On this episode of the Learn With Less podcast, we were joined by Mercedes Thomas, of Advanced Practice Wellness.
We chatted about:
- Mercedes’ personal and professional background, and how she came to do the work she’s doing today
- What to ACTUALLY expect as a parent, what kinds of topics to collect wisdom about (to prepare for that beginning phase), and how to prepare for that
- Why it’s so important to develop your postpartum plan, not just a birth plan
- Mercedes’s top 3 tips and resources for supporting new parents through that initial postpartum period
Resources Mentioned in This Episode:
Download a portion of Mercedes’ forthcoming book, What In The Baby?! The Modern Mama’s Guide to Confidently Caring For Your Baby and Surviving the Postpartum Period
Mercedes’ classes and services (parenting classes, lactation services, healthcare consulting)
Learn With Less® Classes: “parent & me” classes worldwide (in person and virtual) using the Learn With Less® curriculum
Learn With Less episode with Dr. Katayune Kaeni: Perinatal Mood Changes and Postpartum Mood Disorders
Learn With Less episode with Arianna Taboada: Postpartum Care and How to Get Your Mental Health Needs Met
Learn With Less episode with Kate Turza: What Is A Postpartum Doula?
The Womanly Art of Breastfeeding, by Diane Weissinger
Hypnobirthing (Marie Mongan Method) and Natal Hypnotherapy (Maggie Howell)
DONA International (find and connect with a birth or postpartum doula)
Connect With Us:
Ayelet: Facebook / Instagram / Pinterest
Text Transcript of This Episode:
Ayelet: Welcome! Today, I am speaking with Mercedes Thomas, a board certified pediatric nurse practitioner, certified lactation counselor, maternal child health consultant, and author of What in the Baby: the Modern Mama’s Guide to Confidently Caring For Your Baby and Surviving the Postpartum Period, which will be released in February, 2021.
Mercedes is also the owner of Advanced Practice Wellness and Lactation, which is a private practice based in the Washington DC area, where she provides virtual lactation services, parenting classes, and healthcare consulting to organizations serving families. Mercedes was most recently awarded the 2020 Washington Parent Pick in the category of breastfeeding support. I saw that, Mercedes that’s so cool! And Mercedes has over 12 years of nursing experience working in both the neonatal intensive care unit or the NICU as well as inpatient and outpatient pediatrics.
Her mission is to combine her nursing experience with her experience as a mom, to support families with evidence-based education and resources, which is why I just love everything you share, Mercedes, and I just want to welcome you so graciously to Learn With Less!
Mercedes: Thank you for having me. I’m excited to be here today.
Ayelet: Great. Well, I’ve asked you today to come onto the show to speak to us about, you know, how to prepare for baby’s arrival by developing a postpartum plan. But first, why don’t you just tell us a little bit more about you and how you got into the work that you’re doing today?
Mercedes: Sure. So I’m a wife, I’m a mom of one. I have a two and a half year old son, and my story is pretty straightforward. So as you’ve seen, I have, uh, basically my whole career has been dedicated to babies and pediatrics. It was obvious to me right out of nursing school. I didn’t need to do any soul searching. I didn’t need to do any figuring: it was pediatrics for me and NICU. I thought it was a great place to start. For those that are listening that may not be familiar. A NICU is when babies are born too early or premature, and we help them and their families to grow and learn during that period.
And really, although I’m making it sound a little rosy, it can be a little scary for families. So I, I thought it was a good place for me to start. I got a ton of great experience at a huge NICU down in Atlanta, which is where I started my career. And we learned a lot. We learned from critical care how to take care of really sick premature babies. So that was starting at 25 weeks of gestation all the way down to a lot of education with breastfeeding. We had a lot of multiples too. I’m not sure how that ran, like in terms of numbers with our hospital, but I just remember having a ton of multiples and we were in about a hundred bed unit. So a lot of great experience.
I stayed in NICU for about three and a half years. Went back to get my master’s in pediatric primary care, which is kind of a different token. So I went from being in a hospital setting to being in a primary care setting, or when you would go visit your pediatrician, that’s essentially the role that I was doing, but as a nurse practitioner. So I did that for several years. And then I had my son, we moved up to the Washington DC area and yeah, the rest is history.
We had some troubles with lactation, even though I knew a lot. I thought I had it covered. Our story wasn’t rosy because he didn’t come out and it wasn’t just, it wasn’t just an instantaneous ease to breastfeeding. Taking care of the baby was pretty easy because I had a ton of experience with that. But the, the trials and tribulations of being a new mom, postpartum, and breastfeeding is not going right for you. We had a lot to work out.
And so I had a lactation consultant myself because I felt like, you know, you can have a baby and have all this experience and then your baby comes and you’re like, huh? Like I literally actually have a Facebook post that I’d like to go back and find when I was the new mom. And I was like, now I get what everyone’s saying. When it’s your baby, you don’t know anything, which is absolutely crazy, right. 12 years of a career. And then you’re like, huh, what do I do? How do I do this? It’s just kind of, it’s kind of like a postpartum fog almost that you almost may even be in for up to a year. So it’s totally normal. And I can sympathize with that.
So that’s why I’m doing what I’m doing. I’ve decided to help other families. And I, the real thing is to get out quality, evidence based information to them because there’s so much swirling around. I love mom groups. I’m a part of some of them in my area. And they’re great. They’re very supportive, it’s a great way to network with other moms and that are in small businesses, which is great.
But you have to be careful about the information that you get sometimes because people can mean well, and I don’t think anyone ever means to hurt anybody with the information they give, but sometimes it may not be reliable information that you get. So, yeah, that’s why I’m here today. Um, hopefully we can get you the right information or where to look for the right information.
Ayelet: Absolutely. Well, I just, I appreciate so much what you said about how, you know, you’re, you’re the best parent until you become a parent and you’re like, Holy moly, what just hit me?! So let’s dig right in, you know, also pulling from my own experiences as a parent, I definitely, from on my end, like I had a lot of information and ideas around supporting my tiny human’s development and, and knowing how to connect with my baby or play with my little one and things like that. But there were many areas that I was not, I, I suppose I could say informed around or prepared for, you know, for me it was things like the realities of infant sleep patterns or how to my own postpartum mental health, and so many more.
So I would love to know what you think, you know, in your opinion, professionally, from your own experience, both as a professional supporting your parents and pulling from your own experiences as a new mom, what are some of those things that we can actually expect as, as a parent? What are the kinds of topics that new and expecting parents can collect wisdom about in order to really prepare for that beginning phase?
Mercedes: So I think you need to know your options. That’s first and foremost. So before you have the baby is when the preparation really begins. So you don’t want to get just insane about it and reading 50 books and reading all the blogs and… Pick several trusted resources, maybe two or three, figure out what your mode of learning is.
So is it a book? Is it a class? How do you learn best and figure that out. There’s also even individual classes that you can have where someone can teach you one-on-one if you work best that way, we did a hospital class, which was great. The nurse that taught it, she had a ton of experience in lactation and in both L and D. So I…
Ayelet: Oh, Labor and Delivery, for those who don’t know.
Mercedes: Oh, sorry! Yeah. So she had a lot of experience, and it was fun. It was a fun class. We got to get up and feel things. We got to simulate different positions and comfort measures that my husband could try and so that is very helpful. Getting a class. You want to try to look for those resources that you are going to sign up for, like commit to and around your third trimester. So I would really suggest a birth class that’s first and foremost, because you need to know your options.
Some people out there, they don’t even know where a baby comes from anatomically. So please know where the baby is coming from, coming out of how they’re growing in there and what you need to do as a parent when the baby is on the other side. So after you’ve had your baby, do you want to formula feed? Do you want to breastfeed? I have to insert that I’m a huge breastfeeding advocate, but as a pediatric nurse practitioner, I support all families. So although a lot of my content, a lot of my book is very infant feeding heavy. It’s probably like half of my book. That chapter is like very heavy for obvious reasons because it’s one of my focuses, but I want you to know what you want to do.
So you don’t have to have it all figured out, but know your options. Maybe you want to breastfeed and try and see how it goes. And then maybe you have to figure out another way, if that doesn’t go right for you. You mentioned a lot about your mental health. So you have to figure out what is going to work for you as a parent and whoever your support system is. If it’s your spouse, if it’s a family member, maybe it’s a neighbor. Maybe you’re a military spouse and maybe your partner is not going to be able to be there.
So figure out your situation, get a book, if that’s your mode of learning, that’s – really, people can do that in between working, in between other kids, get a podcast like this one, you can listen and consume that information. If you have another child, it makes it easy to pop in maybe a wireless headset, but get reliable information from professionals in whatever mode you learn best. We talked a lot about when we initially talked about this podcast about a postpartum plan.
A lot of people, they are gung ho about their birth. They know what they’re going to do. They’ve got an eight page birth plan about what it is that they want to have happen. Sometimes those things happen. Sometimes they don’t. Sometimes the nurse may look at it and the doctor and go, what is this? And kind of sit it to the side.
Keep your plans, at least a page. So that can be front and back, but try to keep it to a page, try to really figure out what it is that you want not to happen, right? So we can figure, I think that list is going to be a lot shorter for most of us than what we want to have happen. So maybe you don’t want to have an episiotomy, but these are things again that you’ve talked to your provider about before you’ve had the baby, but these are kind of like reminder bulleted points about what to do.
You get a postpartum plan as well. So don’t just focus on the birth. What’s going to happen after? Who’s going to help you. How do you get to your first doctor’s visit after you have the baby? Can you have someone else come into the doctor’s visit with you with the baby? You know?
Ayelet: Especially right now, as we record, right, during COVID. Yeah,
Mercedes: Absolutely. So things have changed. Know what your pediatrician or your pediatric nurse practitioner, what their office policies are. Are they going to have someone on call? If you need to call someone in the middle of the night and think your baby’s sick or have a question, is someone going to be available to you to answer those phone calls at midnight one o’clock in the morning. If that’s something that you need, then that’s really important to discuss when you’re looking for a pediatrician before, certainly should go in your postpartum plan. Because you would be seeing your pediatric provider, at least maybe on the second or third day after going home from the hospital.
Think about those things. Are you going to go somewhere where they’re able to space out your vaccines or are you going to be on a schedule? These are not things you want to go somewhere and figure out afterwards what you want to do and get into that is going to mess with your mental health and you don’t want that. So figure out what you do not want to happen, right? And then work from there and come up with a plan. That’s going to be workable for you and your family.
Ayelet: Yeah. I love that. I would love to just dig a little bit deeper about this sort of distinction between developing a birth plan versus a postpartum plan. Because again, like you said, if you have never experienced, assuming you are carrying your child physically, and I think a lot of us do focus on birth. What does that look like? What is that gonna feel like? What is the whole experience going to be like? Because that’s something we can wrap our head around, right? And then, and then there’s a baby, or maybe several babies.
So what are some of the things that you would recommend considering? And including in that postpartum plan? I, myself, I had a birth doula, but not a postpartum doula, but I, for my first birth, when we were living abroad, my mom was in town. She was here for, for the first month. And that was incredible and so important for me. And so what, what are some of the pieces there that you would recommend to new parents looking into this?
Mercedes: So you touched on one, definitely. So who’s your village, who’s your support system? So is that support system going to be a family member? Is it someone that can reasonably get to you in a safe way, meaning “safe” because we’re in the midst of a pandemic still. So how can you figure out a plan for if you want a family member that may not be local to you, for them to be able to help you, if you don’t have any family, if you don’t have friends to help you, do you have the resources and the funds to be able to hire out help?
You mentioned a postpartum doula. That’s something that definitely I would look into as a new parent, as a new mom. They are not only really there to help support you, but they’re there to help support you with the baby. So if you need to go take a nap, if you need help preparing meals, they’re there for you to do that. And it’s absolutely great if you have the resource and the funding to be able to do that. If you do not have that, your postpartum plan should most certainly talk about what is going to happen in each situation. Maybe think of a week of what your normal week would look like when you’re doing laundry.
When you’re cooking, try to have a plan for your meals. That’s important. Are you going to have a meal train? Are people going to drop off a meal to you that’s home cooked? Are you going to make a bunch of meals and then freeze them? That’s a really good way to approach it. Are you going to have a family member that’s going to be able to come in and cook for you? After I had my baby, my mom was able to come up immediately, right after we had him.
It actually, I had him two weeks earlier than my due date at 38 weeks. And so it actually worked out that my mom was on her spring break. She’s a teacher. So we wouldn’t have had that additional time built in to her being able to be there for like almost seven days, if not a little bit more. So we didn’t want him to, you know, you want the baby to stay in there. You want to be patient. But I did have him two weeks early. He was still full term, but that was actually a blessing for us.
So my mom was able to come and, I mean, my mom does everything. She cooks. She cleans, she, I mean folds the clothes too. So, she’s doing it all. And so I think the thing that you need to ask yourself is what can you do to help make things easier for you? You may not necessarily need help with the baby, right? Because this is your time immediately after birth to bond, but what can you do so that your time is freed up and so that your body can heal.
You’ve just had a baby that you’ve been carrying around for most women have been carrying for nine months, at least. So what can you do to support that? So that you’re not in a stressful state, in a heightened, stressful state because you’re already emotional and you have hormones that are readjusting.
And that’s another important thing -before you have the baby, right? Who is your support system to know how you normally are, right? So does my husband understand that I’m just a little tearful and sad versus like I’m having scary thoughts about harming myself or my baby. Those are absolutely things that you want to consider before you have your baby. Because when you’re in the thick of it in the midst of it, you may not even, I mean, your partner or your support may be tired too and miss some things. But I think these are real conversations that we need to have.
And not to assume that anybody knows these things. I had, I had someone say they didn’t even know what postpartum depression was. That was at the, and it was a person that I has gone through masters and doctoral program. And they still, so don’t assume people understand that they know that, they may have. That’s why I backtracked to, before you have the baby, did you take a class? Did you read, did you prepare yourself? Figure out at least one or two resources, definitely taking a class about the way that you would care for your baby. If you don’t have any experience with that, realizing a lot of families and people have never even changed a diaper before they’ve had a baby.
There are classes that can go through all of that with you. And infant safety, what to do if your baby is in a scary situation, they’re choking. If they change color, what do you do in those situations outside of calling nine one one, but what can you do before, you know, in the midst of that? So these are really important things. And I, my book goes through those steps of what to do.
I use a method that I used to teach and I go through, from infant feeding from your postpartum plan. I like to call it a postpartum wishlist rather than a plan, because a plan sounds so, like, serious, but I think we need to communicate what you want to have happen. And so those are our wishes, right? What we really want to see happen and yeah, work on that and know that your postpartum, what you, what you’re normally like have a baseline for that with whomever is going to be the closest person to you so that you can measure if you’re not feeling well.
I even have a, a little chart in there to kind of document your feelings for the day. And it’s super easy. You just kind of check off the smiley face. It’s not writing anything if that’s not your thing, but just to kind of check in with yourself and say, Hmm, how do I feel today? And if you’ve been putting in only frowning faces for greater than three weeks, four weeks, and you just can’t figure out how to get out of that, you definitely want to talk to somebody, even if it’s before your six week visit, which is usually when you get back in to see your OBGYN or midwife.
Ayelet: I am going to absolutely link to several other podcast, episodes that touch on some of these things. In addition to your book, Mercedes, which I’m so excited about, and we can let people know that they can listen to a few of those other podcast episodes that inform people about, like, we had an interview with Dr. Katayune Kaeni about postpartum mood disorders. We’ve had an interview with Arianna Taboada about maternal mental health – going, going back to work and setting yourself up and things like that. So we have a lot of great resources that we’ll link to in the show notes, in addition to a link to pre-order your book.
Okay. So we’re going to just take a brief break to hear a word from our sponsors. And then we will hear a few tips from Mercedes about what you can do to prepare for that postpartum period. And we’ll hear about her favorite resources to share it with families.
Ayelet: Okay. Mercedes, we would love to hear your top say three tips for really supporting new parents through that initial postpartum period.
Mercedes: So, we, I talked a little bit about what is going to be an evidence-based resource versus just maybe a personal blog or maybe information that you’ve gotten that are, “this work for me, so…” Yeah, try to stay away from that, right? Because what worked for somebody what even worked for, if you’re not a first-time parent for another child that you have may not work, just because, so, one of the things that I like to do is give out websites that are going to be reliable for families to be able to get the information that they need.
One of my favorite resources for that is Healthychildren.org that’s by the American Academy of Pediatrics. They even have an symptom tracker on there that you can look in there and kind of, you’re not diagnosing yourself, but you’re kind of seeing, is this something that I should be worried about, which is important to know as a parent also napnap.org. That’s the National Association of Pediatric Nurse Practitioners and it’s napnap.org/families. So you’re also going to get a bunch of information and it’s kind of divided by development category. So you’ll get all the way from birth up until 21, which is the range of pediatrics.
If you are looking for a book on understanding how to feed your baby, maybe breastfeeding, a really helpful book is The Womanly Art of Breastfeeding. Like I said, my book also has, it’s pretty heavy on infant feeding and goes through positioning, latching, all of those things. But that book is pretty comprehensive and giving you what you would need to know about preparing to breastfeed.
Take a class. So there’s a lot of resources for that. You can take a class, I even teach classes on infant development. So I think that’s really important to know what’s normal and what’s not – I think a really great example is that most families do not know that a newborn baby, their sleep wake cycle is about an hour to 90 minutes at a time. That’s a shocker to a lot of people because they think, “my baby’s not sleeping. They’re up all the time,” but it’s not just you. It’s pretty normal, the research tells us that.
So you want to manage your expectations, too, as a new parent, because that can really take you in a, in a dark place. You don’t want to go, if you feel like you’re doing it all wrong… Why is my baby not doing X, Y, and Z? This person said their baby was sleeping eight hours by X, Y, and Z time. Developmentally, your baby is going to be waking and it’s for, one, safety purposes and also to feed. So those are really good resources that you can check out to have something reliable. You want to stay away from just a personal blog post that someone wrote, and it’s, it’s just opinion based. And it may not be fact based, and it may not apply to your situation at all.
Ayelet: I love that. And I also want to pull that back into what you said earlier about, like, how do you like to learn? Do you like to learn through listening, right? Whether it’s an audiobook or a podcast, do you like to learn through reading, whether it’s through text, or do you like to learn by watching – whether that’s in a class or watching a series of videos or something like that? And I love that, like you pointed out, you have these fantastic infant development classes, Learn With Less® classes are all over the world, as well, and offered, and you know, all about evidence-based practice.
Even if you’re not like a terribly social person, I think there’s so much to be, there can be so much to be gained by just that power of observing others and seeing the differences actually, because that’s, that’s a piece of it too, is knowing like, all right, well, my baby is not crawling and is eight months old and this baby is, but look like they’re both developing along a spectrum that is a typical progression.
And having that knowledge base of sort of like a facilitator who does have that knowledge and understanding to help you to see that, like there’s a range of typical development and you may or may not fall within that with your child, but like having that community based network of other families who are going through it at the same time is so important. So just another plug for community in general, I think is just such, there’s so much to be gained from that. So awesome. What else have you got for us Mercedes?
Mercedes: So, I don’t want to leave out on us on a scary note, but this is something I like to, for all families to know. And like I said, this is about your support person, too, being able to sometimes recognize things that we may not see. So I did want to talk about the post-birth warning signs, absolutely important for all women [birthing persons] that have just birthed the baby. And basically it’s an acronym and that was developed by a nursing association. I won’t get into the whole acronym, but, so it’s literally just that.
So it’s POSTBIRTH. And so the P stands for pain. These are things you want to watch out after you have your baby. That may mean that you need to contact your healthcare provider right away. The O is for obstructed breathing or shortness of breath. Seizures is the S, T is thoughts of harm. So we talked about those scary thoughts, which is what I like to call it. If anything is, if you ever hear voices, if someone is, if you feel like you’re compelled to do something to harm you, your baby, or a family member, the birth B is for bleeding. So bleeding is specifically soaking heavy soaking of a pad within an hour’s time. So if you see that happening after you have a baby, you’re doing a very soaked pad within one hour constantly, then that is an immediate call to 9 11 and to your provider to get in, to be seen right away.
The I in birth is for incision and healing. If you ever have any reddened area, if it’s burning, stinging, has any like discharge coming from it, that’s another sign that there may be an infection, a rather swollen leg that could mean that you have a blood clot forming, which is really common, and you don’t want that to happen to get up into your lungs. So again, it might just feel like, man, what’s going on? Am I just swollen because of pregnancy or am I just swollen for other reasons? So just watch that. And you just want to monitor that if you see that and elevate your legs up, if you notice that.
A temperature, a lot of people are not really clear on what a fever is. So a fever is a 100.4 [farenheit] and a baby that’s rectally adults. We have some flexibility with taking that. But in a baby that’s a rectal temperature of 100.4. So you wouldn’t ever stick a thermometer in a baby’s mouth. You can do under their arm, but under three months, you want to stick to doing a rectal temperature. And then headache, right? So this isn’t your normal, like just hormonal headache. This can be changes in your vision. This can be, you just are not even functional, not your normal headache.
So these are things that you want to look at, the things that you want to contact your healthcare provider about right away. In some of my mom groups, I see people oftentimes say that they have these things, and they’re not quite sure what it is and skip the mom group and call your provider. Okay. So, that’s very important. You could save your life or someone else’s life by just knowing those things.
Ayelet: Wow. That is that’s all so important. And so good. I had never heard that acronym before. Thank you so much for sharing that. I’d love to know, too, what are some of your favorite other resources to share with families who are looking ahead and who are expecting the arrival of their baby? You mentioned a few amazing ones, right? Healthychildren.org. Yeah, go ahead and let us know what some of the other ones that you would recommend.
Mercedes: So I, I mentioned those earlier, but in specific the types of birth classes that you want to take. So I would look for a certified childbirth educator. So there’s multiple out there. There’s Lamaze, that’s really popular. That’s internationally known. You can also look at – some parents like Hypnobirthing. I’ve never participated in that, but there’s been a lot of good feedback where you’re able to kind of channel your mind into another place, to help with the pain and, hopefully alleviate some of the pain that you may have going into birth.
Ayelet: Anecdotally, I did do that in the UK, the natal hypnotherapy, which is like the same idea, but it it’s, it’s fascinating. Yeah.
Mercedes: Yeah. I’ve heard some really positive feedback about it. So I would explore those. And there are also classes if you decide that you want to have a birth at home, so you may have a midwife, there’s either nurse midwife or a certified professional midwife that you would hire, and they’re able to also come into your home.
DONA International has a really great checklist. If you’re looking to interview someone for a birth doula or postpartum doula, they have a list on there. So you don’t have to reinvent the wheel. You can go to that website and they’re able to get a list that you can use to interview someone that you’re potentially thinking about having help you. So birth doula would be a really important thing.
Really important thing to note is even with COVID, there are virtual services available to you. Please look at those. You can be supported whether in person or virtually – same thing with the classes, there are classes, a gamut of classes that are available to you virtually even if it’s just not even having to do with COVID, it may just fit into your schedule better. Yeah. So look at those and definitely look into getting a doula that would be something really important, a resource, even if you’re a family that may not be able to afford it, there are resources out there to get scholarships and lower costs in many different areas.
Ayelet: Yes. I’ve even heard that some hospitals are providing that as a service, which is incredible. Awesome. And I understand you have a special link that you’d like to share with our audience.
Mercedes: Yeah. So I am going to be giving away a couple of pages of my first chapter. So, check that out and it will allow you to be able to stay in touch and learn about pre-sales. And, also I have some awesome giveaways coming up, so that will allow you to get first dibs on that as well. It’ll include my book and then also some other awesome items. I partnered with a local mom and she does beautiful crochet items. So that’s all I’ll say. And she has, graciously donated a few items. So we’re excited about getting those out to parents. So we have a few giveaways happening.
Ayelet: Excellent. And the link to that will be in the show notes available on this episode. So do not miss that. That’s an amazing gift. Thank you so much, Mercedes.
Mercedes: Thank you.
Ayelet: Thank you for all of your time and energy today, Mercedes, and for everyone joining us from home or on the go, thank you so much. And we will see you next time.
