The Blob Trimester: Baby’s Z’s 1st 3 months

As my youngest (baby Z) is one week shy of 4 months, I find myself fondly reflecting on the fourth trimester haze. If you are not familiar with the term “fourth trimester”, it is common terminology for the first 3 postpartum months. Due to human anatomy and the limitations of the birth canal, human babies are born neurologically premature. Thus my rationale for (very affectionately) calling my newborn a blob.

Let’s put it this way: newborns would never survive in the wild. They can’t hold their heads up, they can’t make meaningful movements with their arms and legs, they can barely see, and they are easily surprised. They can only communicate via crying and they spend a great majority of their days sleeping, drinking milk, peeing and pooing. This is one reason why the fourth trimester is so challenging for new parents: you are suddenly in charge of keeping a small, defenseless human alive. No pressure!

Prety daunting, huh? Couple this with the fact that new parents are chronically sleep-deprived (newflash: babies don’t know the difference between day and night, so you may find yourself pulling a lot of all-nighters), moms are experiencing a hormonal hailstorm (why does everything make me cry? why am I suddenly so angry at my husband? why am I so worried about every damn thing?) and everything you previously knew about yourself has gone out the window (so long hobbies, singular focus on career, social life). Given all of the above, we might as well also call this time period the sob trimester.

Never fear, however. Between 3-4 months, everything gets easier. Yes, there are still challenges (hello 4 month sleep regression!), but your little blob has turned into a reciprocal mini-human who tracks your movements, produces wide-toothed smiles and even cackles with laughter, which makes the experience much more rewarding.

For the sake of preserving my own memories, here’s a recap of Baby Z’s first 3 months:

  • Birth: By far the best of three (third time’s the charm!). Baby X was induced and we barely made it to the hospital with Baby Y. For Baby Z, we went to the hospital as soon as contractions started and were told to walk around until they intensified. We did this for quite some time, even coming home to shower and re-pack, so by the time we returned to the hospital, it was go-time but not baby’s-about-to-fall-out time. I was able to get an epidural (thank you, modern medicine), labor peacefully and when it came time to push, he was out after basically 3 pushes with no tearing involved.
  • Sleep: We purchased a Snoo for this guy, but I wasn’t quite comfortable having him sleep in it from day one. The rocking seemed a bit intense for me and I capped it (there is a function where you can limit the motion) and have kept it as such to this day. In the beginning, he honestly mostly slept in bed with me (my husband would supervise so I didn’t roll on him) and we also lay him down in the Snoo (without turning it on) or put him in the Rock n Play (which he honestly never liked very much and also isn’t safe for unsupervised sleep). We hired a weekend night nanny for those first rough nights and she fell asleep holding the baby on the third night she worked for us! As my husband would say: WTF? YOU HAVE ONE JOB!!! That was pretty traumatic, but baby was okay and we gently told her we were no longer in need of a night nanny. I have to be honest: the sleep was pretty rough early on. He would spend a few hours up each night and I often had no idea what to do with him around 2-5am. My husband was also saving his paternity leave so I tried not to bother him since he had to work the next day. It was pretty intense. I tried to establish an early bedtime for him, but he went to sleep around 11p for a long time! Just recently (close to/when he hit 3 months), he started falling asleep around 9. Early on, he would be up cluster-feeding for quite a few hours (e.g. 8p-11p/12a) but more recently he would do a longer stretch, waking up either at 1a or 3a. So most nights he’ll wake up 1-2 times. The first nap was also the first to fall into place, as it usually does. It’s the one I can actually set him down “drowsy but awake” for! At the moment, we are traveling (good-bye Snoo!) and have him in a Pack n Play. I have to say that he’s not loving it. Last night, he was up every 2 hours, and spent the bulk of the night in bed with me. I’m not sure if this is a Snoo transition issue, a travel/change of environment issue, or the start of the 4 month sleep regression, but I don’t like it.
  • Temperament: When we first brought him home, we were a bit concerned he would be colicky like Baby X. Turns out he was just a normal newborn who wanted to be held, cuddled and carried pretty much all day. With every need attended to/preempted, he’s happy as a peach. He likes tummy time, mat time, play time (songs and the occasional book when he gets his own) and of course still loves when we tote him around all day. So far, he’s a happy, go-lucky baby who can also entertain himself independently (for now, this mostly involves staring at something in the distance).
  • Feeding: Baby Z latched pretty easily. I had one of the nurses remind me of the appropriate position when they are little blobs and can’t hold up their heads, but he quickly got the hang of it. I don’t have him on any particular schedule at the moment. He should technically be eating every 3-4 hours, but sometimes it’s less. Of all the baby things, nursing has always been fairly easy for me. Yes, it was always painful in the beginning. I enrolled in a lactation class prior to the birth of my first, worked with lactation consultants in the hospital the first two times, and also had private lactation consultant visits after the first two were born. These steps allowed me to feel more comfortable nursing. And yes, I worried ALL all of the time whether they were getting enough to eat, especially my first. Was he colicky because he was hungry? Were those tears of starvation? Did he want to nurse all of the time because he wasn’t getting enough milk? I also always pumped just enough and was worried each time about how pumping at work would turn out. Yet I was able to nurse the first two for 15 months and pumped until they were 11 months, using up my freezer stash for months 12 and 13. We’ll see what happens with this guy. I’m a bit worried because I had 187 oz and 300 oz of milk saved up for my first and second, respectively, when I went back to work, but currently have only 55 oz with only a few weeks to go (poor third child!). But I am telling myself that the freezer stash really only helped me to stop pumping a bit earlier, so it isn’t the end of the world that his is so limited. After all, every lactation consultant I’ve spoken with has said you only need enough milk for your first day back (and this is true).
  • Developmental milestones: Baby Z was quick to roll from tummy to back. I know I sound like a delusional mom saying this, but he was doing it month one and still does it to this day. He’s flailing his arms around and kicking his legs much more now. He sees well, follows you around with his eyes, smiles and laughs, has coo-ing conversations, and has started to grip things and bring them to his mouth. Actually, everything is starting to wind up in his mouth – his hands, the carrier strap, teething toys, etc. He can also reach out with his hands to swipe things hanging above him on his playmat or on one of his chairs. His neck is pretty strong and I will often place him forward-facing in the carrier (if it’s not naptime) because he likes to observe the world. He’s actually starting to show interest in food already, which seems early to me, but I’m looking forward to introducing solids.

I honestly can’t believe he’s almost 4 months and am definitely patting myself on the back for getting through those tough first few months. Work is just around the corner (a story for another day), but I feel very fortunate to have had this time with him.

 

Not a sleep whisperer

I spend a good chunk of my day convincing little humans that sleep is a good idea. The other day, as I was prematurely patting myself on the back for getting all 3 kids to nap at the same time, my two oldest decided they were simply going to skip their naps. Of course, they were little (cute) monsters by the end of the day.

Right now, I’m struggling most with my middle child. He has recently started to extensively delay bedtime. He wants ten stories, ten songs, a million cuddles. Every time we acquiesce, he asks for more. After all of the above, he started asking for more lights on (we already have a nightlight). So we started with one, then two (after all, if he was truly afraid we didn’t want to be the mean parents who ignored this). This was enough for a bit but then the demands escalated. He wanted all the lights on but then also wanted us to hold him to sleep. The thing is, we’ve been down this path before. With both of our older children, we’ve always given in, and then regretted it some time later. Who doesn’t love the feel of their young child against them, all chubby cheeks and fat fingers, warm breath on your shoulder, kissing your cheek and saying “I love you, mommy”. I mean, what could be more precious? But it is hard to tack on an additional two hours for bedtime after a day packed with activities and attention doled singularly on the children. That extra times leaves us extra wiped, so we bring even less to our relationship, our home, and our work. And I am a firm believer in children needing to get a good night’s (or nap’s) sleep! When our kids put themselves to sleep, they fall asleep more quickly and wake up better rested.

This is on my hand because my middle child just cried himself to sleep for nap time. He only cried for five minutes or so, but it of course broke my mama heart. In truth, if I didn’t have a third child currently strapped to my chest for his own nap (we are visiting family and my oldest is sleeping in my room, where the crib is), I would probably just hold the kid to sleep. Again-who doesn’t love that feeling? So there’s the added guilt of attention being taken away from him by the baby. But we did try the “cuddle to sleep” method the last two days and he just ended up giggling, playing, and essentially doing everything BUT sleeping.

I reached out to our sleep consultant this week (honestly, at this point I should just have her on retainer) and she advised that if the gentle approaches weren’t working, to firmly return to business as usual. She advised either letting him cry or spending less and less time in the room with less and less physical or verbal interaction. The latter sounds like it would be torture to do, so we have settled to let him cry. Bedtime has improved dramatically (still delays, but not as many demands and we haven’t had tears for a few days). Naptime has proven to be more difficult, perhaps because there is less sleep inertia and it involves taking a break from playtime. I joked with our sleep consultant that I should print out a frame with “When in doubt, cry it out” for the nursery, because this seems to be what we resort to after a few days of failing at every other approach. Her philosophy, at least with our family/children, has always been: if baby/toddler/child is dry, fed, healthy, has gone to the bathroom and if you’ve addressed all of their fears, questions, and concerns, then there’s no reason why they shouldn’t be able to sleep by themselves.

I recognize this is a very Western philosophy. It is very foreign to my mom, who always had children in bed with her. In truth, our youngest (almost 4 months now) has spent more time in bed with me than I’d like to admit. This is mostly because I’m so exhausted when he wakes to feed that I accidentally fall asleep with him. I sleep alone (poor hubby has been banished to the guest room for this reason), with no extra pillows, blankets, or throws. I wear warm clothing so as not to cover myself and make sure the baby’s unswaddled and in the very center of the bed. It always fills me with great trepidation, despite all of these measures. For us, the main reason we haven’t intentionally shared a bed is fear. The second reason is that it’s been really important for my husband and I to have adult time after the kids go to sleep. We are not perfect in this regard, as I often allow housework or work work to bleed into our time, but it is theoretically more possible if there is no child in our room.

I’ll end on a positive note: my 4 year old has become a much better sleeper with time. He was our crazy colicky baby who refused to sleep on his back and had us up every twenty minutes as a newborn. We held him to sleep for naps until he was almost 3! But now this very same child will tell us he’s tired (before nap or at bedtime) and then go to sleep by himself. He sometimes needs a bit of encouragement when it comes to changing into PJs, but then he’ll happily settle in under the covers with his stuffed animal and put himself to sleep with no extra support. If you had told me this four years ago, I would have never believed it. It’s amazing how children change over time.

One of the greatest challenges of parenthood has, for me, been sleep. There are a good days and bad days, but definitely lots of sleepless nights, sleep regressions, and changes – potty training, separation anxiety, nightmares, travel, teething, etc., etc., etc., which seem to knock the schedule right off its track. But one day, these little humans will become (really) big boys, and then I will probably be nagging them for sleeping TOO much. Funny how things work. For now, I’ll try my hardest to revel in the baby snuggles and to try to focus less on the naptime/bedtime snuggles. However, I will never sleep when the baby’s sleeping, because when else would I get anything done!?

The Village

I was recently surprised to learn that I had lost my desire to move back to New York. As recently as a few months ago, when people would ask me whether I envisioned myself staying in California forever, I used to respond with “Probably, because I don’t think I can convince my husband to live anywhere else.” Now I pause, because the answer is that I can’t quite imagine living anywhere else.

When and how did this drastic shift occur? I left New York when I was 18 years old. To be honest, I was thrilled to do so. I lived in the suburbs outside of NYC, had moved during my freshman year of high school (NOT a good situation), and was excited to “discover the world”. I floated around New England for college and medical school, and spent a requisite year living and working in NYC. When it was time for residency selection, my husband (also an East Coaster) and I were adamant that we needed to get out of the cold. He wanted to work in California and I was game to live in California and so I applied and was accepted.

We flew to the West Coast with one suitcase. (I can imagine myself telling this story to my children one day, at which point they’ll roll their eyes at this particular sentence.) We had less than $5,000 combined in our bank accounts. My husband was unemployed (“between jobs”) and I was days shy of starting my intern year. We rented a small unit in a house of four units total and decked it out in IKEA furniture. My husband bought a Samsung flat screen TV which we still own 8 years later. We weren’t married yet but reasoned that we needed to move in together because the rent was too expensive to swing two apartments. When he proposed to me, the engagement ring was the most expensive thing we owned. We didn’t have much but we were so happy.

In the past 8 years, we’ve spent 5 of them living together (we were apart for 3 years while I completed my residency), got jobs, got married, bought a house, tucked away money for retirement, had 3 kids, tucked away money for college education, and created the life we always wanted – one we could have never quite imagined when we landed in California in 2010.

Yet there were bumps in the road. I started my first job out of residency in 2014 and had a baby 3 months later. I’ve had 2 additional children since. I had no idea how difficult it would be to raise a family away from our families. It often felt impossible. I vividly remember those first colic-filled weeks with our oldest. We had help for a few of them but were on our own most of the time and I cried constantly. When I went back to work I was convinced there was no way I could juggle motherhood and my career without help. Most of our acquaintances at the time were my husband’s friends and, although mostly good people, they just weren’t my people. Is that a terrible thing to say? I hope not. You know that feeling when you just click with someone? When you can tell them anything – lay all your cards on the table, be completely vulnerable – and they will accept you wholeheartedly? Let’s just say I didn’t get that vibe from his people. And that’s what I struggled with the most – not having someone I could text frantically when our first was up at all hours of the night, not having someone I could ask to watch him for an hour while I took a breather, not having a tribe to commiserate with.

So I put myself out there. I met a group of women I now call “The Mommies”. My first mom friends! Now, the group has changed dramatically these past 4 years as moms move away and group dynamics shift, but we have each other’s backs, an ongoing calendar of events, never-ending birthday parties, and most importantly the knowledge that we have known each other since our little ones were just months old. I rekindled friendships with people from my intern year and became closer to co-workers with young children. I met more moms through preschool and subsequent “new mom” groups as more children joined our family. We acquired a network of people who have helped us out in some capacity around the house – gardeners, painters, nannies, cleaning crews, etc. Today, our nanny saw that I was clearing out our shed for some upcoming work and (unsolicited) called her husband to see if he would be willing to pick up all of the items we were throwing out to save us the hassle. He came by an hour later and I was so happy I could have cried. With such distance between ourselves and our families, these random acts of kindness mean everything.

I also have to admit that there are serious perks to living in California: great weather, tons of diversity, generally liberal politics. It’s also true that we both love our jobs and our house. But the game-changer for me was truly the evolution of our community and little village. We’ll see how we feel as the kids get older and schedules become more demanding but, for now, I am truly loving where we live, and this is the first time since 2014 that I’ve been truly able to say that.

Chaos coordinator

I’m 3 weeks into having three children (one day I’ll get around to sharing the birth story, but for now I’ll just say: the baby was not born in the car and I was able to get an epidural, which is seriously the best medical innovation to date) and it is absolute chaos.

Let’s discuss some of the ridiculous things that have happened since bringing our baby home:

  • Our middle child, Y, bit new baby’s Z finger when he was only a few days old. Seriously kid!? Fortunately Z was okay, but it was a clear sign that Y was not going to warm up to him easily. We’ve since made sure that Y has a bit more one-on-one time with everyone, and we continue to call him our baby. He has since only given him lots of kisses, so perhaps our approach is working.
  • Z was not sleeping at all the first few days (and, truth be told, is not sleeping great now, but I’m giving him the benefit of the doubt since he’s still a newborn). I should clarify: he would sleep just fine as long as he nursed the whole time and/or I held him. We ended up hiring a night nanny, who came highly recommended by two friends. We had her spend 3 weekend nights with us so we could be as well-rested as possible for the big kids during the day. It was incredibly helpful (even though I still had to wake up every 2-3 hours to feed the baby), but on the third night we caught her catching a snooze with our baby on the couch next to her! As my husband would say: “Seriously!? You have one job.” So we don’t have a night nanny anymore. But Z is cooperating and starting to sleep a bit at night. We can usually get one or two 2-2.5 hr stretches. I believe there was one night when we got two 3 hr stretches. Glorious!
  • I took Z out with me to a store the other day, when he was 2 wks old. I’ve been trying to lay low and not exert myself too much (also trying to keep Z away from germs), but I have unfortunately had a few time-sensitive errands to run. On this particular day, Z bawled his eyes out in the car (his M.O.). After we parked, I was trying to load up the stroller quickly so that I could pick up the wailing newborn. I thought I had closed our SUV’s trunk, and didn’t see that it had ricocheted back to half-open due to an umbrella stroller wheel sticking out the back. Unfortunately, I wasn’t looking up when I walked behind the car again and I ran straight into the side of trunk door. It was a pretty good blow, but when I touched my hand to my head to feel it, I was still surprised to see my hand coated with blood. OMG. My husband was at work, my mom was at home with Y, and I was bleeding from my head in the middle of a parking lot 30 minutes from home, with a wailing newborn still buckled into his carseat in the car. The whole thing was ridiculous. I ended up keeping my appointment at the store (I’m sure the woman working there thought I was insane coming in with a newborn with a blood-soaked Kleenex pressed against my head, asking whether I could use their bathroom to clean out my wound). I called one of my surgical colleagues right away and asked whether she had time to squeeze me in that day because I was pretty sure I needed stitches. And that’s how my quick errand turning into an afternoon spent in my clinic getting stitches. Silver lining: at least this happened on my scalp, where the scar will be hidden by my hair, and not on my forehead!
  • Negotiating 3 sleep schedules has been tough. As I mentioned, Z is not sleeping great. X has woken up really early a few days (e.g. 5:30am). I wouldn’t care if he could just sit quietly in bed, but he usually uses the restroom and calls someone to wipe him (so that’s one adult who needs to wake up) and then he goes back into his room, usually noisily, and wakes up Y (since they are now sharing a room). I also wouldn’t care about this if Y was a morning person, but he likes to sleep in, so this automatically makes for a cranky pants morning. Y still takes long naps (3 hours) so we pick him up after a half day of “preschool” and let him snooze at home. Honestly, it would be much easier to have him stay at school all day as opposed to driving to this school three times per day (drop-off for both kids, pick-up for Y mid-day, pick-up for X end of day), but the times we’ve tried a full day of school (including today) have been an absolute disaster. Y is a zombie and in a TERRIBLE mood, so it’s honestly more miserable than taking an extra drive mid-day. Just a few nights ago, I had finally settled Z out of my arms and into the Rock ‘N Play. Then, all of a sudden, I hear crying coming from X&Y’s room (it’s around 9:30pm so this shouldn’t be happening since they had fallen asleep some time before). I check out the Nest Cam and see that Y is standing up in his crib bawling. Oh no. If he wakes up X, we’re going to have a problem. And why is he up crying!? I rush into the room to make sure he doesn’t have a dirty diaper or a fever. Negative on both counts. I carry him out of the room to comfort him and then tell him calmly that he’s going to have to sleep in his crib tonight. That doesn’t go over very well. Ultimately, I let him cry it out in his crib and spend the whole time praying that X doesn’t wake up. By some miracle, he does not, and Y settles to sleep after a few minutes. And, of course, Z wakes up just a bit after that.
  • Family outings are a nightmare. I’m serious! It takes forever for us to get out of the house and we seriously need a rolling suitcase as opposed to a diaper bag whenever we leave. My mom has been in town, so right now we have a 1 adult to 1 child ratio. However, when she leaves, we are going to be in big trouble! X and Y always seem to dart in different directions. Z has blowouts literally only when we are out somewhere! And without fail someone will throw a tantrum.

In sum, things are crazy. I feel like I am barely surviving when all 3 kids are home. That being said, I would choose to have a third child a million times over. I love the chaos and would honestly love a fourth child (crazy, right? Pretty sure there’s no way to convince my husband that this would be a good idea). I also know that these days are fleeting. In just a blink they’ll be teenagers, looking for ways to escape into their rooms. So I’ll enjoy the endless cuddles, each boy vying for mom’s attentions. And I’ll even take the tantrums, tears, and sibling rivalry.

How I do it

I can’t get into Instagram. Like other social media platforms, I follow a handful of friends, family, and acquaintances and post very sparingly. I don’t post a lot because I’m fairly paranoid about privacy (all I can say is: thank goodness it did not exist when I was in high school – I would be mortified to have those memories immortalized) and I honestly just don’t have time for it. I’m constantly in awe of people who capture and share so much of their lives. How do they manage to do it? I have no idea.

I worry about young women following certain “influencers” (what does that even MEAN!?) who post regularly on working motherhood, work-life balance, etc.  These influencers leave out so many important details of their lives when they post. They talk about being imperfect but then always post “perfect” photos. I couldn’t believe it when I learned that some people hire photographers to take their pictures! What happened to authenticity!? How can these people write about “keeping it real” when someone’s following them around with a camera? I’d love to see more influencers post while wearing yoga pants (not actually used for exercise, mind you) with their unwashed hair pulled up into a tight bun because they haven’t been able to escape for 15 minutes to take a shower in 3 days.

These influencers also rarely address the role of privilege in their lives. Did they come from money? What role do their husbands play in their financial success? Have they faced any hardships? What does “hustling” mean in the context of not really having to work?

I would be a terrible Instagram influencer because I don’t sugarcoat things. I am very upfront when I give advice to young women who ask me about work-life balance. So I’m writing this post today to share the authentic side of working motherhood, how I’ve been able to balance both aspects of my life, and how I’ve learned to be at peace with my decision.

1. How I decided to keep working full-time after my first child was born: I actually didn’t have a choice.* This is not a glamorous answer, but it’s the truth. My husband supported us through medical school (full disclosure: my parents also supported me quite a bit through medical school, before my husband and I were married) and residency. Once I graduated and had a real job that brought in actual income (sorry residents!), it was my turn to support our family while my husband started his own company. I came home from the hospital after my son was born and announced that I never wanted to go back to work (I loved my job and still love my job, but those postpartum hormones and attachment to your newborn are strong forces!). My husband, who is very loving and supportive, looked at me and said that wasn’t an option. Ultimately, he was right. We had a mortgage, lived in a high-cost of living area, and both had to hustle to set our family up for success, because we were not about to inherit millions of dollars any time soon (or ever, having both come from humble backgrounds). So 4 months later, I went back to work.

I vividly remember new moms I met during maternity leave saying things like: “I can’t imagine going back to work and leaving my baby with a stranger”, “babies need their mothers”, etc. and feeling so incredibly hurt. I never once congratulated myself in front of them for going back to work, or made any arguments as to why working motherhood was “better” (is there a better? I don’t think so – I truly believe every parent tries to do their best within their means). Although I was hurt at the time, I think they were trying to rationalize their own choices, and I don’t fault them for it. I now have almost 4 years of perspective to see how that decision has impacted their relationships and careers, and I also see that our kids don’t differ in any appreciable ways, despite mine having had >1 caregiver. So the first thing I tell young women is this: you have to do what’s best for you and your family. How much choice you have in the matter will depend on many personal circumstances, but you can never go wrong if you love your child and try your best. And don’t listen to anyone who tries to tell you there’s only one right way to do things – they are trying to convince themselves, not help you. 

2. How I “do it all”: Today, a weekday, I organized a play date with a close friend and her kids. I ran errands, prepared dinner for everyone, read a story to my son’s preschool class, and spent some time calling patients with results, speaking with other doctors about complex cases, and working on administrative projects. My friend sent me a text saying “Wow – super mom! You crushed it today!”. Yes, I was pretty productive, but I also have a lot of privilege and extra help, so it’s really not that impressive.

First of all, I have a very rewarding and flexible job. I love what I do and who I work with, I have great benefits, I have a lot of autonomy, and I have the opportunity to do some work from home. I’m not in the hospital taking 24 hour call and I’m not working a dull, minimum-wage job. So how did I get here? Well, I have always been driven, but I also had parents whose main goal was to set me up for success. They were present, supportive, loving, and sacrificed their own livelihood to put me first. This allowed me to focus on my education, to attend an Ivy League college, and to ultimately graduate from medical school and enter into a competitive specialty. I worked hard, but I also won the lottery by being born into an amazing family, and also encountered a lot of luck along the way. There are many bright and promising people who are not so lucky, or whose lives are transformed by tragedy. Second of all, I have an amazing husband. He is very affectionate, closely involved with the kids, does groceries 90% of the time, and cooks pretty much every night (my cooking tonight was indeed an anomaly). He has also been very successful in his career, and this has set a solid financial foundation for our family. I truly won the husband jackpot. Finally, we can afford to hire help. We have our oldest in a nurturing, full-time preschool (and his brother will join him in a few weeks) and we also have a full-time nanny. Without family in the area, I can’t imagine doing this without our nanny. She has been a true lifesaver, taking great care of our kids, tidying up our home, doing our laundry – I could go on and on. And because our jobs are flexible, we don’t utilize our childcare resources to the max, so we are still able to be their primary caregivers.

Now, there are certainly many people who are much better off than we are, and our arrangement may also not work for everyone. But the advice I usually give is this: split the household responsibilities with your spouse. If you can afford it, outsource household work you don’t enjoy or find fulfilling (e.g. washing dishes, cooking, etc.). If you can’t afford it or can but wish to reach financial independence more quickly, figure out what you can do without. Can you ignore the laundry piling up for a few days? Can you leave dishes in your sink? In sum: try not to sweat the small stuff so that you can focus on what you truly love, which for most people is spending quality time with their kids. Doing it all is really just a matter of how much you put on your list. Put less on your list and you’ll automatically do much more!

In sum: I don’t think my situation is all that impressive. I continued working because I had to (but 4 years later am so incredibly happy that I did, because I truly do believe I have the best of both worlds now) and I “do it all” because I was privileged enough to have been set up for success and I can outsource some household tasks and afford quality childcare. And this is precisely why I would have a terrible public Instagram account – the truth is not very awe-inspiring, but I do think it’s important for young women to hear it so they are not discouraged by “perfect” lives on social media.

*In truth, there were things we could have done to make my staying at home feasible. My husband could have stayed at his well-compensated job, we could have moved to a lower cost-of-living area, we could have relocated closer to family. Ultimately, however, we chose to remain on this trajectory because we liked where we lived, I had a great job, and my husband had a lot of opportunity with his new endeavor. It was not an easy decision, and I shed a lot of tears, but I don’t regret making this decision.

 

A-holes on airplanes

My kids were much better behaved on our trip back and we had a much better flight with an extra set of hands (thanks to my husband who flew out just to fly us home). I should mention that the flight ended with my oldest projectile vomiting, which was not, as I assumed at the time, motion sickness, but was actually a horrible GI bug that he is still grappling with and that I am desperately hoping no one else in our home contracts. But that’s a story for another day, because first I’d like to talk about a-holes on airplanes.

I have flown a ton with my kids in the past 3.5 years. I have been fortunate to encounter nothing but gracious people, who have tolerated some tears, tantrums, and other infant/toddler behavior on our flights. The kids are actually great travelers, and I think this is part of the reason we have never encountered animosity on airplanes – they don’t scream/shriek the entire time, they are not rude, and obviously they are incredibly cute and win everyone over (biased mom here). Part of the reason we get a lot of sympathy is also that my husband and I always come equipped to entertain them, and we hustle the entire flight to keep them as calm as possible. We don’t let them run around willy-nilly, we are mindful of how their movements and noises affect surrounding passengers, and we try to have new/engaging/interesting items on hand to pique their interest.

However, we did meet our first disgruntled passenger on this week’s flight. We boarded the airplane first, and barely noticed an overweight, older gentleman board a few minutes later. He was seated two rows in front of us. Because we had boarded so early and the majority of seats were empty/passengers were still getting situated, I let my youngest sit on my oldest, start hugging, and begin to play as I set up our seats (safety harnesses, waters, books, wipes, etc). They were basically hugging and making noises. My youngest was saying things so that my oldest would copy him, and they were having a blast. Cue grumpy old man: “I’m sorry, but that is unacceptable behavior.”

I was taken aback – was this man talking to me? It sure looked like he was staring in my direction, but what could be unacceptable behavior? Well, never fear, he proceeded to explain: “It is unacceptable for you to let them hug and yell and cause a commotion for everyone.” First of all, the cabin wasn’t even 25% full. Second of all, who gets angry at playing toddlers who are literally just sitting in their seats!? We hadn’t even been on the airplane for five minutes! If this guy was already annoyed, he was definitely in for a treat during the 5+ hour haul.

I was honestly speechless. I was also slightly embarrassed (was I an oblivious parent? Had my kids actually been loud/obnoxious and not cute/endearing?) and wanted to stay calm for my kids. I was also worried that he would start cursing in front of the kids or become otherwise belligerent. And I didn’t think there was much point in arguing with someone who would yell at a pregnant lady traveling with 2 toddlers – what were the chances he would honestly empathize? Plus you see all of these viral videos these days of families getting kicked off flights for the smallest things, and I did not want any trouble on this flight. My husband, who was sitting across the aisle from us, had zero of these reservations.

He got into it with this man, telling him not to talk to me like that, asking if he had ever flown with children, and on and on. The grumpy old man yelled something back about common courtesy/being nice and I pretty much zoned out and tried to distract my kids, while simultaneously asking my husband to calm down. It was an ugly scene and I was not in the mood for confrontation.

I felt pretty crappy the rest of the flight. We worked as hard as we usually do to keep the kids calm, but it felt different – like we were somehow acquiescing to his demands. I was grateful that both of them napped and were generally in stellar moods. I also felt very grateful to have my husband there. I don’t know how the scene would have played out if I were solo, except that perhaps more passengers would have come to my immediate defense. A few gave us smiles of solidarity after it happened, told us the grumpy old man passenger was a jerk after the flight landed, and also commended us for having well-behaved kids. We were grateful to those people for their small acts of kindness. And a special thank you to the passengers across the aisle from us who handed me a barf bag when they saw my oldest vomiting and me searching frantically for something to contain it.

And if you find yourself on an airplane with parents who have young kids, try to have some empathy. I get it – you paid for your flight, you’re tired, you want to sleep/read/watch a movie/etc. But guess what? It’s not a private jet. Most (I can’t speak for all) parents are trying their best to keep their kids contained and respectful, but kids aren’t robots. These families have also paid money for their seats – in our case, we purchased four of them – and have the right to talk, walk around within reason when the seatbelt sign is off, and so on. And no matter how little you think you’re relaxing by the kids being in your mere presence, the parents are relaxing 100% less trying to entertain them. Moral of the story is: try not to be an a-hole on airplanes. After all, isn’t that what common courtesy is all about?

Toddler tears

Tonight is our last night visiting our families, who live on the opposite coast. We fly out here often (and vice versa) so that our children can still be close to their grandparents, even though we live far apart.

I tucked my kids into bed tonight and reminded them that I would wake them up early in the morning (“tomorrow”) to fly back home. My oldest seemed to process this information quickly, but then called me back into the room a minute later. “What does tomorrow mean?”

“Tomorrow will be when you wake up,” I said. His eyes welled up with tears and his lower lip quivered. “But I don’t want to go home!” he said. “I like being at grandma and grandpa’s house. I don’t like our house and I don’t like my school!” For reference, he is 3.5 years old and has never expressed a dislike of our home nor his preschool.

His words broke my heart. The back-story here is that I myself often wonder if we’re doing the right thing living far away from family. I have discussed moving back home countless times with my husband (ad nauseam really) but he’s adamant that we are building a better life for our kids by staying where we are, and in many ways I think he’s right.

I didn’t feel a desire to flock back home until after I had kids. My husband and I both left home at 18. We come from involved and attentive families who sacrificed their own quality of life to provide us with everything we needed, and we subsequently both attended the same Ivy League college. After college we went our separate ways but found ourselves living in the same city (not near our parents) a few years later. 9 years after college, we moved together to the opposite coast because it’s what we wanted to do. We had both flirted with the idea and thought it would be a great time to try it. We ultimately stayed because my husband achieved some career success locally, even though, had I been single, I would have likely left the state. After our first was born, we stayed because we had a house and great jobs, and we have stayed since for similar reasons: it’s comfortable, we have short commutes, we have great careers, we love the area.

I grapple with staying a lot (my husband, who is very rational and pragmatic – as I have mentioned – does not). I often wish we had extra sets of hands to help out with the kids. We are on our own in terms of childcare, with the exception of that which we pay for. I also think the kids would grow to be more well-rounded if they had different caregivers intimately involved in their care. We have a lovely nanny, and she has been around since my first was born, but as much as we trust her, it’s just not the same as family. My closest friends are also here, and I find it so time-consuming to make adult friendships, especially with kids and working full-time. I also think about the fact that our parents are getting older. These are the years they will enjoy with their grandkids – when the grandparents are young enough to spend quality time with them and the grandkids are young enough to love spending this time with them, before they become self-absorbed teenagers. If anything happens to our parents, will I regret not living closer when it mattered the most?

More and more of our friends and acquaintances are moving out of state, for one reason or another. Some days I yearn to be one of them as well – packing up the house, putting it on the market, starting our lives elsewhere. But really I would only move back home, which is funny because I didn’t particularly love growing up here. As I’ve mentioned, my parents were great, but I moved when I was about to start high school, and this put a bit of a damper on everything. Adolescence is tough! I actually disliked my house for the longest time, but now that I’m an adult who has purchased a home in a high cost-of-living area, I can’t help but think: it’s so large! Look at all of this space and land! What a steal!

I am sure my oldest will wake up feeling fine tomorrow morning, but I don’t think my own feelings will be forgotten so quickly. I don’t know what the right answer is, and I don’t want to pressure my husband into making a decision until I am certain it is the right choice. And so I’m stuck in limbo, flying back and forth, feeling not-quite in each place, trying to put a positive spin on the situation for my kids. It reminds me of a few lines I read in the book “This Is How It Always Is” by Laurie Frankel:

“This is how it always is. You have to make these huge decision on behalf of your kid, this tiny human whose fate and future is entirely in your hands. Who trusts you to know what’s good and right and then to be able to make that happen. You never have enough information. You don’t get to see the future. And if you screw up – if with your incomplete contradictory information you make the wrong call – nothing less than your child’s entire future and happiness is at stake. It’s impossible. It’s heartbreaking. It’s maddening. But there’s no alternative.”

Worried and kicking

It’s been 5 days since I learned about my possible toxoplasmosis infection and I’ve just been a rollercoaster of emotion:

  • doom and gloom: worst case scenario congenital toxoplasmosis situation. How will we adjust to having a severely disabled child? Is this fair to my other children? How will our lives change?
  • denial: this MUST be a false positive. I don’t spend time around cats, I don’t eat meat, I have barely eaten raw fruits and vegetables this pregnancy and never without washing them. Then I think about the one time our cat lady neighbor picked up two packages for us while we were away. This was back when I was very early pregnant, 1-2 mo. What if one of her cats pooped on the packages and then I grabbed them? Is this enough contact to transmit toxoplasmosis? Would my IgG be positive if this were the case?
  • anger: why did my ob check this lab? There seems to be no clear guideline to doing so (for asymptomatic patients without exposure risk). I switched to this ob primarily to have the same person I saw for regular visits deliver my baby instead of a resident (to clarify: not because I didn’t think they’d do a great job, but because I would prefer for residents I work with not to see me in labor. Although, two residents did deliver my second and I can barely remember who they were) but now I’m having second thoughts. Should I have stuck with my original group, who didn’t check for toxo because it’s not standard of care? Now I’m on this wheel of test after test after test (what I’ve been trying to avoid since my first induction for suspected pre-eclampsia) and I’m mad at myself because it’s of my own doing. I also wish she had a clear algorithm in mind. If she sends off a test, then she should have a clear plan as to what to do if it’s positive or negative. Yet, I know that this is not always true in medicine, and this is how we learn.

My husband is a level-headed, pragmatic individual. He is not worried at all. He says that worrying won’t change the situation. There is literally nothing I can add to the situation by worrying, and I need to relax and wait to see what the doctors say next week. I have an ultrasound scheduled and will follow up with high-risk ob the day after (by phone at least). I wish I could be reasonable like him and not worry, but I have a tough time doing so. I worry about the need for invasive testing or treatment which could be dangerous to the baby. I worry about being in a perpetual state of worry (is this the ultimate sign of anxiety or what?) during this pregnancy. I worry that the baby will need unnecessary testing when he’s born. And I think about what it would be like to have a baby with congenital toxoplasmosis – how different from my prior newborns. How will I handle that on top of having a newborn and 2 toddlers?

In the past few days, the baby has started to kick more. He was moving early on this time around, but his movements have been much more intense and exaggerated. I like to think that he’s telling me not to worry, to calm down, that he’s alright. I hope this is true. Only 3 more days until I have my ultrasound. I pray that everything is normal.

Bad news

This month has been hectic. It started with a lovely get-away (without kids!) for my husband and I. It was lovely. We were away for a week and were able to sleep 10-12 hours per day, finish both our conversations and our meals, lounge leisurely by the pool (under an umbrella, of course), walk along the beach, read, and simply be.

As always, I returned home with a desire to incorporate some of that into my daily life: taking a few minutes per day to just be together, reading more for fun, enjoying leisurely meals, exercising. Except we came home to a 1 year old and a 3 year old and two full-time jobs so none of the above happened.

It’s also a busy time. I’ve been taking advantage of my second-trimester energy to complete a few projects, including submitting plans for a minor home renovation. I’ve also had a pesky cough since our time away and though it would go away but it didn’t, and the coughing would often rob me of my energy and cause me to feel even more tired than usual. To top things off, my oldest came down with hand foot mouth disease (HFMD) and was home the entire week prior to a flight I was taking solo with both kids. He was in pain and cranky the entire week (apologies to all of the moms I counseled on HFMD by saying it was merely viral and would blow over) and, the worst part of all was that he wouldn’t sleep through the night! So the first few nights my husband and I stayed up with him. And then my youngest got a fever (but fortunately did not erupt into HFMD) and then HE wouldn’t sleep through the night.

So I set off with both kids in recovery ALONE on a 6 hour flight and it was by far the worst flight we’ve ever had. My kids have traveled a lot because even though we don’t live close to family, I think it’s so important for them to spend time with them. They are usually shockingly well-behaved. I come prepared, keep them entertained, and they generally keep their crying and tantrums to a minimum. But last week was a different story. Both kids were on the mend, I felt like crap from a combination of not sleeping as well as fighting off this cough (oh and being pregnant), and they wouldn’t nap! So we kept things pretty together until the last 30-45 minutes. And then when the plane landed, all hell broke loose. Both kids wanted to be carried but I only had two hands and had to carry the carry-on bags (we only had travel backpacks with us but it was a lot to juggle!). Then my oldest started throwing a tantrum about everything – he didn’t want to let me into the aisle to organize our bags, he didn’t want his brother to sit by the window, and on and on and on. Meanwhile, I’m frantically trying to organize everything while his little monkey of a brother is climbing over the seats. My oldest won’t move from his spot so I tell him “I’m going to pick you up and sit you down here so that I can grab everything” and do just that. He loses his **** and starts yelling “Mommy you HURT ME!”. Meanwhile, I’m dying.  As calmly as possible, I tell him it’s time to get off of the plane. A very nice lady helps with one of our bags, I carry my youngest off the plane, and my oldest begrudgingly drags his bag and follows behind, complaining all the way.

At the gate, I have to find and unfold our stroller, which was a waste of effort because neither kid will sit in it (but at least I can pile some bags on it). The oldest is crying and blocking people as they walk off of the plane while the youngest just wants to be held. I hightail it out of there with the oldest hitting me on my backpack and throwing the world’s greatest tantrum. We are the last people off the plane and the pilots are begrudgingly walking behind us because (I learned on another trip) they can’t leave anyone behind when they leave the plane. Awesome. And then, to top it all off, I have to walk approximately 20 minutes with one kid in my arms and one kid whining the whole way because we have landed at a huge airport, at possibly the furthest airline!

It was a total disaster. I saw my parents at the exit, handed the kids off to them, and then walked off to baggage claim to burst into tears. I could tell the security guard knew I was going to lose it because he let my parents follow me to the baggage claim to help out with the bags.

Until yesterday, I thought that was the worst thing that had happened. Then, my ob called me. Before I left, I had a few third trimester labs drawn. Apparently, one of those labs was toxoplasmosis. I had already had this checked in January (at 7 weeks) and both IgM and IgG were negative. For some reason, my ob rechecked it. She admitted that this was controversial – that many people don’t recommend rechecking due to low likelihood of infection in our area and false positives. But then she told me that I had a new positive (IgM, with IgG still negative). She wasn’t sure what to make of it. She had spoken to the high-risk obstetrics group at my hospital and they would follow up with me and likely have me return for an ultrasound, as well as labs, maybe an antibiotic, etc. She told me not to freak out so I promptly did just that – freaked out.

Toxoplasmosis!? That’s one of the terrible infections we learn about in medical school that can cause a slew of problems in newborns. WTF!? But I don’t own any cats…and I’m a vegetarian! I couldn’t believe it. I did what I always tell my patients not to do – turned to Dr. Google, and PubMed, and every person I know who is an obstetrician or infectious disease expert. I received a slew of responses: it’s probably nothing/a false positive, you definitely should not ignore this, you need serial ultrasound monitoring, they need to test the baby, there’s nothing you can do anyway because you’re 24 weeks along.

I’m also a bit annoyed at my ob. Why did she check it if it’s controversial? Her exact words were “I’ll probably change my practice after this”. And I am not entirely sure she knows exactly what to do at this time. She referred me to the high-risk ob, and that person called me, but I’m traveling and can’t be seen tomorrow, and she’s going to be out of town next week. The ID expert I spoke with told me to get labs ASAP, but the ob told me it wasn’t time-sensitive. Her exactly words were “I’m going to be blunt with you because you’re a doctor: if this is a true infection, there’s not much you can do at 24 weeks”. But shouldn’t it matter if it’s a true infection?

So I’m just waiting here, anticipating the worst. And it’s made me realize that I’m done having kids. I always thought I wanted a fourth, but pregnancy is too tenuous and stressful. I think about the experiences I’ve had with my kids – my pre-eclampsia scare with my first and him being in the NICU after birth (the briefest NICU stay ever, but seemed like the longest to me), my positive first-trimester screen with my second and having to see genetics for additional screening to rule out a chromosomal abnormality, and now this with my third. I pray that he will be healthy. That this is either a huge misunderstanding (false positive) or that he does not catch this infection. I’ll have an ultrasound in one week and hopefully will have some additional information at that time – and hopefully it’s all good news.

Charley horses and baby kicks

A few days ago I woke up with a terrible muscle cramp in my right leg. It woke me up from my sleep, which was aggravating because I really love my sleep. But it was also incredibly painful! I had completely forgotten about Charley horses during pregnancy, but yes, it is a thing that happens.

(Speaking of things that happen: here’s another one no one told me about. After my second delivery, I experienced terrible uterine contractions – almost as bad as pregnancy – whenever my newborn nursed. This is apparently a thing. When you nurse, oxytocin is released, leading to uterine contractions. Because the uterus has less muscle tone after your first delivery, this contraction is often quite mild – it definitely was for me. However, with each subsequent pregnancy, they become more intense (as uterine muscle tone increases). I was literally doubling over in pain after my second was born, so I am NOT excited to experience this again!)

I have also started to feel this baby kick. At first (around week 17) it felt like very light flutters. It still feels light, but I am certain now that it’s the baby. This makes everything feel more real. We bought baby’s first outfit yesterday. I can’t go too crazy (I already have 2 kids’ worth of boy clothes) but I definitely wanted him to have a new hospital outfit.

I also have his anatomy scan this week. I am always so worried about this test, but trying to stay calm before the ultrasound.