"Crying It Out": Acceptable -- or Abuse?

One of the most primitive, innate reactions any mom has is to comfort her crying child. But as we've talked about here before, many babies can tolerate -- and thrive -- with some crying, when their parents thoughtfully decide why and when that might be necessary.

That's why articles like this leave me mystified -- especially when they come from one of my shrink colleagues.  Her bottom line is that CIO is dangerous. She trots out all the old arguments, hailing the Dr. Sears "science" behind her claims, and providing one of the most common misinterpretations of infant research. She makes the mistake that clinical research findings about abused and maltreated babies -- babies who were pervasively denied their needs over the long-term -- should be applied to NORMAL babies in NORMAL families.

The fact is, there is no evidence whatsoever that occasional CIO in typically developing babies causes any damage. PERIOD.

More importantly, there IS evidence that severely sleep-deprived mothers are at much higher risk of developing an already common --and dangerous -- condition: postpartum depression. And PPD certainly CAN lead to long-term damage to both baby -- and the entire family. CIO is a method that, when implemented thoughtfully, can often lead to improved sleep (and health and happiness) for everyone.

Firebombs like those thrown in the Psychology Today article only make the burden heavier on moms. What a shame.

Aloha as always,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

PS: Wow, what a response! After commenting here, please also see the comments developing over at the Fussy Baby Site.

Pregnancy Help: Tips & Resources For Coping With Postpartum Depression

I'm not prone to depression; I'm more of an anxious type, with a tendency to overreact and sweat the small stuff. So when our (4th) baby is born (I'm 30 weeks along now, folks!), I'm anticipating some hormonal upheavals (as well as the excruciating sleep deprivation that comes along with a new baby), but not depression per-se. But as a clinician, I'm very concerned about the high rate of postpartum mood disorders, as well as the tendency of new mothers to ignore or deny their symptoms. Many of you have written to me, with stories of untreated PPD in your pasts, begging me to help get the word out to moms who might be experiencing the condition now. POSTPARTUM DEPRESSION IS ONE OF THE MOST TREATABLE DISORDERS WE KNOW. If you, or someone you know, might have PPD, PLEASE help her to get help...immediately. You can show her this article, which is a nice, straightforward review of the condition, and you can also listen to my 16-minute, free podcast on PPD.

And I know you don't read BabyShrink for a dose of politics, but the situation regarding health care in America is at a point of critical mass. Insufficient numbers of primary care services in this country result in our missing PPD far more than we diagnose it. This is especially true in rural and semi-rural areas -- where many of us live. We MUST reform our health care system to ensure that ALL women are screened for PPD -- and given the treatment that we know works -- for the benefit of their babies, their families, and themselves. And that will only happen if we reform health care to emphasize the prevention and wellness approaches that we know WORK. Treating PPD isn't the hard part. Reforming health care IS. But it must be done. Aloha,

Dr. Heather The BabyShrink

My Most Popular Post

There's no way I could do a one-year retrospective without starting with DadGoneMad's Danny Evans. Danny and his Hot Wife have been there for me from the beginning stages of BabyShrink, and have been endlessly supportive, inspirational and encouraging. When I was freaking out about my lack of technical abilities, Danny calmed me down. "You're doing just fine, Heh. This stuff isn't as difficult as you think it is. It's going to be awesome!" When I had no confidence in my writing, he was my editor extraordinaire. When I lost my way and wondered if anyone would find my blogging helpful, Hot Wife reassured me, gave me suggestions, and never fed me platitudes. I can always count on Sharon to tell it to me straight.

Danny inspired me to go online with BabyShrink as I saw him struggle with depression, and reveal his inner workings to the world in hopes that he could help others in the process. The note he hits with millions of readers worldwide convinced me that blogging can be a powerful way to help others -- and help ourselves in the process.

So if you missed my interview with Danny, here it is. Because of the power of the DadGoneMad readership, and the tsunami of traffic Danny sent me, this is my most-read post ever. Enjoy!

Aloha,

Dr. Heather The BabyShrink

Sleep & Nap Issues: Older Kids and Bedwetting

My most recent group of posts on Attachment Parenting have been fueled by a fire that caught me by surprise. And while I do obviously have some strong opinions to share on the subject, I'd like to get BabyShrink back to where I think we'd all rather be...right smack dab in the middle of a potty-training problem! So without further ado, here's a case that was accidentally published to the March archive, but should have appeared here first: Dear Dr. Heather,

I have a seven-year-old who has peed in his bed forever. I have tried numerous attempts to get him to stop, like waking him up to go, buying him a night lamp, etc. However, none of these have worked, and now I am thinking it might be psychological, or that maybe something is happening to him and I don't know about it. Whenever I ask him why he wets his bed, his only answer is "I don't know". Can you help me? The medical doctors have ruled this out as "normal" and tell me that one day he will stop, but WHEN??? Thank you for your time.

In desperate need of help,

Gabby

Hi Gabby,

I know it's hard, but bedwetting is common and fairly normal for a lot of kids this age, especially boys. There seems to be a genetic component, as well. It's important to not get into shaming him or trying to control the wetting....you have to leave it up to him. He should wear big-kid size pullups and be responsible (or at least help with) changing sheets when necessary, but the motivation to be dry has to come from him. Leave him in the nighttime pullups until he's dry consistently, so there's no pressure or worry about it.

They have those "bell and pad" things that go off when the kid pees, but it seems like they only serve to wake up the rest of the household, EXCEPT the kid himself....since bedwetters usually sleep really deeply. In fact, some doctors think that bedwetters' brains are a little different, in terms of their ability to transition between sleep and wakefulness. Bedwetters may simply not have developed the ability to awaken yet from sleep in order to go to the bathroom. This ability usually develops over time, though.

In later childhood, by about age 7, bedwetters may start to worry about what others think of them, and feel upset that they can't control their bodies at night. Reassure these kids that you will help them to do what it takes to eventually gain nighttime control; help them restrict fluids after 6pm, make sure they empty their bladder right before bed, and limit nighttime sweets, which can have a dehydrating effect. Getting a little extra sleep at night, even as little as 30 minutes more, can help for some. You can also keep trying to awaken him a couple of hours after going to bed to have him empty his bladder. But this should only be done with the child's cooperation and agreement. Let them know that you have faith in their bodies, and their ability to gain nighttime dryness when they are ready. And try to eliminate sources of shaming or ridicule. He's doing the best he can, and shame only worsens the problem.

We worry more about trauma, a medical condition or psychological stuff when there is an abrupt change...as in, they USED to be dry, and NOW...it has suddenly changed. But if he has always more or less been wet at night, and if there are no other indications in his daytime life that things are amiss...well, then, it looks like you're just gonna hafta be patient.

Of course, for something like this, you always need his pediatrician's blessing that nothing else is wrong, but other than that, all I can do is assure you that it WILL stop.

Let us know when that happens, we'd like to hear how it goes!

Aloha, Dr. Heather The BabyShrink

Pregnancy Help: More Postpartum Depression/Postpartum Anxiety Support

Julie Malone of CoolMomGuide launched a support forum for moms with postpartum depression and anxiety. She's also hooked it up to play my podcast on PPD/PPA. If you haven't listened to it yet, hit my podcast button to the right, or listen to it over at Julie's place! A new mom has about a 10% chance of having postpartum depression or anxiety. This is the most common complication of childbirth. Postpartum illness impacts the entire family. Not only does it affect mom's mood, it impacts the development of the baby -- and the functioning of the entire family. Most of us are too ashamed to ask for help -- yet it is very treatable! If you or someone you care about might have PPD or PPA, please listen to the podcast and take the steps to get help.

Parenting Tips: Do We Overprotect Our Kids?

Dear Dr. Heather, I have a daycare question about my 7-year-old twins; they go there on school breaks. My question is whether we are overprotecting them. How do you balance between teaching kids to stand up for themselves -- and protecting them?

Their provider's eight-year-old son is very big and plays rough. Without tormenting or actually bullying them, he sometimes holds them longer than they would like, or accidentally hits them. They say it's not on purpose, and trust me, my son is a tattle-tale, so I'd know. They don't seem at all afraid of him, but they get angry (understandably). His mother's response is to spank the boy after the fact. I would rather have it prevented than punished. On the other hand, I want them to learn to say no if they don't want to play with him, or if he gets rough. We could take them out of this daycare, role- play standing up for themselves and talk with the provider, or leave things as they are if we are over reacting. Both my husband and I were teased and I was bullied as a child, so I can't tell if I'm over or under-reacting to this situation.

I also wonder about playing alone outside. They need to be able to play outside sometimes without close supervision at this age, I feel. Is this wrong, and I'm expecting too much for their maturity level? It seems like in the 70s I was riding my bike around the neighborhood and playing unsupervised at their age.

I would love your advice! Mary H, Grand Rapids MI

Hi Mary,

It's a very complex question you ask: How much do we push our children to stand up for themselves -- and when is the right moment to jump in and protect them?

And you're right -- it is a different time we're in now. Most of us (of a certain age...ahem) remember riding bikes until dark (without helmets, of course), exploring uncharted neighborhood territories with only our pals along with us, and riding without seat belts, in the front seat of the car (in my case, I remember riding in the front-seat FOOTWELL of our VW Bug!)

Our parents think we're nuts about all this safety stuff. We all somehow lived...isn't it good enough for OUR kids? And to a certain degree, they're right. Our society does place an inordinate amount of scrutiny on the moment-to-moment activities of our children. They're not able to run free and just PLAY, and have unstructured "down-time". Free play, just for the sake of PLAY, is really important to the development of children. We schedule them like mad, and then wonder why they have ever-increasing rates of emotional and academic problems. There's just too much pressure to perform, every minute of the day. So you're right to wonder about letting them tackle their own problems, and having some room to grow.

But it is a different time -- we're more sophisticated today about safety issues, and we also understand that bullying can be really damaging to kids. So there is more than a kernel of truth in the approach that says we'd better watch our kids carefully, and intervene when necessary.

So how do you strike that balance?

That depends on your unique kids. Each one will have different needs for supervision, at different ages. Some may need a lot of coaching for how to negotiate complex social situations, like the one you describe. Other kids will have more of a knack for handling themselves. Similarly, their need for constant supervision will vary from kid to kid.

So this means you need to KNOW YOUR KID. What are their strengths and weaknesses, in social situations? What is their judgment like? Are they likely to cave in to peer pressure, or can they hold their ground? Are they leaders, or followers? Impulsive, or analytic? Constantly evaluating your kids in this way will help you know what they CAN handle, and what they still need your help in tackling. And don't worry if they DO still need your oversight; social situations are one of the most complicated things our brains process, and they are mostly handled in the outer cortex of the brain; the last to develop in humans. In fact, it looks like these brain areas are still a work-in-progress until the early 20's. So don't hesitate to step in and help your kids think through these things.

The other issue for you, Mary, is that your kids are in a daycare. Your daycare provider is being paid to keep your kids safe -- and so she'd better be watching them closely. Just for the sake of liability, she must provide them with an inordinate amount of structured, safe care. So SHE may be overreacting to her son's acting out. But I certainly think it would be fine to approach her with your observations about your kids, and let her know that you're fine with letting the kids hammer it out themselves in most cases.

And your idea about role-playing with your kids is terrific. I think that's something every parent should do, starting at about the age of 4 or 5; play-act tricky social situations with your kids. Take examples from scenes you have witnessed with them. Wait until everyone is feeling good and you all have some time. Then talk to them about how they might handle a tricky situation. "Let's play pretend. I want us all to practice what happens when a friend wants to play tag, but you'd rather go on the swings. What can you say to them?" I find kids really get into it, and even start suggesting wrinkles in the scenario. I think you'll be pleasantly surprised to hear them echo the lessons they've learned with you -- when they're out on the playground.

As for so many of the issues we struggle with here at BabyShrink, this is not a "One Size Fits All" solution. But by following your own knowledge about your own kids, you'll find that balance over time.

Aloha,

Dr. Heather The BabyShrink

PS If you're interested in learning more about the importance of PLAY in childhood development, read this great article in the New York Times.

Pregnancy Help: Hope for Postpartum Depression: A Podcast

Tune in to Dr. Heather on Postpartum Depression. Here at BabyShrink, I get emailed questions from all over the world. Many of these make it onto the site; questions about potty training, TV-watching, and poop-smearing (which is my most-read post, if you can believe it!)

But there are other questions; questions too pained and personal to be published. Questions from mothers desperate about the difficulty of having a new baby. Questions from grandmothers, worried about the dark circles under their daughter's eyes. Questions from husbands, worried that their wives (and marriages) might never be the same after the birth of their baby.

In our Lamaze class, we met several couples. You know how it is; you can't help bonding with other couples going through the same trial-by-fire. You stay in touch with some of them. Others fade away, but you always recognize each other, say "hi" at the grocery store, and ask about their child, who is the same age as yours.

There was one couple we met and really liked. But they never seemed to follow through on suggestions of get-togethers. When we ran into them, they seemed fine. But they weren't.

Quite by accident, I found out that the Mom had suffered a terrible, crushing postpartum depression after the birth of their baby. They never came to us -- knowing we were both psychologists -- and suffered alone.

I was stunned to have been so clueless about the pain they went through. Luckily, they eventually got help, and all is well now. But I never forgot about the terrible shame and hopelessness that must have driven them into silence.

I know there are many more of you out there, similarly suffering in silence. I hope that this, my first BabyShrink podcast, can help.

There are many people to thank in the launching of this podcast. Ilima Loomis, who helped me see that a podcast was the perfect vehicle for communicating with new mothers, who are alone and up with the baby at night. Heather Sanders, for my tech-support and visual flair extraordinaire, Glenn Sakamoto, my most tireless and knowledgeable supporter and designer, Danny Evans, who made BabyShrink happen, and his lovely Hot Wife, my BFF and straight-shooting reviewer. I also want to thank the women and families who have opened up the most frightening and painful chapters of their lives to me, to help me understand how best to help others.

I'm also collecting stories of recovery. If you've suffered from PPD and come through to the other side, please post a comment here to encourage others to get help....and send the message that you CAN feel better.

Note: This is a 16-minute podcast. It downloads to your player OR your computer in less than one minute, with a broadband connection.

[Click to Download Podcast Here]

Parenting Tips: Do I Have Childhood "Baggage" About Moving?

Hello Dr. Heather, My husband and I have a 6-year-old son, a 4-year-old daughter, and a baby due in early August. We are moving across the country about two weeks after I have the baby. My husband will be attending graduate school in our new city. We were settled here and I'm having a really hard time with this. The kids are, too, though not as much as me. My daughter threw a penny in the fountain the other day and said "I wish we didn't have to move." My son was really looking forward to starting first grade with his kindergarten friends, and he's quite upset from time to time, although not every day. Currently, we are still searching for a place to live there, and we have just sold our home here, which we all love, and so everything feels so unsettled.  I moved in the middle of second grade and still remember how traumatized I was by it, although my dad had lost his job, so there were some other difficulties going on in my family. I don't want to project my childhood onto them, in addition to the sadness I'm feeling now.

My question is, how do I make this transition go as smoothly as it can for them, and how much does my sadness about this situation transfer to them?

Thanks,

You can call me "Emily".

Dear "Emily",

Did you see my recent post about moving?  I'm getting lots of questions like that at this time of year.

I do understand your concerns; it's a big deal for me too; we moved several times in my childhood, and I am pretty sensitive about the issue. Uprooting your life is no small thing. The familiarity of your routine, the process of making new friends, adjusting to new jobs and schools; it's harder than most people realize. But for young kids, it's a lot easier.

It sounds to me like the challenge is going to be more for you, not the kids. Wow, Mama, you have your hands full! Moving 2 weeks post-baby? With 2 other little kids? Yowza! That's a huge job, physically and emotionally. And your past negative experience with moving is likely to haunt you, to some degree.

YES, your kids totally pick up on your emotional reaction to the move. You (and their Dad) are their main emotional signposts, at least until they get to about second grade. In order to get through this with as little stress as possible, you need to lean on your husband as well as anyone else you can; family? Friends? Clergy?  Don't hold back on asking for help.

Do you have any risk factors for postpartum depression? Please keep that in mind, especially in the 2-week-plus-postpartum period, when PPD is most likely to strike. That much change and stress -- moving and a new baby, with two little ones, a whole new city, as well as your own childhood history of the difficult move...it all raises your risk for depression. Ask your husband to help monitor your mood as well. Make sure you hook up with an OB/GYN as soon as you get to your new city -- and make sure you go in for a checkup. There are lots of resources available online to help you find a counselor if you need one.

Try to look at it all as an adventure. Help the kids see how to handle change in a positive way. Look at this as an opportunity to have a "re-do" on your own negative childhood experience of moving. This is not the same thing as when you were a kid; this is not an unfortunate turn of events that you all have to live with. This is you and your hubby making a decision for the ultimate good of the family. You have a chance to do it again...but different. Better.

Good luck with everything and keep us posted!

Aloha,

Dr. Heather

The BabyShrink

Pregnancy Help: What NOT to Expect From "The Birth Plan"

There is a strain of pregnancy propaganda out there that sets new moms up for failure. It says that unless you “achieve” some particular kind of delivery perfection, well, then…you haven’t quite made the cut, as a Mom. And that makes me angry. It’s in all the standard pregnancy books. Something along the lines of, “Create your own birth plan. Be in charge of your delivery. Don’t let that mean, nasty doctor force you to deliver in some way that’s NOT in your plan. Decide in advance if you want to use pain medications for the delivery….or not.”

What they don’t say is that the birth process is usually so unpredictable that your carefully crafted “Birth Plan” gets left at the bottom of your carefully packed “Going To The Hospital Bag”…that got left at home, in a panic, as you rushed to the hospital.

Now, I’m a recovering control freak, so don’t get me wrong. Anything that’s called “a plan” looks fabulous to me. I did it myself, with our first baby. Here were my rules, when I was cluelessly buying into the notion that I could actually control the birth process by planning for it in advance: No induction. Lovely, inspirational music playing in the background. No pain meds. No pitocin. No c-section. (Oh yeah: no binkies or bottles for the baby either, but that was a different lesson for me to learn, for a different post!)

What happened, you ask? Oh, surely you must have guessed by now. I had it coming to me, big time. The control freak gets hammered. The doctor wanted to induce labor, since the baby was getting big, and she was overdue. But oh no, that was not in my Birth Plan. So we waited. And waited. When labor finally did begin, the early stages went well. But when it came time to push…not so well. I pushed and pushed and pushed…and nothing happened. I stood up to push. I squatted to push. I pushed and pushed for hours. The doctor wanted to add pitocin in order to add strength to the contractions, to help me along. No way. Not in the Birth Plan. She wanted to add an epidural, to relax me. No dice, doc. Finally the doctor had to go and do an emergency c-section on another lady. I had some time. The nurse convinced me to have the epidural and the pitocin, and then our baby was finally born. After four solid hours of pushing.

I was so sore after the delivery I had to sit on two huge pillows for weeks, and I still was miserable. Here are some other examples of “Birth Plans” that didn’t “pan” out:

The alternative-medicine-practitioner who swore she’d never use pain meds, who begged for (and got, with huge relief) an epidural after 12 hours of excruciating labor

The Maui-Hippie-type who arranged to have a birthing bath (with doula) brought to her home, only to need an emergency c-section at 34 weeks

My pain-fearing friend who hoped for every drug in the hospital, but delivered in the hallway of the ER while her husband was parking the car

Now, I’m all for planning, to the extent that planning is possible. But I’m really against the notion of feeding new mothers the idea that there is somehow an ideal birthing situation that they should be aiming for…other than the delivery of a healthy baby, with a healthy mother. Because that sets us up for comparisons, judging, and disappointment. The labor and delivery process is so unpredictable, and so individual and varied, that you really cannot plan for every possibility.

Many of you have expressed sadness, even a sense of failure, because you had to have a c-section. Or if you “caved”, and got an epidural. Unrealistic expectations can lead to big problems. For some, this disappointment can even lead to postpartum depression.

Lamaze Shlamaze; use whatever works.

The breathing techniques I learned in yoga and exercise classes helped me way more than anything I learned in the actual preparation to have a baby. That said, I still pushed for four hours! The only thing that is important in delivering your baby is that both you and baby are healthy. I don’t care if a Martian comes down and performs some kind of weird alien delivery for you, as long as you and your baby are healthy at the end of it.

Did you have any surprises in your delivery? Do tell!

Aloha,

Dr. Heather The BabyShrink

Stefanie Wilder-Taylor: The BabyShrink Interview

At BabyShrink, we are inclined to believe Stefanie Wilder-Taylor is the long, lost lovechild of Erma Bombeck and Carol Burnett. How else to explain Stefanie’s sharp wit, stunning honesty and widespread public appeal? She is the author of two hilarious books: Sippy Cups are Not for Chardonnay: And Other Things I Had to Learn as a New Mom, and her second salvo, Naptime is the New Happy Hour: And Other Ways Toddlers Turn Your Life Upside Down, which will be released this Tuesday, March 25. Stefanie will be on the Today Show that day promoting it. It will be her fifth appearance on the show as a parent/humorist/author.

We happen to love Stefanie. We read her blog, Baby On Bored, where she writes about her three daughters (including four-month-old twins!), her experience with postpartum depression, and about life in general, with the superior brand of humor that has also served well in her stand-up comedy pursuits.

We are naturally thrilled that Stefanie agreed to be the subject of the second BabyShrink Interview.

BabyShrink: Why did you start Baby On Bored?

Stefanie Wilder-Taylor: About three years ago, a few months after the birth of my daughter, Elby, I decided to start a blog since I was a writer who was unemployed due to HAVING A BABY. I'd been told how absolutely wonderful it was going to be to become a mother and had been looking forward to "the blessed event" for nine months. But I was in for a rude awakening. Not only did I have horrendous postpartum depression and not know what it was, but I felt unbonded to my baby, overwhelmed, full of regret and ripped off that I'd been sold a bill of goods that didn't live up to the

{Photo courtesy of Alex Asher Sears Photo, Los Angeles}

expectation.

BS:  You don’t sugarcoat what it’s like to be a mom, and you’ve been very successful in being honest and funny about that.

SWT:  My first book deal came from my blog being seen by an agent and sold pretty straight away. I couldn't believe that anyone would be interested in my decidedly unromantic take on the early days of my parenting experience but they were. Since the book received such a great response, I've found it's my calling to be honest about everything. I'm feeling safe in the knowledge that others out there feel the same way.

BS: Tell me about your parenting approach.

SWT: Of course, the bonding did take place with my daughter and I love her in an obsessive, crazy, stalker, "mommyish" way. But I refuse to believe that there is one specific way to parent. I do believe that one should treat each child as an individual and parent that individual to the best of our abilities. Yes, you are a parent and you have to suck it up and make sacrifices. But I don't think you have to live your entire existence thinking of ways to enrich their little minds and ensure they will get into an Ivy League school. Hey, I didn't even go to college and things worked out okay.

I also believe that all parents lie, so you can't compare your parenting to what others say. They all let their kids watch TV (otherwise how would you take a shower?). They all let their kids eat cookies (unless they're completely crazy and controlling), and they all lose their temper once in awhile. It's reassuring to say the least.

I must also say, I'm in praise of praise! The more the better as far as I'm concerned -- this is in response to some articles saying parents overpraise their kids these days.

BS:  You had twin girls four months ago. Knowing you were prone to postpartum depression (PPD), how did you approach this pregnancy differently?

SWT: I did plan to go back on Zoloft the second I gave birth. When I found out my babies were coming early, I wasn't so sure I would take the meds so fast because I knew I would be trying to pump as much as possible. But, my doctor was fairly insistent that the Zoloft wouldn't affect my milk enough to warrant possible PPD, so I went ahead and started it. I still pumped for a month while the babies were in the NICU and even the nurses there told me the Zoloft wasn't a problem.

BS: Has it been different this time?

SWT: It's been different, yes. My PPD didn't get nearly as bad in part from the anti-depressant and in part because I knew what I was in for as far as sleep deprivation. The first time around I was paranoid that my horrible attitude would chase my poor husband screaming into the arms of another woman or even another house. But this time, we knew it was just divide and conquer -- make it through the first few months and things will get better.  This pregnancy I didn't mess around and I'm so glad I went back on the medication immediately. With twins, I seriously wouldn't have had time to be moping around the house all day.

BS:  Did your preparations and advance knowledge help?

SWT: Yes and no. Of course it helps to know that you've had another baby and survived it. But, part of PPD is chemical and that can't be solved by knowing about it in advance. For me, that required meds -- pure and simple, and I refuse to feel weak because I need a little something to get me through. Hell, I need meds with or without a baby or three.

BS: Did the twins being preemies and in the NICU make things more complicated, in terms of how you were feeling and recovering?

SWT: On one hand, I think having the babies be in the NICU made it easier. I knew they were okay and I had a chance to recover from my C-section and fix up the house before they came home. On the other hand, the fact that I went on hospital bedrest and had these babies much sooner than I thought I would, combined with hearing there was a major growth problem with one of the babies, caused an enormous amount of stress. Even though it's all over, the babies are safe and home and we have help, I realize I’m still recovering from that stress. And it will probably be awhile until things are back to normal.

BS: What can you say to the other moms out there who might also be prone to PPD but are afraid of reaching out to ask for help?

SWT: When I had my first baby, Elby, I thought I was crazy because I was crying inconsolably all day everyday. I felt ashamed that I didn't feel connected to my child and that instead of feeling blissful I just felt sad and, to be honest, angry. But when, due to my inability to censor myself, I told my doctor exactly what I was feeling, he blew me off and said that "having a baby is a big responsibility" and to basically suck it up. So, not knowing better, I did. It took me 14 months to get the help I needed. It wasn't until after my daughter was hospitalized for dehydration that I realized I'd felt stressed for months and needed help. I went to a shrink and was put on Zoloft and I suddenly realized that I hadn't felt normal since my daughter was born. It was like a window opened. Hey, if you're against pills and think maybe yoga or aromatherapy is going to make a difference for you than by all means do Downward Facing Dog or get a Glade Plug-In. But if you really want to fight fire with fire, I say GET HELP.

To read more of Stefanie's thoughts, buy her books (linked above) and visit her blog at babyonbored.blogspot.com

Danny Evans (Dad Gone Mad) Interview

I'm thrilled to bring you my interview with Danny Evans (better known to the world by his super-hot blog, Dad Gone Mad), my good friend of 15 years. Since 2003, Dad Gone Mad has offered a colorful glimpse into bona fide, in-the-trenches fatherhood. With sharp wit and a healthy sense of self-deprecation, Danny plods through the havoc and collateral damage wrought by his two young children. Danny lives in Southern California and is currently writing his first book.

Danny has a lot to say to parents, and especially dads. Becoming a good dad, or at least a “good-enough” dad, isn’t easy. But despite facing the challenges and demons that many of us share, he’s got Hot Wife (one of my best friends) their terrific kids, and a career that is certain to skyrocket beyond even his current success. Danny and I recently spoke about becoming a father, learning lessons from our own parents, and depression.

BabyShrink: Let’s start at the very beginning. Why did you start writing Dad Gone Mad?

Danny Evans: Dad Gone Mad was the lovechild of misery and self-preservation. In 2004 I was working for one of those enormous, Fortune 100 HMOs that everyone thinks so poorly of because their focus in revenue, not health. I hated it. I was a nameless, spiritless corporate drone and I frankly needed to distract myself from those feelings. So I just started writing. About my life, my kids, my marriage, my bowel movements and on and on. Somehow that struck a nerve with people and the site has become what it is now because of their support.

BS: How did becoming a father change you?

DE: It changed everything. Beyond the obvious chaos inflicted on one’s life by a wailing eight-pound shit machine, it thrust me into a period of hardcore self-reflection about my life, my choices, my general readiness to be someone’s dad. I always wanted to be a father, but the moment I became one I wondered if I had what it took to develop this little mass of pink skin and cradle cap into a respectable, confident and driven human being. He forced me to think about the world and the future from the point of view of someone other than myself. That’s an enormous change.

BS: So, you didn’t just start out as a confident father? There were times when you doubted yourself and your ability to be a “good enough” dad?

DE: I don’t think it’s hard for guys to believe they’ll be great dads when the child is just a concept. A fetus. A lot of us are so hard-headed and macho that we think we can do anything if we just decide to do it. We’ll run through a brick wall if we have to. But we're not a particularly emotional bunch, so I tended to believe that being a good dad simply mean warming up a bottle and installing the car seat and, when the child was old enough, teaching it to burp the national anthem.

That all disintegrates when the concept becomes an actual human life. I was intellectually prepared, but the boatload of emotional and spiritual ramifications that accompany such a drastic change in one’s life can be a bit overwhelming. It brought to the surface issues about my relationship with my own dad, my own aspirations in life, my own priorities and learning to live with the all-consuming love I had for this child. Like I said, it changes everything.

BS: So how did you get past the point where all your self-confidence about being a dad started to disintegrate? How did you build a real, not just intellectual, sense of confidence about being a father?

DE: I think it’s more a function of time than effort. As our son grew older and became more interactive, the bond between us began to solidify. He became human, as opposed to just this crying, screaming, pooping blob of skin. But I want to be clear on the difference between connection and bonding. I was connected to him and completely in love with him before he was even born. But like I said, I didn’t know what to DO about him. The connection came when things like eye contact and smiles and whatnot began to develop. Perhaps it’s a bit selfish to say I needed something back from him before I could feel that bond, but no one ever told me fatherhood was easy.

BS: What do you think society expects in terms of being a “good dad”? How are you different than the way your father was when you were growing up?

DE: I don’t know — or care, frankly — what society expects. I know there are certain standards by which people are judged, and by which their children are judged as well, but the bottom line for me is doing what I feel is right for my kids. That’s not meant as a cop-out or a cliché or as a sign that I think I’m better than other dads — because I certainly do not. But they’re growing up in a much more threatening time than I did and it scares me on their behalf. So I expect that I will do not what is popular, not what the dads on Disney Channel do, but what is right for my kids in their worlds. That’s a big enough challenge, let alone trying to fit into some giant cultural cookie cutter.

I think the father question touches on the most important issue in my life. My dad grew up in an environment where he wasn’t valued or shown love, and that certainly colored the way he fathered my sister and me. My dad and I butted heads a lot, and I always had a feeling that I was being controlled. I can understand that; having no control in his youth, he wanted to have all of it in his adult life. I see the opposite developing in my conversations with my own kids, and the challenge is finding that delicate balance of structure and freedom to explore the world.

BS: How would you respond to those guys who DO feel society’s pressure - whatever that may be - to parent their kids in a certain way? Say, in relation to their boys, and boys’ emotions. Just the other day, we saw a guy yell at his six-year-old son for being a “cry baby” when he fell and hurt himself. This guy really isn’t a jerk; he just was embarrassed that his son was crying. What do you say to guys like that who have a knee-jerk reaction to their kids’ feelings?

DE: I think the scenario you described about your neighbor is actually reflective of the kind of machismo and robotic behavior dads have tried to instill in their sons for generations. Boys aren’t supposed to cry or feel or emote anything but toughness, and if they do they’re labeled a “pussy” or some other such thing. It’s my personal feeling — based on my own experience — that this type of social stereotyping is why male depression has become such an issue in our society. Men are not robots; we DO feel hurt and sadness and disappointment. But because it’s not considered kosher for us to articulate those feelings, we swallow them. And for some, there’s only so much of that you can eat before it overwhelms us and makes us (clinically) depressed.

I’ll be honest: I’m not perfect in this area either. My son tends to cry over a lot of things that aren’t worthy of tears, and it does frustrate me. But I try not to call him names or make blanket statements about his maturity level just because he is prone to tears. I prefer to help him understand why he reacts that way, and to give him alternative tools to deal with disappointment. It’s NEVER easy, but I think it’s worth the extra time.

BS: I think that’s a really interesting statement you make about men, society, and depression. One thought in psychology is that depression is anger and aggression, turned inward. So as a father, how do you help your son to be appropriately assertive, but not aggressive, without totally thwarting him? What advice can you give other dads who struggle with the same problem - raising confident, strong and happy boys?

DE: I think being a respected and assertive dad requires knowing as much about yourself and your own biases as you do about changing diapers and replacing a detached arm from a Barbie doll. I think a lot of us tend to parent from the perspective of someone who wants to do better with his kids than our parents did with us. There’s nothing wrong with that idea, but when parenting becomes a competition with our own inner demons, the child is the one who suffers most. I saw those sorts of behaviors in my own fathering early on — the competitiveness and ulterior motivation — and it finally occurred to me that I was robbing my kids of something crucial by behaving that way. Fatherhood is almost never easy, but why make it harder by virtually forcing the kid to be something he’s not.

BS: Yeah, it’s easy to just be reactive to what our parents did: my dad did it THIS way, so I will take a 180 and do it the opposite, just BECAUSE. What do you say to other dads who are struggling with depression? About even recognizing that you had a problem, that this was not “status quo”? About the stigma and shame of getting help, going to counseling, trying meds? How did you get past that barrier?

DE: We talked earlier about the societal norms regarding fatherhood (which I believe to be sort of silly), but it’s obvious that our world’s expectations of men in general make a diagnosis of depression a serious spirit-crusher for men. We learn as boys that men must be stoic, rugged and emotionless. We must ignore pain. On the schoolyard, the boys who performed poorly in sports were labeled a “pussy” or a “faggot”, words intended to convey femininity, which in this context connotes weakness. But we are not emotionless, robotic beings; we are entirely fallible and completely human. We feel sadness, sorrow, fear, angst - but we resist it. It’s shameful.

That's all BS. The National Institute of Mental Health says six million American men -- almost seven percent of the U.S. male population -- are stricken with a depressive illness each year. Sadly, it’s in our nature to hide from it through compulsiveness and self-destructive behavior (e.g., alcohol, workaholism, infidelity, etc.). In my personal experience, the only way to get oneself “better” is to accept that we need help and attack the depression with a shock-and-awe type of assault. There are studies that suggest the best possible course of action is a combination of meds and therapy. That’s the path I chose, and I’m glad I did.

If you feel stressed or anxious or irritable, or even if you just think something isn’t right, address it. Swallow your pride and take an honest assessment of your life and your feelings. Contrary to what we most boys learned as kids, there’s no shame in asking for help. The shame comes from ignoring a problem so long that it becomes a detriment to your family.

For more on this and lots of other great stuff, visit Danny online at www.DadGoneMad.com.

Pregnancy Help: Do I Have Postpartum Depression? Me?

Brooke Shields and Marie Osmond are celebrities who are helping the sufferers of postpartum depression by reminding us that it can happen to anybody. Like all new Moms, they were told that they are supposed to “fall in love” with their newborns the moment they are placed in their arms. But for up to 15% of new mothers, a combination of biochemical changes and other stresses can result in real problems. Women with previous histories of depression, poor social support, or other life stresses have an even higher rate of difficulties. Feeling unloving about the baby, feeling sad, overwhelmed, and irritable; having trouble with sleep and appetite, and feelings of worthlessness or guilt, can occur in up to 80% of new Moms and are commonly referred to as the “Baby Blues”, but when the symptoms last for more than two weeks, it could be Postpartum Depression (PPD), and it’s time to get help. But new Moms are ashamed of these feelings, and often don’t ask for help. They are told to “get a grip”, to “appreciate your beautiful family”, or that “in my day, we didn’t have time to be depressed”. All these reactions make the PPD sufferer feel worse, and less likely to seek help. We now know that babies of untreated PPD sufferers have a much higher risk of developmental delays and other social, emotional and other health problems. Depressed Moms are not able to provide the strong attentive, responsive, emotional comfort and eye-to-eye contact that newborns need for their little brains to grow. Infants really only feel that they exist in the light of their mother’s eyes. If she is distracted by emotional pain, fatigue, and depression, the baby suffers. And as the saying goes, “If Mom’s not happy, nobody’s happy”. The whole family suffers from PPD. So, treating Mom for PPD helps Mom, the baby, and the whole family as well.

Living in Hawaii, as I do, or in other rural areas, can present unique challenges to new Moms. Many families are recent immigrants from far-away countries or the mainland, and are disconnected from extended family and friends who can help in difficult times. New Moms often feel stuck at home with a crying baby, and no energy to leave the house to get support and help. Other Moms are afraid of what people may think if they admit their feelings, based on highly publicized media reports of mothers hurting or killing their babies. A very rare but severe form of postpartum disorder, called Postpartum Psychosis, occurs in about 1-2 out of 1,000 Moms and can include feeling out of touch with reality, rapid mood swings, and obsessive thoughts of hurting the baby. This is a rare form of the disorder, and women with a history of Bipolar Disorder or other more serious psychiatric conditions are at higher risk of developing this disorder. Living on an island or other rural area also means that resources are limited, and it may be difficult to find treatment providers out there who are trained to recognize and address the problems faced by new Moms.

But help is out there, and it works!

For most women, a combination of counseling and short-term antidepressant medication makes all the difference. If you don’t want to try medications, ask your therapist about starting with counseling first, to see if that is enough – often, it is. Also make sure to ask about the importance of getting adequate sleep, exercise, and good nutrition….many studies show that these factors can help a lot! New Moms can ask their OB/GYN, Family physician, clergy, or friends for a referral to a psychotherapist who can help Moms suffering from PPD.

Let’s keep talking about PPD, so that we can have happier Moms, happier babies, and happier families!

Click this link for a great resource:  Postpartum Support International has regular, free, confidential chats, tons of information, and resources for moms, their families, and professionals.