Bonding can take place in so many different ways, it can be immediate, and it can be in the third trimester for many parents. It can be the first time you hold them, lay eyes on them, or it can take a little bit longer and maybe need some facilitation of things like massage and, and some help from experts. Your mental health plays such a big part of it as well—Kirsty
Kirsty is a physiotherapist who works with neonates and she’s mum to two-week-old Matthew. She shares how her insights into neonates have impacted how she cares for her newborn. We talk about bonding and attachment and how falling in love happens very differently for everyone. We go on to explore kangaroo mother care or skin to skin. The how, when, and why. Of course, we also talk about how to cope with toddlers’ demands and jealousy when the new baby arrives. So stay tuned as we explore the life of a mum of three through the eyes of Kirsty.
Welcome to Sense by Meg Faure the podcast that’s brought to you by Parent Sense, the app that takes the guesswork out of parenting. If you’re a new parent, then you are in good company. Your host Meg Faure is a well-known OT—Infant Specialist and the author of eight parenting books. Each week, we’re going to spend time with new mums and dads, just like you to chat about the week’s wins, the challenges, and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg here every week to make the most of that first year of your little one’s life. And now meet your host.
Meg: Hello, mums and dads. It is so good to have you back again. I am loving our weekly chats with real moms, exploring the weekly highs and lows of parenthood. And as you know, each week, I’m joined by a parent. And I share my knowledge, my years of experience as an occupational therapist, and the author of eight books. And I apply the sense that I’ve learned to what can otherwise be a tricky time in life.
And so this week we’re joined by Kirsty who is a mom to three little ones. So she has two-year-old twins, Charlie and Adam. And then she’s got two week old, little Matthew, who by the way, for this entire podcast is lying in her arms. And you’ll hear his little grunts and groans as we go through. But Kirsty is also a colleague from Cape Town. She’s a physiotherapist who is specialized in pediatrics and she and I have worked together with each other over many years with little ones. I would refer all of the developmental challenging babies to her, and she would refer the little ones with sleep problems and feeding problems to me. And more recently she’s become very specialized in prem-babies. So she works in a Neonatal ICU at Mirabel Maternity Hospital in Cape Town where she uses sensory developmental care to look after these little ones. She is an incredible physiotherapist. And now an experienced mom with three little ones.
Welcome Kirsty, and tell us a little bit more about your family and about your journey as you embark on the newborn journey for the second time.
Kirsty: Hi Meg, thank you for having me. It’s lovely to be here. So yes, I had twins two years ago and it was quite a whirlwind of an experience. And when we decided to have a third, I was keen on making the journey a different one. So I wanted to focus on bonding with my boy in the first week of getting to know him.
Meg: Yeah. Did you find bonding in the first with the first little ones tough or tricky? I mean, twins is quite a thing, isn’t it?
Kirsty: Yeah. So twins in itself is a thing. And my journey was forged with challenges, unfortunately. So I had a very anxious pregnancy the first time around. And then when the baby came along, we had to bring them into the world a little bit earlier than expected. I had a bit of pre-eclampsia.
Meg: So how far along were you?
Kirsty: I was 35 weeks.
Kirsty: Which is still pretty good for twins.
Meg: Yeah. Yeah.
Kirsty: But it was still a challenge to bring forward my plan date at the last minute,
Meg: For sure. And I think it’s important for people to know the context in which maybe some of that anxiety came about. And that is that you and I have worked together because you’re a physiotherapist. And I sometimes feel like that kind of background of knowledge maybe can increase the anxiety because you just know how vital that pregnancy and that birth is.
Kirsty: Yes. And I work in the neonatal unit of the Moriah Maternity and in the high-risk clinic there. And in my private practice too, I see a lot of babies that have had challenges. So perhaps my perception of the reality is a bit skewed. So I think that was one of the reasons I was so anxious in the pregnancy. I’m an older mom. I was 40 at the time, I had multiple pregnancies, so twins, Stephanie Morris factors. And I was just surprised at the emotional challenges I faced during the pregnancy in particular.
Meg: Yeah. And I think that’s common for so many moms that, you know, I mean, I know that you and I both had that background of knowledge, which does make you maybe slightly more anxious. But for lot of moms, I mean, pregnancy, we know that it’s important and we have these niggles and we don’t know if that means that something’s going to go wrong. And of course, pre-eclampsia in itself is something very scary to go through.
Kirsty: Yeah. So then it came time for the babies to be born and they arrived in the world a little bit of a frenzy to get dad here from Mauritius. He was living in Kenya at the time and there was phone calls at all hours and flags from different places and managed to get him in town just in the nick of time. To be wheeled into theater on a Monday morning. And unfortunately, my condition wasn’t great during, and after the surgery. And as a result, I had an extended stay in the hospital with a couple of other operations and a few other physical challenges myself. And I was just very fortunate that the boys were allowed to, they were moved into the NICU and they were allowed to stay there until I was physically fit to look after them. But that was about 23 nights. So it was a long journey to get them into my arms.
Meg: Oh my word, Kirsty. I didn’t realize that. So when you say they were in the Neo ICU and, and for those in the UK, they call it the SCABU, you know, different names. What was the reason that they were, I mean, they were born five weeks early, did they need to be in the Neonatal ICU, or was it because you were being hospitalized that they were there?
Kirsty: So the one little baby, the firstborn, Charlie, he was grunting a tiny bit. And so the doctor recommended that he move across to NICU and they generally don’t split twins.
Kirsty: So they just took Adam along with. And at that point, my blood pressure was well over 200 over 200. And I was in quite a critical condition and just getting them anywhere safe was my priority. So I was happy to consent for them to move the boys ASAP.
Meg: Your condition, had it progressed into a help situation because that sounds quite serious.
Kirsty: It was serious. I went into major pre-eclampsia on the table, which is very unusual. And, you know, I was in the hands of a team and they were just incredible. My doctor was incredible and so, yeah, so that happened. And then, it was a cascade of events that led to a bleed and I had a big bleed and intra-abdominal bleed. And then I had to have further surgery to remove that the next day. And then I had to have blood transfusions, but that caused anaphylaxis. So that caused further days in the ICU.
Meg: Oh my, goodness me, a proper cascade.
Kirsty: A proper cascade. And just what a pity. It was just a pity, it was just bad luck.
Meg: So for 23 days, how much of that time could you, I mean, you clearly couldn’t breastfeed, but how much of that time could they be with you and how much, how much contact did you have with them? And do you feel like that was disruptive?
Kirsty: So as an anti-personality that, you know, I self-mobilize myself. I think it was on the second night after my second surgery and found myself walking through, into the NICU in the dark and saying, I need to hold my baby. Of course,
Meg: Of course, of course.
Kirsty: So I think I held one of them, but I was quite drugged up, so it was all a bit of a haze, I held one of them that day. And the other one, I only held again on the third day.
Kirsty: So they were bound to my chest and then they were whisked away. And then it was a few days till I got to hold them. And then after that, I made sure I went through whenever I could. I tried to feed them, care and see them, sit with them on my chest and just like our moms do at Mobray, I wanted to spend as much time with them as possible, but I had to balance that with looking after myself and getting rest and recovering my health as well. And stupidly I was having lots of visitors, and in retrospect, I shouldn’t have had so many visitors. I should have just knuckled down. And now in COVID when little Matthew was born, we aren’t allowed visitors in hospitals and I really can suggest that moms consider that as a good alternative and just be present and just be with your little baby. So Matthew’s—.
Meg: Matthew’s utterly gorgeous. He’s lying in your arms, your little two-week-old. I mean, maybe you could just talk a little bit about, I’m sure you’ve reflected on the difference in your bonding journey, you know, having been an ill mum the first time around and having had a more typical kind of journey this time round, has it been very different?
Kirsty: Absolutely. I went in with the intention to bond because with the twins, with all of those changes, I felt like they were these little aliens that didn’t belong to me. And it was quite sad for me to feel that. And so my intention this time was to maybe have the experience of lots of other moms are blessed with. And I took him into my room as soon as he was born, and I was able to, yeah, he wheeled three with me now that I remember it. And he stayed on my chest in KMC for about four days. I just kept him with me
Meg: And how was that? We’re going to come back to KMC just now because I really want to go and do a deep dive into that. But before we do, have you felt a difference? Do you feel like you’ve had a different journey to falling in love this time around?
Kirsty: Absolutely. Absolutely. And my knowledge before knows that every mom is different and every journey is different and bonding can take place in so many different ways. It could be immediate, it could be in the third trimester for many parents. It can be the first time you hold them, lay eyes on them, or it can take a little bit longer and maybe need some facilitation of things like massage and some help from experts. Your mental health plays such a big part of it as well. Yeah. So for him, I just said, I’m going to wear him and stare at him for the first few days. I love that wear
Meg: I love that. Wear and stare
Kirsty: Wear and stare.
Meg: I love it. So I think Kirsty, it’s so important to just bring that up because I think that there’s a lot of guilt and particularly for new moms who’re listening to this who maybe got a three-month-old where they don’t feel that they’ve bonded properly or they just don’t have those feelings. And I just want to go back to what you said there, the pictures that are portrayed in marketing ads and in and on social media are that you fall in love, love at first sight as you see your baby, but it isn’t true. And for a percentage of moms and I was one of those moms, you fall in love, right, from the get-go, because as soon as you knew you’re pregnant, as soon as you feel those movements, as you see those ultrasound scans, you’re just in love from day one, you’re utterly besotted and that’s your journey.
And then you get other moms who don’t attach all in pregnancy, particularly moms who’ve gone through fertility treatments or have lost a baby because, or maybe for those moms who’re career moms, and this wasn’t a planned baby. And so for those moms, they don’t attach in pregnancy. And then sometimes they look back afterward and have this guilt around not having fallen in love and not having wanted this baby, having maybe some mixed emotions around being pregnant. And then you get the bunch of moms who fall in love, love at first sight, but you do get moms. And I loved what you said about that. You know, there’re so many factors that can impact on that. There is, is this a wanted baby? Did your birth go according to plan? Do you have postnatal depression? All of these factors can play a part in not bonding in the first three months. Well, maybe even the first six months. And what we know about the research is that babies are very resilient and so bonding as long as they get good care and fairly consistent care in the early days if you only really fall in love at nine months or six months, and that’s the first time that you connect with your baby, it’s okay. They can have a good and robust emotional span in the world. And I think it’s just a very important thing because your journeys have been very different with your little ones.
Kirsty: Yeah, absolutely.
Meg: Yeah. Very interesting. I want to go back around to the ‘wear and stare’ because I mean, you spoke about the word KMC and I think that’s not necessarily something that’s familiar for a lot of moms and you’re referring to the wearing of your baby and you work as a physio in a Neonatal ICU. So do you want to just tell us a little bit about KMC, what it is and how beneficial it is?
Kirsty: Absolutely. So hospital, where I’m employed, has a doctor called Neil Bergman who did some incredible research into the neurophysiology and the understanding of what they call Kangaroo Medicare can do for a child. The knowledge started when, I hope I get my story, right, but as far as I remember, there was a hospital in quite a rural area of Africa and they had a policy.
Meg: I’ll tell you where it was. It was in Bogota, Columbia. I’ll let you in a little bit about the story.
Meg: No, it’s a fascinating story. So in Bogota, Columbia, South America, they had a Neo ICU that didn’t have incubators and they literally couldn’t care for these babies. And so the babies would die. The prem-babies, I’m talking about the very prem-babies would be born and not be able to regulate their body temperature, their breathing, and so forth, and so they would die. And then there was a doctor who became very well known, he was the father of Kangaroo Mother Care. And he said you know what we’re going to do is we’re going to put these babies on their mum’s chest naked because then the mum can just have that moment of closure before the baby dies. And this was the idea. It was let’s put the baby on the mum’s chest, the baby’s going to die.
But if they set that connection with the mom, the mom might have less, you know, depression or whatever it is after. And then what ended up happening was that these babies, particularly the older premies, so the babies who were maybe 34, 35 weeks, just didn’t die. And so suddenly it became, right, we’ve got to research this because if these babies are not dying, what’s the reason for that?
And part of that is that the mother is just the most unbelievable incubator and Neil Bergman is incredible because in some ways he, I don’t want to say he commercialized it, he kind of made it, he popularized it because he’s such a brilliant speaker that when you hear him talk about Kangaroo Mother Care, KMC you start to realize just how vital this is. So that’s actually where it started from. But please continue, because I know that you’ve heard this from the horse’s mouth, from Neil’s mouth.
Kirsty: Probably preggy brain, forgot the real details. But never mind the feeling is that you put your baby’s skin to skin and we do this with all our moms in the ICU, the sickest and the most compromised of babies, we get the moms to wear them for as long as they will during the day and your body by touching your baby’s body, your skin to skin creates these incredible pathways through your neural systems, and it taps into your Amygdala, your emotional brain and you end up bonding. So you have an emotional connection with the baby and the baby has an emotional connection with you. It’s your skin-to-skin contact, but also your system helps regulate the baby’s needs. For example, a small baby who will have issues with regulating temperature, your body temperature will change according to what your baby needs as you wear your baby on your chest. And so—
Meg: And that’s a really interesting fact. So, before you move on to the sensory part, just that physiological part, and many moms as they fall pregnant, look down at their chest or look at their chest in the mirror and they see all of these blue veins going down to their breasts. Now, I mean, that for me was one of my first signals every time that I was pregnant, as soon as I saw the blue veins, I thought, okay, I know what’s happening here. And of course, it’s important because we need to develop our breast tissue to be able to feed the baby. But what also happens is because we’ve got all of these veins, bringing blood to the area, those veins can dilate and bring more blood if you need to be warmer. And so your body knows the temperature of your baby. And as if your baby’s a little cooler than you are, for instance, your body knows it needs to be warmed up. And so the blood floods to the area and literally mom’s chest can change about four degrees to warm their babies up.
Kirsty: Yeah. What about dad?
Meg: Dad’s chest can’t do that. But having said that, I mean dads can also KMC their little ones if moms cannot be there.
Kirsty: Great. And then the other, so besides temperature, they can listen to your heartbeat, it’s a very calming stimulation. It’s also putting some pressure on their tummy, which is also very calming. Their midline, they often see snuggle their hands against you, so there’s a nice, deep pressure. It feels like it’s like a little womb. I had a specially made KMC top, which had a little slip where the baby slept in, and then I had a little wrap that went across each my body that a lady had made for our moms at Mobria, and I got one from her. And it is just so wonderful.
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Meg: So for moms who wanting to do this, and I mean, if you’re pre-pregnant and you’re listening to this, the principle that we always talk about is KMC your little one as much as possible in the early days, exactly as you’ve described. And how to do it is babies naked with a nappy on. And I like to put a little hat or a little beanie on their heads so that they don’t lose heat through their heads. And then you put a covering and in your case, Kirsty you actually put a t-shirt or shirt on, but a mom can even just put a towel or a blanket over herself and her baby to keep them warm. And it is amazing. I think the research in it is so significant. It does help them to survive as I mentioned with the babies in Bogota, Columbia. It helps them to connect and helps moms to connect as well. It also increases the chance of breastfeeding because when your baby has quite unrestricted access to your breast, particularly in the early days, it’s very good for milk stimulation. So it helps in that way.
It helps with falling in love because when you’ve got the skin-to-skin touch, you’ve also got oxytocin, which is our falling-in-love hormone that gets released more. And so you, connect more and what’s incredible with oxytocin is when you have more connection, your baby actually releases oxytocin as well. So you get this whole falling and love cycle that happens. They’ve also shown that babies gain weight better through being in KMC. So there’s just a myriad of reasons why moms should be kangarooing their babies. And you obviously experienced that, you know, full-on with, with Matthew. Are you still, can seeing him at two weeks, or have you stopped now?
Kirsty: I really am. And mostly because it keeps me hands-free. So in my particular setup, he’s super-secure where he is inside and I can walk around the house. I can put the laundry on, I can do all the jobs I need to do, and I can play and look after the twins. So
Meg: So just to be clear, when you talk about doing all of that, so you, a mom could do all of that just in a normal carrier, but you’re saying he’s naked on your chest like that, or he is in a carrier. No, he’s naked on your chest.
Kirsty: No, he’s naked on my chest. He wasn’t, I didn’t even put clothes on it till the fourth day.
Kirsty: And now in the mornings I take his clothes off and generally pop him in there and he stays there until it’s time to get dressed in case he’s going to see somebody else.
Meg: Well, you’d need to have a very special type of sling to do that. For the other moms who’re listening, because it would have to be very secure.
Meg: You know, and I mean, I can remember having a conversation with Moss Bergman who you spoke about earlier actually at our infant mental health group many years ago, where he, I mean, he’s an extremist and of course, a very loud and vocal voice for, for KMC and rightly so because we need people to have a have strong voices. And he said to me in his, I think he’s got a German accent on an Austrian accent, I don’t know where it’s from. But he said to me, you need to kangaroo for six weeks without stopping. And I said to him, “Moss life happens, you know, people are going to go to the shops. You can’t kangaroo all day, every day.”
Kirsty: But you can, you can. Yeah.
Meg: Well, I think one of the things for moms is, if you can, that’s absolutely incredible like you doing. For me, I did kangaroo and particularly my third one who was my Caesar baby, but I also then had a carrier that I would then whenever I was going out the shop, she would rather be in a carrier. And I think, you know, one of the messages that I’ve always tried to give to moms is put your babies in carriers rather than in prams, because when they’re up against you, there are so many benefits, even if it’s not naked in KMC, there’s just so many benefits of wearing your baby.
Kirsty: So, yeah, my first week was a few days in the hospital. I opted for an extra night just to get the rest I needed. And thank goodness I did because I arrived home to a sick nanny.
Meg: Oh God.
Kirsty: And had no help first week when I got home. So that was chaos, but also an adventure in itself, and we all just figured it out.
Meg: How did you find that the boys responded to having a new baby and how were there things that you did that really worked well to help them adjust between, you know, kind of being, having all your focus and now having your focus on a newborn?
Kirsty: Well, the fortunate thing is that the babies in the first two weeks, they sleep so much, they are pretty calm. I think it’s only after two weeks that your digestion and all sorts of things start to wear their little heads. So, you know, Mattie sleeps quite a lot. So whenever I get the chance, I’m generally wearing Emmy’s inside my top and then I don’t have to pay much attention to him and I can give the boys as much attention as they need.
Kirsty: The one, I think its personalities, the one baby, the one little boy Charlie likes to come and go gentle, gentle, and gently stroke his chest and then end with a little poke. Otherwise, he wiggles his toe slowly creeps his foot toe by toe, closer, closer to the baby, looking at me sideways, and then when he gets very close, he gives a little flick. So he knows he’s being ignored.
Meg: Yeah. That’s so funny. And also a way that they can get attention from you as well.
Kirsty: Attention from me.
Meg: Because you’ll immediately respond then.
Kirsty: And I’m pretty calm. I just go be gentle with the baby. We are nice with the baby. We don’t poke the baby. We don’t kick the baby. And then I bring them in for a hug or a kiss or a whenever I see them trying to create a reaction with the baby. I give them an extra big, a deep squeeze, and a bit of attention.
Meg: I love that. So I think that’s so important. You know, I think when we talk about the attention, that’s probably what they’re looking for and you’ve got to find ways to do that positively rather than, because if you don’t do that, then they’ll find ways to seek the attention. And then it’ll be negative attention. A couple of the tips that I often tell mums to do, and particularly as he gets old, and one of the things you said that’s so true is that often toddlers are completely oblivious for the first few weeks, but when Matthew starts smiling and he gets cuter or crying more or demanding more, you know, then you know, the rivalry or the jealousy well is more likely to raise its head. But one of the things that I always did with my little ones was, I had a box of books next to where I would feed because breastfeeding is, I mean, it’s half of your day, you know, it’s all the time. But the newborn, Matthew doesn’t need anything more than just your breast. So I would sit down with a box of books next to me and I would say, oh, it’s storytime now. So it’s not feeding time. You know, it’s storytime now, and I’ll keep Matthew I’ll occupy by feeding him so that they don’t think that this is Matthew’s feed time, therefore they get a story. They think this is our storytime and by the way, Matthew will be kept quiet on the breast, you know, type thing. So it’s all about them.
Kirsty: That’s so clever.
Meg: And then having a box of books wherever you are, I think that’s really, really important. And it’s great for Matthew’s brain as well because when newborns hear their mum talking and reading during breastfeeding for those moms who don’t have older siblings, you know, older toddlers, they can do that anyway, when they hear you talking, they’re learning and wiring the language part of their brain anyway. So yeah, it is a good thing.
Kirsty: Great, thanks. Great job.
Meg: Yeah. So I think we’ve only really got another minute or two and Kirsty I’d love to keep up our through the course of the year because you have so many fabulous insights because of what you do. Is there any milestone, if you think back to the last two weeks, he’s only two weeks old, is there any milestone that you think that you’ve noticed and gone, “Oh my gosh, that’s so magical.” I wonder if all mums have noticed that, you know, being that you have the insider’s of being a developmental physio.
Kirsty: There’s nothing that surprise me at the moment, but what I will say is a developmental milestone. I’ve been working on his visual tracking and so working on getting his eye contact, looking at me, and then following me from side to side. Yeah, so I use my face. I come in not too close, not too far, just right. So from my nose to my nipple is kind of the distance that his eyes are focusing at this age. And every week his eyes will learn to focus a bit more, a bit further, a bit clearer. So keeping my distance to about 20 centimeters away from him and I just go from side to side and I allow his eyes to follow me and slowly I’m going to start introducing up and down as well. So a visual tracking, visual regard.
Meg: I love that.
Kirsty: I think that’s a really nice thing to work on.
Meg: Yeah. That’s lovely. So a couple of things around that, so we know that babies can focus, as you said, exactly 23 centimeters or 20 centimeters, which is actually an absolute miracle because they’re perfectly wired for engagement when they’re lying at your breast. And so if a mom does hold their baby that distance it’s really perfect visually. The other thing I always say to moms is when you’re doing those exercises, which develop the extraocular muscles and the intraocular muscles. So the intraocular muscles are responsible for focus. So if you move slightly, further away and slightly close, so that’s the intraocular muscles having to change or hone their strength or their accuracy. And then your extraocular muscles are the ones that move you left to right, and up and down. So those are the type of things that moms should do.
But to do that, that’s a fine motor skill. Even though it’s an eye skill, that’s a very high level of coordination for a two-week-old baby. And if he’s bothered by his movements of his body, his gross motor movements, if he doesn’t have stability of his neck muscles and of his head, he’s not going to be able to use those fine motor muscles. And so I always say to moms, make sure they’re very heavily supported and that there’s no other movement in their body while they do that. Shoulders leaning slightly forward, head supported fully, and then they will actually be able to kind of really hone those intra and extraocular muscles. So that’s a great piece of advice for the two weeks. Kirsty, thank you.
Kirsty: Yes. Actually, wrap him up. I waddle him in those periods.
Kirsty: I cup him against my legs brilliant with my knees up in the bed, and I hold his hands to his tummy and his feet are a little in, so he’s in a little nest.
Meg: I love it.
Kirsty: And then I use my face from side to side. Yeah, exactly.
Meg: That’s brilliant. That’s
Kirsty: And that’s great.
Meg: Well, that is such a fabulous piece of advice for moms, a little titbit that you can all do with your not-to-two-week-old baby, developing those eye muscles. And then of course, as a byproduct, you also developing engagement and, and so on, which is stunning. So Kirsty, thank you so much. And Matthew, thank you for joining us. Matthew. He’s been so good. Just a couple of little grunts. He’s sleeping so beautifully.
Kirsty: I’m lucky.
Meg: Yeah. Well enjoy him, Kirsty and we will have you back on again. It’s stunning to talk to you. Awesome.
Kirsty: Awesome, I really enjoyed it too. Thank you for having me.
Meg: Thank you very much. All right.
Thanks to everyone who joined us. We will see you the same time next week until then download Parent sensor and take the guesswork out of parenting.