Self-Care & Wellness for Moms – PediaCast 404

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  • Dayna Kurtz, author of Mother Matters: A Holistic Guide to Being a Happy, Healthy Mom, joins Dr Mike in the PediaCast Studio to explore self-care and wellness for moms. We hope you can join us!

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  • Mother Matters (Book)
  • Self-Care and Wellness for New Moms

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Dr. Mike Patrick: Hi, I am Dr. Mike with Nationwide Children's Hospital, and this is PediaCast.

Dayna Kurtz is a licensed social worker and author of the new book for moms called, "Mother Matters: A Holistic Guide to Being a Happy Healthy Mom". That's what she's here to talk about. The physical and mental well-being of mothers and the important role mother wellness plays not only in a mom's life, but also in the lives of her children and family. So let's give a warm PediaCast welcome to Dayna Kurtz. Thanks for being here today.

0:00:27

Dayna Kurtz: Thank you so much. It's really a pleasure. Happy to be speaking with you.

Dr. Mike Patrick: I really appreciate you taking a time out of your day to join us. So tell us about your book, "Mother Matters….

Dayna Kurtz: So in a book market that, I think saturated with titles on child's care, I realized when I had my son that there seem to be a lack of evidence-based, practical guides for informing women about mothercare, which is a term I coin to describe what I think should be a basic right of every women to have access to resources to help her through the maternal transition and to make mothering and motherhood more enjoyable.

0:01:18

Dr. Mike Patrick: Absolutely. And one of the things I really love about the book is all the stories. I mean there's just tons of stories from real-life moms. And I think that those truly serve to drive home the importance of wellness and self-care for mothers.

Dayna Kurtz: Thank you. I must say I do as well. And that's why I brought in material from my clinical practice in providing talk therapy to expectant mothers, because I wanted the tools that I wrote about in a book to be illustrated in a very practical way, so that moms who were reading the book at home would be able to have some of sense of how they could employ these tools in a practical and realistic way.

0:02:06

Dr. Mike Patrick: The practical tips are really another shining moment, I think, of the book. Just ways that moms can sort of take the experiences of other mothers and then really some sound advice to put those into practice. And then there's a terrific resources section at the end of the book that we'll talk more about a little bit later on in the interview. So why did you write this book?

Dayna Kurtz: So I mistakenly thought some years ago that I was positioned to move into motherhood with great ease and success. I was very privileged to have many resources at my disposal: I had a supportive partner, and family who were eager to help me, and resources. And I was blindsided when I brought my son home from the hospital and felt completely ill-equipped to manage the challenge at hand.

0:03:10

And that's when it struck me that there had been a great deal of emphasis on my prenatal care, and there was a great deal of emphasis on my infant's care. But there didn't seem to be anyone paying attention to my own well-being. And I came to realize when I eventually narrowed my clinical practice to working just with new and expectant moms that my experience was unfortunately quite common. And so the birth of the book, really, the book was born out of that experience, and I think, as I said, the experience of so many women.

Dr. Mike Patrick: Now you coined this term, "mothercare…. What exactly is meant by that?

0:04:02

Dayna Kurtz: So I use it to describe, as I mentioned before what I think should be, a right of every woman to have access to research-based, concrete, cost-effective, safe tools that can be employed to smooth the transition into motherhood. And I do believe that becoming a mother is a transition. It happens in bits and pieces over time. For many women, it's not just about being handed a baby and then going home, and all of a sudden, "I am a mother!… It's a multi-faceted transitional life process. And it needs to be supported accordingly.

Dr. Mike Patrick: Absolutely. And there's plenty of research out there sort of come into light now, that not only is good self-care and wellness for mom important for her, but there's plenty of benefits for her children too: that really is as mom is healthy and well, that there is improved health in her kids, that there is improved IQ development, reading, academic stuff, and that the family unit also benefits.

0:05:17

Dayna Kurtz: Absolutely. And I am so glad you brought that up because sometimes what I will share with mothers I'm working with is that, if they do not believe that they, as individuals, are entitled to self-care, to a mothercare regimen, then at least they should use the reality that you just pointed out. That can be a great benefit to their children and their families to care for themselves. And sometimes, that's what it takes to kind of get them onboard, because as you say, there are tangible effects, positive effects of a mother tending to herself on her children and her family. There's been research that points to an enhanced mother-infant bond when a mother is taking care of herself.

0:06:13

I often use the metaphor of placing your oxygen mask on yourself on the airplane first before you can then place it on your child. There's a reason for that, and it's just critically important. It's not a luxury, it's a necessity.

Dr. Mike Patrick: Absolutely. I think as we think about mother wellness, one of the first things that come to mind, just in terms of wellness in general, really have to do with diet and exercise. And of course you put those into so many more ways in which mothers can achieve wellness. But let's start there with diet and exercise and in your healing meals for momma's chapter. You really kind of focus more on learning how to eat rather than dieting, right?

Dayna Kurtz: Yes. I do very purposefully so. 

0:07:02

I think the way our culture exists now is that the emphasis, unfortunately, around food in the postpartum period is very much about what I can eat to lose the baby weight or what I should not be eating in order to be able to lose the baby weight. And what I really hope new moms can begin to think of about is shifting away from that focus and instead thinking about how they can reframe their relationship with food at this particular moment in their lives. Food can be a tremendous source of healing, of physical healing for the body postpartum. It can be learning how to eat in a healthy and satisfying way can be a wonderful lesson that we can impart to our children. 

0:08:04

So it's an excellent opportunity, this moment in a woman's life, to perhaps learn how to eat in a rich and wonderful and healing way for the very first time. Because most of us are never taught how to eat that way, how to eat mindfully, how to eat thoughtfully. And so that's what I focused on in that chapter of the book. It has nothing to do, really, with losing the baby weight. It has to do with being thoughtful about the way we eat.

Dr. Mike Patrick: So if you eat in a smart way and you are also exercising in a smart way, then that weight loss will come. It just comes along with doing things that are good for your body in general.

Dayna Kurtz: Absolutely. It becomes a bi-product of making healthy choices psychologically and physically.

Dr. Mike Patrick: One of the stories that you relate in that chapter is from Abigail. 

0:09:00

And it talks about how she lost ten pounds in her mid-20s. She was really feeling great about her weight. She just felt healthy and well. And then she got pregnant at 30 and came that way back and was worried about losing it again. And what she did that made a big difference for her was to actually meet with the nutritionist who really sort of set her on a plan for make meals a sacred time, concentrate on the food with no distractions so you don't mindlessly eat watching TV. And then she found that that was very helpful for her. She was eating less and enjoying more. When she did eat, she really enjoyed it more realistic, not able to do it with a 2 year-old at home at that time, but it has made a difference. And I would just put a plugin for seeking that out like Abigail did in terms of meeting with a nutritionist who can really sort of give you an individualized plan.

0:09:50

Dayna Kurtz: Absolutely. I'm so glad you brought that up because I do think that having, even if it's just one time-consult with a well-trained nutritionist or a registered dietitian who can sit down with you one-on-one, get a sense for what your lifestyle is, and then prescribe eating as a form of healing, as a form of medicine if you will, can be really beneficial. And then you can take that and put it into your own practice. 

And I'm also so glad that you mentioned that there should not be an expectation that mindful eating can happen with every meal. So the postpartum period is rife with sleep deprivation and hormonal recalibration and it's a challenging time. So I encourage moms, whether it's with their eating or anything else, to be kind with themselves, to be gentle with themselves. If you manage to eat mindfully, during a snack once a day or once every other day, then give yourself credit where credit's due.

0:11:08

Dr. Mike Patrick: Absolutely. And the other thing to keep in mind for moms is that food not only plays a role in weight, but really just fatigue, and your mood, your health, and just how you're feeling in general, and even can affect nursing and breastfeeding too. So really, paying attention to food is important even if you're not trying to lose a lot of weight.

Dayna Kurtz: Absolutely, absolutely. It really can inform how we feel. So just having a basic knowledge of maybe which choices might be better at particular moments in the postpartum transition is really helpful.

Dr. Mike Patrick: Some folks, even during pregnancy, they're exercising and feeling good about that, and then you have a baby at home. How do you get back into an exercise routine when you're trying to care for a little one?

Dayna Kurtz: It's a great question. And it's entirely doable. I promise, it's entirely doable. 

0:12:05

So the first thing is just to make sure that it's safe to resume exercising after you've been through labor and delivery. Even though they are natural processes, they are traumatic on the body. It's a lot for the body to go through. So I always make sure that moms don't rush into an exercise program, that they are cleared by their healthcare provider to make sure that their bodies are ready for exercise. And that once they are, that they start slowly again, a little bit at a time.

I have on my website some videos that demonstrate that there are exercises that can be done with baby, which is a wonderful way to bond, to enhance the maternal-infant bond, to escape from the monotony of early childcare which is often just about changing, and feeding, and those kinds of things. This is a different activity that women can employ. So there are lots of ways to go about doing it. Slow and steady is typically what I prescribe in the beginning.

0:13:15

Dr. Mike Patrick: Absolutely. Jennifer story kind of resonated with me a little bit in this particular chapter. Did she had hoped for a natural delivery like so many folks do? And then of course kind of snag in that in her plan. And they had failure to progress. 16 hours of contractions, ended up with a C-section, and really had a lot of pain, and was depressed after her C-section, which both are very common. And it turns out her sister had also had a C-section. And she let her know that a daily afternoon walk really saved her. And even though a walk around the block doesn't seem like that much, a week after delivery, Jennifer gave it a try, took the baby for a 20-minute walk in the stroller. And they felt, she really did feel revived and energized. Just with that, she found her mood lifting, she was less bothered by the pain, and it became a daily routine just to go on a walk together. 

0:14:10

So I think, even when we think about strenuous cardio-type exercise or strength training, but even just getting outside for a walk can really do you a world a good.

Dayna Kurtz: I think walking is extraordinary. And I think, I guess a really bad rap. I think that the opportunity to be outside in the world beyond the walls of the nursery is therapeutic: psychologically therapeutic, physically therapeutic to be able to see other people, to know that the world is moving because being a mom, a new mom especially, can be tremendously isolating. 

So being out in the world and seeing other adults, seeing other people, when the weather is good, getting some vitamin D can also be very healthy and we need that from the sun outside. 

And of course you can cater a walk to your level of fitness. You can make it as long or short as you want. You can easily stop to tend to the baby, do a quick diaper change. I just think incorporating a walk as part of one's lifestyle. Mom or not, to be honest, is really, really important.

0:15:22

Dr. Mike Patrick: Absolutely. You touched on this, but I sort of want to drive it home for folks that you really have some great ideas for doing exercising. And especially I was thinking about more strength training type of exercises, of actually doing that with your baby. And not just like with the baby in the room, like you can actually do these things with your baby. Tell us a little bit about that.

Dayna Kurtz: Absolutely. So here's a secret: a baby can be used "for his or her weight", right? And in fact, baby provides a built-in challenge because as baby grows so does his or her poundage as it were. 

0:16:02

And it becomes a wonderful and really joyful activity to incorporate baby in strength training and resistance training. To bolster one's upper body, one's core, and to be able to learn how to use baby to one's physical advantage. 

And of course doing that will also in turn make it easier to hold baby up as he or she grows because there are all sorts of exercises that I write about in the book that allow for the baby to be, hate to say, utilized. But utilized in that way.

Dr. Mike Patrick: I'm sure the baby gets a lot of joy out of that too. And of course you want to do it safely, which is why reading the book is a good idea because there are certain ways you'd want to do it and certain ways that wouldn't be as good of an idea in terms of using the baby.

Dayna Kurtz: Absolutely, absolutely. And there are certain exercises when baby needs to be a little bit older because of neck strength and that sort of thing. So absolutely, you want to be mindful about it.

0:17:04

Dr. Mike Patrick: Moving to sort of beyond just diet and exercise, there's some really interesting topics in the book in ways that in which mothers can pursue self-care and wellness. One of those is expressive art. Tell us about that. 

Dayna Kurtz: Yes. So this maybe one of my favorite chapters of my book because it really took me by pleasant surprise.

Art therapy is not about making art in the conventional way which is to say about making art for beauty's sake or making a piece that will have some sort of financial value. It's about making art specifically for the purpose of healing and during the postpartum period and for that matter, during pregnancy as well. There are relatively easy art therapy exercises that a woman can engage in with specific healing purposes. 

0:18:04

So just to give you an example, there is an exercise I write about in the book where I take a new mom through a series of steps of creating a piece of art. And the purpose of doing it is that it allows her to adopt a sense of ownership and control. 

And in the postpartum period, both of those things are often bust: babies not on the schedule, mom is outside of her routine. And being able to have a concrete step by step process to be engaged in a creative purpose and see it through from the beginning to the end, even if it's not consistently, even if there are interruptions, can be tremendously empowering and can give a woman a sense of control when she might not otherwise be feeling it. So these are the kinds of exercises that I write about in the Expressive Arts Therapy chapter. They really are about creating art as a means to healing.

0:19:25

Dr. Mike Patrick: And it can be even as simple as a coloring book. 

Dayna Kurtz: Absolutely, absolutely. These are "no previous art experience is necessary…. And again here, art can be something that you engage with your baby if you're feeling like you want a different way to connect. I write a story about one mom who used to paint in college and had sort of let it go by the way side. And she's feeding her little one at one point. And the baby takes some vanilla pudding and wipes it on her high chair. And the mother is reminded that she used to love to paint, then make some edible finger paint using yogurt. And the two of them "paint together…. And for this particular mother, it was the first time that she felt very strongly that this was her daughter. She had been having some trouble connecting with her. And for the first time, she felt like: "Ah, that's my girl…. So it can be very powerful.

0:20:34

Dr. Mike Patrick: Yep. And that really sounds fun for the baby, too. Because not only is the mom connecting with the baby, but the baby is connecting with mom as well. 

Dayna Kurtz: That's right. Absolutely.

Dr. Mike Patrick: You also talked about massage and meditation. And I think, people can get a fair idea that "this would benefit me in terms of health and wellness. But you also mentioned acupuncture, and that really struck my interest. So tell me how moms can use acupuncture in order to achieve wellness.

0:21:07

Dayna Kurtz: So acupuncture, I think probably, most people have some familiarity with what it is. It's about a five thousand year old healing treatment from the East. And typically it involves the use of strategically placed special, very thin needles at certain points of the body. Acupressure, and I should say it has been used effectively for a wide range of various conditions effectively. Lots of research to demonstrate its efficacy. Acupressure works similarly, but instead of using needles, one uses pressure, usually applied by a thumb or finger. And the reason it can be so effective in the postpartum period is because, well, for a number of reasons: one, it can be self-administered. 

0:22:05

So with very simple instructions, a woman can treat herself using acupressure, and the effects can be remarkable. I site one study in the book that proved that milk production could be bolstered through the use of acupressure treatment on a particular point on the body. So these kinds of things, these kinds of treatments can be tremendously helpful postpartum.

There are points that can be treated to alleviate anxiety, to help enable sleep. And they're super simple, they're really easy. It's just a matter of knowing which points to target and how much pressure to use, and that's it. The learning curve's really easy.

Dr. Mike Patrick: Just anecdotally, if I had a tension headache, I know right where to just kind of push, and rub, and help it go away. So I mean, I think folks have, in their own ways, as they think back. There are probably times that you use acupressure, and didn't really call it that, but you can understand how that would help out.

0:23:18

Dayna Kurtz: Absolutely. And as you share that, I'm reminded of the use of, I think they're called, sea bands, which are sometimes for people who get sea sickness or car sickness. Just these elastic bands that put some pressure on the inside of the wrist. Well, that's an acupressure point and it's been demonstrated to alleviate feelings of nausea. So yes, I think you're absolutely right. Sometimes we used it without really knowing that that's what it is.

Dr. Mike Patrick: And so folks can, if they check out your book, learn lots more about acupuncture, and acupressure, and how moms can use those, and as I mentioned also, massage and meditation as well. And then you talked about talk therapy. What is talk therapy?

0:24:04

Dayna Kurtz: So talk therapy is an umbrella term that covers many different kinds of therapy that employs…it's interesting. It's called talk therapy, but it's really about listening. It's about being in a room with a trained professional who has been oriented to one or more different types of therapeutic intervention around dialog. 

And there are many things that a mom can do to help herself. And sometimes, as is the case in life for all of us, we need more help. We need more than we can get ourselves. And we're entitled to that. And that's when a trained clinician can be really helpful in providing some guidance. 

0:25:00

As I said, there are many different kinds of talk therapy. There's psychodynamic therapy, cognitive behavioral therapy, and each of them has been developed to help with a particular kind of issue that may be going on. So there are certain talk therapies that might work better to help reduce anxiety and depression. 

And in thinking about using talk therapy, it's helpful for a woman to have a sort of an understanding of what she is experiencing and what might be the most helpful to her. And in the book, as I said, I sort of outlined a number of different kinds of talk therapy and how to go about finding the right practitioner for you. 

Dr. Mike Patrick: There are a lot of choices in terms of providers. And to some degree, it's going to depend on the expertise and availability in your local area. 

0:26:00

But I do like how you, coz it can get a little confusing for folks: what's the difference between a psychiatrist and a psychologist, where's the psychiatric nurse 

practitioner fit in, who are marriage and family therapists versus social workers. 

And so, I just think, getting a better understanding of who is out there that you can get help from, and then maybe talking to your regular doctor about what resources are available in your area, may be a helpful way to sort of get connected with someone who can help.

Dayna Kurtz: Absolutely. And I would emphasize also that talk therapy can be incredibly effective, incredibly helpful, and also that it is not a quick fix. It does take a little bit of time. And so I urge women to be willing to commit for at least three months, and then re-evaluate with the therapist, and see how things are going. 

0:27:00

And secondly, that in choosing somebody, and speaking with your healthcare provider for referral is a great place to start. But in choosing somebody to really pay attention to how you feel when you speak to that person, whether it's over the phone or whether it's an in-person consultation, and to go with your gut because ultimately therapy will only work if you really feel a sense of trust and connection with the clinician. And that's a very personal thing. So I really urge women to listen to their internal experience.

Dr. Mike Patrick: And I would just put another plugin to say, this is really important, that depression and feelings of, even if you don't think of it as: "Oh, I'm not depressed", but you still just have decreased energy level, just not as interested in the things that used to interest you. You feel anxious. These are normal feelings after you have a baby and with that dynamics that change in the household as you add more babies to the family. And it's okay to have these feelings, but at the same time, when those feelings begin to really interfere with the quality of your life and your family life, it really is okay to get help. And in fact, you should.

0:28:18

Dayna Kurtz: Absolutely. I couldn't agree with you more. It's so important to hear people: pediatricians, and OB-GYN's, and midwives make a strong thought for that because it's so, so important. It's critically important. And just to throw out a sobering statistic, as many as 20 percent of women suffer from a perinatal mental health disorder. 

So either during pregnancy or in the period after birth up to a year, 18 months after birth, that's a staggering number of women. And those are women who are reporting, so we have to assume that there are many more than that. So it's really common and it is imperative that women get the health that they deserve.

0:29:11

Dr. Mike Patrick: Yes. And it's not the mom's fault. Sometimes you can get that impression that like: "Well, I just need to push myself up by my boot straps, and I'm doing something wrong." But there is a chemical basis, and a genetic basis, and environment basis for all of these things. It's very complex interaction. And so, when one in five, in a minimum, of moms face this, it's so common that it really is something that just happens.

Dayna Kurtz: Absolutely, a hundred percent. 

Dr. Mike Patrick: Now, we talked about how bringing a baby home kind of changes the culture of the house. You have a chapter where you talk about how a baby can actually draw a couple closer together. Tell us about that.

0:29:52

Dayna Kurtz: So there are a couple of things around becoming parents that are not really talked about, societally. And one of those is the impact of bringing a third person into a family, or a fourth, or a fifth, and the implications of family expansion on the couple. And they are very real. The implications are very real, even when bringing home a baby is incredibly joyous and celebratory. 

It is also a stressor. And it is not uncommon for the couple relationship to be stressed and to take a hit or two. There have been studies that demonstrate a dip in marital satisfaction when a baby comes home. So with all of that in mind, it's really important for a couple, first of all, to be prepared that there's going to be a shift. Not only a physical shift, but an emotional shift, as individuals and also within a couple. And to have tools to be able to navigate through that transition with greater ease. I won't say with total ease because that's not realistic, but, with greater ease. 

0:31:30

And there are things that couples can do. One of the things I talk about is being purposeful in communication. So you bring a baby home, things are different now. Don't assume you know what your partner needs because his or her needs may be changing more rapidly now. 

So checking in saying, "How are you doing?…, "Is there something that I can get for you or something that you need?…, "How are you feeling?… on a regular basis is really helpful, recognizing that sexual intimacy is going to be different when you bring a baby home. And acknowledging that there are lots of things that can be done short of sex to keep the romance alive. 

0:32:17

Think about the early days of courtship and sending little love notes or doing whatever you did to woo one another in the first place, and coming back to that and keeping that connection. So there are practical tools that can be employed that can, not only help a couple through this period of time, but in the long run can strengthen the foundation of the relationship, which ultimately is a real gift to a child.

Dr. Mike Patrick: Absolutely. And that's just so important. And again that really does tie in to: this is a huge change. And whenever there's change, we're going to have all sorts of emotions, and then when you have two people who are feeling a variety of emotions, then that really does spell the possibility that things can have issues and problems. But if you work intentionally to resolve those, then I think this chapter has some great ideas on doing that. 

0:33:17

Dayna Kurtz: Yes, absolutely. And just to piggyback on the idea of talk therapy, I also think that seeing a couple therapist is a real gift to a couple, to a family. I sometimes will tell couples to go see somebody, and things are feeling pretty good actually as a kind of preventive mechanism to have some tools in place for when things get stressful. Because if you can head things off of the past, you're better off than waiting until when things are really hot and heated and then seeking out help. 

Dr. Mike Patrick: I think therapists ought to have gift cards and this would be a great baby shower gift, right?

0:34:04

Dayna Kurtz: That's right. That's a fabulous idea. She kept working on that. That would be great.

[Laughter]

Dr. Mike Patrick: At the beginning of the interview, I'd mentioned that there's a fabulous resources section at the end of the book. And really, there are just tons, I didn't count them up, but there's just lots and lots of resources. And they all have links. Of course, if you have the print copy you can't click on them. But there are tons of URL's and, I mean, there's resources for a lot of the things that we've talked about: acupuncture and acupressure, counseling therapy, mental health services, exercise, the expressive arts, healthful eating, massage, meditation and mindfulness, I mean really just there's a ton of external resources that folks can use. It must have taken a lot of time and effort to pull those altogether.

Dayna Kurtz: It took some time. It was also a great joy to be able to do it. There are always a long list of people who are interested in telling you what you should be 

doing with your child. 

0:35:12

In utero, once he or she is born, and I was never interested in sort of hopping on that bandwagon. But what I was interested in doing was to help each women recognize what she needed for herself to bolster her own mothercare routine. And to that end, I wanted to incorporate a lot of resources because I recognize that one size doesn't fit all. 

There are certain tools in the book that will resonate with some women, and not with others. And that's how it should be. We are all different. What works for one doesn't work for someone else. So pick and choose and leave the rest and make it work for you.

Dr. Mike Patrick: And you had mentioned that this is evidence-based, and I also want to point out, I did count these up. There were 170 references in the book. So this really is evidence-based.

0:36:10

Dayna Kurtz: I did not know that, Dr. Patrick! Thank you for letting me know.

Dr. Mike Patrick: 170. But again, it's very well researched and not just your thoughts and opinions, but really there's evidence to base, to back up what you're talking about in the book. So "Mother Matters…, where can folks find this?

Dayna Kurtz: So you can find it on Amazon, also Barnes & Noble. You can order it direct from my publisher, which is familius.com, and anywhere else my books are sold.

Dr. Mike Patrick: Perfect. And we'll put links to both of your publisher, Amazon, and Barnes & Noble so that folks can find it pretty easily in the show notes for this episode 404 over at PediaCast.org.

So Dayna Kurtz, licensed social worker, certified personal trainer, and author of "Mother Matters…, thank you so much for joining us today.

0:37:07

Dayna Kurtz: It's such a pleasure. Thank you for giving me an opportunity to speak out about mothercare. I really appreciate it.

Dr. Mike Patrick: All right! That wraps up our time together. PediaCast is a production of Nationwide Children's Hospital. Don't forget full length episodes of the program, featuring news parents can use, answers to listener questions, and interviews with pediatric experts are available on iHeartRadio, in iTunes, and on most podcasting apps for iPhone and Android. 

Our landing site is pediacast.org, where you'll find an archive of hundreds of episodes, show notes, transcripts, and a handy contact page to ask your questions and suggest show topics. Also, your use of PediaCast is subject to our Terms of Use Agreement which you'll also find at pediacast.org.

We'll see you next time. And on behalf of all the folks at Nationwide Children's Hospital, this is Dr. Mike, wishing you and your family a healthy day. 

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