Working With Anxious Parents

Crystal Cooper, PhD., IBCLC

When my kids were young, I considered myself a good parent until one day a woman I knew who had a master’s degree in child development told me the story of the one and only time she ever raised her voice to her kids. She said she had realized in that moment the harm she was doing and vowed never to do it again. Suddenly the bar on being a good mom had been raised to perfection, and as I recalled all the times that I had been less than my ideal mom self, I felt inadequate. 

I told my husband we needed to be on guard about everything we said and how we said it to the kids. There was no room for making mistakes! He asked me where this was coming from, and when I told him about that woman’s comment, he shrugged it off and told me that she was the most emotionally repressed person he had ever met. Thinking of it that way helped pull me out of the headspace that I was in. Maybe her version of what a parent should be like was not only unrealistic, but required a level of self-control that was itself somewhat dysfunctional.

Vigilance among parents also comes in the form of anxiously watching for signs there is a problem. Ruby, a postpartum doula, described her experience with hypervigilant clients and related it to the advice that medical professionals give you to observe and keep track of things related to your baby:

“The only way that parents feel like they can be a good parent is if they are totally on all the time. They can’t really trust their own child to resolve themselves. I think this goes back to the newborn phase, thinking about when you think there could be something going on with the baby, like watching for reflux or you are watching for a reaction to a formula-based feeding or after changing your diet and breastfeeding. The main thing that a medical professional is going to tell you is, “Observe your child, see how they react to things and keep track of it so that you can see if this changes, if it’s a positive change, or if we need to revisit an approach.”

I think that hyper vigilance can get really instilled in parents and they don’t know how to let go of it as their kids become more independent and their needs change because the parent’s need is not getting met in that situation. The parent’s sense of satisfaction that everything is fine has to be reset very often because of our parenting culture and because they only have this one way of responding.”

I noticed this when I was doing research with lactation consultants and their clients. In the hospital, families were given charts where they could track diapers and feedings. Vitals were frequently taken, and babies were weighed often by the nurses. I saw that many parents would continue tracking things long past what was requested. Some of them would use apps to help them track all things baby related. One dad proudly showed me a spreadsheet he had made for tracking.

Parents were also overly concerned with weighing their babies, or trying to measure their milk supply by pumping. They would ask where they could buy the special lactation scales that tell you how much milk your baby just drank from the breast, and would create huge stashes of breast milk that were bigger than they needed as a just in case measure. Now you can buy baby wearables that, like a Fitbit, record an infant’s biological data.

All of this can lead to anxious, hypervigilant parenting becoming the norm. Books, blogs, and other types of advice for practicing gentle, or responsive parenting can make parents feel shame for the times they may have been impatient, didn’t stop to consider how their child felt, or didn’t consider the child’s needs over their own need for physical and emotional well-being. Parents are left to feel like the moments when they are hangry, exhausted, or not watching for cues, that they need more self-control because they aren’t good enough.

There is a reason why flight attendants tell parents that in an emergency they need to put the oxygen mask on themselves before they put it on their child. Having our own needs taken care of first is the key to being able to adequately care for another. On the other hand, this doesn’t mean that the moments when a parent is cranky or inattentive that they are necessarily damaging their children.

I don’t know any parents who are perfect or who are getting all of their needs met. When I admitted to my daughter’s 8th grade teacher that I probably had postpartum depression after she was born, the teacher made some comment about how these things can leave an impact on a child. My daughter had been struggling emotionally in middle school like so many middle schoolers do, but for a while after that conversation I felt I was responsible for this because I had cried too much and didn’t smile enough at her when she was a baby. One comment can send a parent spiraling, and suddenly they fear that because they gave their baby formula and let them cry too long, they will have a juvenile delinquent.

Doulas might feel uncertain about how to deal with parents who are anxious and overly self-conscious. It can be helpful to think of yourself as a neutral observer who is looking for areas where you can offer support when you enter a client’s home. From Ruby’s perspective, the client is letting a stranger into their space, where they will see their pile of dirty laundry and see them in their pajamas with their bed head and even see them topless as they nurse or pump. This can be an uncomfortable situation for the parent. She has always practiced making them feel safe by being that one person in their life who isn’t judging them.

You can set the stage by letting the parents know that you aren’t concerned if their house is messy, in fact you expect that from someone who is recovering and has a newborn. People like to be reassured that their behavior and situation are normal. If you are used to clients who are disheveled, have piles of dishes, and feel like they have no idea what they are doing with their baby, this is reassuring to them. Give them the sense that every aspect of their experience is welcome, and that your job is to serve their needs, not to judge them.

While first time parents might ask for an expert who can give them advice, it is helpful for you to think of yourself as someone who is there to serve and guide them. This is a different mindset from being an expert who gives advice. Guiding someone is like taking their hand and walking beside them rather than telling them what they should do. It is less likely to trigger the feeling or fear of being judged.

Think about a time when you were served and guided. What did that look like and feel like? Clients appreciate doulas who anticipate their needs because they have paid attention to what is happening for a client. They often request doulas who won’t judge them if they decide, for example, that they want the epidural after all, or if they decide to stop breastfeeding. Guidance isn’t telling them what the best choice is in a non-emergency situation, but neutrally helping them walk through the pros and cons of available choices and seeing if they match up to their ultimate goal.

If you are a postpartum doula, you may find that many parents have the expectation that your job is primarily to care for the baby. Helping anxious parents get their emotional and physical needs met, however, will help them to be emotionally regulated so that they can then care for their baby. This may not mean in that moment while you are there, but in the moments when you are not. Hopefully by the time you have finished care with a family they will be more confident and self-assured because you were a safe sounding board for them, and because you allowed imperfection and self-care to be normal.

Image: Sarah Choi with pexels.com