by Jen Milligan
From around 84 nappy changes per week in those first few weeks, down to just one night nappy, a parent sees an awful lot of poo!
So how do we know what bowel movements are normal? Poos are telling us a story of what is happening in your baby's precious little body and can be such a helpful tool for us to know how best to care for our little ones.
So...let's talk poo!
A normal poo for a breastfed baby is mustard-coloured and runny. That’s your gold standard! A formula-fed baby will have a slightly formed poo, often resembling a soft serve ice cream (delightful!). It is often a bit greener in colour due to the extra iron in the formula.
What if my baby’s poo is explosive and/or green and frothy? This can be an indication that your little one has a sad and sore tummy. If a mum breastfeeds a little from one breast, then a little from the other breast during the feed, the baby is getting a big hit of the front milk (foremilk) which is higher in sugar. This milk is by no means bad; however, too much of it in one feed and not enough of the back milk (hind milk) can cause the sugar to ferment in the gut and produce excess wind and discomfort. See our blog on Colic for further information on this topic.
What if it is green and has streaks of mucus or blood? If the issue of excess front milk has been addressed and there is still mucus or blood, this can indicate that your baby doesn’t enjoy the dairy you are eating. By stopping your dairy intake, including milk, cheese, yoghurt and chocolate (sorry!), this can greatly improve this issue. If the issue continues after at least one week of being dairy-free, or if your child becomes unwell, you will need to consult your doctor.
Note - it can often take at least 6 weeks after birth before the above issues show themselves in the nappy.
How do I know if my baby has diarrhoea? All babies have runny poo! You will know that it is diarrhoea as it will have a very offensive smell and your baby will most likely be pale and sad. It is very important to seek medical attention in this situation as babies become dehydrated very quickly.
Do bowel movements change once solids start? They sure do! It’s time for a peg on the nose. The poo should be soft and would have been formed had they not squashed it when they sat in it!
Are 'pellets' normal? Pellets are a sign of constipation. It means the bowel and poo is too dry. If they have not yet started solids, try increasing the milk feeds to increase fluids. Despite what some text books say, from professional and personal parenting experience, it is not ideal for a breastfed baby to go for longer than 4 days without doing a poo.
If they have started solids, increasing their water intake at meal times and adding a prune to their meals should help. If it is not working, don’t let constipation go untreated. Chat to your early childhood nurse, your doctor or us at The Nurtury and we will help you on the road to a healthy bowel for your little one.
Are smelly streaks in the nappy or undies normal? This is also an indication of constipation. There can be a blockage in the bowel as small amounts of liquid poo can slide down around the blockage and into the nappy or undies without the child even being aware.
We run our Coughs, Colds & Common Concerns class regularly on the Central Coast, where you will learn so much more about constipation and many other common childhood illnesses. We will also equip you to manage burns, choking and an unconscious child.
by Jen Milligan
“Have you considered that it might be postnatal depression?”
That’s what my GP said to me when I went to her when my third baby was 10 weeks old. I went so that she could “fix my crying baby”, not me. My precious little girl had been trying to tell me for about 6 weeks that I didn’t have enough milk to feed her. She had been ever so polite at first, just letting me know after the feed that she was not quite satisfied. With a little protest and the need for 2 hourly feeds 24/7, she'd tried to send a hint. After being very patient with me for several weeks, my little treasure said “seriously mum, I’m getting nothing. From here on in, I refuse to feed from your warm and nurturing, yet very empty breast, and I will no longer even settle in your arms. I would rather settle in your best friend Kate’s arms, because at least she doesn’t smell like milk”. Despite being a midwife, I was too tired, too emotionally invested and too overwhelmed to comprehend that the 2-litre bleed I had experienced at birth had affected my body more than I had realised. I went to my work colleges and said “fix my baby!” The beautiful midwives said “Jen, she’s hungry”. Oh.
There is a history of depression in my family. I had very difficult pregnancies and I had a traumatic postpartum period for my third delivery. I had all the red flags for needing a bit of extra care in my postpartum period, but “midwives should know what to do”, “I help others with postnatal depression”, “I’m organised”, “I’m in control”, “it won’t happen to me”. Turns out it did.
When that GP asked me if I had considered that it might be postnatal depression (PND), it hit me like a tonne of bricks. I had all the symptoms - constant crying, wanting to just curl up in a ball and not do life, sweeping the floor constantly (that was my way of having some control in my life ... at least the floor was clean!). However, the guilt was my biggest battle. Guilt that I wasn’t being a good mum to my other children. Guilt that I wasn’t a good wife. Guilt that my house wasn’t perfect. Guilt that my newborn would be a runt of a child as we hadn’t bonded through breastfeeding. Guilt that she would be perpetually sick as I had “failed” and had to bottle-feed her. Guilt that a midwife had dared to bottle-feed.
Everyone with PND has differing symptoms. Some cry a lot, some feel nothing - neither happy nor sad, some are very protective of their precious baby and others don’t want to see their baby and may even want to harm their baby. Some mums may want to harm themselves. It is often those around you that see or recognise your emotions before you do. The official diagnosis describes PND as feelings of sadness for most of the time, for 3 or more weeks. In reality, it is often far more than 3 weeks before we end up chatting to someone about how we are truly feeling.
Why why why?PND is sometimes triggered by difficulty conceiving your baby, a stressful pregnancy or a traumatic delivery, but it may just come your way out of the blue. For me, there was a family history of depression playing a role too.
What do I do now?It was a big step heading to the GP, but I had the blessing of a GP who was compassionate and understood the truth and reality of PND. It wasn’t just in my mind. There was something going on that was outside my control. She told me about the Mental Health Plan offered here in Australia, where I could visit a psychologist for next to no cost, to talk through my feelings.
I ended up needing more than weekly sessions and had to explore the idea of medication. This was a huge step for me. I was so worried that medication would change my personality and that I would be under the control of drugs!
What that medication actually did (after holding it in my hand for about 2 hours before I actually swallowed it) was 'bring Jen back'. After a few weeks of managing the side-effects that often happen with new medication, the enormous cloud of guilt started to lift and the old Jen was back. I could think rationally about how much I loved my baby, how she was thriving on a bottle and how we had developed a beautiful bond. She would pull off from the bottle teat, give me an enormous grin and then start sucking again. “You did it Mum! You worked out that I was starving! I’m so proud of you. Love you, Mum”. I smiled again, laughed again and was able to start to manage my PND.
Is medication a life sentence?So many mums have a period of time on medication and happily come off the medication after a few months or years. Some mums just need counselling and never require medication. Some mums have a need for medication long term. This is me. I would LOVE to be off my medication, and I have tried several times. I work very hard on having good gut health as the link between good gut health and good mental health is becoming clearer by the day. I eat very well, I exercise and I pray. But for now, I am still at my best when I'm on my medication.
A note on exercise: I hate exercise! I know how incredibly important it is for good mental health, so I had to find a form of exercise that I enjoyed. That was a challenge. I finally committed to a gym and I go to classes with other mums. Camaraderie, great music and an encouraging instructor have been the key for me.
A note for dads: Postnatal depression can hit dads too. Don’t underestimate the feelings you are going through. A great GP is a fantastic asset when navigating life as a dad.
There is hope.There is definitely hope. When I felt so low that I wanted to self-harm and had no confidence at all that I would ever feel better, I did not believe there was hope. But there is. With the right professional care, friendships and support, you can come out the other side flourishing as a mum, partner and individual.
Don’t lose hope.
Love Jen xo
Beyond Blue: www.healthyfamilies.beyondblue.org.au
By Jen Milligan
Breastfeeding can be really hard. It can be emotionally and physically draining and it can be very tempting to feel like 'throwing in the towel'. Here are a few tips from a seasoned midwife to help you with your breastfeeding journey.
How a baby feeds for the first few weeks is very different to how they need to feed for the following 6 months ...
The first two weeks for a baby and mum are all about establishing a milk supply and “getting the hang” of breastfeeding. Mum often needs to feed from both breasts to establish her supply. However, once her milk is established, it is very important that baby can get a “full feed” from one breast before moving to the second breast. By providing a long feed on one breast, your baby gets a wonderful mix of the rich and fatty milk along with the more watery/sugary foremilk.
A full feed from one side, before offering “dessert” from the other breast, means baby is receiving ample calories to allow longer periods of sleep between feeds. In addition, feeding in this way often relieves many upset tummy issues that may be caused by not allowing one breast to be drained before moving to the second breast.
Babies cry for more than just hunger ...
Crying may be caused by a need to sleep, a pain or a worry. Often, when you’re out and about, the crying bothers you more than anyone else and it’s easy to get flustered - fast!
All babies cry as it’s their way of communicating a need. However, they are not always needing more milk. If your toddler told you that they were tired and you responded by placing another meal in front of them, it probably wouldn’t end well. This is similar to how a baby might feel when they are crying because they’re tired and a teat or nipple is popped into their mouth. Whilst the sucking is temporarily soothing, the ingestion of more milk is often not.
We encourage mums to be intuitive. You know your baby best, and with a little bit of time and effort, you can learn to read your baby really well and respond appropriately.
Sucking doesn't always indicate hunger ...
The sucking reflex is very strong for a newborn and mums are often not aware that the suck can purely be for comfort. It may help them drift off to sleep, or comfort them while they get that bothersome burp up. If your baby is needing to suck to deal with a sore tummy, a feed may even make it worse.
We encourage parents to assess whether their little one is wanting to suck because they’re needing milk, or if they’re just needing to satisfy that strong urge to suck. Often, mum knows that her baby isn’t hungry, but having the confidence to go against comments from those around them can be very difficult in the early days.
Help is at hand ...
Ingrid and I, at The Nurtury, are passionate about helping mums settle into their new breastfeeding role. We know that it takes a village to raise a child, and we love seeing positive changes in families as they learn how to nurture and grow their new little baby.
Are you feeling overwhelmed by the challenge of breastfeeding? We offer phone consults at a scheduled time that suits you, to offer you advice and support as you navigate the tricky issues that feeding can present.
We also run Baby Care Classes over 5 weeks, covering feeding, sleep & settling, birth debrief & postnatal depression, starting solids and the importance of play. These classes are held in Berkeley Vale in a beautiful and intimate setting tailored to your needs, complete with homemade cake and a warm cuppa.
We would love you to be part of our village!
By Jen Milligan
It has been 11 years since I experienced my final bout of “morning sickness” and I still shudder at the thought. The term “morning” or even “sickness” didn’t quite cut it. It would be more accurate to call it “24/7 torture for months on end”. If I lifted my head, I would vomit. I had several trips to emergency and on many occasions willed the pregnancy, which I had desperately wanted, to be over.
For some, morning sickness, or ‘hyperemesis’ for those of us that had the more extreme version, can leave us feeling pretty low, sometimes angry, sometimes desperate and sometimes guilty. It was a strange fusion of joy and thankfulness for the precious child growing in me and a deep anguish of persistent nausea, vomiting, social isolation and what seemed to be an endless sentence.
It’s not only normal but totally okay to have these extreme feelings on both ends of the spectrum. It’s also incredibly valuable to chat those feelings through with someone wise and safe as they can often rear their ugly head in the months after your precious baby is born. They certainly did for me, and wise counsel and medical support was critical.
Not all experience hyperemesis, but many still experience the challenges of morning sickness in those first few months. During the first pregnancy, we often push through with day sleeps, restful weekends and a whole lot of crackers. But what happens when there is a toddler to run around after too?!
Here are my top 10 tips for managing:
1. Shop online for groceries. This can help if you find it hard to face a multitude of foods and smells at the shops. Try and do the online shop after you’ve had a good snack so that your family get more than just the crackers and chips that you’ve been craving delivered to the door.
2. There are some great meal kit companies that deliver ingredients to your door for you to then make fresh main meals, e.g. Hello Fresh or Marley Spoon. Your partner can come home and follow the recipe, with the ingredients measured and ready to go. I have been known to stretch a meal designed for 2 to my family of 6 with a few extra veggies. It saves a bundle!
3. Have snacks ready to grab. You will always feel better with a bit of something in your tummy. ‘Small and often’ is the best rule. Crackers by the bed are a win. Have some pieces of carrot, hard cheese, pear, apple, cucumber (i.e. bland food) cut up in the fridge ready to snack on, and crackers and nuts on the bench to eat throughout the day. Often as mums we are good at feeding our little people but not ourselves. By having it there, you will have a healthy snack at your fingertips.
4. Avoid fatty foods, caffeine and acidic foods like tomato, orange and chilli. They are perfectly safe in pregnancy, but if you are feeling unwell or have reflux, they can increase your symptoms.
5. Try having a main meal at lunch time. Nausea and exhaustion often go hand in hand. Often mums can’t face food by the end of the day and the very best thing for their bodies is sleep. Try and get that nourishment in at lunch so that there is no pressure to eat too much at dinner. A toddler generally eats less as the day goes on too. It is great to get the day’s nutrients into a toddler by 4pm as they are often just too tired at the end of the day to eat well. Enjoy your broccoli together at lunch and your cheese and crackers at dinner! It won’t be forever.
6. Sleep! Sleep plays a huge role in relieving nausea. It is very normal for a mum to need up to 12 hours sleep in the first trimester. I found this really hard as I just wanted to spend time with my husband on the couch at the end of the day, but sleep won every time. Again, it’s not forever. It’s also a good idea to grab a nap at lunch when your toddler does. Just lie quietly and ready stories together and you’ll both be asleep in no time! “But I’ve got washing to fold, dinner to make….!” . Try and do these chores with your toddler in the morning and afternoon as activities. Toddlers are great at chopping zucchini with a butter knife whilst you get the rest of the meal sorted. Toddlers can match socks whilst you fold the rest of the load. They LOVE to help and one day it will ACTUALLY be really helpful!
7. Take supplements. Some find ginger helpful, but others find it burns their throat when they vomit, so you may need to give that a miss if you are vomiting. Vitamin B6 is very effective; take 10-25 mg three times a day (healthywa.wa.gov.au/Articles/J_M/Morning-sickness).
8. Acupuncture and sea bands are very effective for many people.
9. Chat to your GP about medications to stop the vomiting, such as Zofran or Maxolon. Be aware of the constipation that some of these medications can cause, so try and drink as much as you can and chat to your doctor about safe laxatives in pregnancy.
10. If you cannot keep fluids down, you may need to go to the emergency department to get re-hydrated. Good ways to hydrate are lemon and ginger tea, peppermint tea, watermelon, soups and bone broth, and of course water. Taking small sips often is best.
Rest assured that your precious little bundle will be just fine, despite how you feel. The morning sickness is due to the change in hormones and has a lot to do with your placenta, not your baby.
All the very best with your pregnancy and may your nausea pass quickly!
By Jen Milligan
I need to repent of my midwifery sins of long ago. Taking a photo of a dad when he had fainted during his wife’s labour before running to his aid probably wasn’t my finest hour of compassion. His wife found it highly entertaining though! Once that epidural is in, the cheeky personality of mum (and midwife) can really come out!
I actually do have a real desire to help dads and partners feel valued and useful during labour, as their role really is pivotal in the birthing experience.
Often the partner can feel apprehensive about what is lying ahead as they prepare for the birth of their baby. Most are wanting to offer the utmost support, but are unsure of the best way to go about it. So many dads and partners comment on the fact that they “felt useless”, “powerless to take the pain away”, or “didn’t have a role” during labour.
9 TOP TIPS FOR BIRTH PARTNERS DURING LABOUR
By Ingrid Clark
There was a time in my life when I viewed Mother’s Day as just another over-commercialised event on the calendar. Not that I ever felt my Mum wasn’t worth celebrating; on the contrary – my Mum is the rock star of all mums, and all 5 of her children agree. What I mean is, I felt it shouldn’t be necessary for us to have to be told to celebrate our mums and to let them know they’re appreciated. I’d like to think that Mum felt this on some of the remaining 364 days of the year.
However, now that I’m a mother myself, I realise amid the full-time job of parenting that it is nice to have a day where mothers are told how much they’re appreciated; when they perhaps get a bit of pampering (even if it means toast crumbs in the bed – eeew!), and where society as a whole jumps on board. It’s really sweet to see the kids do their own shopping at the school Mother’s Day stall, especially when they can’t wait beyond the school bell on the Friday afternoon to present you with their gift! Sure, it might not be what you’d have chosen for yourself … but for me, this is a time when it’s definitely ‘the thought that counts’!
I could go on and on about how celebrating Mother’s Day is actually a healthy lesson for our children to learn to acknowledge what others do for them, to verbalise their gratitude and love for another person, etc., but I actually want to digress a little.
Years ago, I read a quote: ‘Being a mother is to have your heart walk around outside your body’. It was before I had children myself, but it resonated with me nonetheless. I thought it was possibly the best way to describe the intensity of the love a mother feels towards her child. A few years later I had my first baby and that quote popped back into my head. As it did, my heart felt like it would explode out of my chest. It was indeed the closest words could come to describing what I felt.
Yet, that doesn’t always mean that being a mother is full of such ‘lovey-dovey’ feelings and words. Those little people who steal our hearts don’t just walk around with them; they also have the capacity to stomp on them at times, and boy does THAT hurt! But you know what? That can only happen because of how much we love them. If we didn’t care, it wouldn’t hurt. And it makes sense, doesn’t it? We’ve grown these little babies inside us, birthed them, fed them, changed them, rocked them, comforted them, taught them … the list goes on. And that’s natural; it’s what mothers are supposed to do. We love them sacrificially. We constantly put our children before ourselves, even whilst trying to teach them independence as they grow and mature.
Except sometimes, a mother isn’t able to be a mother to her baby, and someone else takes on that role. It may be someone who’s had her own biological children and adopts another. It may be a single mum who has foster children. And it can be anything in between. This is next-level sacrificial love. To unconditionally love your baby comes naturally to most – they are your own “flesh and blood”, hopefully a product of love, and when we give birth there’s a wondrous cascade of hormones that helps us to bond, love and protect our babies. To choose to unconditionally love a child that you haven’t birthed is simply amazing.
These reflections got me thinking. There are all sorts of motherly figures in our lives. It may not be someone who actually fed, clothed and raised us; it could be someone in more of a mentor role. And it may only be for a particular season of your life. I think when we think of the word “mother”, we most often think of a woman with a newborn babe in arms. When Mother’s Day rolls around each year, mothers are spoiled and celebrated. And although there is that aspect of overdone commercialism that makes me cringe, I actually love the whole idea of intentionally celebrating mums for all that they do.
Yet there are mums out there who get overlooked, because they don’t have ‘children’, as such. This day can be a lonely one for many; for those battling infertility, for those who are single & childless, for those whose children have passed away. I guess I just want to acknowledge mothers everywhere, including those who don’t ‘fit’ the traditional mother description. If there’s someone in your life who is like a mother to you, make sure you celebrate them. Maybe with something from the school Mother’s Day stall … or maybe not!
By Ingrid Clark
“Birth is natural...”
“Thousands of women have done it before you…”
“That happened to me, and I got over it...”
“Everyone’s got a story...”
Perhaps it’s that last comment, meant in a throwaway “your story is nothing special” kind of way that really makes me feel sad. Yes, everyone does have a story. And every story is important.
Unfortunately, whether your birth experience was good, bad or downright harrowing, sometimes you’re made to feel like you should just ‘move on’; as if the only outcomes that matter are that mum and baby are alive. Let me tell you, as a postpartum doula, I’ve heard many a birth story from a mother who is ‘alive’ in the sense that she’s breathing, but her heart and soul have been crushed by an experience she never could have imagined.
Sometimes it’s the result of a genuine and rare medical situation and it’s only by the grace of God and modern medicine that she’s alive to tell that story. Other times, tragically, it’s the result of a jaded midwife or overworked obstetrician who’s said or done something, no doubt inadvertently, but it’s scarred mum in a way that can’t be seen but is immeasurably felt.
Sometimes, it’s been a situation where mum was left feeling like she had no voice, therefore no choice. Things may not have been explained clearly enough for her to interpret between contractions. It’s not always possible to make informed decisions in a state of utter exhaustion. Sometimes I feel that the ‘everyday-ness’ of the job for the medical professionals means that the miracle unfolding before them gets forgotten. It might be the fourth baby they’ve seen into the world that shift ... but it’s the first for the couple in the birthing suite. That is a sacred time that should not be rushed, interrupted or taken for granted.
Then there’s the other side…
If you had a wonderful birth experience, I am genuinely excited and thrilled for you. And you definitely have the right to share that positive experience (quite frankly, not enough positive birth stories get told). BUT (there’s always a 'but'), be mindful of how you share it. If you have a friend who had a tough, or even traumatic birth experience, there’s no reason why you can’t refer to your own positive experience so long as you listen to her first, then empathise with her ... and finally, with kindness and compassion, ask if there’s anything you can do to help her change that next time around. Can you recommend a particular mode of pregnancy care? A wonderful practitioner? A beautiful doula? A talented birth photographer? A great hospital or birthing centre? An experienced chiropractor, massage therapist or acupuncturist?
Either way, whether your experience was really positive or quite the opposite, if you don’t debrief about it at some point, it will resurface and need to be worked through (often more so if it was a negative birth experience). Many mums find that they can stuff those feelings away and just ‘get on’ with the full-time role of being mother to a newborn … until they fall pregnant again. Suddenly, the thought of giving birth again can paralyse them. With the right help, this can actually be a catalyst for making different decisions and setting up a great support network for birth preparation, the birth itself and the postpartum period.
Some mums find that their birth experience was so traumatic that they actually can’t be the mum they wanted to be. They can’t bond with their newborn, often experience feeding problems and sometimes, are in such anguish mentally and emotionally that they actually can’t look after themselves, let alone their baby. So whilst it’s often enough to just debrief with a friend, there are definitely situations where professional help is needed.
Here at The Nurtury, we offer birth debriefs as part of our Baby Care classes as well as in a more intimate home-visit setting. Sometimes, gaining insight from a midwife or doula (people who know birth), can help explain why things happened the way they did. This can offer some closure for mums who perhaps feel disappointed that their birth didn’t go according to plan. Sometimes they’ve come to terms with how things went, but would like some tools to empower them for next time.
We see the benefits of a good and safe debrief so often. We have quite a number of mums who say “I wasn’t going to come today; I haven’t been able to talk about my birth because I cry every time I think about it”. And yet, it’s these mums who, after talking, walk away from that session visibly lighter. It’s truly amazing. But what makes me sad is thinking about all the mums who don’t get to safely debrief about their birth. Who don’t get to have their questions answered. Who think they just need to move on … until they find themselves faced with birth again and they realise they haven’t. Or who spiral into postnatal depression, because the pressure just builds and builds.
Processing your birth is the first step towards loving and nurturing yourself, so that you can nurture and love your family. Although we all know that having a healthy baby is the desired result, how that comes about does matter.
Please, don’t underestimate how important it is to talk through your birth experience; or indeed, to listen to that of another woman. And if you or someone you know needs a little help from a professional, don’t hesitate to call us here at The Nurtury. We can arrange a birth debrief with you, or put you in touch with a counsellor with experience in working through trauma.
Does my baby really need medication for reflux?
Jen is a midwife with almost 20 years experience in a Sydney birthing unit. She now lives & works on the Central Coast, supporting new mothers as they transition into motherhood.
Ingrid is a birth & postpartum doula, living and working on the beautiful NSW Central Coast.