Breastfeeding 'cuts depression risk', according to study

From the BBC News website:

Breastfeeding can halve the risk of post-natal depression, according to a large study of 14,000 new mothers.

However, there is a large increase in the risk of depression in women planning to breastfeed who are then unable to do so.

The study, published in the journal Maternal and Child Health, called for more support for women unable to breastfeed.

A parenting charity said mental health was a "huge issue" for many mothers.

The health benefits of breastfeeding to the baby are clear-cut and the World Health Organization recommends feeding a child nothing but breast milk for the first six months.

However, researchers at the University of Cambridge said the impact on the mother was not as clearly understood.

Read more here.

Postnatal depression more likely after unplanned pregnancy

Women who get pregnant unintentionally are four times more likely to suffer from postpartum depression, according to new research. The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, found that postpartum depression was more likely in women with unintended pregnancies at both three and twelve months after birth.
The study, conducted at the University of North Carolina prenatal clinics questioned participants about pregnancy intention at 15-19 weeks gestational age. The increased risk was highest at 12 months and indicates that this group of women have a long term risk of depression.
When age, education level and poverty status were factored into the results, women with unintended pregnancy were still twice as likely to have postpartum depression at twelve months.
Louise Silverton, director for midwifery at the Royal College of Midwives, said:
"We are seriously short of midwives in England and we know that postnatal care is suffering because of this. We are hearing of midwives having to make fewer postnatal visits, if at all. This is a concern because the problems this research highlights may go undetected and the consequences of this can be serious, for the women, for families and for the health service."

Unintended pregnancies increase the risk of postpartum depression - Female First 8th May 2013

Shortage of midwives means some women get more postnatal visits than others

Almost two-thirds of new mothers feel let down by the NHS after giving birth, according to a report. In some places women get three postnatal visits at home, while in neighbouring areas new mothers will see a midwife just once. The report from the National Federation of Women’s Institutes and NCT said the vast majority of maternity units are having to cope with shortages of midwives.
Belinda Phipps, chief executive of the NCT, said ‘We are extremely concerned about the shockingly high number of women who have been let down by their maternity care.
‘It is equally worrying to see that the level of care given to parents varies so significantly by postcode.’
Cathy Warwick, chief executive of the Royal College of Midwives, said ‘We are 5000 midwives short in England. Without enough midwives to cope with the increasing demands on maternity services I fear that we will not see the situation depicted in this report improving.
‘Postnatal care has been an area of concern for some time. This is a vitally important period for women who need support, guidance and advice when they return home after giving birth. Too often resources are taken away from this key area leading to fewer visits by midwives and less contact with them for women."
2 May 2013 The Daily Mail

Help others adjust to parenthood: Sign up for The Big Push

Do you remember your first few weeks as a parent? How was it? A breeze? A nightmare?

For me it was neither of those. It was hard work though, and I hadn't a clue what I was doing. Being on my own meant I was anxious at times, not having anyone here to ask silly questions, like "do you think his breathing is OK? Is that nappy too tight? Should he really spit up this much?

I was lucky. I didn't suffer from post natal depression, or even the baby blues, but I do know people who did. Even though I was fine, getting out and socialising with other people was vital to me. It still is. We try to leave the house every day, even if it's just a walk to the post box or the corner shop.

In some ways, I think being single helped me here. I had to go out if I wanted to have a grown up conversation. I joined some groups, started baby swimming lessons, and baby massage classes. I think I would have done less if I had a husband, and my days may have been more about waiting for him to come home.  BB was breastfeeding so he had food wherever we went - if we weren't home at tea time no one cared.

I believe that as a new parent, having a place to go where you can chat with people in a similar situation is vital for any new mum. Even better would be a place that also attracts people that have been where you are, learnt a few tips which they can pass on, and better still survived!  Groups such as B3 are a perfect example. This is why I volunteer for the NCT, to make sure the funding for these groups continues.

One part of my volunteer role is to help organise the Big Push. The Big Push raises money to support new parents who are struggling; giving them the opportunity to share their anxieties and frustrations through local support groups like Bumps & Babies and via the helplines and other services.

Our Isle of Ely Big Push is taking place on Saturday 18th May. So far we have two people signed up to walk (and one of those is me!). We need more! Could it be you? You don't have to be a member to join in and we welcome new people. Coming for a walk could be great way for you to make some new friends, or catch up with some old ones.

In case I haven't convinced you, here's Marisa's story

by Marisa, Kidderminster 

There is a day I will probably remember forever. Not wanting to go home because of how I was feeling but not knowing where to go, I drove into town. In the car my two year old started to behave badly, my baby started crying and things became really fraught. I was driving quite fast and the thought of driving into a lamp post to make the noise stop and get some rest and support from my family crossed my mind. I was really frightened and pulled over to try and pull myself together. That was me at my lowest.

I had a difficult pregnancy with my second child, suffering from pre-eclampsia and sickness but after the birth I came home feeling lovely and content. In fact, my midwife was amazed at my recovery from a caesarean section and the smile on my face.

I cannot tell you when those feelings changed as I don’t know myself. Two weeks after the birth of my first child I had had the baby blues, I felt anxious all the time and thought I would never cope as a mother. However they only lasted a couple of days and I never looked back. This time though, I did not notice my mood change, all I know is my sweet two year old became the devil and I was finding things very hard.

Postnatal depression is more common than you think - it can affect anyone. NCT supported me without judgement and I’m telling my story to ensure that others can receive the same help.

When my husband went back to work, I noticed I was shouting at the children a lot more and I could not stand the baby crying. One incident that particularly sticks in my head was when my daughter would not get dressed and was screaming and kicking me. I got really angry and shouted and got her hand and smacked it. I will always remember the shocked look on my daughter’s face, it will stay with me forever.

Things were getting out of control and I could not see it. Thankfully my midwife eventually suggested I visit my GP. It was hard talking about how I had been feeling, but I had to recognise I was depressed and not enjoying motherhood. The doctor suggested I got more support to speak to my husband about how difficult I was finding things and gave me a prescription for antidepressants.

The day after I hit rock bottom I went to my NCT coffee morning. It was there that I found my true friends. Cath, Teresa and Jenn made me feel like I was not alone. I thank them so much and want them to know that that moment meant a lot.

I am currently still taking the medication, most days are good, some days are still hard but I can cope with them better and I am happy.

If you are able to raise a little cash to help the NCT to continue to support people like Marisa, please sign up here.

Thank you

Postnatal Depression: Experiences and Advice

The article below was recently shared with NCT editors for use in their newsletters. As someone that has suffered from postnatal depression, I thought it would be useful to share it on our blog. 

My daughter, Maria, is now 17 months old. I found the first year of motherhood very difficult. She didn’t sleep at all well and she wouldn’t be put down during the day. I didn’t adjust well from having routine, independence and lots of company every day to being completely depended on, tired and lonely!  I felt like I’d completely lost my freedom and I couldn’t get anything done! 

The worst effects were on my sleep. After a few months, I developed insomnia – I could never sleep during the day when Maria slept and my sleep patterns were so disturbed that I would lay awake at night for hours. I dreaded going to bed. It was exhausting and I was tearful a lot of the time. I felt much better when I was out and about but I didn’t like to plan anything in advance in case I didn’t sleep well.

I also received quite a lot of criticism from family, friends and health professionals about my parenting choices. Because Maria was quite an unsettled baby, some family members thought that my breast milk wasn’t enough for her so were convinced that I should bottle feed her! She wouldn’t take a bottle – she’d scream if I tried to put one in her mouth – and trying to get her to take it was an added stress!  

She would only sleep in a sling during the day and in our bed at night. I was told that this was the “biggest accidental parenting mistake” I could make! Even a health visitor, a doctor and Maria’s eczema nurse said I should try controlled crying. So I tried to get Maria to sleep in the cot. Again, she would cry and scream until she made herself sick and bang her head against the side of the cot! Another added stress!

I kept my feelings well hidden (I think!), pasting the smiles on when I was out! I remember being at one of our baby groups and other mums seemed so happy when I just wanted to cry! 

For many months I didn’t attribute my feelings to PND. I thought I’d just developed insomnia and the way I felt was a knock-on effect of that. It was only when my mum said she thought I had it and I looked up the symptoms online that I accepted it could be PND. 

I didn’t feel that the doctors were particularly supportive at first. When I originally went about not being able to sleep, I was just given some fairly rubbish advice about developing good sleeping habits and was told I couldn’t take any sleeping tablets because I was breastfeeding. PND wasn’t mentioned. 

Eventually, the need for me to take some sleep medication was behind my decision to stop breastfeeding after just over a year. It was then that the doctor also prescribed me some antidepressants. 

Since then, things have definitely improved. I’ve slept better and started enjoying motherhood! One of the factors behind feeling much better has been accepting that I’ve made the right parenting choices for my child. She’s now a very bright and happy toddler and it no longer bothers me if I get any negative comments about things such as bedsharing! I can just brush them off! And after almost five months, I’ve halved the dose of my antidepressants (with the consent of my doctor) and hope that I can come off them altogether soon.

If you have been experiencing similar problems or feelings, the following advice may be useful. It was written by Dr Charlotte Granger. She is a clinical psychologist working on a research trial for the University of Oxford, which aims to develop effective psychological therapies for postnatal depression.

Understanding postnatal depression

Having a baby involves considerable adjustment for a woman, whatever her age, lifestyle or how many children she already has.  From conception, pregnancy and birth, to the practical demands and responsibilities that take over daily life, it is a transformation on many levels, biological, physical, social and emotional. Every baby will be different in the challenges they present from pregnancy onwards, and each mother different in how she is able to cope with these and what other pressures she will also have to cope with during this time. In 10-15 per cent of new mothers, the changes and challenges involved in this adjustment will overwhelm their usual coping strategies, and they develop postnatal depression.

Symptoms of postnatal depression are similar to that of typical depression, and happen within the first year after having a baby. Natural adjustment to motherhood often includes feelings of being tired and overwhelmed, changes in sleep and appetite, and less time to relax and enjoy things.  In the first 10 days after giving birth, 80% of new mothers will experience ‘baby blues’, feeling tearful, exhausted and tense, and these feelings typically go away by themselves. Post-natal depression differs from these natural feelings when feelings of sadness, being overwhelmed or feeling anxious last longer than two weeks and are around most of the time. This persistent low mood is accompanied by difficulty in sleeping even when the baby is asleep, lack of energy, feelings of worthlessness or guilt, struggling to concentrate or make decisions, or thoughts about harming oneself. It can develop at any time in the first year of having a baby, although between three to six months after the birth is the most common time for it to occur.

Difficulties in seeking help

For many women, getting help for postnatal depression can be difficult due to the emotional impact that asking for help involves. There a number of reasons why women can find it particularly hard to admit to anyone else that they are struggling. Often women feel that they shouldn’t be depressed after having a baby, and this leads to a sense of guilt and unwillingness to talk about how they feel. They may also feel that they have no ‘obvious’ reason why they should feel sad, particularly if the baby was planned and they have a comfortable, settled lifestyle. Fears that family and friends will think they are a bad mother who should be coping better are common, particularly if experiencing low mood which increases negative thinking and makes it difficult to make decisions such as who to talk to. Often not talking about how difficult it all is leads to the depression increasing, as the mother may feel a sense of loss about not enjoying their baby’s first year, and worry that their baby is being affected.

Treating postnatal depression

Treating postnatal depression is in some ways very similar to treating typical depression; the most effective treatments are anti-depressant medication and talking therapies e.g. cognitive behaviour therapy or counselling. GPs and health visitors are widely familiar with the symptoms and will know what help can be offered in the local area.  Anti-depressant medication can be rapidly effective, and GPs can discuss what type of medication may be suitable for those mothers who are breast-feeding.

Talking to your GP or health visitor is the best way to get help if you feel you are experiencing postnatal depression. It can often be the hardest step, and if it is difficult, choose a trusted friend or family member to try talking about it with first. It is important to remember that health professionals see talking about feelings and asking for help as effective coping, rather than not coping.

Self-help strategies

There are also a number of self-help strategies that you can try to lift your mood.

Talk

Having the support of people who know you well is very important. It can also be a little too easy in modern life to not get enough daily human contact. Online shopping, emailing and texting can all give us fewer reasons to get out of the house or pick up the phone. Talking to people about the daily delights and stresses of having a baby is an anti-depressant for a number of reasons. It puts life in perspective and makes worries seem more manageable, and may lead to useful advice. It can also distract you from how you are feeling, and help you feel relaxed and supported. Be honest about how you feel with people who you trust and feel safe with. You may help more people than just yourself. The more the reality of motherhood is discussed, the more women will feel normal and understood about how they feel after having a baby.

Organise your week

Getting organised is no mean feat with any amount of small children, and therefore both the difficulty and the benefits should not be underestimated. Getting a regular routine for the week is a great anti-depressant. When feeling low, it can be too easy not to do things that are good for us. Most people will have days when they don’t want to go to work, however because they have to, they do, and generally after a short while they will feel better for having done it. Having a baby and being at home can make it much harder to get things done or go out. Make a routine for the week and schedule in baby groups, walks, time to do chores and time for yourself. Sticking to the routine even when you don’t feel like it can help you feel more in control and keep you doing things that will help with feeling better, such as getting physical exercise or seeing other people. Try to get a good balance of activities across the week, including time for what your baby needs, time for what your house and family need, and time for your own needs. 

Be kinder to yourself

Often our harshest critic is ourselves, particularly when we have a lot to cope with. Again, modern life is a major contributor to us developing a way of talking to ourselves which is harsh and judgemental. Television and the internet help us believe there is not only a right way of doing things but that everyone else is doing it right already. However, learning to talk to yourself in a warmer and encouraging way is not only likely to help you achieve more than self-criticism, but chances are if you model this to your child, they’ll grow up knowing how to talk to themselves the same way. Specifically, it is through seeing you as their parent make mistakes and recover from them that children learn mistakes are okay and how to work them out. Practice noticing your own self-critical thoughts and gently challenging them with warmer and more accepting thoughts. It can be surprising how hard this is and will take regular practice. Keep at it: even small changes to your daily life will add up over time and help life feel more manageable and enjoyable.

Advice on postnatal depression can also be found on the NCT's website http://www.nct.org.uk/parenting/postnatal-depression