of the taste of your breast milk, mix half fresh and half frozen milk together to alter the flavor. If that doesn’t work, add non-alcoholic vanilla or almond extract to breast milk to cover the flavor.

– Many people advise scalding breast milk to deactivate lipase. This is not recommended by the American of Breastfeeding Medicine as it may destroy many of the immune boosting factors in breast milk. However, it’s safe if your baby is only receiving a few ounces of heat-treated breast milk per day. They will get immunologically active factors from fresh breast milk with other feedings.

– Discard remaining milk within 1–2 hours after your baby is finished feeding.

– Breast milk can be safely stored in a workplace refrigerator but make sure it's labeled with name and date.

– Heads up: You may prefer to store milk in a personal freezer pack or cooler, separate from communal refrigerator areas. It’s safe to do so for up to 24 hours! Make sure to label and date your breast milk!

– Breast milk does not need to be warmed prior to feeding it to your baby. It can be given cold or at room temperature.

– If you have breast or nipple pain from a bacterial or yeast infection, you do not need to discard stored expressed milk. Discard breast milk that appears stringy, foul, or containing pus.

Fresh breast milk- room temperature for 4 hours:

– You can keep breast milk at room temperature for 6-8 hours if pumped under clean conditions.

– Clean conditions: hands washed and pump parts cleaned per pump manufacturer's instructions.

Fresh breast milk- store in refrigerator for 4 days:

– Fresh milk can be good in the refrigerator (39 degrees F) for up to 5-8 days if pumped under clean conditions.

– A pro tip for combining milk from a previous pumping session: chill fresh milk in the fridge before combining it with older milk to prevent warming that could lead to bacterial growth.

– Protect breast milk nutrient levels by slowly warming breast milk to body temperature over 20 minutes in lukewarm water. To protect your infant’s health, don't microwave breast milk.

Fresh breast milk- store in freezer up to 6 months or deep freezer (-4 degrees F) up to 12 months:

– Use oldest milk first. Freeze breast milk in small batches, 2-4 oz/bag.

– Have a freezer stash of 1-2 weeks worth of pumped breast milk. If possible, pump what you need for the day because fat, protein and calories decrease in human milk when frozen for 90 days compared to fresh human milk. Frozen breast milk changes over time, as does your baby’s needs. The fresher the better!

– Once frozen milk is thawed you have 24 hours to use it.

Breast Milk Storage Guidelines Gravida Guide 50 #preterminfants Born before 37 weeks Premature babies have immature GI tracts, so they need easy-to- digest food to protect their belly. Your breast milk contains enzymes that help with digestion and epidermal growth factor to Breast Milk Storage: help the intestines mature. Guidelines for Preterm or Hospitalized Infants:

If your baby is born prematurely or in the NICU, the guidelines for breast milk storage change.

– Fresh breast milk- room temperature for 1- 4 hours.

– Refigerator for 48 hours if fresh, 24 hours if thawed.

– Freezer: 3 months (use compartment with separate door, not side of door).

– Deep Freezer: 6 months.

Separated from baby or exclusively pumping? Here’s how much milk you should get per pumping session.

– Day 1-3: Per pumping session: Drops Heads up: Total per day: up to 3 - 5 ml

– Day 4-5: The amount pumped between breastfeeding sessions Per pumping session: 25 – 30 ml (1oz) will be less than if you were pumping for a missed Total per day: Around 200 ml (6.5oz) feeding or if you are exclusively pumping.

– Day 7-30: Per pumping session: 45 ml (1.5oz) Total per day: Around 300 ml (10oz)

– Day 14: Pro tip: Per pumping session: 45 – 60 ml (2oz) Total per day: Around 450 ml (15oz) Add massage (by hand or with a massage component that connects to your pump) to increase milk output! – 3 – 4 wks plus: Per pumping session: 60 – 120 ml (1-4oz) Total per day: 600 – 900 ml (20-30oz)

Power Pumping: Mimics cluster feeding to boost your supply!

– Prepare for a normal pumping session

– Pump for 10-20 minutes.

– Rest for 10 minutes

– Pump 10 minutes

– Continue this cycle for 60 minutes once a day, up to a few days or until you notice an increase in pumped milk.

Finding the right breast shield size: Breast shield size is based on diameter of your nipple.

Here’s how to measure nipple diameter: Use a ruler or measuring tape to measure the distance across the middle of your nipple (at the base) in millimeters. Do not include your areola!

Breast shield size:

36mm 30mm 27mm 21mm 24mm

Nipple diameter: Up to 17mm Up to 20mm Up to 23mm Up to 26mm Up to 32mm

Milk Storage Guidelines Gravida Guide 51 Feeding Baby: How to Increase Your Milk Supply Gravida Guide #milkboosters Herbal galactogogues (gal-act-o-gog-ues): an herb or medication that increases milk supply. Milk Supply: 3 Ways to Pump It Up! 3 Things You Need to Know About Low Milk Supply:

1. Low milk supply? Don’t f ret beautiful momma, most supply issues can be fixed by addressing the root of the issue:

– Preemie? -> Try power pumping (see our Power Pumping Gravida Guide) and pumping after skin to skin.

– Breast surgery or cancer less than 5 years ago-> stimulate the breasts as often as possible the first 2 weeks postpartum when your body is establishing how much milk you need in the coming months.

– Do this by breastfeeding baby directly, then pump or hand express (removing milk with your hand) after each feeding for the first 2 weeks.

– Incorrect positioning during feeding, incomplete latch, tongue or lip tie in baby ->work with a lactation consultant!

– Supplementation, giving formula or bottled breast milk after baby feeds at the breast -> pump after you breastfeed baby.

– Using pacifiers or nipple shields -> wait 4 weeks before introducing to protect long-term milk supply.

– Mom’s medications -> start with LactMed for meds that can complicate breastfeeding and talk with your OB provider and lactation consultant to troubleshoot,

– Drinking alcohol, smoking tobacco -> 5 alcoholic drinks or more decreases milk production. Limit the amount of alcohol you consume while breastfeeding. Smoking inhibits let-down, if you continue smoking, consider smoking after a breastfeeding session.

– Cutting feedings short, scheduling feedings, baby sleeps too much or sleeps through the night -> feed baby on cue or pump after feeding!

– General health issues -> talk with OB provider and lactation consultant to troubleshoot.

2. Unsure of what herbs or medications will impact your milk supply? Limit large amounts of the following to protect your milk supply. Or use them to decrease oversupply or help with weaning:

– Oregano – Thyme – Periwinkle herb

– Parsley – Black walnut – Sorrel

– Peppermint – Chickweed – Yarrow – ed – Sage – Geranium – Sudafed – – Spearmint – Lemon balm – Birth control with estrogen

Milk Booster Gravida Guide 53 #milkboosters

Herbal galactogogues (gal-act-o-gog-ues): an herb or medication that increases milk supply. Milk Supply: 3 Ways to Pump It Up! 3 Things You Need to Know About Low Milk Supply:

3. Want to increase your milk supply without herbs or medications? Try the following:

– Avoid alcohol and smoking.

– Practice hand expression or breast massage. See our breastfeeding bonus video for guidance!

– Practice power pumping: you can pump in between feeding sessions or continue pumping after the last drops of milk have been expressed.

– Try Kangaroo Care, also known as skin-to-skin with baby.

– Breastfeed on demand (or more if baby sleeps longer stretches).

– Offer both breasts for each feeding if baby is interested or if weight is lagging.

– Switch multiple times from breast to breast if the baby is tired/falls asleep too quickly.

– Make sure the f requency of nursing is enough (8-12 times every 24 hours, at least every 3 hours at night).

– Rest, a balanced diet, and water are all very important. And also often very hard to do during times like these. Eating foods one-handed while breastfeeding or using the time to catch up on drinking water will help a lot. You’re doing great and sharing your first meals with your child!

Want to increase low milk supply with food and herbs?

We have got you covered?

Check out our Healthy Noms Gravida Guide for recipes.

Milk Booster Gravida Guide 54 Feeding Baby: How to Select The Best Pump (for you) Gravida Guide #handsfreepump The greatest invention of all time. Continue to work or complete tasks while you pump. Part 1: How to Find the Perfect Pump (for you):

Step 1: Figure out pros and cons of electric, hospital-grade, or manual pump:

– You might want an electric breast pump if:

– You want to adjust speed or suction pressure for a comfortable and productive pumping session.

– You need to pump on the go (battery-operated).

– You want to save time pumping both breasts at the same time.

– You’re a busy mama who needs to pump in-between breastfeeding sessions.

– You might want a hospital-grade pump if:

– You don’t mind the price or have great insurance (they are the most expensive pumps).

– You plan to exclusively pump or have a baby in the NICU. These pumps mimic your baby’s natural breastfeeding rhythm to remove more milk and have a powerful motor to make pumping efficient and effective.

– You don’t need to go anywhere. These pumps are best kept at home because they can be too large to take on the go.

– You might want a manual pump if:

– You don’t mind the work! They don’t have motors and use pressing motions with your hand to create suction for pumping.

– You need to pump on the go but don’t have room to carry an electric pump. They are the size of a bottle and include a flange or breast shield to attach to the body.

– You forgot your breast pump at home. They are inexpensive, easy to throw in a bag or store at work, and great for short trips out of the house. Step 2: Determing how often will you pump:

– If you plan to exclusively pump:

– You need a hospital-grade pump to keep your milk supply booming. The cost of rental should be covered by insurance.

– Consider adding a massage component, like Lilu, to your pump to increase milk expression.

– If you only pump at work:

– You need a hands-free electric pump to save time at work!

– You might want to store a manual pump at work in case you forget your electric pump.

– You might consider having one pump at work and home to lighten your load.

How to Select the Best Pump Gravida Guide 56 #freepump Your health insurance plan must cover the cost of a breast pump Ask and you will receive. Part 2: Talking Points to the Pump You Need:

Talking point #1:

– Let your Insurance company know which pump you need and why because breast pump coverage policies aren’t set in stone. Don’t hesitate to let them know.

Talking point #2:

– Be prepared to ask for a prescription for a hospital-grade pump from your OB provider! (Majority of insurance companies cover them, but most require pre-authorization.)

Talking point #3:

– Ask when your breast pump will be delivered. (Request it be delivered in pregnancy so you can acquaint yourself with the pump or bring with you to the hospital for an in-person tutorial.)

Talking point #4:

– If your in-network plan doesn't cover the pump you want, you can get reimbursed or get partial coverage. (You just have to ask!).

Talking point #5:

– Insurance plans cover lactation consultations! Don’t do it alone! (Most private practice lactation consultants require you to submit the bill to your insurance plan for reimbursement. However, check to see if your hospital provides outpatient lactation services that can bundle into your postpartum bill!).

– If you or your baby have a medical issue (e.g. if the baby is in the NICU) or if you plan to pump exclusively, get a hospital-grade pump! A hospital-grade pump helps you maintain your milk supply when separated from baby because it mimics your baby’s natural breastfeeding rhythm.

How to Select the Best Pump Gravida Guide 57 Feeding Baby: How to Get Privacy While Pumping. Gravida Guide Place this sign on your door to remind others you’re pumping!

Breast Milk Privacy Please

I’m whipping up a meal for my baby. I need minutes to finish. Saves Lives (You’re welcome.)

Hang tight! Postpartum superefficiency is at work! (Yes, I’m making food for my baby, knocking out emails, and cleaning my pump parts.)

If you need to reach me, I’m available via email or text. I’m here to support the team as I support my family, too.

How to Get Privacy While Pumping Gravida Guide 59 6 Weeks and Beyond: Will My Baby Ever Sleep? Here’s What to Expect Gravida Guide “Cry-it-out is not a method that gets your baby to sleep faster than others. There’s not even enough evidence to support a particular method of sleep training. To develop a sleep strategy that gets the whole family rest, you'll have to understand the needs of your baby and that of the family to create a personalized approach.” -Gravid a Will My Baby Ever Sleep? Here’s What to Expect:

The Newborn Stage: Birth- 2 months Your baby will: – Sleep 14-18 hours of sleep per day but in 1-3 hours stretches (You will need a nap or two!) – Have no schedule! It’s predictably unpredictable. – Go to bed late, around 10-11pm, the first few months of life (Don’t worry, your baby will find their “perfect” bedtime.) Pro tip: To cope with the late bedtime, split it. Have your partner hang with your baby while you go to bed early. Then swap.

– Experience an early evening peak in crying associated with reduced sleep at 6 weeks of age (Get all hands on deck, don’t do this part alone if you don’t have to!) – Sleep in your room. The World Health Organization (WHO) and American Academy of Pediatrics (AAP) recommends room sharing until 6-12 months.

How to handle infant sleep like a 3rd time mom:

– Infant sleep works itself out in time even if every baby has a different timeline. – Get your baby to sleep better at night by having them nap in a common area during the day. – Expose your baby to more light in the early afternoon by taking them on walks or sitting in front of a window to develop their circadian rhythm. – Establish a morning and evening routine: Open blinds in the morning, take a bath, sing songs, or read books before bedtime. – Keep your spirits up with this mental reframe: You can feel confident your baby’s neurological and respiratory systems are functioning correctly with all the frequent wakings.

The Infant Stage (Part 1): 2-4 months

Your baby will: – Sleep 14 hours of sleep per day, 2-4 naps per day. – Take short naps. Infants at this age often sleep longer when contact napping. If you’re working on getting your baby to sleep independently, plan to work on naps for a few weeks or months. The pros and cons of contact napping and independent sleep: Pros: Contact napping: Daytime flexibility (you aren’t restricted to napping at home), longer stretches of sleep, time to bond, easy to breastfeed on the go in the carrier, calm baby.

Independent sleep: develop a schedule sooner, more body space, independence. Cons:

Contact napping: Babies are heavy to hold for long periods of time,, lack of personal space, they might.

Independent sleep: Spend your maternity leave trying to get baby to sleep on their own, restricted schedule during the day, temporary stress while you help them learn how to sleep and stay asleep. Heads up: Sleep training is temporary and doesn’t offer long-term results (this is normal!). You can re-sleep train or take baby’s lead. – Experience a sleep transition around 3-4 months with more frequent night wakings. – Outgrow the swaddle once they roll over.

How to handle infant sleep like a 3rd time mom:

– Bedtime naturally shifts a little earlier. You can attempt to move bedtime by starting your routine 15 min earlier each day OR follow your baby’s lead. – Infants and children across the world have later bedtimes than infants/children do in the United States! Find the norm for you and your baby. It’s ok if what works for you is different from family or friends.

Will My Baby Ever Sleep? Here’s What to Expect 61 “If what we expect from our babies’ ability to sleep were not that di!erent from our babies’ expectations for themselves, the “will my baby ever sleep through the night” fear might disappear.” -Gravid a

The Infant Stage (Part 2): 4-8 months Your baby will:

– Sleep 12-14 hours of sleep per day, 2-3 naps per day. – Have variation in sleep quantity and quality. Some infants wake as frequently as 10 times/night. Around 20% of babies don’t respond to sleep training. It’s normal, but you’ll need a sleep strategy to get rest. – Officially establish their circadian rhythm by four months of age. How to handle infant sleep like a 3rd time mom:

– You can sleep train or take a baby led approach. Your baby will figure out how to sleep on their own, in time, either way. Listen to your gut, pay attention to your baby, and experiment. – Frequent night waking is common from 4-12 months. – If at 6 months your child starts to wake up at night after sleeping through the night, it may be related to the introduction of food. Give it time! Your baby will adjust.

The Infant Stage (Part 3): 8-12 months

Your baby will:

– Sleep 12-14 hours of sleep per day, 2-3 naps. – Have more of a schedule. Around half of the babies sleep through the night at this stage, the other half still wake frequently. – Occasionally experience the universal developmental phenomenon of night waking through the first year of life. How to handle infant sleep like a 3rd time mom:

– Developmental leaps are real and impact your baby’s drive to sleep. Some babies are so excited to practice new skills in their sleep and wake themselves (or you!) up. – The number of night time wakings is a function of age. Studies have found that by 24 months regular night waking requiring attention becomes much less common. Older infants exhibit the ability to self- soothe after nighttime awakenings better than younger infants. Self-soothing is a skill learned over time as the brain develops the capacity to practice it. – It’s all going to be ok. Sleep training is only slightly associated with the quality of the child’s attachment relationship. If you feel ready for consolidated sleep or your baby isn’t getting adequate rest, it’s ok to sleep train. And you’re not overhelping or limiting your baby’s ability to learn how to fall asleep if you comfort them overnight while their brain grows and develops. Listen to the needs of the whole family

Will My Baby Ever Sleep? Here’s What to Expect 62 6 Weeks and Beyond: Hacks Every New Mom Needs Gravida Guide For products that make you feel on top of your mom game, check out our ‘Peace of Mind’ product playlist at www.gravidamom/productplaylist! Hacks Every New Mom Needs:

Pump Like a Pro Here’s how to hack the moment!

– Forgot bottles for the pump? Create a makeshift bottle by attaching a plastic bag or water bottle to the pump with tape or a rubber band.

– No spilled milk! Use a breast shield (the little plastic piece that attaches to your breast) as a funnel by flipping it upside down to avoid spilling milk.

– No time to wash your pump parts after pumping? Place parts unwashed in a plastic bag in the f ridge until your next pumping session. Wash them before you pump again but at least you bought yourself a little time!

– Forgot your pump, don’t have time for a full pumping session, or feel full? Hand express for a 3-5 minutes (or until you feel relieved of pressure) into a milk storage bag or container of your choosing. Repeat as necessary throughout the day.

Pump on-the-go like a pro!

– Always have a pump on hand! Keep one pump at work and one at home to prevent lost pump parts. Or grab a manual pump for back up.

– Did you know you can pump and store in the same bag? Store a pack of Kiinde twist pouches at work for low-maintenance pumping.

– So you don't have to hand wash pumps multiple times per day, use Medela Micro-steam bags, breast pump wipes, or sanitizer spray to clean pump parts in a matter of minutes.

Here’s how to hack the moment!

– Deep breathe while you put your baby to bed to have them mimic your breathing pattern! This slows their nervous system, making them more drowsy.

– Infants love massage too! Massage using baby lotion or massage oil with chamomile or lavender to help lower stress hormones.

– If your infant won’t sleep on their own, ask your caregiver to hold or wear them for naps.

– Time. As with most things, your baby probably needs time to adjust to life outside the womb!

Pro Tips for Baby Sleep Track it!

– Use Nanit to track baby’s sleep behavior over time.

– Or the Snoo to gently rock your baby to sleep. It can be used for first 6 months.

– Use Nite Nite LED bulb to safely care for baby without disrupting their sleep.

– Smart Changing Pad by Hatch baby to keep track of baby’s diapers, weight, and sleep schedule.

Hacks Every New Mom Needs Gravida Guide 64 Body changes are as emotional as they are physical! You might need a daily pep talk: “Write on your mirror: ‘I had a baby. I’m a superhero.’” —Kelly Rowland New body. Who dis?

Top body concerns everyone has and how to handle them like a pro:

How to hack the moment:

– It hurts to sit! Roll two towels into a ‘U’ shape and place under your butt to take the pressure off your perineum.

– Where are my abs? Act like you’re 37 weeks pregnant- roll to the side when sitting up, no heavy lifting, and ask for help! Give it 4-6 weeks before expecting to feel stronger.

– I can’t stop sweating! Sleep on top of a towel (or 2!) to prevent drenched sheets.

– What should I wear postpartum? Wear button up shirts or tops you can pull down for easy access to breastfeed. Keep wearing maternity clothes while you heal.

Thinking ahead:

– Buy a donut seat or breastfeeding pillow for sitting to take pressure off your perineum.

– Support your abs and back with a belly binder! Forget about carrying the car seat the first 6-8 weeks. It’s heavy and hard on your back, stomach, perineum. Babies transfer easily f rom car seat to carrier or purchase a car seat that attaches to a stroller.

– Sweating: ditch the towels and try a waterproof mattress pad.

– Purchase a handful of breastfeeding tops and nursing cover to use while you figure out latch and how to breastfeed in public.

Hacks Every New Mom Needs Gravida Guide 65 6 Weeks and Beyond: Science Says Do This to Raise Healthy Kids Gravida Guide #mindfulparenting Bring conscious attention to what’s happening. Paying attention to what you’re feeling without letting it take over. Loving Babies: Top 10 Ways to Raise Healthy Kid s (based on research):

1. There’s no such thing as too much love and affection.

– Heads up: The quality of relationship you have with your child contributes to their happiness and health. Go make those memories- it’s not about how much time you spend together, but the way you spend your time.

– Pro tip: You can’t spoil a baby so go ahead and bounce, hold, rock and play with your little one. Take turns exploring ways to bond. Bring your baby into something you love to do and join your baby in an activity they love. Does your baby have a favorite song? Turn it up and dance like crazy!

2. There are hidden perks to managing your stress.

– Heads up: Managing your stress improves the physical and emotional health of the whole family!

– Pro tip: Go for meditation, talk therapy, or experiment with using humor to reframe difficult experiences to build resilience. It doesn’t change the situation, but it lightens the load! If you’re having a tough day, feel overwhelmed, annoyed, or like you want to quit, remind yourself that toddlers aren’t the only ones who need to let out a little steam.

3. There’s no such thing as too much couple time!

– Heads up: Relationships need babyproofing too! Maintaining a good relationship with the other parent indirectly benefits your child.

– Pro tip: Don’t forget your partner once you have a baby. Even if you don’t have time for a date, you can find time to connect with something as simple as a long hug. Your kid might want to join too! Practice supportive co-parenting whether you are together or separated from your partner.

4. There’s more to your baby than meets the eye.

– Heads up: Your baby is very smart. Follow their lead and practice developmentally appropriate independence by respecting your child’s stage of development.

– Pro tip: Between the age of 0-3 there is rapid brain growth. Your baby or toddler might need help sleeping at night. Your 4 year old might just be figuring out how to share. Learn about your child’s brain development and what they can or can’t do at a specific age to tailor your response. Check out Section 12 video 5 for a few ideas!

5. There’s so much to learn!

– Heads up: You can promote educational opportunities in every form. Teach your child about emotions or how to save money. The options are endless.

– Pro tip: Talk to your baby about everything even if you think they’re not paying attention, they are. Fill them in on what’s happening at home and in the world. Talk to them about their mood, your mood, and how to handle difficult emotions! It’s never too early.

6. There are benefits to eaching your child about creating a life plan!

– Heads up: Talk to your child about how to organize and plan for life starting with things like how to grocery shop, pay bills, or make food.

– Pro tip: When your child is a baby, talk to them about the decisions you make and why. They’ll start to map your mind and get to know you better in the process!

Raising Healthy Kids Gravida Guide 67 #mindfulparenting Learning how to respond instead of react. You got this! Loving Babies: Top 10 Ways to Raise Healthy Kids (based on research):

7. There’s more to disciplining than times outs.

– Heads up: Instead of a time out and disciplining by withholding, wait until your child is calm and talk to them about their behavior. They’ll be much more receptive to what you have to say!

– Pro tip: Avoid spanking or timeouts. Hang with them when they’re acting out and when your child is calm and receptive, talk to them about the difficult emotions they experienced and brainstorm ways to handle it in the future. When you do this you support the integration of their “emotional” brain with their “thinking” brain. 8. There’s a good reason to stay healthy!

– Heads up: Modeling a healthy life is far-reaching. It keeps you in tip-top shape and shows your child what it looks like to practice self-care.

– Pro tip: Exercise with your kid and cook healthy meals together (let them smell all the spices and stir alongside you!).

9. There’s a greater purpose in talking about spirtual or religious development.

– Heads up: Every child questions the world around them, and you can help navigate their philosophical questions to develop spiritual or religious awareness of the world near and far.

– Pro tip: Read books with your child that talk about religions across the world, the benefits of meditation, or what it means to be a good person.

10. There’s helicopter parenting and then there’s mindful parenting.

– Heads up: Your child’s safety is so important. It’s ok to take necessary precautions to keep child safe but check in on whether you’re over-protecting them or discouraging autonomy. Try asking yourself why having your child try X makes you nervous. From there find appropriate ways to respond to protect and nurture your child’s development.

– Pro tip: If you notice your child doing something dangerous or outside their skill set, instead of reacting or telling them “no,” talk to them about what they need to know to do it safely. Example: if your baby is active and wants to crawl off the bed or couch without you. Teach them how and practice with them so they can learn without feeling afraid. –

Raising Healthy Kids Gravida Guide 68 6 Weeks and Beyond: Workout Like a Mom Gravida Guide #bodyimage Body image satisfaction is an important factor for psychological health in pregnancy and postpartum. Exercise before, during, and after pregnancy may be protective against depression, has Need a Boost? minimal risks and lots of other benefits. Workout Like a Mom!

Want to work out but don’t know what’s safe? Here’s how to do it!

1. Do you have a low-risk pregnancy? (Not sure? Ask your OB!)

– It's safe to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.

2. Set your goal!

– Aim for moderate-intensity exercise at least 20–30 minutes per day on most or all days of the week.

3. Have concerns? Let's take care of that! Here are top concerns when working out pregnant:

– What if I get too hot?

– Regulating your temperature when working out is dependent on hydration and environmental conditions (watch out for hot summer days and hot yoga classes!). You can still break a sweat in your yoga, Barre, Equinox, or Soul Cycle class, but drink water and tune into your body.

– Stay hydrated and cool by drinking 1-2 cups of water before working out and continue drinking water during your workout. Wear breathable, loose-fitting clothing, and avoid high heat and humidity to protect against heat stress (especially during the first trimester!).

– Do not exercise outside when it is very hot or humid.

– Will I get hurt working out?

– The most common sports-related injuries in pregnancy come from joint laxity. You can thank the pregnancy hormones that cause the ligaments that support your joints to become relaxed and mobile.

– Avoid jerky, bouncy, or high-impact motions that can increase your risk of being hurt. Ask yourself: Will X put me at risk of twisting my ankle or falling on my abdomen? If so, modify or avoid that particular exercise.

– Discontinue exercise if you experience joint pain, difficulty breathing, vaginal bleeding, leaking of fluid, dizziness, headache, chest pain, muscle weakness affecting balance, calf pain or swelling.

– Make sure to eat before working out to prevent low blood sugar and dizziness. Eat a light snack to boost your energy before working out like:

– Smoothie (Check out our Nourish Gravida Guide for inspo!) – Half a PB&J – A banana

– I didn't work out before pregnancy. Can I work out now?

– Yes! If cleared by your OB, follow a more gradual progression of exercise.

– I did high-intensity exercise programs before I was pregnant. Can I keep it up?

– If you regularly exercised before pregnancy and have an uncomplicated pregnancy, high-intensity exercise programs are typically ok, just talk to your OB provider first! “Duh, I know that... but remind me once more?”

– Watch your balance!

– The extra weight in the front of your body shifts your center of gravity and places stress on joints and muscles in your pelvis and lower back. Working out can keep you better balanced by reworking your muscle memory!

– Remember to breathe!

– While you are pregnant, your need for oxygen increases and may affect your ability to do strenuous exercise.

– Watch out for signs of dehydration.

– Look for signs like dizziness, a racing or pounding heart, and urinating only small amounts or having urine that is dark yellow. Workout Like a Mom Gravida Guide 70 #Protip Regular exercise shortens the length of labor and need for epidural and boosts confidence from the inside out! Need a Boost? Workout Like a Mom!

“Duh, I know that... but remind me once more?” (continued)

– Wear a sports bra and support belt.

– Extra support reduces discomfort and protects your breasts and a belly while walking or running.

– Practice good posture when standing and sitting.

– Limit time spent resting on the couch, instead opt for an exercise ball to promote good posture.

– 20 weeks and beyond:

– Avoid crunches, planks or exercises that work your six-pack muscles to prevent increased abdominal pressure and abdominal separation. Ask your exercise instructor how to adjust the ab workout or grab a mini exercise ball for support.

– Avoid:

– Lying flat on your back to prevent your uterus from pressing on a large vein that returns blood to the heart.

– Positions that strain pelvic floor or abdominal muscles with extreme asymmetrical positions like splits or deep lunges.

– Bending and twisting at the same time.

– Sitting cross-legged, standing on one leg with hip jutting out, or holding your baby on one side of your body (make sure to alternate sides!). Protect your Core in Pregnancy and Postpartum:

– Use proper body mechanics – bend from the knees and hips, not your back.

– Activate deep core muscles with all movement to lower the workload on your six-pack muscles and prevent abdominal separation. These muscles include the pelvic floor, deep abdominals, and deep spinal muscles

– Practice activating your deep core muscles by bracing:.

– Stand with hips directly under your ribs. Activate your butt by gently squeezing to tilt the pelvis forward. Feel the front, side, and back sides all contract at the same time.

– Squeeze and lift your pelvic floor muscles up and in, pull your abdominal muscles inward.

– Once you feel which muscles you're activating, you can practice bracing while sitting, standing, or on all fours anytime, anywhere.

– Keep your low back in a neutral posture.

– Always listen to your body. If it doesn’t feel right, don’t do it.

Workout Like a Mom Gravida Guide 71 6 Weeks and Beyond: Healing Postpartum- Beyond 6 Weeks Gravida Guide Fifth Trimester: Birth of the working mom. Pro tip: Check out Lauren Smith Brody, author of Fifth Trimester, for more working mom inspo. Mom Life: When the countdown to work is on, and you need to get back into the swing of things…

1. Remember you matter:

You might feel pressure to put your body on the back-burner, but caring for your body can prevent postpartum depression and heal unresolved problems f rom pregnancy and childbirth!

– To prepare for your return to work, use appointments as an opportunity to practice gentle separation f rom your baby.

– Work with a physical therapist (PT) specializing in pelvic floor therapy. Use Herman & Wallace Pelvic Rehabilitation Institute to find a PT in your area!

– Work with a chiropractor trained in Webster technique to restore balance and function to the pelvis and nerves after pregnancy and birth.

– Have a massage therapist who comes to your home. Try Soothe or Zeel.

– Find a mental health therapist. To find one, check out Psychology Today or The Postpartum Stress Center.

– Work with an acupuncturist specializing in postnatal care.

2. Make memories:

Your baby feeds 24/7, and you haven’t slept properly in months, making the last 6 weeks of leave overwhelming and chaotic.

– Tip 1: Make memories. Somewhat clean is good enough when it means slowing down and marking time as a new family.

– Tip #2: You’re not failing if life feels “out of order.” Every family finds themselves here.

– Tip #3: This state doesn’t last forever, but you might not have order until your baby is closer to 6-9 months.

– Tip #4: You’re a master at evolving and adapting. It doesn’t feel great in the moment but it’s a great skill to have!

3. Set your intentions for the last 4 weeks of maternity leave:

– Do I need more time at home?

– If 6-12 weeks off isn’t enough time to bond and heal, contact HR to discuss phasing in, working remotely, or delaying your return by 1-2 weeks. If you love your job but need a little more time with your baby, it’s worth the hard and awkward conversation to find a plan that works for you.

– You might feel pulled in a lot of different directions. Make a list of things you have to figure out before returning to work and things you can figure out as you go.

Thing to figure out now: Month 1 work schedule (Section 13, Video 4) Temporary childcare (Section 13, Video 5) Our morning routine (Section 18, Video 1) What to feed my baby (Section 11, Video 1)

Things to figure out as I go:

Infant sleep (Section 10, Video 2) Work-life integration (Section 15, Video 5)

Long-term work schedule (Section 5, Video 2+3) Long-term childcare solutions (Section 13, Video 1)

Healing Postpartum Gravida Guide 73 #morelove Ongoing support is a must-have. Don’t feel bad asking for help, it’s how you make the leap into parenthood. Mom Life: When the countdown to work is on, and you need to get back into the swing of things…

4. Ask for help:

In some cultures, when a baby is born, ten adults help out. It takes a village! Here are top milestones to expect and plan for your first year postpartum:

Month 1 (The Newborn Bubble). Surprises: Sleep debt, no rhythm, healing body.

Helper #1- The Listening Ear:____ Helper #2- The Baby Whisperer:____

Month 2 (The Fussy Baby). Surprises: Peak in crying, growth spurt. Breastfeeding is easier. Work countdown is on! Not breastfeeding? Expect a period soon.

Helper #1- The Baby Bouncer:____ Helper #2- The Task Rabbit:____

Month 3 (The Tearful Good-bye). Surprises: Your return to work coincides with your baby interacting and smiling. First time you can cook without holding a baby.

Helper #1- The Chauffer (Bring me my baby!):____

Month 4 (The Mental Swirl). Surprises: Sleep regression and first tooth. Don’t feel like yourself: tired, hair loss, sore back, and want to quit work.

Helper #1- The Physical Therapsit:____ Helper #2- The Hair Magician:____ (Thinking ahead: Weekends are for? My partner and I need?)

Month 5 (Is This Really My Life?). Surprises: Wonder if work is meaningful enough to miss out on key moments with baby. PPD symptoms might show up.

Helper #1- The Pro Parent:____ Helper #2- The Self-Care Guru:____ (Thinking ahead: Activities to bond with baby? Look for a mental Health therapist?)

Month 6 (Settling in). Surprises: Baby eats solids. Another sleep regression and growth spurt. Your body isn’t what it was but beginning to feel a new normal. Dentist time!

Helper #1- The Dentist:____ Helper #2- The Workout Buddy:___

Month 7 (A Part of My Routine). Surprises: Baby is rolling and sitting up. More teeth. Baby fits into your life. First postpartum period if exclusively breastfeeding.

Helper #1- The OB Provider:____ Helper #2- The Babysitter:____ (Thinking ahead: Do I have a reliable birth control method?)

Month 8 (The Next Stage). Surprises: Sleep regression; baby exploring, scooting, or crawling. Linea nigra begins to fade. Option for work opportunities to lean into.

Helper #1- Infant Sleep Expert:______(Thinking ahead: What’s our sleep plan? Convo with partner about work and family goals.)

Month 9 (What just happened?). Surprises: Moody baby asserting independence; more sleep regression! Your body feels ready for those pre-pregnancy workouts.

Helper #1- The Masseuse:____ Helper #2- The Cheerleader:____

Month 10 (Back to square 1). Surprises: Rethinking schedule at home and work, wondering when things will settle down or if this is the new norm. Melasma starts to fade.

Helper #1- The Dermatologist:____ Helper #2- The Vocational Coach:____

Month 11 (Where’d My Baby Go?). Surprises: Baby is crawling/walking, more teeth. Stretch marks fade (but still present) and body shape less variable.

Helper #1- The Personal Shopper:____

Month 12 (We made it!). Surprises: Another sleep regression. Figuring it all out or ready for baby #2?

Helper #1: The Reproductive Life Plan Guru:____

Healing Postpartum Gravida Guide 74 Parental Leave: How to Rock Your Maternity Leave Gravida Guide #maternityleave The maze you must navigate to have time to heal and bond with your baby. Only 14% of women have access to FMLA.

How to Rock Your Maternity Leave- Top 6 Questions to Ask HR:

1. What is the elimination period? (Heads up: elimination period refers to the time period between a medical event and time of benefit payments.)

– How long do I need to be out of work before my benefits begin?

– I heard some policies pay immediately while others don’t pay until I am out of work a certain number of days. Can you let me know how many days I should expect to go without pay? – Do I need to use vacation or sick days to cover time off before benefits kick in?

2. When do I gain access to employee benefits? And how can I use them?

– How long do I have to be at my job before gaining access to short term disability (STD)?

– How much of my salary does STD cover?

– Can I use accrued vacation or sick time to extend my leave beyond 12 weeks of FMLA?

– Does STD have to be used at the same time as FMLA? – Do I qualify for STD if I did not have a pregnancy complication?

3. Does my employer offer paid leave beyond STD?

4. Should I consider working with a broker to navigate STD, FMLA, or PFL?

5. How do I find out what will happen to my benefits, like health insurance, if I extend maternity leave beyond what my employer covers?

6. Do you provide access to LeaveLogic, a software program designed to help both employers and employees navigate leave options and benefits in a timely and cost- effective way?

How to Rock Your Maternity Leave Gravida Guide 76 Parental Leave: Nesting At Work: How to Prepare for Leave Gravida Guide #pregnancybrain A critical time of neurodevelopment Pregnancy-induced brain changes make you ready for parenthood. Forgot your keys? Your brain has more important things to focus on, like what does my baby need when they make that face?! The Hando! Nesting at Work: How to Prepare for Leave

Pregnancy:

1. Consider where you’ll work the last few weeks of pregnancy:

– If you have a low-risk pregnancy, it is safe to work up until your due date.

– Here’s what to keep on-hand at work:

– Pack your hospital bag and leave it in your car or office.

– Keep a protein-dense meal at the office in case labor starts there!

– Create plan B if labor moves quickly:

– I will notify______that I’m in labor.

– I will leave my car______and have______pick it up.

– ______will take me to the hospital.

– If you don't want to be at work, consider:

– Flexible work hours, working remotely, using PTO without touching FMLA.

. 2. Prepare your handoff:

– Draft a hand-off memo by 37 weeks so you’re ready to pass the batton when you go into labor:

If you’re receiving this message it means I had a baby! I will be out of the office now through____. I plan to check my email _____ times per ____. If you have any questions, reach out to_____, the rock-star holding down the fort while I’m away.

– Check in with HR to review your maternity leave checklist.

– Ask your team what they need from you as you prepare for leave.

– Delegate responsibilities in the 3rd trimester so your team can ask questions.

– Don’t judge your emotions. You might feel ready to abandon ship (nesting hormones!) or sad to say good-bye.

– Expect to find your new normal around 6-9 months post leave.

3. Talk about life changes with your coworkers and boss:

– The end of pregnancy and first months back to work aren’t easy- you need your team!

– Talk about what type of flexible work hours you might need for your return.

– You might be coming back to work with a different identity.

– Pro tip: Prepare yourself and team that early mornings or late nights might not be feasible the first several months back to work.

– Be real with your team!

– Let them know (to the degree that is appropriate or feels comfortable to you) what it feels like to prepare for or to return from leave.

Nesting at Work Gravida Guide 78 “All women, everywhere, have the same hopes: we want to be self-su!cient and create better lives for ourselves and our loved ones.” - Melinda Gates The Hando" Nesting at Work: How to Prepare for Leave Maternity Leave: 4. Plan for your return:

– Block time during business hours to schedule necessary appointments for you and baby.

– Expect to have 1-2 appointments per month until 6-9 months postpartum.

– Block time to pump or breastfeed baby directly during working hours. Here’s what to plan:

– You’ll need to pump every 2-3 hours the first 6 months.

– A pumping room that isn't a bathroom (that's your legal right!).

– A place to store your breast milk:

– Put it your lunchbag in the office fridge: make sure to label your breast milk with name, date, and time.

– In a portable cooler at your desk like Teamoy Breast Milk Pump Bag.

– Flexible hours the day the first 2 weeks back as you figure out daycare and pumping.

– If you take daily medications , have them delivered in advance to your house. If possible, request medications to be auto-filled and delivered every 3 months.

– Add baby as a dependent on your health plan!

– Your baby is automatically covered under your insurance for the first 30 days.

– After you give birth, notify HR and call your health plan and to add your child before the 30 day window closes. Have your baby’s birth certificate and social security number on-hand! Your Return:

5. How to handle your first weeks back:

– Rethink your work schedule. Look for opportunities to do your work effectively in a new way!

– Start first week back on a Wednesday.

– Phase- in first 2-4 weeks after leave.

– Work remotely on Wednesdays or Fridays.

– Start your work day at home before heading into the office.

– Leave work at 3pm, spend time with baby, wrap up work day after bedtime.

– Schedule a lunch with your boss on your first day back to get aligned on what your top priorities should be. Topics to consider:

– Pumping time blocks.

– Option of breastfeeding your baby in the workplace.

– Option of bringing baby to the office for portion of the morning/afternoon.

– Navigating how to handle work hours when your child is sick.

– Boundaries: travel, working late, end of day meetings, etc.

Nesting at Work Gravida Guide 79 “Women have always worked, and they have always done critical jobs in sharing the work with men, supporting the household and supporting the family’s income.”- Lisa Keller The Hando! Nesting at Work: How to Prepare for Leave

Your Return:

5. How to handle your first weeks back (continued):

– You don’t need to get caught up on everything in a day.

– Maternity leave isn't something that needs to be "paid back" It's something that's your right and you're picking up where you left off. But you don't need to do extra.

– Don’t be shy about doing your own prioritization, too. It’s a strategic way to make something challenging work for everyone.

– Send an email to the team.

I’m back! I need a couple of days to get caught up before I can have a substantive conversation with you about ___. I’ve got to focus on __ this first week, but I can talk with you about ___ next next week instead.”

Bonus:

6. Going back to work checklist:

– Freeze meals before going back to work. See our Nourish Gravida Guide for ideas.

– Take 1 day to relax by yourself (no planning, strategizing, coordinating).

– Plan a special day out for you and your baby. Enjoy a few of your favorite activities together (mommy and me class? eating out for lunch? napping together?)

– Bring your baby to work before your first day back to introduce your baby to coworkers.

– Bring a picture of your baby to put in your office.

7. Normal return to work emotions and behavior checklist:

– Self-doubt (you’re just as good at your job as before, but you’re still healing and adjusting to your new life. Don’t be too hard on yourself!)

– Compartmentalizing (to keep your emotions in check, you might compartmentalize. Make sure to find an outlet for your emotions before or after work. Call a friend or find a coworker to share your thoughts)

– Bonding hormone emotions (fatigue, anxiety, mood swings. Pay attention to these feelings. PMAD can occur anytime during the first year postpartum)

– Excitement (get it, mama!)

– Dread (every mother finds herself here. If you loved your job before you had baby, give it 6 months before you make a decision to quit)

– Guilt (there’s no evidence that children are worse off by having a parent work outside the home. Ditch the guilt)

Nesting at Work Gravida Guide 80 Parental Leave:

How to Talk to Your Boss About Your New Life Gravida Guide Returning to Work? Here’s How to Prepare.

Work redesigns are temporary.

But asking for what you need is so hard. What you need to feel sane at home and work will change just as fast as your baby- everything is temporary! Remember this is a trial period. Feedback and open communication is key to finding what works!

A letter outlining what you need for your return and why

Hello!

We are so excited to be welcoming our baby into the world. We hope to organize and prepare home and work life to ease the transition of becoming a working parent. Here are a few “heads up” items I need to run by you.

Time to heal:

From physical therapy to pediatrician appointments, to heal as efficiently as possible, I am going to need to “When I feel like work & life are both block off an hour or two each week for the first 6 months back. I will make up this time by working late or going well, I feel like I can be early, so the net effect is the same. And I will work to fully present at both. I think the schedule them at times that naturally fit into our existing workflow. reminder to me is that both are super Time to pump: important, & I need to be able to feel like I learned that it’s medically necessary to pump as f requently as my baby eats for a host of health reasons for I can experience both in the way that myself and baby. To keep f rom having hospitalization and sick days due to not pumping enough (I know, that’s a makes me happiest. If I'm not happy in real thing!), I’m going to set 45-minute pumping blocks 2-4 times per day for 12 months. I got a hands-f ree pump one or the other, it really a! ects the other so I can easily work during these times, I’ll need to do them in a private space. If traveling, I’ll need to pump 8-12 side.” times a day while away f rom my baby (unless my baby comes with me) and ship my pumped breast milk home. I’d like to have a conversation on how to approach traveling during my child’s first year of life. Katrina Lake, Founder + CEO, Stitch Fix Time to adjust:

Workplace flexibility is essential to managing work and parenthood. It also benefits to co-workers who care for aging parents, have a chronic illness, or commute. I’d like to continue this conversation with you, and collaborate with others navigating competing demands at home and work, to create a supportive and efficient workplace culture. There will be moments where I will be unreachable, but I promise I will get my work done on time. productive as ever. Working together: I hope you understand where I’m coming f rom with these temporary adjustments to my schedule. The intention of getting them on the calendar is to get them out of the way so that productivity can remain the same or higher amidst this structure.

How to T alk to Your Boss About Your New Life 82 Parental Leave: Leaning in Work Day Gravida Guide Tips + real life examples to empower you in your quest for a more integrated life. Leaning in Work Day- Because it’s not all or nothing!

Step 1 Work-life integration

Working parents find ways to fit baby into your work day.

- Start your day at home: head into the office during/after baby’s first nap.

- See if someone can bring baby to the office midday or visit baby at on-site daycare.

- Breastfeed your baby directly at work (during a meeting, perhaps?).

- Consider pumping in your office. It sends a strong message that pumping is normal. You can work and pump with your hands-f ree pump.

- Prioritize favorite ways to connect with your baby.

Find a low-stress childcare situation for you and your family. Here are a few things to think about:

Daycare might be your low-stress solution if:

- You need very realiable childcare.

- You have a predictable schedule.

- You don’t want to manage another person.

- You want early socialization and don’t mind germs!

A nanny might be your low-stress solution if you:

- Don’t want to deal with pick up and drop off.

- Can afford back-up childcare.

- Don’t work traditional hours and need a flexible schedule.

If you haven’t found the right childcare provider before going back to work, don’t fret, but do keep searching! Ask any parent, and they’ll say t’s worthwhile to take your time and find the right childcare provider for your family.

Stay at home or work f rom home parents:

-You will need time away and mental stimulation. Here’s how to get it:

-Hire a sitter for a set time each week (even if you have nothing planned, even if it’s only for an hour).

- Don’t forget to do the things that make you feel like you.

-Write, journal, paint. Get your creative juices flowing.

- Take a class or go to a gym that provides free childcare for a mental break. Step 2 Ask for what you need Give your coworkers, boss, family a #BTS of what life is really like to help them understand where you are coming from: - How I cleaned up the house using my toes!

- How I mastered entertaining a child while driving.

- How I managed to breastfeed a baby while changing my toddler’s diaper.

Leaning in Work Day Gravida Guide 84 “It became commonplace to see me breastfeeding her in the middle of a meeting.” - the future of motherhood

Leaning in Work Day- Because it’s not all or nothing! Step 3 Practical hacks Life on the go:

-Unsure of how much you need to pump? Check out our pumping calculator to estimate how much you need for your baby each day.

-Need a quick and healthy breakfast on the go? Prep smoothies or overnight oats.

-Crunched for time or want a less rushed morning? Hire someone to take your baby to daycare or walk the kids to school

-Create a family calendar and share with your partner, nanny or daycare, and other important people in your life. Start with the big picture and work your way down:

- List important dates, events, birthdays, time for self-care, couple-care, meaningful work, and family time for each month (plan far, far ahead!).

- Create a weekly calendar: List deadlines, meetings, and family and personal connection time (how and where to get it).

- Daily: List top tasks and organize them based on your natural energy cycle. Notice what time of day you’re most focused, in need of social connection or alone time. Check out do less by Kate Northrup for more ideas. time. - Time and money are precious commodities when raising kids. Outsource what you can when strapped for time. Get creative with saving money on childcare (family? alternate work schedules with partner?) and meals (meal prep! Check out our Nourish Gravida Guide for ideas). -You don’t, and can’t, do everything! Learn the art of letting go so you can live the life you want! Drop those balls, mama. Step 4 Motivation

Rachel Zoe What she did: Created on-site nursery when 5 out of her 40 employees were expecting.

“I wanted to create an environment where these new mothers wouldn’t have to make a choice between career and motherhood.”

What you can do: How many parents are in your office? Rally together and start a conversation with management about needs and expectations. Patagonia

What they did: For 35 years they’ve offered on-site daycare, parents eat lunch with their kids, buses school-aged kids back to the company’s headquarters giving parents time to connect after school, supports breastfeeding during meetings.

“It’s not just making a living, it’s making a life.”- Patagonia employee

What you can do: Share Family Business: 30 Years of Innovative On-site Child Care by Malinda Chouinard and Jennifer Ridgeway with HR and management.

Norway

What they did: Implement mandatory paid paternal leave.

“Fathers started taking leave, and it has probably had an effect in terms of the cultural norms around parenting… in Norway today, it would be very hard to insist on just being the breadwinner and not caring about the children.” - Margunn Bjørnholt

What you can do: Share with HR and management the benefits of mandatory leave for both sexes as it helps predict workers’ expected absenteeism and employment status. Leaning in Work Day Gra vida Guide 85