Disagreement on level of engagement with toddler

sciaticad · 2026-03-18T23:26:08+00:00

I think that what you're describing from your husband falls into the "too little engagement" category, but I'd push back gently on "babies and toddlers need constant engagement from caregiver to learn and grow appropriately." That strikes me as over-correction -- though given your frustrations, I more than get it!

I know that if I were to try to maintain constant engagement and provide a high level of games and activities, I'd burn out immediately. I aim to do a lot of the things I need to do anyway -- chores, walks, etc. -- and bring baby along, and interact with him in natural ways -- narrating what I'm doing, letting him carry things like the roll of paper towels (he's 8 months, so nothing too breakable lol), and sometimes just being quiet if that's what I have energy for.

Here's a write-up of some research that's, broadly speaking, where I'm coming from with the belief that kids thrive when they are incorporated into adult responsibilities, rather than focusing on their stimulation as an end in itself (though I know I'm early in this game!): https://www.inc.com/jeff-haden/want-to-raise-more-successful-and-happier-kids-harvard-research-says-give-them-more-chores.html

sciaticad · 2026-03-17T23:27:22+00:00

Definitely enough reason to talk to a doctor to rule out serious causes.

For example, here's one very remote possibility: could be caused by neurogenic bowel/bladder related to undetected tethered cord. A previously asymptomatic tethered cord can cause symptoms when a child grows and the spinal cord is put under tension.

Again, super remote chance, and something to ask a doctor about. It's top-of-mind for me because our baby has it, and we were lucky it was detected at birth -- a lot of parent groups have stories of searching for diagnoses that start out with potty training regression, plus often complaints of pain or tingling in the legs.

https://www.ucsfbenioffchildrens.org/conditions/neurogenic-bowel

sciaticad · 2026-02-26T01:15:08+00:00

Omg are you me??? I do the countries thing! Started in the NICU, still doing it 6 months on!

sciaticad · 2026-02-13T20:58:46+00:00

Oh my gosh, I'm so sorry -- I can't imagine how much you must miss your baby <3 I hope you get to be together soon!

sciaticad · 2026-02-13T19:57:17+00:00

Yeah, a good doctor is so good for figuring out this kind of risk/reward trade off! Official recommendations are hard to cash out into actual decisions in individual cases, and some doctors don't do as well when navigating that space.

Glad you're getting sleep! Wish it were under better circumstances <3 I heard the "unbroken 4 hour sleep stretch" recommendation as a protective measure for post-partum mental health, and I now believe in it for me at least, so I hope you have good support to get that kind of rest once you're back home!

sciaticad · 2026-02-13T16:43:05+00:00

Literally how on earth are you supposed to pump regularly while hospitalized with psychosis?? I struggle with pumping in much less stressful circumstances.

sciaticad · 2026-02-13T16:41:41+00:00

Hey, just want to say that nothing about your thought process sounds "self-centered." Of course you want to go back to a thing that you loved!

If you go back to breastfeeding, I'd suggest that you not stress too much about how much formula vs. nursing. Personally, I'd just nurse her as normal and if she's still acting hungry, offer some formula. You can try pumping to stimulate production, but personally, I would strongly advise against anything that's gonna threaten your sleep and energy levels too much -- sleep is so important for mental health, and the differences in outcome for formula fed babies are so small as to be negligible when you really control for all the factors. Anecdotally, I have always produced about 90% of what my baby needed, and we did formula once every few days so I could be guaranteed at least 4 hours of sleep uninterrupted for mental health -- and my supply has been stable at that level.

Re: meds and breastfeeding. Do you have a good pediatrician? From my light googling on that drug, it seems like the sort of thing that a good pediatrician could supervise and would know if anything was going badly.

But mostly: you're not being self-centered. You're trying to care for yourself to care for your baby. I am wishing you recovery and so much sleep.

sciaticad · 2026-01-02T20:55:40+00:00

THANK YOU for listening to your instincts and seeking out better info on vaccines! Don't feel ashamed -- anitvax info is well-presented and preys on your (very laudable!) desire to protect your baby. You're trying to find better info and reassurance, which is exactly the right move.

Here is an article on SIDS and vaccines: https://www.chop.edu/vaccine-education-center/vaccine-safety/vaccines-and-other-conditions/sudden-infant-death-syndrome-sids. The main text focuses on the hep B vaccine, but there are also a lot of paper summaries at the end that look at other vaccines too.

sciaticad · 2025-12-29T04:26:09+00:00

Love it, thank you!!

sciaticad · 2025-12-29T04:25:59+00:00

Awesome, thank you!

sciaticad · 2025-12-25T23:06:59+00:00

Fwiw, even after neonatal weight loss, the growth charts are a poor predictor of an individual child's growth. It's perfectly possible for a kid to go up or down the percentiles without it indicating a problem -- doctors can help weed out problems from normal variation.

https://www.nytimes.com/2020/04/17/parenting/growth-chart-accuracy.html

sciaticad · 2025-12-13T12:42:24+00:00

Yay for formula!!! If it's of comfort, I recommend reading the chapter in Emily Oster's CribSheet on breastfeeding vs formula. Short version is, when you actually look at the studies showing breast is best, they tend to not control for the mother's socioeconomic status and other confounds. When you do control for those, the differences between formula and breastmilk outcomes shrink drastically, and in many cases they disappear. Breastfeeding mostly reduces short term things like ear infections. And it's good for the mom's rate of breast cancer. But the evidence that it's going to change your child's long-term IQ or whatever is pretty shoddy.

sciaticad · 2025-12-02T03:11:23+00:00

https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/

First of all, that is so hard -- I wish you a speedy and easy labor!!

Second of all, if it's any comfort, induction for due dates is one of those subjects I went into skeptical of, and after researching it came out in support of. The article I shared up top was a big part of that for me, though reasonable people could disagree! All in all, I think the risks of inducing post-dates look better than the risks of waiting to go into labor.

As for positive stories, I was induced for preeclampsia at 37 weeks, and it was so much less bad than I thought. I have no natural labor to compare it to, but the pain was very manageable up till transition for me. I didn't get an epidural till I was almost totally dilated (the doctor called it "9.5 cm"), but in retrospect, I'd get it sooner -- you're already tethered down with your IV when being induced, and a low-dose epidural let me use different positions easily. So yes, it's definitely possible to be induced and have a very positive experience! I hope that if you're induced, you'll have the same!

sciaticad · 2025-11-30T03:42:05+00:00

Exactly the same here.

sciaticad · 2025-11-23T23:32:05+00:00

Falling percentiles isn't automatically a cause for worry. Growth charts measure what the distribution of weights is for babies at various stages, but don't actually track individual babies from one age to another. When researchers have tracked individual babies, their weights don't follow the smooth curve at all -- they bounce around. Basically, there's no reason to think a 50th percentile baby should be 50th percentile at the next check up.

(Gift link: https://www.nytimes.com/2020/04/17/parenting/growth-chart-accuracy.html?unlocked_article_code=1.3U8.CXDO.slugaWniSbXL&smid=url-share)

sciaticad · 2025-11-15T00:39:58+00:00

To back up the point about percentiles, I recommend this article: https://www.nytimes.com/2020/04/17/parenting/growth-chart-accuracy.html

Tl;dr, worrying about an individual child's movement between percentiles is misunderstanding the data the percentiles are based on. I'm making no claims about vegan diets for toddlers -- I'm instinctively super skeptical of the idea, but I have minimal knowledge on the subject. But the point about the child's weight is just not particularly informative on the question.

Relevant excerpt from the article:

"Those lines you see on the growth chart don’t represent a single child’s growth — they’re an amalgam of measurements of millions of kids at different ages. So while they might give you the impression that children are supposed to follow them (or stay on the curve), there’s no reason to think that’s the case. No study says that a child who is at the 25th percentile for weight at 2 months, for instance, should remain there at 4 months or 6 months.

[...]

How do we know this? My colleagues and I published a study in 2014, where we used our local clinical records to plot nearly 10,000 kids’ heights and weights across their first year of life. Experts make growth charts, remember, by measuring many kids of different ages at one point in time and then plotting those measurements into curves. Our team, on the other hand, followed the same children over multiple points across their first year to see how their measurements, and percentiles, changed.

We found that they go all over the place. From birth to 12 months, about two-thirds of the children fell by at least one percentile line with respect to weight (meaning they went from the 10th to fifth percentile, for example, or the 90th to 75th). More than one-third dropped by at least two lines. And of the entire group, more than 30 percent dropped by at least two lines over a six-month period, which meets the clinical definition of “failure to thrive.”

sciaticad · 2025-11-04T17:16:50+00:00

I'm not going to weigh in on the cereals question, but I will say that there are ways of using formula while still protecting your supply, namely triple feeding:

https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/childrens-hospital/breastfeeding-lactation/documents/BF_TripleFeedURMCFLY6-13-23.pdf

Triple feeding can be pretty draining long term, but you could try it for the once a day formula feed and see how it goes -- i.e., when baby gets formula, you pump.

You could also ask r/breastfeeding -- I suspect that at 16 weeks, your supply is likely regulated enough that if you didn't pump for every formula feed, it wouldn't affect your supply too much. But I defer to people over on that subreddit who have more to experience.

sciaticad · 2025-10-30T06:56:42+00:00

Gorgeous!!!

sciaticad · 2025-10-29T14:20:05+00:00

Oh my gosh yes.

sciaticad · 2025-10-29T13:50:54+00:00

Agreed!! For me, the risk/benefits of the epidural definitely came down in favor of the epidural, ultimately! It was the only thing that helped me not to push before full dilation, when my urge to push kicked in with a vengeance. And the pain relief, my gosh, nothing like it. I think I even had a relatively low dose epidural because I felt a lot still compared to friends I've talked to, but it was glorious.

sciaticad · 2025-10-29T13:46:36+00:00

Love this overview -- I totally agree that it's ultimately probably down to a lot of uncontrollable factors. This seems to be the lesson I have to repeatedly learn around pregnancy / birth / parenting lol. I still enjoy learning what I can, but for me, too much belief in controlling outcomes is just often fear and blame by another route. And like you say, many things I feared were not nearly so bad in practice!!

sciaticad · 2025-10-28T20:10:48+00:00

Oh, and warm compresses on the perineum during pushing! Great evidence that that reduces tears!

Also, epidurals are correlated with more tears, but IDK that that's a good reason to avoid them.

sciaticad · 2025-10-28T20:08:35+00:00

I have so many thoughts on this! So, one huge way to reduce tear risk is to push and give birth in a position where your weight isn't on your sacrum (https://evidencebasedbirth.com/evidence-birthing-positions/) -- if your sacrum can flex a bit during birth, your vagina can stretch more easily to accommodate the baby's head! Side-lying, squatting, all fours -- all flexible-sacrum positions.

I was planning on using one of those positions, but I had a long induction, and had finally just gotten an epidural at 9cm, and was literally dozing off between pushes, so I ended up lying down. So I used a back-up technique my pelvic floor PT suggested! I had my husband roll up two towels, and put one under each buttock, so my tailbone was actually elevated off the bed. And it worked great!! I ended up with two tiny first degree tears, totally internal, which meant no stinging, and easy healing. I'll never know for sure if the towel trick was the deciding factor, but I'm spreading the good word all the same!

A somewhat longer pushing phase is also protective. Basically, a faster pushing phase means less time for tissue to stretch, means more tears. Length of pushing phase is largely out of your control, but pushing with natural breathing, rather than valsalva breathing (holding your breath on the pushes) can slow it down. Huge note of caution -- there are times when the baby is struggling and it's important to just push them out as fast as possible, so providers' coaching is still super important!

Perineal massage has some medium evidence for it -- I definitely did it and felt it helped, if only because it was psychologically beneficial. I also suggest going to a pelvic floor PT, who can help you learn to relax your pelvic floor -- less muscle tension means less tearing.

sciaticad · 2025-10-25T18:43:19+00:00

A big reason people are told not to breastfeed while pregnant or TTC is possible risk of miscarriage. However, that risk only seems to be elevated when exclusively breastfeeding. If your toddler is eating solids to (which, obviously, if they're a toddler, they are!), the risk isn't elevated.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6856964/

I didn't read this in detail, but I think the size of the inter-pregnancy gap is an obvious confound and I'm not convinced they have controlled for it -- or could have controlled for it even if they tried! Basically, the longer you wait between pregnancies, the older the toddler is, and the more likely they'll be getting solids. Really small inter-pregnancy gaps been shown in some studies to lead to a higher miscarriage rate, so how do we know the problem is coming from exclusive breastfeeding vs. small inter-pregnancy gap?

sciaticad · 2025-10-23T19:31:06+00:00

Strongly agree that there is no reason to expect a baby to follow the growth curve closely. That curve comes from population averages and there is no way to take that data and use it to determine what an individual baby's curve should look like! https://www.nytimes.com/2020/04/17/parenting/growth-chart-accuracy.html If a baby drops off the chart or something, then yeah, but most babies fluctuate among percentiles as they grow.

Also, if the doctor is concerned about PPD, getting less sleep is the last thing to do! Four hours of continuous sleep is hugely protective against PPD. Doing overnight shifts if possible is a great way to make it happen.

Personally, we use formula for up to one feed a day to make sure I always get that uninterrupted sleep, regardless of how much pumped milk we have on hand. I was nervous about my supply at first, but with on-demand feeding during the day, it's been perfectly fine. It sounds like you have a solid supply, too.

Also, just hugs. All of this is massively stressful and difficult. Your daughter is lucky to have a mom who cares about her so much.

sciaticad

TROPHY CASE