Fatigue adds to baby blues

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

This week I will conclude our discussion on postpartum, but first I will suggest a few ways to cope with a high-need baby.

Mothers want to begin by spending lots of time during the day holding their baby. If mom is not comfortable nursing while lying down, I recommend finding the most comfortable chair in the house and setting it up in the location of your choice.

Wherever you choose, next to you should be a table to keep a drink and some snacks, the remote control, or whatever you need to really settle in and get comfortable. Moms need to get their rest, so remember that all the housework will wait.

Your family and friends can help you around the house, so you can put your energy into your baby and your own highly required rest. Or you can wait until the little one has come off the breast, is relaxed and satisfied before carrying him/her to bed, and then resting together.

Purchase a baby sling. The obvious benefit to the baby is lots of close contact with mom, and this will also free up the mother's hands to go about her regular routine. Fussy babies often love to nurse while in the sling.

When the baby does fall asleep, mom can continue to carry him or gently lie him down to nap. The sling can serve as a lightweight blanket for the baby. Use it for short periods of time every day, until the baby is comfortable in it. When breast- feeding, let the baby come off the breast on his own before switching sides.

Sometimes moms who like to "marathon nurse" switch back and forth several times during a feed. When this is done, a baby may not be receiving much of her rich hind milk, which will signal the end of the feed, and help him to remain satisfied for a longer period of time. An overabundance of foremilk can cause gassiness and colicky symptoms in some babies.

Now onto postpartum blues; there is a more severe form of blues called postpartum depression. It occurs in approximately 10 percent of childbearing women. Women who have experienced the baby blues are at increased risk of developing postpartum depression.

Symptoms are more intense and longer lasting than those of the blues. They can occur any time within the first year after birth. The signs and symptoms include constant fatigue, lack of joy in life, a sense of emotional numbness or feeling trapped, withdrawal from family and friends, lack of concern for yourself or your baby, severe insomnia, excessive concern for your baby, loss of sexual interest or responsiveness, a strong sense of failure and inadequacy, severe mood swings, high expectations and overdemanding attitude, and difficulty making sense of things.

No single cause for postpartum depression has been identified. A woman's body experiences enormous changes through the course of labor and delivery. The transition in hormone levels from pregnancy to postdelivery is drastic. Your body also undergoes changes in blood volume, blood pressure, immune system and metabolism.

In addition to your body's physical changes, fatigue also plays a large role in the baby blues. Several factors may combine to make you feel overly tired, i.e. lack of sleep, caring for a newborn, increased visits by family and friends, unsatisfactory birth experience, sense of loss in no longer being pregnant, unsatisfactory marriage, a baby with a high level of needs, lack of social support and a family history of postpartum depression.

The transition to parenthood can be difficult, but experiencing mild or severe depression doesn't mean you have failed as a person or a parent. Expect to recover as you learn new ways to balance your daily life and responsibilities.

The process of defining your new identity as a parent can enrich your life in ways you may never have thought possible. Inform your doctor early if you, family members or friends identify even a few of these signs and symptoms. Early intervention can lead to a more rapid recovery. Treatment varies according to individual needs, but it may include counseling, antidepressant medication, hormone therapy and attending a local support group.