The Benefits of Nighttime Sleep Support for Families with Twins

March 14, 2023 | Katrina Nelson

If you’re expecting twins or have them at home, you know getting a good night’s sleep in the first 12 weeks can be a challenge. An extra pair of hands or a sleep consultant will support you with staying on track with your circadian rhythm.

Nighttime sleep support provides guidance and care to help you feel confident and empowered in supporting the sleep needs of your twins; from night wakings to feeding issues.

With tailored guidance, flexible sleep plans, and predictable bedtime rituals, you will establish healthy sleep habits and manage sleep associations and disruptions.

Parents with twins often experience unique challenges when it comes to sleep.

Twins may have different sleep schedules and soothing needs, which makes it challenging for you to establish a consistent sleep routine.
Additionally, twins may wake each other up during the night, leading to disrupted sleep for you and the babies.
These challenges may be exacerbated by factors such as colic, reflux, or other medical issues that are more common in premature or low birth weight twins.

How to Find a Postpartum Doula in Your Area

February 5, 2023 | Katrina Nelson

A family sent me an inquiry to ask if I had doula referrals for Seattle; which inspired me to expand on this list which I wrote in my guide ‘How to Hire a Postpartum Doula.’

An internet search

This is how I found my birth doula 12 years ago!

I went down a google search rabbit hole and discovered two doulas via a parenting forum; one of which was via the Berkeley Parents Network and the other escapes me.

I met with them both and ultimately chose the doula who had the professional and personal experience to support my vision.

Cons: This probably isn’t a great way to find a doula if you prefer personal referrals.

Pros: This is a great way to find a doula if you don’t mind checking references and taking time for an in-depth meet and greet.

I also highly recommend investing in a consultation; my clients find it’s money well spent. They get to ask questions related to their needs versus the generalities which are found on FAQ, for example.

Referrals from friends who’ve used a postpartum doula

Many families find a doula through friends.

A personal referral from a trusted friend offers an opportunity to find out what it’s like to work with a particular caregiver from someone you know and already trust.

It also gives a well rounded picture of how the doulas skills and services translate into a beneficial experience for your family.

Cons: If you and your friend aren’t on the same wavelength in regards to parenting philosophies, you may find the doula isn’t the right fit.

Pros: You know the doula is great because your friend probably wouldn’t refer someone with whom they didn’t have a great experience.

Ask your childbirth educator

This is how I discovered my pediatrician.

Most childbirth educators have an exhaustive list of providers related to pregnancy, postpartum and newborns; pediatricians, lactation consultants, massage therapists, perinatal psychologists, Mommy and Me groups and doulas.

Cons: It’s possible they refer you to someone who they’ve referred others to without much consideration; who is nice and professional, but isn’t the right fit for your family.

Pros: You’re receiving a referral from a trusted professional who more than likely is referring to care providers they have vetted.

Practicing RIE

June 16, 2021 | Katrina Nelson

As a mother and postpartum doula, I am a huge proponent of Resources for Infant Educarers (RIE®).

RIE teaches parents and caregivers to trust the innate abilities of children to communicate their thoughts, feelings and needs from birth.

So, how do we get started you ask…

We create a safe and simple environment
We weave consistency and predictability through their days and nights
We observe their actions and self initiative, for babies we wait for cues and vocalizing, with children who speak we look for a combination of what they tell us and what we see in front of us in that moment
Participate in parent-infant guidance classes at a RIE center

Observation

Through our observation, we build awareness of subtle communication cues babies and children use to let us know what they require from us at any given moment. I also feel we learn to anticipate their needs quite accurately by being observers.

As a parent or caregiver, we learn when children are inviting us to provide support and when we get to be a quiet observer; we also begin to discover the “beingness” of non-action.

Trusting yourself and your child

What I mean by beingness is, allowing our children to be autonomous in a safe environment, be with them and do nothing.

Our children in turn, learn to build confidence in their ability to communicate their needs accurately, confidence in us as responsive parents and caregivers and confidence in their own abilities to problem solve and work things out for themselves.

How to Hire a Postpartum Doula

February 17, 2021 | Katrina Nelson

What is a postpartum doula?

A postpartum doula is a trained professional who provides non-medical, emotional, physical and educational support to families welcoming home a new baby.

How does one find a postpartum doula?

An Internet search or social media
Referrals from friends who’ve used a postpartum doula
Calling a doula organization to find a doula in your area
Asking your midwife, obstetrician, pediatrician, childbirth educator or lactation consultant for referrals

Should one hire a postpartum doula?

Yes, absolutely! Postpartum doula support enhances all postpartum experiences.

For first time parents, a postpartum doula is a solid resource to guide them through every step of welcoming their baby home.

Even for parents who are confident with newborn care, second time parents and those who have been around babies, the presence of a doula provides educational support. Having a doula also provides reassurance, as well as, tips for recovery from birth and breastfeeding support.

When parents experience a challenging postpartum journey due to a traumatic birth or pregnancy complications, a doula with that specialty will guide the family. Doulas employ the method of physical in-home support to ensure all family members are well rested and draw wisdom from educational resources while providing emotional reassurance.

How long should one hire a doula?

Postpartum Doulas typically provide care from birth through 12 weeks.

Some believe it’s beautiful for families welcoming a new baby to have support during this time; I would agree.

This is what I tell my friends…

NICU Family Support

February 1, 2021 | Katrina Nelson

The day a NICU family goes home from the hospital, without the weight of their new baby in their arms, is a day not easily forgotten. I still remember the morning I left the hospital after my son’s preterm birth: with a commercial breast pump, a NICU wristband and no baby. Ten-weeks, several blood transfusions and a minor surgery later… I finally brought my baby home.

With all of the ‘how to’ about childbirth and parenting circulating online and in our communities, it is almost shocking we don’t share in equal measure what happens after coming home alone – baby-less – or what happens when you do everything ‘right’ according to ‘experts’ and your birth still unfolds in a way never anticipated.

This is where support from a Postpartum Doula may have a major impact on providing emotional support for families. We are present as non-medical, non-judgmental support. We provide evidence-based information, emotional support and referrals for the entire family. We mother the mother and educate the family in the best ways to nurture themselves after the birth of their baby.

A turning point for me during the first week home after my son’s birth, was when my Birth Doula came over and we watched a video together about Kangaroo Care. I hadn’t even held my son yet, but I remember the hope I felt inside when the video ended.

Common concerns and questions from NICU Families:

How may a mother recover from her birth while attending to the needs of her infant in the hospital?

How may the family and newborn bond when they pass so many days and hours apart from one another?

Will my baby know me when the nurses care for them so many hours and I only visit?

Must I visit my baby in the hospital every day?

Will I be able to breastfeed? Do I have to breastfeed?

What happens when I bring my baby home?

These are questions that may be answered in a myriad of ways. As Doulas, we guide families to the resources which; support their decision-making, feelings, ideas, beliefs and goals as a family.

Eileen Henry on RIE® and Compassionate Sleep Support for Babies

August 26, 2020 | Katrina Nelson

Sleep is foremost on the mind of most parents with a baby under one-year-old. What time should they go to sleep? Where should they sleep? How to get them back to sleep? I could go on and on.

For sleep-deprived new parents, their baby’s nighttime sleep pattern can become a never ending loop of trial and error without any relief. This dilemma often means no one in the family is well-rested and leads many parents to choose sleep training.

As a postpartum doula and a mother of two, I know there are ways to teach our babies from the beginning how to ‘eventually’ sleep independently. This will occur when it’s developmentally appropriate without ever needing to sleep train.

Eileen Henry is a Resources for Infant Educarers® (RIE®) Associate, author, and compassionate sleep coach. She educates families on how to respectfully and empathetically support their baby’s independent sleep in the most caring way.

I have read Ms. Henry’s book, Compassionate Sleep Solutions. I reached out to her because I study and practice RIE.

When it comes to infant sleep, I notice people think RIE means ‘cry it out’ and though I’ve never felt that way, I know many do.

In the interview that follows, Ms. Henry shares her perspective about cry it out (CIO) and the principles of RIE and infant sleep. As well, below she shares her knowledge and expertise in compassionate infant sleep.

Thank you, Eileen!

The RIE® Approach to Infant Care

What is the compassionate sleep solution?

It is a respectful and mindful approach to infant and child sleep. It is based in the RIE® Approach of caring for infants and grounded in Attachment Theory and Regulatory Theory. When practicing compassion, we are very present and actively listening to the other, in this case our child. To be this present we must be able to handle difficult emotions as well as positive emotions. All feelings are welcome.

Prenatal and Postpartum Ayurveda with Kim van der Veer

August 16, 2020 | Katrina Nelson

Ayurveda is the sister of yoga and a healing science that can be traced back 5000 years to the Indus Valley Civilization. It is a complete mind, body, and spirit approach to health, which is practiced all over the world.

My knowledge of Ayurveda began as a teenager when I would accompany my mother to her Ayurvedic doctor. I felt like those one-hour visits lasted forever. The doctor would ask her lots of questions and usually send her home with herbs and recommendations for her daily routine.

Because of that experience, during my early twenties, I went as far as finding out what my dosha was and reading a couple of books about Ayurveda; that was as far as I went with it.

Around the time I began studying to become a childbirth educator, and welcomed my first baby, one of the things my birth doula encouraged was the practice of Kayakalpa; also referred to as the sacred window or body time.

Kayakalpa is an Ayurvedic practice observed for the 42 days after the birth of a baby. It is a time of bonding, with rituals for mothering the mother, caring for the new baby, and healing the body, mind, and spirit after birth.

Kim van der Veer is a yoga teacher, Ayurvedic practitioner student, and mother based in Amsterdam. I discovered her through my friend Erica Jago and was impressed by her passion for Ayurveda.

On her Instagram, Kim regularly shares simple and easy to follow tips for incorporating Ayurveda into ones daily life. More impressively, she even talks about Ayurveda for children and has a Dosha test for kids on her website.

Here, Kim shares her wisdom about Ayurveda for mothers, babies, and children.

Enjoy!

Prenatal Ayurveda

How does Ayurveda support mothers and babies during pregnancy and postpartum recovery?

We all know that we have to take care of ourselves during our pregnancy. Not only to stay healthy ourselves, but also because we need to set the right conditions for our baby to grow inside us. In Ayurveda there is this saying that a pregnant woman should be carried as if she is a bath filled to the edge with golden oil and no drop should be spilled. Hence, a huge emphasis is put on relaxation and good nutrition of the mother during pregnancy. Ayurveda even gives suggestions on what to eat in a particular month to support the growth of the baby.

But what is even more important, and this part seems to be lost in the west – is taking good care of yourself in the 42 days after. It is in this period that you can grant yourself a good recovery which is the basis of good health in the 42 years after according to Ayurveda. In this period it’s all about balancing Vata Dosha. Because Vata Dosha – which is the manager of Ether and Air – has gone sky high after giving birth. This sounds very logical if you think that there is such an empty cold space left in the centre of your body where once your baby was comfortably laying. This may even feel as if you are leaving all the doors and windows of the house wide open in order for those drying and physically and mentally disturbing (Vata Dosha) winds to come in. Eating warm nourishing and grounding foods and covering yourself in warm oil everyday are key for an effective and good recovery.

Breastfeeding Premature Twins

Kathryn Stagg, IBCLC

July 24, 2020 | Katrina Nelson

As mothers of preemies, we learn that our breastmilk is the perfect food for our babies.

Within hours of giving birth, we are encouraged to begin pumping, so our babies will benefit from our milk. The breastmilk of preemie mothers has special nutrients, is easier to digest, and can reduce the risk of infections.

Although breastfeeding is a natural physiological process, it’s not always intuitive or easy to get our babies latched and nursing.

For mothers of premature twins, it is especially challenging. Often babies become more familiar with bottles in the NICU. While their mothers, in turn, become well acquainted with their hospital-grade double electric pump.

Kathryn Stagg, IBCLC is a U.K. based Lactation Consultant, certified through the International Board of Certified Lactation Consultants. She is also an expert in supporting breastfeeding mothers with multiples.

What makes her unique is, in addition to her professional experience as an IBCLC, she successfully breastfed, and tandem nursed her twin boys.

A while back, I interviewed Kathryn, about nursing twins, this time she’s here to offer guidance for breastfeeding premature twins.

Breastfeeding Premature Twins

Could you share your advice for a twin mom who plans to breastfeed and knows her babies are going to be born prematurely? How should she prepare, before, and after the babies are born?

If she has some warning and her health professionals think it’s safe to do so, she could do some antenatal hand expressing and collect the colostrum. This would give her a head start.

What would you recommend for a twin mom whose babies arrive unexpectedly premature, and she didn’t have time to prepare for breastfeeding ahead of time. If she only has the energy to do one thing while her babies are in the NICU, what should it be?

She should be supported to hand express her colostrum preferably within an hour after birth, but certainly within 6 hours after birth. Then to try to hand express every 2-3 hours from then on. Once her milk begins to come in she can move on to a hospital grade pump and continue to express every 2-3, not leaving it longer than 4 hours overnight.

After the Birth

What should mom do if it’s been 2 or 3 days since her babies were born, and she’s pumping every 3 hours, and she’s just getting drops?

If babies are stable enough for kangaroo care this can really help. Massaging the breast before and during the pumping session can help massively. Having photos of babies, a video, some clothes, or a blanket that smells of them can really help. And trying to relax, not watching amounts, listening to music, watching comedy, chatting to friends or family can improve. Ensuring the pump is efficient (a hospital grade pump is recommended) and that the cones fit correctly will have an impact on yield. If milk volume continues to be low then exploring whether there is a medical issue for this would be a good plan.

Humbled By Motherhood with Dairian the OT

July 14, 2020 | Katrina Nelson

My knowledge and understanding of Pediatric Occupational Therapists (OTs) and therapy began during my son’s time in the NICU.

During my first interaction with our OT in the hospital, we sat together while she assessed my son to see how far and how comfortably he could turn his head to the left and right.

The second time she sat with me, she spent time bottle-feeding my son and watching how he swallowed.

My son was periodically evaluated after his discharge from the NICU to see if he would benefit from additional occupational therapy for his development.

Before he formally began first grade, I sought out and chose to work with an occupational therapist for help with his handwriting.

It is through my personal experiences I’ve come to deeply value the work of pediatric occupational therapists. I see how much value and education they offer to parents, and I know how hard they work to help children meet their developmental milestones.

Dairian the OT

Dairian is an occupational therapist licensed through the California Board of Occupational Therapy. She resides in Los Angeles with her husband, 3.5-year-old son, and 6-month-old daughter. Here she gives us a mini crash course about the work of pediatric occupational therapy.

Dairian the OT

Occupational Therapy

What is occupational therapy?

Occupational therapy (OT) is a profession in which we support individuals across the lifespan (newborn to elderly) participate in their daily activities. It sounds very general because it is. OTs are traditionally trained as generalists, then we specialize once we start working. The concepts are the same, but the techniques and activities change based on the population.

How does OT benefit infants and toddlers in their development?

OTs are trained in a holistic way. We look at the baby, the environment, and the demands of the task in order to make recommendations to help them in their development. We can work in a preventative model for “typically” developing babies, babies “at-risk” of delay, or those that are already displaying a delay in their development.

What are the common development delays you treat in infants?

The “occupation” or daily activities for infants that I normally treat are play and feeding. Feeding difficulties can start immediately through insufficient weight gain. Play difficulties are usually seen in the older baby (3+ months) when they are unable to hold toys, not tolerate tummy time, not meeting milestones such as rolling/sitting/crawling, not engaging in social play, etc.

Licensed Midwife Jocelyn Brown on Homebirth

August 25, 2019 | Katrina Nelson

Childbirth is fluid and has a life of its own. We can’t guarantee an outcome, but we can prepare ourselves throughout our pregnancy by making the best choices for our babies and our bodies.

We can choose a place of birth that gives us space to be private, and where we feel safe, and find a care provider who listens, answers our questions, and works collaboratively with us throughout our pregnancy.

For most families in the United States, due to accessibility, and medical insurance, that will be a doctor and hospital, but for a growing percentage, that means birthing at home with a midwife.

Jocelyn Brown is a licensed midwife who delivers babies in Los Angeles. Read on for her insight on midwifery and home birth.

Becoming a Midwife

What motivated you to become a home birth midwife?

It was more of a gut thing and not a conscious motivation. I think I was drawn into the mystique of it all, that there was an “alternative” to doctors and hospitals and I wanted to be that. Then I learned that other countries use midwives as mainstream sources of maternity care and have *better* outcomes than we do in the US. So now I don’t want to be on the fringe – I think it’s an injustice to our pregnant population that midwives are considered the “alternative.” We should be the go-to.

Midwifery Model of Care

What can a family expect from midwifery care that is different from the care they receive from an obstetrician?

Time. And more of a relationship with your care provider. Most midwives can offer up all the same low-risk prenatal testing and screening options as OBs do, but we actually sit with you, explain your options to you, give you alternatives if you want. We also are highly invested in keeping your pregnancy low risk, so we are going to give you tons of nutritional and lifestyle advice for good health. Many OBs have little choice but to see 20-30 patients a day. They don’t have time to talk to you about nutrition and yoga poses for your sciatica and building your emotional support network. It’s bonkers!

Some midwives have offices that their clients drive to. I personally do all visits in clients homes, so that’s a huge perk. You get all the same care, but in your home with your kids and your pets and your spouse around. It makes the home birth aspect so intuitive.