Why "you're okay" is not okay

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On the playground and around town I've heard a lot of parents using the same phrase when their little one takes a spill. Dusting them off, they say, "You're okay," and usually pat them on the back and send them on their way, back to whatever they were doing. I understand what these well-meaning parents are trying to do: let their child know that this spill is not the end of the world and that they will be fine. However this small statement is a lot more complicated than that. Telling a crying child that they're "okay" invalidates their actual emotions in that moment and sends a confusing message. The internal emotional response may be something like this: "if I fell and felt scared and now I'm crying, why is my parent telling me that I'm okay?".  We would never tell an adult who fell on the sidewalk that they're okay and should just get up and keep going, we check in to make sure they're not physically hurt and then we offer support  or help. The same response is appropriate for children.

When a child takes an unexpected spill they usually look to their parent to gauge the appropriate reaction. I believe many parents have adopted this casual response with the thought that if they make a big deal the child is going to cry harder, while downplaying it will make them bounce back faster. Unfortunately, instead of creating resilience this approach can create emotional confusion and a lack of trust in the care provider and the child's own emotional response.

"I'm NOT okay!" 

So what can we do to create resilient kids who can bounce back from a spill? There's a very simple response that includes a description of what happened, an empathic statement to validate their feeling, and a brief comfort measure. Using these three steps are simpler than you might think and will help your child feel understood and secure and ready to continue playing. And since the tears are usually from the surprise of the fall, rather than the fall itself, validating their reaction goes a long way to soothing the tears.

For example: Baby Jessica is toddling around the playground when a bigger kid runs by, disrupting her concentration and balance. She falls onto her tush. The surprise of the quick movement brings her to tears. Her mother comes over and simply states, "Oh, you fell down when that big kid ran by. I can see that made you feel upset. Let me help you back up so I can give you a hug" (or an even simpler. "Aw, you went bonk. Did that surprise you? Let me help you up"). Hug ensues, tears stop and baby Jessica is back on her way.

For a bigger kid the response varies a bit but follows the same pattern. For example: Tommy is running through the indoor play area and slips on a wet spot. He tumbles and starts to cry from the impact. Dad  comes over and says, "Hey buddy, I see you slipped in the wet spot. That must have felt a little scary to come crashing down so fast. Can I help you up?". After a little sniffle and a kiss from dad, Tommy is back on his way. He was able to see that his dad understood that he got a little scared, and his dad showed his that it is okay to feel that way but it doesn't have to stop the fun.

This approach also teaches children how to respond to others who are hurt or upset. If we as parents and caregivers are constantly telling our children the equivalent to "suck it up", then that is how they will respond to others. If, however we respond to them with kindness, respect, and empathy they in turn will respond that way to .




Photo credit: istockphoto.com

The Non-Stress Test: What it is and how to out smart it

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Often when expectant mothers approach their 41st week of pregnancy obstetricians will call for a non-stress test to test for fetal well-being. The idea of the test is to get a record of the baby's heartbeat using an external fetal monitor (the same kind often used in labor) for a standard period of time (20 to 40 minutes) with the assumption that a healthy baby's heartbeat will increase by about 15bps for an average of 15 seconds every time he moves. If baby moves twice and the heart beat acceleration is recorded this is considered a normal or reactive test and there is no need for worry. If the test is done for 40 minutes and no movement is recorded the test is deemed abnormal or non-reactive and further testing is needed to ensure baby is a-okay.

Here's the tricky part: what happens if baby is asleep? What happens if you move and the monitor falsely records a deceleration? Both of these things are common and also avoidable. Dr. Sear's notes in The Birth Book that although "a reactive NST correlates well with a healthy infant, more than 75% of the time a nonreactive NST is a false alarm" (emphasis mine). Incredibly there are some very simple things you an do to ensure that your baby has the best chance possible of passing this test with flying colors.

• Before your test drink a sugary juice or caffeinated beverage. Orange juice is great if you're not experiencing heart burn, but you could just go for that nice cold iced coffee you've been craving. There's no need to worry about the sugar or caffeine affecting baby that late in pregnancy. 
• Arrange for the test to happen during a time of day baby is usually active.
• If the monitor moves on your belly at all immediately remove the device and call for the nurse. She will then restart the strip. 
• Give your baby a good prodding before you sit down (don't worry there's so much padding that you can't hurt your baby by feeling around). I know that by the end of my pregnancy every time I poked the Peanut she gave me a good kick in the ribs as retaliation. 

PPMD Awareness Month: Call for Your Stories

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May is Postpartum Mood Disorder Awareness Month here in Illinois and to help bring some light to this hard subject I'm putting out a call for your stories. Last year we had a series of PPD stories that got mother's voices out in the open. This upcoming month I'd like to do the same. 


If you would like to share your story (anonymously or not) please email me at birthingshifrah@gmail.com




This Month in Illinois (from ppdil.org): 

The Path to Postpartum Emotional Wellness Workshop The PPD Alliance of Illinois offers a FREE workshop for pregnant and new moms each quarter.The next one is:Wednesday May 2nd, 2012 from 9.30 - 10.30amNorthbrook Public Library,1202 Cedar Lane,NorthbrookCall PPD IL Alliance director Dr. Sarah Allen on 847 791-7722 to register or for more information
Packing Your Emotional Diaper Bag: Tools for Stress After Delivery May is Perinatal Mood Disorders Awareness Month - Join us for a FREE one hour class for moms and expecting moms coping with the changes and adjustment after having a baby. Learn self care tools to have in your Emotional Diaper Bag because taking care of yourself is the first step in handling your many responsibilities, especially on days when you cannot find the pacifier! Understand the signs of Perinatal Depression or Anxiety disorders. Options for treatment and resources will be provided. Partners are welcome.Presented by Kathryn Gardner, LCPC  www.kathryngardner.comSaturday, May 5, 2012  10am-11amPalos Heights Recreation Center  6601 W. 127th Street, Palos Hts., IL 60463Call to register - 708.448.7848  Please leave your name, phone # and how many will be attending and someone will return your call promptly.

5th Annual Treating Moms Well LuncheonPlease join Healthcare Alternative Systems, Inc. (HAS) to raise awareness of postpartum mood disorders, support treatment, and celebrate five years of Treating Moms Well!May 11 2012, 12:00 PMThe Standard Club320 South Plymouth CourtChicago, Illinois 60604Call to register - 773-252-3100 ext 242. Please leave your name, phone # and how many will be attending and someone will return your call promptly or visit to their website click herePPD Alliance of IL Volunteers are going to be at Chicago Children’s Museum on Mother’s Day! Be sure to stop in and talk to us in the Pritzker Playspace on May 13th and join the open playgroup that’s exclusively for babies, toddlers and preschoolers.  It’s a great place to meet other families, play and get information about Perinatal Mood Disorders and how and where to access help! The 8th Annual Alexian Brother Health System Walk for PPD Prevention and Awareness May 19, 2012 starting at 10 am at Volkening Lake, 900 West Schaumburg Road, Schaumburg, IL.For donations please make checks payable to ABHS Foundation and write on the check account #003.2480.01100 The Postpartum Depression Program.There will be raffle tickets sold at the walk, drawing held immediately following the walk.  Prizes include: jewelry, spa certificates, plants, gift cards and more!

Introducing Birthing Shifrah's New Contributing Authors!

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I take great pleasure in announcing that two new writers will be joining me here at Birthing Shifrah!  


Hallie Palladino, M.A., is a writer, teacher and mother. She will be covering issues related to parenting with a particular interest in natural parenting, attachment parenting and breastfeeding issues. She and her husband are raising their one year old son, Rocco, on the north side of Chicago. 


Heather Baker, P.T., is a physical therapist at the Galter Life Center at Swedish Covenant Hospital in Chicago. She earned her doctorate from Northwestern University. Heather specializes in working with women during and after pregnancy with a special focus on pelvic pain and recovery from birth trauma. She will be covering issues related to the body during the perinatal period. When not working as a physical therapist at Swedish Covenant Hospital, she loves to be active and regularly competes in triathlons and even completed her first half Ironman last summer. She currently lives with her husband on the north side of Chicago. 

Exercise and Pregnancy

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By Heather Baker, PT
                  Aquestion that I am commonly asked by my patients is whether it’s safe toexercise during pregnancy. For the most part, exercise is safe and incrediblybeneficial to both mom and baby. Due to the frequency I encounter thisquestion, I thought it’d be useful to provide you with some general guidelinesfor exercise and pregnancy. My suggestions are all based upon the most recentguidelines put forth by “The American College of Obstetricians abdGynecologists” but as always, check with your healthcare provider beforebeginning or changing your exercise regime.
Benefitsof Exercise:·      Improves aerobic and muscular fitness of mom·      Facilitates labor and recovery from labor·      Enhances psychological well being of mom·      Establishes (hopefully) permanent healthylifestyle habits
Reasonsto Discontinue Exercise During Pregnancy:·      Pain or bleeding·      Dizziness or loss of consciousness·      Pain in the back or pelvis·      Heart palpitations or very rapid heart rate·      Shortness of breath
Exercisesto Avoid During Pregnancy:·      Jumping, bouncing, and twisting·      Sit-ups, crunches, and oblique twists ·      High altitude sports (especially if you like ina low altitude)·      Heavy weight lifting·      Board and platform diving·      Contact sports·      Scuba Diving·      Exercising in hot, humid conditions
Summaryof Safety Considerations:·      Obtain medical clearance if in doubt·      Increases in exertion should be gradual·      Drink fluids before, during, and after exercise·      Avoid exercise if/when you are feeling exhausted·      Periodic rest intervals are advised·      Avoid exercises that require you to lie flat onyour back after the first trimester·      Being able to talk while exercising typically indicatesthat you are working at a safe intensity
HeartRate Guidelines:·      Fit female between ages 20 and 29: 145-160 bpm·      Low fitness female between ages 20 and 29:129-144 bpm·      Fit female between ages 30 and 39: 140-156 bpm·      Low fitness female between ages 30 and 39:128-144 bpm
If you want more information or ideas about the effects of exerciseduring pregnancy or exercise suggestions, the 2 following books are bothincredibly helpful and are both available on Amazon.com.·      Exercising Through Your Pregnancy byJames F. Clapp ·      Essential Exercises for the ChildbearingYears by Elizabeth Noble