All Posts tagged postpartum

Indecisiveness and Motherhood

By: Dr. Tanya Cotler, PhD, CPsych
Why is it so hard for me to decide what to make for dinner since becoming a mom?

Mothering and parenting often involves a barrage of daily decisions, many of which we don’t even notice. How often do you wish someone else (maybe your partner?!) would figure out who is wearing clothes three sizes two small and what the kids are going to have for dinner? Or what about when your child asks if they could go out for lunch or stay at the park after school and you feel like they are asking you how to initiate world peace?

The difficulty with making these sometimes basic decisions is that as mothers our every day routines require decisions. All the constant choosing and deciding wears out the primary decision maker (for many that’s mom!)

Below are some of the reasons decision making is compromised:

  1. One of the symptoms of depression, and specifically postpartum depression, can be difficulty making decisions. When someone is struggling with depression and feels things are more hopeless or they themselves feel helpless-  this often translates to seeing minimal options available or feeling that your power or your agency over your choices is missing.
  2. Anxiety: there is a lot of research to support how anxiety can actually inhibit decision making by disengaging the prefrontal cortex- the area of the brain specifically responsible for executive functioning, planning and judgment as well as flexibility in decisions. The prefrontal cortex allows for “calm” decision making- it removes the intensity of emotion from decisions by quieting the amygdala (the part of the brain that runs on raw emotion and instinct). The research shows that anxiety seems to interfere with being able to limit distractions, making it difficult for the person to weed through the muck so to speak. Distractions can be physical but also emotional such as thoughts or worries. Anxiety numbs some neurons in the prefrontal cortex that are specifically involved in choice making and accordingly anxiety selectively shuts down mechanisms needed for clear choice making.
  3. Motherhood as a period of change and loss: During a phase of life when you are inundated by so many changes (hormones, physiology, psychological, relationships etc) and losses (relationships, identity, expectations and hopes) it can be unbearable to add to the exhausting list of changes and losses. With every decision comes a loss, as well as one more thing to think about and one more thing to grieve -or at least one more thing to adjust to. Simply put, the decision- even just what to make for dinner- feels like one more thing to consider when the mind is already overwhelmed with making adjustments.
  4. Guilt: with guilt often comes an increased difficulty decision making. This is because part of what complicates decision making is the sense of “loss.” As described above, with every decision there is something you “gain” and something you “lose.” If someone is already feeling worried or concerned about wrong doing, or not being good enough it  becomes harder to decide anything else for fear of making more mistakes.
  5. Insecurity and lack of trust in oneself or fear of feeling exposed or judged: With so much noise on how to mother, combined with the general idealization of motherhood, many mothers fear they will fall short or won’t be able to measure up to the expectations held out for them. This can also affect decision making. The more one feels insecure about how they are performing in their mothering role, the less likely they are going to be to rely on themselves for anything. Every decision feels like a challenge when you feel you can’t trust yourself.
  6. The  tendency for the mothering one to take the primary role with the emotional load or otherwise  termed emotional labor. The mothering one’s mind is often responsible for the executive functioning of parenting (think of it as mom as the organizer, planner, thinker, holder of all detail from who needs socks to what’s for dinner to program registration and more). This role can often keep a mom up at night running through her to-do list fearing what she missed or will miss. The perpetual cycle from “emotional labor” to anxiety to sleep deprivation to anxiety to emotional labor and back again, makes it inevitable that decisions are increasingly difficult for many moms. It’s just too much for the mind to compute constantly!
  7.  Decision Fatigue– Mothers are constantly needing to decide everything from bedtime routines to what to wear (themselves, their children, their partners!) It can become exhausting and utterly depleting to be in charge of any additional, even minute, decisions like what’s for dinner. Decisions require conscious thought and attention and even when invisible (or we aren’t cognizant of it) our brains go through a process of weighing pros and cons and thinking through. An element of expending energy occurs with every decision whether we want it to or not. Taking this together, more decisions mean diminished energy reserves and willpower impacting future decisions.

There are ways we can mitigate these difficulties making decisions. If we learn from prominent leaders in our world- one trick when in a position of power and high decision making power- is to minimize other competing decisions which may be of less importance.A quick look at some business or world leaders (I.e Steve Jobs or Barack Obama) and you can see how many leaders openly talk about wearing the same color scheme everyday or limiting wardrobe to few pieces to minimize daily choice and allow more space for bigger decisions.

Of course in addition to limiting the number of less crucial decisions what’s also required is some advanced planning. For example, having a daily menu of meals that rotate each week.

Also important is to ask for help  and to  attempt to share decision making power with others you trust such as a partner. Like in any business partnership, this requires dividing roles. If you feel that a lot of the “mental labor” is falling on you,  talk about it with your partner. Perhaps your partner becomes in charge of wardrobe while you are in charge of meals. And maybe you divide seasonal ownership over activities registration or doctor appointments.

Ultimately if you are struggling with decisions try to identify which of the many possible reasons might be contributing to your decision difficulty and then try to plug in some solutions or help accordingly. All this needs to be couched in the fact that no one can do this alone mama, we all need help, and with help it’ll feel easier.

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Spotlight On: Osteopathy

This month we thought we would introduce you to the world of Osteopathy.  Osteopathy is a non-invasive manual therapy that works on the muscles, joints and spine to enhance your body’s natural health.  In other words, an osteopath will stretch your body for you, allowing the muscles and joints to move more freely.
What can it treat?
Almost anything!
Ok, ok, we’ll be a bit more specific.  Osteopathy is great at treating any and all sports related injuries as well as that chronic pain (read headache) that just doesn’t seem to go away.But beyond that osteopathy can help those things you may not think about when it comes to manual therapies.  Our osteopath Marine is able to treat things such as insomnia, gastrointestinal problems and varicose veins!  Definitely something to look into!
And for all you breastfeeding Moms out there- Marine has techniques that could help stimulate milk production!  To me, this sounds much better than downing Domperidone and Fenugreek!So if any of this sounds like something you might need help with book with Marine today!She is available on:
Tuesdays 8:30am-2pm
Wednesdays 8:30am-12pm, 3:30pm-7pm
Fridays 8:30am-5pm

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Introducing: Pelvic Floor Physiotherapy

By Amy Gildner

What is Pelvic Floor Physiotherapy?

Physiotherapy is a holistic healthcare profession that aims to help those affected by injury, illness or disability.  Physiotherapists specialize in the assessment, diagnosis, and treatment of a variety of neurological, orthopedic, and cardiorespiratory conditions.  In Ontario, individuals can see physiotherapists without a doctor’s referral.

Pelvic floor physiotherapy is the assessment and treatment of various conditions including, but not limited to, conditions of the muscles, bones, connective tissues, and ligaments surrounding the pelvis.  This is a specialty within the physiotherapy profession, and is conducted by registered physiotherapists who have also undergone further education.

A typical initial appointment will include a detailed internal and external examination of your pelvis, a discussion of the findings as well as a possible treatment plan specifically tailored to your needs.  This treatment may include additional internal pelvic floor therapy, bladder retraining, stretching, and strengthening techniques.

Why is Pelvic Floor Physiotherapy so important?

As women, our bodies can end up going through a lot. In addition to the maintenance of overall health and strength, pelvic floor health is equally as important, especially pre- & postpartum. Some conditions that can be treated through pelvic floor physiotherapy include:

  • Vaginal pain
  • Urinary incontinence
  • Pain during sex
  • Pelvic organ prolapse
  • Low back pain
  • Sacroiliac pain
  • Piriformis syndrome/sciatica

Contact the clinic to find out more information!

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Meeting Your New Needs While Breastfeeding

New moms wonder how to best adjust their eating habits while breastfeeding in order to optimize their baby’s nutrition, maintain a healthy weight, and navigate the new demands on their bodies. While you don’t have to drastically change the menu of healthy foods that you already enjoy, here are some of the adjustments you’ll likely need to make as a breastfeeding mother.

forkManaging a big appetite: Breastfeeding women will often notice a significant increase in hunger as the result of their increased metabolic rate. It’s important that you nourish and listen to your body. If you fail to give yourself enough nutrients from your diet, your body will draw upon reserves you can’t afford to lose. Eat balanced meals and healthy, portion-controlled snacks to find balance between maintaining a healthy postpartum weight and keeping your energy up.

bathroom scaleChanging your perspective on postpartum weight loss: While your pregnancy weight may fall away quickly, it’s important to have a realistic idea about returning to your pre-pregnancy shape, size and fitness levels. Plan for gradual weight loss, and only diet and exercise with approval from your physician. Instead of being preoccupied with a short-term weight or size goal, focus on eating healthily and keeping your energy high- not only for physical exercise, but also for the demands of new parenting.

Thinking about fat: You’ll want to focus on healthy fats contained in olive oil, avocados, olives, nuts, and fatty fish. While this is always an important dietary concern, you should be particularly mindful to avoid saturated and trans fats while breastfeeding. These can change the composition of your breast milk and have potentially adverse effects on your infant’s health.

Being critical of contaminants: In addition to unhealthy fats, many environmental and food contaminants can find their way into breast milk and negatively affect your baby. Have an understanding of which fruit and vegetables harbour the most pesticides, or choose organic options. Consider buying locally and in-season, in addition to choosing lean meat and filtered water.

Watching for baby’s reaction: While many nursing mothers eat a wide variety of foods and flavours, it’s important to keep an eye out for any patterns between your eating habits and unwanted symptoms your baby experiences. If you notice changes in your infant’s stool or mucous, look for cues in your eating. Sometimes babies have sensitivities to certain components of their breastfeeding mother’s diet.

For more tips about breastfeeding nutrition, check out this neat “A to Z guide to physical and nutritional needs while breastfeeding.” 

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The Opposite of the Baby Blues: Postpartum Hypomania

by Maya Hammer, M.A., Counselling Psychology | www.mayahammer.ca

We all know about the “baby blues”, a common experience of emotional ups and downs in the first week or two postpartum. Many of us, however, have never heard of the “baby pinks,” or The Highs, a feeling of intense happiness or euphoria following birth.


Symptoms
of postpartum hypomania include:
-racing thoughts
-fast talking
-being very active
-decreased ability to concentrate
-impulsivity, e.g., shopping
-decreased need for sleep
-irritability

These symptoms can be triggered by childbirth and usually subside after 6-8 weeks postpartum. In some cases, however, postpartum hypomania is an early indicator for bipolar disorder, depression, or psychosis. Therefore, it is very important to seek treatment if you or a loved one you know is experiencing.

Causes
Pregnancy and childbirth can trigger mental imbalance because of physiological changes such as stress, dysregulated cortisol, increased inflammation, decreased serotonin, and hormonal fluctuations. In addition, psychosocial factors can impact mental well-being including disrupted sleep, the demands of caring for a baby, lack of support, life stress, marital difficulty, or trauma. Genetics plays a part too: a personal or family history of mental illness, in particular bipolar disorder, predisposes a woman to prenatal and postpartum mental illness.

Treatment
It is important to seek treatment immediately if you notice unusual behaviour in your partner or loved one. Treatment can involve:

1)      mood stabilizer medication

2)      therapy to stabilize mood and regulate daily schedule

3)      support and education for partners and families


For further reading, check out these resources:

A blog post on postpartum hypomania and mania

mom’s experience of hypomania induced by anti-depressant medication

study on the prevalence of postpartum hypomania

And another study demonstrating that hypomanic symptoms can be used to correctly diagnose postpartum bipolar disorder.

As well, check out an article in Today’s Parent, and Maya’s appearance on CTV Canada AM talking about the baby pinks.

 

 

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What to Expect from a Lactation Consultation

 

If you’re a new mother or a soon-to-be mom, you might already realize that breastfeeding can be an unpredictable journey. Many mothers and newborns face challenges with latching and effective feeding, and while these are perfectly normal, they can require the help of a counselor who has plenty of experience with breastfeeding.

When you’re tired, hormonal and experiencing more physical and emotional changes than you know what to do with, the challenges presented by breastfeeding can feel overwhelming. Sometimes mothers will have a very emotional response to breastfeeding, and the inability to get your baby to latch can feel like a personal failure.

Nothing could be further from the truth -and with the help of the right lactation consultant, you’ll have no problem remembering that.

Why consult on breastfeeding? Shouldn’t it be intuitive?

Breastfeeding feels wonderful and natural in many ways. It’s a time for a new mother to bond with her baby, to experience her femininity and maternal instincts fully, and to connect with her new identity as a mother. However, the most important outcome of breastfeeding is a healthy baby that is being nourished and gaining weight at a normal rate.

Sometimes –often in fact- some extra support is necessary to ensure that you’re optimizing feeding time for your baby. A breastfeeding consultant is not only highly helpful and instructive, but she’s also a major source of comfort if you’ve been finding the experience frustrating or disheartening. Your consultant can help you regroup and strategize effectively, while consulting on any of the following issues:

1. My baby won’t latch: If your baby doesn’t seem interested in feeding, can’t latch effectively, or doesn’t seem to be swallowing much milk, a consultant can help by introducing you to alternative breastfeeding techniques and tools.

2. Ow! Is it supposed to be this painful? While breastfeeding can initially cause some discomfort, one of your breastfeeding goals will be to eliminate pain. Your lactation consultant can offer you different latching techniques and natural remedies to help make breastfeeding more comfortable. She will also carefully analyze and help optimize your baby’s positioning and suckling.

3. I’m worried about my milk production: If you’re worried about low milk production, your consultant can advise you on how to effectively boost your supply with techniques like pumping between feedings and compressing your breasts to fully drain them of milk. Often the problem isn’t supply at all. It may be that you are producing plenty of milk- it just isn’t being effectively delivered to your baby. Getting a second opinion will better enable you to understand your supply, particularly weighed against your baby’s needs and feeding behaviours.

4. My baby isn’t gaining weight: If your baby is having trouble regaining newborn weight or is falling into a low percentile for his or her age group, it’s time to analyze and adjust feeding habits. Your lactation consultant will determine your baby’s suckling and swallowing patterns and help you to make any necessary modifications to your feeding technique and position. Sometimes babies need to be stimulated during breastfeeding, so your consultant might recommend that you alternate sides, re-position, or play with your baby’s hands or feet. This can help to keep the baby alert and suckling actively.

Building a relationship with your lactation consultant
Since your lactation consultant is meant to be a helpful and comforting presence to you, you’ll want to choose someone whose company and guidance you genuinely enjoy. Consulting on breastfeeding is an important postpartum process, and directly connected to your baby’s health and growth. Accordingly, we take breastfeeding seriously and sensitively. We’re thrilled to welcome Maria Lameiro of DoulaNatur Holistic Family Services to our team at Thrive Health as our on-site lactation consultant! Maria is a doula, lactation consultant, childbirth educator, and mother of three. She is passionate about holistic family health and loves to empower others to reach their parenting, birth, breastfeeding and lifestyle goals. She’d love to assist and support you on your breastfeeding journey.

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Dads Get the Blues Too

This post is brought to you by Maya Hammer. Maya Hammer is a psychotherapist in private practice at Thrive Natural Family Health and the Health Psychology Clinic. Don’t miss Maya’s recent interview about postpartum hypomania, or “the baby pinks,” on CTV Canada AM

Dads Get the Blues Too
by Maya Hammer

It is common for women to suffer from depression and anxiety following the birth of a baby. About 10 to 20% of women are diagnosed with postpartum depression. What is less common, however, is our understanding of postpartum depression in men. Recent research has found that 10 to 25 % of new fathers may suffer from depression. Dads or secondary caregivers experience stress related to feeling rejected after the arrival of the child, relationship or marital dysfunction, burden of financial responsibility, grieving pre-baby freedom and lifestyle, or feeling overwhelmed by partner’s postpartum depression.

Paternal postnatal depression (PPND) is often overlooked because, generally speaking, men don’t express suffering the same way women do. For example, men may not acknowledge feeling sad, guilty, and hopeless. Here are some symptoms to look for in men:

  • Increased anger and conflict, violent behaviour
  • Increased use of alcohol or drugs
  • Frustration or irritability
  • Lower threshold for stress
  • Risk-taking and impulsivity
  • Physical symptoms such as headaches, pain, digestive problems
  • Fatigue
  • Loss of interest in work and hobbies

If these symptoms are familiar to you or a loved one you can get help through therapy and naturopathic or psychiatric medication. For more information, check out postpartummen, a website for men suffering from PPND and in the book Postpartum Depression for Dummies, by Dr. Shoshan Bennett that has a section on depression in fathers.

If you are a dad and your partner/wife is experiencing postpartum depression, you can find helpful information at postpartumdads and The Postpartum Husband by Karen Kleiman.

Another great resource is Parenting From the Inside Out by Daniel Siegel and Mary Hartzell. This book helps to examine how past issues, including trauma or how you were raised as a child, impact your ability to parent.

 

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