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Katie: Can you picture this: A new mother sits alone in her living room at 3:00 a.m. and she's desperately googling, "Is my baby getting enough milk?" Well, her grandmother, who raised five children, is sleeping peacefully in another city, never having been asked for the advice. Meanwhile, her great-grandmother's generation might have been surrounded by a community of women who'd literally nurse each other's babies without a second thought.

I think the scene in my mind captures something profound about how we're fundamentally changing the environment where new mothers navigate these crucial early weeks in the postpartum period.

Today, on the "7 Domains of Women's Health," we're exploring how the environmental domain of women's health isn't just about toxins in breast milk or contamination in formula, although we're going to talk about that a little bit. It's also about how we've engineered separation into the very heart of motherhood.

We've been working our way through what we're calling the fourth trimester of pregnancy, or the postpartum period. In this episode, we're going to focus on the environmental domain.

I'm Katie Ward. I'm a professor in nursing and a women's health nurse practitioner in clinical practice. And with me today, as always, is Kirtly Parker Jones, who's with the Department of Obstetrics and Gynecology, and she's a reproductive endocrinologist.

The other thing I study is anthropology, but from a medical perspective and from an anthropologist's perspective, I'm always surprised that nursing is difficult. After all, for most of our history, it had to work. It's what we do. We're mammals. We nurse. It's part of our makeup. But in our modern lives, we've made it much more difficult for women to do.

Our ancestors lived in villages with communal support and there were lactating women all around and you might naturally nurse somebody else's baby because you were holding it and babies nurse. You'd be surrounded by people who'd been through this journey, and you'd see examples of a variety of techniques of how to hold your baby, how to hold your breast, how to navigate getting work done with a baby on your hips.

But now, we live isolated in houses surrounded by fences. Nursing is hidden in pods. I just was in an airport with a . . . And it seems like an advance to give mom a little room where she has a little box to go in and nurse, but you're hidden away, and that seems strange. Or we hide under a wrap, literally.

As mothers, you don't see those examples of what works for other mothers. So here we are with our phones, all the world's knowledge at our fingertips, and what we might need in this case is human connection.

Kirtly: Absolutely. I think that's really what's lost as we think about . . . and you know, Katie, in the evolutionary perspective . . . who were we when we were hunter-gatherers, and who were we in our small villages?

We are the only species that shares our babies with strangers, meaning not strangers, but people who aren't our blood relatives. And we would pass our babies around and nurse our babies around. We're in a new environment, I think. You've got that just right.

Katie: I think babies would have just latched on, right? The other thing I think that I've observed is we talk about now baby wearing like we've invented something, but mothers have been carrying their babies forever. That's what our bodies are built to do.

Mothers were co-sleeping out of necessity, and so infants were literally attached to their mother's bodies all the time and they nursed frequently throughout the day, some cultures every 20 minutes or so. So that constant feedback loop and connection and regulation was just built in, and now we've replaced it with schedules and separate cribs and pacifiers. We've created physical distance and temporal distance where our biology might have intended more constant contact.

So the environmental domain of the fourth trimester isn't just about the physical space where you recover, but that matters too. But I'm thinking really about the whole ecosystem of support and knowledge and cultural practices that surround new moms, and that ecosystem is, I think, what's changed.

I was going to just share a personal story. When my mother was having children, this was at the height of Dr. Spock's influence and formula was really considered superior at this time. My mother wanted to breastfeed, although that was socially not acceptable. And there was a woman in her church who thought this was just a terrible idea.

This woman actually went to my mother's doctor, or maybe they went to the same doctor, I don't know, and attempted an intervention to convince them this is such a terrible thing, that this crazy lady was trying to nurse her babies and somebody needed to do something about it. And the name of that woman was a curse word in my family for many years.

Kirtly: Well, I have my own Dr. Spock story. I was very pregnant and shopping in our local grocery store, and there was a Dr. Spock book was on the shelf next to the baby food. I took it down to look at it and an older woman came up to me. And as happens when you're pregnant, she patted my pregnant tummy. So having a pregnant tummy is like an invitation for people to make comments or touch you, and I don't mind that. But she said, "Put that book away. You should take the advice of your mother."

Well, I thanked her and did not say that my mother's fourth trimester with me was in a mining camp in Mexico, and I was raised on Dr. Spock, and I thought I came out pretty well. When the woman walked away, I put the book in my grocery basket, and so I think my son got a lot of Dr. Spock too.

Katie: And I don't mean to say he was all bad, but I think that these stories sort of illustrate the generational knowledge gap that we're talking about. That woman in the grocery store was pretty well-intentioned. She was like, "Talk to your mother."

If my mother had been a formula-feeding mother, she wouldn't have had any advice to give me about breastfeeding, and I might have given up on it much sooner. So I think that intergenerational knowledge is really important.

Today with us, we have a colleague of mine, . Anna is a certified lactation consultant, and she's also a student in the program where I teach where she's becoming a women's health nurse practitioner and a certified nurse midwife.

But she came to us as the expert in lactation. She has her own lactation consulting practice, and she helps new mothers navigate this complex world of infant feeding, and I think a business as well.

So, Anna, welcome.

Anna: Thanks.

Katie: First, will you tell us a little bit about how you got into being a lactation consultant and what you do and all of that?

Anna: I became a registered nurse, and at that time, there was actually a shortage of jobs in nursing. And so it was difficult to find a job, but I found one in an OB/GYN office.

As I was on the phones taking phone calls from moms, they would ask questions that had to do with breastfeeding. And at the time, I wasn't a mom. I had never had any experience. I didn't have knowledge in breastfeeding. So I'd ask other people and they didn't have answers to the breastfeeding. I'd ask the providers, and they didn't have any answers for the breastfeeding questions.

I just thought, "Somebody has got to have these answers for these moms to help support them and help them through these questions, because if they don't get answers, they're just going to stop breastfeeding and have difficulties."

And so I decided to start going through the training to become a lactation consultant. I had my first daughter, and so through my own experiences now as a mother and then starting to work as a lactation consultant, I just knew that moms needed way more support than what they're getting.

So many times, as I've told people that I'm a lactation consultant, they'd say, "Oh, man, where were you when I was having my babies?" They just never got the support that they needed in the past, and so many women still now don't know that there are people out there that can help them and support them and answer their questions. But working with families, they need that information, that connection, that advocacy, and support that they can trust.

I am so glad that I became a lactation consultant. I started my own business, The Lactation Collection, so that I could be a source of support to those mamas.

I've grown that space so that moms can get in-home care. We go visit moms in their home, or we have an office. We have free support groups for moms to come to. We teach prenatal classes to help prepare for this fourth trimester so that they don't just start into this fourth trimester and not have any information to go off of.

I really want them to learn that their breastfeeding journey is worth honoring no matter how it looks, and there are people out there to support them through it.

And I want to help them to rebuild that village that you were talking about from clinical and compassionate perspective. So I want to be able to help them know prenatally as well as postpartum where they can get that support, who they can go to, to get that knowledge and information, and connect women with other women in similar situations so that we can get that village back.

Katie: I think that's such a great idea. I love that you're doing that. You mentioned you go into people's homes. When you're going into someone's home to see, what is the ideal environment? What are the things that you're looking for that are going to be helpful or harmful?

Anna: I love going into women's homes because, number one, that is where they're going to be breastfeeding their baby the majority of the time. So if I can help them in the environment that they are in the majority of the time, there's going to be an increased likelihood of success or help with what I'm trying to help them with.

Whereas if they come to an office or they go to a place that doesn't have the same chair that they have at home or it's just a different environment, the things that they might do in a doctor's office to get their babies fed are going to be different when they get home.

And so when I go into a mom's home, I'm looking at the surroundings. What setup does she have? Where is it that she feeds her baby most? Is it on the couch? Is it in a recliner? Is it in a fancy new chair that she bought for her nursery? And how can we make that space work even better to help improve positioning, to help improve latch?

I'm also looking around at the environment. What does it look like? Is it immaculate and everything is spotless and clean and mom is completely put together? Because to me, that could be a sign that she has anxiety . . .

Katie: That's a warning sign.

Anna: . . . and that the things I'm going to have to help her with might not necessarily be lactation and latch. It's going to be education and information on how to help with her anxiety and learn more about what she should expect with that, and then, yes, helping with lactation.

But sometimes what I see in their home helps me to be able to gather that information of what the focus actually needs to be on during a consultation, whereas when they come to an office, you don't always get that. You don't get that information of what their home environment looks like, if you can help them set things up differently, if you can help them with mental health because you can see what's going on.

Whether it's anxiety and the house is spotless and everything's immaculate, or whether the kitchen sink is overflowing with dishes and nothing is clean and everything's a mess, which can be totally normal in this fourth trimester period, but could also mean that mom is having a really hard time functioning, being able to breastfeed, take care of her baby as well as herself, and then her home.

So being able to be in that environment and seeing what's going on, I think, is a real key part of the practice that I have and helps us then to be able to also refer for different mental health things as well.

Katie: That is really cool. You mentioned the chair. I was just thinking back to my own experience raising kids, and that was important to have a special nursing chair. Are there other recommendations that you make for making nursing work for people?

Anna: Yeah. I think, honestly, wherever they are going to be most comfortable themselves is going to help the breastfeeding process go smoother. I always tell moms the first part of breastfeeding before you latch on anything is to make sure that you're comfortable. If you're comfortable, then baby is going to feel more comfortable, baby's going to latch on better, you're going to have a better breastfeeding experience.

So if that means that you are sitting or laying down on your couch, great, totally fine. It's a piece of furniture you already have. You don't need to buy anything else. If you already have a recliner and that's where you want that spot to be, great.

I've always thought it was funny that people spend so much time getting their nursery all put together and buying the chair and the crib and all of these fancy decorations and they put so much effort into that. Preparing for baby to come in that sense, but not preparing for all of the actual things that happen physically to them, to their body, and things in this fourth trimester.

They don't prepare for breastfeeding, which is something that can . . . That's a long period of time to feed your baby. So to have the knowledge and preparation to be ready for that new full-time job that comes along after you have baby, to be prepared for other changes in your life in the fourth trimester that can affect your mental health and physical health, but instead we focus on this fancy room. And then guess what? Baby doesn't sleep in there sometimes for up to a year.

So why is it so important to us to have all of that stuff ready? And there's so much marketing for all of these different products that you have to have and all these things that you need to help soothe your baby and to help them sleep better and all these different things, when really it comes down to you could probably not buy anything and you'd be totally fine.

Kirtly: All over the world people don't have the income. All over this country people don't have the income. And all the fancy stuff is really focused on the first-time mom.

Then, of course, once you've got the experience of having been successful the first time, which is so important, the next time you say, "Well, I've done this before," but then you're trying to breastfeed while you've got baby number two or baby number three who might be well spaced or might not be well spaced and they might be all climbing on your lap wanting a drink too.

And so each experience is different, but all this stuff that comes with it . . . If you want to have that stuff, you can, but you don't need any of that stuff.

Anna: If you want it, if you have the means to have it, then go for it. Although some of the things really aren't needed and some of the things can actually harm your breast milk supply and can affect things that way too.

So I think talking to lactation consultants, talking to moms that have had multiple children and who have learned over time the things that are actually needed and necessary during this time can be a lot more important than following the influencers on social media that are trying to make money from all of these different things that are being sold.

All the different breastfeeding or bottle-feeding things are not a market that's regulated. And so any bottle company or pacifier company can say, "This is the best thing for a breastfed baby. This is the best bottle shape for a breastfed baby. This is going to help you in your breastfeeding journey. You need this if you're going to be breastfeeding," and it's totally false. Usually, the bottles that say they're the best ones for the breast are actually the worst.

Katie: Interesting.

Anna: There are so many different things out there and that marketing just isn't regulated, and so it's so hard for new moms to know what's true, what's not true, what things are useful, what things aren't.

But when it comes to setting up your environment at home, when you are breastfeeding, depending on the space or spaces that you'll be feeding your baby, because sometimes it's different for the feedings during the daytime versus feedings at night, you just have to think, "What things might I need?"

And during the day, it might be that you need just a basket of things that you can move around wherever you are going to be so you have easy access to . . . I usually tell moms, "It's probably most important for you to just have water and snacks close by."

The oxytocin that comes when you're breastfeeding is going to make you thirsty. You want your big jug of water. You want easy one-handed snacks that you can grab and eat so that you can also get the nutrition that your body needs to continue to produce breast milk and to heal after you've had your baby.

You might need some burp rags and you might need your nursing pads or nursing nipple ointment or different things like that. So make a basket that you can have at your couch when you're downstairs, that you can move upstairs when it's nighttime and you're feeding up in your room, or wherever that might be, just as an easy thing.

Some people will set up multiple stations and have multiple baskets. It just kind of depends on probably what your budget is and what things look like in your home. There's just a wide variety of things you can do.

Kirtly: I'm only laughing . . . I'm thinking about taking my son who was maybe three weeks old to "Indiana Jones and the Temple of Doom" on the big screen. It was really noisy and I just lifted up my shirt and I plugged him in for the movie, and he was just plugged in nursing and sleeping and nursing and sleeping through a very loud movie. It was easy because I had a shirt I could pull up, and he was a happy camper. It's the confidence of just saying, "Hey, I can do this anywhere," and getting that confidence.

Katie: But having the right shirt . . . I remember when I stopped nursing that I was finally able to wear dresses that didn't have . . . It was a whole dress that didn't have a button or something that opened up. I was like, "Oh, this feels quite different."

Anna: Sometimes people think that they have to buy a whole new wardrobe for breastfeeding, which depending on what your wardrobe looks like, you may need to buy some items that have easier access to the breasts. But sometimes if you're just wearing a shirt and bottoms, it is pretty easy to just lift up that shirt. You don't have to go buy the expensive, specifically made clothing that's the nursing clothing that has the zippers that gives you access to your breasts.

Yes, when you get dressed in the morning, you're going to be thinking, "Can I feed in this outfit? Can I feed in this dress? Can I feed in this shirt?" It's going to affect what you wear, but it doesn't necessarily mean that you have to go out and buy a whole new wardrobe either.

Katie: Again, I mentioned the pods in airports, which, like I said, on the one hand, it's nice for moms to have a private, quiet place to go. But I also just think it's a little weird that we're going to say, "Oh, you've got to go sit in this box to nurse." The community that we're in, it feels like people are squeamish about seeing nursing moms. And so what can we do to support breastfeeding success more out in the public?

Anna: I think a lot of it has to do with just the fact that we've now had generations of women that have kept breastfeeding more quiet, more hidden. A lot of the times I'm teaching these prenatal classes, and these women and their partners have never seen anybody else breastfeed in their entire life, and I just think that needs to change.

If women don't see other women breastfeeding, how are they going to get an idea of how to do it? If all we have is the models that we see on television or in the movies, which are not always the best representations of a lot of different things, then we're not going to have much to go off of.

And so I always talk to women when they're breastfeeding that it's totally fine to breastfeed out in public. If you're going to the park, you can just breastfeed your baby. And if, for them, they're not comfortable with the breastfeeding in public idea, then we talk about different options of, "You could use a cover. You could turn around, go to somewhere a little bit farther away from other people." But I really do try to encourage women to breastfeed in public where other people can see what they're doing.

Whenever I see women breastfeeding in public, when I do go to the airport, or when I'm at a restaurant, I'm always like, "Thank you for breastfeeding in public and normalizing breastfeeding," because I think it's important.

I love going to an amusement park and seeing a mom sitting there on the bench breastfeeding her baby without a cover. And guess what? I can't see anything. I just know that she's breastfeeding because that's what I do for work. But it's not like her breast is hanging out and she's showing off and being immodest type of thing. She's feeding her baby.

And in all 50 states in the United States, it is legal to breastfeed your baby in public. We have that right. If somebody asks us to not do it, we can say, "I have that right. I don't need to move. I'm sorry if you're uncomfortable. Maybe you can go somewhere else."

But I think a lot of people in the culture now is just to try to not make other people uncomfortable, and so a lot of moms overthink this breastfeeding in public idea. "I'm going to go sit in my car," or, "I'm going to go sit in the bathroom." Are you going to go eat in the bathroom? Why should we go feed a baby in the bathroom?

Katie: Right. Plus, somebody else might need that stall.

Anna: Yeah.

Katie: This is why the line is so long in the women's bathroom.

Anna: Exactly.

Katie: Let's talk about one more thing: going back to work and having to be away from your baby and navigating feeding when you're gone a long time. What advice do you have for women about making that work?

There are a couple parts to it, right? It's getting the baby to accept a bottle, even if it's a bottle full of breast milk, but combining those different nipple sources and taking food from other caregivers. And then also just the hard parts about being at work and being away from your child and keeping your milk supply up.

Anna: For sure. And I think a lot of this starts pretty early on in this fourth trimester where a lot of the general recommendations of when to start introducing the bottle say, "Wait until 4 to 6 weeks old before you start introducing the bottle, or even just a couple of weeks before you go back to work."

But some people have to return back to work sooner than that 4 to 6 weeks, or some people don't have to return back to work until 12 weeks or later on. And if baby has never received a bottle before being 3 or 4 months old, they might not suddenly just take this plastic thing that you're shoving in their face because they're used to skin.

And so I always recommend to moms that maybe around 2 weeks old even . . . And this is what I did with my first. I just collected milk a little bit throughout the day, maybe had one pumping session. Now there are different things that you can collect milk in. Or sometimes your let-down milk throughout the day.

Combine that and have baby get maybe one bottle a day or one every couple of days. And this is kind of their introduction to bottle feeding. It's their practice bottle. You just continue that one bottle every once in a while until it's time to go back to work.

I've also had lots of moms that say, "Well, baby took a bottle when they were 4 weeks old, but now baby's 12 weeks old and they're not taking a bottle." They've now had 8 weeks between.

And babies are not always just going to take it because it's full of breast milk and it's what they're used to. There's a process.

But I usually tell people to start a little bit earlier on, if it's one bottle a day, one bottle every couple of days, once a week, whatever it is. Sometimes that also helps mom get extra sleep, which is great, and then baby gets used to practicing this use of a bottle to prepare for going back to work or going back to school or even just being able to be away from baby for a little while.

Katie: Yeah. And then there are times when you need to maybe take a break from breastfeeding, like if you're on a medication that they can't have, when it might be nice to have a bottle to substitute.

Kirtly: I think, first of all, there are medications . . . women going through chemotherapy, certain anti-epileptic drugs. There are some drugs that you really don't want to feed your baby and you can pump and throw in the most immediate time when the blood levels are the highest after your medication.

But you should talk to your doctor. And if your doctor is not knowledgeable, if you're seeing a cardiologist and they're clueless, there are data about breastfeeding.

I think these are complicated questions, but the environmental toxins and things, we know that our placentas aren't the perfect barrier protection for the baby. So this is the placenta, and what we eat and drink and breathe goes through the placenta into the baby.

We used to think that the placenta was a perfect barrier. So, of course, we recommended no smoking by the mom, and no smoking in the house so the baby didn't get secondhand, thirdhand through mom, through the placenta, and keeping a good air filter in your furnace, and staying inside on bad air days when there are forest fires causing smoky air.

This is true for pregnancy, and now in the fourth trimester, the baby is breathing those toxins and they are getting into your breast milk. So not only air pollution but heavy metals like arsenic, mercury, and others, and insecticides and pesticides, and forever chemicals, or PFAS, or PCBs and dioxins.

And still, 70 years after being banned in the U.S., DDT is all in breast milk. In one study, samples of breast milk from 50 women were studied and they all had heavy metals and persistent organic compounds and tiny particles of plastics, microplastics, and they're all in breast milk.

So the difficult question is that heavy metals and persistent organic compounds are stored in the mother's fat from years ago. And so it's not that you can turn off this pipeline of heavy metals and persistent organic compounds by just being uber-careful in your breastfeeding months because you've accumulated these toxins for years and years, and you're still pulling them out of your fat supply.

So what are you supposed to do about this and not freak out about it? Well, it turns out the same chemicals are found in baby formula. Most baby formula is made out of cow's milk, but not all. Some are made out of other soy products, but soy is grown in the ground and the ground is contaminated. So we know that heavy metals and persistent chemicals are in formula, and the process of making formula and storing formula often is in plastic.

So what do you do? Well, breast milk is still the best nutrition for babies in almost all circumstances. And knowing that there are contaminants in human breast milk, the Centers for Disease Control and the American Academy of Pediatrics still recommend breastfeeding.

If a mom is going to use baby formula, use water from a safe source or consider using a water filter in your home. Bottled water has microplastics and isn't necessarily safer than your municipal water in most cases.

So keep the house as clean and safe as you can with clean air filters and air purifiers if air pollution is a problem in your area. And don't cook in plastic, keep a smoke-free kitchen, buy organic if you can, and avoid plastic food packaging. These are all good practices, not only for the fourth trimester, not only for a breastfeeding mom, but for everyone of all ages that's in your house.

You can freak out about the level of contamination that we all carry around and that we offset into our breast milk. It's worrisome, I'd say, for the future generations. Be an advocate for better control and less pesticide use and for many things, but for this baby right now in your fourth trimester, breastfeed if you can, be responsible about the water that you dilute your formula in, and try not to get big bunches of bottles of formula all ready in plastic bottles.

Do the best you can and understand that it's you and your baby trying to be the best mom that you can. And good on you for breastfeeding and for trying the best you can.

Katie: I mean, I think we're all facing some real environmental challenges right now and it impacts everything, but I still am such an advocate for breastfeeding.

I was thinking about during the pandemic when we had supply chain issues and everybody was out of formula, and I thought, "How terrible would that be that you're dependent on formula and it suddenly disappears off the shelves?" And the magic moment of establishing breastfeeding is if you miss that and your child's a bit older, you can't just replace it.

And how important the work you're doing is, Anna. I'm so glad to have you in our community and as a resource for women in Utah. I think you're doing this really important work that helps repair that knowledge gap that we find ourselves in with a generation of moms that didn't nurse and don't have the information that used to be passed down from generation to generation.

Anna, if women need help with nursing, are there some resources?

Anna: Yeah. So for my company, they can find me online at thelactationcollection.com. We do in-home consultations, but we also do virtual consultations, which can be really helpful for those that are in more rural areas and don't have lactation support around them.

They can find local classes around them. We have classes online and in-person. Hopefully, they can find support groups around them, whether it's from a local lactation consultant or a La Leche League or some other group around them, even if it's a mom group that they can find other women that are in similar situations to them with babies and gather that support themselves.

But I can also be found on Instagram and Facebook at The Lactation Collection.

But other great resources online, I always like KellyMom. She's a lactation consultant and always has good research-based information on all sorts of different things lactation. So when people are looking up questions, that can be a great place to be.

I've really worked hard to try to create my website as a great resource that has . . . We even have a glossary of terms. So if there are terms that you have never heard of that have to do with lactation, you can look it up on my website. We give the definition, how it has to do with lactation, what it is. It has an image with it so you can get a better understanding.

I have lots of different blog posts and resources that way to help through up-to-date information, because as we all know, some doctors' offices can take quite a long time to change protocols and policies from updated information.

The nice thing about owning my own business as a lactation consultant is research can come out today and I can say, "Great, we're going to implement this tomorrow. We're going to write a blog post about it and inform women about this new information."

And so I think sometimes looking at smaller companies when it comes to lactation can be a faster way to get more up-to-date information rather than larger groups or hospital systems that can take up to 15 years to say, "Oh, yeah, this research came out 15 years ago and we're finally going to start implementing it and telling women to not use heat on their breasts anymore, but let's use ice to reduce inflammation." That can take a long time.

Kirtly: Well, I think many hospitals now, in part of their baby-friendly certification, do have lactation specialists every day at the hospital. I know at our hospital, women are expected to meet briefly . . . and briefly isn't long enough, but briefly with the lactation consult.

And that lactation consultation service at the hospital is available in the postpartum period for women who are struggling. So we do have resources, although it's at the hospital and it may not be as convenient as having someone come into your home.

The point is that there are a number of resources out there. And sometimes you need better advice than your auntie or your sister. I mean, it's nice to have advice from people who have been there, but their personal advice is just them, and sometimes having someone broader like a lactation specialist like Anna can really help you take a broader look at all your options. There are many ways to do this.

Anna: Yes. That's great to mention. There are definitely lactation consultants at the hospitals. There are lactation consultants at WIC. And you don't just have to have Medicaid to go to WIC for a free consultation. There are private practice lactation consultants. And more and more of us are trying to get insurance coverage with a wide variety of insurance companies so that we can provide insurance-covered visits.

It's nice to have so much support available out there, but I also like to remind women that sometimes if they go to one place and they didn't get all of the answers or it still didn't quite work out, there are still the options of all the other places.

They might see a hospital lactation consultant and they might not be quite as sure what to do with a 4-week-old versus a 2-day-old, because that's what they're used to seeing in the hospital.

Kirtly: Exactly. Or even at 3 or 4 months, when you're past the time that you have that automatic resource through four months.

Anna: Exactly.

Katie: Awesome. Anna, thank you so much for sharing your expertise and your passion and all the work you do supporting new families. And also to our listeners, I want to say thank you for listening to the "7 Domains of Women's Health" and this series on the fourth trimester.

You can catch all of those conversations , or online at womens7.com.

For everyone, take care of yourselves and take care of the new mothers in your lives. They really do need their village, so be part of that village. And we'll see you next time.