Tag Archives: baby

Guest Post: Experience with Perinatal Mood Disorder

storm before calm

By Rachel O’Dwyer

 

Where to start? It’s hard to say, my symptoms came on gradually, then all of a sudden.

A perinatal mood disorder cannot be oversimplified. Sure, I now understand some of my main contributors, yet the disorder has a complexity of layers, and each person’s experience is layered differently.

Under the best care a mother could possibly have, my beautiful twins were born at 41 and 3, breech, vaginally. This was by no chance. I was under co-care of the best midwives in the country, who were also connected to a unique OB/GYN, whose beliefs about the capabilities of a woman’s body aligned with our family’s goals: to have as natural of a birth as possible and give my twins a full chance at a full-term gestation. I also have an extremely supportive husband and network of family and friends (and I didn’t discuss my preferences with those who were not supportive); oh yeah, and I’m determined as hell.

Looking back, my first symptoms started to show as early as 6 weeks, with their first growth spurt. It was blatant at their 3 month growth spurt, which lasted a week! I didn’t even really realize that what was going on with me was something I had heard of before. Luckily, I had a wonderful, accepting friend, who I first told of my intrusive thoughts and anxiety. I was so confused because I loved the babies so much and felt deep gratitude for them finally being in our lives. She calmly told me to reach out to our midwives. Upon reflection, I felt most comfortable reaching out to our birth class instructor. She had gone over challenges we might face, and I knew she would be a safe person, caring, to reach out to as a first step.

counseling

I immediately started going to a counselor* my instructor recommended. The first meetings were soaked in tears, fear, hurt, confusion, and fog. I was one of the lucky ones: I recognized the symptoms early, got help early, and was connected to the best network of support imaginable. So many suffer unknowingly, unnecessarily for years, and my heart aches for them.

Without ever getting a concrete diagnosis of what kind of mood disorder I had, the matter of the fact was that there was not one or two reasons I as struggling, there was a multitude. As Macolm Gladwell says in his book Outliers: The Story of Success, when something perceivably negative happens, there are not one or two factors that contribute to the outcome, there are at least 7. For me, I had had a miscarriage before getting pregnant with the twins, both through IVF. Not having time, or perhaps the capacity, to mourn our lost baby impacted me significantly. We had also been on quite a journey through infertility. I was back to work when the babies were 8 weeks. And then, we were adjusting to life with twins. As my counselor put it, the event is not actually the birth, but bringing a new family member (or two) home.

As we adjusted, I was breastfeeding both, and my son had to be supplemented, so I got about an hour and a half of sleep between feedings at night for the first 7 weeks. I was severely sleep deprived, and headed back to work. Despite the incredible help and support we received, I was still on my own at one point, and was trying to be super woman and clean and cook and take care of myself and my babies. I also was doing my best to be accommodating to my husband, okaying later work days often. This was the norm before. Please know my husband is one of the rare ones, the incredible ones, and at the same time he’s not psychic. He had no idea I was struggling so badly with the weight of everything, and at the beginning I was clueless as well.

My understanding of the relationship of cause and effect has also shifted. For example, one of the twins was fussier than the other, and her crying stirred my anxiety, but it was how she decompressed to go to sleep. Originally, I thought that the crying was causing the anxiety. Now, I have learned that my lack of sleep and healthy boundaries, and my previous experience, was causing an overall anxiety, and my threshold for stress was low. As a mother, hearing your child cry causes angst. During my toughest times, her crying caused me to suffer, my stomach would turn. Now, after months of being well rested and going to counseling, I realize that my anxiety was a symptom of the above mentioned, and my daughter’s crying was not the cause.

baby-feet

The main reasons I am at this point of healing and happiness is due to the support I received. The combination of counseling and as well consulting from a sleep consultant got me creating healthy boundaries in many aspects of my life. For example, my husband committed to being home during the few hours before bed when the babies were fussiest, or else he would find someone I was comfortable with to help me if he could not. Then, we worked on subtle shifts in eating and sleeping during the day, and after some work, my babies were sleeping 12 hours at night. After counseling and continued consulting, my mind and body started to recover. It was as though I had lost who I was, I had lost my personality, and it was coming back.

As Anita Moorjani says in Dying To Be Me, “I was experiencing a battle between my heart and my mind, and my heart was winning.” Thank god for expert support, and the power and wisdom of listening to your heart.

I share my story in hopes that others will read something that helps them. These experiences only help us to connect with others. I am so fortunate to say that I feel like I have never felt before now. And it is in many ways because of the darkness I experienced.

*The counselor who worked with Rachel O’Dwyer:
Jessica L. Shepard, MA, LPC
Licensed Professional Counselor
817-715-9152

 

For more information on perinatal mood disorder, signs of depression and anxiety, as well as well as treatment options, visit: Moms’ Mental Health Matters by the National Child & Maternal Health Education Program.

 

Looking Back on the First Quarter

Brantley- three year old happy sleeper
Three Year Old Happy Sleeper, Brantley

The first quarter has been full of fun clients, new packages, and building my Sleep Happy Team!  I am so thankful for the opportunity to support sleep-deprived mamas each week in my part-time business.  This past month, I worked with clients in Nashville, Connecticut, and Washington, D.C., along with Texas clients in Melissa, Aledo, and Fort Worth.  In February I got to work with several 4 month olds, while March’s clients included multiple 7-12 month olds and two 2-3 year olds.

Working on sleep through sickness and tornado sirens is always tons of fun and we had plenty of those struggles this past month.   I am looking forward to summer in hopes my clients are experiencing less sickness.  A common theme this quarter has been learning importance of day sleep at any age.  If there is not a commitment to day sleep, you often hit roadblocks you can’t overcome with night sleep.

On the business side, I added a new follow-up package for former clients…the Sleep Happy Club Membership.  Families receive up to two hours of sleep consulting support each month through text, email, or phone, along with monthly updated milestones for an introductory rate of $100 per month for a 3-month or 6-month membership.

feeding guidelines for infant nutrition and sleep

Dietitian Discusses How Feeding Routines & Nutrition Affect Infant Night Sleep

Infant Nutrition and Sleep- baby feeding routine guidelines from dietitian

If your baby isn’t sleeping well, nutrition could be part of the puzzle.  Good feeding habits are the foundation for healthy growth, development, and sleep.  This article includes general guidelines appropriate for most healthy infants.  Discuss any recommendations with your baby’s pediatrician or healthcare provider to make sure they are right for your baby.

Is your baby getting enough to eat during the day to sleep through the night?

Some babies are not eating enough and this can affect sleep.  While it is difficult to track total ounces for breastfeeding babies, consider keeping a 24 hour food diary for babies who drink pumped breast milk or formula.  This can be helpful in determining if your baby is generally taking in the recommended ounces for his age.  Your pediatrician can also compare your baby’s growth chart with his previous height and weight data and determine if your baby is following his growth trends.

Take a look at the Nutrition Guidelines for Infants adapted from John Hopkins Feeding Guide for the First Year.  You can see how breast milk or formula intake typically changes during your baby’s first year.

Nutrition Guidelines for Infants

Age Amount of Formula or Breast Milk per Feeding Number of Feedings per 24 Hours Total Ounces per 24 Hours
1 month 2 to 4 ounces 6 to 8 times 16 to 24 ounces
2 months 5 to 6 ounces 5 to 6 times 24 to 32 ounces
3 to 4 months 6 to 7 ounces 5 to 6 times 28 to 32 ounces
5 to 6 months 6 to 8 ounces 4 to 6 times 28 to 32 ounces
7 months 6 to 8 ounces 3 to 5 times 30 to 32 ounces
8 months 6 to 8 ounces 3 to 5 times 30 to 32 ounces
9 months 7 to 8 ounces 3 to 5 times 30 to 32 ounces
10-12 months 7 to 8 ounces 3 to 4 times 24 to 32 ounces

 

Follow your baby’s lead on feeding.  A baby’s intake will vary from feeding to feeding.  It is normal for some babies to have smaller, more frequent feedings.  If you force feed your baby, you are more likely to get a fussy baby who spits up.  Formula-fed babies often go longer between feedings due to the digestion process of formula versus breast milk.  There are no absolutes on ounces and feedings, so make sure you are paying attention to your baby’s cues.

Evaluate the bottle and nipple size.  Switch to a larger bottle and nipple when developmentally appropriate.  Most babies over six months need an 8-ounce bottle.  Older babies who are still on a size one nipple (the smallest one) may become frustrated or exhausted and limit their intake during feeding times due to the extra work of sucking from the small nipple.  Older infants usually need a size two, three or larger nipple.  Keep in mind that if the nipple hole is too large, however, it is possible for the breast milk or formula to come out too quickly and this can be a choking hazard.  There are many bottle and nipple choices available for consumers, so if your baby seems unhappy or overly fussy, there are options out there that mimic nursing, have an ergonomic design, or have venting systems that decrease air bubble intake.

Hold your baby during feeding times.  Parents and caregivers are often multi-tasking during feeding and may either prop a bottle or put their baby to sleep with a bottle.  Going to bed with a bottle increases the likelihood of ear infections and tooth decay.  Some babies are fussy and have reflux-type symptoms.  Holding your baby upright during bottle feeding may improve these symptoms and that equates to better sleep.

 Switching formulas.  If your baby has recurring gastrointestinal problems, sometimes switching formulas can help with digestive issues and improve infant sleep patterns.  There are a lot of formula options, so it is good idea to discuss formula changes with your baby’s healthcare provider. Breast-feeding moms can also look at their diet to determine if eliminating certain allergens or food/beverages help your baby have improved digestion.  Babies sleep better when they don’t have tummy pain.

baby eating

Introducing solids.  It is an exciting time to begin solid foods with your baby!  Generally you want to introduce solids around four to six months of age, or when your baby has at least doubled their birth weight and weighs about 13 pounds or more.  Other ways to assess readiness for solids is ensuring that your baby can sit up independently, can open her mouth when food comes her way, and can move food from the spoon to the back of her mouth (it is normal for this step to take some time).

It is best to start with a rice or other single-grain cereal mixed with formula or breast milk, and then move onto pureed vegetables, fruits, and then meats.  Most babies show a preference for sweet foods, so you may want to offer grains and vegetables first to ensure variety.  Remember that during the first year, babies will still get the majority of their nutrition from breast milk or formula.  Continue offering breast milk or formula before solids at most meal times, especially if you are working on sleep.

It is recommended that you start with one new food at a time and try the same food for three or four days before introducing the next new food.  This is helpful if your baby has an allergy or intolerance to a certain food item. Remember that infants ONLY need breast milk or formula for the first four to six months.  It might be tempting to give pureed foods to young infants under four months, but most babies are not developed enough to sit in a high chair and have good head control until at least four to six months.  There is also evidence that introducing solid food too early can cause allergies and eczema.

Calorie-rich foods.  Each ounce of breast milk or formula has about 20 calories.  If your baby is taking four to six ounces, this is easily 80-120 calories per feeding.  Babies who fill up on baby food may have to eat several servings to get this many calories, and likely the baby food will not provide the necessary fat or protein that is found in breast milk and formula. For babies with growth or sleep issues, offering formula or breast milk first during feeding time will keep your infant well-nourished and may help with sleep habits.  After the bottle is finished or your baby cues you to move on, then you can then work on developmental milestones (and the joy and sometimes frustration of introducing a new food to your baby) with pureed or mashed foods and a spoon.

baby food- feeding routines for infants

Homemade baby food.  It is convenient to purchase baby food, but you can make your own baby food that could be more nutritious (again, a well fed baby will hopefully sleep better for you).  Making your own baby food saves money, can have fewer added fillers or extra ingredients and can be nutrient-rich.  With commercial baby food, check the food label to ensure that it does not contain starches to thicken, added preservatives, or sweeteners.  The trend now is to offer simple baby foods with fewer ingredients, so you can easily find healthy choices in the grocery store.  Just make sure you are well-informed and reading food labels and ingredient lists.

If you want to make foods at home, one of my favorite baby foods to recommend is a simple fork mashed avocado.  It is a great source of healthy fat, vitamins and minerals.  Just peel a ripe avocado (no cooking required), remove the pit and mash or puree until the desired consistency.  You can also make homemade fruit or vegetable purees from cooked fresh fruit or vegetables with no added salt or seasoning.  Prepare purees in a food processor or blender by mixing with breast milk, formula, or water.  You can make baby food ahead and refrigerate for three days or freeze in ice cube trays for longer storage.

Ensuring that your baby is healthy and well-nourished can be the key to great sleep in infancy and beyond. Making nutrition a priority early in life can help your child have the right foundation for optimal growth, development and happy sleep.

Guest author Amy Tramm is a Registered Dietitian, Registered Nurse, and Mom of three teenagers who love to sleep in on the weekends.Dietitian and Nurse Amy Tramm

 

This information should not be used as a substitute for medical care and advice of your pediatrician. Discuss any health or nutrition concerns with your healthcare provider.  This article contains nutrition guidelines that may not be appropriate for your baby’s specific needs.