All went (for the most part), according to plan: you endured nine long months of pregnancy, having tracked your baby’s progress week by week, taken your folic acid and followed your gynae’s advice. The nursery was set up, baby clothes bought, equipment sorted and the birth plan carefully arranged. Family and friends joined in your excitement and the countdown began… and finally your beautiful bundle arrived in the world. Nothing could prepare you for the incredible connection that you would feel for this brand new person. Your little one was brought home and you celebrated with your nearest and dearest. This is what you had been looking forward to for as long as you could remember.

So how can it be possible that you feel this empty, isolated, useless and sad?

If you’re feeling this way, the most important thing to know straight away is that you are not alone. Thousands of women throughout South Africa and the rest of the world are in the same miserable boat as you are right now. So make a cup of tea, grab a tissue or ten and read on. We’re here to help.

POSTNATAL DEPRESSION OR SIMPLY THE BABY BLUES?
Spotting the Difference  

It is perfectly normal, and often expected, for a new mother to be a bit on the moody side in the weeks following the birth of her baby.  Extreme hormonal shifts, overwhelming pressures and responsibilities as well as fatigue during this settling-in period all contribute to what is known as the baby blues, which may include the following:

• Mild depression and sadness
• Sudden crying spells
• Anxiety
• Changes in appetite
• Insomnia
• Irritability and fluctuations in mood
• Low-concentration levels

Fortunately, these unpleasant (though common) symptoms are short-lived and subside without treatment within two to three weeks after the birth. For tips on how to wage war against the baby blues, scroll down to our battle plan.  

Postnatal depression (also known as PND, postpartum or peripartum depression) is a more serious condition. Characterised by the following symptoms, swift and focused treatment of this illness is vital:

• Feelings of sadness, emptiness or loneliness
• Feelings of guilt, despondence or worthlessness
• Feelings of anxiety or irritability
• Loss of pleasure or interest in life and everyday things
• Poor memory, difficulty concentrating or making decisions
• Changes in appetite and weight
• Disinterest in friends and family
• Lack of libido
• Fluctuations in sleep quotas
• Lack of energy, motivation and positive thought
• Feelings of ambivalence towards or disinterest in your baby       
• Physical symptoms such as headaches, palpitations or nausea

If you are experiencing some or all of the above, you may possibly be suffering from PND. 

In some cases, a severe form of postnatal depression can develop, usually within two weeks after birth.  Known as postpartum psychosis, this condition affects only 1-2 women in 1000. Those affected experience all the symptoms of PND, as well a heightened level of some or all of the following:

• Delusional behaviour
• Aggression
• Suicidal thoughts
• Turbulent, manic episodes
• Auditory hallucinations
• Paranoia
• Rapidly declining moods
• Attempts to or fantasies about harming yourself or your baby

Postpartum psychosis is significantly more prevalent in those women whose history includes previous mental illness. This rare condition requires urgent medical intervention.     

WHY ME?
Occurrence and Causes of PND       

Affecting an estimated 10-15% of new mothers within the year following their baby’s birth, PND is a globally-occurring emotional and mental condition that affects women in all socio-economic groups.  

Research shows that estrogen and progesterone are the baddies here:  the sudden change in these hormone levels immediately after birth appears to trigger PND (similar to how hormonal changes cause mood swings prior to menstruation, but on a grander, much scarier scale).  Low thyroid levels can cause similar symptoms, in which case a quick blood test and medication is the way forward.

Hormonal influences aside, lifestyle changes can be factors in the development of PND:

• Exhaustion caused by the delivery and subsequent broken sleep patterns
• Stress from worrying about family, financial or work issues
• Feelings of pressure to be the perfect mother and partner
• Frustration at the loss of one’s sense of self
• Low self-esteem due to changes in physical appearance
• Anger at the loss of control of your time, body and emotions
• Physical changes such as low blood pressure or fluctuation of metabolism

You are more likely to get PND if you have, or have had, one or more of the following:

• Previous depression of any kind
• Severe PMS
• Lack of or no support from your partner, family or social circle
• A sick, difficult or colicky baby
• Family history of substance abuse or mental illness
• Financial, relationship or social difficulties
• Problems with previous pregnancies, births or subsequent child-rearing
• Anxiety about the health or future of your baby
• External stress and painful life experiences

THIS IS WAR!
Treatment Options for the Baby Blues and PND      

While you may not feel like there’s much to be happy about right now, it should help to know that both the baby blues and postnatal depression are easily treated. Up to 85% of new mothers are affected by mood disturbances, and if they can come out of it unscathed, then so can you.  All you need is an action plan.

Postnatal psychosis, on the other hand, is a very serious illness and needs urgent medical attention, so if you suspect that you or a friend or relative may be affected, please seek professional help as soon as possible.

Beating the Blues
Symptoms of the blues are not nearly as severe as those of postnatal depression, and will generally subside without treatment within two weeks of childbirth. Having said that, there are a number of simple ways to make yourself feel better in the interim so that you can enjoy that precious dimply darling you’ve just brought into the world:

• Take power naps whenever you can
• Relax! Read a magazine, treat yourself to a pedicure, surf your favourite website, watch a favourite TV show
• Accept help when it’s offered and ask when it’s not
• Don’t be a martyr - nobody is handing out noddy badges, and nobody is putting pressure on you to be perfect, except you! You don’t have to be perfect, just content
• Get up, get dressed, get groomed and get ready for the day… every day
• Make a point of spending time with your partner and your friends
• Talk about your feelings to whoever is willing to listen
• Take each day as it comes, and enjoy the journey of discovery that makes motherhood so worth it
• Focus on your nutritional needs by eating small, healthy meals throughout the day
• Try to stay active - moderate exercise every day will make the world of difference

Punching the Lights out of PND
Postnatal depression can be difficult to live with, but the good news is that this condition can be treated.

Here are some options:

• Implement our guidelines for alleviating the baby blues. These will help no matter what
• Investigate your counseling options; make an appointment to chat to a psychologist
• Consider antidepressants or hormone therapy; your GP will guide you through this process. If you are breastfeeding, you must mention this to your doctor before any medications are prescribed
• Visit an alternative health practitioner. Acupuncture, massage and complementary medication could make you feel so much better
• Join a support group
• Make healthy lifestyle choices
• Avoid isolating yourself from the rest of society
• Focus on the positive
• Take up a hobby and throw yourself into it
• Remember to treat and pamper yourself, and give yourself a huge pat on the back for a job well done - nobody ever said that motherhood would be a walk in the park!

WORTH A MENTION
Good to Know

Although less common than either the baby blues or PND, new research has shown that paternal postnatal depression is on the increase.  Symptoms are very similar to those experienced by women, so it should be easy to spot. So don’t forget to check in on baby’s dad… chances are he’s fine and dandy and happy as Larry, but he could just be putting on a brave face, and may need some TLC as well.

FEELING ANY BETTER?
Now you Know

Hopefully you can take a deep breath now that you know that both the baby blues and PND are treatable and manageable conditions.  Take that first step right now:  go for an energising walk; pick up the phone and call a friend; write a list of all the good things in your life; run a bath and soak for as long as you like.  Then take further action and promise yourself that PND was but a fleeting visitor in your newly expanded family, and that it’s time for it to get packing.

WORTH A LOOK
Further Reading        

A practical self-help guide:
Postpartum Depression Action Plan

Print this one out and give your partner a copy (okay, maybe one for each room):
How to Help a Woman Survive Postnatal Depression

References:
webmd.com
familydoctor.org
medic8.com
pndsa.co.za
mayoclinic.com
emedicine.medscape.com

Click here for more in-depth info on what foods to avoid during pregnancy.

What is colic?

Colic is the term given to a condition that causes babies to appear to suffer from abdominal pain and have bouts of extended crying. Babies’ digestive systems are considered to still be quite underdeveloped when they are born which could lead to difficulties in processing formula and even breast milk. Babies can also have mild allergies to certain components of formula and breast milk, such as lactose, which can worsen the problem. Medical professionals do not have conclusive evidence for the root cause of colic but it is a common problem that most babies grow out of fairly quickly.

How common is colic?

According to Medical News Today at least 20% of babies suffer from colic in their first few months, making it a fairly common complaint though this does not make it any easier to deal with as a parent. Colic usually appears in the first three to six weeks after the baby is born and lasts for about three to four months until the digestive system has matured a little. While it is an exhausting experience for both baby and parents, there is unfortunately no real cure for colic, but you can rest assured that your baby will outgrow the condition. If by five months the crying has not abated, other medical problems must be considered.

What causes colic?

Experts have no definitive answers as to what causes babies to suffer from what seems to be agonising abdominal pain as well as exhausting bouts of crying, but there are a number of theories that surface time and again. According to Bennetts For Babies the following criteria often apply:

• Trapped wind in the intestine due to an immature digestive tract, as well as swallowing air while feeding.
• Over exposure to a busy environment. Baby spends a whole nine months cocooned in the shielded world of the womb and, though they are born with the ability to block out unwanted stimuli, this wears off by about four weeks old and the world can become quite over-stimulating.
• Some foods eaten by breastfeeding mothers such as caffeine, dairy products and nuts, have been attributed to colic in babies who may suffer from allergies or sensitivities to these products.
• Too much or too little milk or starting solids too early can also be a cause of colic - this is once again assumed to be linked to the immature digestive tract.
• Colic is also thought, by some experts, to be an after effect of the position of the baby in the womb. For some babies it can get a little cramped in there towards the end and this could cause some lingering discomfort.
• Colic can, in itself, cause colic, in that the extended crying periods cause the baby to gulp in air which leads to bloating and a build up of wind, which causes them further discomfort.

What are the symptoms of colic?

You know the old adage things happen in threes? Well this is very true of colic, too. One way you can determine if your baby is suffering from colic is if she cries for at least three hours, at least three days a week, for at least three weeks.

Colic is not a serious condition and, though your baby seems like she is in intense pain, it is thought that this is not actually the case. Babies may also draw their legs up to their tummy or arch their backs, going red in the face, but as long as they continue to eat and gain weight it is not considered to cause any harm. The biggest problem arising from colic according to British Private Health professionals, BUPA, is the stress that colic causes in the home, especially if it is your first baby. It is often very difficult to come to terms with the powerlessness you have to calm or comfort your baby, so ask for help and support where you can and take a break whenever possible.

What remedies or treatments are there for Colic?

Since it is not known what actually causes colic there is no specific medicine or current cure, but there are a number of techniques, tried and tested by mothers, that have proven beneficial. If you are struggling to overcome colic you could:

• Put your baby in a baby swing to provide a rhythmic movement which is often calming for babies.
• Take her for a walk in the pram. Once again the rolling motion is known to soothe babies.
• Hold her close and dance around with her. All babies love the closeness of being held in their mother or father’s arms.
• Allow a continuous sound like the vacuum cleaner or washing machine to soothe her.
• Try an elimination diet. Although there is little evidence to suggest that colic is linked to diet, some health experts may recommend changing your baby’s formula or cutting out certain products if you are breastfeeding.
• Complimentary therapies such as aromatherapy and tummy massage have been known to alleviate the symptoms of colic, although you should always check with a qualified practitioner as some may be harmful to babies.

So even though it seems as if your tiny baby is suffering in agonising pain and there is nothing you can do about it, take comfort in the knowledge that it has little or nothing to do with your parenting skills or what she is eating. Colic is a common, non-serious condition that one in five babies suffer from and, with a little patience and a lot of support you will all get through it in a few months.

References
Medical News Today
BUPA
Colic

www.babysense.com