"In My Day . . . "

Yesterday a reader responded to What Not To Say - Grandma Edition with this hilarious story:

yes, my MIL loves to say “We didn’t have anything like that!”  My favorite is that she likes to say that about cloth diapers.  wtf? 

! 

It made me remember some of the excellent/horrifying/unbelievable Grandma quotes I’ve heard over the years:

We always gave you honey to help with teething.

We always rubbed whisky around your mouth while you were teething

We didn’t have teething then.

No one breastfed then.

You were out of diapers before your first birthday.

There was no such thing as “side-lying” nursing in my day.

We just spanked you when you woke up in the middle of the night; that taught you quick!

(That last one, so horrible; I heard it probably ten years ago and have been haunted ever since — in case it’s not obvious, just don’t don’t don’t do that.)

So — what are the best “in my day” remarks you’ve heard so far?  And <shudder> what do you think you might say happened in your day, some time, decades on, when it’s your turn to be Grandma?

What Not To Say To A New Mother: Eleven Ways To Get It Right

Recently, I wrote about undermining things I’d heard hospital staff say to new mothers, and I have been overwhelmed by the feedback. I have read over a thousand responses and comments, too many of which confirm the themes of my original post:  that moms can feel seriously undermined by even small thoughtless remarks by their caregivers, mixed messages, or misinformation, and they hold on to the pain of that for years to come.  This comment struck me particularly:

when my daughter was placed in my arms, I had an overwhelming feeling of confidence that I could take care of this child, no problem; this was slowly eroded over 4 days in hospital, getting contradictory advice and information — so confusing!

Ugh!  

Seasoned moms know that once the adrenaline of childbirth wears off – be it 24 hours or four months - taking care of a child is rarely a “no problem” thing.  We all doubt ourselves sometimes; no one has perfect confidence.  But in those first few days, moms need encouragement.  They need to be taught what to do when they feel doubt, and confusion; they don’t need more doubt and confusion heaped upon them.  

But!  Several people wrote in positive comments about their time in the hospital, too, and those stories are so moving – not just as a reminder that there are great, great hospital staff members out there, but as a reminder for all who encounter new moms: small positive comments and acts are surprisingly helpful, just as the small negative comments were surprisingly destructive. Years later, moms still remembered: 

• how good it felt when a nurse congratulated her on how much she’d pumped, and 

• when a L&D nurse brought a newborn who needed immediate pediatric care to mom’s belly for a kiss and hug before being rushed away, and 

• the doctor who said “I can see you’re going to be great,” at a moment when the mom could not see it herself, and 

• Nurses who knocked before entering, asked, “is this a good time?” or “do you need to pee before we do this?”

And there were several comments about caregivers who slowed down, sat on the edge of the bed and simply smiled.    

I don’t mean you should tell a new mom everything is spectacular if it isn’t. But if you’re a friend or loved one visiting a new mother, or if your work requires you to care for new parents – small things make a huge difference and are remembered for years to come. 

Helpers, loved ones, and all who interact with new moms can be memorable for the good they do with these eleven basics:

• Put yourself on a five-second delay.  Helpers often “hit the ball back” with a response as soon as they hear a new mom’s question.  Whether you are a caregiver or a friend, take a pause before answering mom’s question, and think about what you’re about to say, and check the phrasing. 

• Make sure you are qualified to answer.  (If not, there’s no shame!  You can say, “let me think about that” or “let me ask so and so”).  Then, get help for her.

• Think about your tone.  If you sound bossy or defensive, New Mom may hear that, more than she hears your words.

• You are responsible for your body language – If your shoulders are relaxed and you’re smiling, it’s easier for the new mom to hear the substance of what you’re saying, and to learn.  If she sees your eyebrows scrunched together and a frowny face and your shoulders up by your ears, it can drown out whatever you’re trying to tell her!  Even if you’re worried, don’t distract with your body. The most effective way to get the baby and mom cared for is not to scare them, but to use your brain and words to get them what they need.

• SMILE.  It makes everything you say more absorbent.  Try not to behave as though there is an emergency unless there is an emergency.  

• Stay away from hypotheticals (“if, by tomorrow, we don’t see a change in X, we will have to do Y” or, for friends: “if your baby starts doing A now, you’re going to be in for it when she’s B months old”) unless there is a clinical need to discuss them right now.  People do this to show off their knowledge and to spread their own anxiety around, but it’s not fair to the new mom.  Unless it’s clear you need to act, try to keep the mom to the present, and stick with her so you can jump in if need be.

• Ask whether you need to say anything at all.  Sometimes a grin is truly enough interaction. 

• Use open ended questions to get the mom talking.  ”Tell me how breastfeeding is going” or “How are you feeling today?” or “So, what do you think of your baby?” will get you more information than, “how many minutes did he latch?” or “has he pooped yet?” or “has he been crying a lot?” 

• Observe the mom.  Find something she is doing well.  There will be something – the way she smiles at the baby, the way she holds him more confidently each time, the way she asks good questions or shows appropriate instincts.  Tell her, specifically, that you notice these good things.

• Observe the baby!  Find something totally adorable, and tell them mom you notice.  I remember one client I had whose baby was in the NICU.  I saw them on day 2 and pointed out how adorable it was that the baby was gripping Dad’s finger.  The mom burst into tears, saying, “That’s the first compliment she’s gotten since she was born!  Everyone is only talking about all the things she’s not doing.”  

• Friends and loved ones:  Help the new family develop a “home team” (and be part of it), to get their needs met and their questions answered once they’re home.

What about you?  Do you remember what helped in those early days and weeks?

What Not To Say To A New Mother: The Hospital Edition

The other day I was visiting a family and their just-born baby in the hospital, and in the few short hours I was there, I heard a bunch of surprising comments:

•  A nurse told a new dad (who was standing up, holding his 20 hour old baby) to put the baby down in the bassinet, warning him that his son was safer in the bassinet — otherwise Dad might drop the baby.  

• A different nurse told a new mom (who was holding her 8 hour old baby) that her daughter would be safer in the bassinet because Mom might doze off and “co-sleeping is not allowed.”  

These comments, by two different staff members to two different families, are, to me, eye-rollingly laughable — obviously babies can be safely held by parents, both seated and standing.  Obviously babies don’t need to lie in a plastic bucket all the time for fear of being dropped.   

Probably the first nurse meant: “if you did drop him, we’d end up with a law suit,” I.e., it’s potentially dangerous to us, the hospital, not: “it’s actually likely you’ll drop him.” 

And probably the second nurse meant, “I have been trained to warn mothers not to fall asleep with their babies in bed because for non-breastfeeding babies there are certain risk factors to bed-sharing, and I see so many new moms per day that I can’t be more specific on an individual level,”  and not:  “it’s actually dangerous to for you to hold her right now, in bed, with visitors in your room.”

And, happily, both families took the comments with a grain of salt.  (The mom paused, concerned for a moment, but then looked around the room for encouragement and said, calmly, “well I’m awake right now.”  The dad made a comment under his breath about Americans’ fear of liability.) Both families have older children at home.

Here’s what I worry about, though:  first-time parents who have no other experience, and those who don’t have visitors to help them remember common sense.  Or who are just so tired and impressionable that they can believe that their urge to hold a newborn is wrong; and that he’s safer in a plastic box.  

It’s not that I think one statement, in isolation is so damaging, but, rather, the tide of small comments like this, pervading the new parents’ experience in the hospital.  Because while I was there, I also heard: 

1.  by a pediatric resident, re: a well baby:  “we’re taking the baby’s temperature to make sure she doesn’t have a fever.” (which suggests that she might have a fever, or might develop one),

instead of: 

“we’re doing our well-check up of the baby’s vitals so we have a record of how healthy she is.”)  

AND

2.  by a nurse:  “Here’s the breast pump.  If you don’t get enough to put in a bottle, we can give it by syringe.” (which suggests that mom might not make enough milk — a common fear), 

instead of: 

"one-day-old babies can only handle a tiny volume of colostrum because their stomachs are so small, and there’s no bottle small enough to appropriately feed a baby this young — so, we’ll give you a syringe you can put in her mouth, to give her the precious colostrum you get.”)  

(Or even better: "I hear you asked for a breast pump, so we’re sending one over along with an IBCLC who can teach and advise you, and help you figure out your options.”)

AND

3.  by an OB, to parents being discharged early after a healthy birth (unprompted, without previous discussion of infant feeding):  “Definitely take home some of the formula. You can top him off after each feeding to make sure he doesn’t get dehydrated.” (which suggests that the baby will get dehydrated if “only” breastfed) 

instead of: 

"I’m not an expert on lactation, but if you have concerns about breastfeeding, let me get someone who can help you."

See how insidious this is?  Each remark alone might be a smallie (I don’t think this last one is a smallie, though), but the cumulative message, over and over is:  

Things are about to go wrong.  You can’t trust yourself, or your judgment.  That feeling of relief that the baby is healthy and in your arms?  It’s probably just wishful thinking and the rug is about to get yanked out from beneath you. 

Newborn parents, who, for the moment, are tired, sometimes overwhelmed, understandably confused and facing lots of new stuff, are more vulnerable to suggestion than the rest of us.  They need encouragement and support so that they can:

• learn to take care of themselves and their babies, 
• learn to distinguish “emergency, requiring medical care” from “common sense situation I can handle myself,” and
• learn to cope with the normal new-parent anxiety.

They deserve to encounter staff who understand their concerns, worries and knowledge level. They deserve staff who don’t plant seeds of self-doubt and a culture of fear.  We patients pay huge sums of money to be cared for while we are vulnerable — it shouldn’t be “caveat emptor”: let the patient beware — any advice you get may be misguided.  

So, but here’s the thing:  I don’t think that hospital staff who say stuff like this mean any harm.  I don’t think they intend to undermine parents’ confidence or give faulty guidance.  At all.  I do think they may be influenced by the pressure to think about liability avoidance, and they may be too overworked to individualize service and attend to each new family’s particular needs.  Any of us can say the wrong thing when we’re under stress, because we’re human.

But I think it should be a priority, for all who work with pregnant folks and new parents, to try to get that tone right as often as possible.  To slow down, remember that that new dad holding his baby is, inside his head, probably worried, anxious and far more likely to be riddled with insecurity and self-doubt than he is to actually drop the baby.  It’s so unfair to saddle him with the hospital’s fear of a law suit, when what he needs is to be reassured that he is competent and has good instincts.  When we talk to him as though he already knows he’s competent, we are not reaching our audience. 

By the way, you know who *does* understand how to reach their audience?  You know who never gets so tired or busy with their other priorities that they get off message?  You know who’s really good at sending the message they mean to send? 

Advertisers.  

Advertisers think, all the time, about how their message will be received.  That’s what they’re paid to do.  And that’s why, when I see a sign like this (text at bottom)

in every single baby’s bassinet in the hospital, with the Similac logo, and a completely horse-shit ambiguous message about infant feeding, I become pretty annoyed.  I have two Ivy League degrees, a pretty decent comprehension of English, and even got a full night’s sleep last night, but reading this message, I feel completely confused.  

That’s because the message is meant to confuse me.  I am meant to conclude that infant feeding decisions are very important and confusing and require far more complex micro-analysis than a normal person with normal breasts and a normal brain could possibly figure out, which is why, thank god, there are doctors, nurses, nutritionists (note absence of IBCLC in this list) and, most of all, Similac, bringing me this lovely “keepsake,” a reminder that I am completely incompetent.  

Note also that this solemn, authoritative missive about infant nutrition doesn’t mention breastfeeding.   

See how savvy this bit of marketing is?  Similac donates these advertising cards to the hospital.  The flip side of the card, which faces into the bassinet, says the baby’s name, age, and birth weight; the hospital accepts the cards so they don’t have to pay to make and print thousands of name cards.  The side with the Similac message faces out through the plastic and is positioned at eye level — it’s the first thing you see every time you look at the bassinet to check on your baby.

Unlike hospital staff who are, I think, unintentional when they undermine parents’ confidence, advertisers are cleverly exploiting parents’ fears.  This marketing message is aimed — visually — right at parents who are already a little confused, tired, worried that they don’t understand everything. The message is:  you can’t understand this stuff. 

It’s marketing designed to reinforce your worry and then sell you something to ease it.

Now look, we are lucky, in this time and place, to have ways to care for our babies if things do go wrong.  But we shouldn’t be starting there.  Scare tactics, and undermining messages should not be a part of routine patient care, whether by advertisers who do it on purpose, or by well-meaning, but careless, staff persons who do it because they’re not paid to prioritize anything else.

We can do better than this. 

WHAT YOU CAN DO IF YOU’RE AN EXPECTANT PARENT:

• New moms should not be isolated for long stretches.  Have someone who knows and loves you with you, not only during labor, but to stay with you while you’re in the hospital postnatally, to hold the baby while you nap, tell you how awesome you are, and to help you make sense of everything else that happens.

• If you’re feeling confused by what anyone has said, ask them to explain why they’re recommending whatever they’re recommending.

• If someone is saying or doing something that’s making you feel nervous or anxious, ask for more information.  Explanations demystify a lot.

• If you’re told something that sounds like it doesn’t make sense, entertain the possibility that you’re right and ask for more information until it does make sense.  

• If you have a clinical question about breastfeeding, it should be directed to an IBCLC.  If someone is giving you breastfeeding advice, ask them what training they have had. Anyone can call herself a “lactation consultant.”  Is this person an IBCLC or not?

• Take the damn card out of the bassinet and throw it away.  Put in a new piece of paper with your baby’s age and name and weight.  Or turn the bassinet so the card faces away from you.  If you’re feeling energetic, tell someone at the hospital that you don’t like the Similac logo in your face.  (After you get home, when you have the energy (and this could be months later) write to the hospital and/or your caregiver and let them know what you liked and what you didn’t like.  You can use these form letters as a model.  Things change when people complain. 

• If you’re feeling like everything is desperately hard, it is a good sign that you need help, not that you’re a failure already.  Ring the nurse.  Ask for help, and if it’s not something she can help with, ask who can.  Ask for help finding local resources for new parents in your neighborhood.  

I am sorry if this feels like all the burden is on you to ask.  But until our world changes so that all these things are just the routine, expected care of new parents, you do have to ask for the help you need.  When you do, you’ll find that competent, compassionate care helps.

(You can read more “What Not To Say” posts here (grandma edition), here (why comebacks are hard) and here (general dumb remarks), and you can read a followup to this post (what TO say) here).

10/9/12 update:  I’m sorry some readers can’t see the photo clearly enough to read the text.  This is what the Bassinet Card says:  

Deciding what to feed is an important decision, one that should be made by those who know your baby’s nutritional needs best.  Don’t make any changes in the feeding that has been specified for your baby without talking to your baby’s doctor, nurse or nutritionist.

Provided as a keepsake from Abbot Nutrition, Makers of Similac

In addition to the other problems with this card, deciding what to feed is a decision that should be made by parents, even if they have no nutritional expertise.

What Not To Say To A New Mother, Grandma Edition

Let me start by saying I love grandmothers, generally.  And when I’m working with a new mother, almost always, NewGrandma strikes me as loving, enthusiastic, concerned, and deeply lovable. 

 Yet her foot is often in her mouth.  And so, continuing with What Not To Say, this list is specific to New Grandmas.

1.  “Why don’t you just … “ 

“Why don’t you just hire a babysitter so you can get some baby-free time.”

“Why don’t you just stop worrying about everything?”

“Why don’t you just grow a vegetable garden in your window-box, and then cook my son nourishing food every night like he deserves after he works so hard all day.”

These remarks are undermining if they suggest that you don’t take her situation seriously.  And they aren’t questions at all, unless NewMom can respond, “Well, Mom, it’s because I’m overly controlling/anxious/inadequate just like you’re implying.” 

“Just” implies that whatever the new mom’s got going on is solvable by something extremely simple.  The journey into motherhood is not “solvable,” people.  It’s a process. 

Most of the time NewGrandmas say these things because they are concerned and want to help.  So, NewGrandma:  when that feeling springs up, why don’t you just say,

“What could I do right now that would help?”

And, New Moms:  if you hear one of these questions, feel free to respond to the question she ought to have just asked, by saying,

“I’d love it if you babysat for an hour so I could get a break!”

or

“I’m not ready to be apart from the baby yet but I’d love if you did a load of laundry!”

or

 “I’m amazed at how many little things worry me these days, but it might help if I met some other new moms, could you help me pack the diaper bag so I can get to the new MOMs group?”

or 

“Thanks so much for the joke about the vegetable garden, it’s so helpful to have some laughter to break up the intensity of my day with the baby.”

2.  Anything about your body or her body

Once I had a client with a five day old, whose mother told us that back in the Day, when she was nursing, she got a clogged duct.  “There were no pumps then,” she said cheerfully.  “So NewGrandpa had to suck the clogged duct out of me.” 

Silence.

Now, I love breastfeeding and am fascinated by the human body and actually could have chatted at length about this with NewGrandma and NewGrandpa.  But they weren’t my parents and I hadn’t just had a baby.  NewMom didn’t want to hear anything about it. 

Let us generalize from that and say it’s best, NewGrandma, for you to avoid telling NewMom about your episiotomy, hemorrhoids, bleeding nipples or postnatal weight loss timeline.  She has enough to deal with as her own body changes.

Speaking of which, don’t talk about NewMom’s body either, unless it’s to say, “You look great!” New moms can be sensitive about how they appear, and some will hear even your most sympathetic delivery of:

“You seem tired today”

as

“You look like crap!” 

So it’s best to avoid that possibility by skipping it.  Instead, why don’t you just say “Would you like me to hold the baby while you lie down?”

3.  “In my day we never/always did ________ and it was just fine/ even better / much more work than you are <lazily> doing / much less work than you are <stupidly> doing.”

The classic examples are how she fed the baby and how she dealt with sleep, but I’ve heard this on everything from car seats (“when you were a baby we just lay you across the seat!”) to making baby food (“in my day we pureed everything by hand!”) 

Logically NewMom might hear this as an interesting artifact from another time, but logic doesn’t always prevail.  Some moms hear, in these statements, an unspoken conclusion: 

“ … and the way you do it now is bad.” 

A breastfeeding mom might hear her mother-in-law’s reminiscence (“I had bottles lined up in the fridge at the ready!”) as a criticism of her nursing efforts.  A mom who’s struggling with a wakeful baby does not need to hear that “in my day we put you on your stomach and you slept through the night right away.”* 

I think NewGrandmas say these things, almost always, out of pure nostalgia.  After all, how trippy must it be for her to realize that several decades have just disappeared?  So, NewMoms, I encourage you to do a mental translation and hear it as though she just said, “Gosh, I’m so flooded with memories that at the moment I’m not thinking about you at all!”

And, NewGrandma: try to say that instead!  Because even if NewMom is being oversensitive, she just had a baby.  Cut the woman some slack. 

Occasionally, NewGrandmas do mean it personally.  And to them I say:  your daughter is not breastfeeding as a passive aggressive way of saying ,“You Were A Crappy, Ignorant Mother!” It’s not all about you.

*BTW, NewMom, you so did not sleep through the night; NewGrandma doesn’t remember as clearly as she thinks she does.

What Not To Say To A New Mother, part 2

A couple of months ago, I blogged about “What Not To Say To A New Mother” and I’ve gotten interesting responses since then, overwhelmingly consistent in theme.New moms, it seems, feel criticized easily, and (surprise) hate the feeling.

They can feel a sting even when they know that they’re not being criticized (e.g., “wow, your baby is big/small/hairy/bald/loud/quiet”) (mom mentally inserts the word “too” after “is”), or that the person criticizing them is ignorant (“is your one-month-old sleeping through the night?”), or a dumbass (“you shouldn’t be carrying your 3 month old around because he’ll never learn to walk”) or creepy (“you should cover your child’s legs because otherwise someone will come over and bite them like a chicken drumstick”).

When you’re not the mom on the receiving end, it seems obvious that the response to these is, “Mmm.”No one has to live with your baby but you, so who cares what their random “advice” or questions are?

But it’s not so simple when the remark is made to you.Moms – especially first time moms, not only want to do right by their kids, they also want to know that their judgment is good, that they’re Good At Being Moms.Until they feel self-assurance, they look for assurance, and approval, from others.This is why it’s so important for new moms to have real community, not just books and Expert Advice.

Once, while I was nursing my first baby at a family event, a relative of my husband’s said breastfeeding was “nasty” and “barbaric.” I was astonished that I cared at all about his judgment and yet the sting of it silenced and shamed me.It didn’t matter that he was the one who was acting nasty and barbaric.It couldn’t roll off me then.

                      Check me out being all nasty and barbaric

Here’s the weird thing:that desire for approval of the early decisions can last long after you grow confident in the mothering role.Which is why some small part of me, even ten years later, is not content to know that my husband’s step-mother’s cousin’s remark was nasty and barbaric, but, still, hopes that you are offended on my behalf.

This is also why you might hear defensive remarks from your own mother or mother-in-law (e.g., she sees you lie your baby down on his back and reacts as though you did it to accuse her of being an idiot for putting you down on your belly).

How can your mother feel even a tiny bit defensive about decisions she made 30+ years ago?It’s because when she made them she was a vulnerable new mom like you, wanting to strike the right balance between the “expert” advice and the idiosyncratic experiences of her own life.

Just the other day, I blogged in response to a mom who is considering travel that will separate her from her baby for four days.I mentioned that my mom had done this when I was a baby and that I thought it had been a big deal to her.My mom responded,

“It was a big deal.Big decisions involve hard choices.Glad we went and don’t think it impacted you much.I’m the one who missed those 9 days, so there r regrets.But it also made the time after my return that much more precious.Hope you know that.”

I read it and though it’s not written in a really defensive or insecure way, I immediately wanted to reassure her, “Of course I know that! I am not judging you!I am not upset that you weaned me, or went away!It’s OK!”

It was funny to hear even the smallest note of New-Mom concern in my own mother’s voice.To me, of course, she’s Mom.But she was once just like my students and clients, and like I was in those early days, a Beginner, finding her way, hoping her decisions were good enough, hoping it would turn out that she was good enough, not knowing, yet, that of course her children would find her more than good enough.Not even realizing, yet, that her tiny baby would one day be a woman and a mother along with her, sharing life and experiences.

Go give your mom a hug and remember that she was, once, a new mom, too, and that part of her always will be.