S08|15 - The One for New Moms, with Dr. Erin Appleton, MD

 

Did you feel entirely unprepared for new-mom-hood with your first child? Or maybe you’re currently prepping for that experience and looking for support? Dr. Erin Appleton, MD IBCLC FABM, joins me on the podcast today to discuss the BIG things: breastfeeding (and infant feeding in general), postpartum anxiety and depression, and the trauma that mothers deal with when delivery and postpartum are so vastly different than “the plan”. 

Dr. Appleton discovered her passion for breastfeeding after enrolling in specialized courses in breastfeeding support while completing her Bachelor of Science in Nursing. In 2012, she began her breastfeeding medicine training, eventually co-founding the Nurture Family Feeding Clinic, and in 2014 became an International Board Certified Lactation Consultant (IBCLC), then in 2018, she became one of only a few hundred MDs in the world with a Fellowship in the Academy of Breastfeeding Medicine (FABM).

While she’s proud of her education, training, and experience, she believes that some of her most valuable lessons have been firsthand, with her struggles with feeding her children, and with helping the thousands of new families that she’s seen over the past decade of her career (including me!).

In this conversation, we cover: 

• Common breastfeeding issues and how to prepare yourself beforehand
• Postpartum depression and anxiety signs, and how to know if you need help
• The gap between what we “plan” for in birth and postpartum and what actually happens (and how painful that can be)
• Social media and the rise of anxiety (seeking connection and not finding it)
• Dr. Appleton’s journey with her babies and nursing (and how we met!)

Connect with her below:
Latching logic: www.breastfeedingmd.com
Breastfeeding support: Www.nurturefeeding.com
IG: @breastfeeding.md
FB: Nurture Family Feeding Clinic and Dr Erin Appleton, MD IBCLC FABM

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Crystal The Parenting Coach: Hi, I'm Crystal The Parenting Coach. Parenting is the thing that some of us just expected to know how to do. It's not like other areas of your life where you go to school and get taught, get on the job training, or have mentors to help you, but now you can get that help here.

I believe that your relationship with your children is one of the most important aspects of your life, and the best way that you can make a positive impact on the world and on the future. I've made parental relationships my life study; and I use life coaching tools, emotional wellness tools, and connection-based parenting to build amazing relationships between parents and their children.

If you want an even better relationship with your child, this podcast will help you. Take my Parenting Quiz, the link is in the show notes. Once we know what your parenting style is, we will send some tips tailored to you and a roadmap to help you get the most out of my podcast. 

 

Welcome to today's podcast episode, The One for New Moms, with Dr. Erin Appleton, MD. 

Did you feel entirely unprepared for new-mom-hood with your first child? Or maybe you’re currently prepping for that experience and looking for support? Dr. Erin Appleton joins me on the podcast today to discuss the BIG things: breastfeeding (and infant feeding in general), postpartum anxiety and depression, and the trauma that mothers deal with when delivery and postpartum are so vastly different than “the plan”. 

 

Dr. Appleton discovered her passion for breastfeeding after enrolling in specialized courses in breastfeeding support while completing her Bachelor of Science in Nursing. In 2012, she began her Breastfeeding Medicine Training, eventually co-founding the Nurture Family Feeding Clinic, and in 2014 became an International Board Certified Lactation Consultant (IBCLC), then in 2018, she became one of only a few hundred MDs in the world with a Fellowship in the Academy of Breastfeeding Medicine (FABM).

 

While she’s proud of her education, training, and experience, she believes that some of her most valuable lessons have been firsthand, with her own struggles with feeding her children, and with helping the thousands of new families that she’s seen over the past decade of her career. 

 

In today's conversation, we're going to cover all of the common breastfeeding issues, how to prepare yourself, what to do for all of that. We talk about latching, all the things. 

We also talk in detail about postpartum depression and anxiety signs, because oftentimes it doesn't look like what you think it looks like…and how to know if you need help, and what to do to reach out.

We also talk about that gap between what we plan for in birth and postpartum, and what actually happens and how painful that can be, just like in my first birth experience; and we discussed Dr. Appleton's personal journey with her own babies in nursing, and also mine…and how we met.

 

Hello everybody, and welcome to The Parenting Coach Podcast. If you have not yet had a chance to check out Parent School, that is still going on; and we would love to have you join as well. If you're enjoying this podcast, go and rate and review and subscribe and all the things. I'm excited for this episode for several reasons, but we'll get into that.

 

What Dr. Erin Appleton does and how she got started, and how we met

Crystal The Parenting Coach: First, I'm going to introduce my guest to you, Dr. Erin Appleton. Erin, do you want to just give us a little introduction about who you are and what you do?

 

Dr. Erin Appleton: For sure. Thanks for having me. I'm so excited to be here. My name's Dr. Erin Appleton. I am a family doctor; and I am a International Board Certified Lactation Consultant and fellowship of the Academy of Breastfeeding Medicine. 

I've been practicing Breastfeeding Medicine pretty much exclusively for the last 12 years of my career, and it has brought me immense joy. It has been the most fulfilling part of my medical career. 

And I truly love what I do, day in and day out – helping families to feel that they have completed a nurturing and loving feeding relationship…whether that means that they end up exclusively breastfeeding, exclusively pumping, exclusively formula feeding – and helping them to feel that they have really gotten what they want out of the journey while also maintaining their mental health and a Fed is Best mentality. So, that's where my--

 

Crystal The Parenting Coach: Yes.

 

Dr. Appleton’s journey with her babies and nursing (and how we met!)

Dr. Erin Appleton: Yeah, that's where-- That's where my most important aspect of care really evolved from, was feeling like when I was breastfeeding my first, that I was somehow failing as a person, as a being. And I didn't reach my breastfeeding goals, and that was really difficult and it impacted my future feedings for my next two kids. And my feeding journeys with them were also quite difficult, and probably tainted with a fair amount of anxiety and PTSD around feeding. 

And my goal, working with moms, has been to help alleviate at least some of that fear and anxiety that comes from feeding, and not feeling like you're maybe reaching the goals that you had set out for yourself with feeding.

 

Crystal The Parenting Coach: Oh, 100%. I feel like you just explained my entire first-- my first experience with breastfeeding, for sure. But first of all, I want to mention, one of the reasons, for all of your listeners, that I'm excited for this is because this is actually my doctor, I guess, like, not currently because I'm not breastfeeding currently. 

But in real life, I feel like most of the people that I have on the podcast are like virtual friends that I know. But not very often do I get to have someone on the podcast that I know physically, in person, from my own town. So, I'm excited about this. 

So, I started seeing the breastfeeding clinic when, I think, on my third – he's almost 11, so almost 11 years ago. And it made a massive difference, the third and the fourth breastfeeding journey, compared to the first and the second where I didn't have support; and the support that I did find was not helpful. 

And with my first, like you said, I ended up nursing…did not work out, did not-- it just didn't happen. And I didn't even think it was going to be hard. So, I think part of it was this expectation of like, I guess I thought breastfeeding was just going to be easy and we'd figure it out and like, that's just what people do. Nobody really talked about that to me. 

And so, again, for sure, felt like this massive failure, like how could I-- And added onto that, I thought I was going to have this like lovely amazing natural birth, and ended up in an emergency c-section and was in the hospital for like a week. And I was like, 'Wait, this is supposed to be very different than it was so.'

 

Dr. Erin Appleton: Natural, easy.

 

Common breastfeeding issues and how to prepare yourself beforehand

Crystal The Parenting Coach: Yeah, definitely some PTSD-type things from both of those experiences. But the reason that I wanted to bring you on is because I think that with this being a Parenting Podcast, oftentimes I focus on kids; like kind of what my kids are going through in their ages and their stages. And so, I don't talk a lot about toddlers, and I don't talk a lot about babies, and I don't talk a lot about postpartum; but that's such a huge part of parenting. 

And so, I think kind of gearing this conversation towards moms – and by young moms, I mean moms with really young kids – need to know so that they don't end up in that same situation. Because it took me years to unravel that, like everything that had happened within that time of having this ideal situation. 

And not even that it was ideal because it was, but I also just didn't even-- There was no room for like, it's not going to be that way. I didn't even know enough people to know that there was actually like a lot of ways that birth and pregnancy, and all of that, could go. 

So, I kind of just thought it was like a shoe in; and I was like, 'Oh, I'm going to have this lovely natural birth, I'm going to nurse this baby forever.' And because I grew up with people that had done that; my mom and my aunts all nursed their babies for years, like actually lots of years…and had natural births and never really talked about it being hard, I guess. 

So, I kind of just thought, 'Of course, it's going to happen for me too.' And then when it didn't just that, really that shame of like, what's wrong with me that I can't do this? And kind of just like keeping that under the surface and hidden and not really talked about for a long time until I learned about emotional wellness; and here we are. But okay, I would love for you just to talk a little bit about that, about that expectation and how it affects your mental health and whatnot.

 

Dr. Erin Appleton: I think we are all prepared for labor; that is kind of how everybody in pregnancy has their education geared – that's what we think, as women, that we need to know. And we go to prenatal classes and we see birthing and we do lamaze and we have breathing class and we know that this big event is coming; and boy, we have to be prepared for that. 

So, we get as prepared as we can; and nobody talks about how to prepare for the longest and, sometimes, this journey that comes after that. And so, being prepared for not only the birth, but the journey that comes after of becoming a mom and of becoming this person that you sometimes don't even know or recognized in the mirror…it's such a challenge, and we aren't really prepared for it. 

So, I think having some ideas of how to temper expectations or know, maybe, what to expect…how to prepare your body, how to learn what your body is actually meant to do when it comes to breastfeeding, knowing how your breasts work – like that's one thing that we don't even have education about in prenatal classes. 

Like learning how to hand-express is not talked about – or, traditionally wasn't. 

 

Crystal The Parenting Coach: Yeah.

 

Dr. Erin Appleton: It's becoming maybe more commonplace but still really isn't-- Like you're not often even examined; your breasts aren't often examined during your pregnancy. And so, you're not prepared for what comes after. It's just an expectation that it's natural, that it's going to be the next natural consequence; the baby's going to do all the work. 

And yes, it works out like that sometimes, but it doesn't always; and I mean the stats are probably close to 70% of women, will struggle with breastfeeding in some way, shape or form – that's the vast majority of people. It doesn't mean they're all struggling with low supply or--  

But they're often having nipple pain that they weren't prepared for. They certainly weren't prepared for how to latch their baby, and to make it comfortable. Our mirror neurons are triggered, often, in our social situations to bottle feed. So, what we see growing up is often not normal breastfeeding; it's covered with a-- cover to be out in public. 

We are often covering up if we're breastfeeding, or we're seeing baby dolls being fed with a bottle in the crook of your arm; and you're just mimicking that. And so, oftentimes what our natural inclination is to bottle-feed our breast to our baby, and that really can lead to a lot of discomfort when you're trying to breastfeed your baby…is if you are like literally taking your breast and bringing it into your baby's mouth, you can often have like nipple pain, trauma, compression – and it's simply because you're not holding your baby in the right way, with tummy to mom.

 

Crystal The Parenting Coach: But it's so interesting that comes--

 

Dr. Erin Appleton: -subtle things.

 

Crystal The Parenting Coach: -them not seeing it, right? Because that is so true. Like in the beginning, I was definitely very like, cover up, cover up, cover up; and over time I was just like, why are we sexualizing like breasts and nursing and body and all the things? 

So, then I kind of swung all the way to the other opposite side. I'm like, no, no, no, we need to make this way more normalized. So, I don't-- I mean, I don't-- I don't have a baby right now, but I nursed for a long time and I just stopped covering up because I do feel like there's this weird stigma around you having to like be covered all the time…and seeing so many other cultures that don't do that. 

I just wonder what the ratio of difficulty in breastfeeding would be in other cultures where it's very normal, it's very open, everyone, nurses and see each other nursing. 

 

Dr. Erin Appleton: A lot less.

 

Crystal The Parenting Coach: Because that didn't even occur to me that it would be, even in our minds, like not knowing exactly how that goes.

 

Common Postpartum issues

Crystal The Parenting Coach: What are the biggest issues that you see when people come into your clinic around, just like kind of all things postpartum, like nursing specific…but then like, what are other issues you see as well kind of going on at that same time?

 

Dr. Erin Appleton: A lot of mental health struggles, particularly in the last four or five years – particularly, there's been an increased rate of mental health, anxiety, postpartum depression. There's definitely an uptick in anxiety, particularly. I think there's a lot of social media use; that's probably around, that that comes from. There's comparisonators and looking at-- maybe not the greatest information online, that's just a quick TikTok that shows you how to do something but maybe not necessarily evidence-based but it's gone viral. And so, people with really high followers.

 

Crystal The Parenting Coach: You believe in it. You're like, there's millions of you--

 

Dr. Erin Appleton: Yeah.

 

Crystal The Parenting Coach: That must be-- It must be true.

 

Dr. Erin Appleton: Yeah. Yeah.

 

Crystal The Parenting Coach: Okay.

 

Dr. Erin Appleton: So, I mean, there's definitely a lot of low supply, oversupply, anxiety, mental health. I think a lot of just feeling of loneliness has also increased. We're more connected than ever, and there seems to be also a feeling of loneliness.

It's gotten a little bit better in the last year-and-a-half or so since more programs have started up again, and moms are getting together and feeling more of a sense of community. But that was a really big feeling, I think, over the last four years that really increased that social isolation and feeling that they were alone a lot.

 

Crystal The Parenting Coach: What about--

 

Dr. Erin Appleton: That's what I noticed in--

 

Correlation between mental health and nursing

Crystal The Parenting Coach: Is there some sort of connection between those? Like, so for me, I had more of like an undersupply for my first two kids, and pain and not getting the right proper latch or the proper like positioning or whatever. And with the last two, I feel like it was an oversupply. But I'm curious if there's any difference between-- not difference, but I guess correlation between mental health and nursing. So, if you are like having struggles with your nursing, does it affect your mental health and vice versa?

 

Dr. Erin Appleton: Yes, absolutely. Feeding not going well is very well associated with mental health concerns – but yet when feeding goes better and you start to turn things around and you get good support, mental health definitely improves. 

And it's not that anxiety and depression is associated particularly with breastfeeding because you can have that with formula and bottle feeding as well…but that pervasiveness of anxiety that often comes into my clinic is because feeding is not going well, and that improves when they get support, and feeding starts to improve.

So, getting the support for breastfeeding, particularly, is super important; and getting it in a timely manner is really important as well, and that's sometimes a challenge in a system where access can be really difficult.

 

Crystal The Parenting Coach: Yeah. It can be really, really hard to access, which we'll talk about in a minute because you have a amazing course that we're going to-- we're going to share with everybody in case they're feeling that way and need some support right now. 

But so, going back to the breastfeeding issue – and you said that there's lots of different issues, kind of oversupply and undersupply and the positioning and all of that – do you feel like more preparation is needed before you have baby or during baby? 

Like, if somebody's listening to this podcast – maybe they haven't had kids yet, or maybe they are pregnant or have just barely had children or whatever – what kind of issues can they maybe foresee happening, and how can they help support themselves before they happen?

 

Dr. Erin Appleton: I think understanding what your body can do and that it's meant to do, this is a really important piece. There's often a feeling of their body is somehow broken, especially if you've gone through a really traumatic delivery, that somehow maybe you end up with an emergency c-section like you were saying. 

And that mental anxiety and anguish and grief is really also a part and parcel of the breastfeeding journey and how difficult that can be. Plus, you're recovering from a major surgery. 

I think there's ways that you can-- You can't necessarily prepare yourself for that eventuality, but you can prepare yourself for making sure you know how your breasts work and how babies feed, and how tiny their tummies are. And that they don't all need to be supplemented immediately if they haven't fed in the first six hours of after life, like of life. 

They can be fed by little bits of colostrum that you hand-express, and you have that power; your body is built for this. And you knowing that and going into the feeding journey that your babies are meant to do this and that there are very simple, easy things that you can do – like learning how to latch your baby in the most logical way where they have their ear, shoulder, hips, all in a nice straight line…and they're tucked tummy-to-mum.

And they're in a little bit of a sniffing position and their cheeks aren't turned side to side, they're nice; and symmetrically attached to the breast so that there's no drag of the breast out of the mum-- or out of the baby's mouth. So, there's simple little things that make logical sense, but until someone's actually had that teaching, they don't necessarily feel like it's all that natural or logical. 

So, there are really simple little steps you can take; you can learn how to hand-express and you can learn how to latch your baby really well, but before you even go in to a delivery room.

 

Crystal The Parenting Coach: Yeah. I wonder why--

 

Dr. Erin Appleton: And when you get that baby out.

 

Crystal The Parenting Coach: -this is something they teach you at the hospital; like when you're going through all the things and they're like, 'This is how you put a diaper on, or this is how--' I don't know, just little things like that. Like, I wish that there was more training on, 'And this is how nursing happens.' And I think some nurses have more knowledge about that than others, but there was a lot of experience--  

 

Dr. Erin Appleton: Absolutely.

 

Crystal The Parenting Coach: -where I didn't get any training on that and was kind of like, 'Wait a second, what is this whole thing? Like how do I even-- How do I even do this?'

 

Dr. Erin Appleton: Yep. 

 

Crystal The Parenting Coach: Yeah.

 

Dr. Erin Appleton: Yeah. And babies are meant to do this; they are really instinctive. If they come out and they have an unmedicated vaginal delivery, they are bright-eyed and they will crawl to the breast. 

 

Crystal The Parenting Coach: Yes.

 

Dr. Erin Appleton: Like you put them on a mom's chest and they just crawl and get there, and they will do it. It oftentimes isn't that perfect of a delivery; they've had maybe medication, they're a bit sleepy or they've had a very difficult entry into the world…and they've had some, maybe, face or a knack or jaw trauma – and that first feed is a little bit more difficult and then they get sleepier, and so they can get behind. 

So, knowing how to pay the insurance policy and express after every feed for the first couple of days…get those little drops of colostrum off of the breast after the baby's fed, put it into its spoon and give them desserts.

There's a really beautiful website called First Droplets, and it's by Jane Morton; and she's a physician who's been doing Breastfeeding Medicine for a very long time – and her website is just beautiful, and it teaches about how to hand-express and get those first droplets into baby. And she speaks about how to give them dessert; and who doesn't like dessert, right? 

Like, so getting all those beautiful little droplets out into baby's mouth so that their gut is really well-covered with that gorgeous, first milk called colostrum. It's the best antibody boost and health food on the planet. 

 

Crystal The Parenting Coach: Yeah.

 

Dr. Erin Appleton: And it's so good for their little guts, and it protects them from all kinds of pathogens; and it's meant to shellac the inside of their bowels and keep them protected from the outside environment and corn proteins, and that's important. Like that's an important first food. 

There's often so much fear that part of human physiology is going to fail. And I think that the hospital kind of works on those principles, a lot of times, is there's this fear that human biology is going to fail. And because that's where the worst cases are seen, right? Where it has; where babies have not been fed well enough, and they've been readmitted. 

And so, of course, we want to feed them first and make sure that they're well-fed…but that lack of faith, I think, in human biology is a really big part of why there's such sometimes a push for supplementation when maybe it isn't always necessary. It comes from that place.

 

Crystal The Parenting Coach: Yeah. And I think that anxiety…if you're feeling all that anxiety yourself and then the, everyone around you in the hospital is just like, 'We got to get this done,' and then you're feeling more anxiety…how hard that is going to be to be able to release, to relax, to like--  

 

Dr. Erin Appleton: Absolutely.

 

Crystal The Parenting Coach: The process that needs to be happening in order for you to be able to nurse, it's just opposite; it's just opposite of that.

 

Dr. Erin Appleton: Yeah. It's fight or flight, not breast and digest.

 

The gap between what we “plan” for in birth and postpartum and what actually happens (and how painful that can be)

Crystal The Parenting Coach: Yeah. Yeah. Okay. So, I love what you said there; and I also want to move to when breastfeeding journey does not turn out the way you want, right? Mm-Hmm. So, for me, it didn't--I tried lots of things. I tried switching positions and whatever; and I got the support that I could find in the town that I was at, but there wasn't a lot back then. 

And so, feeling like-- Initially, supplementing and then having supplementing over time make it so that they had it even more difficult time latching and eventually just didn't nurse at all. And by eventually, I mean, within 12 weeks, it was like, there's no more nursing and he was just bottle-fed. 

And for me, I didn't like talking about it with people. I didn't, like-- I was like, 'Ooh, I don't want people to know that I'm feeding him with the bottle and that I'm not nursing anymore.' Because I think there is this idea of we do know that like biologically and physiologically, breastfeeding is so good for them and it's natural and all those things – but when it doesn't go well or if we can't figure it out, I think that affects mental health so much too. So, what would you say to women struggling with that?

 

Dr. Erin Appleton: It isn't your fault; and if you haven't had the support you need or if the support you need was there and it's still not going the way that you wanted it to, that is grief. And it's okay to grieve the loss of something that you really, really wanted. And it's normal to have that grief period when things don't go the way that you had planned. 

We often say the expectations versus reality. The space in between that is often where anxiety and grief and depression can live. And sometimes when we really build up this high expectation that we just crash because we haven't achieved it, that can be a really hard place to be. And without counseling and coaching or help and support, that can be a really dark and often trauma-inducing place. 

I mean, I still deal with trauma from having a baby that I was told, had failure to thrive; and that was my fault, I took that completely on myself – even though the system wasn't there to support me and tell me at the time, 16 years ago, what to do and how to make it go better…I was just told he needed to be bottle-fed and given formula because my milk was not good enough for him. And I believed it.

 

Crystal The Parenting Coach: Me too. That is exactly they told me. And they were like, "You have a week, or he's going to be in the hospital." 

They're like, 'Now you have-- You have to come back in in two days. You have five days, or he is going to be in the hospital.' It was so-- It was so anxiety-inducing to be like, 'Your child-- and by the way, they might die.' Like it was just so-- The whole rest and digest, it was like the opposite of that. Like, how are you supposed to then go home--

 

Dr. Erin Appleton: Absolutely.

 

Crystal The Parenting Coach: -and figure out this thing if you are then feeling all this pressure of like, this is my fault that this is happening and this is affecting them in such big ways.

 

Dr. Erin Appleton: Yeah. Yeah. Absolutely. Absolutely.

 

Crystal The Parenting Coach: So, I love what you just said. I like wrote it down as you were saying it because I was like, 'This is so--' I think that everybody needs to hear like; this is not your fault if you didn't get the support that you needed or if the support that you're getting is still not working, sometimes it doesn't work. Like it's not always going to happen even if you have all the support that you need. 

And so, just knowing that, that if it's not working out for you, it is not your fault; you don't need to take that on. And I know sometimes that's harder to believe than just having us tell you that, but hopefully that helps a little bit. And like you said, I think getting counseling, therapy, coaching to help support your mental health which is what I want to dive back into before we end is mental health specifically.

 

Postpartum depression and anxiety, and how to know if you need help

Crystal The Parenting Coach: Because like you mentioned, there's been an uptick in anxiety and depression, but particularly anxiety. What do you see? Like, how does that--  

For instance, when I was first having babies, so this was like 17-and-a-half years ago, I didn't know anything about depression and anxiety. And I don't know if I would've known that what I was dealing with was depression or anxiety. I had intense rage often, but I didn't know that, that had anything to do with depression or anxiety. And even when the public health nurse came over and was like, 'Are things going good?'

And I'm like, 'Yeah, I mean, I guess, I don't know, like I'm tired and cranky all the time,' but like I didn't-- I don't think that we often know what to look for.

 

Crystal The Parenting Coach: Like, I would love for you just to say kind of what you notice, what maybe to look for in what depression is, what anxiety is…and when you might need to get more support.

 

Dr. Erin Appleton: Mm-Hmm. There's a really well-researched depression scale that you can do. And actually, it's free online. It's called the Edinburgh Postnatal Depression Scale (EPDS). And you can-- You can actually score yourself. And it just is a scoring of how frequently within the past week you're feeling those feelings of overwhelm, those feelings of not wanting to get out of your bed, not that-- Even feelings or thoughts of self-harm or-- Those are really important to recognize and to get help immediately. 

So, if you score anything on the last question, you need to reach out for help immediately. And that is the most important thing, is keeping yourself and your baby safe. Any intrusive thoughts that you may have no idea or plan to act on these thoughts, but scary and intrusive thoughts are also a sign of anxiety and depression. 

And they don't necessarily mean that you're going to be doing anything to harm yourself or your baby, but they are something that you really need to be getting in contact with supports quickly in order to make sure that you are getting the treatment that you need.

 

What are intrusive thoughts?

Crystal The Parenting Coach: Can you explain quickly intrusive thoughts for people that maybe haven't heard that term before, that this is like their first go around? Yeah.

 

Dr. Erin Appleton: So, those are thoughts that are just scary and might frighten you or just kind of come into your mind immediately and then fly out, and you just go, 'Oh my God, why did I think that? Why did I think that I was going to drop my baby as I was going down the stairs? Why did I think that maybe that somebody could come in and hurt my baby, when that kind of thought has never occurred before?' 

That's very, very common in postpartum. And it's related to all kinds of hormonal shifts, and can be underlying anxiety. But that's the type of thoughts that's called intrusive. That should just like, you're fine; and then boom, boom – something kind of interrupts your fine sunny day, like a dark cloud.

 

Crystal The Parenting Coach: Okay. Thank you. Because I know a lot of people might be kind of new to the mental emotional wellness space, so I think that is helpful. 

 

Signs of anxiety and depression

Crystal The Parenting Coach: So, kind of continue on what you were talking about as far as mental health and what to look for depression and anxiety.

 

Dr. Erin Appleton: Mm-Hmm. So, it's good to do a self-screening. I would talk to a trusted friend or partner as well if you are having thoughts that you're wondering because that can be helpful. Sometimes we can't see the forest or the trees. It has to be a trusted partner or a trusted friend. 

And if you are feeling that you just are almost emotionless at times, that can also be a sign of depression. So, not having a lot, like having that flat feeling can also be a sign that you may want to reach out for help.

 

Social media and the rise of anxiety (seeking connection and not finding it)

Crystal The Parenting Coach: Okay. What about anxiety? You said that you've been seeing an uptick in anxiety, which may have to do with like social media or something like that. When people come into your office and you can tell that, anxiety is something they're dealing with, what does that usually look like?

 

Dr. Erin Appleton: It often looks like a lot of tracking, but sometimes we also feed into that a little bit. I ask you, "How many times is your baby feeding or whatever?"

And apps are kind of pervasive. So, tracking, in and of itself, isn't…but obsessive tracking, and being really over-obsessed with very minor things or what may be just normal infant behavior is like really a struggle to handle. Feeling very overwhelmed by all of the things there are to do, and feeling like you can't take a deep breath; those are signs of anxiety that I see really frequently. 

Really over-obsession with sleep can also be like a sign that anxiety's creeping in, is like that control. And really trying to schedule a lot including feeding and sleeping, which is fed into by all of the apps and tracking and all of that in the sleep industry as well. 

So, it all just, kind of, there's this societal push towards all of these things. It's just pushing moms into more and more of this like micro-obsession with little things that in the big picture actually really don't matter all that much sometimes.

 

Crystal The Parenting Coach: Yeah. I would say that probably would be increasing anxiety more. And like you said, I think social media in comparison and just having that access to so many people, but yet not feeling that deeper connection…can add to that loneliness.

And another thing I see is just like, there's so much access to information. There's just like constant barrage of information.

 

Dr. Erin Appleton: TMI.

 

Crystal The Parenting Coach: Right? And more and more and more, it's just like this acceleration of information; and when you have anxiety, you often have just like thoughts that don't seem like you can stop them. Right? It's just like consistent thinking, thinking, thinking all the time. So, then to have all of this access to all of this information, opinions, voices all the time, like, how could that not make that anxiety so much worse? 

And another thing that I see also is kind of like outsourcing our own inner wisdom, right? Being like, 'Well, they probably know better because they have a PhD or because they have a million followers on TikTok.' Or seeing so many opinions--  

 

Dr. Erin Appleton: Absolutely. 

 

Crystal The Parenting Coach: And so, many voices that you're like, well-- And I think the overarching belief for me was like, 'Well, then I must not know…I need to go find somebody else that does know this answer to my parenting, to my breastfeeding, to my anxiety, to my depression, because I don't have those answers inside me.'

 

Dr. Erin Appleton: Yes, yes. Absolutely. I think that we don't often even give ourselves enough time and space to know what we're thinking at any given moment or what we're feeling at any given moment. And when you're exhausted – and this time of life when babies and littles are taking all of your time and your space and your energy – it is so hard to have insight even to how you're feeling. 

And that does sometimes feel easier to download to somebody else, like that expert, right? Like, I want an answer and I want it now. I think part of what we are dealing with as a society is this instantaneous, there's an answer for everything; and actually, sometimes there just isn't a good answer. And that's hard, even for me to say – as the professional that people are looking to for answers – is like, actually this is really complicated. 

Like there are infinite variables on mom's side, and then there are infinite variables on the baby side; and these two infinite variables have to interact in this incredible physiologic dance, that makes it so complicated sometimes to have a right answer. 

And so, sometimes, even my, bit of OCD wants to have that answer, and I don't; and sometimes that's hard, but we have to sit with it, and we have to know that it's okay to not always be right. 

And it's okay to not always have the answers. It just is what it is; life is 50/50, and we do have to have that, and just sit with it – and that's hard to do, I think, more and more and more these days is just having the time and patience to sit with it. And you need a lot of time and patience to sit with breastfeeding.

 

Crystal The Parenting Coach: Yes. And when you're constantly, like, anytime a kid asks a question and I don't know it, then they go ask Siri, right? 

 

Dr. Erin Appleton: Yes.

 

Crystal The Parenting Coach: And they find a barrage of answers on the internet for every question. And so, I think what you said is so spot on of like this instant gratification of I can have an answer right now…when in reality in life when it comes to relationships or breastfeeding or all of the postpartum issues that we're going to be dealing with, lots of times there isn't an instant answer. It's not something that's going to come quickly; it's going to come with time, over time, and sometimes the answer doesn't come. 

And I think the discomfort of that is difficult. And I think we're really growing out of a society like if you look around-- I'm on the train right now in Japan often, and I'm looking around and everyone's on the phone all the time, or you're standing in line and everyone's on the phone all the time. 

And I think we're losing our capacity to just like sit and be uncomfortable and be bored and be-- and not know answers and not be entertained. And it's not just like an individual thing; this is like a global-- like everybody is going through this all across the world. 

And I think it is a struggle I can personally tell for me when I've been on social media too long or when I've been on my phone too long or been too in that world…that I do lose out on that stillness. Like I just-- There's just something within me that feels more agitated inside. And so, I think that definitely affects mental health, for sure. 

So, if you're listening to this episode and you're like, 'What do I do? How do I-- I do feel like I'm dealing with that.' Something that's helped me has just been doing little resets, little like, I'm just going to put my phone away for a weekend or for a day or for a week, or I'm just going to delete social media off my phone for six weeks – I usually do that in the summer. And just see how you feel. 

And again, just notice like, is this making a difference for me? How am I feeling? And I think I truly believe we're all very intuitive beings, and I think that we have way more wisdom inside of ourselves than we give ourselves credit for in a vast area of things.

 

Dr. Erin Appleton: I agree.

 

Final tip from Dr. Erin Appleton

Crystal The Parenting Coach: I would say, to end, if somebody is dealing with any of these issues – either anxiety, depression, breastfeeding, kind of all the things that comes postpartum, and maybe feeling a little bit overwhelmed right now – what kind of tip, or what would you tell them to start doing or maybe help that could be supportive for them?

 

Dr. Erin Appleton: I think, especially postpartum, this is probably a difficult time to learn it – but meditation, just taking maybe even five deep breaths like a physiologic sigh…it has profound effects on your nervous system. So, taking that deep breath in and then another sip, and then huuh (blowing it out through pursed lips), that physiologic side can actually bring back that feeling of at least some calm and rest and digest. 

That side of your nervous system can be triggered so that you can take that bit of time to just breathe and get yourself out of that fight or flight state, because that's a really common place to feel when your baby especially isn't feeding well is just constantly ramping up because they're all so ramping up. And it's hard to regulate your own nervous system. But that's an important skill to learn, and that's an important skill to learn for the rest of your life…like I'm still learning how to do that as an adult. 

 

Crystal The Parenting Coach: Oh yes.

 

Dr. Erin Appleton: I think that's an under-recognized skill within human physiology. Like it is a life skill that if you just can learn to take that pause, it really, really helps with so many things; with feeding, it's particularly helpful – babies need to be in that side of their nervous system in order to latch, in order to feed, in order to receive. 

And moms can actually, and dads actually have this superpower, they can do vagal stimulation for babies; just skin-to-skin and having baby chest-to-chest and humming…their big, deep rumbly voices have this beautiful ability to vibrate the baby's vagus nerve and put them into a much calmer state so that they can actually feed. 

So, dad can do that maybe and hand to the partner; and that can be an incredible skill for the non-feeding parent to the feeding parent is to just be able to get baby out of that fight or flight state where they're just ravenously looking for something to latch to, and then they just calm right down if their vagal tone is increased. 

And so, it goes both ways for moms and babies, and for dads too; like, as a family, you need to be bonding and you need to be nurturing one another. And at the end of the day, if that bonded family has a well-fed baby and a well-nourished mom and a well-supported dad, that whole family is going to do a whole lot better if they are in a state where they don't feel so fight or flight all the time; and having a welled baby is going to do that. And knowing that you have it in you to be able to tap into that part of your nervous system, it's an incredibly empowering tool.

 

Crystal The Parenting Coach: Oh, amen. All of that, yes. I always tell people like when we're dealing with self-regulation and trying to learn that, I'm like, 'Breath, breath is your best friend.' Breath is like the number one, and also the only thing you can bring with you. Right? There's not always going to be little doodads that you can bring with you to help you with emotional regulation. 

 

Dr. Erin Appleton: That's right.

 

Crystal The Parenting Coach: But breath, you can. And meditation has been part of my journey for the last several years, and it's been so supportive from my nervous system. And even if you don't notice in the moment that it's supportive, just notice over time. I'm actually doing a little 21-day meditation challenge with my group right now in that, just notice how you feel after a few weeks of even meditating for like one minute in the morning, 30 seconds in the morning.

 

Dr. Erin Appleton: Yeah.

 

Crystal The Parenting Coach: And just releasing the thoughts in your mind and just slowing down your breath, which I think also helps with what we just talked about with anxiety and depression and social media and postpartum issues. 

 

Dr. Erin Appleton: Yes.

 

Crystal The Parenting Coach: That will be huge as well. So, I love that you gave us such a simple, but also the best tip ever because I totally agree. 

 

How to connect with Dr. Erin Appleton

Crystal The Parenting Coach: So, I want you to share with us a little bit about how people can connect with you and especially if they need support and maybe there isn't the kind of breastfeeding support that you give in their area, or if there is and they're waiting for you – because I know you always have such a long wait list – what they can do in the meantime.

 

Dr. Erin Appleton: So, in my clinic in in Lethbridge, it's called Nurture Family Feeding Clinic, I actually have a website with lots of free resources on nurturefeeding.com. So, you can go to that website for lots of protocols and tips and tricks. 

Because my wait time is six to eight weeks and I can't seem to get it down, I actually have created a online video course that has pretty much all things preparations for breastfeeding that we talked about kind of at the beginning. But also troubleshoots Frequently Asked Questions, how to use nipple shields, how to supplement your baby, how to pace bottle feed, how to get rid of a nipple shield, how to make formula. 

It has pretty much everything feeding-related question-wise that I get asked a lot in the clinic that you can troubleshoot before getting to see me…because my wait time has been so long, I had to kind of think of some ways to get people the information. 

So, people that have taken it and then come to see me, have definitely found that they kind of have been able to pinpoint what the problem is – if it's a tongue-tie or if they have insufficient glandular tissue and they need medication for their milk supply, they've been able to figure that out by doing the course before coming. So, that's kind of really helpful; and for other people, it's just saved them from having to come in at all. So, that's been really helpful. 

It's been a journey of trying to figure out how to get this into people's hands and make sure it's valuable. So, it's definitely been helpful for people. 

And you can find me online @breastfeeding.md on Instagram and Dr. Erin Appleton on Facebook. I'm not prolific on social media because I definitely find it overwhelming, but I definitely try, and there's some definite tips and tricks that you can find on my Instagram and Facebook pages.

 

Crystal The Parenting Coach: Awesome. Thank you so much. And thank you for sharing all of your wisdom with us today.

 

Dr. Erin Appleton: My pleasure. Thanks for having me, Crystal.

Crystal The Parenting Coach: Thanks for listening. If you'd like to help spread this work to the world, share this episode on social media and tag me – send it to a friend, or leave a quick rating and review below so more people can find me. If you'd like more guidance on your own parenting journey, reach out.