The baby’s finally here, and she’s adorable! Six months after Nipunie Rajapakse, M.D., gave birth to her new baby girl, we’re catching up with her for a candid conversation about how the first few months of parenthood have gone, including:
* Nipunie’s delivery story
* Her recovery after her C-section and tips to get through it easier
* The first steps for the baby right after delivery
* Breastfeeding: both mom and baby getting used to it
* What surprised Nipunie most about delivery and the first postpartum period
* Her biggest challenge about being a new parent
* How breast pumping has gone so far
* Things she bought for the baby that have been more helpful than she thought
* Things she bought that she thought she would use and didn’t
Read the transcript:
Dr. Mattke: Welcome to the Mayo Clinic Moms: Talking Pregnancy podcast. I’m your host, Dr. Angela Mattke, and we have a special episode for you. Last time we talked with my co-host, Dr. Nipunie Rajapakse, she was still pregnant. And today, we’ll meet her daughter, discuss her delivery story, and review the joys and challenges of raising an infant.
Nipunie, I’m so excited. Who do you have with us here today?
Dr. Rajapakse: So I brought baby Isla with us today. She’s six months old now. Kind of hard to believe that time has gone by so fast.
Dr. Mattke: It’s insane. I feel like we just talked about your pregnancy and anticipating your delivery.
Dr. Rajapakse: She’s here and she’s great. She’s been lots of fun. Some challenges, but mostly fun for the last couple of months.
Dr. Mattke: So she’s six months old now?
Dr. Rajapakse: Yeah.
Dr. Mattke: Oh wow, my goodness. What kind of new things is she learning to do?
Dr. Rajapakse: Lots of new things. We have lots of smiles and laughing. She might do some of that today. We’ll see. She is sitting up really well. She’s pretty social. We started solids this last couple of weeks. We’ve had a couple hiccups there. And she’s transitioning to a crib in our room. And so that’s been also a little bit of a challenge, but she’s doing pretty well so far.
Dr. Mattke: Is she sleeping?
Dr. Rajapakse: She sleeps. We’ve been really lucky so far, I have to say. I know before we were talking about sleep and all of those things and all of my anxieties about whether she would sleep or not. And I would say for the first four months, so just before I came back to work, she actually was a really good sleeper.
Dr. Mattke: But as soon as you came back to work….
Dr. Rajapakse: Yeah, , I came back to work and that changed a little bit, but I really can’t complain too much. She wakes up in the night a couple of times, but she settles pretty easily.
Dr. Mattke: She’s so calm and she’s just like, astutely checking everything out in the room and just feeling all those textures.
Dr. Rajapakse: Yeah, new environments I think she likes. We’ve been pretty much at home quite a bit because of COVID and other things. And so any new environment that she’s in, she’s pretty interested and.
Dr. Mattke: She’s not too shy, though.
Dr. Rajapakse: She’s doing really well. She’s starting to get a little bit of the stranger anxiety now, but she warms up when she’s been around someone for a while.
Dr. Mattke: You like new faces, yes, you do. Yeah. Well, Miss Isla, thank you so much for joining us today. I understand you have an appointment with a nap. Yeah. Are you to go home with Daddy?
Dr. Rajapakse: Bye bye.
Dr. Mattke: OK, Napunie, I really would love to hear your delivery story. And I know that everybody’s delivery story can be, like, a little fraught with unexpected things, so hopefully nothing like that happened in your situation.
Dr. Rajapakse: Yeah. So we had some expected things and some unexpected things come up, which I think is probably the case in a lot of situations. For us, I’ll say we were somewhat fortunate, so I had a planned C-section, so I actually had a sense of when those things were going to happen and a bit of us ability to kind of plan for how things would go and think a bit in advance about how things would go. So I think that kind of helped to relieve some of my anxieties while delivering.
She was born in December…December 7th was her birthday…and so this is winter in Minnesota. So of course there was a big snowstorm the morning that we were supposed to come into the hospital. So that was interesting. But we made it there on time.
And really the process from there was relatively straightforward. Everyone I would say the staff was really great at kind of telling us what was going on and what to expect next, which really helped a lot. And so we got all checked in and got our room, and they gave Thomas the stuff that he could wear in the operating room.
And so things mostly kind of were as expected. I think for me, probably the hardest part of it was the initial time in the operating room. So he wasn’t there with me for the initial part with anesthesia and getting the spinal anesthesia as well. And so that part was a little bit challenging but again, the staff were kind of great at really explaining what was going on, which I really appreciated.
And so once I was all ready and set for the obstetrician to start the procedure, then they allowed him to come in, which is nice that he could be there with me for that. And really, I think one of the surprising things for me was just how quickly from when they started to when she was actually delivered, he had his camera going pretty much the whole time.
It was like 7 minutes from when they started to when she came out of. So that part went really fast and thankfully getting her out was uncomplicated. One of the reasons I had had the C-section was because of concerns about fibroid, which is kind of a benign mass on my uterus that could have potentially complicated a vaginal delivery. So we decided that we would just go to C-section route.
But one of the unexpected things that happened was when they actually saw the mass intra operatively, they thought it looked kind of atypical or unusual for a fibroid. And so from there, things got a little bit more complicated because they ended up calling an emergency gyne- surgery consult..so another surgeon came into the room….
Dr. Mattke: Did you know what was going on?
Dr. Rajapakse: ….Yeah, they kind of explained it. And so there was a lot of kind of discussion about whether to remove this thing or just to do a biopsy. And eventually they decided to just biopsy it because they felt that removing it would be kind of risky from a bleeding perspective. And so they did that. And then so I think the whole procedure itself took longer then a usual C-section.
And of course, during all that time, I really wanted to see her.
Dr. Mattke: Had you seen her?
Dr. Rajapakse: Yes, they had showed me her over the drapes. And then they did eventually bring her back and put her on my chest….
Dr. Mattke: I call that the Simba moment…when they hold the baby up over the drape.
Dr. Rajapakse: Right, and the song to goes off in the background.
Dr. Mattke: Yeah, exactly.
Dr. Rajapakse: And then they did eventually bring her over and she was able to lay on my chest while they were doing all the other stuff as well. So yeah, it was a bit of a nerve wracking couple of weeks waiting for the pathology results and the biopsy…but thankfully everything came back as nothing really to be too concerned about. So that all went OK.
Recovery wise, I kind of had an idea of what to expect, but I’ve never had a major abdominal surgery before. So there was obviously some pain associated with that. I think probably what’s to be expected…some challenges kind of just getting up and moving around afterwards was kind of uncomfortable…and then on top of that, trying to breastfeed a baby and maneuver a new baby around was a bit challenging as well.
But I think overall our hospital stay was reasonably uncomplicated. We had kind of the usual kind of newborn screening tests for Isla. Thankfully, all of those went well. When they did the screening test for jaundice she flagged as potentially being high, so she had to get a blood test for that. But otherwise, I think everything else went pretty smoothly in hospital.
One of the things maybe that I didn’t anticipate was just how difficult the breastfeeding was going to be. I think I knew that it would be a challenge, but for something that people kind of say is natural, it really took a lot of effort.
Dr. Mattke: Just push the baby to the breast and they just magically make it.
Dr. Rajapakse: Yeah, yeah. So a steep learning curve for me and a steep learning curve for her as well to kind of figure it out. It really is like a skill. Like you need to practice it and…when you’re like in pain and in hospital, it’s not kind of the easiest setting to practice. And I think maybe one of the things I would have done differently is we were mostly trying to breastfeed while I was in bed.
And I found once I got home and was in a chair, it was it was way easier…
Dr. Mattke: The latch is a lot deeper if you’re not bent over.
Dr. Rajapakse: And so, yeah, it was a struggle in the hospital for us, but thankfully she didn’t lose too much weight. And I was very thankful for Thomas’s support with breastfeeding because on the second day, like, her little lips were looking dry and I was ready to just give her the formula. And he encouraged me to keep going. And so, yeah, we kind of got over that hump and she was a pretty good feeder when she got the hang of it.
Dr. Mattke: Days two and three are the hardest for breastfeeding. Because you’re so tired, you’re in pain. They’re not very good at it.
Dr. Rajapakse: Exactly.
Dr. Mattke: Yeah, they get sleepy. I have two questions. One, how did Thomas do during the delivery?
Dr. Rajapakse: He was good.
Dr. Mattke: OK, he didn’t pass out.
Dr. Rajapakse: No….I was worried because he’s he doesn’t work in medicine and he hasn’t really spent a lot of time in a hospital setting, has never been in an operating room. And so I was kind of more worried about him than I was for myself. But he was fantastic. Yeah. He didn’t pass out. He caught the whole thing. He was super excited to be able to be there and to see it.
Dr. Mattke: OK, second question, you talked about recovering from the C-section and the pain. What tips would you give moms…little things that helped you that they can use?
Dr. Rajapakse: So there was a few things. I would say don’t get behind on your pain medication and I know I was like, oh, yeah, I can keep track of every 3 hours alternating Tylenol or ibuprofen and acetaminophen. But unless you write it down you’re going to forget because you’re also trying to remember when baby fed last and feeding them.
There’s so many different things to keep track of. And so I was lucky to have my sister here actually around the time of the delivery. She had like written down a medication record for me.
So she was checking off and reminding me every 3 hours to take something because I could tell when I missed a dose or something. It was really quite painful for those first few days. So I’d say definitely stay on top of your pain medication.
I found one of the belly binders to be really helpful post C-section, just in terms of providing some additional support. Contrary to what you see on TV, you don’t just snap back to having a belly like you did before you were pregnant right after a baby is born. I think they say your abdomen is kind of like four to five months of pregnancy. And so having that kind of pressure on the C-section area was quite painful. And so having a belly binder I found really helpful.
And the other thing I found really helpful was she slept in the bassinet next to our bed, and getting one that had the side that kind of could pull down so I wouldn’t have to fully sit up to get her out of it…that was kind of a big, big game changer for us as well. It was much easier for me to maneuver and get her in and out to feed her.
Those things were really helpful kind of in the immediate recovery period for me.
Dr. Mattke: We talked in our previous episodes about there’s so many things that you kind of don’t know what to expect, you know that things are going to be different or challenging and stuff. But what surprised you most about delivery and that postpartum period?
Dr. Rajapakse: Probably the biggest surprise to me, even though I kind of knew it, was the breastfeeding…kind of how challenging that would be, how much practice that would take for us to get the hang of it. I think the other thing that surprised me was just kind of how much of the normal newborn things I didn’t know, like the best way to give her a bath. What temperature should the water? Those things that they don’t teach you in medical school.
Those things we were Googling…and thank goodness for Google because I don’t know how parents did it before. There’s so many just random things that I’ve looked up and been able to find online. But yeah, those kinds of normal baby things were a bit surprising. I figured I would probably know more of those or gathered them along the way training in pediatrics.
And then the other kind of, I guess personally, plus a nice surprise was kind of just how well Thomas kind of adjusted to her being around and how helpful he was and how supportive he was as a partner. I think that was really kind of critical in our first few months. Now, with just how much work it is taking care of a baby to have a supportive partner has really been a game changer for me in terms of being able to come back to work and things like that, so that was kind of another night. I knew he would be great, but it was a nice, nice surprise to see just how well they’ve bonded and she just adore them. So yeah, that’s been fantastic.
Intermission…
Dr. Mattke: Could you imagine having twins or triplets or multiples now that you have one? Just knowing how hard it is to care for one little tiny human being.
Dr. Rajapakse: We have had that conversation and we were like, I don’t know, first of all, how single parents do it. I think it’s like super difficult to do everything on your own. But also to have multiple babies at once. So I guess you just kind of make it through.
Dr. Mattke: But hats off to all those parents. So what’s been the biggest challenge about being a parent? There might not be one, but…
Dr. Rajapakse: Yeah, I guess there is. It’s hard to pick the biggest out of all of them. I would say returning to work has been a challenge. So I took four months off for maternity leave after she was born, which I think is kind of considered a long time in the United States. In other countries and in Canada where I grew up, it’s pretty short.
Making that adjustment was challenging. I think trying to get over that mom guilt of being at work when she’s at home. I’m fortunate Thomas works from home and he’s been taking care of her at home, which has been really nice. But yeah, the fact that I can be there with them has been a bit of adjustment for me.
And then just trying to juggle baby things with work, things like at the end of the day, like I just wanted to get home and be with them. But there’s always charts and paperwork and stuff that need to be done. And then things that maybe I didn’t really think of that much like meeting times. We have 7:30 in the morning meetings, not infrequently, and just how challenging it is to get her up, get her fed make sure that she’s OK before going to a meeting or something like that, I think can be can be hard.
And then I have done now two weeks of call it the hospital since she was born.
Dr. Mattke: Your calls are busy, too.
Dr. Rajapakse: Our calls are busy. And at first I was like, what do I do with my pager? Because I don’t want the pager waking me up in the middle of the night. And all of these things kind of logistically had to figure out.
And so those are all kind of things that I haven’t really put much thought into before it to be honest. But we’ve had to try and figure out.
Dr. Mattke: You’re still breasts breastfeeding and nursing. That I think was also just an added challenge I think for me of trying to fit it in during the day. And then that work doesn’t go away when, you have to, you know, pump…o it just adds up. And how did you find that you’ve been able to kind of manage.
Dr. Rajapakse: It can be really challenging because for example, like in clinics, sometimes patients show up late or things like that. And so even if I have kind of tried to set aside some time to pump, things happen, right? You get a page, you have to talk to the nurses or something like that, and you get off schedule there. So trying to fit in something that I wasn’t doing before — that has to happen every 3 hours during the day — on top of seeing patients and doing other things is challenging for sure. And just all the equipment that it takes…so the other misconception about breastfeeding or trying to give your child breast milk is that it’s free. And I can say it certainly is not. There’s so many different pumping parts and accessories and things that I have to bring. I’ve already made the mistake of leaving stuff at home and having to improvise at work. You have to be able to store the milk safely, keep it cold at work, and then even transporting it back and forth and things like that are challenging and so yeah, it’s been kind of a juggling act.
I think I’m finally only now two months after getting back to work, getting into a bit of a routine. But yeah, it’s, it’s a lot. I think it was important to me to breastfeed and so we’ve kept it up also with the formula shortages…all of those other issues, it’s been kind of additional motivation to try and keep it up. But yeah, I have my eye on that one year mark because it’s definitely a lot of extra, extra work.
Dr. Mattke: Yeah. Kudos to you. I definitely with each of my children, forgot my pump at least once. And the nice thing about Mayo Clinic is there’s a lot of these wonderful pumps all around, but you have to have an adapter. And I remember like running down to the store to buy the adapter. So I ended up having like two or three sets of these adapters by the time I finished pumping and passed them on to somebody else, at some point right now. Yeah, but you’re just stranded. You’re like, I have to pump. I can’t go home. I can’t do this…
Dr. Rajapakse: Yeah, I know. And yeah, the washing of the pump parts is like the other thing.
Dr. Mattke: So a huge plug for a longer maternity leave so that women can just breastfeed and not have to provide express breast milk for their babies.
Dr. Rajapakse: I know you asked kind of what was surprising. I think having not really looked at maternity leave policies and support that are provided to new parents in this country before I got pregnant… that was a surprise to me. I think it’s really very unfortunate that there’s not paid parental leave for families.
Dr. Mattke: Yeah, and that’s why I think directly one of the reasons why breastfeeding rates are probably lower in our country compared to other countries, because it’s really hard to continue to do it while maintaining a full time job.
I remember one of my mentors came to work for an early 7 a.m. meeting, and I come in with all these bags and you came in with all these bags, right? You got your pumping bag, you got your work bag, you got your bag for the milk, and like 25 other bags and she goes: “Wow, how many people did you feed today?” It just felt so such a great acknowledgment of like, Yes, I am feeding multiple human beings and myself and doing the job, you know, so it’s, it’s a lot of work.
So congratulations is really hard. You’re doing a great job.
You know, one of the episodes before we talked about all the things that we get for babies. And then sometimes the things that you don’t register for. So I’m curious to know, what did you find that you didn’t think you were going to use that’s been really useful.
Dr. Rajapakse: There’s a couple of things that come to mind, and one of them is kind of small…when we had Isla here before. I don’t know if you could see it, but she had like a scratch on her head where she scratched herself. And I did not realize how quickly Vivian’s nails grow and how often you have to trim them. And I was kind of terrified of using the little clippers. And so we got like one of these little baby electric nail file. And it doesn’t do anything if it touches their skin. And that thing we use like every other day. Yeah. Because their nails grow so fast.
Dr. Mattke: That’s brilliant. I just use an old school nail file. Yeah, I wish I would have had that.
Dr. Rajapakse: So, yeah, it’s super quick because they don’t like to sit still for very long. All right, so we have to do it quickly when she’s distracted by something else. So that is like one little thing that we got that we’re like using multiple times a week.
Dr. Rajapakse: The other thing that we got that I didn’t, wasn’t really sure if I would use it was we kind of set up like a baby command station in our living room in a play yard, which has a change changing service on it…And so we have kind of everything in one place and that it’s made it really easy.
Dr. Mattke: It’s like the only place you change her.
Dr. Rajapakse: Yeah, yeah. And we have like all of her, we have like a dresser for her stuff, but all of her clothes are in there, all of her lotions and ointments and everything.
So not having to, like, go to the bedroom or nursery to do all of that stuff made things a lot easier. Those are probably two of the things that we use the most that I wasn’t really sure.
One thing that I probably didn’t appreciate before she had come was how important and how nice it is to have somewhere safe to kind of put her down when I need to do something with my hands. So some the bouncy chair and things have been really great or even just to put her in if I have to take a shower, those are just put her inside the shower and get a shower in. And so that’s been really nice to have.
Dr. Mattke: Did you register for anything that you thought you were going to use and you haven’t even taken out of the box yet?
Dr. Rajapakse: Yeah. So talking about bouncy chairs…so we had actually bought one of the like super fancy ones that are on the market. They’re really expensive and they move in like 15 different. Directions and make a whole bunch of sounds and things. I didn’t end up taking it out of the box. We sent that back because she was perfectly happy in the little when we can just push with her.
Dr. Mattke: It’s more mobile.
Dr. Rajapakse: Exactly. It’s a lot lighter, it’s easier. I can move it into the bathroom and to the shower. So that one we didn’t take out of the box. We sent that back.
The other thing I had gotten was one of these really fancy baby monitors because I thought that I would like to have the baby monitor on my phone, but I realized that I couldn’t really use my phone if I wanted to see what was going on with her. And so we got another monitor. It was less than like half the price, but it has a video and sound and a separate screen on it. And I really preferred. So those are two things that we spent quite a bit of money on and didn’t use and ended up returning.
Dr. Mattke: Those separate monitors where you just want to intermittently look on them are good when they’re older, like my kids age. When you’re like, are they sleeping or are they reading a book or are they playing Legos or something later at night? But I agree that separate thing is nice because it just you can just take it with you and it’s on all the time.
Dr. Mattke: So she’s six months old….and this is like the most invasive question. But I’m going to ask it anyway because you told me it was OK…but do you think you’ll have another one? I know. Like, I think the worst time to ask somebody is like, right now when you are so tired and exhausted and you haven’t slept for six months, but yeah. Do you think there’ll be another baby sometime?
Dr. Rajapakse: We do. We do want her to have a sibling. And so in terms of kind of the timing of that, it’s something that we did talk to our O.B. about, and they recommended with a C-section, ideally at least 18 months between deliveries. And so we’re going to wait until kind of that point. But yes, we do plan to have a second one.
Honestly, right now, though, it seems like overwhelming just to think of two because one is like 100% of our attention and time but I know people manage more than one child and survive. So yeah, that’ll be a whole, whole new juggling act, I’m sure.
Dr. Mattke: Chaos. It’s chaos. Yeah. Speaking of this, Mayo Clinic Press is busy working on a new podcast called “Toddler+Baby: Embracing the Chaos” that’s going to address exactly this how on earth you add another child to this mix. Nipunie, thank you so much for being here today and sharing your pregnancy story and sharing your daughter with us.
It was just beautiful to hear everything that you’ve been through with your daughter and your family and with Thomas.
Dr. Rajapakse: Thanks for having me. It was great. I’m glad you got to meet Isla, as well.
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