Tag Archives: infant

Postpartum Depression

Risk Factors, Symptoms, and What To Do

Take a Screening Test for PPD

The Baby Blues has become as much an accepted part of being a new mother as engorged breasts and sleep deprivation. But what if the Blues don’t go away? For 10-20% of new mothers, Postpartum Depression (PPD) is an unwanted and difficult part of the first year of motherhood. The causes of PPD are many, and can include hormonal and lifestyle changes, a lack of social support, sleep deprivation, a high-risk pregnancy, a traumatic birth or difficult recovery, or breastfeeding problems. You are also at a higher risk of PPD if you have suffered previously from depression, or have recent losses or trauma in your life. Symptoms of PPD and related disorders can include:

  • Feeling sad, depressed, numb, or crying a lot
  • Restlessness or irritability
  • Unusually strong feelings of anger or resentment
  • Lack of energy
  • Having headaches, chest pains, heart palpitations, numbness, tingling, dizziness or nausea, hyperventilation or other unexplained physical symptoms
  • Difficulty sleeping or excessive tiredness
  • Loss of appetite or conversely, overeating and weight gain
  • Difficulty concentrating, remembering, and making decisions, or confusion
  • Excessive worry about the baby or lack of interest in the baby
  • Feelings of guilt and worthlessness
  • Lack of interest or pleasure in activities
  • Obsessive thoughts or compulsive behaviors
  • Fear of hurting the baby or yourself

Many mothers experience only a few of these symptoms, but if you feel like something is wrong and you’re not quite yourself, that is an important signal. If these symptoms persist for two weeks or more, the mother should promptly get support by talking to her doctor or a mental health professional. PPD is a highly treatable condition, with therapy, medication, or a combination of the two.

If you need medication and you are told that you must give up breastfeeding, make sure you get the advice of a psychiatrist who is knowledgeable about medications for breastfeeding mothers. There are a few antidepressants which are routinely prescribed for breastfeeding mothers with untraceable amounts detectable in the baby’s bloodstream. Moreover, breastfeeding can be beneficial both for the depressed mother, the long-term health of her baby, and bonding, which is even more challenging when a mother is depressed.

Depression not only affects you: it affects your relationships with your partner and your baby. Untreated, depression can lead to bonding difficulties and delayed development or failure to thrive. Getting the help you need to recover quickly is the best thing you can do for your baby and yourself.

Most importantly, tell your support people (your family, friends, partner) how you are feeling. The burden of trying to seem happy and “keeping it all together” can make the depression worse. You need to lean on the people who care about you, get as much help as you need until you’re back to feeling like yourself, and don’t beat yourself up for having PPD. It is NOT YOUR FAULT.

Co-Parenting With a Partner

The First Year Can Be Rough, by Meri Levy, MFT

family twinsIf you’re like me, I really thought that, despite my decision to breastfeed, my husband was so gung ho about being a Dad that we would share the parenting responsibilities pretty equally once our first child was born. I was in for a rude awakening. Breastfeeding meant that much of the time I was literally attached to my new baby, and when I was not, I had an easier time calming him than my husband did. And even when I didn’t, I couldn’t stand to have my husband trying to comfort our fussy baby without stepping in and trying to help. Whether due to biology or psychology, I was so attached to my new baby that I couldn’t tear myself away long enough to really get a break. As a result, I became more comfortable in the baby care role, and he became less.

There are many reasons why fathers often take a backseat in the early days with a new baby. Whether because of a hormonally-afflicted “helicopter” Mom, an inexperienced Dad, a baby who is more easily calmed by the mother, or gender-related attitudes about who does what, newborn care often falls disproportionately to the mother. And since Mom is generally recovering from childbirth, likely adjusting to breastfeeding, undoubtedly sleep deprived, and in the throes of huge hormonal changes, this disproportionate share can become a BIG PROBLEM. You know that saying that “if Mom isn’t happy, nobody is happy?” I think the truth of that statement is widely underestimated.

So, we’ve got a Mom who can’t let go to allow her partner to care for the baby, a Dad who is either mildly incompetent or feels he is (or is being treated like he is), a baby who’s getting used to being cared for by Mom, and a Mom who is at the end of her rope and feels like she just can’t get a break (and is not sure she would take one if she could). Not a recipe for a happy family.

Negotiating who does what, recognizing the barriers to fairly allocating parenting and household responsibility and actually making and carrying out a plan to address those barriers and create a cooperative, supportive and fair allocation of workload is one of the major tasks of the first year of parenthood. Working out a plan for who does what, figuring out how to set goals for change if change is needed, and implementing those changes, can make a world of difference.

I once read a study (and I don’t have a citation, but I like to believe that it is true) that claimed that of all the factors that might predict the well-being of children as they grow up (e.g. praise, affection, discipline, structure, etc.), the one variable that is most predictive of a child’s future well-being is the degree to which his or her parents have a cooperative relationship around parenting. So, if that is true, it matters less who does what (or if it is done correctly), and it matters more that parents are supportive of each other as parents and partners.

Nurturing the Nurturer

By Meri Levy, MFT

Taking Care of Yourself as a New Parent

As parents, our job is never-ending. For the next 18-21 years, you are either “on duty” or “on call” 24/7. Strangely, while this never-ending job doesn’t necessarily get easier with time, it often seems less like “work” as our children (and we) mature, and more like “life.”

But it is easy, as we grow into our role as caretakers of our children, to forget another important person who relies upon our care – ourself. We all make this mistake sometimes. If you don’t make sure that your own nutritional, health, emotional, and spiritual needs are met, who do you think will? It has been my experience that the answer is “no one.” As much as our partners may want to attend to our needs, they cannot do it for us. No one but you really knows what it is you need, and many of the things that fulfill us as human beings cannot be done for us.

No one but you can make sure that you eat a balanced diet, get regular exercise, indulge in treasured hobbies or activities, get needed downtime, or connect with beloved friends and family.

How important is it to make sure that your own needs are met? Only you can say. One mom might be able to tandem-nurse twins and a toddler while home-schooling her older two children and never see a movie or have dinner out for five years. And be perfectly content. Another might feel burdened and overwhelmed if she doesn’t have lunch with a friend or enjoy a leisurely uninterrupted bath weekly. Or maybe you need an hour every day to drink a cup of tea and read the paper or a good book. You are the only person who can say when your engine’s running low on gas, and what it takes to fill it up.

And it doesn’t help to feel guilty about what you need to do to take care of yourself. If your child needed a nap long after his peers had given it up, would you tell him to “tough it out” and be grumpy for half the day? No, you would do whatever you could to arrange things so that he could get his nap. You deserve the same recognition for your unique temperament and needs.

And you don’t do anyone any favors if you let yourself run on empty for too long. No one wins if you allow yourself to run out of gas on the side of the road. And everyone is affected when you are running low, not just you. You don’t make it to the finish line any faster if you never slow down and take it easy.

This is your life. And raising children is a path, not a destination. You cannot travel the path with joy and stamina without giving yourself the same care you give your children. So take some time this week and plan a couple of activities you can do that will help “fill up your tank.”

Bonding With Your Baby

The Importance of Attachment to Your Newborn, by Meri Levy, MFT.

Most new mothers face a number of fears as they look forward to welcoming their first child. Will they be “ready” when the baby comes? Will they have everything they need? Will the birth go smoothly, without too much pain? Will the baby be healthy? Will they know how to care for their new child?

But the process of bonding with a new baby is rarely considered. Of course you will love your new baby. Of course you will feel attached, and be able to relate to your own flesh and blood.

What is bonding?

Bonding is the process of attachment which, when everything goes smoothly, creates a symbiotic relationship between mother and baby. The mother feels a loving bond with her baby and feels capable of meeting her baby’s needs. The mother’s hormones (aided by breastfeeding in the best case), combined with the babies reflexive response to soothing by the mother, help the two form a positive attachment. Add in a good dose of mother/infant physical and eye contact and the bond between mother and baby are virtually guaranteed, in the absence of other barriers.

What can cause bonding difficulties?

Sometimes the process of bonding doesn’t go as smoothly as expected. There are many factors that can contribute to a new mom having difficulty bonding with her baby. Among others, these include:

  • A traumatic birth experience and/or a difficult recovery
  • A colicky or fussy baby who is difficult to care for or soothe
  • Feeding difficulties
  • Separation from the baby associated with medical interventions
  • A lack of support for the new mother, causing feelings of being overwhelmed or unable to cope.
  • Perinatal depression or anxiety, which can also be correlated with the other factors

Sometimes, a combination of these or other variables can cause a new mom to feel disconnected from her baby. She may feel unable to calm her baby, like the baby isn’t really “hers,” or that she is a bad mother.

Early intervention in the case of bonding difficulties can have a dramatic effect on the well-being of both the baby and the mother. Prolonged failure to bond can be associated with attachment-related mental health problems in the developing child, as well as a sense of failure by the mother. Getting help early on to recover physically and mentally from birth, addressing feeding and calming difficulties, maintaining close physical contact between the baby and mother, and addressing other barriers to bonding can have a huge impact on the lifelong relationship between mother and child.

Self-Care for New Parents

The Importance of Taking as Good Care of Yourself as You Do Your Baby

By Meri Levy, MFT

This is a topic that I cover regularly in my new parent support groups, because it is so important to remember as a new mom or dad. It is easy to feel that the needs of your new baby, and even your partner, outweigh your responsibility to take good care of yourself. But this is a dangerous trap, because you are only as good a parent as you are nurtured as a human being.

This is not meant to be a guilt trip about getting your nails done or taking time to work out. The whole idea of nurturing yourself is about minimizing the avoidable “shoulds.” You don’t want anything about your own self-care to feel like an obligation. Pick ways to take care of yourself that you look forward to, and that fill your cup. It could be as simple as a long, hot shower with the music turned up high (while someone you trust minds the baby). Or taking an hour at Starbucks to read the paper over coffee while your partner has some baby bonding time.

Each of us as parents needs to listen to the voice inside of ourself that tells us when we’ve reached our limit. Parenting with heart requires living with heart, which is only possible if you feed your own spirit and body, and set appropriate boundaries to prevent building up resentment.