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As most new parents discover, the repetitive tasks involved with taking care of a new baby can lead to joint and/or muscle pain. For example, it’s estimated that between one quarter and one half of new parents experience DeQuervain’s tenosynovitis (or “Mommy thumb”) alone. Additionally, taking care of a growing infant who is up at all hours of the night can easily lead to fatigue. Those who have chronic underlying health challenges may already have bodily pain and fatigue at baseline, which can be easily exacerbated by caring for a new infant.
In the following article, I will provide strategies to protect a new parent’s joints/muscles and manage fatigue. I will draw from my training as an occupational therapist, which is a holistic field dedicated to helping persons with health challenges successfully complete everyday tasks. Occupational therapists have training in both the physical as well as the mental health aspects of chronic conditions, and are experts in “life hacks” and everyday workaround strategies.
As a parent with rheumatoid arthritis, I will also provide tips from my own experiences. This article will focus on my favorite baby items and strategies for clothing, toileting, eating, moving, sleeping, fatigue, and determining when to see an expert for help with the transition to being a new parent. I will mention some specific products I find helpful, but please note that I have no connection to or relationship with any company or product mentioned! I will focus on the first two years of life (from newborn to toddlerhood). In a subsequent article I will focus more on preschoolers to big kids.
Baby Clothing Strategies
Choose your materials wisely:
Since baby clothes can be deceptively difficult to put on, I recommend that new parents consider the following three features when selecting clothing items for their baby.
- Closures: How is the clothing item secured – zippers, snaps, Velcro, buttons or something else? I have come to prefer zippers and Velcro as they require much less stress on my thumb and finger joints and are also quicker to take on and off than snaps or buttons. if you have outfits with snaps, consider just snapping the middle of the 3 snaps to save some stress on your joints.
- Resistance of clothing material and openings: how stretchy is the clothing material as well as openings? If you have joint or muscle pain, clothing items that are stretchy and have larger openings (for the neck, arms and feet) will be the easiest to put on.
- Tightness: Loose clothes are generally much easier to put on a baby than tight ones, with one caveat: for safety, sleeping outfits should be snug around the upper body and neck to avoid a smothering hazard while they sleep.
Conserve your energy:
- Reduce your workload. I recommend minimizing the total amount of clothing changes you attempt/do in a day. Does your child really understand or care about the concept of “daytime” clothes versus “pajamas?” Unless there is a temperature, cleanliness, or safety related reason for them to wear a separate outfit, I avoid changing just for the sake of it being a certain time of day.
- Enlist your child’s help. As they grow, encourage the baby or early toddler to help you out by participating in the activity! Children typically learn to take clothing items off before they can put them on (anyone with a toddler who likes to take off socks can attest to this fact). Allow your child to help you out if you’re in pain or super fatigued!
Specific items I found helpful:
- Swaddles: I found the pre-formed ones with zippers or Velcro (such as Summer Infant SwaddleMe, Halo Sleep Sack, or the Woombie) to be by far the easiest to close and open.
- Bibs: Consider using bibs with Velcro rather than snaps since Velcro produces less direct strain to your thumb joints. Once the baby starts ripping off the bib, you might have to change to snaps as they tend to be harder for babies to take off. We really like the Tommy Tippee Comfy Neck Bib, which has relatively easy snaps.
- One piece outfits versus 2+ piece outfits: I’ve definitely come to prefer one piece outfits (usually marketed as “pajamas”), as they require you to put on just one item of clothing and many come with zippers. However, it might be easier to put two loose/stretchy items onto a squirmy baby, so I recommend doing some trial and error with your babe and seeing which is easiest.
Diapering strategies:
Since you will be changing 10-15 diapers a day in the early days, it’s important to consider how easy the diaper is to put on and take off and the ergonomics of where and how you will be changing them.
Diaper Characteristics:
- Cloth diaper pros and cons: I don’t have any personal experience with cloth diapers, but I know that they come in two main options: snap versus Velcro. This post provides a comprehensive overview of the two options, and you might not be surprised after reading the clothing section that Velcro is reported to be the easiest on the joints (however it is less durable, and some report that their babies figure out how to take the diaper off!). Mamas Facing Forward founder Mariah Leach has used cloth diapers for three children over six years. She recommends an All in One (AIO) cloth diapers, which have liners attached so that the cloth diaper is all one piece, as these are easier to manipulate than a pocket diaper or prefold plus cover.
- Disposable diaper pros and cons: Most disposable diapers have similar closures that are as easy as Velcro, but you might want to try a few brands to see what is easiest on your body. I have used Pampers and Huggies with similar ease, and found the Honest Company brand diapers to provide slightly more resistance and thus required a little more force/strain on the fingers than Pampers or Huggies. The same concept of “stretchiness” from above applies: the stretchier the diaper material, the easier it is to stretch the closure around the baby’s body and thus less force required on your joints when you are going to change them.
Set up of changing area and body mechanics:
- Consider the ergonomics of your changing area(s). Your main options are: buy a special changing table, use the changing table extension on a crib item such as the Pack ‘N Play, and/or use a travel changing pad on whatever surface is nearest you (such as a counter, couch, or floor).
- Regardless of what you choose, it’s generally advised to change the baby on a surface that is slightly below the level of your elbows so that you don’t have to reach up or bend down excessively (which can cause strain on the back and/or knees). This article provides a nice overview of how to set up a changing table, and I will echo their suggestion that you make sure all your important items are nearby (wipes, clean diaper, cream, hand sanitizer, etc) so you can conserve your energy and avoid excessive bending/lifting/carrying of items.
Baby Feeding Strategies
Your main options for feeding in the first 6 months are breastfeeding, bottle feeding, or “combo feeding,” which involves a combination of breast and bottle feeding. What’s in the bottle typically will be formula, breastmilk, or a combination of the two. This area is hugely complex, and I will focus on relevant aspects to protecting joints/muscles, preventing repetitive stress injuries and managing fatigue.
Body Mechanics while feeding baby
- Positioning: Whether breast or bottle feeding, be aware of your body position and try to assume positions that result in the least amount of stress/strain on your body. This sounds obvious, but trust me, for many people getting the hang of feeding will require an intense amount of focus on the baby and it will be easy to forget to protect yourself during this process. This article by a physical therapist a fabulous and comprehensive set of instructions for the ergonomics of feeding and includes some really great pictures, so I encourage you to check it out.
- Pillow choices: Most people use pillows such as the Boppy or My Brest Friend while feeding, as the pillows support the baby’s body weight and thus minimize potential shoulder strain. Also consider your wrist position as you hold the bottle, breast, or baby; it’s best to avoid extreme or awkward angles. Take care to remain as upright as possible, rather than slumping downward towards the baby (easier said than done!).
Breastfeeding tips:
- Clothing items: Consider avoiding “nursing tanks” or bras if possible, as these often require weird/awkward wrist and finger positions to get them on and off, from my experience. I found it easiest to live in simple loose robes for the first 8-10 weeks of Charlie’s life. If you do need to use special nursing bras, tanks, and other clothes, be sure to test out the closures beforehand to make sure they are as easy to open and close as possible.
- Breast pumping: I highly recommend getting a bra that allows you to be “hands free” to minimize stress on finger joints and awkward wrist angles required to hold the bottles otherwise. As a bonus, most of these bras zip up the front, which is easier on the shoulder joints than “regular” bras which typically are secured in the back!
Bottle Feeding tips:
I recommend considering the following as you select a bottle type/brand in order to minimize stress on the joints:
- How many little parts are there, and how easy are the parts to put together/take off? These two are related, as you can probably deal with a brand with lots of little parts as long as they are easy to put together/take apart. I only have experience with the Dr. Brown’s brand, and most of the parts are easy with the exception of the vent tube (cylindrical shaped object) and vent insert (or as my husband and I called it, the “white thing”). I would recommend testing out friends’ bottles and brands before making a choice.
- How will you clean the bottle parts? Since most bottles have lots of little parts, cleaning them can be a big job. Your general options are to wash by hand or in the dishwasher, the latter of which is obviously easier on the joints! To sterilize parts, you can boil the parts or purchase a microwave steam bag, both of which are relatively easy on the joints.
- Ready to feed formula bottle option: If you are formula feeding it is often recommended to use “ready to feed” bottles for the early days. These bottles are by far the easiest on your joints as they come pre-mixed and assembled, however they are also the most expensive by a very wide margin as compared to powdered or liquid formula.
Strategies for Moving Around, from Baby Wraps to Strollers to Car Seats
Baby carriers can be a great way to minimize stress on the hand joints…once you have them on! When designed and fitted correctly, carriers can keep the baby close to the center of your body so the baby’s weight is distributed and supported by your large joints rather than your small wrist/hand joints when you are carrying them.
There are many different resources to help you decide on the best and safest carrier(s) for you and your baby, and most major cities have “Baby wearing” groups where volunteers let you try on different carriers and help you decide between the overwhelming options. I will highlight aspects of baby carriers that are particularly relevant for people with chronic health issues, pain, and/or fatigue.
Things to consider when selecting a baby carrier:
- Closures and adjustment mechanisms: Does the carrier require lots of pinching or pulling in order to secure or tighten it? If you have thumb pain (as I do), this is particularly important as many of the closures require pinching with the thumb joint. Are the straps easy to tighten and loosen? Are they located on both sides or just one side? For example, I like that the Pikkolo has strap adjustment areas on the left and right side of the bottom part of the carrier (as opposed to the Ergo, which has just one), so that I can choose to tighten/loosen the side with the hand that is experiencing the least pain in the moment.
- Resistance the material provides as you put it on or have to put baby in it: Soft carriers such as the K’Tan are really comfortable for the baby, but they differ in how much force is required to put them on. For example, the K’Tan eliminates the sometimes confusing process of getting the wrap onto your body, but since it is “fitted” to your body size (it comes in specific sizes as opposed to the one size fits all wrap), I found it required more force to open the fabric wide enough to get the baby in than the Ergo or a basic wrap.
- How does this product support the baby’s weight so that you don’t have a lot of stress on your back or other tender areas? In my personal experience, the carriers that require closures such as the Ergo and Pikolo seem to distribute the weight of a heavier baby a lot better than soft carriers such as the Moby. Again, a lot will depend on your own body mechanics and the size/shape of your little one.
- Versatility of wearer: can this item be used easily by a partner/friend so they can take some of the load off you (literally)? One of the best strategies for energy conservation is simply to delegate tasks to someone else! The Ergo and Moby were great in this regard, and the K’Tan is not as versatile in this way.
- General advice: I recommend having a few different carriers or using one carrier with a few different “holds” so that you don’t cause repetitive stress on one area of your body. Look at your carrier’s guidelines for what ages / stages are linked to different holds; it can be confusing because keep in mind that babies reach stages at different ages.
Things to consider when selecting a car seat:
I highly recommend you utilize resources such as The Car Seat Lady as you make a car seat decision. Additionally, consider the following
- How heavy is the car seat? Weight is important if you are using an infant seat and plan on taking the baby in/out of the car while in the seat, but it may not be as important when you get to the convertible or booster stage when you will likely not be moving the seat in and out of the car as often. I used the Chicco Key Fit 30 infant seat, which is one of the lightest yet safest options. I “hooked” it in my elbow and tucked my elbow close to my body when I carried it, which helped minimize strain on my hands.
- How easy it is to put the car seat into and out of the car? You will want to try this yourself because the ease will depend on your specific issues and the size/shape of your car and the seat in question.
- How easy is it to tighten/loosen harness/straps? Keep in mind that this will be important as you will be loosening the straps every time you get the child out of the car, and tightening them each time you put them into the car seat.
- How easy are the buckles to clasp and unclasp? Unfortunately for caregivers with tender joints, car seat buckles are usually difficult to manipulate as they have to be resistant enough to prevent a child from successfully unbuckling themselves. Again, be sure to try this aspect before you purchase a seat. I found our infant buckles were way easier on my thumbs than our convertible seat’s buckles.
- Could I use a device to help me buckle and unbuckle the seat? Particularly if you have hand weakness or pain, you may want to consider a gadget or device to help you buckle your child in an easier way. I’ve found the Unbuckle Me to be helpful, and others have reported success with the Bucklebee.
Stroller strategies
Strollers vary widely in weight, ease of pushing, ease of folding up/securing, ease of getting baby in and out and resistance/ease of closures. The the same concepts from baby carriers and car seats apply to strollers regarding harness straps and buckles. Additionally, consider:
- How easy is the stroller to fold and unfold? I had a Snap ‘N Go (which only works for my infant car seat), which is super easy to fold and super lightweight. I had a BOB Revolution for working out and longer/bumpier walks and the City Mini Baby Jogger (which specifically states in it’s instruction manual that it is NOT a jogging stroller!) for shorter trips. They both fold super easily (video for City Mini here), but the City Mini is much lighter and more compact and thus easier to put in and take out of the car.
- How easy it is to put the baby in and out of safely? The same buckle/strap issues apply from the car seat section. In terms of initially getting the baby in and out of the stroller, however, strollers allow more wiggle room than car seats. With a car seat you have to work within the confines of the relatively small door opening, whereas with a stroller you can move your body around either side of the stroller or stand directly in front of it to put the baby in comfortably, depending on how you are feeling.
- How easy is it to push over the types of terrain you expect to traverse? Here’s a classic example of a tradeoff; the BOB is heavy to lift and put into and out of the car, but it is extremely easy to push over a wide variety of terrains and requires less force to push than a light weight, less sturdy stroller. The Snap ‘N Go is extremely light and easy to fold/unfold and put into and out of the car, however it requires more force/stress on the hand joints to push, particularly over any terrain that is not entirely flat. So, keep that in mind as you make stroller decisions.
- General recommendation: Remember to pay attention to your body mechanics as you fold/unfold and put the stroller into and out of various places (“lift with the legs, not the arms!” and keep the stroller close to your body).
Fatigue strategies
I have woven some strategies for managing fatigue throughout the sections above. Some concepts that might be helpful for those struggling with fatigue include:
- Energy conservation: This simply means thinking about how you can conserve your energy throughout the day.
- Activity pacing: Within any one activity or task, try to pace yourself and set up the activity so that you minimize the amount of energy you are using.
- Consolidating tasks: I try to group my errands and social activities so I’m not constantly battling getting Charlie into and out of the stroller and car seat.
- Alternating easy with hard tasks: This allows you to rest in between difficult tasks.
- Workaround strategies: Workarounds involve finding ways to avoid the task or some aspects of the activity altogether. Examples include:
- Grocery delivery rather than going to the grocery store (this eliminates 80% of the lifting burden of shopping for items yourself)
- Meal delivery rather than cooking
- Using speech to text rather than typing
- Mental versus physical fatigue: Finally, I recommend you consider whether the fatigue you are experiencing is more physical, mental, or both. This is a gross over simplification, but it’s possible for someone to feel physically fatigued without being overly mentally fatigued, or more mentally/psychologically fatigued without being physically fatigued, or both. If you are feeling very mentally fatigued, you might benefit the most from mental/psychological approaches versus life hacks that are designed more to avoid physical fatigue.
Seek expert guidance if needed/desired
If you feel a degree of physical or mental pain that prevents you from performing basic or essential tasks to care for your child, I encourage you to consider seeking professional help. Please know that caring for a child is a very physically and mentally demanding job, and medical professionals such as occupational and physical therapists can provide many options for minimizing current pain and preventing future pain.
For example, I have a total of four splints to address wrist and thumb pain from caring for Charlie and my job as a pediatric occupational therapist; they hold my wrist and thumbs in place to help as I pick him up and put him down. The harder splints really help support Charlie’s weight and I’m so glad I was proactive in getting a referral to a Certified Hand Therapist before the pain progressed further. Splinting can help support your joints and minimize additional pain and inflammation from performing daily activities.
Additionally, I started seeing a traditional psychologist (therapist with a PhD in Psychology) for postpartum adjustment challenges when Charlie was about 13 months old. This has been extremely instrumental in helping me cope with transitioning to motherhood while managing my chronic illnesses.
Conclusion
Preparing for a baby can be very overwhelming, and it’s easy to focus so much on the baby that you forget to consider what might be best or most appropriate for the caregiver. Long term, the baby will be best served by a caregiver who can use their body and mind to the maximum of it’s potential, so you’re doing both your baby and yourself a favor by investing in your own health and well being!
Mad it past the baby stage? Check out How to Protect your Body while Parenting a Big Kid: Tips from an OT Mom!
