Musings About Life... After Birth



Posted by Chelsea on February 23, 2010

Maintaining a romantic relationship with your partner is nearly impossible when you’ve got little kids. Luckily for you and your partner, The Family Groove has a great feature this month on how to keep that spark of romance alive when you’ve got kids. Here it is, courtesy of The Family Groove:


THE FAMILY GROOVE: Every parent needs to read your book. It would be a great gift with purchase of a stroller.
ESTHER PEREL: If every time you buy a stroller, you get a book that reminds you of another focus that you are likely to forget at that time, that would be incredible.

TFG: You are so likely to forget about your sex life when you’re mired in your life with little children. It’s often the first thing that parents give up on. In your book, you talk about overzealous parenting. A lot of media and child-related companies have picked up on the overzealous trend and have exploited parents by playing on their worst fears that their child won’t be successful or happy or smart or pretty or won’t be liked unless this is done or that is done. And so we play into this fearmongering by giving up our own lives and our own identities for the sake of our children. It really strips a woman—and probably a man, too—of sexuality.
EP: Well, it’s not helping families—that’s the main thing. The divorce rate is very high, and for those who stay together, it’s very hard, too. There is something so isolating about overzealous parenting that disempowers them. It empowers the child but disempowers the adults.

TFG: Let’s talk about security and passion. We need both in our lives, but how can we as parents who really need security and the ability to foster security re-establish the passion?
EP:  If I were to take the general frame, I would say that Mating in Captivity came out of my work as a therapist with many happy couples who have good, caring, loving relationships but whose sexual lives are dull. Time and again, they would describe to me the paradoxical relationship between the security, the familiarity and the predictability that people seek in their committed relationships and the eroticism, the novelty, the mystery and even risk.

How can we reconcile these two sometimes conflicting human needs? How can we sustain desire over the long haul with one person—especially given that we live much longer than we did before? The idea of reconciling security and passion is in itself very new. It is not something that we thought to do in our marriages or committed relationships historically. Marriage was for companionship, economic support and family life. Passion existed somewhere else, if anywhere at all. We must understand that this is a new expectation that we bring to our relationships. We marry out of love—it’s a free choice en-terprise these days in the West. We come with expectations about intimacy and sexual gratification. What happens when people transition to family is that they begin to bolster the security needs and begin to make themselves more of an anchor so that their children can become the ones who will go out to explore and discover the world. They will be the adventurous ones, but in order for them to do so, they need to have a secure base, emotionally speaking. There is a tendency in us to begin to suppress our other side during that transition. This is not the time to race the motorcycle—it’s the time to trade it in for a car with safety belts and air bags. This is not a time when you can decide at the spur of the moment to go out, because there is somebody else here who needs you at home.

So you slowly begin to change your own adventurous needs and your own desires for the spontaneous and playful. The transition is a shock to the system—a shock that sometimes takes a long time for people to work through, to find their bearings and to get some time back for themselves. It often takes people a long time to remember the beginning of the book when they reach the end—especially when it’s taken months and months to read the book.

Parents must learn to be able to cordon off an erotic space in time, where they can be adults with each other and not just together in their parental, responsible, caretaking roles. The joke is often that sex must be out the window as soon as children enter the picture. When you look at this new modern family, you notice that the erotic energy is very much there, but it is transferred onto the children. The children get to experience novelty—you look for the latest activity to do with them—and the adults often become mired in repetition and routine when they try to do something together. The kids get to wear the latest fashions, and we walk around in our colored sweatpants. Kids get the long hugs, and the parents are left with a diet of quick pecks. So at some point, the erotic energy needs to be brought back to the couple. You are not going to live in a steady state of passion—desire doesn’t flow all the time—but there is a need for the adults to reintroduce the X in sex. Bring back playfulness, curiosity, novelty and imagination into your own life instead of cordoning it off exclusively in the realm of parenting.

For the other two parts of TFG‘s interview with Esther Perel, click here.

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Posted by Chelsea on February 17, 2010

Whether it’s your first pregnancy or your fifth, it’s nearly impossible to get a clear handle on the rules of which activities, foods and drinks to avoid when pregnant. While there are countless do’s and don’ts swirling around the prego-sphere counseling you on what you should and shouldn’t do during your nine months of gestation, the information isn’t always clear. Some docs okay certain things, while others don’t. Confused? I gathered the latest info for The Family Groove and am reprinting it here on The Momtourage, but if you’ve still got reservations, ask your doctor.

MYTH: Pregnant women shouldn’t take baths.
TRUTH: Lori Albright, a certified nurse-midwife at The Midwife Center for Birth and Women’s Health in Pittsburgh, says a warm bath is a wonderful way for anyone to relax—pregnant or not. “The danger is when the water temperature is too hot,” she notes. “In the first trimester, very hot water can cause developmental problems in the fetus, and later in pregnancy it can cause preterm labor.” In general, a pregnant woman should avoid anything that raises her body temperature above 102 or 103 degrees, whether it’s hot baths, fevers or Jacuzzis. “Also, if a pregnant woman is leaking fluid or bleeding, she should avoid bathing altogether and consult her care provider,” Albright says. Hot tubs, steam rooms and saunas, however, are all off-limits.

MYTH: Avoid caffeine.
TRUTH: Good news: There’s no need to give up Starbucks for the next nine months. According to Dr. K.B. Lim, an ob-gyn at Scripps Memorial Hospital in La Jolla, Calif., there is no proof that small amounts of caffeine—which means one cup of coffee or tea a day—adversely affect a normal pregnancy. However, if you are having a complicated pregnancy, you may want to limit your caffeine intake. If you have questions or concerns about how much caffeine is okay for you and your particular situation, check with your doctor to be sure.

MYTH: You must sleep on your left side.
TRUTH: Often, pregnant women are told that they must only sleep on their left side. However, it’s not necessary to change your sleep habits. “While some women who sleep on their backs can get dizzy or sweaty from too much pressure put on the vena cava, during a normal pregnancy, sleeping on the right side is just as good as the left,” says Trish Woollcott, a certified nurse-midwife in Chicago. However, if you have high blood pressure, if your kidneys aren’t functioning properly, or if the baby isn’t developing well, sleeping on the left side is slightly better than the right, she says. Bottom line: Whichever way you can sleep comfortably at night, just do it.

MTYH: It’s okay to have an occasional drink.
TRUTH: Despite any disapproving looks they may receive, some pregnant women still have an occasional glass of wine. Experts, however, advise that you think before you drink. “No safe level of alcohol consumption has been established—but since there is no safe level, you and your doctor need to decide,” says Siobhan M. Dolan, MD, assistant professor of obstetrics and gynecology at the Albert Einstein College of Medicine in the Bronx, N.Y. Dr. Dolan recommends excluding all alcohol, especially during the first trimester, when so much of the baby’s nervous system is being formed.

MYTH: Don’t color your hair.
TRUTH: Most research, although limited, does show that it is safe to color your hair while pregnant, as the chemicals in permanent and semipermanent hair dyes are not highly toxic. While some studies have shown that very high doses of the chemicals in hair dyes may cause harm, it would take using a massive application of hair dye—we’re talking using enough for a thousand women—to cause any harm.

If you’re still concerned and would prefer to stay on the utmost safe side, wait to dye your hair until after the first 12 weeks of pregnancy, when the risk of chemical substances—hair dye or otherwise—harming the baby is much lower. If you’re coloring your hair yourself, wear gloves, leave the dye on for the minimum time, and work in a well-ventilated room. As highlighting your hair doesn’t involve the dye touching your skin and reaching your bloodstream, it poses less of a risk. Of course, semipermanent pure vegetable dyes, such as henna, are a completely natural, safe alternative.

MYTH: Steer clear of soft cheese.
TRUTH: In the past, pregnant women were told to avoid soft cheeses like brie, camembert and gorgonzola altogether during pregnancy. These days, the Centers for Disease Control and Prevention (CDC) says it’s safe to eat soft cheese as long as it has a label clearly stating that it’s made from pasteurized milk. Raw milk and any cheeses or other dairy products made from unpasteurized milk can carry disease-causing organisms, including the potentially deadly bacterium listeria. While raw-milk soft cheeses are thought to be the Martha Stewarts of hosts for listeria, the pasteurization process kills the bacterium and other potentially harmful organisms.

What’s 100 percent safe? As most dairy products made in the U.S. are pasteurized, your local grocery store has a whole range of pregnancy-safe dairy options. Cottage cheese, ricotta, cream cheese, processed cheeses like American, and hard cheeses such as cheddar and Parmesan are fine, as are cultured dairy products like yogurt and buttermilk. Regardless, before you indulge, check the label and make sure that it’s been made with pasteurized milk.

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Posted by Chelsea on February 12, 2010

We gets lots of questions here at The Momtourage. We get all sorts of interesting, kid-related questions for our panel of expert docs, inquiries about various products (What’s the best stroller? Do I really need an exersaucer?) and sometimes, fashion and beauty questions too. Recently, Tamara, a reader in Knoxville, TN wrote in to ask us for a few blog recommendations. Here are the ones we’re loving right now:

1) Reality Blurred - All the news you need about reality television

2) Lucky Right Now: Lucky Magazine’s Shopping Blog - All sorts of sale news, clothing and product recommendations, etc.

3) May/December  - A blog by Melissa C. Morris, a 20something NYC socialite married to a guy old enough to be her dad. Before you judge, however, know that she’s truly the the anti-Real Housewife. She’s sweet, preppy and loves to cook and travel. Her blog chronicles her activities, the dinners she prepares, her dog’s adventures, etc. We’re hooked.

4) Jamie’s Foods and Finds - Written by a friend in the DC-area, this blog offers some truly awesome daily tips for deals and freebies.

4) Pete Bakes! - Another DC-area blog, this one, by a guy who loves to bake, chronicles his adventures in baking, complete with yummy pictures.

5) Apocalypstic Now - A very funny, honest beauty blog

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Posted by Chelsea on January 14, 2010

If you’re preparing to welcome child number two, you’ll soon be faced with the task of introducing child number one to the subject of his soon-to-arrive sibling—not to mention your changing shape. Unsure of how to do so in a way that will foster sibling love as opposed to loathing? Our on-call child psychiatrist, Dr. Michael D. Kaplan, gave me these helpful tips a while back when I wrote this piece for The Family Groove. I think it bears repeating for anyone who needs help facilitate a child’s transition into siblinghood.

At what time are kids truly able to grasp the concept of pregnancy or that a new baby is about to enter the scene?
DR. MICHAEL KAPLAN: Parents typically assume that young children have a more fully developed sense of pregnancy and the impending arrival of a new child than young children are actually capable of. Parents are usually excited for themselves and anxious for their current children, and often respond to this anxiety by giving their under-5s more information than they need or can process. Children under 5, and especially those under 3, respond much more to parents’ emotional states than to the information. They are observers and will notice how the parents talk to them more than what they actually hear.

There is a difference between how kids understand pregnancy and the arrival of a new baby. Children have a very limited understanding of pregnancy and a limited ability to plan for the sibling rivalry that is on the way. This is due to the fact that kids don’t start to grasp a firm understanding of the concept of the future until they are about 5 years old. While kids under 5 can talk about these things—especially precocious children—it is only around age 5 that it truly hits them.

What a child can connect with, however, is the reality of his or her mother’s growing belly and her potential preoccupation with the changes in her body and life. Children under 5, as we all know, are very needy of their parents’ physical attention. When the pregnancy proceeds into the final trimester and mom can’t lift as much or as frequently, is tired more, and is moving very slowly, kids pick up on that. In their egocentric worlds, they may experience pregnancy in its later stages (and even more so if mom is on bed rest) as a withdrawal from them. Try as best as you can not to be overly concerned about this stage; it is a completely normal developmental phenomenon. In fact, it actually helps to prepare your child psychologically for the decrease in attention he or she will need to manage when the baby comes.

In what kinds of ways can parents help their child feel like a part of welcoming a new family member and not an outsider to the process?
MK: Parents can do a lot of things to help their child through this period. I recommend parents invite the child to help set up the nursery and pick out new toys and stuffed animals (as long as they get a new one each time, too). I also advise making sure that the child gets extra time with parents prior to the birth. As mom gets tired, dad and other family members need to pick up the slack. In fact, dads can do a lot at this time in terms of expanding their role with the first child. I encourage parents to take a child under 5 on a hospital tour for siblings, if the hospital where you’re giving birth offers one. Today’s hospitals are much more welcoming of siblings than in the past, and it will help your child feel secure once he or she visits mom and the new baby there after its arrival.

A key bit of advice: Have extra presents for the first child in the closet. Many friends and family members will know the protocol of bringing two gifts—one for baby and one for your first child. In case anyone forgets, mom or dad can run to the closet and choose a pre-wrapped gift. Additionally, allowing the child to open all the gifts for the baby will make him or her feel like an important part of the process.

Parents should carefully plan for arrangements for when mom goes to the hospital, taking care to make everything as similar for your existing child as they generally are. For example, the child should go to school or day care on that day. Keep his or her routines as familiar as possible.

What should parents avoid doing or saying to their existing child about the new baby before a baby arrives?
MK: Again, the biggest risk is in going overboard. Many parents tell kids under 5 that a baby is on the way the moment they know—all in the service of “being open” with their child. I would advise waiting until mom is fully out of the first trimester and the pregnancy is a sure thing. My feeling is that for young kids, they should be told when they have something concrete like a big belly to help them. Once mom’s belly is big enough to notice, it’s probably a good time to introduce the concept to a child under 5. Until then, keep it quiet, being especially careful of loud conversations on cell phones to friends, etc., because the kids will always be listening.

Parents should avoid going overboard with guilt-reducing comments, such as “We will still love you just as much.” As with everything else, you don’t want to put those ideas into your child’s head if they are not already there. Once you tell your child about the pregnancy, tune into what they ask about, and avoid putting adult ideas into their heads. Remember: The ways in which we handle these big events set the stage for how we handle informing our kids of other big changes down the road.

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Posted by Chelsea on December 23, 2008

Reader Fiona in New Orleans asks, “Medically, is it an OK choice to not circumcise your son?”

We asked our on-call pediatrician, Dr. Reva Snow, for her thoughts on the (delicate) matter:

In short—absolutely yes. You should feel comfortable with whatever decision you make on the issue.  The decision of whether or not to circumcise your son is a very personal one that involves religion, culture and ethnicity in addition to any medical concerns. If you’re trying to make the decision based mainly on the health perspective, I’ll go over the known health benefits and risks to circumcision.


1) A lower risk of urinary tract infection in infancy. Circumcised boys under a year have about a 1 in 1000 chance of having a UTI, while the chance for an uncircumcised boy is about 1 in a hundred.  Bear in mind though that UTIs are, generally, very treatable with a low risk of any future problems.

2) A slightly lower risk of STDs. Studies have shown that circumcised adults are somewhat less likely to acquire or transmit HIV and other STDs. However, uncircumcised men can lower their risk through proper hygiene.  And while we’re on the subject, though it’s impossible to think of your baby boy ever being a teenager, talking to him then about safe sex and condoms can go a long way towards keeping him healthy!

3) A lower risk of developing penile cancer as an adult. Now, “cancer” is never a word you want to hear, but penile cancer is actually pretty rare (about 10 in a million) so whether or not your baby is circumcised, he probably won’t be up against this particular disease.

4) Less chance of minor and manageable issues like foreskin infections and phimosis (a too tight foreskin).


1) It is a painful procedure. Anyone who performs a circumcision in this day and age should be using some form of pain control.

2) Complications of the procedure.  These are most often minor and might include bleeding, infection, leaving too much or too little foreskin, and problems healing.  It’s a somewhat more involved and risky procedure in older boys, so it’s recommended to do it in the newborn period if you’re going to do it.

You might hear people say that circumcision diminishes male sexual pleasure. There’s really no research supporting or disproving that claim, not to mention it’s a pretty subjective outcome, no?
Bottom line (to quote to American Academy of Pediatrics): circumcision is not essential to a child’s health. Take all the facts and your personal influences into account and make the decision that makes sense to you.

(Editor’s Note/Chelsea’s take: Do it, Fiona. You don’t want all the chicks in the sorority house making fun of your kid one day. Then again, if all the chicks in the sorority house are talking about his penis, perhaps he’s doing something right…....).

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Posted by Chelsea on July 15, 2008

Rachel from Grosse Point, MI writes: My husband and I are both in our early thirties and are in good health. We’ve been trying to conceive for about four months now, with no luck. Neither of us have any reason to believe we’d have trouble getting pregnant. Is there a certain time you recommend “trying” before seeing a specialist?

Our on-call Reproductive Endocrinologist, Dr. Eve Feinberg, answers:

The classic definition of “infertility” is the inability to achieve pregnancy after one year of unprotected intercourse.  With that being said, however, 80 percent of couples will conceive within four months of trying and an additional 10 percent will conceive between months four to six.  In other words, 90 percent will achieve pregnancy within six months.  If you are under the age of 35, it is a good idea to make an appointment to see a Reproductive Endocrinologist, a fertility specialist, after six months of “trying” without success, though traditionally, the recommendation is to wait a full year.  If your menstrual cycles aren’t regular or you have reason to suspect fertility issues, I advise seeing a specialist sooner rather than later regardless of your age.

There are many reasons why men and women in good health may not be getting pregnant, most of which a Reproductive Endocrinologist could discover with testing.  Common causes of fertility issues are ovarian dysfunction, blocked fallopian tubes, uterine issues and male-oriented issues like low sperm count, irregularly-shaped sperm and motility issues (meaning, how those guys swim).  “Ovarian dysfunction” issues can include things like problems with ovulation and problems with your ovarian reserve (a marker of how “old” your ovaries are acting).  If you have regular menstrual cycles every 28-34 days without the pill, there is a high likelihood that you’re ovulating.  If the interval between your menstrual cycles is longer than 34 days, chances are you’re not. Polycystic ovarian syndrome (PCOS) is a very common cause of not ovulating, and is present in six to ten percent of reproductive-aged women (Chelsea’s note: I’m one of them!).  If you have irregular or non-existent periods, PCOS could be your issue. Problems with ovarian reserve are much harder to diagnose, as there are no outward symptoms that a woman might experience.  Smoking is a common cause of diminished ovarian reserve, so if you are still smoking, this is one additional reason to quit! Blocked fallopian tubes are also a common cause of fertility problems that also have no outward physical signs. If you have or have had endometriosis, pelvic inflammation or prior pelvic infections, this may be what’s giving you trouble. The thing is, many women are not aware that they have any of these issues, so they go about “trying” not knowing there’s actually an impediment there. Additionally, the majority of couples with male factor infertility (which accounts for 35 percent of all causes of infertility) also have no symptoms.  Therefore, it’s never a bad idea to get yourself and your partner “checked out” if you or he suspect something might be up.

On a good note, once a diagnosis is established and treatment begun, the odds of becoming pregnant are greatly increased!  The mistake many couples make is waiting too long to be seen by a specialist. Seeing a specialist will not only improve your chances of pregnancy, but will make that dream come true faster.

Got a fertility-oriented question for Dr. Feinberg? {encode="" title="Click here to contact her!"}

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Posted by Chelsea on July 01, 2008

Heather from Sarasota, FL writes:

“My kids will eat nothing but the typical kid-fare: french fries, mac and cheese, fried chicken fingers, PB&J, etc. They like fruit, but hate vegetables. Should I be concerned that they’re not getting enough vitamins? Should I give them supplements? Will they ever like good food?

The Momtourage’s illustrious pediatrician, Dr. Reva Snow, answers:

When my older son was 3 1/2, he gave up mac and cheese (which, by the way, could only be Annie’s white cheddar with shells; any other pasta shape was anathema).  Priorto that he had given up pretty much anything else he used to eat including spaghetti, all vegetables, most fruit and anything dairy. My irritation level spiked: now what the heck was I going to feed him? Now he’s 6, and while his diet is still quite limited compared to many of his friends, he now eats an assortment of fruits, a few vegetables, and a
fair variety of proteins and carbs (I’ve given up on dairy; thank goodness for calcium-fortified orange juice). And once in a blue moon he’ll even try something new without gagging.

It’s normal for children to go through a sometimes prolonged picky eating phase, usually beginning between their first and second birthdays. At least in part this is a result of wanting to exert some more independence and control. And because it’s about independence and control, fighting or forcing the issue will make things worse, not better.  Plus, you never want to set up bad or confusing associations with food (or with pooping, but that’s for another “Ask the Pediatrician”).

Your best bet is to remain low-key and model the eating behaviors you want your kids to acquire.  Easy to say and hard to do when feeding your kid is a basic tenet of mom-dom.  Here’s some tips to hopefully make that job easier:

1) Whenever possible, eat meals together and let your kids see you enjoying a variety of healthy foods.

2) Keep treats as treats, not as bribes or substitutes. I promise your child will not starve even if she seems to refuse to eat anything but potato chips and you don’t give them to her.

3) Know that children - toddlers in particular - will grow and thrive on what to an adult is a remarkably small amount of food.

4) In addition to putting out foods you know he’ll eat, put out a small amount of something you wish he’d try (like a vegetable).  Repeated exposure will actually, over time, make these hated foods more acceptable.

5) Even though you absolutely do, act like you don’t care what your child eats or how much. Calmly encouraging or mildly offering verbal positive reinforcement for tasting new foods is fine.

6) Teach older children (3 or so, and up) about “growing foods” that make them strong, fast, big, etc., and involve even younger kids too in choosing (and growing, if you’re so inclined) and preparing food.

7) When your young toddler starts refusing previously acceptable foods, don’t give up altogether on offering them. It might just be a “food jag” or phase that will pass fairly quickly.

8) Try different forms of the same food -  cooked, raw, with sauce, with cheese, spicy, mixed with other foods, whatever you think will work.

9) Encourage your child to physically explore preferred foods, even if they don’t actually ingest them. Use zucchinis and peppers as stamps, or bang a drum with carrots! Again, the more familiar the food the more acceptable it will become.

10) Know that it’s actually pretty uncommon for American children to be significantly vitamin-deficient (assuming you’re not feeding them exclusively Cheez Curls and Pepsi), so they don’t really need vitamins.

11) Take the long view on their intake - if they hit all food groups over a week, rest easy. And if you are concerned enough that you can’t at least pretend to be relaxed about their eating habits, or if their diet is exclusively white, by all means give them a multi-vitamin.

12) All of us were once, to some degree or another, picky eaters. And all of us, to some degree or another, learned to eat and enjoy a variety of healthy foods. Someday, and it will probably be here before you know it, so will your strong-willed, chicken-finger-lovin’ finicky kid!

[NOTE: There are some kids who have significant sensory issues relating to foods and textures, medical issues that show up as severely limited diets or overall intake, or who are not gaining appropriate weight. If you are concerned about any of these, or feel like your child is significantly more picky than typical, please talk to your pediatrician.]

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