Motherhood isn’t about finding yourself—it’s about rewiring yourself to meet every cue, every comfort, and every cry.
– Susan Landers
Becoming a mother is more than a moment — it’s a multi‑year journey of transformation that reshapes your body, brain, and identity. In this in‑depth conversation, Dr. Susan Landers — a veteran neonatologist, bestselling author, and mother of three — walks us through the concept of matrescence, the structural and hormonal brain changes that prepare women for caregiving, and the real‑world strategies that help families thrive. Drawing on decades of NICU experience and her own story, she translates cutting‑edge research into practical advice for new and expecting parents.
Whether you’re navigating postpartum mood shifts, balancing career and childcare, or simply curious about the neuroscience behind “mother knows best,” you’ll find clear, compassionate insights here. Dr. Landers shares proven techniques for reading newborn cues, building a supportive “village,” and maintaining work–life harmony. Read on to discover how evidence‑based parenting can ease the roller coaster of early motherhood and empower you to embrace every rewarding challenge.
Thank you so much for joining us! Our readers would love to get to know you a bit better. Can you tell us a bit about your backstory?
I trained as a pediatrician before subspecializing in neonatology, and for over thirty years, I’ve worked in Level III and IV NICUs, spaces where the margin between life and loss can be paper‑thin. Early on, I was captivated by those microgram doses of oxygen that could tip a preemie toward thriving or tragedy. While guiding families through ventilators, IV lines, and feeding tubes, I was also raising three children at home. Balancing night‑float shifts with cheerleading practice taught me that clinical precision alone doesn’t equip parents for the 3 a.m. panic when their baby’s lungs sound rattly.
That realization fueled my first book, So Many Babies, a memoir weaving case studies with the untold emotions clinicians feel yet seldom voice. Feedback from readers led me to develop the Newborn Nurture ebook and the Moms Matter newsletter, in which I condense recent research into bite-sized advice delivered weekly. My goal is to bridge the gap between academic journals and real‑world parenting, so caregivers feel empowered by knowledge rather than overwhelmed by jargon.
You introduced the term “matrescence.” What exactly does it mean, and why should every mother know it?
Matrescence refers to the physical, psychological, and social transition women experience when becoming mothers. Whereas adolescence reconfigures a child for adult sexuality and independence, matrescence reconfigures an adult for the demands of caregiving, emotional attunement, and identity transformation. It isn’t a moment — it’s a multi‑year process covering pregnancy, birth, and the first two years of parenting.
Knowing that matrescence is biologically programmed helps mothers reframe disorienting experiences — identity loss, mood swings, or detachment — as natural phases of growth. Rather than self‑criticizing unpleasant feelings, moms can say, “This is part of my neural redesign.” It also prompts societies to provide structural support — paid leave, peer groups, partner coaching — instead of expecting new mothers to “bounce back” overnight.
How does the brain actually change during matrescence?
Functional‑MRI studies show that during pregnancy and postpartum, women undergo selective pruning of gray matter in regions responsible for self‑referential thinking, creativity, and social judgment. Concurrently, there’s increased volume and connectivity in networks governing empathy, theory of mind, and threat detection — essential for decoding an infant’s cries, facial expressions, and subtle movements.
Hormones orchestrate these shifts. Estrogen surges enhance sensory acuity; progesterone fosters calm focus; prolactin regulates stress response and milk production; oxytocin cements bonding by amplifying reward circuits when gazing at one’s baby; and cortisol spikes in short bursts to keep mothers hyper‑vigilant to potential threats. Collectively, these changes rewire the adult brain for the complex, unpredictable demands of newborn care.
Is that why the saying “mother knows best” rings so true?
Precisely. That neural retooling creates a specialized intuition I call “maternal radar.” Mothers often detect subtle anomalies — a slight change in skin tone, an atypical cry, a brief gaze avoidance — hours or even days before clinical signs like fever or lab abnormalities appear. In pediatrics, we’re taught: if a mother says something’s wrong, take it seriously, even if the vitals are normal. Her brain’s pattern‑recognition algorithms are finely tuned by constant, real‑time feedback loops with her infant.
Cortisol is often labeled as “just a stress hormone.” Can it actually play a beneficial role?
While chronic cortisol elevation can harm immunity, mood, and metabolism, intermittent spikes serve as nature’s emergency alert. Imagine a newborn’s urgent cry at 3 a.m.: a cortisol surge jolts a mother awake from deep sleep, primes her muscles, and heightens sensory perception so she can respond rapidly. The key is creating “off‑duty” periods — protected time where support systems take over, allowing cortisol to reset rather than stay elevated. In that context, cortisol isn’t an enemy; it’s a targeted alarm system honed for survival tasks.
Postpartum depression is common. How does it fit into this brain‑rewiring story?
The neural circuits strengthened for nurturing — particularly in the anterior cingulate cortex and amygdala — overlap with regions that regulate mood and anxiety. If genetic predisposition, profound sleep deprivation, lack of social support, or traumatic birth experiences disrupt this delicate remodeling, mothers can develop perinatal depression or anxiety. One in eight women will face these mood disorders, making them the most prevalent complications of birth, yet stigma and lack of awareness often delay help.
Symptoms range from persistent sadness and apathy to intrusive fears and irritability. Early treatment — combining therapy, medication (when indicated), and peer support — restores neural balance and protects both maternal well‑being and infant development. Recognizing postpartum mood disorders as neurobiologic phenomena rather than character flaws is critical for timely intervention.
Your daughter dealt with severe postpartum depression. How did that experience shape your perspective?
When my daughter chose to taper off her long‑term antidepressant during pregnancy, she believed it would safeguard her baby. Instead, postpartum, she plummeted into despair — unable to eat, overwhelmed by guilt, and hesitant to hold her newborn. We coordinated rapid intervention: reinitiating a safe, breastfeeding‑compatible medication, intensive therapy sessions, and daily check‑ins from family. Within three weeks, her affect shifted: she smiled at her baby, initiated feedings, and described feeling “myself again.”
That deeply personal journey reinforced two truths: untreated depression carries greater risks than many antidepressants during pregnancy, and swift, holistic support can bring a mother back to the fullness of maternal joy. It’s a lesson I impart in every lecture: mental health care is as vital as prenatal vitamins.
Many mothers feel guilty about returning to work. Any advice?
Guilt often reflects a clash between evolved neurobiology and economic necessity. While maternal brain circuits are still fine‑tuning attachment mechanisms, many families require dual incomes. My advice is threefold:
- Vet caregivers thoroughly. Treat interviews with daycare providers or nannies like critical consultations — observe their interactions, review their training in cue‑based care, and ask for references.
- Use technology mindfully. Video check‑ins or discreet updates can reassure you without eroding trust.
- Prioritize intentional presence. Even ten undistracted minutes of playtime can deepen attachment more than hours of divided attention.
By focusing on secure, responsive moments rather than clock time, mothers can mitigate guilt and maintain confidence in their dual roles.
Single mothers shoulder even more. What’s one practical tip for them?
Build a “chosen village” before the baby arrives. Categorize helpers into emotional support (friends you can vent to), practical assistance (meal trains, errands), and emergency backup (someone ready to step in if you’re suddenly unwell). Ask permission early so your network knows you value their help. Complement in‑person support with vetted online communities and telehealth options. Ritualize weekly “sanity sessions” — whether a Sunday coffee date or a midweek walk — to break isolation and reinforce resilience.
You’re passionate about reading newborn cues. Can you give a quick cheat sheet?
Babies communicate through a nuanced lexicon. Focus on four domains:
- Physiological cues: Rapid, shallow breathing or hiccups often signal overstimulation — pause stimulation, dim lights, and offer skin‑to‑skin.
- Behavioral cues: Gentle limb movements and soft eye contact mean “I’m ready to engage,” whereas frantic flailing or clenched fists often denote distress or fatigue.
- Auditory cues: A rhythmic “neh‑neh‑neh” cry suggests hunger; a sudden high‑pitched wail may signal pain or fear.
- State cues: Frequent yawning, gaze aversion, or arching the back point to sleep readiness — intervene before the meltdown.
Accurate cue decoding fosters trust: babies learn their signals prompt effective care, reducing prolonged crying and fostering secure attachment.
How long does matrescence actually last?
Approximately two years, the timeframe during which infants progress from total dependence to semi‑autonomy in mobility and communication. Neurologically, maternal brain plasticity remains elevated throughout this period, iterating with each developmental milestone: rolling, sitting, crawling, walking, talking. Recognizing matrescence as an extended phase encourages mothers to allow themselves ongoing emotional shifts rather than expecting a quick “return to normal.”
In the NICU you watched bonding under challenging circumstances. How does it unfold with preemies?
For extremely preterm infants, traditional cuddles may be too intense. We introduce kangaroo care — skin‑to‑skin chest contact — which stabilizes heart rate, oxygenation, and temperature. Nurses coach parents on modified containment — gentle swaddling holds that mimic the womb — and whispering or singing to soothe unsettled infants. I’ve witnessed a one‑pound baby’s oxygen saturation jump ten points when a mother’s fingertip tracked his cheek. That biotech feedback loop cements parental confidence: “My touch helps.”
Cue‑based caregiving remains central: parents learn to interpret subtle shifts — changes in breathing rhythm, slight color variations, tiny muscle tremors — as distress signals. By discharge, many report feeling more empowered to care for their medically fragile infants than their peers who started with healthy newborns. The NICU becomes a rigorous training ground for attuned parenting.
What infant‑care myths still trip up new parents?
- “Crying always means hunger.” Babies cry for many reasons — overstimulation, fatigue, discomfort, or a need for soothing touch.
- “Never wake a sleeping baby.” Some late‑preterm or jaundiced infants require scheduled feeds to prevent weight loss or hyperbilirubinemia.
- “Holding too much spoils them.” Decades of research confirm that responsive cuddling lowers infant cortisol, improves emotion regulation, and fortifies secure attachment.
Dispelling these myths empowers parents to act on evidence, reducing anxiety and promoting healthier developmental outcomes.
Why did you release Newborn Nurture as a bite-sized ebook?
Imagine a parent scrolling their phone at 2 a.m., one hand cradling a cluster‑feeding baby. They need quick, actionable answers — “Why is my baby hiccuping nonstop?” or “How do I soothe overtired fussiness?” A searchable ebook lets them jump directly to relevant sections, saving precious minutes and mental energy. Moreover, digital distribution allows me to push updates when guidelines evolve, ensuring parents access the latest recommendations without waiting for a new print edition.
What role should partners play during matrescence?
Partners are indispensable co‑pilots. Studies show that when partners share nighttime care, maternal REM sleep improves, reducing postpartum depression risk. Practical contributions — diaper changes, laundry, meal prep — signal shared responsibility, easing pressure on mothers. Emotionally, partners can validate new identities, offering affirmations like, “You soothed him so quickly — he trusts you.” I recommend weekly “state of the union” check‑ins of ten phone‑free minutes: discuss what went well, what felt hard, and how to adjust support. Those small, consistent conversations prevent resentment and strengthen teamwork.
If you could change one thing about maternal care in the U.S., what would it be?
Comprehensive paid parental leave is critical. Cost‑benefit analyses reveal that it reduces healthcare spending, increases workforce retention, and enhances child developmental outcomes. Biologically, the first six to twelve weeks postpartum represent a critical window for endocrine and circadian synchrony between mother and infant; disrupting that period for financial reasons undercuts lifelong health for both.
Equitable access to perinatal mental health services would be a close second. Rural and minority communities often lack providers; tele‑psychiatry reimbursement parity could dramatically expand access and save lives.
What is one action expectant mothers can take right now?
Draft a detailed postpartum support plan: list specific names for meal deliveries, errands, and emergency childcare; schedule standing “sanity dates” with friends; identify mental‑health resources — hotlines, therapists, reputable online forums — and bookmark them. Assemble a bedside command station with water, snacks, diapers, chargers, and quick‑reference cue guides. These preparations convert potential chaos into a matrix of manageable tasks.
How can communities better support new mothers?
Communities thrive when they recognize matrescence as a collective responsibility. Faith groups, parent cooperatives, neighborhood associations, and employers can offer meal trains, childcare swaps, and peer‑mentor programs. Local libraries or community centers might host monthly “mom circles” led by trained facilitators to share experiences and resource tips. By normalizing mutual aid, communities buffer isolation and strengthen family resilience.
What advice do you have for mothers of multiples or infants with special needs?
Multiples and special‑needs infants amplify matrescence challenges but also deepen rewards. For multiples, staggered feeding and nap schedules, selective formula supplementation, and employing twin‑specific feeding pillows can streamline routines. In special‑needs scenarios — whether prematurity, congenital conditions, or developmental delays — early intervention therapies and wraparound care teams are vital. Seek out parent support networks tailored to your child’s diagnosis; shared experiences offer not only practical hacks but profound emotional sustenance.
How can our readers further follow your work online?
I invite you to explore more resources and insights on work–life balance and newborn care at my website, SusanLandersMD.com. You can connect with me on LinkedIn for regular updates and practical parenting advice. If you’re interested in a deeper dive into the joys and challenges of balancing a demanding medical career with motherhood, my book So Many Babies is available at susanlandersmd.com/book. For weekly, science‑backed parenting insights delivered straight to your inbox, subscribe to my Substack newsletter, where over 2,000 parents have already joined the conversation in just one month.
Susan, this conversation has been deeply informative and reassuring. Thank you for sharing such thorough insights and compassionate guidance with our readers.
Thank you, Stacey. It’s an honor to support parents through the remarkable, complex journey of matrescence. Remember: you’re never alone on this path, and every question deserves an answer grounded in both science and empathy.
