Five Minutes a Day Can Combat Urinary Incontinence
Urinary incontinence and poor bladder control is something that affects many women and unfortunately is not frequently talked about. There are many things that can contribute to urinary incontinence such as diet, surgical history, and pelvic floor strength. The pelvic floor is considered the group of muscles that forms a hammock within the pelvic and is very important when managing bathroom habits. Stress incontinence is a term used for incontinence when doing things such as sneezing, coughing, or jumping caused by poor pelvic floor strength. Child birth and menopause can both affect the integrity of these muscles and limit them from functioning efficiently.
The term “Kegel” is a well-known word for an exercise that strengthens the pelvic floor. Although this exercise is well known and attempted, a Kegel exercise if often done incorrectly. The problem is common and it’s that many people compensate and use muscles such as their abdominals, glutes, and hip adductors when performing a Kegel. This can exacerbate the problem because people do not isolate the pelvic floor muscles, and the results are poor effectiveness of the exercise and not true strengthening.
The Proper Kegel:
Goal: Gently tighten and lift the pelvic floor without using other muscles
The endurance of these muscles is also an important factor for proper bladder control. It is recommended once you have properly tightened the Kegel, you hold it for five-10 seconds and perform a minimum of thirty a day to improve muscle strength. Simply, five minutes of exercise can greatly improve your strength and quality of life.
Physical therapy can significantly help train people to do a Kegel correctly and help manage urinary stress incontinence. At Therapeutic Associates, we can do a non-invasive evaluation and teach you how to do a proper Kegel by using our Real Time Ultrasound machine that shows you which muscles you are using while attempting the Kegels. Visually seeing how these important muscles are functioning help correct bad habits and strengthen the proper muscles. Combined with other techniques we can help combat urinary incontinence and allow you to get active without worrying about where the next rest room is.
As I sit here writing this recipe for you guys, I find it ironic that its the Fourth of July and instead of posting some gourmet hotdog or potato salad recipe (how gross is it that, THAT is the epitome of "American food"), I'm writing about an ethnic inspired, stew in the middle of the summer. But heres the deal, I'm a mom to three kids under the age of three and my motivation to hop on the computer is usually very far down the drain. Today though, the kids are all happily playing in the living room with dad, I have a delicious, aromatic, HEALTHY stew on the stove and I have a few minutes to get this recipe posted for you to enjoy too! So here it goes, onward and against the grain!
I'm going to assume that since you're reading this, you are at least open to and possibly interested in cloth diapering. Many people are shocked to find out that I cloth diaper my twins and when I was still pregnant with them and told people we were planning to continue our cloth journey once the twins arrived, they looked doubtful. I will admit that the thought of doing cloth with twins was a bit daunting but then, pretty much everything about having twins sounded that way.
We jumped right in with cloth with our first child, Sterling at just 10 days old. We did disposables until his cord fell off and then immediately swaddled his little bottom in soft, eco friendly cloth diapers. When the twins were born, we temporarily put away our cloth stash and all three kids were in disposals. I got Sterling mostly potty trained around 22-23 months old and that was when I started to think about getting the cloth diapers back out for round two! I wanted to get a grasp on being a mom of three and hopefully get my oldest out of diapers before starting the twins in cloth.
It probably would have been just fine putting all 3 in cloth simultaneously, but I didn't really feel like having two different sized diapers going. I wanted to keep it semi simple and just have one size to deal with.
So here it goes, the seven things I think are pertinent to successfully cloth diapering your little ones!
1. Buy Used
Before you say ewe, its not gross! I actually hate new cloth diapers. They are such a pain in my bum; pun intended. Cloth diapers can easily last for several children (or more) from birth to potty training.
If you want to buy a big lot of brand new cloth diapers and can afford to, that's great but hear me out on the used ones. Even if you intend to buy new or get them as a gift from your inlaws or sister, it still might be smart to get some used ones to start off with.
I would suggest doing some research on different styles and brands of cloth diapers. If you have some friends who use cloth, pick their brains! There's no one type fits all for this. One of my very best friends uses cloth diapers on her boys and she despises the style that I prefer and I equally hate the type she loves. You have to find what works for YOU.
You may be able to determine what kind you want just by doing research (I got lucky here) but often it takes a little bit of trial and error to find your groove. Pick a few styles and brands that appeal to you after reading about them and test them out.
Where to find used cloth diapers you ask? The black market! Just kidding, I've purchased used diapers from Craigslist, Ebay, Facebook Market, Goodwill, a friend, and at a kids consignment sale... The only one of those I regret is Ebay. That was a bad batch; they appeared to be in good shape but the PUL (the waterproof part of the cover) was damaged and they leaked which almost turned me off to cloth entirely. I thought, "my gosh, this sucks, why does anyone do this?" Your diapers should not leak straight through the PUL. The only leaking thats acceptable is around the top or legs, in which case it's your fault for not changing your kid often enough or you need to use more absorbent inserts (I will cover this later)!
Why I would not purchase used cloth diapers online again? There's no way to inspect them for damage. You can do this easily by holding them up to the light and looking at the PUL from beneath. You're looking for tears, snags or anything that doesn't look completely uniform with the rest of the diaper. These are areas where the waterproofing might be compromised.
Once you find some diapers you really like and decide to commit to cloth diapering, go forth and purchase new if you so desire. Otherwise, there is absolutely no shame in using a myriad of used diapers that still work great and have experienced their fair share of poop. Just be warned, new cloth diapers require several washings before they reach their full absorbency. Its not an exact science, most sites say around 3 washes will do the trick but in my experience its more like 10 washes before they actually "work." It can be an annoying process of leaking diapers and frequent changes during this break in period which is why I think some parents quick cloth so quickly. They never actually get the the stage where their diapers are totally awesome! But on the bright side for you, this means sometimes you can score almost totally new diapers that already have a handful of washes on them for cheap.
Pocket diaper brands I love:
2. Details to Consider
If you have one of those old school, water hogging washers with the agitator in the middle that washes the heck out of your cloths, they are PERFECT for washing cloth diapers. In my experience those make your life the easiest. Don't be scared off if you have a newer HE (high efficiency) washer though. It is possible to get them nice and clean with those, its just going to take a little more care and effort on your part.
Personally, I wash my diapers daily but according to my online reading, it seems I wash them on the more frequent side of the spectrum. I do this for several reasons that make sense for my life.
Ok, now for a big complicated can of worms that I am only recently getting sorted out for myself; type of washer. When I started doing cloth diapers we had an ancient washer we bought used for $75 from a guy who was refurbishing them out of his garage and looked like he might be on some sort of drugs. This washer was fantastic for cloth, it used a lot of water and friction to scrub my son's dirty diapers sparkling clean. I didn't even both rinsing his breastfed baby poop off of them first!
Fastforward two years and a new house later, we now have a HE washer. Fancy and eco friendly right? Nightmare for cloth diapers.... until I figured it out, which like I said is a fairly recent discovery and I'm still fine tuning things. The two big differences in my experience with the HE washers is that the wash cycles take longer and I need to more thoroughly clean soiled diapers before putting them in my washer.
What the heck do I mean by CLEAN my diapers BEFORE putting them in the washer (what an oxymoron!)? I'm talking about removing excessive baby poop before putting them in the washer.
You can do this a few different ways. I use a diaper sprayer that taps into the water pipes supplying your toilet and use that to spray off poo into the toilet then flush it away. Or if you don't have a sprayer, which I did not for the first 18 months of cloth diapering, you just dunk it in the toilet bowl and maybe flush a few times to add some extra water power to the removal. I also used an old kitchen spatula that I would scrap it off into the toilet with and I stored it in a wide mouthed mason jar stashed behind the toilet.
If you or your partner or your dad is even semi handy, you can very easily install a diaper sprayer to your toilet. In fact, the sprayer we have is actually a hand held bidet from Lowes. I've also seen DIY YouTube tutorials where they hook up the kind that is made for a kitchen sink!
What to do with dirty diapers? We use the Ubbi diaper pail that can be used for cloth or disposables. It has a reusable, waterproof, cloth bag that you can use in it for your cloth diapers or incase you are a par-timer, you can also use any ol' plastic trash bag in it as well. Its stainless steel and doesn't absorb odors, it has a child lock for older babies and toddlers who might like to dig in it or put toys in there, and the opening is nice and wide so you can easily stuff a big, dirty cloth diaper in it. That's where I put all the diapers that are only peed in and all of the soaked inserts. I pull everything apart immediately after I take it off my baby and stick it in the pail individually that way later, I can throw it all in the washer.
Soiled diapers go straight to the bathroom where I spray them to remove poop and then they go in a little plastic bucket that has a lid next to the toilet. Our washer use to be in a bathroom so I would remove excess poop and put them straight in the washer with the lid closed until it was time to do the load; choose whatever makes sense for your setup!
What to do about wipes? I am 100% in favor of using cloth wipes if you are using cloth diapers! It makes zero sense to me to be using cloth diapers but disposable wipes. Using cloth wipes doesn't significantly add to the amount of laundry you are already doing. However, my biggest reason is what the heck are you going to do with a disposable wipe when your diaper pail is full of cloth diapers? Maybe you have a seperate trash can near your changing table or maybe you plan on taking them out to the trash with you when you leave but people, thats more complicated than it needs to be.
You can either make or buy cloth wipes. My mother made me about 30 little cloth wipes for me before I had Sterling. She bought an old flannel receiving blanket at a thrift store and cut it up into little 5"x5" double sided squares and sewed around the edges. They work fabulously! If you have a sewing machine you can easily make a batch. I've also heard of people using wash cloths, though this to me is a bulkier option.
With cloth wipes, you will need some sort of cleaning solution. You can do a quick google search to find a DIY recipe or use this one that I came up with. I created my own because all of the other ones I found contained soap and the thought of leaving soap residue (even biodegradable, natural soap) on my baby's bottom didn't appeal to me.
You'll need a small plastic squirt bottle. I actually re-purposed the 8 oz peri bottle the hospital sent me home with after my birth. None of these measurements are exact, but this is roughly what I put in there.
3. The Wash/Fold Routine
Every night after bath time or bedtime, that's when I round up all the dirty diapers from the day and get them in the washer. I grab the main bag from the diaper pail, the bucket of rinsed poopy diapers and any that might still be hiding in a sealed wet bag in my diaper bag from a family outing earlier.
Once the diapers are washed, I separate out the covers and the inserts. I throw all the inserts into the dryer and hang the covers either outside on the clothesline or inside on a small fold up rack to dry overnight. If it's particularly cold and damp I might throw the covers into the dryer on LOW heat for a bit to speed up dry time. In the morning everything is dry and ready to be assembled.
We use pocket diapers so I sort the inserts then start assembling. I know some families assemble as they go, making their diaper at each change but I found it works best for me to put in roughly ten straight minutes of sorting and folding everything all at once so they are ready to go during changes.
There's normally some down time in the mornings while the kids eat breakfast or if I let them watch one episode of a cartoon or whatever. If its an especially chaotic morning, I just try to catch up during nap time and its really easy to assemble diapers while watching a show or listening to a favorite podcast.
4. How to Wash
If you're a lucky one with an old style washer your routine is nice an simple.
5. How many diapers do you need?
This really hinges on two factors, how often you plan on washing diapers and how many children you have in diapers at once.
For just one kid in diapers full time, washing once a day I was comfortable with about 20-25 diapers. I found that he used roughly 8-10 per day and while these were washing, there was still a decent number still clean for him to wear and to give me a buffer if I was really busy and didn't have time to make them immediately. As babies get older, they use less diapers too since they aren't going through as many diapers during the night.
With 4 month old twins, I started out with 27 diapers and I had to do two loads a day. One in the morning and one at night and I had to get them assembled promptly once they were dry or we ran out. I just purchased a fresh batch of 18 used diapers from a consignment sale. I also went through a box of slightly bigger diapers that we had used with Sterling and I can adjusted them smaller to make them fit the twins. We now have 64 working diapers and I think that will be a really comfortable number for us so I can get back in my once a day wash routine!
6. Increasing the absorbency of the diaper as your child grows.
Hemp and bamboo inserts or boosters are your best friend if you have a heavy wetter or an older baby/toddler. They hold wayyyyy more liquid (aka urine) than microfiber or cotton which boosts the absorbent power of the diaper without making it overly bulky. I have no idea how some cloth diapering parents go their entire cloth journey without ever using hemp or bamboo boosters!
I always layer my diapers when I make them. I am totally about to nerd out here for a second, I have a very specific strategy. I use one microfiber insert that I place closest to my baby's body and I layer 1-2 hemp or bamboo boosters under that (sandwiched between the microfiber and the PUL). I do this because the microfiber inserts are really amazing at quickly absorbing urine, especially key as babies start to hold it then pee a large amount at once vs, younger babies who go smaller amounts more often. The microfiber also does a good job at wicking the moisture away from your child so that they are more comfortable. Hemp and bamboo are slower absorbing but hold much, much more so I layer that further away from my kid.
7. Travel and Family Outings
We almost exclusively used cloth on Sterling even when we were out and about. I did this because I didn't want to buy disposables and if you switch back and forth, their cloths fit funky (either too loose when in disposables or tight with the cloth). I keep a wet bag in my diaper bag and that's where I put the used cloth diapers until I get home, just don't forget they're in there. If we travel overnight, that's when I buy a pack of disposables and just call it OK.
With the twins I have decided to use disposables when we are out and about on a daily basis. We still leave the house in cloth and I keep the wet bag handy, but I pack the diaper bag full of disposables. Its a space concern. I just don't have room for 3-4 clean cloth diapers in my diaper bag plus a potentially full wet bag. I do however have room for up to 2 dirty cloth diapers in the wet bag and a handful of disposables. Their cloths will fit lose if they end up in a disposable, but that's not a big deal for an afternoon.
If there's anything I didn't address in this post that you would like me to talk about, just comment below or send me an email. I am very passionate about cloth diapering and I think that it is a practical way of living for most families. I'd love to help you troubleshoot or give you advice on how to get started!
Reflections on my birth story one year later...
My daughter was born just over a year ago** via a (very reluctantly) planned C-section. I found out my baby was footling breech just before 34 weeks. I dove headfirst into any and all attempts to get baby girl head down – Spinning Babies, chiropractic care, acupuncture, Hypnobirthing and even two versions. External cephalic version is a process by which a breech baby can sometimes be turned from buttocks or foot first to head first.
Despite the excitement surrounding me and my husband, imminently welcoming our first child into the world, I felt devastated. There were so many feelings and emotions: loss and heartbreak at not getting a chance to have the birth I'd envisioned and prepared for. Anger at my care providers for not noticing her positioning earlier and ashamedly some anger towards my baby for not doing what babies are "supposed," to do and total frustration with my body for somehow failing me at the end of my pregnancy. It felt like not many people truly could empathize with what I was feeling... as long as baby and mom were healthy, why should it matter?
I'd done some reading on the "gentle" C-section and felt so strongly that immediate skin-to-skin in the Operating Room (OR) was the only option I could accept if a C-section was my fate. When my care provider could not guarantee the type of C-section I was asking for, knowing very well that it was being practiced at another local hospital, I left. I sought out a caring and empathetic provider who not only agreed to my birth plan, but assured me that this was her normal C-section procedure.
Being able to see my daughter and hold her immediately on my chest is a feeling I'll never forget. The moment they brought her up to my face, new and bloody and just-birthed, she reached right for my nose and grasped on. When I look at that picture, it feels like my heart will explode and tears brim in my eyes even a year later. It’s my dream that the future of C-section births will start to look more and more like this - that C-section moms will feel more connected to the moment their babies arrive earthside and will feel more respected, heard and involved in their surgical births.
With the passing of a full year, the pain I felt at not having the birth I so wanted began to soften. I still mourn that loss but what I've learned from therapy and self-reflection is that it's ok to feel both immense joy at the birth of my beautiful baby as well as sadness and grief for the birth I would have preferred. I hope that more moms can learn and accept that it's ok to feel both.
But most importantly, if there is anything that I could impress upon my fellow expecting mamas, it is to ADVOCATE – for yourself, for your baby and for your family. You deserve the opportunity to make the best decisions possible. When I didn't get the answers I needed, I found a new doctor at 39 weeks! I am proud of that decision, I am proud of every question I asked, every "no" I pushed back at. One day I will tell my daughter about her birth and I will make sure to include in that story, the bravery with which I brought her into this world.
**My daughter is now 16 months old and I’m happily expecting our second child in September! I’m very happily planning for a beautiful VBAC!
Jenny Robertson is a Boston based yogi and mother. She teaches prenatal yoga at Om Births where we met and did our prenatal yoga teacher training together. She is a beautiful soul and inspires expectant mothers every day.