Ask Dr. LaRusso: How do I take care of myself during pregnancy?

May 21st, 2013

We’re kicking off a semi-regular Q-and-A with Dr. Elizabeth LaRusso, a perinatal and reproductive health psychiatrist. Send your question to Social@TheMotherBabyCenter.org, and Dr. LaRusso will answer it in a blog post in August. 

Q:  I am pregnant with our second child, due in July. With a full-time job, husband, busy toddler and house to take care of, I often feel burned out. I know I need to take care of myself too during pregnancy, but usually…I’m last on the list. How do you set boundaries for yourself/family/friends/work to stay healthy?

Dr. Elizabeth LaRusso

A: I think that the fact that you are asking this question at all signifies that you are way ahead of the game in terms of understanding the importance of prioritizing your own health and wellbeing.  But understanding and implementing are two different things, and you are not alone in feeling stretched thing between various roles and responsibilities.  There are multiple domains that contribute to optimal physical and emotional health during and after pregnancy, and I will review them in more detail below; but in my experience, many people are familiar with these areas and the problem is feeling like there is no time to engage in these healthy behaviors.  I remember back in medical school, reading an article someone had given me about decreasing stress.  The article listed different relaxation techniques, like taking a bath, going on a walk, etc.  I felt like it missed the entire point: of course, in an ideal world, I would be doing all of those relaxing activities, but the problem was I was too busy and overwhelmed to find the time.  And that was before I had children, and understood what being busy and overwhelmed really meant.

I’m sure you have been given information from your physician about the importance of restful sleep, regular exercise, and adequate nutrition to the health of you and your baby.  What your doctor likely won’t discuss with you is how you make time for these healthful activities, and what may be getting in the way of prioritizing your own needs.  At the end of the day, I think that each woman has to engage in self-reflection to identify major sources of stress, consider interventions that may decrease this stress, and identify what may be getting in the way of accepting help or modifying expectations.  Women deprioritize their own needs for many reasons, but one common theme is inadequate recognition of the critical role the mother plays in the family.  If the mother is not optimally supported and adequately functioning, the entire family unit will suffer.  All mothers are working mothers, and women cannot fulfill their caretaking role when they are overwhelmed and depleted.  The husband of one of my patients put it best: We were discussing modifications that the family could make to decrease the unsustainable workload my patient was facing and the important role she played in the family.  “You mean, happy wife, happy life, right?”  Right.

Sleep:  Nap when your child/infant naps.  Choose going to bed over cleaning the house or doing the dishes.  Plan for 30 minutes before bed to do a relaxing activity, like reading a magazine or taking a bath, in low light to get yourself ready for sleep.

Nutrition:  Don’t make this another source of stress.  Just choose easy foods, like cut carrots, bring them with you, and try to get a varied diet with a focus on more healthful foods.  Avoid overindulgence in unhealthy foods that you know make you feel worse after you eat them, but don’t obsess if you fall off the wagon now and then.

Exercise:  Getting 30 minutes of physical activity most days of the week is ideal, but anything is better than nothing.  Shoot for 10 minutes of brisk walking, take the stairs, and do some stretching at your desk at work or before bed at night.

Schedule pleasurable/relaxing activities:  Engaging in pleasurable and relaxing activities is not being self-indulgent, it is recognizing that you are an autonomous individual with unique interests and relationships that require nurturing.  If you do not plan in advance when you will engage in these activities, they won’t happen.  Try to pick one activity for each day of the week, identify when you will engage in it, then do it.  For example, plan to take a bath after you put your children to sleep each night, schedule a walk with a friend on the weekend, or choose a favorite TV show and watch it instead of cleaning the kitchen.

Work:  Women work outside the home for many different reasons, but one common theme is feeling like there is limited choice in modifying work schedules to accommodate the needs of the family.  I ask women to discuss with their partners if it is in their best interest to consider working part time, or taking extra time off postpartum, or considering a modified return to work schedule (ex: taking less time off for maternity leave and then going back to work one day less each week for the first several months).  Frequently patients say “We  can’t afford to do that,” and I understand the real financial pressures families face.  I encourage people to think in smaller chunks of time, like six months or one year postpartum, and to reframe the question as “Can you afford not to?”  The answer is different for every individual.

Goals:  Set realistic goals, and include as your primary goal setting limits that promote your own health and wellbeing.

Standards:  Lower them!  Pregnancy and the postpartum period are the time to decrease your expectations about how much you will accomplish, how clean your home will be, how many projects you will complete.  Try to become more comfortable with doing less, focusing on the things that are most important to you and your family and letting the rest slide.

Avoid optional responsibilities:  During my first pregnancy, I decided in advance that I could not take on optional responsibilities at work.  Since this was difficult for me, as it is for many women, I promised myself that I would respond to any request by saying, “Thanks very much, that sounds like a great opportunity, please let me think about it and get back to you next week.”  Then I would have time to decide if this were something I could manage or not, and generally the answer was no.  I think that this approach can be helpful in various domains of life, and making a goal to take on less, and a prepared response to requests, can be helpful in limit-setting.

Enlist your partner/friends/family:  Explain to the people who love you that you are feeling overwhelmed, that you are trying to limit your responsibilities and to prioritize your health, and that this is difficulty for you and that you need their help.  Being specific about how they can help you, ex: “Can you watch my toddler for one hour on Saturday so I can go for a walk?” is much more effective in getting the help you need.

Posted in Expert Commentary, Maternal Health, Staff Q&A's | No Comments »

Mother, Baby and Me: Ammie Nelson

May 17th, 2013

On Fridays, we try to profile the incredible staff at The Mother Baby Center. This week, we feature Ammie Nelson.

How long have you been a nurse? I’ve been a nurse for 16 years.

Where do you work at The Mother Baby Center? I work in post-partum and the newborn nursery.

What drew you to the profession? I had my first son at age 19. He was breech and had to be delivered by caesarean section. I was a single parent and all alone. The nurse in the operating room held my hand until my mother was allowed in. Right after my son was born, that same nurse leaned over to congratulate me. She had tears in her eyes. I knew right at that moment that I wanted to be a nurse!

What do you enjoy most about your job? I love helping new parents get to know their new baby.

While the Center has a nursery that you work in, we encourage moms and dads to have their newborn room in with them. Why is that important? Rooming-in truly allows parents to get to know their new baby. Each baby has his or her own personality. Even if this baby is the couple’s fourth child, I still encourage them to get to know the new baby’s personality by rooming-in.

To learn more about rooming in, click on this rooming-in handout.

 

Posted in Nurses | No Comments »

How kangaroo care came to the United States: One mom’s journey

May 15th, 2013

This post originally appeared on the Kids’ Health Blog by Children’s Hospitals and Clinics of Minnesota. 

Chris Clark was 23 weeks pregnant, on bed rest after her water broke, and had been given little hope of having a viable pregnancy.

A mom of three kids already and a natural protector, she wondered, if her child was born, was there something she could do to enhance his chance of survival? Bed rest gave Clark, who had a background in respiratory therapy, time to research.

She landed on an article in the magazine, Mothering, about kangaroo care in Colombia. Kangaroo care is the practice of holding your newborn baby skin to skin, which provides benefits to both the parents and the child. It helps premature babies develop. At the time – 1989 – kangaroo care wasn’t being practiced in the United States.

“I read the article through and thought, ‘Oh, my gosh, they’re holding babies skin to skin and the babies are doing better,’” she said. She contacted a researcher listed in the article, shared her condition with her and asked for medical literature supporting kangaroo care. The researcher sent the information overnight – she doubted Clark had much time before delivering.

Hours after getting the literature, Clark was rushed to United Hospital where she gave birth to Danny, who arrived at just 29 weeks on May 7, 1989. He was taken to the neonatal intensive care unit (NICU) at Children’s Hospitals and Clinics of Minnesota in St. Paul.

Danny, born on May 7, 1989

As soon as Danny was born, Clark started asking the neonatologist, Dr. Mark Mammel, if she could try kangaroo care.

“I was interested and also cautious. Maybe it’s growing up in the ’60s, but it seemed like a good idea. Parents holding babies – rocket science? No. But we all worried about the issue of temperature control, monitoring, airway obstruction, and so on,” Mammel said.

Clark persisted. “I asked every day if we could please, please try it,” she said.

Five days after giving birth on Mother’s Day, Clark held Danny for the first time. There were two crash carts and two resuscitation teams nearby – ready in case anything went wrong, she said.

“It was crazy. (Some of the staff) appeared terrified,” she said.

But the minute Clark started holding her son, terror and fear disappeared. She found only comfort and connection.

“It made me feel like his mom,” she said. “It was like I was in my own world with him.”

“Chris was very smart about the process. She initially saw the technique mentioned in a magazine…which I was familiar with as a fringe publication. It was not a great source for me to rely upon. Chris knew this!” Mammel said. “She gathered the actual medical literature – though there wasn’t much – and brought it to me and the group to review. Like all change in a NICU setting, a champion is needed to bring others along. I liked what I read – kangaroo care looked safe and probably beneficial, as well. So I became that champion, working with my partners and the nursing staff to pave the way for Chris to be the first.”

Chris Clark holds Danny skin-to-skin

Initially, Clark spent about 30 minutes twice a day using kangaroo care.

Danny ultimately spent about nine weeks at Children’s. During that time, he needed nine blood transfusions, experienced numerous spells where he stopped breathing, and early on required a ventilator and 100 percent oxygen.

Prior to leaving, Danny required hernia surgery. Clark held her son for about 24 hours before the operation.  The anesthesiologist visited afterwards to tell her Danny was the “most relaxed baby” he had worked with in his years of surgery.

Danny just turned 24. He’s run a marathon, has no lung or sight problems and is a singer/songwriter, Clark said.

“I believe Danny is who he is because of kangaroo care,” she said.

Kangaroo care is now a standard practice at Children’s and beyond.

“I’m a fairly strong advocate and a fighter for what I think is best for my kids. The fact that it has helped other kids feels like this might be the purpose of my life and, It’s enough,” Clark said. “I was blessed to have enough people that believed in and supported us.”

Today marks International Kangaroo Care Awareness Day – a day we celebrate at Children’s.

“We had always seen ourselves as ‘family-friendly’ – trying kangaroo care was a way for us to really walk the walk. We became recognized around the country for this, though it was never a focus of our research efforts. Others took on that task,” Mammel said. “Today, all our families benefit from this practice, which is as routine as turning on the lights in the morning.”

 

Posted in Neonatology, Patient Stories | No Comments »

A letter to nurse Kelli

May 9th, 2013

By Emily Steffel Barbero

Today’s children are born into diverse families, both big and small. Grandparents (even great-grandparents), siblings, aunts and uncles, cousins, step families, half families – the family tree can boast many branches.

But not all children are blessed with nurses for family.

On a frigid and snowy January morning, our son, Ziggy, made up his mind to arrive at just 30 weeks. He had a mess of black hair, and he was a true wriggler.  His first cry burst my heart open like a firecracker, breaking it up into a million little pieces of joy that rained all over inside me.  We posed for one brief photo opportunity and then he was promptly admitted to the Special Care Nursery. It was in the nursery that he was cared for by many fabulous nurses, including Kirsten, Martha, and Kelli. Today I want to tell you about Kelli.

Sometimes when people ask me how long we were in the nursery, I tell them Ziggy lived in the nursery for 64,800 minutes (six weeks). As Ziggy’s primary nurse, Kelli was by our side for thousands of those minutes.  On any given day I would spend 720 minutes or more by Ziggy’s isolette, watching him sleep and cry and stretch and kick and try to free himself from the IV jabbed and taped into his ankle or foot or arm. Kelli taught me how to dab Vaseline on his lips when they cracked and position his head so his airway was clear. She patiently taught me how to pick him up when he had more cords attached to him than Clark Griswold plugged into his home at Christmas time. She made me smarter, making sure I understood all of his procedures, even checking up terms with me online. Every inch of his skin, literally, was touched for and cared by so preciously by a woman who had otherwise been a complete stranger to us.

After about 20,000 minutes, I began to notice how his eyes would seek out her voice when she entered his room. I would watch how he’d snuggle into the nook of her shoulder when she burped him, or smack his lips against her gloved knuckle when he was hungry.  When she talked with him, her voice was tender and sweet, with the tone of a healer and a mother and a cohort. She sat watch over his isolette, she fed him, she held him as he literally grew in her hands over time. Many mothers might be jealous of a relationship like this, and I would understand it. But I never was. I considered it an unbelievable honor that this woman was in my son’s life.

Toward the end of his stay, Ziggy surprised everyone by suddenly falling ill with a serious gastrointestinal illness with a high mortality rate. By that time, so many minutes had passed that Kelli knew Ziggy inside and out.  She was able to spot the symptoms when they were still minor, and, because of her attentiveness, an x-ray was given, treatment was started, and my son’s life was probably saved. It was an incredibly emotional time for me. One morning I collapsed into a chair by his isolette, completely beside myself with worry and sadness (and lack of sleep and physical energy). I just wanted someone to tell me when he was going to get better.  It was all I wanted that day, it was all I wanted for so many of those minutes we lived through. I just wanted someone at the hospital, anyone, to tell me he was going to get better.

Kelli didn’t do that.

Instead, Kelli hugged me that day, picked me up enough to keep moving forward.  She entertained me with conversations about reality television.  We looked at photos from blogs about Wal-Mart shoppers and discussed recipes for the CrockPot. We swapped movie recommendations, urging us to stop at a Redbox and watch a movie she and her husband loved (it actually turned out to be half decent).  She gave me fashion advice and we talked how I might recover from bang regret with my new haircut. She talked me through those 900 minutes, and the next 720 minutes after that, and the next 720 minutes after that. All while we checked his temperature dutifully, changed his diapers, monitored his central line, snuggled him through his hunger pains. But she never once told me he was going to get better.

She told me I was going to get stronger.

You know what? I’m proud to say I did. And my husband did. And my son did, too.

After all those minutes together, I realized I didn’t need false promises from anyone that my son was going to get better. Because the little boy who could turn my heart into a firecracker had more strength in his 3-pound body than a 300-pound lion. That was all that mattered.  No need to worry about future minutes when time is so precious right now. None of those minutes in the nursery ever got easier from one day to the next. But each day, with Kelli, we got a little more light-hearted, a little wiser, a little stronger.

You can’t just call Kelli a nurse.  Kelli is family.

Posted in Nurses, Prematurity | No Comments »

Seeing a chiropractor during and after pregnancy

April 17th, 2013

We recently reached out to one of the chiropractors in our Allina Health system who treats pregnant moms and asked her about how a chiropractor can help moms prior to and after giving birth. This is what Dr. Rochelle Rougier-Maas, DC, at Allina Medical Clinic in Edina had to say:

What role can a chiropractor play in prenatal care for expecting moms? The role of a chiropractor in prenatal care is to establish pelvic balance and alignment, not only to reduce the mother/baby discomfort but also to allow the baby to be in the best position for delivery. When the pelvis is misaligned it may reduce the amount of room for the developing baby to be comfortable and they may seek out a less than optimal positioning for birth.  Our chiropractic training provides safe exercises, stretches and manipulation (adjustment) to the low back and pelvis to optimize alignment.  “Currently, the International Chiropractic Pediatric Association (ICPA) recommends that women receive chiropractic care throughout pregnancy to establish pelvic balance and optimize the room a baby has for development throughout pregnancy. With a balanced pelvis, babies have a greater chance of moving into the correct position for birth, and the crisis and worry associated with breech and posterior presentations may be avoided altogether. Optimal baby positioning at the time of birth also eliminates the potential for dystocia (difficult labor) and therefore results in easier and safer deliveries for both the mother and baby.” Most expectant mothers state that they feel like they walk better because there is fluid motion in the hip joints (SI joints).

How can a chiropractor help during postnatal care?  Often after birth, whether vaginally or via c-section, the mother’s pelvic biomechanics change – these changes can bring discomfort with walking, nursing and sleeping. We restore the pelvic balance with similar manipulation, exercises and stretches that were used in the prenatal care. It can also be beneficial to mobilize the thoracic region due to positions during breastfeeding, bottle feeding or simply rocking children. There is a tendency for new mothers to flex forward for long periods of time which can aggravate the mid back area. Carrying car seats with infants in them also alters biomechanics.

What should a woman consider before seeking care from a chiropractor?  Consider insurance coverage and asking the chiropractor if they have worked with pregnant women and if they have tables to accommodate pregnancy.

Does the OB-GYN have to refer the expecting mom?  Most insurance companies do not require OB or PCP referrals – it is always a good idea to call your plan before making the appointment just to make sure you have coverage.

What are some of the conditions you treat in expecting moms or moms who just had a baby?  The most common conditions we treat are pregnancy-related sciatica or pelvic pain with walking, sitting and/or sleeping. We also treat middle back pain in postnatal mothers related to breast feeding, bottle feeding or simply rocking babies to sleep.

What do you like about working with expecting moms? For the two women in the group, we remember what it was like and love to see other women’s excitement about the upcoming new arrival!  We enjoy seeing the pregnancies advance and the care that we provide support the mother through her journey.

How long have you worked at Allina Medical Clinic?  Dr. Molly Magnani has been there the longest — 16 years — and I have been part of the system the shortest amount of time 12 years.

 

Posted in Maternal Health, Staff Q&A's | No Comments »

Mother, Baby and Me: Dr. Elizabeth LaRusso

April 12th, 2013

Meet Dr. Elizabeth LaRusso, a perinatal and reproductive health psychiatrist.

Dr. Elizabeth LaRusso

As a perinatal and reproductive health psychiatrist, what are some of the conditions you treat? The term “perinatal and reproductive psychiatrist” really means that I specialize in treating women for conditions that are related to the reproductive cycle. Currently, I focus mostly on pregnant and postpartum women. The conditions I treat commonly include depression and anxiety during pregnancy, postpartum depression and anxiety, as well as bipolar disorder and at times, psychosis during and after pregnancy. I love to do pre-conception evaluations, meaning that I see women who have a history of psychiatric illness or are taking psychiatric medications and are planning to become pregnant. The goal here is for women to be well-informed about the treatment options during pregnancy and the postpartum period, and to generate an individualized plan to help promote emotional health during and after pregnancy. I also evaluate women who have premenstrual dysphoric disorder (PMDD) as well as emotional issues related to menopause.

Are you seeing any trends in perinatal and reproductive health right now? If so, what are they? Currently, I believe that there is much more emphasis on identifying and treating postpartum depression than there has been in the past. Psychiatry, OB/GYN, family medicine, and pediatrics are all looking for novel ways to integrate mental health screening and treatment into their practices, as there are many barriers to women accessing psychiatric care at mental health clinics.

What general advice do you have for pregnant or new moms? I believe that pregnancy and the postpartum period are among the times that women are most highly scrutinized, by physicians, by society at large, and often by other women. Women may feel negatively judged or inadequate in their maternal role, and many women deprioritize their own needs in their efforts to focus exclusively on the wellbeing of their fetus/infant. I think that women would benefit from knowing that taking care of themselves, including getting adequate rest, exercise, support, and asking for help when needed, is one of the most important parts of being an effective mother. Mothers play an essential role in the family, and if the mother is not functioning well, the family cannot function well. Many women may think that they have to “do it all” or have wishes to be “perfect.” While this is normal and understandable, especially because of all of the cultural and societal pressures put on women, it is impossible and unsustainable. If women can understand that they need to care for themselves in order to care for their children, and at times this will mean lowering standards or asking for help, then they will not only experience less distress but also will be modeling for their children a mature and balanced approach to the conflicting demands of modern life.

What drew you to The Mother Baby Center? The opportunity to be involved in the Mother Baby clinical service line and to help integrate psychiatry into OB/GYN is a very exciting one that I feel very fortunate to be involved in. Allina Health and Children’s Hospitals and Clinics of Minnesota have exhibited a strong commitment to improving the emotional health of pregnant women and new mothers, and I am thrilled at the opportunity to help to shape a system that better addresses the needs of these women.

What do you enjoy most about your job? What I enjoy most about my job is the variety. I am able to practice clinical psychiatry, to form relationships with women, and to be a part of helping them navigate difficult emotional terrain. At the same time I have the chance to shape the development of a larger system of care that will ultimately be able to help more women and support the Mother Baby commitment to improved mental health care for all mothers.

Do you have questions for Dr. LaRusso, too? Send them to Social@TheMotherBabyCenter.org by May 7, and we’ll pick a few for Dr. LaRusso to answer here on the Great Beginnings blog. 

Do you have a suggestion for a Mother Baby employee who should be profiled in Mother, Baby and Me? Send your ideas to Brady.Gervais@ChildrensMN.org.

Posted in Expert Commentary, Mental Health, Mother, Baby and Me | No Comments »

Why I march for babies

April 9th, 2013

By Jana Cinnamon

I vividly remember the first time I held Sadie. She felt like she weighed no more than the purple blanket she was wrapped up in. It wasn’t at all what I imagined it would be like to hold my baby for the first time.

We sat together in a rocking chair. I was nervous to move, afraid that any movement I might make would trigger an alarm from one of her monitors. After some time, I bravely leaned down to kiss her little head and then I started to sing quietly to her.

“You are my sunshine, my only sunshine.
You make me happy, when skies are gray.
You’ll never know dear, how much I love you.
Please don’t take my sunshine away.”

With tears in my eyes and a lump in my throat, the last line of the song became my cry out to God. Please Lord – do not take her away from me.

Sadie’s early arrival was a complete shock to my husband and me. We were readying ourselves to become parents, but nothing could have prepared us for becoming parents to a preemie. Sadie’s first seven weeks on this earth were spent in the neonatal intensive care unit (NICU) at Children’s Hospitals and Clinics of Minnesota. I remember walking the halls, seeing pictures and reading stories of other babies that had been born early. There were tremendous success stories of babies that had been born decades ago at a time when the survival rates of premature and low-birth weight babies like Sadie was not nearly what it is today.

Sadie

Although I still had uncertainty about Sadie’s future, reading those stories gave me an overwhelming feeling of gratefulness. I became thankful for the advances in medicine and the access we have to superior health care. I became thankful that Sadie’s prematurity and small size was not the end of her story. And I became thankful for the work of the March of Dimes.

Prior to Sadie’s birth, I had heard of the March of Dimes, but was not familiar with their mission or work. Since I became a mom to a miracle, I have learned a lot from the March of Dimes. Most of all, I learned I was not alone. In the United States, one in nine babies is born prematurely.  Yes, there can be comfort in numbers, but this is not a comforting statistic. The March of Dimes is actively working to reduce the number of premature births in the United States. Additionally, they are funding lifesaving research to support healthier babies.

Today, Sadie is five years old and has no lasting effects from her premature birth.

This spring, my family, friends and I will be walking in the March for Babies. This event is a major fundraiser for the March of Dimes and this year, in particular, is exciting as they celebrate their 75th anniversary. Participating in this event has brought me hope and healing. My favorite part of the walk is the last mile – “Mission Mile” – where signs are posted along the street featuring babies that entered this world too early.

My daughter, born 10 weeks too soon and weighing 1 pound, 9 ounces, is a fighter. She has inspired me to fight for healthier babies. Will you walk with me?

Find more information at www.marchforbabies.org.

Posted in Guest Posts, Neonatology | No Comments »

Mother, Baby and Me: Debbie Biffle

April 5th, 2013

This week’s edition of Mother, Baby and Me features Debbie Biffle, one of our patient care managers. Learn about her, what a typical day looks like and what drew her to labor and delivery.

How long have you worked at Abbott Northwestern Hospital? I have worked for Abbott Northwestern Hospital for 27 years! I have fulfilled multiple roles and have enjoyed every aspect of each position. I have been a staff nurse, quality management specialist, information system specialist, and a patient care manager. Abbott Northwestern is one of the best places to be a nurse. I have participated in multiple initiatives and committees throughout the years and feel strongly that I am a valued part of this place!

As a patient care manager, what does a typical day look like for you? I am the patient care manager for the labor/antepartum units for The Mother Baby Center. As a patient care manager, I am responsible to make sure that the patients and families experience an amazing stay with us! That being said, it is extremely important to me that all the staff caring for these patients feel supported, engaged, and has everything they need to provide excellent care to our patients and families. My typical day surrounds these goals. I make rounds on patients making sure that the experience we have provided them is meeting our standards. I connect with staff frequently and problem-solve barriers to care. Making sure that staffing is adequate and ongoing evaluation of what we need is also an important part of my work.  My day also entails participating in performance and quality initiatives that have been established by Abbott Northwestern and The Mother Baby Service Line.

What drew you to labor and delivery? I love being a nurse working with moms, families and babies. When I was growing up, I never envisioned myself as a nurse. Although I loved the sciences in high school, I couldn’t quite envision myself as a nurse for a career. I started off my college career going into business. After many statistics, calculus and accounting classes I quickly discovered that working only with numbers was not for me! I began interacting with other nursing students through taking science classes and discovered how much I loved pharmacology, physiology and chemistry! I then worked a summer as a nursing student and knew that this was the career for me. I chose labor and delivery because it seems like such a great fit for me. I have a great deal of passion, calm presence, strength and a love for working in an action packed environment!

What do you enjoy most about your job?  I can honestly say that I love coming to work as much today as I did on my very first day. Whether I have an absolutely spectacular day or one that is difficult and overwhelming, I will always love what I do!  I love my co-workers! The relationships that I have developed over the years are part of who I am as a nurse. I am very blessed and honored to not only be part of a fabulous staff but also have the opportunity to work within this amazing building. One of our patients said to me during rounding, “This is a world-class organization, and it is the best place to have a baby!” It is pride, compassion, passion and joy that bring me back each and every day! I take great joy in making sure that people are aware of what a positive impact they have on people’s lives through dedication to their patients.

What do you think are some of the key ingredients to a baby having a great beginning? I believe that The Mother Baby Center has all the key ingredients to making sure that the babies get off to a great beginning. We have the best facility, the best staff and leadership that support what we need. As a nurse, I need to make sure that the parents are starting off with a fabulous birth experience. We are so fortunate here that we are able to provide all the options to parents.  For babies we have specialized nursing care through neonatal intensive care unit (NICU) and special care nursery (SCN) if necessary, all so close to where the birth actually happens! We also have knowledgeable nurses who can help instill the confidence and provide education to the parents so they feel at ease with their new baby.  Lactation support is also so important and we have those resources available for patients. Families need that even though they may have spent considerable time educating themselves; babies may have not read the same books! They need to know that they may not know everything, but there are resources to help them.  Many times patients and families focus so much time preparing for the birth. Then the baby is born and now what? It is our job to walk them through this most important time after birth. We give them knowledge, instill confidence, and praise them during this amazing time in their life! Their lives will be changed forever, and as we care for these families, so will ours…

Posted in Mother, Baby and Me | No Comments »

What’s the fuss about solids?

April 2nd, 2013

Even though doctors recommend waiting until babies are 6 months or older to feed them solid foods, a recent Centers for Disease Control and Prevention study indicates parents are introducing solids too early.

Babies are ready for solid food when their birth weight has doubled, they have head and neck control, can sit up with support, can demonstrate when they are full (turn their head away or no longer open their mouths) and show interest in foods others are eating, according to the American Academy of Pediatrics. These skills are usually developed between 4 and 6 months.

We reached out to our clinical nutrition team at Children’s Hospitals and Clinics of Minnesota for more insight. Introducing solids before the age of 6 months could result in increased risk of chronic diseases such as obesity and diabetes, they said. Breast milk and infant formula in adequate volumes will meet a baby’s nutrition needs through the age of 4 to 6 months with the exception of vitamin D for breastfed babies (supplementation is required).

While it doesn’t matter for most babies which foods are introduced first, breastfed babies benefit from meat-containing baby foods initially. Meat is a good source of iron and zinc, two nutrients important for brain development.

Last week we shared this New York Times story on introducing solids too soon on our Facebook page and asked parents when they first fed their children solids and what items they introduced. Most waited until their infants were 6 months or later. When they introduced solids, they tended to be fruits and veggies and items like sweet potatoes and avocados. One parent said she fed her child steak.

When did you introduce solids? What was your baby’s first solid food? 

Posted in Expert Commentary, Nutrition | No Comments »

Mother, Baby and Me: Nikki Brockel

March 29th, 2013

Meet Nikki Brockel, a perinatal social worker who recently transitioned into her new role at The Mother Baby Center, for this week’s edition of Mother, Baby and Me.

How long have you worked at Children’s Hospitals and Clinics of Minnesota and The Mother Baby Center? I have worked for Children’s as a full-time employee for almost two years. If you count my master’s degree internship though and the maternity leave I covered for another social worker, I have really been with Children’s for almost three years!! I transitioned into the Mother Baby social work role in January of this year joining Kara Marriott and Sara Moeller as perinatal social workers in the Mother Baby service line.

What does a perinatal social worker do? The Mother Baby perinatal social work team includes Kara Marriott, Sara Moeller and myself.  As perinatal social workers, we provide pregnant patients and families a single point of contact and support across the continuum of care from pregnancy, to delivery and through the discharge of their baby from the hospital.

The role of the Mother Baby perinatal social worker is to provide a consistent contact person to pregnant patients and their families and a link between the multiple healthcare providers from different organizations who are following the family due to the high-risk fetal diagnosis.

We follow specific high-risk pregnancies by referral from the Minnesota Perinatal Physicians clinic. We follow all pregnant patients and families who have a prenatally diagnosed fetal congenital anomaly and high order multiples.

Our goal is to develop and maintain relationships with pregnant patients and their families along with their medical providers to facilitate supports and resources related to the specific fetal diagnosis.

Each of us carries a caseload of pregnant patients and their families and work to address the psychosocial, developmental, behavioral, financial, educational and medical needs of pregnant patients and their families striving to attain the very best outcomes for high risk pregnancies.

Why drew you to social work? I knew early on that I wanted to help people. When I was in middle school, I thought that meant I wanted to be a lawyer. I was on the debate team through much of my middle and high school years and really enjoyed the challenge of competitive debating.

That being said I realized fairly quickly that the kind of help I wanted to offer others was not in the form of a defense attorney!! My mom had her degree in counseling and addictions and with her help and encouragement, I found social work. Imagine my delight as I found my passion for advocacy, empowerment and social justice was not only satiated by social work but lifted to new heights, this was definitely the profession for me!

I believe strongly that with timely clinical assessment and purposeful clinical intervention we can work side by side with individuals, families and communities in need to increase their overall functioning, well being and quality of life. This is why I went into social work!!

What do you love about your job? Working as a Mother Baby perinatal social worker lends itself to loving my job! We see families not only through those moments when they hear the unthinkable but ongoing as they navigate through a pregnancy and likely hospital stay due to a high-risk fetal diagnosis.

Being told your unborn baby has a congenital anomaly or another fetal diagnosis is earth shattering. As a Mother Baby perinatal social worker I have the honor and privilege of being at a family’s side on what is an exhausting journey physically, mentally, emotionally and spiritually.

I am inspired each day by the calm strength, steadfast resolve, unbridled hope, thoughtful consideration, lighthearted humor, spirited determination, intense honesty, quiet vulnerability and unparalleled buoyancy exhibited by the families I work with. In a nutshell, I love everything about my job!!

I turned to my colleagues Kara and Sara for a quick quote on what they love about the work we do. Here is what they had to say:

Kara said, “Helping families build resiliency and become strong advocates for their baby.  Knowing that families feel supported throughout their pregnancy journey, birth of their baby, neonatal intensive care unit (NICU) stay and transition to home. Seeing their sense of relief when they see a familiar face after their baby is born and they are worried about their baby.”

Sara said, “I love watching a mom interact with her new baby, being the consistent support person to parents through what can sometimes be a very long, painful as well as joyous journey. I also love being a strong advocate for families and encouraging them to advocate for themselves. “

What do you think is needed for new families to have a great beginning? I remember the first week home with my first born. What a crazy, fantastic, scary, lovely, worrisome time!! I kept looking at him with his smooth, soft pink skin, dark hair in patches on his arms and the small of his back, perfect wrinkly toes and fingers, pouty full lips and deep blue eyes and the wonder of him, of this new beginning was intense and confusing.

I joked out loud with my husband during those first days at home after discharge, “Hmmm, when are his parents going to come and pick him up and give me a fat check for babysitting?” But they did not come, which is a good thing because it was astonishing how quickly I came to see him as mine. What a joyful and conversely difficult time. Luckily I had my family there at our side each step of the way.

The things that I think new families need to have a Great Beginning are tons of support, encouragement, information, education, patience and forgiveness. Families need support, someone to call on even at 3 a.m. for input and advice. Families need encouragement, to be told they can do this and will succeed. Families need information, about resources and what to expect. Families need education, knowledge about when to ask for help or seek out another opinion. Families need patience, to take each thing or day in stride and be flexible. Families need forgiveness, for the times when they don’t do it perfectly (and there will be many of these times) and are being hard on themselves. I know Great Beginnings just like families come in all shapes and sizes one thing I know for sure, much of what families need to have a great beginning cannot be bought in a store!

I turned to my colleagues Kara and Sara for a quick quote on what they think families need to have a great beginning. Here is what they had to say:

Kara said, “SUPPORT and assistance in understanding the process, processing complex medical information, navigating through the crazy medical system(s), understanding and knowing resources are available to them ahead of time to help relieve anxiety and worry about basic needs, advocacy.”

Sara said, “Consistent encouragement to families that they can do this! They have come so far in their journey and bringing their baby home is scary, exciting and definitely a new beginning!”

Do you know of a staff member at The Mother Baby Center who should be featured in Mother, Baby and Me? Send your suggestions to Brady at Brady.Gervais@ChildrensMN.org.

Posted in Mother, Baby and Me | No Comments »

« Older Entries