I am so honored to speak to Dr. Pooja Lakshmin (@womensmentalhealthdoc on Instagram. She is a Perinatal Psychiatrist and contributor for the NY Times.

We speak about “Mom martyr mode,” Postpartum Depression, Postpartum Anxiety, and how to know when you need to talk to someone about your mental health.

Our hope is to break the stigma surrounding maternal mental health. Understanding things are not okay take strength. Getting help takes strength. We want to normalize therapy and the medications and diagnosis of postpartum anxiety and depression.

00;00;06;10 – 00;00;36;17

Dr. Mona

Hey, everyone, welcome to the PedsDocTalk podcast. I’m your host, Doctor Mona, where each week I hope to educate and inspire you in your journey through parenthood with information on your most common concerns as a parent and interviews with fellow parents and experts in the field. My hope is you leave each week feeling more educated, confident, and empowered in decisions you make for your child.

 

00;00;36;19 – 00;01;00;24

Dr. Mona

Hello and welcome to this week’s episode where I am so excited to welcome Doctor Pooja Lakshmin, who is a perinatal psychiatrist and contributor for the New York Times based in Washington, DC. And we are talking all about moms today mom guilt, martyr mode, postpartum depression, postpartum anxiety because we need to be taking care of ourselves and each other.

 

00;01;01;00 – 00;01;06;22

Dr. Mona

And I am so excited to welcome Doctor Lakshmin here to help us do that. Thank you, Doctor Lakshmin, for being here today.

 

00;01;06;27 – 00;01;29;07

Dr. Pooja Lakshmin

Well, I am so excited to be here. Mona. Thank you a million for having me. I love all the work that you do. I love your podcast and your Instagram page and, yeah, it’s great to be here with you and hopefully we’ll be able to have a, a helpful conversation that can help your listeners really kind of get a sense for what to look out for in terms of their mental health.

 

00;01;29;09 – 00;01;40;14

Dr. Mona

And I found Doctor Lakshmin’s Instagram page, women’s mental Health doc. I’m going to be attaching it to my show notes. I found her page maybe earlier this year when you probably just started out right?

 

00;01;40;17 – 00;02;02;00

Dr. Pooja Lakshmin

Yeah, I started out in, actually in December of 2018, but it took me literally six months to figure out what was going on with Instagram. So I would say I didn’t really get serious about it until like last summer. And I found you, when you shared your birth story, and that kind of whole series about your birth trauma and everything that happened.

 

00;02;02;00 – 00;02;13;04

Dr. Pooja Lakshmin

And, I remember reading about that and just instantly being like, I really wanted to connect with you because I loved how transparent you were about everything you went through. Yeah, yeah.

 

00;02;13;11 – 00;02;33;25

Dr. Mona

So we were talking about before we got started, how important what you’re doing is to me and to all of my patients and their moms, because there’s just not a lot of mental health resources out there to begin with, especially for mothers. You know, we focus way more on the baby. I think every mother can attest to that, that even in hospitals, it’s baby centric hospitals.

 

00;02;33;25 – 00;03;00;14

Dr. Mona

They’re not focusing on the well-being of mothers at all, in my opinion. So when they go home, it’s like they feel like they’re at a loss here. Sometimes where they’re trying to navigate this new world and feel alone and they feel like, are these feelings that I’m going through normal? So we’re going to be talking about how normal these feelings are and how to kind of know when when it’s normal motherhood adjustment versus something that’s more clinical.

 

00;03;00;16 – 00;03;10;11

Dr. Mona

And so we’ll get into that. But tell me, do you have a particular niche in terms of, in your, you know, in perinatal psych psychiatry, something that you’re most passionate about?

 

00;03;10;14 – 00;03;38;18

Dr. Pooja Lakshmin

Well, you know, I take care of patients that are dealing with any number of mental health issues. So depression and anxiety during pregnancy, depression and anxiety, postpartum. But I think the thing that I’m probably the most passionate about and that I’m probably known for the most in my writing is, my critique of self-care and my passion around helping moms not get into martyr mode or to get out of martyr mode.

 

00;03;38;21 – 00;03;57;00

Dr. Pooja Lakshmin

Like you were talking about. Mona. I think it’s natural when you become a mom, to want to sacrifice everything for your kids and especially when you have an infant. The work of taking care of an infant is just, you know, 24/7 demands, right? And if you’re pumping or nursing, you’re the only one who can do that work.

 

00;03;57;00 – 00;04;30;24

Dr. Pooja Lakshmin

Right. But I think what I’m really interested in is looking at how, or I guess, helping women reclaim their thoughts and feelings. Because I feel like so much of the messaging we take in from our culture is around the fact that moms should be doing everything, that you’re not a good mom. If you’re not, you know, with your kid 24 seven and there’s so much conflicting advice and conflicting information like you might get, differing advice from your pediatrician versus your ObGyn or your psychiatrist, right.

 

00;04;30;24 – 00;04;50;19

Dr. Pooja Lakshmin

Like you can’t follow all the rules. So I think it’s really important for moms to understand that, like that guilt that you’re constantly feeling. It’s not real. You know, it’s something like I always talk about with my patients. Like guilt is a feeling that’s just so easy to grab for as women. It’s like a check engine light.

 

00;04;50;19 – 00;05;06;02

Dr. Pooja Lakshmin

That’s not accurate. My biggest focus is helping women understand that the way that you feel, the way you do, makes sense. And there are things that you can do to help yourself feel better. And suffering is not something that’s helpful to you or your family.

 

00;05;06;05 – 00;05;27;07

Dr. Mona

I agree with this completely, and I found this even before I became a mom. Just how much this was happening with mothers in my office, with my friends who were mothers. And I said to myself, When I’m a mom, I’m not going to let it happen to me. I’m going to figure out ways to, you know, maximize myself and make sure that I don’t lose my identity and lose my, you know, the things that make me happy.

 

00;05;27;07 – 00;05;42;18

Dr. Mona

And of course, when you become a mom, you are going to have to make some sacrifices. But I think, you know, over the course of the nine months, and I wonder if my birth trauma had a lot to do with it. I really feel like I’ve found this balance of being able to say, okay, I need I know my limitations.

 

00;05;42;18 – 00;05;59;21

Dr. Mona

I know where I’m not getting self-care, I’m feeling overwhelmed, my cup is feeling really full and I need help. And I think that awareness is what I hope mothers get, you know, get out of this episode is that you need to understand that you are not able to do everything, whether you’re a working mom or a stay at home mom.

 

00;05;59;27 – 00;06;19;09

Dr. Mona

It is impossible to do everything for your child. Do everything for yourself, do everything for your family, do everything for your clients or patients or whoever it is at work. Because we’re just only one person. And I’ve had those moments where I’m like, I’m only one person. How am I capable of doing all of this? And I will, you know, get so frustrated and upset.

 

00;06;19;09 – 00;06;34;25

Dr. Mona

And I take a moment. I’m like, I am capable of doing things. I just need to prioritize. And I also need to remember that I can’t do everything. I have to learn to say no, and I have to learn to delegate. And like you said, that self-care is so important and it starts from the moment that baby comes out.

 

00;06;34;25 – 00;06;51;21

Dr. Mona

And when you’re in the hospital, right? If you have a partner or a nurse asking them for help, asking them to take on the responsibilities that you don’t need to, you don’t need to do all the diaper changes. You know, if you’re a bottle feeding, you can have them warm the bottle. There’s so many little ways to get that self-care in.

 

00;06;51;23 – 00;06;56;17

Dr. Mona

And you mentioned martyr mode. What exactly is that? If you can define it. Yeah.

 

00;06;56;17 – 00;07;22;22

Dr. Pooja Lakshmin

So martyr mode is the phenomenon that happens where you take pride in making yourself so small in the service of your kids and your partner, where you feel better about yourself because you’re suffering. Like that’s the definition of a martyr, right? And it’s so interesting with moms because our culture really, validates women for their self-sacrifice as moms, right?

 

00;07;22;22 – 00;07;45;08

Dr. Pooja Lakshmin

Like, oh, that’s so great that you, you know, you know, you missed your workout today, but you were with your kids, right? You know, like, it’s it’s it’s a sense of pride, but you don’t understand that in the end, you’re actually hurting yourself. And with martyr mode, though, it comes with this sense of ego, actually, because you’re kind of like, wait, I’m doing everything, and I feel like the savior in my family.

 

00;07;45;10 – 00;08;07;17

Dr. Pooja Lakshmin

But then you also secretly are very resentful and frustrated and angry that nobody else is stepping up to help. With martyr mode. We also see what’s called maternal gatekeeping. Right? Where you on the inside want everybody to help. But when your partner actually steps in and says, hey, like, yeah, I’ll wash the bottles for you, you’re standing over, looking over his shoulder saying, no, that’s not how you do it.

 

00;08;07;17 – 00;08;28;22

Dr. Pooja Lakshmin

You missed the spot. You know, you didn’t change sniper, right? This is how we have to do it, right? And part of that there’s interest. It’s interesting because there’s some overlap there with postpartum anxiety. If you have untreated anxiety it’s going to be feel really difficult to actually let go of that control, to have your partner ask your partner actually to step in and take over some tasks.

 

00;08;28;22 – 00;08;55;13

Dr. Pooja Lakshmin

If you have untreated anxiety, it’s going to be really difficult to watch your partner make mistakes or, you know, quote unquote mistakes, not do it the way that you would like it to be done. So that’s one piece that’s important to kind of be able to differentiate and can that’s where it can really help to get a clinical evaluation to see is untreated anxiety, driving your need to sort of be in control all the time when it comes to taking care of your baby.

 

00;08;55;15 – 00;08;59;05

Dr. Pooja Lakshmin

But yeah. So that’s, that’s martyr mode. That’s how I think about it.

 

00;08;59;08 – 00;09;18;23

Dr. Mona

Yeah. And I think you’re right on that. This is something that I think a lot of mothers do, but they don’t realize that there’s actually a terminology for it. They don’t realize that how it can affect their relationship with their child, but also the relationship with their partner. You know, if you’re like you said, like if you are in this martyr mode and feel that you have to do it all and I, I hear you.

 

00;09;18;23 – 00;09;39;27

Dr. Mona

I’ve heard this from a lot of moms that they feel that even if they have a partner who is very capable and very involved, they feel it’s on them and that can make you feel isolated, that can make you feel overwhelmed. And like you said, we’re going to kind of try to hash out the differences of when it is more just normal adjustment to motherhood or something more clinical.

 

00;09;40;00 – 00;09;56;01

Dr. Mona

So what are some signs of postpartum anxiety? Obviously getting into that more clinical diagnosis that I think mothers need to hear. And to be honest, I think a lot of people focus a lot more on postpartum depression, which is why I want to talk about people first.

 

00;09;56;04 – 00;09;56;22

Dr. Pooja Lakshmin

Yeah. Yeah.

 

00;09;56;22 – 00;09;59;23

Dr. Mona

So what would you say some of the signs of people are. Yeah.

 

00;09;59;23 – 00;10;24;11

Dr. Pooja Lakshmin

So there’s a couple really prominent signs of postpartum anxiety. So one is, difficulty sleeping when your baby’s sleeping and when you have clinical anxiety, you’ll notice that you’ll be up even though the baby’s sleeping. Your mind will be racing. You’ll be worried about any number of things. You might also not be able to sleep because you feel like you kind of constantly need to check and make sure the baby’s still breathing.

 

00;10;24;19 – 00;10;50;09

Dr. Pooja Lakshmin

Of course, a little bit of that is normal, obviously, when you first bring home a newborn, but it should be getting better over time, you know, you know, you shouldn’t have a four week old and still be waking up every 30 minutes to make sure the baby’s still breathing. Another really, common symptom of postpartum anxiety is intrusive, obsessive, scary thoughts about harm coming to the baby.

 

00;10;50;12 – 00;11;12;05

Dr. Pooja Lakshmin

And or harm coming to you. And this is interesting because, some of this is normal. So there’s research looking at new parents. You know, there was a study looking at 100 new parents and found that every single person in that study had thoughts of unintentional harm coming to their baby. 50% of the people in that study had thoughts of intentional harm coming to the baby.

 

00;11;12;11 – 00;11;31;29

Dr. Pooja Lakshmin

But it becomes clinical when those images. So the most common form of those images is things like, you know, I’m walking down the stairs with my baby, and I’m just seeing a flash of him slipping out of my hands, falling. And it can be really graphic, you know, seeing the babies sort of, crack their head or you’re giving the baby a bath and you see images of the baby slipping out of your hands.

 

00;11;31;29 – 00;11;50;24

Dr. Pooja Lakshmin

You know, something really graphic. So a little bit of that is normal. But when it’s so persistent that you can’t let it go, when that thought comes and it’s like, sticky, you know, and you find yourself ruminating on it throughout the day, that’s a sign that it could be something that’s clinical. The other consideration there’s two other considerations that we make.

 

00;11;50;24 – 00;12;11;12

Dr. Pooja Lakshmin

One is, is that anxiety then causing you to have trouble functioning? So, for example, you know, I had a patient recently who had this specific her house had like kind of like a balcony on the second floor. And she whenever she was holding the baby walking across the balcony, she would have these, obsessive thoughts about, intentionally.

 

00;12;11;16 – 00;12;32;28

Dr. Pooja Lakshmin

She didn’t want to do this, but this was anxiety. She had thoughts that she would drop the baby over the banister of the balcony. So she stopped going upstairs. So when her husband was not home, she stayed on the ground floor of her house. Even though she had things to do upstairs. So that would count for us as your anxiety is affecting your functioning, because now you’re quarantining yourself to one part of your house.

 

00;12;33;01 – 00;12;53;19

Dr. Pooja Lakshmin

The other red flag is if these thoughts and this anxiety is then influencing your ability to bond with your baby. Are you having trouble connecting with the baby? You know, obviously some degree of anxiety is normal in the postpartum period, but you should still be able to have tender moments. You should still be able to have like some joy.

 

00;12;53;20 – 00;13;07;29

Dr. Pooja Lakshmin

You know, when your baby smiles at you or coos at you, or you know, you should still have some of that connection. Somebody that has clinical postpartum anxiety isn’t able to identify, like any moments of joy or contentment or connection.

 

00;13;08;01 – 00;13;30;04

Dr. Mona

Oh, absolutely. And you brought up two comments. The first one was how you described the sticky. You said the word sticky when it says that it’s more like a pervasive thing, right? Like like you said, I actually have had intrusive thoughts, but it was momentary and it didn’t occur repetitively. And I think I’ve spoken maybe to you and I’ve spoken to other my I have a therapist about hey, is this okay?

 

00;13;30;04 – 00;13;50;04

Dr. Mona

And she’s like, yes, just monitor for if it’s a consistent thing. That’s a great way to put it, because I think what we were saying earlier is that differentiation of this, is this just normal postpartum adjustment or like you said, is this actually a clinical condition? So I really appreciate you differentiating that in such a great way. The other thing that you mentioned was the bonding with the baby.

 

00;13;50;04 – 00;14;09;13

Dr. Mona

And as a pediatrician and a mother myself like that to me is one of the biggest things because I also had delayed bonding with Ryan. But it happened eventually, and I was able to find those moments of joy and look at him and feel happy. Yes, I had gone through my own birth trauma where I did feel sad at times, but the overwhelming emotion was joy.

 

00;14;09;15 – 00;14;28;17

Dr. Mona

It wasn’t overwhelming fear, overwhelming sadness. Right? And that’s what it is. It’s the overwhelming feeling should be. In the past month, I am feeling good. I’ve had bad days. I’ve had days that are not, you know, going to be going swimmingly and I’ve cried or whatever it is. But overwhelmingly, I’m feeling joy when I look at my baby.

 

00;14;28;24 – 00;14;48;05

Dr. Mona

And this, to me is really important that mothers who are listening realize is that being able to bond with your baby is important for you, but it’s also really important for baby’s development, for their ability to feel connected to someone. And I don’t want mothers to feel guilted or anything like that when they’re hearing this. This is more because the more to know that you know what?

 

00;14;48;05 – 00;15;06;04

Dr. Mona

If you’re not feeling that bond, I want you to get the help you need because it can have amazing benefits for you. And also baby’s development. Social, emotionally, right. The baby needs to kind of have that sort of reciprocity, being able to look at a mother in their eye and, you know, you feel that joy and smile from time to time.

 

00;15;06;04 – 00;15;22;02

Dr. Mona

Of course, we’re not saying that every day is going to be roses. It’s not. But I want that for mothers. And I have seen that in my office six months postpartum. I’m seeing a mom for the first time, and I, I’m very vibey, like, I know when I walk into a room, if something’s not right and I’m talk to the mom, I’m like, are you feeling okay?

 

00;15;22;02 – 00;15;38;21

Dr. Mona

And she’s like, I just am overwhelmed. I’m like, have you talked to someone about it? And she’s like, no, I just, you know, I feel like it might just be normal. I’m like, you should feel joy more days than not, and I want you to at least speak to someone about it so that you can come to the, you know, come to the understanding.

 

00;15;38;21 – 00;16;00;29

Dr. Mona

Well, is this something I monitor, or is it something that I should be evaluated and treated for? Because I think that would be one of the reasons why moms don’t get the help they need is they may not know the symptoms or they think, well, maybe I’ll just get through it and they never seek out more help. Would you say that’s kind of why you see mothers not get help for PPA or postpartum depression?

 

00;16;01;01 – 00;16;21;14

Dr. Pooja Lakshmin

Yeah, I think that, exactly what you said. A lot of times women just feel like, well, this is a hard time. I’m not sleeping very much. I’m sleep deprived. I’m overwhelmed. It’s supposed to feel this way. So they don’t recognize that it could actually be a clinical condition. I think there’s a lot of shame that comes with these feelings.

 

00;16;21;14 – 00;16;42;12

Dr. Pooja Lakshmin

Like what you pointed out, that feeling of, not feeling connected to the baby. If it’s something that persists is a sign, actually, of depression or anxiety. And so when you treat it, it gets better. But most of my patients, when they come to see me, they don’t know that that’s a sign of depression or anxiety. So they just feel guilty.

 

00;16;42;15 – 00;17;02;08

Dr. Pooja Lakshmin

They already feel like they’re a bad mom. They don’t see it. They don’t. They didn’t know that. Oh, that’s actually my depression that is making me feel that way. So I think that prevents a lot of women from actually getting the help that they need and recognizing that that this is a, this is, a symptom. This isn’t a moral judgment on you.

 

00;17;02;10 – 00;17;20;09

Dr. Pooja Lakshmin

And again, like we said, it’s not like we’re saying, oh, my gosh, you know, you’re supposed to be like, you know, it’s not like roses and daisies, but, you know, that’s not what we’re saying. It’s that, like, if you’re not feeling any positive emotions at all, that’s when we worry. Like it’s going to be in the normal course of postpartum period.

 

00;17;20;09 – 00;17;41;25

Dr. Pooja Lakshmin

There’s going to be hard days. But if you’re suffering from, depression or anxiety, it’s it’s that you’re constantly feeling this sense of dread or this sense of hopelessness, and you don’t have that feeling of contentment or joy or connection at all. That’s when we worry. And and I love what you said, Mona, about the fact that that this is important, actually, for your baby’s development.

 

00;17;41;25 – 00;18;05;02

Dr. Pooja Lakshmin

So one of the things I think that actually does bring women into my office is, this is one of the few times in your life where you recognize, like, actually, my health really impacts the health of my baby. And so you getting treatment for for your symptoms, if you’re having them, that actually is that’s going to exponentially improve your baby’s health as well.

 

00;18;05;04 – 00;18;22;27

Dr. Pooja Lakshmin

So you should never feel like it’s selfish to take the time to go to therapy, or to, you know, see your doctors or things like that. Because you feeling better is, is only going to help you be more present and more emotionally available to your children.

 

00;18;23;00 – 00;18;43;20

Dr. Mona

And we talk so much about infant development. And, you know, there are many domains of infant development. But like I said, the social emotional domain of development is the foundation, in my opinion, to be able to develop all the other domains of development. You can’t have someone communicate with you or, you know, start doing motor skills if you don’t have this as the foundation.

 

00;18;43;20 – 00;19;06;03

Dr. Mona

And like I said, I went through it too. And this is me talking to you as a mother who went through seeing a therapist, you know, I went through it. I, I saw the therapist. I recently talked to you about how I was. I’m now on, antidepressant. And this was a big thing for me, you know, that actually developed eight months postpartum where I was just feeling like I wasn’t myself anymore.

 

00;19;06;03 – 00;19;28;14

Dr. Mona

And that’s what I told my husband. I’m like, I’m not me. I’m sad, and I just feel angry and upset. And I think it was a cumulation of everything. It was the trauma that hit me later. It was working in a pandemic. It was the probably hormones still, but it really is something that I want mothers to understand that it happens and it’s not a sign of weakness.

 

00;19;28;14 – 00;19;49;15

Dr. Mona

It’s not a sign that you didn’t do enough of anything else, or that you didn’t have the support you needed. I have all the support in the world. I have an amazing husband, I have a beautiful son, and I have a great job. But life is kind of hard sometimes, and especially as a mom, when you feel that overwhelming weight on your chest that you just feel like, wow, I don’t feel like myself.

 

00;19;49;15 – 00;20;07;18

Dr. Mona

I just feel, like I just feel not off. I think it’s important that you understand that. Talk to somebody. This is something that you need to feel okay to feel better for your partner, for your child. And there is nothing wrong with that. This is like you said, this is to be the best mom for your child.

 

00;20;07;18 – 00;20;22;16

Dr. Mona

The best person for yourself and your child will be much happier knowing that you took care of yourself and went through all the avenues, to get help for yourself rather than saying, okay, I’m just going to brush this under the rug and not take care of my own well-being.

 

00;20;22;18 – 00;20;39;26

Dr. Pooja Lakshmin

Right, right. And I think, like one of the things that happens when when women come to see me and if we, you know, diagnose them with postpartum depression or postpartum anxiety, and they start medication and the medication starts working, you know, they’re just like, wow, I wish I would have done this sooner, you know, like, why did I wait so long?

 

00;20;39;28 – 00;21;01;12

Dr. Pooja Lakshmin

And I think part of that also is just stigma in our culture. You know, people still believe that taking medication is cheating. You know, that you should be able to do it by yourself, quote, unquote. And I always say like, look like if you broke your leg and assaulted your surgeon was like, hey, we need to take you to the O.R. and operate on your leg.

 

00;21;01;15 – 00;21;26;09

Dr. Pooja Lakshmin

You’re not going to be like, oh, no, I’m sorry. You know, I’m going to just try and, like, go to physical therapy and do this on my own. Like, nobody’s going to say that, right? But when your doctor recommends medication, that’s how people feel, you know? And I think that’s just that’s because, you know, depression and anxiety, I see a lot of patients who are still really high functioning, even though they and I and I, I feel like you’ve spoken about this before, right?

 

00;21;26;09 – 00;21;43;08

Dr. Pooja Lakshmin

Like, it’s like you can have depression and anxiety and you can still be going to your job every day and doing a really good job at your, a good job at work and taking care of your kids. Right? So depression, anxiety doesn’t always look like, you know, I can’t get out of bed or I can’t do the things that I need to.

 

00;21;43;08 – 00;21;59;12

Dr. Pooja Lakshmin

And so then women are kind of like, well, if I can do all of this stuff, then I must not be depressed or I must not have anxiety. But you really have to look at how much of your suffering on the inside. How hard is it to do these things that you need to do? And was there a switch that happened?

 

00;21;59;12 – 00;22;26;08

Dr. Pooja Lakshmin

Right, like, are you just really feeling disconnected? Does everything just feel like it’s a chore? Does it just kind of feel like one constant to do list that you’re not actually present or able to really focus on what’s important to you? So and that’s where therapy is really important too, because you kind of have to tease apart these different pieces to see, what can be, improved by learning new ways to interact with your thoughts and feelings.

 

00;22;26;08 – 00;22;30;16

Dr. Pooja Lakshmin

And then what does require medication to, get better?

 

00;22;30;19 – 00;22;51;14

Dr. Mona

Well, you said it beautifully, because the trigger for me was the fact that I had to go back to work in the pandemic, and that was for me. That’s a personal situation. But it was that. Plus, working at a place that gives me a lot of anxiety even prior to being pregnant. So now that I’m a mom and having had all that, like you said, it was just a compounded thing and I was doing everything else.

 

00;22;51;14 – 00;23;09;22

Dr. Mona

Like you said, I was doing meditation. I, you know, work out a lot. And yes, that all gave me benefits, but oh yes, I said the same thing to my husband. I’m like, wow, what was I doing not being on this medicine? Because now I actually feel lighter, like I felt just that weight wasn’t on me, like we talked about.

 

00;23;09;22 – 00;23;25;27

Dr. Mona

And I am sharing the story actually for the first time, even for any of my followers, because, we’re talking about all this, but more so just so if anyone’s listening and they are feeling like, you know what? I have been trying, but I maybe need to do something more, that there are options and you shouldn’t feel bad about it.

 

00;23;25;27 – 00;23;46;26

Dr. Mona

You shouldn’t feel, you know, stigmatized about it because it is very beneficial. I know many amazingly successful women who are on SSR rise. I want everyone to know that yes, we are destigmatizing this medicine that it’s not you know you couldn’t do anything else. You are doing everything and this is just another tool in your toolbelt to feel even better.

 

00;23;46;26 – 00;23;52;08

Dr. Mona

And I I’m so happy how you speak about that because it is important that mothers hear this.

 

00;23;52;11 – 00;24;14;00

Dr. Pooja Lakshmin

Yeah, absolutely. And I think that brings up a really good point in terms of. So some of the things I think women are afraid of when they come to see me about medications are one. If I take this medication, is it going to change my personality? And so I love what you said, that, you know, you kind of if you’re on the right dose of the right medication, it should make you feel more like yourself.

 

00;24;14;02 – 00;24;34;12

Dr. Pooja Lakshmin

It should cause the anxiety or the depression is what changes your personality. So so the medication itself, actually what I see is that it brings people closer to who they were before the depression came or before the anxiety came. The other thing people are often worried about is, is am I going to become addicted to the medication? And so as a surprise, aren’t they?

 

00;24;34;19 – 00;25;03;12

Dr. Pooja Lakshmin

They’re not like taking OxyContin or pain medication or something. They’re not something that you become addicted to. That’s not how they work. And that being said, you know, typically if you have postpartum depression or postpartum anxiety, we recommend that you stay on the medication for anywhere from six months to a year because it does take a solid, we say, 2 to 6 weeks for the medication to start working, and then we continue to see benefits actually for 2 to 3 months of improvement.

 

00;25;03;15 – 00;25;18;05

Dr. Pooja Lakshmin

And so in order to make sure that the depressive episode or the anxiety episode doesn’t come back again, we do like you to stay on it for at least six months, but that doesn’t mean that you have to be on it for your whole life. You know, you can come off these medicate. I have patients that I take off medication all the time.

 

00;25;18;12 – 00;25;35;16

Dr. Pooja Lakshmin

Right? Just because you take it in the postpartum period doesn’t mean that you’ll need to be on it forever, by any means. And the great thing about these medications is, is that you you can come off of them and, you know, five years later if something bad happens or you go through a hard time in your life or something comes up again, you can always go back on it.

 

00;25;35;16 – 00;25;40;25

Dr. Pooja Lakshmin

It’s not doesn’t have to be a black or white decision like, oh, I’m on it. So that means that I’m on it forever.

 

00;25;40;28 – 00;25;51;04

Dr. Mona

I do want to talk more about the medicines and, you know, common questions I get. But before we do that we talked about postpartum anxiety. What are some symptoms of postpartum depression.

 

00;25;51;06 – 00;26;15;28

Dr. Pooja Lakshmin

Yeah. And so one thing is important to point out is that most commonly there’s overlap between the two okay. So most women about two thirds of women that have postpartum depression or postpartum anxiety will have some symptoms of both. So there’s quite a bit of overlap. But postpartum depression is characterized by some of the same things. You know, trouble sleeping when the baby’s sleeping again, trouble with connecting with the baby in the same way.

 

00;26;16;05 – 00;26;41;05

Dr. Pooja Lakshmin

But the overall feeling with postpartum depression is this profound sense of like, hopeless ness and dread. It’s like I like to describe it as it’s like you lose complete sense of perspective about the fact that, yes, taking care of a newborn is so difficult. And yes, you’re not sleeping, but when you have postpartum depression, you feel like I will never sleep again, you know, like I will never.

 

00;26;41;12 – 00;26;59;06

Dr. Pooja Lakshmin

This is my life now and this is it. It will never be any different. And you feel like that the whole day? You know, in the normal postpartum experience, you will have some feelings like that, but you won’t feel like that the whole day. You’ll still be able to have some of those moments of joy and some of those moments of connection with your baby.

 

00;26;59;06 – 00;27;24;07

Dr. Pooja Lakshmin

But when you have postpartum depression, it’s like the whole day just feels like you’re, you know, bare knuckles just trying to get through. You know, you wake up every morning and all you feel is dread. It’s just it’s it’s just with this hopelessness. When it gets really bad, you can also have feelings like, you know, my family would be better off without me.

 

00;27;24;09 – 00;27;41;08

Dr. Pooja Lakshmin

It would be better if I didn’t exist. I hope that I just go to sleep and I don’t wake up and, you know, even active suicidal thoughts, if things are severe, that’s kind of that’s one of the ways in which postpartum depression is, is a bit different than postpartum anxiety. But again, they do typically go together.

 

00;27;41;11 – 00;27;56;18

Dr. Mona

And do we know why this happens? You know, because in terms of like risk factors or certain situations that may say, okay, is it hormone related? I’m sure a lot of people have that question as to like why this can all of a sudden happened in that postpartum period. Yeah.

 

00;27;56;18 – 00;28;20;14

Dr. Pooja Lakshmin

So it’s definitely multifactorial. So, it does seem that there is the research shows that there’s a subset of women who are more sensitive to the hormonal changes that occur. So it’s not necessarily that, like one hormone in particular, like estrogen and progesterone. It’s more related to the big change, the big drop that happens after you, deliver.

 

00;28;20;14 – 00;28;42;21

Dr. Pooja Lakshmin

And then also the changes that occur during breastfeeding. So if you’re somebody who, has mood changes or irritability during your period, or if you’re somebody who has had mood or anxiety issues with or, hormonal contraceptives, that could be a sign that you’re someone who’s going to be a little bit more susceptible during pregnancy and delivery.

 

00;28;42;26 – 00;29;12;19

Dr. Pooja Lakshmin

But not everybody, meets that criteria. Even women that don’t have hormones susceptibility could still develop postpartum depression in terms of the risk factors, there’s a couple really powerful ones. One is any prior history. So if you’ve had depression or anxiety at any other time in your life, you’re at a higher risk. So in the general population, about 15 to 20% of women will experience some type of, depression or anxiety in pregnancy or postpartum.

 

00;29;12;19 – 00;29;38;25

Dr. Pooja Lakshmin

If you’ve had a history before, your risk goes up to about 40%. If you’ve taken an SSRI or any type of psychiatric medication and you come off of that medication during pregnancy, your risk goes up to about 70%. So, preexisting history. And then we also know that not having social support, decreased social support is definitely, something that can increase your risk.

 

00;29;38;25 – 00;30;07;02

Dr. Pooja Lakshmin

And also adding in social support improves or decreases your risk. So then obviously, you know, the pandemic with not being able to get as much support that can help explain a lot of the kind of rising rates that we’ve seen. The other thing is sleep deprivation. So, not getting not having support at home so that you’re, you’re not able to get, you know, 4 to 6 consecutive hours, that can also increase your risk.

 

00;30;07;02 – 00;30;30;14

Dr. Pooja Lakshmin

And if you’re somebody that already has preexisting depression or anxiety, you’re it’s going to be really important to protect your sleep as much as possible. This is hard, though. You know, obviously if you’re nursing or pumping, you know, if you’re trying to get your milk supply up. So when I work with patients, it’s we’re always kind of trying to balance the demands of, you know, feeding the baby versus making sure that mom is getting her sleep.

 

00;30;30;14 – 00;30;36;26

Dr. Pooja Lakshmin

And depending how severe symptoms are, sometimes we’ll kind of be a little bit more strict about sleep.

 

00;30;36;28 – 00;30;58;07

Dr. Mona

And I also find, you know, colicky babies and babies with reflux are commonly in my office, you know, having an impact on mother’s maternal health because it makes sense they’re not sleeping as well. And that is a I agree with you personally also that getting good sleep is so important in childhood and obviously in infancy. And it’s not always going to happen right away.

 

00;30;58;09 – 00;31;17;21

Dr. Mona

And that can have a huge impact. And I think going back to what we started talking about earlier is that there’s that culture that, oh, you’re never going to sleep again, that this is what it is. And yes, yes, that there’s a reality that you may not get your full night’s of sleep for a little bit, but it shouldn’t be this culture that you just got to deal with it and that you just got to suck it up.

 

00;31;17;23 – 00;31;35;25

Dr. Mona

If it’s impacting your mental health, then we need to have a conversation about it. I completely agree with that. Now, is there a time frame, like, is it possible to develop this, you know, a couple weeks postpartum? Can it be can it be something that happens within the first year postpartum? When would you define it as postpartum anxiety or depression?

 

00;31;35;25 – 00;31;52;06

Dr. Pooja Lakshmin

Yeah. So that’s a really good question. So it’s about evenly split one third. About a third of women are going to develop symptoms in pregnancy. Another third of women are going to develop symptoms in the first six weeks. And then another third of women are going to develop symptoms in the first year.

 

00;31;52;13 – 00;31;52;25

Dr. Mona

Okay.

 

00;31;52;28 – 00;32;11;23

Dr. Pooja Lakshmin

So and so we really consider the whole postpartum period to be the whole one year after you deliver. So I would say the place where I see so obviously the first six weeks is a critical time, and then the return to work is another time, right? Because that’s when you’re just adding in a whole nother layer of stressors.

 

00;32;11;23 – 00;32;12;27

Dr. Mona

Yeah.

 

00;32;12;29 – 00;32;20;20

Dr. Pooja Lakshmin

And even even though most a lot of my patients right now are working from home, even with that being the case, it’s still very, very stressful.

 

00;32;20;22 – 00;32;39;13

Dr. Mona

That makes sense because like I told you, I was actually doing really well the first four months postpartum because I was on mat leave and I was like, I’m making strides. I’m so excited. Like, I’m feeling good. I’m so, you know, I’m taking control over my mental health. And then I went back to work in the office like telemedicine didn’t give me this.

 

00;32;39;13 – 00;32;57;02

Dr. Mona

But the in office work, you are right. It was like a switch. I was a mess. Like I was crying all the time. I was so overwhelmed and it was not me. Like I told you earlier. And that makes a lot of sense for, you know, these kind of triggers that can happen. And of course, that can happen any time.

 

00;32;57;02 – 00;33;09;13

Dr. Mona

And that in that first year. Now, how do you all make the diagnosis? Is it more just kind of this like, you know, looking at the different symptoms or is there like a checklist that happens? What’s the kind of, you know, way that we make the diagnosis?

 

00;33;09;13 – 00;33;27;26

Dr. Pooja Lakshmin

Yeah. So there’s this there’s a, a screening tool called the Eprdf, which a lot of folks probably know about, that your Gyn probably has given you or your pediatrician. But that that doesn’t make a diagnosis. That’s just a screen. So in order to make the diagnosis, what you would what we do actually is have a clinical interview.

 

00;33;27;26 – 00;33;46;14

Dr. Pooja Lakshmin

So we would have, you know, my intakes are 75 minutes. So we talk for an hour and 15 minutes about, you know, all of your symptoms. What’s going on. We kind of go through the whole list of your sleep and how you’re feeling. And you know, basically just everything that’s going on day to day and then also your history as well.

 

00;33;46;16 – 00;33;49;08

Dr. Pooja Lakshmin

But yeah, so it’s a clinical diagnosis.

 

00;33;49;10 – 00;34;05;18

Dr. Mona

And I want to talk about the medicines again. So one of the most common medicines are SSRI if you can briefly obviously I know a lot of our listeners are not not all not everyone’s medically trained. But how would you describe it to your patients, what that medicine is and how it can kind of work on a basic level.

 

00;34;05;24 – 00;34;28;06

Dr. Pooja Lakshmin

Yeah, absolutely. So accessorize our call. So SSRI is are kind of the main form of antidepressants that we use. It’s a little bit of a misnomer because they’re called antidepressants but they’re also used for anxiety as well. So whether you have postpartum depression or you have postpartum anxiety or if you have a combination of both, most likely this is going to be the first line treatment or this is the first line treatment.

 

00;34;28;06 – 00;35;04;26

Dr. Pooja Lakshmin

So these are medications like sertraline or Zoloft. Fluoxetine or Prozac actually Telegram or Lexapro. These are the most commonly prescribed medications for depression and anxiety during pregnancy and postpartum. And you know, from a safety standpoint, these medications are very low risk to be taking during pregnancy or in the postpartum period. More and more, the data has shown us and the research has shown us that untreated depression and anxiety can come with significant risks during pregnancy and during the postpartum period.

 

00;35;04;26 – 00;35;31;16

Dr. Pooja Lakshmin

You know, we talked a little about the bonding and attachment. So when we weigh the risks and benefits, the risks of being on these medications are generally much lower than the risks of untreated depression or untreated anxiety. Search for lean or Zoloft in particular has very little, secretion into the breast milk. So the amount that the baby would even be exposed to is very low.

 

00;35;31;18 – 00;35;54;18

Dr. Pooja Lakshmin

And so that’s a medication that I commonly prescribe. But that being said, these other medications. So, you know, obviously this is a conversation that you would have to have with your own doctor. Right. Like nothing we’re talking about here is medical advice. But, certainly isn’t the only medication. You know, if I have somebody that’s been stable on Prozac and that’s helped them, I wouldn’t necessarily switch them to search ruling.

 

00;35;54;21 – 00;36;01;03

Dr. Mona

Just say a mother is, you know, on it and becomes pregnant again. There’s really no need to stop the medicine if it’s working for a mom.

 

00;36;01;03 – 00;36;26;12

Dr. Pooja Lakshmin

Yeah. So it’s hard to make a blanket statement because it’s always going to be a risk versus benefit question. But there’s very few medications that are contraindicated in pregnancy. The vast majority of medications, if someone has a history of severe depression or anxiety, the benefits of staying on a medication are typically going to be higher than, than the risks or the benefits are going to be greater than, you know, going off of it.

 

00;36;26;15 – 00;36;29;06

Dr. Pooja Lakshmin

Especially when it comes to things like SSRI.

 

00;36;29;08 – 00;36;43;25

Dr. Mona

So I know we obviously talked about medicine, but there are other things that we can do prior to getting to that point. And of course at that point is needed. I think it’s perfectly reasonable. But what are your basic self-care tips in that postpartum period for moms?

 

00;36;43;27 – 00;37;17;06

Dr. Pooja Lakshmin

Yeah. So I think there’s two important pieces. One is asking for help and accepting help. So making sure that you’re really looking at how can I delegate? Who is my tribe? Who can I have here for support? Even during Covid when I have patients that have a history of depression or anxiety? You know, we I still have have them, you know, have friends or family members that can quarantine and come and still help, even despite kind of the risks of the pandemic, because having somebody that’s there that can help you is so important.

 

00;37;17;09 – 00;37;42;08

Dr. Pooja Lakshmin

Or, you know, also with your partner as well, really looking at what is your communication like, how are you really, using using your partner to actually be a team member, right. Like making sure that you’re not trying to do everything by yourself. But again, depression anxiety can play into that too. So if you’re noticing that it’s impossible for you to actually get help, if you’re noticing that people are texting you and saying, hey, what can I do?

 

00;37;42;15 – 00;38;02;29

Dr. Pooja Lakshmin

Let me drop food off, let me know, and you’re just ignoring it, or you’re not able to actually engage and get that help. That could be a sign that something else is going on. And then the other important thing is sleep. So looking at ways that you can actually find 4 to 6 hours to get a consecutive stretch, even if it’s not every day, even if it’s just a couple days a week.

 

00;38;02;29 – 00;38;27;23

Dr. Pooja Lakshmin

So like for example, one of my patients right now has been really creative in that one of her friends in the area, left DC to go stay with family in the West Coast. So they have an empty apartment. So she’s actually going to her friend’s house a couple times a week to nap for two hours. Just because, you know, she feels like when she sleeps in their house, she just sees all the laundry and the dishes and all the things that she needs to do.

 

00;38;27;23 – 00;38;39;22

Dr. Pooja Lakshmin

So she’s found a way to have some time for herself. So anything you can do to kind of get away, get up, get a nap, get some sleep, you know, go for a walk, make sure that you’re getting out of the house, things like that.

 

00;38;39;24 – 00;39;04;13

Dr. Mona

I agree, I did similar things. You know, mainly it’s that getting outdoors because when you are postpartum, especially in the first three months, if you’re not back at work, you are in this Groundhog Day where everything just seems the same. And when you’re used to a life, maybe that was more, you know, exciting. You did different things, and all of a sudden you’re just doing the same thing over and over, cleaning pump parts, feeding bottles, and changing diapers and wake up.

 

00;39;04;19 – 00;39;29;09

Dr. Mona

It can just seem so monotonous and that can actually just have a huge effect on your overall well-being. So getting out of the home or apartment is so key. Sometimes I know that you’re not going to be, you know, you can’t find that time alone. So even if it means having to roll baby around with you just to get some fresh air, obviously alone time is great, but I understand, like, even for me, my husband worked, so I would have to, you know, take Ryan with me for a walk.

 

00;39;29;16 – 00;39;48;00

Dr. Mona

Whatever you can do to just get some fresh air. And of course, utilizing the resources is key. And that may not be what you thought it would be given. We’re in a pandemic, but whatever it is, whether it’s your partner or a mom who’s coming to stay and help with, you know, help with the baby, don’t be afraid to ask them for help.

 

00;39;48;01 – 00;39;55;26

Dr. Mona

You don’t have to do it alone 100%. Why do you think many mothers just don’t get help for postpartum depression or anxiety?

 

00;39;55;28 – 00;40;30;26

Dr. Pooja Lakshmin

Yeah, I think part of it is that we have this mentality in our culture that as a mom, you should be able to do it all yourself, you know? And I think, we also are just so independent. You know, for many women, this is the first time in your life that you really you can’t do it alone, but you’ve never had experience actually having to ask for help and sort of all the skills that you learned going through high school and college and maybe grad school or in the workplace, none of those things actually work for taking care of a colicky infant or, you know, right.

 

00;40;30;26 – 00;40;51;14

Dr. Pooja Lakshmin

So it’s like we have this, we have this sort of fantasy that, that you should just already know how to do all the stuff to be a mom. So then when you don’t, I think that there’s a lot of guilt and shame that comes up and, and on social media, you see all these images of like, you know, long, slow answers that look like they have it all together.

 

00;40;51;14 – 00;41;16;04

Dr. Pooja Lakshmin

And, I think women kind of get worried about admitting that they don’t have it all together, because there’s so much pressure. And, that’s one of the things that I talk about in, this new course that I launched that I know we’re going to talk a little bit about with Jama, but it’s all about sort of looking at, mom guilt and perfectionism and how does that get in the way from actually accepting help and asking for help?

 

00;41;16;06 – 00;41;38;15

Dr. Pooja Lakshmin

The one other thing that I’ll say that I forgot to mention is that having mom friends is so important, as another kind of self-care tool. So here in DC, we’re really lucky. We have, this group that’s called pace, and they used to meet in person as like an eight week moms group. And now it’s all virtual, but it’s basically they just match you with another cohort of moms that delivered at the same time.

 

00;41;38;18 – 00;41;56;08

Dr. Pooja Lakshmin

So I just think it’s so crucial to have those other women in your life who if, if you’re lucky enough that had babies at similar times so that you can text each other in the middle of the night when you’re there with the fussing baby and you’re lonely? It’s just important to have other women in your corner who are going through the same thing.

 

00;41;56;15 – 00;42;01;24

Dr. Mona

Yeah, and that’s a great segue to Gemma. So tell us more about why you created that. What exactly it is.

 

00;42;01;28 – 00;42;35;20

Dr. Pooja Lakshmin

Yeah, yeah. So Gemma is a, digital educational platform that is all about women’s mental health. And so I created Gemma. I launched Gemma this May actually. And it came after about a year of being on Instagram and just getting so many DMs about mental health questions and just realizing that there is so much out there for moms in terms of, you know, learning how to have the, birthing experience that you want, like how to go into labor, how to how to sleep train your baby, how to swaddle your baby.

 

00;42;35;20 – 00;43;09;21

Dr. Pooja Lakshmin

There’s nothing about you as a mom. There’s nothing there for your emotional experience and supporting your mental health. And so, earlier this summer, I launched our pilot program, which was all, was pregnancy, postpartum and mental health. And it was a four week online zoom course. And I taught 39 women, basically curriculum all about, prevention of postpartum depression, anxiety and depression, going into kind of the treatment options and then dealing with what I call the triple threat, which is mom guilt, martyr mode and, perfectionism.

 

00;43;09;27 – 00;43;27;14

Dr. Pooja Lakshmin

And that was a huge success this summer. And so now I just launched our first digital course that you can download on your own, and you can watch on your own time. And, and it comes with a Facebook group, too, that I’ll be moderating. And so, you know, Gemma is just starting out. It’s just my little baby that I’m watching right now.

 

00;43;27;14 – 00;43;48;28

Dr. Pooja Lakshmin

And, but I really hope that it’ll grow. And I hope that this class in particular particular all about, kind of how to take back your time and how not to get caught in these, these narrative patterns of just beating yourself up and just constantly feeling like you’re not doing enough, really looking at why am I feeling that way?

 

00;43;48;28 – 00;44;02;25

Dr. Pooja Lakshmin

And how can I take back some agency? So that I’m actually present and I’m experiencing motherhood in a way that feels fulfilling to me? That’s what I’m really hope, hoping that this class will help women experience.

 

00;44;02;28 – 00;44;26;10

Dr. Mona

This is so needed. And I’m going to attach this link to my show notes. So for anyone who wants to join because like we said earlier, there’s just not enough information out there for mental health for anyone, but especially for moms. And I think this is just going to be so helpful. And I’m so proud of you for starting this, because you recognize the need and you’re running with it, and I know it’s going to be very successful because we need it.

 

00;44;26;10 – 00;44;45;25

Dr. Mona

You know, moms need it. It’ll help so much with their bonding with the baby, bonding with their partner. It is so important that we take care of ourselves, because if we don’t take care of ourselves, we cannot do all the other amazing things that women can do. You know, my feeling about all this is that we as women are programed to be very successful.

 

00;44;45;25 – 00;45;03;14

Dr. Mona

I mean, I think women are so successful and their ability to multitask and do all this and like you said, accomplished so much. But you have to be in a good state to say, you know what, I’m going to handle this. I know where I’m lacking maybe a little bit of this or that to get the help that I need.

 

00;45;03;20 – 00;45;28;10

Dr. Mona

Because if you are feeling like in that you said like that state of perfectionism where everything is perfect, that you have to do this a certain way because on social media it’s this way or that way, you’re going to find yourself in a rabbit hole at some point. But you have to kind of go with it that I’m doing the best I can every day with the information and resources I have and whatever I need help with, I’m going to feel great and positive about getting the help that I need.

 

00;45;28;10 – 00;45;48;21

Dr. Mona

And mental health is one of those things. And we’re in 2020 and I still feel there is a stigma. I still feel that there is a cultural feeling that we can’t talk about how things are really in our life. It’s not going to be easy. Even though your friends went through something similar and they say, oh, it gets better, it’s fine.

 

00;45;48;21 – 00;46;06;03

Dr. Mona

I want you to always remember that if you’re feeling upset about it, if you’re feeling like, oh, I’m not getting through this as but as good as my other friends did it that there are there is help out there. You know, there is there are resources that are going to help you feel like yourself again. And that is my final message for this episode.

 

00;46;06;10 – 00;46;09;19

Dr. Mona

What would be your final message to everyone listening?

 

00;46;09;21 – 00;46;31;26

Dr. Pooja Lakshmin

Yeah, I think my final message is it’s very similar that that you don’t have to suffer, that there’s solutions out there. There’s support out there. Reach out, talk to your mom, friends and and don’t be, scared to get help. You know, getting help doesn’t mean that you’re weak. Getting help actually means that you’re strong, that you’re brave.

 

00;46;31;28 – 00;46;58;22

Dr. Pooja Lakshmin

And I think that there’s a ton of resources out there, you know, Mona’s, Instagram page is so helpful. If you’re looking for a therapist, that’s probably the best resource out there is postpartum support. International. International. And so hopefully we can link that in the show notes as well. They have an online directory that’s, you can search by state to find specialists in the state that you live in for maternal mental health.

 

00;46;58;22 – 00;47;12;15

Dr. Pooja Lakshmin

So that’s a really great, resource. And yeah. Well, thank you so much for having me. This was just such a pleasure. And, I’m really excited to, to keep connecting and keep talking and sharing resources. Yes.

 

00;47;12;18 – 00;47;37;25

Dr. Mona

Your Instagram page and what you’re doing with the Gemma Project. Everything you do is so needed. I said it earlier in the episode, but when you came on or when I found you on Instagram, I was like, oh my gosh, this is amazing and this is going to be so helpful. And obviously you’ve grown so beautifully on Instagram and, you know, your contributions to The New York Times and all the real input that you put in, you know, it’s just so honest, so raw.

 

00;47;37;25 – 00;47;50;24

Dr. Mona

And as a mother and as a pediatrician, I just value what you’re saying so much. So I’m so grateful that you took time out of your very busy day, because I know you’ve been so busy helping so many moms like me. So thank you again.

 

00;47;50;24 – 00;47;53;28

Dr. Pooja Lakshmin

Absolutely. It was totally my pleasure and I hope to do it again soon.

 

00;47;54;05 – 00;48;13;24

Dr. Mona

Thank you for tuning in for this week’s episode. I hope you guys enjoyed it. As always, please leave a review, share it with a friend, comment on my social media and if you’re not already, follow me at PedsDocTalk on Instagram. Love doing this for all of you. Have a great rest of your week. Take care. Talk to you soon!