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Ever since becoming a mom, coffee has become a very important part of my life. VERY. The cumulative effects of sleep deprivation are just too real, and sometimes a cup of coffee feels like the only thing that is possibly going to get me through the day.
So, I have commandeered a cabinet shelf in our kitchen to house my caffeine supplies. This is my little shelf of joy. And I have even leveled up to buying primo locally roasted coffee beans and purchased an espresso machine. Yum!
Although I love my coffee and ideally would love to sip on it all day long, I have set some limits for myself. And this is because I am breastfeeding and caffeine can transfer to breastmilk. So when I started brewing myself a second cup of coffee everyday, I started to wonder, exactly how much coffee can I drink while nursing?
While Healthline notes that only a tiny 1% of caffeine transfers from mom to baby, some babies may be more sensitive to those small amounts of caffeine. Additionally, especially premature babies and young babies can not process caffeine very quickly, so it can build up in their systems.
Effects of Caffeine on Breastfeeding Babies
In good news, Medical News Today explains that drinking coffee while breastfeeding does not pose the same risks to a baby as drinking too much caffeine while pregnant.
So, while there is not the same concern of effects of caffeine on breastfeeding babies as babies in the womb, breastfeeding mommas may still notice some negative side effects of caffeine on their babies. Healthline states that excessive caffeine can make some babies fussy and disrupt their sleep patterns.
Exactly How Much Coffee Can I Drink Per Day While Nursing?
La Leche League International explains that breastfeeding moms can safely have 200-300 mg of caffeine daily. And that caffeine is greatest in a person’s system 1 to 2 hours after consumption. And ACOG (The American College of Obstetricians and Gynecologists) recommends no more than 200 mg of caffeine per day while breastfeeding.
Like La Leche League International, the CDC (Center for Disease Control and Prevention) also recommends staying under 300 mg of caffeine/day while breastfeeding.
Interestingly though, another web page on breastfeeding from the CDC leaves one with a little different perspective on how much coffee is too much. They state, “Irritability, poor sleeping patterns, fussiness, and jitteriness have been reported in infants of mothers with very high intakes of caffeine, about 10 cups of coffee or more per day.”
10 cups?! That seems like an awful lot for a person whether they are breastfeeding or not. Medical News Today echoes this more lax perspective and states that even more than 300 mg of caffeine per day is “unlikely to harm a baby”.
I’ll continue to play it safe though and stick to my 200-300 mg of caffeine daily, but it does make me feel better about having my 2 cups of coffee knowing that the CDC is using 10 cups of coffee as a reference point for significant effects on baby.
Another point to consider is the timing of coffee consumption. La Leche League Canada notes that caffeine content is highest in breastmilk 1 to 2 hours after drinking it. So I like to try and drink my coffee either right before I breastfeed, while I’m breastfeeding or right after I breastfeed.
How Many Cups of Coffee is 200-300 mg of Caffeine?
Having some clear numbers in regards to a daily caffeine limit is great, but how exactly does 200-300 mg of caffeine translate to a cappuccino or a cup of drip coffee? After all a Venti Starbucks drip coffee is going to have a very different level of caffeine than a cappuccino with a double shot of espresso.
As it turns out, the answer to the question of caffeine content in coffee is really not all that clear. In fact, there is quite a wide range of answers depending on the source.
For example, the table below shows some numbers from different sources I found online regarding caffeine content in a double shot of espresso. As you can see, these numbers range from 58 mg to 150 mg. So can I safely have 3 cappuccinos a day or should I just stick to 1 while breastfeeding? While the difference may not be significant to many people, it can be important for a breastfeeding momma who wants to follow the guidelines.
The reason caffeine content is not always so clear is because the amount of caffeine in a cup depends on how coffee is brewed and the type of bean used.
Stumptown Coffee Roasters explains that batch brew coffee (like that from an automatic drip coffee maker) has the highest caffeine content, then pour over, and then espresso.
- Batch brew coffee has more caffeine than pour over or espresso because the brew time is longer.
As far as type of coffee beans and caffeine content is concerned, Super Coffee explains that there are “robusta” coffee beans and “arabica” coffee beans. You can use either in espresso drinks, but robusta coffee beans can have twice the amount of caffeine as arabica coffee beans. In good news for pregnant or breastfeeding ladies, Super Coffee states that coffee beans sold in the US are usually arabica beans.
I looked on the two different bags of coffee I have in my cupboard, and nowhere does it indicate whether they are robusta or arabica coffee beans. I find this odd given that robusta beans can have twice as much caffeine (even if most coffee beans sold in the US are arabica beans). It would be nice to look on a label and get some confirmation.
Luckily a quick google search of any given coffee bean company usually reveals what kind of beans they use and some general information regarding caffeine content.
For example, Stumptown Coffee Roasters explains that a double shot of espresso usually has less than 100 mg of caffeine. Meanwhile, an 8oz cup of batch brew has somewhere in the range of 120-180 mg of caffeine. And they explain that differences between different coffee bean roasts (with the exclusion of arabica vs robusta beans) are “minuscule”. Again, the caffeine content is determined mostly by the brewing method.
Enjoying my Coffee While Breastfeeding
In conclusion, I’ll be enjoying my cup or 2 of coffee everyday without worrying about ill effects on my nursing baby. There’s enough to worry about and deal with while breastfeeding (eg Nipple Pain, Milk Blebs, etc…), so I’m glad to at least check this one off my list!
And since there seems to be a lot of varying information regarding just how much caffeine is in a cup of coffee, knowing some general ranges is helpful. It also gives me some additional peace of mind to drink my coffee right before, during or right after breastfeeding. Even though our bodies do a pretty good job of metabolizing caffeine before it reaches breastmilk, caffeine is highest in the system 1-2 hours after drinking it.
I’m also keeping in mind that the caffeine content is largely determined by the brewing method. And the longer the brewing time, the more caffeine there is. So espresso, french press and pour over have less brew time and contact with hot water than drip coffee.
So there you go! I hope this is helpful and I’m wishing all the breastfeeding mommas continued strength and endurance on their breastfeeding journeys.
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For the first month or so after bringing home our new baby, I was surprised that my 3 year old had no apparent shifts in behavior. He seemed curious about and delighted by the new baby.
Fast forward a month and this is when the ear piercing toddler screams started. Yikes.
In addition to this outrageous screaming, other 3 year old behavior problems after new baby came home included;
- Refusing to go to bed
- Refusing to get in the car
- Making angry grunting noises when wanting attention
- Ignoring or pretending not to hear directions
In retrospect, I really can’t blame my toddler for acting out in these ways. Things were a bit chaotic as we all figured out a new schedule and I myself took to “silent screaming” on occasion, along with stuffing my face with cookies as my primary coping mechanism… Perhaps this is why it is hard to return to pre-pregnancy weight after a second child.
So when I realized that my new cookie eating habit was getting a little out of control, as was my toddler, I got serious about figuring out how to help him and the whole family adjust to our new family system.
Resources On Helping Toddlers Adjust To New Baby
I read Dr Laura Markham’s book, “Peaceful Parent, Happy Siblings” and this book completely shifted my mindset and approach with my toddler. 100% recommend. For those who do not have time to do a deep dive into the whole book, I share my takeaways below.
I also recommend following @Transformingtoddlerhood on Instagram for bite size pieces of amazing parenting advice.
So as my husband and I implement many of the suggestions from these resources, we have witnessed huge improvements in morale around our house. Our toddler is back to falling asleep at a decent hour, he hasn’t had a major tantrum in weeks, and for the most part he is listening to us when we ask him to do something. Of course there are days where I want to rip my hair out, but overall, my heart is full and our house is peaceful. Well, as peaceful as a house can be with a 3 year old bursting with energy.
Toddler Regressions After New Baby
While I was initially bewildered and frustrated by my 3 year old’s behavior problems after new baby, I have since realized that they actually make a lot of sense given the massive shift in our family system. With a new baby in the house, my 3 year old started receiving far less attention than he was used to, and of course he was/is going to have big feelings about that.
Romper explains that toddler behavior regressions are perfectly normal after brining home a new baby. Young children can feel like they are being replaced and the shift in their parents’ attention can really throw them for a loop!
So after reading about toddler regressions, I realized that those angry grunting noises I mentioned earlier were my toddler’s attempt at mimicking the baby when she cried out. He was making that same “eh, eh, eh” sound whenever we were shifting our attention to her. So to a toddler, mimicking a baby probably seems like a perfectly good way to win back some attention.
To highlight how stressful a new baby can be for a toddler, I love the way that a HuffPost article on the subject frames it; they describe a scenario where your spouse brings home another partner and tells you that this new partner will now be living in the house and how great it is that everyone is going to love one another. Of course most people would not be happy with this situation. So it is understandable that our little toddlers with their undeveloped toddler brains can’t quite comprehend why exactly we have brought home a new baby.
5 Guiding Principles to Deal with Toddler Tantrums After Second Baby
Toddlers can ignite a special kind of fury and frustration in their parents. As a result, I think it is very normal for parents to start feeling like they need to strictly discipline so that they do not become their 3 year old’s personal minion.
Let’s remind ourselves though, our 3 year olds’ need for power and control is not about them having dreams of ruling over us. Rather, it is most often about them feeling insecure, anxious, fearful or overwhelmed.
And as a result, trying to figure out (aka test) where the boundaries are that are going to help them manage those feelings. A boundary lets them know that things aren’t going to get out of control. They also help our littles know what to expect, which helps build a foundation of stability and security in their growing minds.
So reminding myself that little brains and hearts are prone to overwhelm and that I can help keep that overwhelm in check, usually pretty quickly starts to transform my frustration into compassion and love for my toddler.
So what little ones may need most when they are acting out is to know that their parents can remain calm and in control, and that they will continue to love them no matter what. This approach requires putting some trust in our toddlers.
So rather than assuming the worst of my toddler, I assume the best; I assume that he wants to cooperate and listen, but that he is struggling with some big feelings that are making it hard for him to do so. I assume that when I give him my unconditional love and supportive guidance and boundaries, he will better be able to regulate his feelings and behavior.
1. Keep Your Cool
Keeping your cool and calm while modeling emotional regulation skills for your toddler is no easy task. Especially when you are exhausted from being up half the night feeding a newborn. But, it is something to strive for and work on, both for yourself and your toddler.
Keeping your cool does not mean that you do not have or express any emotions of your own. It does mean though, that you do it in a conscious and regulated way. So rather than angrily yelling at your child when he refuses to listen, you step back and take a deep breath (or several).
And when I notice that I am having a hard time keeping my cool with just a few deep breaths, I put extra effort into some self care at the end of the day, or I step up my independent play basket game for my toddler so that I can have a quiet moment during the day.
2. Be a Fountain of Unconditional Love
In the midst of a toddler tantrum, I remind myself that my toddler is likely feeling insecure and overwhelmed, and that his undeveloped toddler brain is in overdrive and is spinning out. This is when he really needs my love and supportive guidance so he can take back control of the wheel. So I remind myself of this over and over and over.
And being a fountain of unconditional love is simply letting my toddler know that I am there for him, whether it be through words or just a calm and loving physical presence. In the midst of a tantrum, the later is more effective since a spinning out toddler brain really can’t process many words. So in these cases, a bear hug or a warm and concerned facial expression while sitting nearby can mean a lot to a little one that is overwhelmed.
3. Cultivate Empathy
We teach our children about empathy by showing and talking about feelings; both our own and theirs. Cultivating this emotional awareness and understanding is a huge part of learning to regulate big emotions.
Giving a name to emotions and talking about them helps kids feel like their big feelings can be managed. They learn to see that big feelings are not illusive all powerful monsters that are going to completely overwhelm them. They are just normal human emotions that can be felt and talked about. Additionally, understanding emotions is an important part of positively connecting with others.
We can also help explain to our toddlers why they might be feeling those big feelings. This helps young children feel seen and heard, and that is so important for our little ones’ sense of self worth and self-esteem.
Here are some ways we can cultivate empathy with toddlers;
- Use an “I feel…” statement and use a facial expression to match it. In the case of a feeling like anger or frustration, using an “I feel” statement is not about trying to emotionally guilt trip or manipulate your child. Rather, it is about teaching them about emotions, understanding others and understanding how they can positively or negatively impact others.
- Empathize with your toddler and help name the feeling they are expressing (eg anger, frustration, sadness, happiness) and pointing out how their behavior and facial expressions match the emotion. And also narrate for them what happened before, during and after the arrival of a big feeling.
4. Set Reasonable Limits
Sometimes it is not enough to empathize with an overwhelmed toddler. Sometimes, we need to additionally set a limit. This is a boundary that helps toddlers know what to expect as well as what is and is not acceptable behavior. And when toddlers know what to expect and know what we will and will not allow, this may lessen anxieties that are contributing to problem behaviors after new baby.
For example, when my 3 year old started having some regressions around bedtime after new baby, he started kicking his door and then me one night. In this kind of situation I’d say, “You are feeling really frustrated because I am asking you to go to bed. You don’t want to go to bed because you are having so much fun playing together. I can’t let you kick me though, because it’s not okay to hurt people”.
And then I step back or put a pillow in front of me. And if he keeps trying to kick me or looks like he might bust his toe by kicking the door, I give him a big bear hug to help him calm down. Bear hugs help activate the body’s parasympathetic nervous system, which is the system that kicks in when we are in a rest and relaxation mode.
I have only had to physically step in like this twice after new baby came home and things were escalating too much for my liking. For the most part, empathizing, setting a limit verbally and lovingly letting my toddler know that I am there for him is enough to get things back on track. And then we talk about what happened once things are calm.
As parents, we decide what limits to set for our children. Sometimes though, it is hard to know what exactly an appropriate limit is. Sometimes I find myself setting limits when one isn’t really needed, or setting limits that do not really make sense. Or sometimes I am too lax about setting a limit and things get a little out of control.
So whenever I realize that I need to set a limit, I ask myself the following questions;
- Is this limit meant to keep my toddler and others around him safe?
- Will this limit help my toddler feel less overwhelmed?
- Will this limit teach my toddler something important?
If I answer yes to one or all of these questions then I know I have set a reasonable and meaningful limit. Setting a reasonable limit also allows parents to explain in simple terms to their toddler why they set the limit. And toddlers are surprisingly reasonable themselves when they understand why a limit has been set.
And when you combine empathizing with setting a limit, it helps your toddler feel seen and heard, as well as helps them know that you are watching out for them.
5. Maintain a Positive Connection with Your Toddler
In her book on encouraging positive sibling relationships, Dr. Laura Marham discusses how young children want to listen and cooperate when they have a positive connection with their parents.
So often we think that we need to focus on strict discipline or complicated parenting strategies to get our kids to listen, but in reality, maybe we just need to play with them more!
Here is what I do with my toddler to build up our positive connection;
- Schedule time for one-on-one activities or special outings. Baby stays home with my husband and my toddler gets my undivided attention. Outings do not have to be extravagant or excessive. It can be a simple trip to the donut shop, a walk to the park or making a batch of cookies together.
- Use encouraging words and comment on positive behaviors
- Play and play and play more together
Doing Our Best to Help Our Toddlers Adjust to New Baby
It’s so easy to talk about unconditional support and maintaining calm as a parent, but I know it can be incredibly difficult in reality. And I don’t think we ever become a “perfect” parent, but we can always be a better one than we were the day before.
And sometimes no matter how calm, empathizing and loving we are, our toddlers are still going to have the occasional meltdown. We might too. And that’s normal.
What I want though, is to minimize the number and intensity of the meltdowns and problem behaviors. I want my toddler and his little sister to have a great relationship growing up together, and I know that I can influence this relationship by practicing patience and consistency, and giving them all my love and support.
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Yep. Postpartum anal fissures. The Mayo Clinic defines anal fissures as small tears in the lining of the anus.
One of the most painful issues a postpartum woman may experience, yet one of the least talked about. And given that the National Library of Medicine states, “…anal fissures occur in about 40% of pregnant women and women during postpartum period”, I think we need to discuss this issue more openly!
But, it’s really no surprise that we don’t. Any malady with the word “anal” in it, is the last thing anyone wants to discuss. But, I am checking my shame at the door. I want other women who are experiencing postpartum anal fissures to know that they are not alone.
And I also want to share what I did to treat my fissure at home. It took a lot of persistence and patience, but I came out the other side!
It’s important to note though, that in the case of chronic anal fissures, Klein Physical Therapy explains that home remedies may not cut it. Chronic fissures are those that have not healed within 6 weeks.
My Experience with Postpartum Anal Fissures
The delivery of my second child was fast and furious. I went into labor the morning of my scheduled c-section, and things progressed so quickly that I ended up having an unplanned VBAC (vaginal birth after cesarean).
And with this surprise VBAC and all the straining of childbirth came a traumatized bum hole. And this was NOT something I was prepared for.
I had some mild trouble with hemorrhoids prior to childbirth, but nothing prepared me for what I experienced after delivery.
The strain of pushing had caused an explosion of hemorrhoids and swelling in my rear end. And a week later, I realized I had developed an anal fissure.
At first I assumed the pain I was experiencing was related to hemorrhoids, since I had never heard anyone talk about fissures as a potential postpartum issue. But after a friend mentioned that she had hemorrhoids and fissures after childbirth, it occurred to me that I too may have had a fissure.
So I consulted Dr Google and came to the conclusion that yes, what I was experiencing was almost certainly a postpartum anal fissure. My OB confirmed my suspicions at a later appointment.
Postpartum Anal Fissure Symptoms
Every time I had a bowel movement, I would break out in a sweat and cringe through the pain. It felt like I was being cut with a knife every time I pooped.
And for hours afterwards, I experienced a strong and deep burning and aching sensation all throughout my behind. This made sitting, walking, and really just existing miserable. And this was a daily occurrence for about 3 weeks.
And as painful as it was physically, I found myself obsessing over it mentally as well. Because how could I not when I was hobbling around all day with a burning bottom?
How could I heal my fissure? How long was it going to last? The thought of pooping terrified me. How could I find a way to sit comfortably for all those hours of breastfeeding a newborn? Would this nightmare ever end? What if it turned into a chronic fissure? The questions and dread were overwhelming.
Home Remedies for Postpartum Anal Fissures
- Plant Based Salve
- Coconut Oil
- Sitz Soak Salts
- Flushable Medicated Wipes
- Peri Bottle/Bidet
- Stool Softener
What Did Not Work to Heal My Fissure
First I want to share what did not help my fissure. Prior to realizing I had a fissure, I was using Doctor Butler’s Hemorrhoid & Fissure Ointment to help calm all the swelling in my postpartum bottom. I did not experience much relief with this ointment, but I kept using it in hopes it was doing something.
After I realized I had a fissure on top of hemorrhoids after delivery though, I started looking through the reviews of the ointment on Amazon to see if anyone had success treating their fissures with it.
One reviewer commented that the ointment was actually harmful to fissures long term (beyond a week or 2 according to this reviewer), because there is a steroid in it that thins skin over time. And thin skin is the opposite of what you want when it comes to healing and preventing fissures.
This same reviewer also stated that the vasoconstrictor Phenylephrine in the ointment is problematic, because it restricts blood flow. And fissures need a good blood flow supply in order to heal. So after checking the ointment’s label myself, I saw that Phenylephrine is indeed listed as an active ingredient.
And oddly, after further looking into the relationship between anal fissures and phenylephrine, I found some advisory information on the Doctor Butler’s site itself. And Docter Butler’s clearly states, “Oftentimes, hemorrhoid ointments contain vasoconstrictors like Phenylephrine, which should not be used on a fissure.”
So to sell an ointment that should not necessarily be used for fissures and to call it “Doctor Butler’s Hemorrhoid & Fissure Ointment” seems horribly misleading and like false advertising to me.
To be fair though, Doctor Butler’s also explains that hemorrhoids can contribute to the development of anal fissures, so treating the hemorrhoids ultimately helps the fissure. So in theory, using the ointment to treat hemorrhoids should help prevent fissures. But in the case of an already existing stubborn fissure, it doesn’t seem like a good idea to use an ointment with vasoconstrictors or steroids in it.
Products I used to Help Heal my Postpartum Anal Fissure
So after feeling disappointed that the goopy Doctor Butler’s ointment I had been smearing on my bum for weeks was likely counterproductive to healing my fissure, I went on a search for another product that could hopefully help speed up the healing process.
Plant Based Salve
I settled on Thena H-Salve ointment. This ointment is a plant based product with the following ingredients;
Organic Avocado Oil, Organic Coconut Oil, Organic Lavender Oil, Organic Grapefruit Essential Oil, Canola Oil, Organic Olive Oil, Vitamin E, Organic Arnica Extract, Cera Alba (Beeswax White), Organic St. John’s Wort, Organic Oatmeal Kernel Meal, Organic Witch Hazel Leaf (non-alcohol), Organic Yarrow, Organic White Oak Bark, Organic Comfrey Root, Organic Calendula, Organic Arnica, Organic Plantain Leaf, Organic Nettle Leaf, Organic Rosemary Leaf.
So after making sure everything was nice and clean around my bum, I would apply this ointment several times a day. And perhaps it was just coincidence, but I started to notice some very small improvement in my pain level.
So I continued to use the salve multiple times a day, for several weeks.
(Pro tip: Get yourself some finger cots! You can buy a bag of 340 for about $6.00 on Amazon. This way you can apply any ointments with a finger cot on, and then just throw the cot away after use. Makes the whole process feel more sanitary and easy.)
Before getting the Thena H-Salve product, I was just using plain old coconut oil to soothe my fissure. Apollo Spectra explains that coconut oil helps moisturize and heal fissures.
I also applied coconut oil to my fissure area before having a bowel movement to lubricate things. And I think that this was incredibly helpful to protect the fissure during those horribly painful poos.
Sitz Baths with Sitz Bath Soak Salts
I also used an over the toilet sitz bath as many times as I could in a day. I got to where I was doing 3 sitz baths a day, and this correlated with an improvement in my fissure symptoms as well.
I will say though, that when my hemorrhoids were inflamed, I actually felt like sitz baths made me more uncomfortable. I believe this is because soaking my bum in the hot water caused additional swelling as it brought more blood to the area from the warm water. This is great for promoting healing of a fissure, but not so great when it comes to already swollen postpartum hemorrhoids.
So on days when everything felt swollen, I would take shorter sitz baths. It was a delicate balance, but ultimately I believe the sitz baths were very helpful for helping heal my fissure.
And since I was having some success with the Thena H-Salve ointment, I also tried the Thena Sitz Bath Soak. Again, I do not know whether it was just coincidence, but I noticed my fissure symptoms improve even more after starting to use this soak regularly. It really helped soothe the pain more than anything else I had tried.
Flushable Medicated Wipes
So flushable wipes that are gentle on the bum and can also deliver some witch hazel and/or aloe vera to the area are a must.
Peri Bottle or Bidet
I also used a peri bottle with warm water for a while to help with the cleaning process. Most hospitals will provide one of these little squirt bottles after delivery. You can also buy them online or in stores like Target.
And if you are using a bidet, just make sure you are not using a full pressure powered setting on that delicate skin and fissure.
Relief from my Postpartum Anal Fissure
After what felt like a million years and a billion sitz baths later, I started to gradually have less pain while pooping. It was a long process and required a lot of commitment, but the pain from a fissure is very motivating when it comes to doing everything in one’s power to support healing!
I also asked my OB at my 6 week postpartum appointment what she might suggest. She wrote a prescription for Rectiv, which is a nitroglycerin ointment. Aside from being extremely expensive, my hubby who is a surgical nurse said that nitroglycerin is a gnarly drug. So I decided to wait on filling the prescription, and as it turns out, never needed it.
So I am happy to report that after a horrible month with a postpartum anal fissure, I can now poop pain free! I can tell things are still a bit delicate down there, so I am continuing to try and do a sitz soak once a day, but I can’t tell you how relieved I am overall!
And I can enjoy my time with my baby so much more now.
If you are suffering from a postpartum anal fissure, know that you are not alone. And if you are feeling completely consumed and bummed out by your fissure, I think that is totally normal given the severe pain they can cause.
To help other mamas out, feel free to share your experience or any products and strategies that have helped you in the comments below ♡
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